• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.149-150
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• 2021

Bruxism is defined as a parafunctional activity during sleep or while awake that includes locking and grinding of teeth and clenching. It generates excessive occlusal force that may lead to implant failure. Therefore, diagnosis of bruxism and providing specific protocols such as occlusal splint and/or injection of botulinum toxin before implant installation are important to prevent increases the risk of implant failure in bruxism patients.

• Journal of Oral Medicine and Pain
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• 제25권1호
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• pp.117-128
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• 2000

The present study explored the influence of temporomandibular disorders(TMD) with anterior open bite on swallowing. Fifteen subjects with anterior open bite(group A), 9 subjects with anterior open bite and TMD(group B), and 24 subjects without malocclusion or TMD symptoms (group C) were included. BioPAK system(Bioresearch Inc., Milwaukee, WI, USA) was used to record the muscle activities of anterior temporal, masseter, sternocleidomastoid(SCM) and anterior digastric muscles during maximum clenching and swallowing. Positional change of the mandible during swallowing was also recorded using the same system. The obtained results were as follows: 1. Group A, B, and C did not show significant differences each other in the muscle activity of resting position in most of head and neck muscles. 2. Group B showed significantly lower muscle activity in maximum clenching than group C in anterior temporal(p<0.01), masseter(p<0.05), SCM(p<0.05) and digastric muscles(p<0.05). 3. Group A showed significantly lower muscle activity during swallowing than group C in anterior temporal and masseter muscles(p<0.01). Group B showed significantly lower muscle activity during swallowing than group C in anterior temporal(p<0.01), masseter(p<0.01), and SCM muscles(p<0.05). 4. Group A and B showed increased positional change of the mandible during swallowing measured from vertical, anteroposterior and lateral aspects, and prolonged swallowing(p<0.05). 5. After given instructions for normal swallowing pattern, group A and B showed increased muscle activity during swallowing in anterior temporal, masseter and SCM muscles(p<0.01). Positional change of the mandible and time elapsed for swallowing also decreased after the instruction(p<0.01). 6. Occlusal splint did not change the muscle activity during swallowing. However, vertical change(p<0.01) and swallowing time(p<0.05) were decreased with splint.

• Journal of Oral Medicine and Pain
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• 제45권3호
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• pp.49-55
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• 2020

Purpose: This study investigated the association between the objective indicator of masticatory function assessment and the masseter muscle thickness (MMT) using ultrasound imaging. Methods: A total of 99 subjects (males: 24, females: 75, mean age: 76) were analyzed. The maximum bite force (MBF) was measured with a pressure-sensitive sheet and an image scanner. The mixing ability index (MAI) was calculated by image analysis after asking the subjects to chew a wax specimen. The MMT during rest and clenching were obtained with a diagnostic ultrasound system, and the difference in MMT during rest and MMT during clenching was defined as the difference in masseter muscle thickness (DMMT). Multiple regression analysis was performed to determine the independent variables affecting MBF and MAI. Results: The MBF showed correlation with the number of remaining teeth (β=0.346, p=0.002) and DMMT (β=0.251, p=0.011). The MAI correlated with only the number of remaining teeth (β=0.476, p<0.001). Conclusions: The DMMT reflects the state of masseter muscle contraction, and can be used as a predictor as well as the number of teeth when assessing masticatory function.

• Journal of Yeungnam Medical Science
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• 제13권2호
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• pp.308-323
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• 1996

저자는 설문지 방식에 의해 1995년 8월1일부터 1995년 11월 30일까지 서울에 직장을 갖고 있는 직장인 282명을 대상으로 그들이 작성한 설문지를 분석하여 측두하악장애의 분포 및 관련요인과의 상관관계에 대해 다음과 같은 결론을 얻었다. 1. 측두하악장애의 증상을 가진 사람이 남자 41.88%, 여자 46.15%로 전체의 43.26%였다. 2. 일반관절 및 근육통의 증상이 심할수록, 두통 및 진통제 복용빈도가 높을수록, 측두하악장애증상의 빈도가 높았으며 이들 사이에 매우 유의한 상관이 있었다(p<0.001). 3. 이갈이, 이악물기, 구강악습관의 빈도가 높을수록 측두하악장애 증상의 빈도가 높았으며 Stress에 예민하게 반응할수록 이갈이나 이악물기, 깨무는 습관 등 이상기능 빈도가 높게 나타났다. 4. 편측저작이 양측저작에 비해 측두하악장애지수가 높게 나타났으며 통증부위와 측두하악장애 지수와의 연관성은 나타나지 않았다.

• Journal of Oral Medicine and Pain
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• 제40권3호
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• pp.115-123
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• 2015

Purpose: The aim of this study was to elucidate the coordination patterns of the sternocleidomastoid and posterior cervical muscles in response to symmetrical and asymmetrical jaw functions in normal adults. Methods: Twenty-seven healthy volunteers (8 females, 19 males; mean age, $30.4{\pm}2.5$ years) participated in this study. Surface electromyography (EMG) was used to record activities in the masseter, suprahyoid, sternocleidomastoid, and posterior cervical muscles at rest and during maximum tooth clenching, biting of a cotton roll with the anterior teeth, unilateral biting of a cotton roll with the posterior teeth, bilateral biting of cotton rolls with the posterior teeth, and jaw opening while seated. Normalized amplitude, activity indices, and asymmetry indices were compared between the muscles and the jaw tasks. Results: During symmetrical jaw functions (e.g., tooth clenching, biting with the anterior teeth, bilateral biting with the posterior teeth, jaw opening), the sternocleidomastoid and posterior cervical muscles showed elevated EMG amplitudes compared with the resting condition. The co-activation pattern of the sternocleidomastoid muscle was more pronounced than those of the posterior cervical muscles during these tasks. During asymmetrical jaw functions (e.g., unilateral biting with the posterior teeth), the ipsilateral sternocleidomastoid and masseter muscles showed higher contraction activity than did the contralateral muscles, but the contralateral posterior cervical muscles were more active than the ipsilateral muscles. Conclusions: The sternocleidomastoid and posterior cervical muscles were shown to be co-activated and coordinated anteroposteriorly or bilaterally according to symmetrical or asymmetrical jaw function. These results suggest an integrated neural control mechanism for the jaw and neck muscles, and provide further evidence supporting the intimate functional coupling between the trigeminal and cervical neuromuscular systems.

• Journal of Oral Medicine and Pain
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• 제19권2호
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• pp.153-168
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• 1994

The aim of the present study was to investigate a relation between occlusal wear area and occlusal contact patterns. For the purpose, occlusal wear area were measured in 58 dental students and in 129 patients with temporomandibular disorders(TMDs) from dental casts. Teeth used in this study were from canine to second molar on both sides in upper arch, totally ten. Occlusal wear area on casts was marked by pencil and photocopies, and then, the area was measured with planimeter. Occlusal relation was clinically examined with regard to Angle's classification, chewing side preference, lateral guidance pattern and bruxing and/or clenching habit. T-Scan, electronic occlusal contact analyzer, was used to record occlusal contact number, contact force, contact time and occlusal balance that is TLR(total left-right statistics) during tooth contact. All measurement were repeated 3 times and the average value was used for data processing. The obtained results were as follows : 1. Mean value of occlusal wear area did not differ significantly between dental students and patients. 2. There ws not significant difference in wear area between chewing side and non-chewing side in both groups. 3. Occlusal wear area was significantly increased with age in both groups. 4. Three subgroups divided by Angle's classification did not show any difference in occlusal wear area among them, but three subgroups divided by lateral guidance pattern showed slightly significant difference between canine guide subgroup and group function subgroup in patients. Occlusal wear ares\a in group function subgroup wear larger than canine guide subgroup. 5. Mean value of wear area in patients with bruxing and/or clenching habit did not differ from those in patients without such habit. 6. Correlationship among items related to occlusal contact pattern were highly consistent and significant in dental students and only one item significantly correlated with occlusal wear area was tooth contact time.

• 구강회복응용과학지
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• 제21권1호
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• pp.43-57
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• 2005

Temporomandibular disorders have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory nuscles, and associated structures. There have been many different contributing factors of TMDs which were traumatic, occlusal, pathophysiological and psychosocial. Among there factors, the effect of occlusion on TMDs have been a controversy for a long time. The purpose of this study was to investigate the effect of occlusal factors and oral habits on TMDs. In this study, 140 subjects with signs and symptoms of TMDs and diagnosed of TMD in the Orofacial Pain clinic of Yonsei University Dental Hospital though March to July 2004 were selected for the TMDs group and 50 subjects without any signs and symptoms of TMDs as the control group. The subjects were evaluated clinically in TMDs' Occlusal and Prosthodontic Restoration examinations. TMDs' examination was composed of the TMJ pain, sound, locking, temporal or masseter muscle palpation, mandibular movement, oral habits and headache. Occlusal examination was made of overjet, overbite, lost teeth number, nonfunctional interference, midline shift, then pattern of lateral movement and attrition. prosthodontic restoration examination had the existence of restoration, placement, then number of crown or bridge and Satisfiable index which estimated the quality of occlusal state of prosthodontic restorations. Following results were obtained : 1. The prevalence of TMDs was higher in their 20s & 30s, female of the TMD patients group. 2. The clenching frequency in the TMDs group(40.71%) was higher than those in the control group(18.00%), and there was a significant statistical difference(p<0.05). 3. The frequency of Nonfunctional interference in the TMDs group(10.00%) was higher than those in then Control group(2.00%), and there was a significant statistical difference(p<0.05). The result of this study indicated TMDs prevalence was higher in their 20s, 30s, female group of TMDs patients similar to the previous studies. Clenching and nonfunctional interference were estimated as the contributing factors of TMDs.

• 구강회복응용과학지
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• 제17권2호
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• pp.75-84
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• 2001

The purpose of this study is to to analyze the mechanical stress on articular disk of the dentated skull with the condition of unilateral posterior molar missing. For this study, the three dimensional finite element model of human skull scanned by means of computed tomography. (G.E. 8800 Quick, USA) was constructed. The finite element model of jaws is composed of 98,394 elements and 38,321 nodes, and it consists of articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. Boundary condition included rigid restraints at the first molar and endosteal cortical surfaces of the insertion points of temporal bone. The data derived from Nelson's study were used for the loading conditions of mandible during clenchings and for maxilla, new loading and constraint conditions were applied. A clenching task during intercuspal position was modeled to the three dimensional finite element model. The stress level and displacement of articualr disc on the model with unilateral posterior molar missing under bilateral clenching task can be analyzed. During bilateral clenchings, the compressive stress level and diplacement of the articular disk on the side of unilateral posterior molar missing is greater than that on the case with full dentition, whereas a higher stress was found on the disk on the balancing side of the full dentition. Although this kind of study is not enough to explain the role of occlusion as an etiologic factor of TMD, there may be a possibiliy that the condition of posterior molar missings may contribute in part to the TMJ biomechanics.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.9-19
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• 1993

The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).

• 대한치과보철학회지
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• 제40권6호
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• pp.577-589
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• 2002

There are several variations in normal mastication. In them, unilateral mastication is chewing, predominantly on a preferred side of the dentition and hardly on e non-preferred side. Continual unilateral mastication may alter the coordination of masticatory muscles. Although they studied about these EMG of masticatory muscles, there were no information about characteristics of masticatory muscle activity in unilateral mastication. Therefore, In this study, we investigated the activity of the masseter and anterior temporal muscles during rest, clenching in maximum intercuspation and gum chewing in habitually unilateral mastication group compared with normal group and tried to know effects of continual unilateral mastication on activity of masticatory muscles. The results of this study were as follows 1. In electromyographic activity during rest, in bilateral mastication group pattern of muscle activity of right and left side was symmetrical. But, in unilateral mastication group, records of anterior part of temporal muscle was higher than that of bilateral mastication group (p<.01) and patterns of muscle activity of right and left side in both muscle were asymmetrical.(p<.05) 2. In electromyographic activity during clenching in maximum intercuspation, records of superficial part of masseter muscle were higher than anterior part of temporal muscle in both group. Muscle activity of temporal muscle in unilateral mastication group was a little higher han bilateral mastication group and asymmetry of activity pattern in temporal and masseter muscle was shown but these differences were not statistically significant. (p<.05) 3. In electromyographic activity during gum chewing, temporal muscle was activated earlier than masseter muscle and maximum bite force is derived from masseter muscle in both group. In unilateral mastication group, electromyographic activity of masseter and temporal muscle of preferred chewing side, regardless of right or left side chewing, was higher than that of bilateral mastication group and especially, difference in masseter muscle was statistically significant. (p<.01) Based on the above results, our study suggested that recording of masticatory muscle activity will be helpful in the effective diagnosis and treatment of some types of the parafunctional habits.