Effects of functional training after orthognathic surgery on masticatory function in patients with mandibular prognathism

Abdelmabood

Egyptian Dental Journal

2021

Aim: To evaluate the postoperative electromyographic changes of temporalis and masseter muscles activity, in patients with orthognathic surgery BSSO,for correction of mandibular prognathism. Material and Methods:Eight adult patients, their ages ranged from 22-45 years, five females and three males, suffering from mandibular prognathism. underwent BSSO, for performing mandibular setback. EMG examinations(peak to peak amplitude, for detection of the strength of contraction of both temporalis and masseter muscles) were done presurgical and twelve months postoperatively.Results: Significant increase in peak-to-peak amplitude values of both temporalis muscles was founded. Moreover, an increase in peak-to-peak amplitude values of both masseter muscles was found,.No significant differences were found in the mean frequency score (as one of the variables of the EMG measurement) of the masseter muscles before bilateral sagittal split osteotomy and that undertaken 12 months after bilateral sagittal split osteotomy (P = 0.06). An increase in the mean peak to peak amplitude score for the right and left temporalis muscle was found, with significant differences between the measurement found 12 months after bilateral sagittal split osteotomy, and that measured before bilateral sagittal split osteotomy fig ( 6) (P = 0.002,0.0001 respectively) Conclusion:No change in the strength of contraction of both temporalis and masseter muscle had detected after performing BSSO for correction of mandibular prognathism ,as detected by EMG examination.

Section: Discussionsupporting

confidence: 89%

Changes in Masticatory Muscles following orthognathic surgery (BSSO for correction of skeletal class III deformity )

Abdelmabood

Egyptian Dental Journal

2021

“…If the patients have problems performing the lateral movement during mastication, the observation of the masticatory correct pattern focusing in the affected side will help to improve the cortical representation of the movement (Figure 7). The training will start with a duration of minutes, until the pattern of the movement cannot be performed correctly due to fatigue, and increased progressively until no more than 6 min of mastication, alternating sides after each minute [183].…”

Section: Masticatory Trainingmentioning

confidence: 99%

Assessment and Brain Training of Patients Experiencing Head and Facial Pain with a Distortion of Orofacial Somatorepresentation: A Narrative Review

Piekartz¹,

Paris‐Alemany

2021

Applied Sciences

The management of patients experiencing chronic orofacial pain is a great challenge, due to the complexity of chronic pain itself, combined with an increased peripheral sensitization in the craniofacial itself. Therefore, patients with orofacial pain may present a clear distortion of the somatorepresentation after some time. In this review, the authors develop a neurophysiological explanation of orofacial distortion, as well as propose assessment and treatment options, based on scarcely available scientific evidence and their own clinical experience. The assessments of facial somatosensory, cognitive-affective and motor dysfunctions are crucial to establish the most accurate treatment; the assessment tools are described in the article. Two-point discrimination, laterality recognition and emotion recognition are altered in patients with orofacial pain. Other sensorimotor assessment tools, such as motor acuity and auditory acuity, are also explained. Finally, the authors review their treatment proposals, based on the integration of brain training techniques and biobehavioral interventions. Somatosensory reintegration (tactile acuity training), facial emotion recognition, movement representation techniques, orofacial motor training and therapeutic patient education are explained in detail, and this may challenge new directions in rehabilitation and research.

Orthod Craniofacial Res

“…changes (see Figure5where 'anteroposterior change' = 0 mm).The effects of changes in mechanobehaviour on the TMJ mechanical environment post-surgically need consideration of the frequency of post-surgical mandibular loading. Studies have reported restoration of normal or near-normal function post-surgery in terms of occlusal contacts, maximum bite force, masticatory efficiency and neurosensory recovery [34][35][36]. Protracted disturbances in dynamic measures of jaw tracking may reflect the period of recovery required to develop neural templates of jaw movement.…”

mentioning

confidence: 99%

Orthognathic surgery effects on temporomandibular joint compressive stresses

Glovsky

Iwasaki

et al. 2023

IntroductionThis study tested orthognathic surgery effects on temporomandibular joint (TMJ) compressive stresses.MethodsPre‐ (T1) and post‐surgery (T2) cone‐beam computed tomography images were collected from consenting subjects aged ≥15 years. Anatomical data were used to measure surgical changes in anteroposterior mandibular position and occlusal plane angle (FH‐OP), estimate condylar loading areas (mm2) and calculate T1 and T2 TMJ and jaw muscle forces (N) during canine biting via numerical modelling. Analysis of covariance tested for sex and biting angle differences in T2 − T1 TMJ compressive stresses (TMJ force/loading area, MPa). Principal component analyses identified jaw muscle forces that accounted for changes in T2 − T1 TMJ loads. Regression analyses tested the correlations between surgical changes in mandibular position, FH‐OP, TMJ loads and muscle forces.ResultsOf 148 cases screened, 28 females and 16 males provided complete records. Condylar loading areas were significantly smaller (P = .024) for females vs males (124 ± 5 vs 144 ± 7 mm2). T2 − T1 differences in TMJ compressive stresses varied by surgical change, biting angle and sex. Overall, the largest increases in TMJ compressive stresses post‐surgery were for females with mandibular setbacks where FH‐OP angle decreased. T2 − T1 changes in jaw muscle forces had moderate (ipsilateral, λ = 4.59; η2 = 0.071) to large (contralateral, λ = 1.49; η2 = 0.31) effects on TMJ loads.ConclusionsT2 − T1 differences in TMJ compressive stresses during canine biting were affected by surgical changes in mandibular position and occlusal plane angle, biting angle and sex. Surgical changes altered jaw muscle forces for the same biting conditions and, thus, affected TMJ loads and compressive stresses.