Clenching TMJs-Loads Increases in Partial Edentates: A 3D Finite Element Study

There is disagreement about the association between missing teeth and the presence of temporomandibular disorder (TMD).Aim: To investigate whether, the span of edentulousness, gender, number of quadrants involved, pathological migration and the type of kennedy's classification are related to the temporomandibular joint (TMJ) dysfunction signs. Materials and methods:Clinical examination of 250 patients (males 99 and females 151) was done among the age group of 35 to 45 years. The patients were partially edentulous for 6 months or more and did not wear any kind of prosthesis.Results: Among 250 subjects, females showed more TMJ dysfunction signs. Clicking sounds were present in 46.5%, mandibular deviation was present in 40% of individuals, TMJ tenderness was observed in 32% and masseter was involved in 32% of individual. Temporomandibular joint dysfunction signs in relation to pathologic migration of teeth show that clicking and mandibular deviation was present in 54.5 and 49.2% and among muscles masseter muscle tenderness 41.9% was more commonly present. Masseter muscle tenderness 64.1% was seen in individuals who were edentulous for more than 5 years. Conclusion:Females subjects had a significantly higher prevalence of TMJ dysfunction signs then male subjects. As the span and time of edentulousness, the number of missing teeth and the number of quadrant involved increased, the signs of dysfunction became more prevalent. Among the TMJ dysfunction signs deviation and clicking sound were most frequently observed. The masseter muscle was most commonly affected and demonstrated muscle tenderness.

show abstract

“…In contrast, severe partial edentulism seems to induce overloading of the TMJ with severity depending on the type of contact. 17…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Temporomandibular Joint Dysfunction and Its Signs among the Partially Edentulous Patients in a Village of North Gujarat

Shet

Rao

Patel³

et al. 2013

The Journal of Contemporary Dental Practice

View full text Add to dashboard Cite

show abstract

“…This is mainly due to the limited age range and the characteristics of the subject's occlusion (inclusion criteria). In our experience, EMG activity varied with age and occlusal condition (del Palomar et al, 2008); these variables should be taken in account in order to enhance the internal validity of the study.…”

Section: Methodological Considerations and Limitationsmentioning

confidence: 99%

“…Since jaw elevator muscle activity can be influenced by orofacial pain (Helkimo et al, 1975;Fogle and Glaros, 1995;Svensson et al, 2004), gender (Sessle, 2000b;Johansson et al, 2003;Sarlani and Greenspan, 2005), age (Fogle and Glaros, 1995), occlusion (Carlsson and Ingervall, 1988;Møller and Bakke, 1988;Racich, 2005;del Palomar et al, 2008), and hemispheric dominance (Pirttiniemi, 1998), this study evaluated 75 full-dentate (except for third molars), normal-occlusion, right-handed (7-10 points in Edinburgh inventory; Oldfiel, 1971), similarly aged (18-22 years), female subjects (inclusion criteria). All subjects (except one control) presented premature occlusal contacts.…”

Section: Subjectsmentioning

confidence: 98%

Changes in EMG activity during clenching in chronic pain patients with unilateral temporomandibular disorders

Santana‐Mora

Cudeiro

Mora‐Bermúdez

et al. 2009

Journal of Electromyography and Kinesiology

View full text Add to dashboard Cite

The study assessed the differences in electromyographic (EMG) activity recorded during clenching in women with chronic unilateral temporomandibular disorders (TMDs) as compared to control subjects. Seventy-five full dentate, normo-occlusion, right-handed, similarly aged female subjects were recruited. Twenty five subjects presented with right side TMD, 25 presented with left side TMD and 25 pain-free control subjects participated. Using integrated surface EMG over a 1 s contraction, the anterior temporalis and masseter muscles were evaluated bilaterally while subjects performed maximum voluntary clenching. Lower EMG activation was observed in patients with TMD as compared to control subjects (temporalis: 195.74+/-18.57 vs. 275.74+/-22.11, P=0.011; masseters: 151.09+/-17.37 vs. 283.29+/-31.87, P<0.001). An asymmetry index (SAI) was calculated to determine ratios of right to left sided activation. Patients with right-sided TMD demonstrated preferential use of their left-sided muscles (SAI -5.35+/-4.02) whereas patients with left-sided TMD demonstrated preferential use of their right-sided muscles (SAI 6.95+/-2.82), (P=0.016). This unilateral reduction in temporalis and masseter activity could be considered as a specific protective functional adaptation of the neuromuscular system due to nociceptive input. The asymmetry index (SAI) may be a useful measure in discriminating patients with right vs. left-sided TMD.

show abstract

“…Considering that jaw elevator muscle activity can be influenced by oro-facial pain [22], gender [23], age [24], occlusion [25], and hemispheric-dominance [26], only patients that fulfilled the following inclusion criteria were included in the study: age less than 30 years; female gender; right-handed (7–10 points in Edinburgh inventory) [27]; presence of complete permanent dentition, with the exception of the third molars; normal occlusion; and diagnosis of unilateral arthrogenous TMD on the Research Diagnostic Criteria for TMD (RDC/TMD) [28,29], Axis I, groups II and III. Patients were excluded from the study if they met one or more of the following exclusion criteria: having pacemaker or other electrical devices, previous experience of TENS or biofeedback, systemic diseases, history of local or general trauma, neurological or psychiatric disorders, muscular diseases, cervical pain, bruxism, diagnosed by the presence of parafunctional facets and/or anamnesis of parafunctional tooth clenching and/or grinding; pregnancy, assumption of anti-inflammatory, analgesic, antidepressant or myorelaxant drugs, fixed or removable prostheses, fixed restorations that affected the occlusal surfaces, or previous or concurrent orthodontic or orthognathic treatment.…”

Section: Methodsmentioning

confidence: 99%

Comparison between sensory and motor transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorder: a controlled clinical trial

Monaco

Sgolastra

Pietropaoli

et al. 2013

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundThe purpose of the present controlled clinical trial was to assess the effect of a single 60 min application of transcutaneous electrical nervous stimulation (TENS) at sensory stimulation threshold (STS), compared to the application of motor stimulation threshold (MTS) as well as to untreatment, on the surface electromyographic (sEMG) and kinesiographic activity of patients with tempormanbibular disorder (TMD).MethodsSixty female subjects, selected according to the inclusion/exclusion criteria, suffering from unilateral TMD in remission were assigned to MTS, STS or untreatment. Pre- and post-treatment differences in the sEMG activity of temporalis anterior (TA), masseter (MM), digastric (DA) and sternocleidomastoid muscles (SCM), as well in the interocclusal distance (ID), within group were tested using the Wilcoxon test, while differences among groups were assessed by Kruskal-Wallis test; the level of significance was set at p ≤ 0.05.ResultsSignificant pre- and post-treatment differences were observed in MTS and STS groups, for TA and MM of both sides; no significant difference was detected between MTS and STS groups. Kinesiographic results showed that the vertical component of ID was significantly increased after TENS in MTS and STS groups.ConclusionsSTS TENS could be effective, as well as MTS, in reduce the sEMG activity of masticatory muscles and to improve the ID of TMD patients in remission. Future studies are needed to confirm the results of the present study. Clinical relevance. The present study demonstrates that the application of TENS is effective in reduce the sEMG activity, as well as in increasing the ID of patients with TMD; our study did not support superior effectiveness of MTS or STS.Trial registrationClinicalTrials.gov: NCT01832207

show abstract

Clenching TMJs-Loads Increases in Partial Edentates: A 3D Finite Element Study

Abstract: During clenching, a uniform distribution of the dental contact along the maxillar arches prevents the TMJ from overloading. In contrast, severe partial edentation seems to induce overloading of the TMJ with severity depending on the type of contact.

Cited by 31 publications

References 36 publications

Prevalence of Temporomandibular Joint Dysfunction and Its Signs among the Partially Edentulous Patients in a Village of North Gujarat

Prevalence of Temporomandibular Joint Dysfunction and Its Signs among the Partially Edentulous Patients in a Village of North Gujarat

Changes in EMG activity during clenching in chronic pain patients with unilateral temporomandibular disorders

Comparison between sensory and motor transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorder: a controlled clinical trial

Contact Info

Product

Resources

About