Keywords
Electromyography
Temporomandibular joint disorders
How to Cite
Abstract
Aim: The study aimed to evaluate the accuracy of the maximum bilateral molar bite force and the Root Mean Square (RMS) Electromyography (EMG) index of the masticatory muscles in the maximum bilateral molar bite (MMBMax) of women with myogenic Temporomandibular Disorder (TMD) and asymptomatic. Methods: This is a cross-sectional study, composed of 86 women allocated to the TMD Group (n=43) and Control Group (n=43) diagnosis through the Diagnostic Criteria for Temporomandibular Disorders. The maximum bilateral molar bite force was evaluated using a bite dynamometer and the RMS EMG index of the masticatory muscles (anterior temporalis, masseter) during 5 seconds of the MMBMax task. Student t-test was used for data comparison between accuracy of the bite force and RMS EMG of masticatory muscles during the MMBMax. Results: The maximum bilateral molar bite force showed high accuracy (AUC=0.99) for the diagnosis of women with myogenic TMD and asymptomatic women, and the RMS EMG index evaluated during the MMBMax showed a moderate level of accuracy for all masticatory muscles (AUC=0.70 to 0.75). Conclusion: The bilateral bite dynamometer with a surface EMG during bilateral bite can be used to diagnose TMD in young women.
References
Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27. doi: 10.11607/jop.1151.
Gonçalves DA, Dal Fabbro AL, Campos JA, Bigal ME, Speciali JG. Symptoms of temporomandibular disorders in the population: an epidemiological study. J Orofac Pain. 2010 Summer;24(3):270-8.
Leeuw R, Klasser GD, editors. Orofacial pain: guidelines for assessment, diagnosis, and management. 5. ed. Quintessence Publishing; 2013.
Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015 Mar;91(6):378-86.
Al-Khotani A, Naimi-Akbar A, Albadawi E, Ernberg M, Hedenberg-Magnusson B, Christidis N. Prevalence of diagnosed temporomandibular disorders among Saudi Arabian children and adolescents. J Headache Pain. 2016;17:41. doi: 10.1186/s10194-016-0642-9.
Santana-Mora U, Cudeiro J, Mora-Bermúdez MJ, Rilo-Pousa B, Ferreira-Pinho JC, Otero-Cepeda JL, et al. Changes in EMG activity during clenching in chronic pain patients with unilateral temporomandibular disorders. J Electromyogr Kinesiol. 2009 Dec;19(6):e543-9. doi: 10.1016/j.jelekin.2008.10.002.
De Luca CJ. The use of surface electromyography in biomechanics. J Appl Biomech. 1997;13(2):135-63. doi: 10.1123/jab.13.2.135.
Manfredini D, Bracci A, Djukic G. BruxApp: the ecological momentary assessment of awake bruxism. Minerva Stomatol. 2016;65(4):252-5.
Berni KC, Dibai-Filho AV, Pires PF, Rodrigues-Bigaton D. Accuracy of the surface electromyography RMS processing for the diagnosis of myogenous temporomandibular disorder. J Electromyogr Kinesiol. 2015 Aug;25(4):596-602. doi: 10.1016/j.jelekin.2015.05.004.
Castroflorio T, Bracco P, Farina D. Surface electromyography in the assessment of jaw elevator muscles. J Oral Rehabil. 2008 Aug;35(8):638-45. doi: 10.1111/j.1365-2842.2008.01864.x.
Xu L, Fan S, Cai B, Fang Z, Jiang X. Influence of sustained submaximal clenching fatigue test on electromyographic activity and maximum voluntary bite forces in healthy subjects and patients with temporomandibular disorders. J Oral Rehabil. 2017 May;44(5):340-6. doi: 10.1111/joor.12497.
Todic J, Martinovic B, Pavlovic J, Tabakovic S, Staletovic M. Assessment of the impact of temporomandibular disorders on maximum bite force. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019 Sep;163(3):274-8. doi: 10.5507/bp.2019.001.
Calderon Pdos S, Kogawa EM, Lauris JR, Conti PC. The influence of gender and bruxism on the human maximum bite force. J Appl Oral Sci. 2006 Dec;14(6):448-53. doi: 10.1590/s1678-77572006000600011.
Koc D, Dogan A, Bek B. Bite force and influential factors on bite force measurements: a literature review. Eur J Dent. 2010 Apr;4(2):223-32.
Castelo PM, Gavião MB, Pereira LJ, Bonjardim LR. Masticatory muscle thickness, bite force, and occlusal contacts in young children with unilateral posterior crossbite. Eur J Orthod. 2007 Apr;29(2):149-56. doi: 10.1093/ejo/cjl089.
Tortopidis D, Lyons MF, Baxendale RH. Bite force, endurance and masseter muscle fatigue in healthy edentulous subjects and those with TMD. J Oral Rehabil. 1999 Apr;26(4):321-8. doi: 10.1046/j.1365-2842.1999.00383.x.
Kogawa EM, Calderon PS, Lauris JR, Araujo CR, Conti PC. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil. 2006 Aug;33(8):559-65. doi: 10.1111/j.1365-2842.2006.01619.x.
Kordass B, Hugger A, Bernhardt O. Correlation between computer-assisted measurements of mandibular opening and closing movements and clinical symptoms of temporomandibular dysfunction. Int J Comput Dent. 2012;15(2):93-107.
Sforza C, Rosati R, De Menezes M, Musto F, Toma M. EMG analysis of trapezius and masticatory muscles: experimental protocol and data reproducibility. J Oral Rehabil. 2011 Sep;38(9):648-54. doi: 10.1111/j.1365-2842.2011.02208.x.
Akobeng AK. Understanding diagnostic tests 3: Receiver operating characteristic curves. Acta Paediatr. 2007 May;96(5):644-7. doi: 10.1111/j.1651-2227.2006.00178.x.
Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. [Outlining clinical research]. 4.ed. Porto Alegre: Artmed; 2015. Portuguese.
Chowdhury RH, Reaz MB, Ali MA, Bakar AA, Chellappan K, Chang TG. Surface electromyography signal processing and classification techniques. Sensors (Basel). 2013 Sep;13(9):12431-66. doi: 10.3390/s130912431.
Lora VR, Canales GL, Gonçalves LM, Meloto CB, Barbosa CM. Prevalence of temporomandibular disorders in postmenopausal women and relationship with pain and HRT. Braz Oral Res. 2016 Aug;30(1):e100. doi: 10.1590/1807-3107BOR-2016.vol30.0100.
Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain. 1997 Aug;72(1-2):95-7. doi: 10.1016/s0304-3959(97)00005-5.
Lundeberg T, Lund I, Dahlin L, Borg E, Gustafsson C, Sandin L, et al. Reliability and responsiveness of three different pain assessments. J Rehabil Med. 2001 Nov;33(6):279-83. doi: 10.1080/165019701753236473.
Cram JR. Electrode Placement. In: Cram’s introduction to surface electromyography. Boston: Jones & Bartlett Publishers; 2005. Chapter 14, p.237-389.
Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med. 2000 May;45(1-2):23-41. doi: 10.1016/s0167-5877(00)00115-x.
Yin J, Mutiso F, Tian L. Joint hypothesis testing of the area under the receiver operating characteristic curve and the Youden index. Pharm Stat. 2021 May;20(3):657-74. doi: 10.1002/pst.2099.
Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005 Feb;19(1):231-40. doi: 10.1519/15184.1.
Kroon GW, Naeije M. Electromyographic evidence of local muscle fatigue in a subgroup of patients with myogenous craniomandibular disorders. Arch Oral Biol. 1992 Mar;37(3):215-8. doi: 10.1016/0003-9969(92)90091-l.
Koyano K, Kim YJ, Clark GT. Electromyographic signal changes during exercise in human chronic jaw-muscle pain. Arch Oral Biol. 1995 Mar;40(3):221-7. doi: 10.1016/0003-9969(95)98811-c.
Ahlberg JP, Kovero OA, Hurmerinta KA, Zepa I, Nissinen MJ, Könönen MH. Maximal bite force and its association with signs and symptoms of TMD, occlusion, and body mass index in a cohort of young adults. Cranio. 2003 Oct;21(4):248-52. doi: 10.1080/08869634.2003.11746258.
Bezerra BPN, Ribeiro AIAM, Farias ABL, Farias AB, Fontes LBC, Nascimento SR, et al. Prevalence of temporomandibular joint dysfunction and different levels of anxiety among college students. Rev Dor. 2012;13(3):235-42. doi: 10.1590/S1806-00132012000300008.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Paulo Fernandes Pires, Elisa Bizetti Pelai, Marcio de Moraes, Ester Moreira de Castro Carletti, Fabiana Foltran Mescollotto, Fausto Berzin, Delaine Rodrigues Bigaton
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