Estimation of tendon-plane orientation within human masseter muscle from reconstructed magnetic resonance images

Musculoaponeurotic architecture of the human masseter muscle: an in vivo ultrasonographic study of architectural changes during mandibular protrusion and lateral excursions

OBJECTIVE

The present study evaluated the in vivo musculoaponeurotic architecture of the superficial head (SH) of the masseter muscle (MM) of asymptomatic participants in excursive mandibular movements compared to the relaxed state as examined with ultrasonography. It was hypothesized that the mean fiber bundle length (FBL) and mean height of the aponeurosis (HA) of the laminae of the SH would differ significantly between the relaxed state and protrusion, ipsilateral excursion, and contralateral excursion.

STUDY DESIGN

The MM was studied volumetrically in 12 female and 12 male asymptomatic participants bilaterally by using ultrasound imaging. Mean FBL and HA in protrusion and ipsilateral and contralateral excursion were compared to these values in the relaxed state using paired t tests (P < .05). The intraclass correlation coefficient was used to assess intraexaminer reliability.

RESULTS

The SH exhibited multiple laminae. Fiber bundles were found to attach to bone and the superior and inferior aponeuroses. Mean FBL was significantly shorter and mean HA significantly longer in protrusion and the excursions than in the relaxed state although the pattern of altered laminae and aponeuroses differed among the mandibular movements. Intraexaminer reliability was excellent.

CONCLUSION

Specific changes in mean FBL and mean HA suggest differential contraction of the SH of the MM based on laminar morphology. These findings provide a baseline to investigate musculoaponeurotic changes in patients with myogenic masseter muscle pain.

Morphological comparison of masseter muscle fibers in the mandibular rest and open positions using diffusion tensor imaging

BACKGROUND

The masseter muscle has a complicated multipennate internal structure and exhibits functional differentiation when performing various stomatognathic functions. It is important to understand the internal structural changes of the muscle during functioning to elucidate characteristic muscle disorders such as local myalgia. Diffusion tensor imaging (DTI) may be useful for investigating the internal structural features of muscle.

OBJECTIVES

To evaluate the features of masseter muscle fibers in human participants using DTI fiber tractography, and to elucidate the structural differences in the masseter muscle between the mandibular rest and open positions.

METHODS

Five healthy men (age 31±7 years) underwent DTI and T1-weighted MRI of the right masseter muscle in the mandibular rest and open positions. MR images were used as a reference for muscle layer segmentation (superficial, intermediate, and deep). DTI fiber tractography of the masseter muscle was performed and the orientation of the DTI fibers was analyzed in each layer using coordinates based on the Frankfurt horizontal plane.

RESULTS

The DTI fiber orientation of the deep layer significantly changed between the mandibular rest and open positions in the frontal plane (p<0.05, Wilcoxon rank sum test). However, no significant change was found in the superficial and intermediate layers.

CONCLUSION

DTI fiber tractography confirmed regional differences in the orientation change of the masseter muscle fibers between different mandibular positions. The results may support the existence of functional partitioning inside the masseter muscle and suggest that DTI may be useful for the evaluation of muscle fibers in multipennate muscles.

The significance and classification of the layered structures of the human masseter and temporalis

A report published in the Annals of Anatomy recently stated that the coronoid part of the masseter was a newly described layer. However, there have been numerous discussions regarding the layered structures in the masseter and temporalis. In this review, we show that the muscle bundle stated as a newly described layer could be similar to the zygomaticomandibularis that was previously reported. Knowledge of various muscle bundles with different fiber directions is essential to understanding the stabilization and closing functions of the jaw. Therefore, the layered structure of the masseter and temporalis should be considered more for clinical and functional applications.

A dynamic ultrasonographic in vivo study of the musculoaponeurotic architecture of the human masseter muscle

OBJECTIVE

In the present study, we sought to investigate the in vivo musculoaponeurotic architecture of the masseter muscle (MM) volumetrically with ultrasound in asymptomatic participants. It was hypothesized that the mean fiber bundle length (FBL) and mean aponeurotic height of laminae of the MM differ significantly between the relaxed state and maximally contracted state upon elevation of the mandible.

STUDY DESIGN

The MM was investigated volumetrically in 12 male and 12 female asymptomatic participants (mean age, 25.8 ± 4.1 years) using ultrasound. The mean FBL and mean height of aponeuroses in the relaxed and maximally contracted states were compared using paired t tests, with significance established at P ≤ .05. Intrarater reliability was assessed using the intraclass correlation coefficient (ICC).

RESULTS

The MM consisted of the superficial head (SH) and deep head, each arranged in multiple laminae. Fiber bundles extended between superior and inferior aponeuroses and/or bone. Statistically significant differences (P ≤ .05) were observed in mean FBL and in mean height of aponeuroses between the relaxed and contracted states only in superficial laminae of the SH.

CONCLUSIONS

These results suggest there is differential contraction of the laminae of the MM in the transition from relaxed to contracted states. Future comparison with pathologic patients can be made on the basis of an established normative database.

Functional and molecular outcomes of the human masticatory muscles

The masticatory muscles achieve a broad range of different activities such as chewing, sucking, swallowing, and speech. In order to accomplish these duties, masticatory muscles have a unique and heterogeneous structure and fiber composition, enabling them to produce their strength and contraction speed largely dependent on their motor units and myosin proteins that can change in response to genetic and environmental factors. Human masticatory muscles express unique myosin isoforms, including a combination of thick fibers, expressing myosin light chains (MyLC) and myosin class I and II heavy chains (MyHC) -IIA, -IIX, α-cardiac, embryonic and neonatal and thin fibers, respectively. In this review, we discuss the current knowledge regarding the importance of fiber-type diversity in masticatory muscles versus supra- and infrahyoid muscles, and versus limb and trunk muscles. We also highlight new information regarding the adaptive response and specific genetic variations of muscle fibers on the functional significance of the masticatory muscles, which influences craniofacial characteristics, malocclusions, or asymmetry. These findings may offer future possibilities for the prevention of craniofacial growth disturbances.

Reproducibility of Frankfort horizontal plane on 3D multi-planar reconstructed MR images

Objective

The purpose of this study was to determine the accuracy and reliability of Frankfort horizontal plane identification using displays of multi-planar reconstructed MRI images, and propose it as a sufficiently stable and standardized reference plane for craniofacial structures.

Materials and Methods

MRI images of 43 subjects were obtained from the longitudinal population based cohort study SHIP-2 using a T1-weighted 3D sequence. Five examiners independently identified the three landmarks that form FH plane. Intra-examiner reproducibility and inter-examiner reliability, correlation coefficients (ICC), coefficient of variability and Bland-Altman plots were obtained for all landmarks coordinates to assess reproducibility. Intra-examiner reproducibility and inter-examiner reliability in terms of location and plane angulation were also assessed.

Results

Intra- and inter-examiner reliabilities for X, Y and Z coordinates of all three landmarks were excellent with ICC values ranging from 0.914 to 0.998. Differences among examiners were more in X and Z than in Y dimensions. The Bland–Altman analysis demonstrated excellent intra- as well as inter-examiner agreement between examiners in all coordinates for all landmarks. Intra-examiner reproducibility and inter-examiner reliability of the three landmarks in terms of distance showed mean differences between 1.3 to 2.9 mm, Mean differences in plane angulation were between 1.0° to 1.5° among examiners.

Conclusion

This study revealed excellent intra-examiner reproducibility and inter-examiner reliability of Frankfort Horizontal plane through 3D landmark identification in MRI. Sufficiently stable landmark-based reference plane could be used for different treatments and studies.

Human masseter muscle fibers from the elderly express less neonatal Myosin than those of young adults

In contrast to limb muscles where neonatal myosin (MyHC-neo) is present only shortly after birth, adult masseter muscles contain a substantial portion of MyHC-neo, which is coexpressed with mature MyHC isoforms. Changes in the numerical and area proportion of muscle fibers containing MyHC-neo in masseter muscle with aging could be expected, based on previously reported findings that (i) developmental MyHC-containing muscle fibers exhibit lower shortening velocities compared to fibers with exclusively fast MyHC isoforms and (ii) transformation toward faster phenotype occurs in elderly compared to young masseter muscle. In this study, we detected MyHC isoforms in the anterior superficial part of the human masseter muscle in a sufficiently large sample of young, middle-aged, and elderly subjects to reveal age-related changes in the coexpression of MyHC-neo with adult MyHC isoforms. MyHC isoforms were visualized with immunoperoxidase method and the results were presented by (i) the area proportion of fibers containing particular MyHC isoforms and (ii) the numerical proportion of fiber types defined by MyHC-1, -2a, -2x, and -neonatal isoform expression from a successive transverse sections. We found a lower numerical and area proportion of fibers expressing MyHC-neo as well as a lower area proportion of fibers containing MyHC-1 in elderly than in young subjects. We conclude that the diminished expression of MyHC-neo with age could point to a lower regeneration capacity of masseter muscle in the elderly.

Functional properties and regional differences of human masseter motor units related to three-dimensional bite force

The aim of this study was to estimate numerically the properties of masseter motor units (MUs) in relation to bite force magnitude and direction three-dimensionally and to confirm the hypothesis that the properties differ between different parts of the muscle by means of simultaneous recording of MU activity along with the MU location and three-dimensional (3D) bite force. The MU activity of the right masseter of four healthy men was recorded using a monopolar needle electrode in combination with a surface reference electrode. The location of the needle electrode was estimated stereotactically with the aid of magnetic resonance images and a reference plate. The magnitude and direction of the bite force was recorded with a custom-made 3D bite force transducer. The recorded bite force was displayed on a signal processor, which enabled the participant to adjust the direction and magnitude of the force. The activities of 65 masseter MUs were recorded. Each MU had specific ranges of bite force magnitude and direction (firing range: FR) and an optimum direction for recruitment (minimum firing threshold: MFT). There was a significant negative correlation between MFT and FR width. There were functional differences in MU properties between the superficial and deep masseter and between the superficial layer and deep layer in the superficial masseter. These results indicate that the contribution of human masseter motor units to bite force production is heterogeneous within the muscle.

Effects of Physical Training and Detraining, Immobilisation, Growth and Aging on Human Fascicle Geometry

In addition to its size and the extent of its neural activation, a muscle's geometry (the angles and lengths of its fibres or fascicles) strongly influences its force production characteristics. As with many other tissues within the body, muscle displays significant plasticity in its geometry. This review summarises geometric differences between various athlete populations and describes research examining the plasticity of muscle geometry with physical training, immobilisation/detraining, growth and aging. Typically, heavy resistance training in young adults has been shown to cause significant increases in fascicle angle of vastus lateralis and triceps brachii as measured by ultrasonography, while high-speed/plyometrics training in the absence of weight training has been associated with increases in fascicle length and a reduction in angles of vastus lateralis fascicles. These changes indicate that differences in geometry between various athletic populations might be at least partly attributable to their differing training regimes. Despite some inter-muscular differences, detraining/unloading is associated with decreases in fascicle angle, although little change was shown in muscles such as vastus lateralis and triceps brachii in studies examining the effects of prolonged bed rest. No research has examined the effects of other interventions such as endurance or chronic stretching training. Few data exist describing geometric adaptation during growth and maturation, although increases in gastrocnemius fascicle angle and length seem to occur until maturation in late adolescence. Although some evidence suggests that a decrease in both fascicle angle and length accompanies the normal aging process, there is a paucity of data examining the issue; heavy weight training might attenuate the decline, at least in fascicle length. A significant research effort is required to more fully understand geometric adaptation in response to physical training, immobilisation/detraining, growth and aging.

Outer shape changes of human masseter with contraction by ultrasound morphometry

OBJECTIVE

The multipennate masseter has a complex internal architecture, which suggests the contraction is not uniform within the muscle. The heterogeneous contraction may cause inequable changes of the muscle's outer shape. This study aimed to elucidate the outer shape changes of the whole masseter with clenching by multipoint measurement of serial ultrasound images.

DESIGN

Serial coronal images (perpendicular to the FH plane, 3 mm interval) of the right masseter of five healthy men were obtained with a real-time ultrasonograph equipped with a 13 MHz linear-array transducer. To define the relationship between the transducer and cranium, we used a 3D mechanical stage with a face-bow. Registrations were made during muscle relaxation and maximal clenching. The distance between the lateral and medial outlines of the muscle was measured at intervals of 1mm from the origin to insertion in each image as the thickness at the corresponding measured point.

RESULTS

The thickness of the relaxed and contracted muscle (R and C) and its difference (Delta) varied among the measured points. Muscle thickness at most measured sites increased with clenching, whereas it decreased at several sites, mainly near the origin and insertion. There were positive correlations in every subject both between R and C, and between C and Delta. On the other hand, the correlation between R and Delta were negative or weak.

CONCLUSION

Changes of thickness with clenching showed great disparity within the masseter, which may result from the complexity of the contraction properties due to the multipennate structure and functional heterogeneity.

Length changes in the human masseter muscle after jaw movement

The human masseter is a multilayered, complex muscle contributing to jaw motion. Because variations in stretch may cause muscle fibers to function over different portions of their length-tension curves, the aim of this study was to determine how parts of the masseter lengthen or shorten during voluntary jaw movements made by living subjects. Magnetic resonance (MR) imaging and optically-based jaw-tracking were used to measure muscle-insertion positions for four parts of the muscle with six degrees of freedom (DOF), before and after maximum-opening, jaw protrusion and laterotrusion in four adult males. Muscle part lengths and intramuscular tendon lengths were calculated, and these data, with fiber-tendon ratios published previously, were used to estimate putative changes in fiber-length. During maximum jaw-opening, the largest increases in muscle length (34-83%) occurred in the medial part of the deep masseter, whereas the smallest changes occurred in the posterior-most, superficial masseter (2-19%). Smaller changes were found during movement to the ipsilateral side, than during protrusion and movement to the contralateral side. On maximum opening, putative fibers in the deep masseter lengthened up to 83%, whereas those of the superficial masseter stretched up to 72%. The masseter muscle does not stretch uniformly for major jaw movement. Jaw motion to the ipsilateral side causes little length change in any part, and the effect of tendon-stretch on estimated fiber lengths is not substantial. The stretch that occurs infers there are task-related changes in the active and passive tensions produced by different muscle regions.

Mandibular movements in response to electrical stimulation of superficial and deep parts of the human masseter muscle at different jaw positions

Anatomical and electromyographical evidence suggests a compartmentalized function of the human jaw-closing muscles during both static and dynamic motor tasks. However, the voluntary nature of these tasks hampers unequivocal interpretation of this evidence, because it is impossible to activate voluntarily a single part of a muscle exclusively. Activation of discrete, localized regions can be accomplished with electrical stimulation. A previous study confirmed a functional subdivision of the temporalis muscle into at least three parts. Here, differences in the direction of the lower incisal-point (IP) movement in response to electrical stimulation of four different parts of the masseter muscle were examined in five healthy men. The deep masseter muscle and the anterior, middle, and posterior parts of the superficial masseter muscle were stimulated with monopolar wire electrodes in four different jaw positions (resting position; 50% maximum mouth opening; and 10-mm right and left lateral excursions, both with respect to resting position). Electrode-insertion depth was measured from magnetic resonance images. Movement responses to stimulation were recorded with the OKAS-3D jaw-movement analysis system. The variation in the direction of the IP movement in response to stimulation of parts of the masseter was partly explained by the effects of stimulus location and jaw position. The response to stimulation of the deep masseter was mainly laterovertically directed, whereas the response to stimulation of each of the superficial parts had a mainly anterovertical direction, the responses being most pronounced with the mandible in its resting position. These results provide further evidence for a functional subdivision of the masseter into a superficial part and a deep part, but not for a further subdivision of the superficial part into an anterior, middle, and posterior part.

Comparison of magnetic resonance imaging and gross findings regarding masseter muscle aponeuroses in cadavers

OBJECTIVES

The main objective of this study was to compare the actual distribution and thickness of aponeuroses in cadavers with the distribution and thickness as determined by means of magnetic resonance imaging for the sake of evaluating magnetic resonance imaging as a diagnostic modality for assessing masseter muscle aponeuroses.

STUDY DESIGN

The aponeuroses of 26 masseter muscles from 13 intact cadavers were examined by magnetic resonance imaging.

RESULTS

The ratio of concordance between gross findings and magnetic resonance imaging findings was 99.0%, although depiction of thin parts of the aponeuroses on magnetic resonance imaging was poor.

CONCLUSIONS

Magnetic resonance imaging was useful as a diagnostic modality in the assessment of masseter muscle aponeuroses. Aponeuroses were distributed throughout almost the entire masseter muscle, although almost no aponeuroses were seen below the lower half of the anterior margin. This was thought to be a characteristic finding of masseter aponeuroses.

Motor unit territory in relation to tendons in the human masseter muscle

In the human masseter, motor-unit (MU) territories are reportedly focal and it is possible that they are confined to the muscle's internal aponeuroses. However, previous electromyographic (EMG) investigations of MU sizes have not correlated them with the muscle's internal architecture. In this study, 162 single-MU territories were assessed by scanning EMG recordings throughout the masseter muscles of 4 subjects. The needle-electrode scans were stereotactically located with magnetic resonance imaging and an optical system capable of tracking the needle movement in three dimensions. Mediolateral territorial dimensions were then displayed graphically within muscle reconstructions. The mean territorial width was 3.7 +/- 2.3 mm and varied between 0.4 and 13.1 mm. The widths were comparable in size to those of previous reports, and were related to the subject's muscle size. Most MU territories were confined, and lay between tendons, although 10% of the units clearly extended across at least one tendon. The dispersion of most territories within discrete tendon-bounded compartments in the masseter provides an anatomical basis for selective activation of the muscle. However, it is also possible that this arrangement provides a flexible means for ensuring tendon stiffness and mechanical adaptation of the multipennate masseter during growth and development, whether or not the muscle is activated selectively.

Stereotactic location of EMG needle electrode scans relative to tendons in the human masseter muscle

A method is presented for locating the positions of moving electromyographic needle electrodes relative to internal tendinous boundaries within the human masseter muscle. It combines scanning electromyography, needle electrode tracking, magnetic resonance imaging, and three-dimensional stereotactic reconstruction. The technique is useful for investigating motor unit territory within the masseter and other complex craniofacial muscles.

Internal organization in the human jaw muscles

The human jaw muscles are essential to mastication and play an important part in craniofacial growth. They contribute to dental and articular forces, deform the mandible, and, like other tissues, are subject to disorders, often manifested as pain. The literature describes how their contraction is controlled by the nervous system, and how their general structure and function contribute to craniofacial biology, but there has been little appraisal of their internal organization. Most of these muscles are not simple; they are multipennate, complexly layered, and divided by aponeuroses. This arrangement provides substantial means for differential contraction. In many ways, jaw muscle fibers are intrinsically dissimilar from those found in other skeletal muscles, because they are arranged in homogeneous clusters and generally reveal type I or type II histochemical profiles. Most are type I and are distributed preferentially in the anterior and deeper parts of the jaw closers. Additionally, most motor unit (MU) territories are smaller than those in the limbs. There is circumstantial evidence for intramuscular partitioning based in part on innervation by primary muscle nerve branches. During normal function. MU recruitment and the rate coding of MU firing in human jaw muscles follow the general principles established for the limbs, but even here they differ in important respects. Jaw muscle MUs do not have stable force recruitment thresholds and seem to rely more on rate coding than on sequential unit recruitment to grade the amplitude of muscle contraction. Unlike those in the limbs, their twitch tensions correlate weakly with MU fatiguability and contraction speed, probably because there are so few slow, fatigue-resistant MUs in the jaw muscles. Moreover, the type I fibers that are present in such large numbers do not contract as slowly as normally expected. To complicate matters, estimation of jaw MU twitch tensions is extremely difficult, because it is affected by the location used to measure the twitch, the background firing rate, muscle coactivation, and regional, intramuscular mechanics. Finally, there have been very few systematic studies of jaw MU reflex behavior. The most recent have concentrated on exteroceptive suppression and suggest that MU inhibition following intra- and perioral stimulation depends on the location of the MU, its background firing rate, the timing of the stimulus, and the task used to drive the unit. Task dependency is a common feature of human jaw MU behavior, reflecting interaction between peripheral sensory information from orofacial and muscle afferents and corticobulbar drive.(ABSTRACT TRUNCATED AT 400 WORDS)