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Szajkowski S, Pasek J, Cieślar G. The Condition of the Masseter Muscles After Orthodontic Treatment with Fixed Appliances. Diagnostics (Basel) 2024; 14:2755. [PMID: 39682663 DOI: 10.3390/diagnostics14232755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 11/20/2024] [Accepted: 12/04/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND One of the methods used in malocclusion treatment is the use of fixed appliances. Research conducted so far has revealed that changes in bite force occurring over the course of orthodontic treatment are directly related to the functional status of the masticatory muscles. It is therefore advisable to find out how the biomechanical parameters of the masseter muscles change after treatment with the application of fixed appliances. METHODS The study material comprised 74 individuals, divided into the study group (n = 37) treated by means of fixed orthodontic appliances over the average time of 12.27 months and the control group (n = 37) consisting of individuals did not undergo orthodontic treatment. The biomechanical properties of the masseter muscles were examined by means of myotonometry. RESULTS Upon completion of orthodontic treatment, the values of the parameters of tension, stiffness, and elasticity of masseter muscles located on both sides did not statistically significantly differ between patients from the study group who were treated by means of fixed orthodontic appliances and patients from control group who did not undergo orthodontic treatment. CONCLUSIONS Treatment of malocclusions with the use of fixed appliances does not affect the biomechanical and visco-elastic properties of the masseter muscles (stiffness, tension, and elasticity) assessed by means of myotonometry and it appears safe for masticatory muscles.
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Affiliation(s)
- Sebastian Szajkowski
- Faculty of Medical and Social Sciences, Warsaw Medical Academy of Applied Sciences, 8 Rydygiera St., 01-793 Warszawa, Poland
| | - Jarosław Pasek
- Collegium Medicum im dr Władysława Biegańskiego, Jan Długosz University in Częstochowa, 13/15 Armii Krajowej St., 42-200 Częstochowa, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Stefana Batorego St., 41-902 Bytom, Poland
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da Silva AP, Sassi FC, de Andrade CRF. The effects of treatment timing on the management of patients with multiple facial fractures and on the self-perception of TMD recovery. Cranio 2024; 42:699-710. [PMID: 35257636 DOI: 10.1080/08869634.2022.2046910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the effects of time on the orofacial functions and on the self-perception of temporomandibular disorders (TMD) recovery in a population of patients with multiple facial fractures. METHODS Orofacial functions and self-perception of TMD recovery was verified in patients with midface and/or lower face fractures. Patients were divided according to the time between fracture reduction and the clinical assessments: 0-1 month (Group 1), 1-3 months (Group 2), and 15 >3 months (Group 3). RESULTS Patients in Group 1 presented a greater compromise of swallowing and mastication when compared to patients with older fractures (p = 0.015), whereas patients in Group 3 presented a poorer TMD recovery (TMJ pain: p = 0.010 and tinnitus: p = 0.004). CONCLUSION Delays in functional treatments involving the myofunctional orofacial system have a negative impact on the recovery of essential orofacial functions and on TMD symptoms..
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Affiliation(s)
- Amanda Pagliotto da Silva
- Division of Orofacial Myology, Hospital Das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fernanda Chiarion Sassi
- Department of Physiotherapy, Speech-language and Hearing Science and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| | - Claudia Regina Furquim de Andrade
- Department of Physiotherapy, Speech-language and Hearing Science and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
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Bär AK, Werkmeister R, Dort JC, Al-Nawas B. Perioperative care in orthognathic surgery - A systematic review and meta-analysis for enhanced recovery after surgery. J Craniomaxillofac Surg 2024; 52:1244-1258. [PMID: 39183122 DOI: 10.1016/j.jcms.2024.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/30/2024] [Accepted: 08/19/2024] [Indexed: 08/27/2024] Open
Abstract
The aim of this study was to determine whether implementing ERAS (Enhanced Recovery After Surgery) elements/protocols improves outcomes in orthognathic surgery (OGS) compared to conventional care. To achieve this, ERAS-specific perioperative elements were identified and literature on ERAS for OGS was systematically reviewed. Using PRISMA methodology and GRADE approach, 44 studies with 49 perioperative care elements (13 pre-, 15 intra-, 21 postoperative) were analyzed. While 39 studies focused on single elements, only five presented multimodal protocols, with three related to ERAS. Preoperative elements included antimicrobial and steroid prophylaxis and prevention of postoperative nausea and vomiting. Intraoperative aspects, especially anesthesiological, showed high evidence. Outcome parameters were heterogeneous: complications and postoperative pain were well-investigated with high evidence, while length of stay (LOS) and patient satisfaction received low to medium evidence. ICU LOS, healthcare costs, and readmission rates were underreported. The meta-analysis revealed significant results for pain reduction and trends towards fewer complications and shorter LOS in the ERAS group. Overall, ERAS protocols are not established in OMFS, particularly OGS. Further research is needed in pre- and postoperative care and standardized multimodal analgesia. The next step should be developing a comprehensive OGS protocol through a consensus conference and implementing it in clinical practice.
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Affiliation(s)
- Anne-Kathrin Bär
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacher Str. 170, 56072, Koblenz, Germany; Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Richard Werkmeister
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacher Str. 170, 56072, Koblenz, Germany
| | - Joseph C Dort
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Departments of Community Health Sciences and Oncology, Ohlson Research Initiative, Arnie Charbonneau Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
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Navarro-Fernández G, Gil-Martínez A, Diaz-Saez MC, Elizagaray-Garcia I, Pili-Mayayo PQ, Ocampo-Vargas JE, Beltran-Alacreu H. Effectiveness of Physical Therapy in Orthognathic Surgery Patients: A Systematic Review of Randomized Controlled Trials. J Funct Morphol Kinesiol 2023; 8:jfmk8010017. [PMID: 36810501 PMCID: PMC9944893 DOI: 10.3390/jfmk8010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
Orthognathic surgery (OS) can present many complications that affect patients' rehabilitation. However, there have been no systematic reviews that assessed the effectiveness of physiotherapy interventions in the postsurgical rehabilitation of OS patients. The aim of this systematic review was to analyze the effectiveness of physiotherapy after OS. The inclusion criteria were randomized clinical trials (RCTs) of patients who underwent OS and who received therapeutic interventions that included any physiotherapy modality. Temporomandibular joint disorders were excluded. After the filtering process, five RCTs were selected from the 1152 initially obtained (two had acceptable methodological quality; three had insufficient methodological quality). The results obtained showed that the effects of the physiotherapy interventions studied in this systematic review on the variables of range of motion, pain, edema and masticatory muscle strength were limited. Only laser therapy and LED showed a moderate level of evidence in the postoperative neurosensory rehabilitation of the inferior alveolar nerve compared with a placebo LED intervention.
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Affiliation(s)
- Gonzalo Navarro-Fernández
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Alfonso Gil-Martínez
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Unit of Physiotherapy, Hospital La Paz-Carlos III, Institute for Health Research IdiPAZ, 28046 Madrid, Spain
- Correspondence: ; Tel.: +34-917401980 (ext. 291)
| | - Marta Carlota Diaz-Saez
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Ignacio Elizagaray-Garcia
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Paloma Qinling Pili-Mayayo
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Julian Esteban Ocampo-Vargas
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Hector Beltran-Alacreu
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physical Therapy and Nursing, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
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Shu J, Li A, Shao B, Chong DYR, Yao J, Liu Z. Descriptions of the dynamic joint space of the temporomandibular joint. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107149. [PMID: 36179656 DOI: 10.1016/j.cmpb.2022.107149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Clinical diagnosis and treatment depended heavily on the motion analysis of the human joints. Although the dynamic joint space (DJS) of other organs was widely used in academic investigations, they were not universally used in the temporomandibular joint (TMJ) field, which was also important for the motion evaluation of the TMJ. The objectives of this study are to introduce the DJS of the TMJ and characterize the DJS regulars of mandibular movements. METHODS Ten asymptomatic subjects were selected to instruct this application. The mouth opening and closing, mandibular protrusion, and left and right protrusions, were tracked by the optical motion tracking system. According to trajectories of markers and reconstructed models from computed tomography, the motions of the mandibles could be obtained. The DJSes, which were described as the minimum Euclidian distances, were subsequently calculated based on the geometrical surfaces between the condyle and fossa during the motions. Then, the DJS map could be drawn based on the calculated values. RESULTS The DJS map manifested a decreasing trend when the condyle crossed the glenoid fossa, while it generally increased after the condyle crossed the fossa during the mouth opening. The results showed that the average maximum and minimum anterior joint spaces were 5.39 mm and 2.07 mm during mouth opening respectively with a great discrepancy existing among the subjects. The average maximum and minimum anterior joint spaces were 4.74 mm and 2.19 mm during mandibular protrusion. As for left and right protrusions, the DJS of the contralateral side was greater than that of the ipsilateral side. CONCLUSION In comparison to morphological analyses or only mandibular motions, the DJS provides more dynamic and interactive information about the TMJ. The research and methodology may help us comprehend TMJ motions and temporomandibular disorders.
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Affiliation(s)
- Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China
| | - Annan Li
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China; Basic Mechanics Lab, Sichuan University, Chengdu, 610065, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, 138683, Singapore
| | - Jie Yao
- School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China.
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Orthodontic Perspective for Face Asymmetry Correction. Symmetry (Basel) 2022. [DOI: 10.3390/sym14091822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Facial symmetry affects the perception of facial beauty. Overall, facial harmony with an appropriate facial proportion and satisfactory midline facial symmetry are crucial factors for facial attractiveness. The role of orthodontists in correcting facial asymmetry begins with providing suitable diagnosis of the condition and identifying patients’ expectations. Through a thorough, subjective clinical evaluation of dentofacial asymmetry, the procedures for the surgical orthodontic management of facial asymmetry are discussed. The aim of this clinical review is to provide information on surgical indications for facial asymmetry, optimal treatment goals, presurgical orthodontic preparation, the surgery-first approach, three-dimensional (3D) surgical simulation, postsurgical orthodontic finishing, and treatment outcome evaluation. A comprehensive 3D diagnosis with appropriate planning, accurate transference of surgical simulation to real surgery, slight overcorrection, periodic assessment of treatment outcomes, and awareness of treatment limitations are essential to improve treatment outcomes of facial asymmetry.
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Use of Transcutaneous Electrical Nerve Stimulation (TENS) for the Recovery of Oral Function after Orthognathic Surgery. J Clin Med 2022; 11:jcm11123268. [PMID: 35743339 PMCID: PMC9225233 DOI: 10.3390/jcm11123268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/07/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
The oral functions of patients are markedly diminished immediately after orthognathic surgery, and novel approaches are needed to accelerate their recovery. The aim of this study was to examine the usefulness of weekly applications of transcutaneous electrical nerve stimulation (TENS) for this purpose, based on the evidence of its effectiveness in other types of patients with muscle alterations. Maximum jaw opening, bite force, pain, and facial inflammation were compared between patients receiving TENS and those receiving sham-TENS for 30 min at baseline and weekly over a four-week period after orthognathic surgery and were also compared between the before and after of each procedure. TENS was applied at 220 Hz, applying the maximum intensity tolerated by each individual patient. The TENS procedure was identical for all patients, but the device was not turned on in the sham-TENS group. Patients were blinded to their group membership. Results were analyzed separately in skeletal class II and III patients. Improvements in jaw opening and inflammation were significantly greater in the TENS than in the sham-TENS group, attributable to the muscle relaxation achieved with the procedure. Research is warranted on the benefits of a more frequent application of TENS.
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Barakat A, Alasseri N, Assari A, Koppolu P, Al-Saffan A. A case report on surgical–orthodontic correction of skeletal class III malocclusion with severe prognathic mandible and retrognathic maxilla. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S1054-S1058. [PMID: 36110821 PMCID: PMC9469259 DOI: 10.4103/jpbs.jpbs_85_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/26/2022] [Indexed: 11/04/2022] Open
Abstract
Mandibular prognathism combined with a retrognathic maxilla is a skeletal discrepancy that is difficult to correct. We report a case of a 25-year-old Saudi male patient with skeletal class-III malocclusion due to severe prognathic mandible who was referred to an orthodontist at Prince Sultan Military Medical City. Complete clinical examination, radiographic assessment, and study models revealed class-III malocclusion due to anteroposterior deficiency of the maxilla and severe prognathic mandible. Orthognathic surgery was performed 18 months after the presurgical orthodontic phase. A 10-mm LeFort I advancement of the maxillary arch, with impaction of 3 mm, was performed with a bilateral sagittal split osteotomy (BSSO) of 11 mm. Stable occlusion and superior aesthetics were observed at the 1-year follow-up. Surgical–orthodontic treatment endows an adult patient with a class-III malocclusion or mandibular prognathism with a stable occlusion and superior aesthetics.
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Damrongsirirat N, Kaboosaya B, Siriwatana K, Subbalekha K, Jansisyanont P, Pimkhaokham A. Complications related to orthognathic surgery: A 10-year experience in oral and maxillofacial training center. J Craniomaxillofac Surg 2021; 50:197-203. [PMID: 34876326 DOI: 10.1016/j.jcms.2021.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/28/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022] Open
Abstract
This article aimed to review adverse events and complications to orthognathic surgery based upon 10 years. This study was a retrospective investigation between 2009 and 2018. Independent variables such as sex, age, pre-operative conditions, diagnosis, type of surgery, bleeding volume, surgery duration, and hospitalization were recorded. The data regarding orthognathic surgery adverse events and complications were evaluated and statistically analyzed with a significance level of p < 0.05. A total of 891 patients were included in this study (male 39.1%, female 60.9%) with a mean age of 26.4 ± 6.09 years. A neurosensory disturbance was found as immediate post-operative sequelae as 93.5%. The four most frequent complications had a relapse (6.4%), post-operative TMD (5.7%), unfavorable osteotomy (5.5%), and infection (4.9%), which seem to be more common in males. An average blood loss was 497 ± 371 ml and the average operative time was 401 ± 109.3 min. Complication rates were statistically affected by bleeding volume (p-value = 0.01), operative time (p-value = 0.03), and type of skeletal deformity (p-value = 0.01). Although numerous complications were recorded, no fatal complications were experienced. Bleeding time, operative time, and skeletal classification have significant influence on orthognathic surgery complications. However, a multitude of factors could be modified to reduce the complication rate and improve the result of the treatment. One of the most significant factors was the operative time.
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Affiliation(s)
- Napat Damrongsirirat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
| | - Kiti Siriwatana
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pornchai Jansisyanont
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Watanabe M, Kawai N, Shibata M, Nakaue E, Horiuchi S, Tanaka E. Establishment of a new rehabilitation program using masticatory training food for jaw deformity patients. J Dent Sci 2021; 17:1217-1224. [PMID: 35784158 PMCID: PMC9236895 DOI: 10.1016/j.jds.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/06/2021] [Indexed: 11/25/2022] Open
Abstract
Background/purpose Patients with jaw deformities may show a reduction in masticatory function as a result of postoperative hypofunction. This study aimed to establish a novel rehabilitation program using a commercially available masticatory training food for patients with jaw deformities after orthognathic surgery. Materials and methods Nine patients with mandibular prognathism (the training group: n = 5, and the non-training group: n = 4) and 6 control participants with normal occlusion were included in this study. For the rehabilitation program with masticatory exercise, patients were instructed to chew the training food once a day for 60 days starting from 10 days after the surgery. The effects of the rehabilitation program were assessed by determining the maximum bite force (MBF) and the masticatory performance (MP). Clinical assessments were performed just before orthognathic surgery (Pre) and at 10 days (T0), 1 month (T1), 2 months (T2), and 3 months (T3) after surgery. Results Compared with the non-training group, the training group showed a trend toward greater recovery amount of MBF from Pre to T3, and a significantly greater recovery amount in MP (p < 0.05) from Pre to T3. When the time-series change of MP was evaluated in both groups from T0 to T3, a significant difference was observed in the interaction terms (p = 0.03). This result indicates that the effectiveness of the training may be demonstrated by following the postoperative course further. Conclusion The rehabilitation using this training food may become a useful method for postoperative hypofunction in patients with jaw deformities.
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Oliveira ZSBD, Silveira MLMD, Gomes PP, Silva JSPD, Germano AR. Early recovery after surgery protocol in orthognathic surgery: a randomized, blind clinical study. Braz Oral Res 2021; 35:e87. [PMID: 34378669 DOI: 10.1590/1807-3107bor-2021.vol35.0087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 01/21/2021] [Indexed: 11/22/2022] Open
Abstract
A randomized, blind and prospective clinical trial was conducted to compare two clinical rehabilitation protocols in patients submitted to orthognathic surgery, during the first 60 days after surgery. Pain, edema, mandibular movement, masticatory efficiency and quality of life were evaluated. Nineteen (19) patients were separated into control and experimental groups. The control group consisted of 10 patients followed by oral and maxillofacial surgeons and submitted to a rehabilitation protocol that involved active and passive mouth opening exercises. The experimental group had 9 patients and followed the surgeons' protocol, in addition to an Early Recovery After Surgery (ERAS) protocol performed by speech therapists, and involving specific motricity exercises and lymphatic drainage. The Student's t-test was applied to compare the results, and the Fisher's exact test of independence, to analyze the quality of life and the masticatory efficiency variables. The statistical significance was set at 5% (p < 0.05) for all the tests. The results showed that the ERAS protocol made a positive difference in pain perception in the first 14 days. However, it did not improve the other variables. Although many variables showed no significant difference, it was concluded that the surgeons can delegate patient rehabilitation to qualified professionals, so that they can optimize their postoperative clinical time.
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Affiliation(s)
| | | | - Petrus Pereira Gomes
- Universidade Federal do Rio Grande do Norte - UFRN, Departtment of Oral and Maxillofacial Surgery, Natal, RN, Brazil
| | - José Sandro Pereira da Silva
- Universidade Federal do Rio Grande do Norte - UFRN, Departtment of Oral and Maxillofacial Surgery, Natal, RN, Brazil
| | - Adriano Rocha Germano
- Universidade Federal do Rio Grande do Norte - UFRN, Departtment of Oral and Maxillofacial Surgery, Natal, RN, Brazil
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Santos JGL, Montezuma T, Perez CS, Sverzut CE, Trivellato AE, Guirro ECDO. Body postural realignment in the first 2 months after orthognathic surgery. Am J Orthod Dentofacial Orthop 2021; 159:e281-e290. [PMID: 33487498 DOI: 10.1016/j.ajodo.2020.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 08/01/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study aimed to assess the static posture in patients with Angle Class II and III malocclusions in the first 2 months after orthognathic surgery. METHODS This was a longitudinal observational study. Eligible participants were adult patients who had an indication of orthognathic surgery (bilateral sagittal split osteotomy of the maxilla and/or mandible, can be associated or not with genioplasty). Thirty-five patients were evaluated from the orthognathic surgery group (OSG) and control group (CG). Measurements in OSG were performed at 3 time points: preoperative orthognathic surgery (P0), first postoperative month (P1), and second postoperative month (P2). Static posture was evaluated using the PostureScreen Mobile (PostureCo Inc, Trinity, Fla) application in 4 views. RESULTS Patients with Angle Class II malocclusion in the OSG evidenced a tendency to a left hip translation at P1 with a significant difference at P2 in the anterior view (P = 0.052). In the right lateral view, patients with Angle Class II malocclusion in the OSG at P1 presented an accentuated anterior shoulder translation when compared with CG (P <0.001). At P1, patients with Angle Class II malocclusion in the OSG showed a significant anterior knee translation compared with the CG and OSG at P0 and P2 (P <0.001 for all). Patients in the OSG with Angle Class III malocclusion presented an average posterior head translation in the right lateral view at P1 when compared with those in the CG and OSG at P0, who presented an anterior translation (P = 0.0008). CONCLUSIONS These findings suggest a realignment of static posture in the first 2 months after orthognathic surgery.
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Affiliation(s)
- Joselia Gomes Lima Santos
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thais Montezuma
- Postgraduate Program in Rehabilitation and Functional Performance, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Carla Silva Perez
- Postgraduate Program in Rehabilitation and Functional Performance, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Cassio Edvard Sverzut
- Department of Buccomaxillofacial Surgery, Traumatology, and Periodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Elias Trivellato
- Department of Buccomaxillofacial Surgery, Traumatology, and Periodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Yang HJ, Kwon IJ, Almansoori AA, Son Y, Kim B, Kim SM, Lee JH. Effects of Chewing Exerciser on the Recovery of Masticatory Function Recovery after Orthognathic Surgery: A Single-Center Randomized Clinical Trial, a Preliminary Study. ACTA ACUST UNITED AC 2020; 56:medicina56090483. [PMID: 32971764 PMCID: PMC7559154 DOI: 10.3390/medicina56090483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/10/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The aim of this study was to evaluate the effects of the chewing exerciser (CE) on the functional recovery of the masticatory muscles after orthognathic surgery. Material and Methods: This randomized clinical trial was conducted in patients undergoing bimaxillary orthognathic surgery including bilateral sagittal split ramus osteotomy. Postoperative physiotherapy (PT) was performed for 3 weeks starting 3 weeks after the surgery. The patients were randomly divided into two groups: control (Con) (conventional PT) group and CE group (use of CE in addition to conventional PT). The masticatory function was evaluated based on three standards: bite force (BF), amount of mouth opening (MO), and surface electromyography (sEMG) of the anterior temporal muscle (TA), masseter muscle (MM), sternocleidomastoid muscle, and anterior belly of digastric muscle before, 3 weeks (before PT) and 6 weeks after the surgery (after PT). Results: Finally, 22 subjects participated in this study: 10 patients for Con group and 12 patients for CE group. In both groups, the BF, which was reduced significantly after the surgery, recovered after the PT similar to that before the surgery. In both groups, the MO was also significantly reduced by the surgery. However, it did not recover as much, as it was before the surgery after applying the PT. There was no difference in BF and MO between the two groups. All muscles did not show significant changes in sEMG by surgery and PT at both resting and clenching states. Conclusion: Applying CE as a PT after orthognathic surgery did not cause any harmful side effects. In both groups, the weakened muscle activity after orthognathic surgery (OGS) was adequately restored 6 weeks after the surgery. However, CE did not offer a statistically significant benefit to the masticatory function in the recovery process after OGS.
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Affiliation(s)
- Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.J.Y.); (I.J.K.); (A.A.A.); (S.-M.K.)
- Orthognathic Surgery Center, Seoul National University Dental Hospital, Seoul 03080, Korea
| | - Ik Jae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.J.Y.); (I.J.K.); (A.A.A.); (S.-M.K.)
| | - Akram Abdo Almansoori
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.J.Y.); (I.J.K.); (A.A.A.); (S.-M.K.)
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (Y.S.); (B.K.)
| | - Yoojung Son
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (Y.S.); (B.K.)
| | - Bongju Kim
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (Y.S.); (B.K.)
| | - Soung-Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.J.Y.); (I.J.K.); (A.A.A.); (S.-M.K.)
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.J.Y.); (I.J.K.); (A.A.A.); (S.-M.K.)
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (Y.S.); (B.K.)
- Correspondence: ; Tel.: +82-2-2072-2630 or +82-2-766-4948
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Chou PY, Denadai R, Yao CF, Chen YA, Chang CS, Lin CCH, Liao YF, Liou EJW, Ko EWC, Lo LJ, Huang CS, Chen YR. History and Evolution of Orthognathic Surgery at Chang Gung Craniofacial Center: Lessons Learned From 35-Year Experience. Ann Plast Surg 2020; 84:S60-S68. [PMID: 31833889 DOI: 10.1097/sap.0000000000002179] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Modern orthognathic surgery (OGS) was established on the basis of contributions from multidisciplinary centers worldwide. This study reports the history and evolution of OGS at the Chang Gung Craniofacial Center (CGCC) and identifies the lessons learned from 35 years of experience. METHODS The total number of OGS procedures managed by the CGCC multidisciplinary team between 1981 and 2016 was determined. The database of the senior author (Y.-R.C.) was reviewed for consecutive OGS procedures performed between 2003 and 2016. A literature review was also performed to retrieve the contributions from the total CGCC team. RESULTS The 35 years of experience at a single center and 13-year experience of a single surgeon corresponded to 8073 and 2883 OGS procedures, respectively. Moreover, 53 peer-reviewed articles were reviewed. Teamwork (plastic surgeons, orthodontists, and anesthetists) ensured an optimal balance between occlusion functional and facial aesthetic outcomes, with patient safety ensured and a minimum of OGS-related complications. Progression from the conventional orthodontics-first approach to the surgery-first OGS approach decreased the overall treatment time. Transition from 1-jaw to 2-jaw surgery enabled more consistent aesthetic outcomes to be achieved. Conversion from the 2-splint to the single-splint technique enabled development of a more precise tridimensional simulation plan and surgical execution, including in challenging scenarios such as malocclusion associated with facial asymmetry. Clockwise pitch rotation of the maxillomandibular complex has been designed for facial aesthetic purposes in class III malocclusion, whereas counterclockwise pitch rotation of the maxillomandibular complex improves airway function in those with sleep apnea. CONCLUSIONS The lessons learned from experience and outcome-based articles reveal that OGS has successfully evolved at the CGCC, with a balance being achieved between functional and aesthetic outcomes and effective decreases in the burden of care (ie, morbidity, complications, and treatment time).
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Affiliation(s)
- Pang-Yun Chou
- From the Plastic and Reconstructive Surgery, and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
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15
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Kim KA, Park HS, Lee SY, Kim SJ, Baek SH, Ahn HW. Short-term changes in muscle activity and jaw movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry. Korean J Orthod 2019; 49:254-264. [PMID: 31367580 PMCID: PMC6658898 DOI: 10.4041/kjod.2019.49.4.254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/27/2019] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
Objective To evaluate the short-term changes in masticatory muscle activity and mandibular movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry. Methods Twenty-seven skeletal Class III adult patients were divided into two groups based on the degree of facial asymmetry: the experimental group (n = 17 [11 male and 6 female]; menton deviation ≥ 4 mm) and control group (n = 10 [4 male and 6 female]; menton deviation < 1.6 mm). Cephalography, electromyography (EMG) for the anterior temporalis (TA) and masseter muscles (MM), and mandibular movement (range of motion [ROM] and average chewing pattern [ACP]) were evaluated before (T0) and 7 to 8 months (T1) after the surgery. Results There were no significant postoperative changes in the EMG potentials of the TA and MM in both groups, except in the anterior cotton roll biting test, in which the masticatory muscle activity had changed into an MM-dominant pattern postoperatively in both groups. In the experimental group, the amount of maximum opening, protrusion, and lateral excursion to the non-deviated side were significantly decreased. The turning point tended to be shorter and significantly moved medially during chewing in the non-deviated side in the experimental group. Conclusions In skeletal Class III patients with facial asymmetry, the EMG activity characteristics recovered to presurgical levels within 7 to 8 months after the surgery. Correction of the asymmetry caused limitation in jaw movement in terms of both ROM and ACP on the non-deviated side.
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Affiliation(s)
- Kyung-A Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Hong-Sik Park
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Soo-Yeon Lee
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Seung-Hak Baek
- Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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16
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Song YL, Yap AUJ. Impact of pain-related temporomandibular disorders on jaw functional limitation, psychological distress and quality of life in postoperative class III East Asian patients. Clin Oral Investig 2019; 24:953-961. [DOI: 10.1007/s00784-019-02994-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
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17
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Prado DGDA, Berretin-Felix G, Migliorucci RR, Bueno MDRS, Rosa RR, Polizel M, Teixeira IF, Gavião MBD. Effects of orofacial myofunctional therapy on masticatory function in individuals submitted to orthognathic surgery: a randomized trial. J Appl Oral Sci 2018; 26:e20170164. [PMID: 29412368 PMCID: PMC5777416 DOI: 10.1590/1678-7757-2017-0164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 04/20/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives The esthetic and functional results of orthognathic surgery of severe dentofacial deformities are predictable, however there are differences regarding the effects on stomatognathic system. The aim was to investigate the effects of orofacial myofunctional therapy (OMT) on the masticatory function in individuals with dentofacial deformity submitted to orthognathic surgery (OGS). Material and Methods Forty-eight individuals (18-40 years) were evaluated, 14 undergoing OMT (treated group-TG), 10 without this treatment (untreated group-UTG) and 24 in a control group with normal occlusion; for clinical aspects the data of an individual was missed (n=46). Chewing was performed using the Expanded protocol of orofacial myofunctional evaluation with scores (OMES-E). Muscle tone and mobility were also analyzed before (P0), three (P1) and six months (P2) after OGS. Surface electromyography of the masseter and temporalis muscles was performed, considering the parameters amplitude and duration of act and cycle, and the number of masticatory cycles. The OMT consisted of ten therapeutic sessions along the postoperative period. The results were compared using parametric and non-parametric tests. Results TG showed higher scores in P1 and P2 than P0; for the masticatory type the scores in P2 were significantly higher than P0. In addition, the proportion of individuals with adequate tone of lower lip and adequate tongue mobility for TG increased significantly from P1 and P2 in relation to P0. The EMG results showed a decrease in act and cycle duration in P2 in relation to P0 and P1 for the TG; furthermore the values were close to controls. An increase in the number of cycles from P0 to P2 was also observed, indicating faster chewing, which may be attributed to an improvement of balanced occlusion associated with OMT. Conclusion There were positive effects of OMT on the clinical and electromyography aspects of chewing in individual submitted to orthognathic surgery.
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Affiliation(s)
- Daniela Galvão de Almeida Prado
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Ciências Fisiológicas, Piracicaba, SP, Brasil
| | - Giédre Berretin-Felix
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Fonoaudiologia, Bauru, SP, Brasil
| | | | | | - Raquel Rodrigues Rosa
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Fonoaudiologia, Bauru, SP, Brasil
| | | | - Isadora Ferraz Teixeira
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Piracicaba, SP, Brasil
| | - Maria Beatriz Duarte Gavião
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Infantil, Piracicaba, SP, Brasil
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18
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Nishi SE, Basri R, Alam MK, Komatsu S, Komori A, Sugita Y, Maeda H. Evaluation of Masticatory Muscles Function in Different Malocclusion Cases Using Surface Electromyography. J HARD TISSUE BIOL 2017. [DOI: 10.2485/jhtb.26.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Rehana Basri
- Craniofacial Biology, School of Dental Science, Universiti Sains Malaysia
| | | | - Shinichi Komatsu
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Atsuo Komori
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Yoshihiko Sugita
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
- Center of Advanced Oral Science, Aichi Gakuin University
| | - Hatsuhiko Maeda
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
- Center of Advanced Oral Science, Aichi Gakuin University
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19
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Silva APD, Sassi FC, Andrade CRFD. Oral-motor and electromyographic characterization of patients submitted to open a nd closed reductions of mandibular condyle fracture. Codas 2016; 28:558-566. [PMID: 27812671 DOI: 10.1590/2317-1782/20162015186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/08/2015] [Indexed: 11/21/2022] Open
Abstract
Purpose To characterize the oral-motor system of adults with mandibular condyle facture comparing the performance of individuals submitted to open reduction with internal fixation (ORIF) and closed reduction with mandibulomaxillary fixation (CRMMF). Methods Study participants were 26 adults divided into three groups: G1 - eight individuals submitted to ORIF for correction of condyle fracture; G2 - nine individuals submitted to CRMMF for correction of condyle fracture; CG - nine healthy volunteers with no alterations of the orofacial myofunctional system. All participants underwent the same clinical protocol: assessment of the orofacial myofunctional system; evaluation of the mandibular range of motion; and surface electromyography (sEMG) of the masticatory muscles. Results Results indicated that patients with condyle fractures from both groups presented significant differences compared with those from the control group in terms of mobility of the oral-motor organs, mastication, and deglutition. Regarding the measures obtained for mandibular movements, participants with facial fractures from both groups showed significant differences compared with those from the control group, indicating greater restrictions in mandibular motion. As for the analysis of sEMG results, G1 patients presented more symmetrical masseter activation during the task of maximal voluntary teeth clenching. Conclusion Patients with mandibular condyle fractures present significant deficits in posture, mobility, and function of the oral-motor system. The type of medical treatment does not influence the results of muscle function during the first six months after fracture reduction. Individuals submitted to ORIF of the condyle fracture present more symmetrical activation of the masseter muscle.
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Zaretsky E, Pluschinski P, Sader R, Birkholz P, Neuschaefer-Rube C, Hey C. Identification of the most significant electrode positions in electromyographic evaluation of swallowing-related movements in humans. Eur Arch Otorhinolaryngol 2016; 274:989-995. [PMID: 27581722 DOI: 10.1007/s00405-016-4288-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/26/2016] [Indexed: 12/11/2022]
Abstract
Surface electromyography (sEMG) is a well-established procedure for recording swallowing-related muscle activities. Because the use of a large number of sEMG channels is time consuming and technically sophisticated, the aim of this study was to identify the most significant electrode positions associated with oropharyngeal swallowing activities. Healthy subjects (N = 16) were tested with a total of 42 channels placed in M. masseter, M. orbicularis oris, submental and paralaryngeal regions. Each test subject swallowed 10 ml of water five times. After having identified 16 optimal electrode positions, that is, positions with the strongest signals quantified by the highest integral values, differences to 26 other ones were determined by a Mann-Whitney U test. Kruskal-Wallis H test was utilized for the analysis of differences between single subjects, subject subgroups, and single electrode positions. Factors associated with sEMG signals were examined in a linear regression. Sixteen electrode positions were chosen by a simple ranking of integral values. These positions delivered significantly higher signals than the other 26 positions. Differences between single electrode positions and between test subjects were also significant. Sixteen most significant positions were identified which represent swallowing-related muscle potentials in healthy subjects.
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Affiliation(s)
- E Zaretsky
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Marburg, Baldingerstr. 1, 35032, Marburg, Germany
| | - P Pluschinski
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Marburg, Baldingerstr. 1, 35032, Marburg, Germany
| | - R Sader
- Center of Surgery, Clinic for Oral, Dental and Cosmetic Facial Surgery, University Hospital of Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - P Birkholz
- Institute for Acoustics and Speech Communication, Faculty for Electrical Engineering and Information Technology, Technische Universität Dresden, Helmholtzstr. 10, 01069, Dresden, Germany
| | - C Neuschaefer-Rube
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Christiane Hey
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Marburg, Baldingerstr. 1, 35032, Marburg, Germany.
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Wen-Ching Ko E, Alazizi AI, Lin CH. Three-Dimensional Surgical Changes of Mandibular Proximal Segments Affect Outcome of Jaw Motion Analysis. J Oral Maxillofac Surg 2015; 73:971-84. [DOI: 10.1016/j.joms.2014.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 11/14/2014] [Accepted: 11/17/2014] [Indexed: 11/29/2022]
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