Saúl Valenzuela

Effects of Head and Neck Inclination on Bilateral Sternocleidomastoid EMG Activity in Healthy Subjects and in Patients with Myogenic Cranio-Cervical-Mandibular Dysfunction

ABSTRACT This study was conducted in order to determine the effect of head and neck position on bilateral electromyographic (EMG) activity of the sternocleidomastoid muscles. The study was performed on 16 patients with myogenic cranio-cervical-mandibular dysfunction (CMD) and 16 healthy subjects. EMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing surface electrodes on the right and left sternocleidomastoid muscles. EMG activity was recorded in the left lateral decubitus position, in a darkened room and with the individuals eyes closed, under the following experimental conditions: 1. Head, neck, and body horizontally aligned; 2. Head and neck upwardly inclined with respect to the body, simulating the effect of a thick pillow, 3. Head and neck downwardly inclined with respect to the body, simulating the effect of a thin pillow. Variation of head and neck positions was determined by measuring the distance from the angle of neck and shoulder and the apex of the shoulder (SND = shoulder—neck distance) of each individual. Then, head and neck were forward or downwardly inclined with respect to the body at one-third of SND. A significantly higher contralateral EMG activity and a more asymmetric EMG activity were observed in the CMD group than in the healthy subjects (Kruskal-Wallis Test).These results suggest a different behavior of bilateral sternocleidomastoid EMG activity in CMD patients than in healthy subjects depending on the positioning of the head and neck.

Body position effects on EMG activity of sternocleidomastoid and masseter muscles in healthy subjects.

This study was conducted in order to determine the effects of body position on integrated electromyographic (IEMG) activity of sternocleidomastoid and masseter muscles in 20 healthy subjects. EMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing surface electrodes on the sternocleidomastoid and masseter muscles (contralateral to the habitual side of sleeping of each subject), in the following body positions: standing, seated, supine, and lateral decubitus position. Significant higher EMG activities were recorded in the sternocleidomastoid muscle in the lateral decubitus position, whereas significant lower EMG activities were recorded in the masseter muscle in the supine position. This finding supports the idea that there may exist a differential modulation of the motor neuron pools of the sternocleidomastoid and masseter muscles of peripheral and/or central origin. Significant differences in the EMG pattern as well as in the levels of EMG activities upon variations in body positions were observed between healthy subjects and patients with myogenic craniomandibular dysfunction reported by Palazzi, et al.

Body Position and Jaw Posture Effects on Supra- and Infrahyoid Electromyographic Activity in Humans

Abstract The purpose of this study was to record the pattern of electromyographic (EMG) activity of supra- and infrahyoid muscles at different body positions and jaw posture tasks. The sample included 22 healthy subjects with natural dentition, bilateral molar support, and absence of posterior occlusal contacts during mandibular protrusion. Bipolar surface electrodes were located on the left supra- and infrahyoid muscles for EMG recordings. In each subject EMG activity was recorded while standing and in the lateral decubitus position, during the following jaw posture tasks: swallowing of saliva, maximal clenching in the intercuspal position, grinding from intercuspal position to protrusive edge-to-edge contact position, and grinding from retruded contact position to intercuspal position. Suprahyoid EMG activity was significantly higher in the intercuspal position than in all the other jaw positions studied (mixed model with unstructured covariance matrix). Suprahyoid EMG activity was similar in both body positions studied. Infrahyoid EMG activity in the intercuspal position was significantly higher than grinding from intercuspal position to protrusive edge-to-edge contact position, similar to swallowing of saliva, and significantly lower than grinding from the retruded contact position to intercuspal position. Infrahyoid EMG activity in the lateral decubitus position was significantly higher than in the standing position. The EMG pattern observed could be of clinical importance in the presence of parafunctional habits, i.e., clenching and/or grinding. The neurophysiological mechanisms involved are discussed.

Does Head Posture Have a Significant Effect on the Hyoid Bone Position and Sternocleidomastoid Electromyographic Activity in Young Adults

Abstract The aim of this study was to evaluate the associations between head posture (head extension, normal head posture, and head flexion) and anteroposterior head position, hyoid bone position, and the sternocleidomastoid integrated electromyographic (IEMG) activity in a sample of young adults. The study included 50 individuals with natural dentition and bilateral molar support. A lateral craniocervical radiograph was taken for each subject and a cephalometric analysis was performed. Head posture was measured by means of the craniovertebral angle formed by the MacGregor plane and the odontoid plane. According to the value of this angle, the sample was divided into the following three groups: head extension (less than 95°); normal head posture (between 95° and 106°); and head flexion (more than 106°). The following cephalometric measurements were taken to compare the three groups: anteroposterior head position (true vertical plane/pterygoid distance), anteroposterior hyoid bone position (true vertical plane-Ha distance), vertical hyoid bone position (H-H’ distance in the hyoid triangle), and C0-C2 distance. In the three groups, IEMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing bipolar surface electrodes on the right and left sternocleidomastoid muscles. In addition, the condition with/without craniomandibular dysfunction (CMD) in each group was also assessed. Head posture showed no significant association with anteroposterior head position, anteroposterior hyoid bone position, vertical hyoid bone position, or sternocleidomastoid IEMG activity. There was no association to head posture with/without the condition of CMD. Clinical relevance of the results is discussed.

Effects of laterotrusive occlusal scheme and body position on bilateral sternocleidomastoid EMG activity.

ABSTRACT This study was conducted to determine the effects of laterotrusive occlusal scheme and body position on bilateral sternocleidomastoid electromyographic (EMG) activity. The study was performed on 20 healthy subjects with natural dentition and bilateral molar support. During laterotrusive occlusal excursion (working side), each individual had to present canine guidance on one side and group function on the opposite side, without balancing-side contacts. Integrated EMG (IEMG) recordings were performed by placing bipolar surface electrodes on the right and left sternocleidomastoid muscles. IEMG activity was recorded seated upright with the head unsupported and in the right and the left lateral decubitus body positions (head, neck and body horizontally aligned), under the following experimental conditions: 1. Maximal voluntary clenching in the intercuspal position; 2. Laterotrusive occlusal excursion with canine guidance; 3. Laterotrusive occlusal excursion with group function. Bilateral sternocleidomastoid IEMG activity with canine guidance or group function was significantly lower than the intercuspal position in both body positions. In the seated upright position, significantly lower activity was observed with canine guidance than in group function. In the lateral decubitus position activity was similar with both laterotrusive occlusal schemes and significantly higher than seated upright. Results suggest that both laterotrusive occlusal scheme and body position have significant influence on sternocleidomastoid IEMG activity. The clinical relevance of both factors is discussed.

Influence of jaw clenching and tooth grinding on bilateral sternocleidomastoid EMG activity.

Abstract This study compares the effect of tooth clenching and grinding on sternocleidomastoid electromyographic (EMG) activity during different laterotrusive jaw posture tasks. The study included 28 healthy subjects with natural dentition and bilateral molar support, 14 with bilateral canine guidance and 14 with bilateral group function. Bipolar surface electrodes were located on the left and right sternocleidomastoid muscles. EMG activity was recorded during the following tasks: A. eccentric grinding from intercuspal position to the right lateral edge-to-edge contact position; B. clenching in right edge-to-edge lateral contact position; C. concentric grinding from right lateral edge-to-edge contact position to intercuspal position. On the working side, activity in the task C was significantly higher than in tasks A and B in subjects with canine guidance, whereas no significant differences were observed between tasks in subjects with group function. On the nonworking side, activity was significantly lower during task A than in tasks B and C, in both occlusal schemes (mixed model with unstructured covariance matrix). When comparing by side, EMG activity was significantly lower during task B on the working side than on the nonworking side. However, there were no significant differences during tasks A and C. The EMG activity was significantly lower with canine guidance than group function on the working side during tasks A, B, and C, and on the nonworking side during tasks B and C. These results could explain muscular symptoms in the sternocleidomastoid muscles if the subject is experiencing parafunctional habits while awake and/or during sleep that exceed the individual’s adaptation capability.

Comparative Study Between Children with and without Cleft Lip and Cleft Palate, Part 2: Electromyographic Analysis

OBJECTIVE This study was conducted to compare electromyographic (EMG) activity of superior orbicularis oris muscle between children with repaired cleft lip and cleft palate and children without clefts. METHODS This study included 28 children with mixed dentition. They were divided into two groups. The study group included 14 children with repaired unilateral cleft lip and cleft palate, ranging in age from 6 to 12 years, who presented clinically with a short upper lip, abnormal lip seal, and inhibition of sagittal development of the midface as assessed radiographically. The control group included 14 children without clefts ranging in age from 8 to 11 years. All had normal lip seal, nasal breathing, and a clinically normal body posture. DESIGN Bipolar surface electrodes were used for EMG recordings of resting level activity and during swallowing of saliva, speech, and chewing and swallowing of an apple. RESULTS AND CONCLUSIONS A significantly higher level of activity at rest and during swallowing of saliva was observed in the cleft lip and cleft palate group. Similar activity during speech and chewing and swallowing of an apple was observed in both groups. The higher level of activity at rest and during swallowing of saliva in children with cleft lip and cleft palate seems to suggest that upon higher functional demands their activity increases less than in children without clefts. From a clinical point of view, if increased EMG activity at rest and during swallowing of saliva reflects increased force on the maxilla, then our findings may corroborate Bardachs findings (1990) that surgical treatment of cleft lip has an iatrogenic effect on facial growth, although the lack of significant correlation between the cephalometric data and EMG findings in the present study.

Body position effects on EMG activity of the temporal and suprahyoid muscles in healthy subjects and in patients with myogenic cranio-cervical-mandibular dysfunction.

This study was conducted in order to determine the effects of body position on integrated electromyographic (IEMG) activity of anterior temporal and suprahyoid muscles. The study was performed on 15 patients with myogenic cranio-cervical-mandibular dysfunction (CMD) and 15 healthy subjects. IEMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing surface electrodes on the anterior temporal and suprahyoid muscles in the following body positions: standing, seated, supine, and lateral decubitus position. Insignificant changes in IEMG activity of both muscles were observed upon variations in the body position. Insignificant differences in IEMG activity were observed between patients with myogenic CMD and healthy subjects. A pattern of higher IEMG at rest and during swallowing of saliva was observed in the suprahyoid muscles than in the anterior temporal muscles, whereas during maximal clenching activity, an opposite pattern was observed. Results of the present study seem to suggest that for the anterior temporal and suprahyoid muscles there is no specific body position that could be relevant to initiate and/or to perpetuate a craniomandibular dysfunction.

Visual Input Effect on EMG Activity of Sternocleidomastoid and Masseter Muscles in Healthy Subjects and in Patients with Myogenic Cranio-Cervical-Mandibular Dysfunction

This study was conducted in order to determine the input visual effect on electromyographic (EMG) activity of the sternocleidomastoid and masseter muscles in the supine and lateral decubitus positions. The study was performed on 22 patients with myogenic cranio-cervical-mandibular dysfunction (CMD) and 18 healthy subjects. EMG activity at rest and during swallowing of saliva and maximal voluntary clenching was recorded in the supine and lateral decubitus positions in the following conditions: 1. with eyes open; and 2. with eyes closed after 5 minutes in a dark room. A significant decrease of EMG activity at rest with closed eyes in both groups was observed in the sternocleidomastoid (lateral decubitus position) and in the masseter muscle (supine position). During swallowing of saliva a significant decrease of EMG activity with closed eyes was observed only in the sternocleidomastoid muscle (lateral decubitus position) in healthy subjects. During maximal voluntary clenching any significant differences were observed upon variation in the visual input. The significant change in EMG activity, mainly observed at rest, suggests that the visual input effect is weak. The absence of a significant change in EMG activity during maximal voluntary clenching upon variation in the visual input could be clinically relevant in patients with myogenic CMD who habitually brux.

The Effect of Tooth Clenching and Grinding on Anterior Temporalis Electromyographic Activity in Healthy Subjects

Abstract The aim of this study was to determine the effect of tooth clenching and grinding on anterior temporalis electromyographic (EMG) activity. The sample included 30 healthy subjects with natural dentition and bilateral molar support, 15 with bilateral canine guidance and 15 with bilateral group function. An inclusion criterion was that subjects have to be free of signs and symptoms of any dysfunction of the masticatory system. Bipolar surface electrodes were located on the left and right anterior temporalis muscles. EMG activity was recorded during the following conditions: A. eccentric grinding from intercuspal position to the right lateral edge-to-edge contact position; B. clenching in right edge-to-edge lateral contact position; and C. concentric grinding from right lateral edge-to-edge contact position to intercuspal position. On the working side, EMG activity was not significantly different between conditions in both occlusal schemes. On the nonworking side, EMG activity was significantly higher during condition C than condition B in both occlusal schemes (mixed model with unstructured covariance matrix). When comparing by side, EMG activity was significantly higher during conditions A and B on the working side than on the nonworking side. However, there was no significant difference during condition C. EMG activity was significantly lower with canine guidance than group function on the working side (in all conditions) as well as during concentric grinding on the nonworking side. These results could explain muscular symptoms in the anterior temporalis muscles if the subject is experiencing parafunctional habits either while awake and/or sleep that exceed the individual’s adaptation capability.