• Journal of Oral Medicine and Pain
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• v.47 no.4
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• pp.206-211
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• 2022

Purpose: The purpose of this study is to develop a reproducible and reliable method for evaluating the masseter's functional state by measuring the masseter muscle with ultrasonography (US). Methods: Nineteen healthy adults (9 males, 10 females) were the subjects of this study. During US scanning, the image was taken from the thickest part of the masseter muscle in the image. To evaluate changes in thickness during masseter function, US images were taken of the participant's masseter muscle at rest and during clenching. In this study, US scanning was conducted using two approaches to compare the difference in masseter muscle thickness determined when inducing maximum bite force (MBF). Results: All 19 subjects completed US scanning of the masseter muscle at rest and during clenching under the conventional method and the articulation paper method. There was no difference in masseter muscle thickness measured at rest. However, the thickness of the masseter muscles determined by the articulation paper during jaw clenching was greater than that measured by the conventional method. Conclusions: In conclusion, using the US for masseter muscle evaluation can offer objective and functional information on the masseter muscle. A standardized US scanning method needs to be developed to obtain reproducible and reliable information on the masseter muscle at rest and during clenching. In particular, generating MBF using an articulation paper can be a reproducible and reliable method of measuring the functional state of the masseter muscle.

• Journal of Korean Dental Science
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• v.13 no.2
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• pp.59-66
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• 2020

Purpose: The purpose of this study was to investigate the masseter muscle thickness before and after treatment using ultrasound sonography in patients with parafunctional habits. Materials and Methods: From September 2019 to March 2020, a total of 27 patients who visited the Department of Oral and Maxillofacial Surgery at Ewha Womans University Seoul Hospital were collected. The thickness of both masseter muscles was measured using a tablet ultrasound scanner. Statistical analysis was performed by using the IBM SPSS version 26.0 statistical package (IBM Corp) with significance level at 0.05. Result: According to the statistical results, the thickness of the masseter muscle was thicker on the right side than on the left, with no correlation with sex or age. The severity and duration of pain did not have a significant correlation with the thickness of the masseter muscle. Botulinum A toxin injection in the masseter muscle was the most effective way to reduce pain and reduce the thickness of the masseter muscle. Splint treatment also showed some effects in reducing the thickness of the masseter muscle. Conclusion: Based on the findings, it can be claimed that ultrasonography is simple, inexpensive and easily repeatable method to get real-time diagnosis and treatment results for masseter muscles.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.473-479
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• 2008

Asians tend to have prominent mandibular angle. The causes of wide lower third of the facial contour are obtuse mandibular angle and hypertrophy of masseter muscles. In cases of hypertrophy of masseter muscles, conventional treatment intends to the contraction of masseter muscle. Recently, volumetric reduction of masseter muscles using botulinum toxin type A injection and radiofrequency (RF) reduction have been introduced. The use of RF energy for masseter muscle reduction is known as a safe, simple, and effective method for aesthetic lower facial contouring. The purpose of this study is to present the effects of RF reduction applied to hypertrophy of masseter muscles, to review and to encourage RF practices in oral and maxillofacial region.

• Imaging Science in Dentistry
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• v.48 no.3
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• pp.213-221
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• 2018

Purpose: The purpose of this study was to evaluate the relationship between masseter muscle thickness, facial morphology, and mandibular morphology in Korean adults using ultrasonography. Materials and Methods: Ultrasonography was used to measure the masseter muscle thickness bilaterally of 40 adults(20 males, 20 females) and was performed in the relaxed and contracted states. Facial photos and panoramic radiography were used for morphological analyses and evaluated for correlations with masseter muscle thickness. We also evaluated the correlations of age, body weight, stature, and body constitution with masseter muscle thickness. Results: In the relaxing, the masseter was $9.8{\pm}1.3mm$ in females and $11.3{\pm}1.2mm$ in males. In the contracted state, it was $12.4{\pm}1.4mm$ in females and $14.7{\pm}1.4mm$ in males. Facial photography showed that bizygomatic facial width over facial height was correlated with masseter muscle thickness in both sexes in the relaxed state, and was statistically significantly correlated with masseter muscle thickness in males in the contracted state. In panoramic radiography, correlations were found between anterior angle length and posterior angle length and masseter muscle thickness in females, and between body length and posterior angle length, between anterior angle length and body length, between ramal length and body length, and between body length and condyle length in males. Conclusion: Masseter muscle thickness was associated with facial and mandibular morphology in both sexes, and with age in males. Ultrasonography can be used effectively to measure masseter muscle thickness.

• Archives of Craniofacial Surgery
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• v.21 no.6
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• pp.337-344
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• 2020

Facial paralysis is a devastating disease, the treatment of which is challenging. The use of the masseteric nerve in facial reanimation has become increasingly popular and has been applied to an expanded range of clinical scenarios. However, appropriate selection of the motor nerve and reanimation method is vital for successful facial reanimation. In this literature review on facial reanimation and the masseter nerve, we summarize and compare various reanimation methods using the masseter nerve. The masseter nerve can be used for direct coaptation with the paralyzed facial nerve for temporary motor input during cross-facial nerve graft regeneration and for double innervation with the contralateral facial nerve. The masseter nerve is favorable because of its proximity to the facial nerve, limited donor site morbidity, and rapid functional recovery. Masseter nerve transfer usually leads to improved symmetry and oral commissure excursion due to robust motor input. However, the lack of a spontaneous, effortless smile is a significant concern with the use of the masseter nerve. A thorough understanding of the advantages and disadvantages of the use of the masseter nerve, along with careful patient selection, can expand its use in clinical scenarios and improve the outcomes of facial reanimation surgery.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.355-363
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• 2023

Purpose: Sonographic elastography can be used to evaluate the hardness of muscle tissue through the application of compression. Strain elastography gauges hardness through the comparison of echo sets before and after compression. This study utilized ultrasonography to measure the thickness and hardness of the masseter muscle in individuals with temporomandibular joint(TMJ) osteoarthritis. Materials and Methods: This study included 40 patients who presented with joint pain and were diagnosed with TMJ osteoarthritis via diagnostic cone-beam computed tomography, along with 40 healthy individuals. The thickness and hardness of each individual's masseter muscle were evaluated both at rest and at maximum bite using ultrasonography. The Mann-Whitney U test and the chi-square test were employed for statistical analysis, with the significance level set at P<0.05. Results: The mean thickness of the resting masseter muscle was 0.91 cm in patients with osteoarthritis, versus 1.00 cm in healthy individuals. The mean thickness of the masseter muscle at maximum bite was 1.28 cm in osteoarthritis patients and 1.36 cm in healthy individuals. The mean masseter elasticity index ratio at maximum bite was 4.51 in patients with osteoarthritis and 3.16 in healthy controls. Significant differences were observed between patients with osteoarthritis and healthy controls in both the masseter muscle thickness and the masseter elasticity index ratio, at rest and at maximum bite (P<0.05). Conclusion: The thickness of the masseter muscle in patients with TMJ osteoarthritis was less than that in healthy controls. Additionally, the hardness of the masseter muscle was greater in patients with TMJ osteoarthritis.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2365-2369
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• 2021

Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

• Journal of Oral Medicine and Pain
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• v.39 no.2
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• pp.55-62
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• 2014

Purpose: This study aims to evaluate the changes in soft tissue thickness of the masseteric region after injection of botulinum toxin type A (BTX-A). Methods: Twenty-four data acquired from medical records were classified into 4 groups: bruxer group that received masseter muscle injection only (M-B), bruxer group that received both masseter and temporalis muscle injections (MT-B), non-bruxer group that received masseter muscle injection only (M-NB) and non-bruxer group that received both masseter and temporalis muscle injections (MT-NB). Injection dose of BTX-A was 30 units for each masseter muscle and 20 units for each temporalis muscle. We measured the reduced thickness of the masseteric region before and after 12 weeks after injection using cone-beam computed tomography. Results: Among the patients that received both masseter and temporalis muscle injections, bruxer group showed a tendency to have more reduction in masseter muscle thickness than non-bruxer group. The difference in reduced thickness between M-B and MT-B tended to show greater than the difference between M-NB and MT-NB. Conclusions: In case of masseter hypertrothy patients with bruxism there was a tendency to show a difference in reduced thickness of soft tissue between the group that received both masseter and temporalis muscles injection and the group that received masseter muscle injection only hence a thorough inspection before the injection of BTX-A is condisered to be needed.

• The Korean Journal of Physiology
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• v.3 no.1
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• pp.33-44
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• 1969

Electoromyographic studies were performed on the action of the muscles of the temporomandibular joints following exfoliation of the deciduous teeth. The subjects examined, being 50 children. between the age of 6 and 13 years, divided into 5 groups. They were; 1) Deciduous dentition were complete in the first group. 2) Deciduous incisors were missing in either upper or lower jaw in the second group. 3) Deciduous canine and molars were missing in the left side of either upper or lower jaw in the third group. 4) Deciduous canine and molars were missing in the right side of either upper or lower jaw in the fourth group. 5) Permanent dentition completed in the fifth group(except third molars). Electromyogram was recorded with 4 channel polygraph (Grass model VII modified for 7P3). Electrodes which were the cup-typed gold discs, 9 millimeters in the diameter, were located on the anterior, middle and posterior lobes of the temporal muscles, and also on the superficial and deep layers of the masseter muscles. Paired electrodes were held by electrode cream so that they were pressed on the skin surface at right angle, adhesive tape being used to anchor them. The distance of the pair electrodes was about 5 millimeters. The results obtained were as follow: 1) In rest position of mandible; All groups showed slight, electrical activities in the muscles involved, but in the middle lobe of temporal muscle they were slightly higher. 2) In molar occlusion of mandible; High activity-anterior lobe of temporal muscle and superficial layer of masseter muscle. Moderate activity-deep layer of masseter muscle. Low activity-middle and posterior lobes of masseter muscle. There were no differences among the first, the second and the fifth groups. In the third group the muscle activity was weaker than that of the right, and in the fourth group opposite characteristics was revealed. 3) In incisal bite of mandreble; Hight activity-superficial layer of masseter muscle. Modertae activity-deep layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. The first, the third, the fourth and the fifth groups showed no differences but the second group showed less activity than those of others. 4) In protrusion of mandible; High activity-deep layer of masseter muscle Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the fourth and the fifth groups, there were no differences in the activities, but the second group showed less activity than the others. 5) In retrusion of mandible; High activity-deep layer of masseter muscle. Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the third, the fourth and the fifth groups, there were no differences but the second group showed less activity than the others. 6) In lateral excursion of the mandible (either direction); High activity-posterior lobe of temporal muscle. Moderate activity-anterior and middle lobes of temporal muscle. Low activity-superficial and deep layers of masseter muscle. The muscle action potentials were weaker than those of the right side in the third group and vice ver'sa in the fourth group. 7) In chewing movement; Temporal muscle activities were higher than those of masseter, especially in the middle lobe of temporal muscle the activity was highest. Right side muscle activities were higher than those of the left in the third group and, on the contrary, the left side was dominant over the right in the fourth group.

• The Journal of the Korean dental association
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• v.41 no.6 s.409
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• pp.450-454
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• 2003

The Purpose of this study is to report the effect botulinum toxin type A injection for the masseter hypertrophy patient with bruxism. Nine patients enrolled in this study were diagnosed as masseter hypertrophy associated with bruxism and the patients were injected with a 25U of botulinum toxin type A (BTXA:Lanzhou) to each masseter muscles. All nine patients showed marked reduction of masseter hypertrophy and eight patients reported the resolution of bruxism in 8 weeks after injection, with no significant complications. This preliminary study suggest that the botulinum toxin type A injection is an alternative method to treat the masseter hypertrophy with bruxism.