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Pascu L, Haiduc RS, Almășan O, Leucuța DC. Occlusion and Temporomandibular Disorders: A Scoping Review. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:791. [PMID: 40428749 DOI: 10.3390/medicina61050791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2025] [Revised: 04/04/2025] [Accepted: 04/21/2025] [Indexed: 05/29/2025]
Abstract
Background and Objectives: The occlusal-temporomandibular disorder (TMD) relation is a contentious issue in dentistry to date. This scoping review's purpose was to map the existing literature on occlusal abnormalities and their potential role in the development and progression of TMD. Materials and Methods: A search in PubMed, Scopus, Cochrane Library, Embase, Lippincott, Medknow, and ClinicalKey was conducted. Articles researching the relationship between TMD and occlusion have been selected. A narrative data synthesis was conducted to chart and summarize the main findings from the included studies. Results: A total of 29 articles were included in this review. These studies confirm that angle class II and angle class III malocclusions, deep bite, and crossbite have a high prevalence of symptoms of TMD, including mandibular deviation, arthritic pain, and tenderness of the muscles. Malocclusion, edentulous spaces, and a reduced vertical dimension of occlusion (VDO) also contribute to the severity of TMD, most prominently in older adults. TMD is also seen with high prevalence in females, with a female-to-male ratio of 2:1 to 20:1, according to studies. Bruxism, premature occlusal contacts, and occlusal interferences also contribute towards symptoms of TMD, in agreement with multiple facets of the disorder. Conclusions: Occlusal abnormalities have a significant association with TMD, but causality cannot be established with most observational studies. This review emphasizes the need for early occlusal examination and intervention to reduce TMD risk.
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Affiliation(s)
- Laurențiu Pascu
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Raul-Samuel Haiduc
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
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Kakkar S, Tripathi T, Rai P, Veena GV, Singh D. Comparison of Peri-Oral and Masticatory Muscle Activity between Repaired Unilateral Cleft Lip and Palate and Non-Cleft Individuals - A Systematic Review. Indian J Dent Res 2024; 35:478-485. [PMID: 39935200 DOI: 10.4103/ijdr.ijdr_157_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 09/11/2024] [Indexed: 02/13/2025] Open
Abstract
Surgical intervention in patients with repaired unilateral cleft lip and palate (UCLP) leads to altered muscular activity and hinders the normal growth of the maxilla. To compare the activity of superior orbicularis oris and masticatory muscles between repaired unilateral cleft lip and palate and non-cleft individuals. A literature search was carried out on MEDLINE/PubMed, Cochrane Library, Science Direct, Semantic Scholar, and Google Scholar databases upto January 2024 resulting in 1320 studies. Specified inclusion/exclusion criteria guided the selection of five relevant articles. Study selection, assessment of the outcome of articles, and subsequent Risk of Bias (RoB) assessment were done independently by three authors. In case of any disparity, the fourth and fifth authors were consulted. All five studies were observational cross-sectional studies. The majority of the studies reported an altered muscular activity in repaired UCLP patients compared to normal individuals, which may affect the normal growth of the maxilla. Patients with repaired UCLP show an increased muscle activity compared to non-cleft subjects, which may lead to altered masticatory efficiency in such patients.
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Affiliation(s)
- Saumya Kakkar
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Nunes GP, Morabito MJSD, Nunes LP, Capalbo LC, Prado AHDR, de Toledo PTA, Ferreira MF, Silva ANA, Martins TP, Colombo NH, Ferrisse TM. Exploring the potential of rapid maxillary expansion and masticatory muscle activity in unilateral posterior crossbite. J Clin Exp Dent 2024; 16:e755-e771. [PMID: 39183996 PMCID: PMC11345080 DOI: 10.4317/jced.61604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 08/27/2024] Open
Abstract
Background This systematic review and meta-analysis aimed to evaluate if rapid maxillary expansion improves the activity of the masticatory muscles (masseter and temporal) in patients with unilateral posterior crossbite. Material and Methods Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and grey literature. A manual search of orthodontic journals was also performed. Randomized clinical trials or longitudinal prospective studies were eligibles. Meta-analyses were conducted using R software with the "Meta" package, applying mean differences with a 95% confidence interval. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was evaluated using GRADE. Results Nine articles were included. Qualitative analysis showed that RME treatment in patients with unilateral posterior crossbite showed a positive correlation with improvement in masseter and temporalis muscle activity. Meta-analyses indicated a significant difference for all models of muscle activity after treatment with rapid maxillary expansion, except for the temporal muscle in the force exerted on the maximum voluntary clenching on cotton rolls. The studies showed low bias risk, and the evidence certainty for each analysis was generally low to very low. Conclusions This investigation demonstrated the benefits of R rapid maxillary expansion in treating unilateral posterior crossbite and its potential therapeutic effects on the masticatory muscles. Key words:Rapid maxillary expansion, masticatory muscles, unilateral posterior crossbite, systematic review, meta-analysis.
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Affiliation(s)
- Gabriel-Pereira Nunes
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- Laboratory for Bone Metabolism and Regeneration, University of Porto, Faculty of Dental Medicine, Porto, Portugal
| | | | - Larissa-Pereira Nunes
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Letícia-Cabrera Capalbo
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
| | - Alexandre-Henrique-Dos Reis Prado
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Brazil
| | - Priscila-Toninatto-Alves de Toledo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Mayra-Fernanda Ferreira
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- Laboratory for Bone Metabolism and Regeneration, University of Porto, Faculty of Dental Medicine, Porto, Portugal
| | - Arles-Naisa-Amaral Silva
- Oral Medicine, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, (UNESP), Araraquara, São Paulo, Brazil
| | - Tamires-Passadori Martins
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Natália-Helena Colombo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Túlio-Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, (UNESP), Araraquara, São Paulo, Brazil
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Kulchutisin P, Sowithayasakul T, Pumklin J, Piyapattamin T. Electromyographic Evaluations of Masticatory Muscle Activity between Patients with Skeletal Class I and III Relationships. Eur J Dent 2023; 17:910-916. [PMID: 36513336 PMCID: PMC10569853 DOI: 10.1055/s-0042-1758064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the muscle activity of the masseter muscle (MM) and anterior temporal muscle (TA) of patients with skeletal Class I and III during maximum voluntary clenching (MVC) at the intercuspal position (ICP) and during chewing. MATERIALS AND METHODS Twenty patients were divided into Steiner's skeletal Class I and III groups. MM and TA activity during each task was measured by using surface electromyography. Averaged MM and TA activity during both tasks, symmetry of each muscle activity, synergy between ipsilateral MMs and TAs, and muscle effort were compared. STATISTICAL ANALYSIS Means and standard deviations of intergroup variables were compared by an independent sample t-test for parametric evaluations or by the Mann-Whitney U test for nonparametric evaluations. A probability value of p less than 0.05 was considered significant. RESULTS Averaged MM activity and muscle synergy during MVC at the ICP in skeletal Class III patients were lower than that in skeletal Class I patients. Neither symmetry nor muscle effort during both tasks was different. CONCLUSION Masticatory muscle performance of skeletal Class III patients was inferior to that of skeletal Class I patients.
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Affiliation(s)
- Pakwan Kulchutisin
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thanaporn Sowithayasakul
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Jittima Pumklin
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thosapol Piyapattamin
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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Li CX, Xie X, Li M, Gong ZC, Nie J, Liu X, Jumatai S. A pilot investigation of condylar position and asymmetry in patients with unilateral posterior scissors-bite malocclusion based on three-dimensional reconstructive imaging technique. BMC Musculoskelet Disord 2023; 24:253. [PMID: 37005598 PMCID: PMC10067181 DOI: 10.1186/s12891-023-06384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE Unilateral posterior scissors-bite (uPSB) malocclusion is common clinically. This study aimed to investigate the condylar morphological alterations and condyle-fossa relationship in patients with uPSB, through cone beam computed tomography (CBCT) and three-dimensional reconstructive imaging technique. METHODS A retrospective study was designed to comparatively analyze 95 patients with uPSB between July 2016 and December 2021. They were divided into three subgroups: 12 to 20, 21 to 30, and ≥ 31 years, according the age distribution. The morphological parameters regarding condyle, fossa, and joint space after three-dimensional reconstruction were measured and analyzed by a series of digital software. SPSS 26.0 software package was performed for statistical analysis on data sets, using paired t-test, one-way analysis of variance, Wilcoxon signed-rank sun test, Kruskal-Wallis H test, and Bonferroni correction. RESULTS The condylar volume (CV) of scissors-bite side was greater than that of the non-scissors-bite side (CV A = 1740.68 ± 559.80 mm3 > CV N = 1662.25 ± 524.88 mm3, P = 0.027). So was the condylar superficial area (CSA) (CSA A = 818.71 ± 186.82 mm2 > CSA N = 792.63 ± 173.44 mm2, P = 0.030), and the superior joint space (SJS) [SJS A = 2.46 (1.61, 3.68) mm) > SJS N = 2.01 (1.55, 2.87) mm), P = 0.018], and the anterior joint space (AJS) (AJS A = 3.94 ± 1.46 mm > AJS N = 3.57 ± 1.30 mm, P = 0.017). The constituent ratios of the different parts of the bilateral condyles were 23% on the posterior slope, 21% on the top, 20% on the anterior slope, 19% on the lateral slope and 17% on the medial slope, respectively. CONCLUSION Due to long-term abnormal occlusion of uPSB, the pathological bite force in temporomandibular joint would cause changes in the shape of the condyle. Among them, CV, CSA, SJS and AJS had significant changes in the scissors-bite status, which has the greatest damage to the posterior slope of the condyloid process.
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Affiliation(s)
- Chen-Xi Li
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, P.R. China.
| | - Xin Xie
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China
| | - Mengjia Li
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China
| | - Zhong-Cheng Gong
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China.
| | - Jing Nie
- Department of Orthodontics, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Xu Liu
- Department of Maxillofacial Surgery, Hospital of Stomatology, Key Laboratory of Dental-Maxillofacial Reconstruction and Biological Intelligence Manufacturing of Gansu Province, Faculty of Dentistry, Lanzhou University, Lanzhou, 730013, P.R. China
| | - Sakendeke Jumatai
- Department of Oral and Maxillofacial Radiology, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, China
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Ghadirian H, Khami MR, Tabatabaei SN, mirhashemi AH, Bahrami R. COVID-19 vaccination and psychological status of Iranian dental students. Front Public Health 2022; 10:946408. [PMID: 36187676 PMCID: PMC9524372 DOI: 10.3389/fpubh.2022.946408] [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: 05/18/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
Objective The purpose of the present study was to investigate the association of COVID-19 vaccination with the quality and quantity of sleep, the level of stress, and temporomandibular joint (TMJ) disorders (TMDs) in Iranian dental students. Materials and methods In this cross-sectional research, we applied a questionnaire including 30 questions on the Perceived Stress Scale (PSS), sleep quality and quantity, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and vaccination status. All vaccinated students of the dental schools located in the city of Tehran were invited to participate in the study. Participants were divided into three groups: those vaccinated for less than a month, those vaccinated for 1-3 months, and those vaccinated for more than 3 months. A paired t-test served for statistical analysis. Results Overall, 171 out of 235 students (72.77%) completed the questionnaire, among which 90 individuals were fully vaccinated, and were included in the data analysis. Stress levels decreased (mean difference = -1.23, p-value = 0.002) and sleep quality and quantity improved mostly 1-3 months after the vaccination (mean difference = -0.5, p-value = 0.016). However, TMD symptoms were mostly alleviated in people vaccinated for more than 3 months (mean difference = -2.86, p-value <0.05). In this respect, no significant difference was observed between the two genders. Conclusion According to the results of the study, vaccination was associated with the improvement of psychological consequences of the COVID-19 pandemic. It is recommended that further longitudinal studies be conducted on larger sample sizes and different age groups by using various data collection methods (especially regarding the assessment of TMD).
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Affiliation(s)
- Hannaneh Ghadirian
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Khami
- Research Center for Caries Prevention, Dentistry Research Institute, Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Hossein mirhashemi
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rashin Bahrami
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,*Correspondence: Rashin Bahrami
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Evaluation of Electromyographic Activity of Masticatory Muscles in Adults with Posterior Crossbite. Int J Dent 2022; 2022:4552674. [PMID: 35313630 PMCID: PMC8934209 DOI: 10.1155/2022/4552674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/09/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction There is evidence that patients with posterior crossbite (PXB) have neuromuscular changes in the masticatory muscles. However, up to the present time, the relationship among these changes on the electromyographic activity of the masticatory muscles is still unclear. Objective To systematic review the available literature on the electromyographic activity of masticatory muscles in adults with PXB. Methods Between August 22 and September 9, 2020, we searched the following seven electronic databases: PubMed, EMBASE, Web of Science, Cochrane Library, SciELO, LILACS, and Scopus. No restrictions were applied regarding the language and year of publication. This systematic review was registered in the Prospective Register of Systematic Reviews (PROSPERO - CRD42020205057) database and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. After data selection and extraction, the methodological quality of the selected studies was conducted independently by two reviewers, using two different evaluation tools. Results 6957 records were initially located after the search process. In the end, eight papers were selected. Most studies were classified as having average to low methodological quality and moderate to high risk of bias. Based on the available evidence, adult patients with PXB have electromyographic activity changes in the masticatory muscles when compared with individuals without PXB. Moreover, adult patients with unilateral posterior crossbite (UPXB) have asymmetrical electromyographic activity when the crossbite side is compared with the noncrossbite side. Conclusion Despite the lack of studies with high methodological quality, electromyographic evaluation of masticatory muscles should be considered in the diagnosis and in the orthodontic treatment plan of patients with PXB. Prospective studies with a higher sample size and follow-up time, conducted using a rigorous scientific methodology, are necessary to reach a more reliable conclusion.
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Cone beam computed tomographic evaluation of the changes in condylar position in growing patients with unilateral posterior crossbite undergoing rapid maxillary expansion followed by fixed orthodontic therapy. Eur Arch Paediatr Dent 2021; 22:959-967. [PMID: 33950475 DOI: 10.1007/s40368-021-00628-z] [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: 02/01/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed at assessing changes in condylar position (CP) in growing patients with unilateral posterior crossbite (UPC) undergoing rapid maxillary expansion (RME) followed by fixed orthodontic treatment (FOT) (experimental-group); and growing patients without posterior crossbite (PC) treated with FOT alone (control-group). METHODS Cone beam computed tomography (CBCT) images were obtained before treatment (T0), 6 months after RME (T1) and after FOT (T2) for the experimental-group (n = 19); and at T0 and T2 for the control-group (n = 22). Condylar position-related measurements including the anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), lateral position of condyle (LC) and condylar angle (CA) were measured. Non-parametric tests were used. RESULTS On the crossbite side, significant increases were found in LC (P = 0.039) and CA (P = 0.007), and on the non-crossbite side significant increases were observed in SJS (P = 0.027) and LC (P = 0.001) between T0, T1 and T2 in patients with UPC. On the right and left sides in the control-group, significant increases were identified in LC (P < 0.001 and P = 0.012, respectively) between T0 and T2. CONCLUSIONS In growing patients with UPC, RME followed by FOT is associated with significant changes in CP-related measurements.
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Dinsdale A, Liang Z, Thomas L, Treleaven J. Is jaw muscle activity impaired in adults with persistent temporomandibular disorders? A systematic review and meta-analysis. J Oral Rehabil 2021; 48:487-516. [PMID: 33369753 DOI: 10.1111/joor.13139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022]
Abstract
Understanding jaw muscle activity changes in temporomandibular disorders (TMD) is crucial to guide clinical management. The nature of these changes is currently unclear. Explore changes in jaw muscle activity in TMD. Electronic databases (PubMed, EMBASE, CINAHL, Scopus, Web of Science, Cochrane) and bibliographies were searched from inception to 9 July 2020 for eligible studies, including grey literature. Case-control and interventional studies reporting time-domain and frequency-domain electromyographic measures of jaw muscle activity in TMD and control groups were included. SIGN checklist for case-control studies was used to evaluate risk of bias. Results were pooled for meta-analysis using random-effects model. Confidence in cumulative evidence was established using American Academy of Neurology guidelines. Forty-five studies were included. Most were rated moderate risk of bias. Activity of four muscles (masseter, temporalis, lateral pterygoid, suprahyoids) was assessed across six domains (resting, clenching, chewing, swallowing, concentrating, resisted mandibular movements), with partial meta-analysis scope. Masseter and temporalis activity were significantly higher at rest (P = .05, P < .0001), but lower during brief maximal clenching (P = .005, P = .04) in TMD vs controls. Insufficient data precluded meta-analysis of remaining outcomes and subgroup analysis. Confidence in cumulative evidence ranged from moderate to very low. Changes in jaw muscle activity exist in TMD, which are both task-specific and muscle-specific. It remains unclear whether jaw muscle activity changes vary between TMD subgroups. Muscle function should be considered in clinical management of TMD. Insufficient subgroup data highlight future direction for research.
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Affiliation(s)
| | - Zhiqi Liang
- The University of Queensland, St Lucia, QLD, Australia
| | - Lucy Thomas
- The University of Queensland, St Lucia, QLD, Australia
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Diagnosis of Temporomandibular Disorders Using Thermovision Imaging. Pain Res Manag 2020; 2020:5481365. [PMID: 33282037 PMCID: PMC7685803 DOI: 10.1155/2020/5481365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022]
Abstract
Temporomandibular joint dysfunction (TMD) is a chronic disease of various etiologies. Correct TMD diagnosis enables to apply effective treatment and significantly improves the quality of patients' lives. One of the diagnostic methods subjected to evaluation in recent years is thermography, which enables safe, noninvasive, and quick imaging of the temperature distribution of temporomandibular joint-associated tissues. This paper, based on Medline, Dentistry & Oral Sciences Source, Academic Search Ultimate, Medline Complete databases, presents basic information related to thermovision imaging and outlines the direction of research conducted in recent years which fight with difficulties in the interpretation of thermograms that require specialized, dedicated analysis and processing of the obtained images. The problem concerns also no standardized protocol for measuring masticatory muscle temperature.
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Pelai EB, Foltran-Mescollotto F, de Castro-Carletti EM, de Moraes M, Rodrigues-Bigaton D. Comparison of the pattern of activation of the masticatory muscles among individuals with and without TMD: A systematic review. Cranio 2020; 41:102-111. [PMID: 33073743 DOI: 10.1080/08869634.2020.1831836] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To verify the characteristics of the electromyographic signal of masticatory muscles in individuals with TMD and asymptomatic individuals. METHODS A systematic review was carried out, selecting cross-sectional studies with at least one electromyographic parameter (FM; iEMG; RMS) of the masticatory muscles (anterior temporal, bilateral masseter, and suprahyoid muscles) of individuals with TMD compared to asymptomatic individuals. RESULTS This review identified 1656 titles, of which 30 articles were included in the final analysis. It was observed that the data referring to the pattern of activation of masticatory muscles in the rest, isometry, and isotonic conditions of individuals with TMD are heterogeneous. This fact may be related to variability in the methods and analyses applied in the studies. CONCLUSION Data referring to the pattern of activation of masticatory muscles in the rest and isometry conditions and in the mastication cycle of individuals with TMD and asymptomatic individuals are diverse.
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Affiliation(s)
- Elisa Bizetti Pelai
- Post-Graduate Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
| | - Fabiana Foltran-Mescollotto
- Graduate Program in Human Movement Sciences, Methodist University of Piracicaba - UNIMEP, Piracicaba, Brazil
| | | | - Marcio de Moraes
- Post-Graduate Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
| | - Delaine Rodrigues-Bigaton
- Post-Graduate Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
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Assessment of Masticatory Muscle Function in Patients with Bilateral Complete Cleft Lip and Palate and Posterior Crossbite by means of Electromyography. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8828006. [PMID: 32908658 PMCID: PMC7474777 DOI: 10.1155/2020/8828006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to evaluate the electrical activity of the masticatory muscles in children with a bilateral complete cleft lip and palate (BCCLP) and posterior crossbite as well as in noncleft subjects with no malocclusion. Another purpose of the study was to examine the possible factors associated with this muscle activity. Methods The study included 52 children with mixed dentition and Class I occlusions (20 patients with nonsyndromic BCCLP and 32 subjects with no clefts). All the cleft patients had posterior crossbite. The surface electromyography (sEMG) was used to identify the electrical potentials of the temporalis and masseter muscles. The electromyographical (EMG) recordings were taken with a DAB-Bluetooth Instrument (zebris Medical GmbH, Germany) at rest and during maximum voluntary clenching (MVC). The relationships between muscle EMG activity and independent variables were identified through multivariate logistic regression analysis. Results The EMG activity of the temporalis muscles at rest was significantly higher in BCCLP patients with malocclusion in comparison with the noncleft subjects with normal occlusion. During MVC, significantly lower electrical potentials of the temporalis and masseter muscles were observed in cleft patients compared to the noncleft group. The presence of BCCLP, unilateral posterior crossbites, increased vertical overlap, and increased overjet are factors strongly associated with higher temporalis muscle EMG activity at rest. Conclusion The use of surface electromyography in imaging muscle function showed that children with BCCLP and posterior crossbite exhibited altered masticatory muscle potentials at rest and during clenching. The presence of unilateral posterior crossbites, increased vertical overlap, and increased overjet had a significant impact on temporalis muscle activity in cleft patients. This knowledge is important in the aspect of early and proper diagnosis and orthodontic treatment of malocclusions, thereby achieving correct occlusion and improvement in muscle function.
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Nalamliang N, Sumonsiri P, Thongudomporn U. Are occlusal contact area asymmetry and masticatory muscle activity asymmetry related in adults with normal dentition? Cranio 2020; 40:409-417. [DOI: 10.1080/08869634.2020.1764270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Napat Nalamliang
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Pattra Sumonsiri
- Private Orthodontic Practice, Smile On Orthodontics & Dental Clinic, Chiang Mai, Thailand
| | - Udom Thongudomporn
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
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Spolaor F, Mason M, De Stefani A, Bruno G, Surace O, Guiotto A, Gracco A, Sawacha Z. Effects of Rapid Palatal Expansion on Chewing Biomechanics in Children with Malocclusion: A Surface Electromyography Study. SENSORS (BASEL, SWITZERLAND) 2020; 20:s20072086. [PMID: 32272810 PMCID: PMC7180919 DOI: 10.3390/s20072086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 06/11/2023]
Abstract
Malocclusion during childhood may affect both morphology and masticatory function and could greatly affect the subsequent growth and development of the jaws and face. The purpose of this study was to evaluate the efficiency of surface electromyography in describing the effects of the rapid palatal expansion (RPE) on Masseter (M) and Temporalis Anterior (T) muscles' activity in 53 children with different types of malocclusion: bilateral posterior crossbite (BPcb), underdeveloped maxillary complex without crossbite (NOcb) and unilateral posterior crossbite on the right (UPCBr) and on the left (UPCBl). The muscular activities during chewing tasks were assessed bilaterally before and after RPE application and three months after removal. Both the envelope's peak (µV) and its occurrence (% of chewing task) were extracted from the surface electromyography signal. Our results showed the presence of statistically significant differences (p < 0.05) on temporomandibular joint muscles, across different assessments, in all the tested populations of subjects. Surface electromyography demonstrated a relationship between the correction of a maxillary transverse discrepancy and the restoration of a muscle's activation patterns comparable to healthy subjects for both T and M.
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Affiliation(s)
- Fabiola Spolaor
- Department of Information Engineering, University of Padova, Via Gradenigo, 6-35121 Padua, Italy; (O.S.); (A.G.); (Z.S.)
| | - Martina Mason
- Department of Neuroscience, School of Dentistry, University of Padua, Via Giustiniani, 2-35128 Padua, Italy; (M.M.); (A.D.S.); (G.B.); (A.G.)
| | - Alberto De Stefani
- Department of Neuroscience, School of Dentistry, University of Padua, Via Giustiniani, 2-35128 Padua, Italy; (M.M.); (A.D.S.); (G.B.); (A.G.)
| | - Giovanni Bruno
- Department of Neuroscience, School of Dentistry, University of Padua, Via Giustiniani, 2-35128 Padua, Italy; (M.M.); (A.D.S.); (G.B.); (A.G.)
| | - Ottavia Surace
- Department of Information Engineering, University of Padova, Via Gradenigo, 6-35121 Padua, Italy; (O.S.); (A.G.); (Z.S.)
| | - Annamaria Guiotto
- Department of Information Engineering, University of Padova, Via Gradenigo, 6-35121 Padua, Italy; (O.S.); (A.G.); (Z.S.)
| | - Antonio Gracco
- Department of Neuroscience, School of Dentistry, University of Padua, Via Giustiniani, 2-35128 Padua, Italy; (M.M.); (A.D.S.); (G.B.); (A.G.)
| | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Via Gradenigo, 6-35121 Padua, Italy; (O.S.); (A.G.); (Z.S.)
- Department of Medicine, University of Padova, Via Giustiniani, 2-35128 Padova, Italy
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He S, Wang S, Song F, Wu S, Chen J, Chen S. Effect of the use of stabilization splint on masticatory muscle activities in TMD patients with centric relation-maximum intercuspation discrepancy and absence of anterior/lateral guidance. Cranio 2019; 39:424-432. [PMID: 31429383 DOI: 10.1080/08869634.2019.1655861] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Shushu He
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Si Wang
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Fang Song
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shu Wu
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiangyue Chen
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Szyszka-Sommerfeld L, Machoy M, Lipski M, Woźniak K. The Diagnostic Value of Electromyography in Identifying Patients With Pain-Related Temporomandibular Disorders. Front Neurol 2019; 10:180. [PMID: 30891001 PMCID: PMC6411686 DOI: 10.3389/fneur.2019.00180] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/12/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Orofacial pain disorders can be divided into several subgroups. One of them is temporomandibular disorders (TMD) with recognizable signs such as joint noises, limitations in the range of motion, or mandibular deviation during function and symptoms-pain in the muscles or joint. Surface electromyography (sEMG) is a diagnostic tool that ensures reliable and valid evaluation of muscle activity. sEMG detects electrical potentials and on this account may conceivably be employed in the TMD recognition. The aim of this study was to assess the sensitivity, specificity, and accuracy of electromyography in diagnosing subjects with temporomandibular disorders, including pain-free TMD and pain-related TMD. Methods: The sample comprised 88 patients with cleft lip and palate and mixed dentition. TMD has been recognized on the grounds of Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). To evaluate the electrical activity of the temporal and masseter muscles in the rest position and during maximum voluntary contraction, a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) was used. The analysis of the receiver operating characteristic (ROC) curve gave information about accuracy, cut-off point value, sensitivity and specificity of the normalized sEMG data. Results: The highest diagnostic efficiency of sEMG in terms of identifying subjects with TMD and pain-related TMD was observed for the mean values of temporal and masseter muscle activity as well as the Asymmetry Index of the masseter muscles in a rest position. A moderate degree of EMG accuracy in differentiating between pain-related TMD and non-TMD children was observed for the mean values of masseter muscle activity and the Asymmetry Index of the masseter muscles at rest. Conclusion: An evaluation of electromyography exhibits its diagnostic usability in recognition of patients with pain-related TMD and it could be used as an adjunctive tool in the identification of this disorder. Clinical Trial Registration: This clinical research was registered in the ClinicalTrials.gov database under the number NCT03308266.
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Affiliation(s)
| | - Monika Machoy
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
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PIMENTEL DJB, MAGRI LV, MELCHIOR MDO, MARAÑÓN-VÁSQUEZ GA, MATSUMOTO MAN, MAZZETTO MO. Rapid maxillary expansion in the treatment of the functional posterior crossbite: joint noise and electromyographic activity analysis. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.03819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction The rapid maxillary expansion (RME) reduces the risk of developing structural and functional disorders in the stomatognathic system. Objective To examine the effects of the RME as a treatment for the posterior crossbite, related with the electromyographic activity of the masticatory muscles and the TMJ noises in a population of children. Material and method 13 girls and 7 boys, regardless of the type of malocclusion, with a mean age of 9 years old (± 3), were treated with RME. The electrovibratography analyzed the TMJ noise, and the electromyography analyzed the masticatory muscles before treatment (T0) and after three months of a short-term follow-up (T1). The comparisons of the affected and unaffected sides by the crossbite were performed using Mann-Whitney’s test, and to compare data before and after treatment the Wilcoxon’s test was used (level of significance: 5%). Result No significant differences were found in the parameters of joint noise in comparison to the sides affected and unaffected by the crossbite, in both T0 and T1 (p>0.05); only the side without the crossbite observed decrease in the peak amplitude of the joint noises after treatment. In the static electromyographic analysis, inter-side differences were observed before and after treatment, since the deliberate unilateral chewing showed greater asymmetry activity in T0 for both sides, which has been corrected after treatment, improving the functional chewing. Conclusion The proposed treatment did not lead to the occurrence of joint noises and improved the functional pattern of electromyographic activity during chewing at the end of treatment.
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Electromyographic Analysis of Masticatory Muscles in Cleft Lip and Palate Children with Pain-Related Temporomandibular Disorders. Pain Res Manag 2018; 2018:4182843. [PMID: 29861801 PMCID: PMC5971269 DOI: 10.1155/2018/4182843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/16/2018] [Accepted: 04/12/2018] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to assess the electrical activity of temporalis and masseter muscles in children with cleft lip and palate (CLP) and pain-related temporomandibular disorders (TMD-P). Methods The sample consisted of 31 CLP patients with a TMD-P (mean age 9.5 ± 1.8 years) and 32 CLP subjects with no TMD (mean age 9.2 ± 1.7 years). The children were assessed for the presence of temporomandibular disorders (TMD) using Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the mandibular rest position and during maximum voluntary contraction (MVC). Results The rest activity of the temporalis and masseter muscles was significantly higher in TMD-P group compared with non-TMD children. A significant decrease in temporalis muscle activity during MVC was observed in TMD-P patients. There was a significant increase in the Asymmetry Index for temporalis and masseter muscle rest activity in the TMD-P group. Conclusion Cleft children diagnosed with TMD-P have altered masticatory muscle activity, and this can affect their muscle function.
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Regalo SCH, de Lima Lucas B, Díaz-Serrano KV, Frota NPR, Regalo IH, Nassar MSP, Righetti MA, Oliveira LF, Gonçalves LMN, Siéssere S, Palinkas M. Analysis of the stomatognathic system of children according orthodontic treatment needs. J Orofac Orthop 2018; 79:39-47. [PMID: 29330612 DOI: 10.1007/s00056-017-0117-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/20/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE The present study evaluated electromyographic activity (EMG), masticatory performance, and tongue strength in children without and with orthodontic treatment needs. PATIENTS AND METHODS A total of 90 children were screened and divided into the following groups: Group I (no treatment needed; mean age: 8.00 ± 0.43 years; n = 26), Group II (few malocclusions, treatment needed; mean age: 8.89 ± 0.43 years; n = 28), and Group III (slight-to-borderline treatment needed; mean age: 8.44 ± 0.22 years; n = 36). Orthodontic treatment need was classified on the basis of IOTN-DHC (Index of Orthodontic Treatment Need - Dental Health Component). The electromyographic Trigno EMG Systems was used for muscle analysis and the Iowa Oral Pressure Instrument (IOPI) was used to measure tongue strength. Data were analyzed using normality tests and one-way analysis of variance with a Bonferroni post hoc test (p ≤ 0.05). RESULTS EMG in almost all mandibular movements was higher in Group III with statistically significant differences compared to position at rest: right masseter (p = 0.03); protrusion: left temporal (p = 0.02); saliva swallowing: left temporal (p = 0.05) and water swallowing: orbicularis oris mouth, right upper segment (p = 0.05). Lower masticatory performance was found in Group III, but the difference compared to Group I and II was not significant. There were no significant differences between the groups in terms of tongue strength. CONCLUSIONS Children with borderline orthodontic treatment needs show functional disorders of the stomatognathic system.
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Affiliation(s)
- Simone Cecílio Hallak Regalo
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Bárbara de Lima Lucas
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Kranya Victoria Díaz-Serrano
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Nicolly Parente Ribeiro Frota
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Isabela Hallak Regalo
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Mariângela Salles Pereira Nassar
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Mariah Acioli Righetti
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Lígia Franco Oliveira
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Lígia Maria Napolitano Gonçalves
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Selma Siéssere
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Marcelo Palinkas
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n-Ribeirão Preto, 14040-904, São Paulo, Brazil.
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Iodice G, Danzi G, Cimino R, Paduano S, Michelotti A. Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review. Eur J Orthod 2016; 38:638-651. [DOI: 10.1093/ejo/cjw003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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