• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.2
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• pp.525-536
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• 1996

The purpose of this study was to investigate the effect of electrical anesthesia induced by non-acupuncture point stimulation on inhibition of amplitude of digastric EMG evoked by noxious electrical stimuli in teeth and gingiva. Experiments were performed with dogs anesthetized with intraperitoneal pentobarbital sodium in an initial dose of 30mg/kg. Maintenance doses of 4.0ml/hour were given through a cannula in the femoral vein using a constant infusion pump. Anterior belly of digastric muscle was exposed and a pair of 0.1mm wire electrodes were inserted for E.M.G. recording. Bipolar electrodes were inserted into the labial and lingual surface of upper canine and the labial area of upper gingiva. Noxious stimuli were delivered to the tooth and gingiva through those electrodes by electric stimulator. Non-acupuncture point stimulation of 2Hz was delivered bilaterally to the femoral area. Amplitudes of digastric E.M.G. were measured from the oscilloscope and the monitor connected to amplifier at different intensities of electronic anesthesia of 1 volt, 4 volt and 10 volt. The inhibited rate of the amplitudes of digastric E.M.G. were analysed statistically with paired t-test. The following results were obtained : 1. Non-acupuncture point stimulation with intensities of 1 volt, 4 volt and 10 volt showed the inhibitory effect on pain of 15%, 25% and 16% in teeth and 15%, 18% and 12% in gingiva respectively 2. In tooth, statistical significance was observed between control and each group. In gingiva, there was statistical significance between control and group 1, 2 except group 3 From these results, low frequency electrical stimulation of non-acupuncture point resulted in reducing of dental and gingival pain, it could be used as adjunct to other pain control methods.

• Imaging Science in Dentistry
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• v.48 no.3
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• pp.161-165
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• 2018

Purpose: To evaluate the usefulness of shear wave elastography in the diagnosis of oral and maxillofacial diseases. Materials and Methods: Ten patients with oral and maxillofacial diseases and 28 volunteers drawn from our student doctors were examined by shear wave elastography with a 14-MHz linear transducer using an Aplio 300 apparatus (Canon Medical Systems, Otawara, Japan). A statistical analysis of the shear elastic modulus(kPa) of healthy tissue (the sublingual gland, submandibular gland, anterior belly of the digastric muscle, and geniohyoid muscle) in the 28 volunteers was performed using 1-way repeated measures analysis of variance with the Tukey honest significant difference test. The maximum shear elastic modulus(kPa) of 8 patients with squamous cell carcinoma (SCC) and 2 patients with benign lesions was evaluated with the Mann-Whitney U test. The analysis used a 5% significance level. Results: The mean shear elastic modulus of the sublingual gland ($9.4{\pm}3.7kPa$) was lower than that of the geniohyoid muscle ($19.2{\pm}9.2kPa$, P=.000) and the anterior belly of the digastric muscle ($15.3{\pm}6.1kPa$, P=.004). The maximum shear elastic modulus of the SCCs($109.6{\pm}14.4kPa$) was higher than that of the benign lesions($46.4{\pm}26.8kPa$, P=.044). Conclusion: Our results demonstrated the usefulness of shear wave elastography in the diagnosis of oral and maxillofacial diseases. Shear wave elastography has the potential to be an effective technique for the objective and quantitative diagnosis of oral and maxillofacial diseases.

• The Journal of Korean Medicine
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• v.39 no.4
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• pp.121-125
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• 2018

Objectives: This study was carried out to analyse Hand Greater Yang Skin in human. Methods: Hand Greater Yang meridian was labeled with latex in the body surface of the cadaver. And subsequently body among superficial fascia and muscular layer were dissected in order to observe internal structures. Results : A depth of Skin encompasses a common integument and a immediately below superficial fascia, this study established Skin boundary with adjacent structures such as relative muscle, tendon as compass. The Skin area of the Hand Greater Yang in human are as follows: The skin close to 0.1chon ulnad of $5^{th}$ nail angle, ulnad base of $5^{th}$ phalanx, ulnad head of $5^{th}$ metacapus(relevant muscle: abductor digiti minimi muscle), ulnad of hamate, tip of ulnar styloid process(extensor carpi ulnaris tendon), radiad of ulnar styloid process, 2cm below midpoint between Sohae and Yanggok(extensor carpi ulnaris), between medial epicondyle of humerus and olecranon of ulnar(ulnar nerve), The skin close to deltoid muscle, trapezius muscle, platysma muscle, inner muscles such as teres major muscle, infraspinatus muscle, supraspinatus muscle, levator scapulae muscle, splenius cervicis muscle, splenius capitis muscle, sternocleidomastoid muscle, digastric muscle, stylohyoid muscle, zygomaticus major muscle, auricularis anterior muscle. Conclusions: The Skin area of the Hand Greater Yang from the anatomical viewpoint seems to be the skin area outside the superficial fascia or muscles involved in the pathway of Hand Greater Yang meridian, collateral meridian, meridian muscle, with the condition that we consider adjacent skins.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.146-153
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• 1992

In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

• Journal of Oral Medicine and Pain
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• v.48 no.4
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• pp.159-168
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• 2023

Purpose: Coordinated activity between the jaw and neck muscles is important in oral motor tasks such as chewing. This study examined coherence between the jaw and neck muscles during chewing in healthy adults. Methods: A total of 12 healthy adults underwent electromyography (EMG) of the jaw and neck muscles during right-sided chewing at a frequency of 1 Hz. Surface electrodes were placed over the temporalis (TA), masseter (MS), anterior digastric (DA), and sternocleidomastoid (SM) muscles on the right side. EMG signals were processed for coherence and phase analysis using advanced signal processing techniques. Results: The MS and TA muscle pair exhibited high synchronization when chewing (median coherence=0.992). Contrarily, the coherence values between the MS and DA, as well as the MS and SM muscle pairs, were relatively low (median coherence=0.848 and 0.957, respectively). Phase analysis revealed minimal temporal differences between the MS and TA muscle pair and the MS and SM muscle pair, whereas substantial phase shifts were observed between the MS and DA muscle pair. Conclusions: During chewing in healthy adults, the TA muscle works synergistically whereas the DA muscle antagonistically with the MS muscle, and the SM muscle supports the activity of the MS muscle. The observed synchrony and coordination provide insights into the intricate interplay among these muscles during oral motor tasks.

• Journal of Korean Neurosurgical Society
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• v.51 no.5
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• pp.253-261
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• 2012

Objective : This study was performed to determine the anatomical landmarks and optimal dissection points of the facial nerve (FN) and the hypoglossal nerve (HGN) in the submandibular region to provide guidance for hypoglossal-facial nerve anastomosis (HFNA). Methods : Twenty-nine specimens were obtained from 15 formalin-fixed adult cadavers. Distances were measured based on the mastoid process tip (MPT), common carotid artery bifurcation (CCAB), and the digastric muscle posterior belly (DMPB). Results : The shortest distance from the MPT to the stylomastoid foramen was $14.1{\pm}2.9$ mm. The distance from the MPT to the FN origin was $8.6{\pm}2.8$ mm anteriorly and $5.9{\pm}2.8$ mm superiorly. The distance from the CCAB to the crossing point of the HGN and the internal carotid artery was $18.5{\pm}6.7$ mm, and that to the crossing point of the HGN and the external carotid artery was $15.1{\pm}5.7$ mm. The distance from the CCAB to the HGN bifurcation was $26.6{\pm}7.5$ mm. The distance from the digastric groove to the HGN, which was found under the DMPB, was about $35.8{\pm}5.7$ mm. The distance from the digastric groove to the HGN, which was found under the DMPB, corresponded to about 65.5% of the whole length of the DMPB. Conclusion : This study provides useful information regarding the morphometric anatomy of the submandibular region, and the presented morphological data on the nerves and surrounding structures will aid in understanding the anatomical structures more accurately to prevent complications of HFNA.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.19-25
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• 1992

The pressure pain thresholds of head and neck muscles of patients suffering from tensiontype headache220, all female, ages ranged from 13 to 50 years (28.4$\pm$9.6) and 39 healthy controls, all female, ages ranged from 14 to 46 years (24.4$\pm$9.2) were recorded by the electronic algometer (Electyronic Algometer Type I, Somedic, Stockholm, Sweden). And the obtained results were as follows : 1. The pressure pain thresholds of patient group were lower than those of controls in superior sternocleidomastoid muscle, middle sternocleidomastoid muscle, and trapezius insertion muscle (P<0.001) 2. The pressure pain thresholds of patient group were not different from those of controls in anterior temporal, middle temporal, posterior temporal, deep masseter, anterior masseter, inferior masseter, medial pterygoid, posterior digastric, splenius capitus and upper trapezius muscle (P>0.05). 3. Seventy-one percent of tension-type headache patients had more than one muscle, of whicb pressure pain threshold was lowered significantly (less than mean of control - 1.5SD). 4. The pressure pain thresholds of head and neck muscles should be considered as a criterion for the diagnosis of tension-type headache.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.171-183
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• 1995

This study was carried out to investigate the relationship between tensed mandibular positions, muscle tenderness and EMG activity, respectively, and between range of motion of the neck and sternocleidomastoid muscle tenderness. Under stressful conditions, most of people take several types of behavioral patterns. Two of them observed frequently are clenching of teeth and grasping of fist. Prolonged clenching or grasping should increase electromyographic activity of associated muscle, especially muscles of mastication and neck muscles and will cause hyperfunction, dysfunction and muscle pain. So it is necessary to relate EMG activity with muscle pain. The author performed routine clinical examination in 47 patients with Temporomandibular Disorders, especially for presence or absence of muscle tenderness. Mandibular rest position was used as a baseline reference position and two more position in which EMG activity was taken were rest postion with grasping of fist and teeth clenching position. BioEMG of Biopak system (Bioresearch Inc, USA) was used for measuring of integrated EMG in masseter, anterior temporalis, anterior belly of digastic muscle and sternocleidomastoid muscle. To measure of the range of neck motion. CROM(Cervical-Range-of Motion, USA) was used. The obtained results were as follows : 1. EMG activity of all muscles except in masseter was higher in grasping of fist than those in rest position and there were significant correlation in EMG activity between the two position except in anterior belly of digastric muscle. 2. When comparing EMG activity between tender and non-tender muscle, all examined muscles did not show any significant difference. From this data, we could conclude that EMG activity was generally not changed with tenderness, of couse, it might be dependent with degree of muscle tenderness. 3. Number of tender points in examined muscles was also not significantly different between in patients with masticatory muscle disorders and in patients with internal derangement. 4. Cervical posture and range of motion of the neck was not differed significantly between in patients with and in patients without tenderness of sternocleidomastoid muscle.

• Restorative Dentistry and Endodontics
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• v.17 no.1
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• pp.10-21
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• 1992

The purpose of this study was to investigate the analgesic effect of eugenol, capsaicin and demethoxy-NE. Young adult cats, weighing 2.0 to 3.0kg, were used. Each animal was anesthetized (${\alpha}$-chloralose 60mg per kg body weight) and divided into four groups; control, eugenol, capsaicin and demethoxy-NE group. The anterior digastric muscles were exposed and a pair of electrodes was inserted to record the electromyograms. To expose the pulp, each canine teeth was prepared with a low speed bur under cooling and used for recording anterior digastric muscular EMGs evoked by noxious stimulation of dental pulp. To observe effects on jaw opening reflex, inferior alveolar nerve of both sides were exposed for drug application and wire electrodes were inserted in anterior digstric muscle for recording the EMGs. To observe effects on action potential, saphenous nerves of both sides were exposed and three tissue pools were made from surrounding tissue. The most distal pool was used for applying stimulation, the most proximal one for recording of action potential, and the other one for drug application. One side of inferior alveolar nerve and saphenous nerve were used for eugenol, capsaicin, or demethoxy-NE application, the other side of nerve for control experiments(only vehicle application). Anterior digastric muscular EMGs evoked by noxious stimulation of dental pulp were recorded before drug application, immediate after drug application, at 60 and 120 minutes, and 5 days after drug application. Action potentials were recorded before drug application, immediate after 30 minutes drug application, at 30, 60 and 120 minutes after drug had been washed out. The results were as follows; 1. Eugenol had a continuous blocking effect on the anterior digastric muscular EMGs evoked by noxious pulp stimulation and after 5 days, showed completely blocking effect. 2. After 5 days, demethoxy-NE applied to dental pulp had a considerable blocking effect on the jaw opening retlex evoked by noxious stimulation but capsaicin had no significant effect. 3. After 5 days, eugenol group showed the strongest blocking effect among the all experimental groups on the jaw opening reflex evoked by noxious stimulation of dental pulp and capsaicin group showed the weakest blocking effect. 4. Eugenol had a completely blocking effect on the action potential conductivity of peripheral nerve. Capsaicin and demethoxy-NE had the blocking effect on the action potential conductivity of ${\alpha}$-and C-nerve fibers. 5. Capsaicin, demethoxy-NE and eugenol applied to inferior alveolar nerve surppressed the jaw opening reflex evoked by noxious stimulation of dental pulp.

• Radiation Oncology Journal
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• v.33 no.4
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• pp.344-349
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• 2015

Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.