Volume changes in human masticatory muscles between jaw closing and opening

Quantitative analysis of masticatory muscle changes by Eichner index using diffusion-weighted imaging

OBJECTIVES

Diffusion-weighted imaging (DWI) provides quantitative functional information about the microscopic movement of water at the cellular level. However, few reports have quantitatively evaluated histological changes in masticatory muscles due to changes in occlusal relationships using DWI. This study aimed to assess the changes in masticatory muscles by Eichner index using DWI.

METHODS

We analyzed magnetic resonance imaging (MRI) studies of 201 patients from November 2017 to April 2018. Each Eichner index group, age, and sex were used as criterion variables, and the average apparent diffusion coefficient (ADC) values of the masticatory muscles were the explanatory variable. The mean ADC value differences were analyzed in each Eichner index group. We analyzed the data using the Kruskal-Wallis test and post hoc Mann-Whitney test with Bonferroni adjustment multiple regression analysis with Shapiro-Wilk test and Spearman's correlation coefficients. P < 0.05 was considered statistically significant.

RESULTS

The mean ADC values of each Eichner classification group were significantly different, with the lowest value in group C (P < 0.001). There was a negative correlation between the ADC value of the masseter, lateral pterygoid muscle, and age (P < 0.001). There were significant differences between the sex groups (P < 0.001).

CONCLUSIONS

ADC values of masticatory muscles were significantly different in the Eichner index groups. The ADC values of masticatory muscles may be useful for the quantitative evaluation of the masticatory muscles affected by the occlusal state.

Masseter muscle volume as a disease marker in adult-onset myotonic dystrophy type 1

The advent of clinical trials in myotonic dystrophy type 1 (DM1) necessitates the identification of reliable outcome measures to quantify different disease manifestations using minimal number of assessments. In this study, clinical correlations of mean masseter volume (mMV) were explored to evaluate its potential as a marker of muscle involvement in adult-onset DM1 patients. We utilised data from a preceding study, pertaining to 39 DM1 patients and 20 age-matched control participants. In this study participants had undergone MRI of the brain, completed various clinical outcome measures and had CTG repeats measured by small-pool PCR. Manual segmentation of masseter muscles was performed by a single rater to estimate mMV. The masseter muscle was atrophied in DM1 patients when compared to controls (p<0.001). Significant correlations were found between mMV and estimated progenitor allele length (p = 0.001), modal allele length (p = 0.003), disease duration (p = 0.009) and and the Muscle Impairment Rating Scale (p = 0.008). After correction for lean body mass, mMV was also inversely correlated with self-reported myotonia (p = 0.014). This study demonstrates that changes in mMV are sensitive in reflecting the underlying disease process. Quantitative MRI methods demonstrate that data concerning both central and peripheral disease could be acquired from MR brain imaging studies in DM1 patients.

Quantitative volume and area assessment of masticatory muscles through magnetic resonance imaging in patients with temporomandibular joint disorders

OBJECTIVE

To compare volume and surface area measurements of the lateral pterygoid (LPM), medial pterygoid (MPM), and masseter muscles (MM) as calculated on magnetic resonance imaging (MRI) based on the position of the temporomandibular joint disk, mouth position, and patient sex, and to calculate the correlations of the measurements among the muscles.

STUDY DESIGN

Measurements of muscle volume and area were performed on the MRIs of 51 patients. Wilcoxon, Kruskal-Wallis, and Mann-Whitney U tests were used to calculate the significance of differences in measurements. The Spearman correlation coefficient calculated the correlation of measurements among the muscles. The significance of difference was established at P < .05.

RESULTS

Volume and area of the left MPM in patients with disk displacement without reduction (DDWOR) were larger than in patients with normal disk position (P ≤ .040). MM volumes were smaller with DDWOR than with DD with reduction bilaterally (P ≤ .031). The volume and area of LPM and MM were significantly different between closed and open mouth positions (P < .001). Differences in volume and area between females and males were significant for all muscles in volume (P ≤ .021) and for MPM and MM in area (P ≤ .021). Significant positive correlations were found among all muscles for volume and area.

CONCLUSION

Volume and area measurements of the masticatory muscles varied according to disk and mouth position and patient sex and exhibited significant positive correlations.

Assessment of lateral pterygoid muscle and temporomandibular joint disc after Le Fort I osteotomy with and without intentional pterygoid plate fracture and sagittal split ramus osteotomy in class II and class III patients

The aim of the study was to examine lateral pterygoid muscle (LPM) and temporomandibular joint (TMJ) disc before and after Le Fort I osteotomy with and without intentional pterygoid plate fracture and sagittal split ramus osteotomy (SSRO) in class II and class III patients. Le Fort I osteotomy and SSRO were performed in class II and class III patients. LPM measurements using oblique sagittal computed tomography (CT) images and TMJ disc position using magnetic resonance imaging (MRI) were examined. Statistical comparisons were performed for the LPM and TMJ between class II and class III patients and between those with and without intentional pterygoid plate fracture in Le Fort I osteotomy. The subjects comprised 60 female patients (120 sides), with 30 diagnosed as class II and 30 as class III. Preoperatively, the width of the condylar attachment, width at eminence, length of the LPM, angle of the LPM, and square of the LPM were significantly smaller in the class II group than in the class III group (p < 0.05). After 1 year, the width of the condylar attachment, width at eminence, and angle of the LPM remained significantly smaller in the class II group than in the class III group (p < 0.0001). TMJ disc position was significantly related to the width of the condylar attachment of the LPM, both pre- and postoperatively (p < 0.0001). However, postoperative disc position did not change in all patients. Next, the class II patients (60 sides) were divided into two groups who underwent Le Fort I osteotomy with or without intentional pterygoid plate fracture. Changes in all measurements of the LPM showed no significant differences between these two groups. Our study suggested that TMJ disc position classification could be associated with the width of condylar attachment of the LPM before and after surgery, while the surgical procedure, including Le Fort I osteotomy with intentional pterygoid plate fracture, might not affect postoperative LMP or disc position in class II patients.

Change of lateral pterygoid muscle and temporomandibular disc position after bi-maxillary surgery in class II and III patients

OBJECTIVES

The purpose of this study was to examine changes in lateral pterygoid muscle and temporomandibular joint (TMJ) disc position in classes II and III patients, before and after bi-maxillary surgery.

MATERIALS AND METHODS

The subjects were comprised of 48 patients (96 sides), 23 of whom were diagnosed as class II and 25 as class III patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO). The cross-sectional measurements of the lateral pterygoid muscles were measured at two levels of horizontal plane images (condyle and mandibular notch levels) by computed tomography (CT), before and 1 year after the operation. The relationship between these measurements regarding lateral pterygoid muscle and disc position by magnetic resonance image (MRI) was also examined statistically.

RESULTS

Preoperatively, class II was significantly larger than class III in condylar angle at the upper level and in long diameter, square, condylar angle, and muscle angle at the lower level (P < 0.05). After 1 year, class II was significantly larger than class III in condylar angle, long diameter, and muscle angle at the upper level and in long diameter, short diameter, square, condylar angle, and muscle angle at the lower level (P < 0.05). TMJ disc position classification correlated significantly with condylar angle at the upper level and long diameter and condylar angle at the lower level (P < 0.0001).

CONCLUSION

This study suggested that there were differences in the cross-sectional measurements of the lateral pterygoid muscles between class II and class III patients, before and after bi-maxillary surgery.

Three-dimensional temporomandibular joint muscle attachment morphometry and its impacts on musculoskeletal modeling

In musculoskeletal models of the human temporomandibular joint (TMJ), muscles are typically represented by force vectors that connect approximate muscle origin and insertion centroids (centroid-to-centroid force vectors). This simplification assumes equivalent moment arms and muscle lengths for all fibers within a muscle even with complex geometry and may result in inaccurate estimations of muscle force and joint loading. The objectives of this study were to quantify the three-dimensional (3D) human TMJ muscle attachment morphometry and examine its impact on TMJ mechanics. 3D muscle attachment surfaces of temporalis, masseter, lateral pterygoid, and medial pterygoid muscles of human cadaveric heads were generated by co-registering measured attachment boundaries with underlying skull models created from cone-beam computerized tomography (CBCT) images. A bounding box technique was used to quantify 3D muscle attachment size, shape, location, and orientation. Musculoskeletal models of the mandible were then developed and validated to assess the impact of 3D muscle attachment morphometry on joint loading during jaw maximal open-close. The 3D morphometry revealed that muscle lengths and moment arms of temporalis and masseter muscles varied substantially among muscle fibers. The values calculated from the centroid-to-centroid model were significantly different from those calculated using the 'Distributed model', which considered crucial 3D muscle attachment morphometry. Consequently, joint loading was underestimated by more than 50% in the centroid-to-centroid model. Therefore, it is necessary to consider 3D muscle attachment morphometry, especially for muscles with broad attachments, in TMJ musculoskeletal models to precisely quantify the joint mechanical environment critical for understanding TMJ function and mechanobiology.

In vivo Cross-sectional Area of Human Jaw Muscles Varies with Section Location and Jaw Position

Muscle cross-sectional area (CSA) is used as a measure for maximum muscle force. This CSA is commonly determined at one location within the muscle and for one jaw position. The purpose of this study was to establish a method to standardize the analysis of the CSA of the masticatory muscles in vivo, and to compare the CSAs along their entire length for two different jaw positions (opened and closed). The CSAs in the planes perpendicular to the long axes of the masseter, medial, and lateral pterygoid muscles were measured in ten normal young adult subjects by magnetic resonance imaging. Our results showed large differences among the muscles and a non-uniform change in CSA after jaw-opening. The method enables the CSA measurement to be standardized in vivo, and allows for a correct comparison of CSAs in different skull morphologies.

Size and Orientation of Masticatory Muscles in Patients with Mandibular Laterognathism

Size measurements of jaw muscles reflect their force capabilities and correlate with facial morphology. Using MRI, we examined the size and orientation of jaw muscles in patients with mandibular laterognathism in comparison with a control group. We hypothesized that the muscles of the deviated side would be smaller than those of the non-deviated side, and that the muscles of both sides would be smaller than in controls. In patients, a comparison of deviated and non-deviated sides showed, in orientation, differences for masseter and medial pterygoid muscles, but, in size, differences only for the masseter muscle. Nevertheless, muscle sizes in patients were much smaller than in controls. Lateral displacement of the mandible can explain the orientation differences, but not the smaller muscle size, in patients. It is possible that the laterodeviation initiates an adaptive process in the entire jaw system, resulting in extensive atrophy of the jaw muscles.

Identification of mastication organ muscle forces in the biocybernetic perspective

Purpose of the Paper. This paper is an attempt to mathematically describe the mastication organ muscle functioning, taking into consideration the impact of the central nervous system. Material. To conduct model tests, three types of craniums were prepared: short, normal, and long. The necessary numeric data, required to prepare the final calculation models of different craniofacial types, were used to identify muscle and occlusion forces generated by muscles in the area of incisors and molars. The mandible in model tests was treated as a nondeformable stiff form. Methods. The formal basis for the formulated research problem was reached using the laws and principles of mechanics and control theory. The proposed method treats muscles as “black boxes,” whose properties automatically adapt to the nature of the occlusion load. The identified values of occlusion forces referred to measurements made in clinical conditions. Results. The conducted verification demonstrated a very good consistency of model and clinical tests' results. The proposed method is an alternative approach to the so far applied methods of muscle force identification. Identification of muscle forces without taking into account the impact of the nervous system does not fully reflect the conditions of mastication organ muscle functioning.

Quantitative magnetic resonance imaging volumetry of facial muscles in healthy patients with facial palsy

Background:

Magnetic resonance imaging (MRI) has not yet been established systematically to detect structural muscular changes after facial nerve lesion. The purpose of this pilot study was to investigate quantitative assessment of MRI muscle volume data for facial muscles.

Methods:

Ten healthy subjects and 5 patients with facial palsy were recruited. Using manual or semiautomatic segmentation of 3T MRI, volume measurements were performed for the frontal, procerus, risorius, corrugator supercilii, orbicularis oculi, nasalis, zygomaticus major, zygomaticus minor, levator labii superioris, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis, as well as for the masseter and temporalis as masticatory muscles for control.

Results:

All muscles except the frontal (identification in 4/10 volunteers), procerus (4/10), risorius (6/10), and zygomaticus minor (8/10) were identified in all volunteers. Sex or age effects were not seen (all P > 0.05). There was no facial asymmetry with exception of the zygomaticus major (larger on the left side; P = 0.012). The exploratory examination of 5 patients revealed considerably smaller muscle volumes on the palsy side 2 months after facial injury. One patient with chronic palsy showed substantial muscle volume decrease, which also occurred in another patient with incomplete chronic palsy restricted to the involved facial area. Facial nerve reconstruction led to mixed results of decreased but also increased muscle volumes on the palsy side compared with the healthy side.

Conclusions:

First systematic quantitative MRI volume measures of 5 different clinical presentations of facial paralysis are provided.

Condylar process contributes to mandibular asymmetry: In vivo 3D MRI study

The purpose of this study was to investigate the differences in mandibular morphology between the deviated and nondeviated sides in patients with noncongenital skeletal mandibular asymmetry. Divergences from control values were assessed to determine which region of the mandible contributes most to mandibular asymmetry. We measured various dimensions of the mandible in 20 young patients and 20 controls using noninvasive high-quality three-dimensional (3D) volumetric magnetic resonance imaging. Mandibular dimensions including the length of the condylar process were significantly greater on the nondeviated side of patients than the deviated side. Measurements of the deviated side were similar to control values, but measurements of the nondeviated side including condylar process length differed significantly from control values. These findings strongly suggest that overgrowth of the condylar process on the nondeviated side in these patients results in mandibular asymmetry, and therefore needs attention in orthodontic treatment, orthognathic surgery, and follow-up.

A ³¹P-magnet resonance spectroscopy study on the metabolism of human masseter in individuals with different vertical facial pattern

OBJECTIVE

The objective of this study was to investigate differences in masseter metabolism by (31)P-Chemical Shift Imaging (CSI) in adult individuals with different vertical facial patterns. The clinical study should be supported by functional findings at the mRNA level after orthognathic surgery.

STUDY DESIGN

Twenty-two male volunteers (mean age 24.6) were divided into a deep-bite (NL/ML 11.8 ± 2.3°) and open-bite group (NL/ML 34.1 ± 2.6°). Vertical jaw relationship, gonial angle, and masseter volume were defined and compared with the phosphate values obtained from the (31)P spectra. Student t test and regression analysis were used.

RESULTS

Phosphocreatine related strongly to muscle volume (P < .001), gonial angle (P < .001), and ML/NL angle (P < .01). Pi was found to be related to gonial angle (P < .05). Muscle volume was found to be inversely related to ML/NL (P < .01) and to the gonial angle (P < .01).

CONCLUSIONS

A difference in masseter muscle metabolism between long- and short-faced subjects was confirmed at rest position.

Evaluation of diffusion parameters and T2 values of the masseter muscle during jaw opening, clenching, and rest

BACKGROUND

Diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI) can be used to evaluate changes that accompany skeletal muscle contraction.

PURPOSE

To investigate whether jaw opening or closure affect the diffusion parameters of the masseter muscles (MMs).

MATERIAL AND METHODS

Eleven healthy volunteers were evaluated. Diffusion-tensor images were acquired to obtain the primary (λ(1)), secondary (λ(2)), and tertiary eigenvalues (λ(3)). We estimated these parameters at three different locations: at the level of the mandibular notch for the superior site, the level of the mandibular foramen for the middle site, and the root apex of the mandibular molars for the inferior site.

RESULTS

Both λ(2) and λ(3) during jaw opening were significantly lower than that at rest at the superior (P = 0.006, P < 0.0001, respectively) and middle site (P = 0.004, P = 0.0001, respectively); however, the change in λ(1) was not significant. At the lower site, no parameter was significantly different at rest and during jaw opening. There was no significant difference in T2 between at rest (40.3 ± 4.4 ms) and during jaw opening (39.2 ± 2.7 ms; P = 0.12). The changes induced by jaw closure were marked at the inferior site. In the middle and inferior sites, the three eigenvalues were increased by jaw closure, and the changes in λ(1) (P = 0.0145, P = 0.0107, respectively) and λ(2) (P = 0.0003, P = 0.0001) were significant (especially λ(2)).

CONCLUSION

The eigenvalues for diffusion of the MM were sensitive to jaw position. The recruitment of muscle fibers, specific to jaw position, reflects the differences in changes in muscle diffusion parameters.

Evaluation of the lateral pterygoid muscle using magnetic resonance imaging

OBJECTIVES

The aims of this study were to evaluate the visibility of the lateral pterygoid muscle (LPM) in temporomandibular joint (TMJ) images obtained by MRI, using different projections and to compare image findings with clinical symptoms of patients with and without temporomandibular disorders (TMD).

METHODS

In this study, LPM images of 50 participants with and without TMDs were investigated by MRI. The images of the LPM in different projections of 100 TMJs from 35 participants (70 TMJs) with and 15 participants (30 TMJs) without clinical signs and symptoms of TMD were visible and analysed.

RESULTS

The oblique sagittal and axial images of the TMJ clearly showed the LPM. Hypertrophy (1.45%), atrophy (2.85%) and contracture (2.85%) were the abnormalities found in the LPM. TMD signs, such as hypermobility (11.4%), hypomobility (12.9%) and disc displacement (20.0%), could be seen in TMJ images. Related clinical symptoms, such as pain (71.4%), articular sounds (30.4%), bruxism (25.7%) and headache (22.9%), were observed.

CONCLUSIONS

Patients with TMD can present with alterations in the LPM thickness. Patients without TMD also showed alterations, such as atrophy and contracture, in TMJ images. Recognition of alterations in the LPM will improve our understanding of clinical symptoms and pathophysiology of TMD, and may lead to a more specific diagnosis of these disorders.

Effects of restriction of fetal jaw movement on prenatal development of the temporalis muscle

Jaw movement affects masticatory muscles during the postnatal period. Prenatal jaw movement has also been implicated in the development of the temporomandibular joint; however, its effect on prenatal development of the masticatory muscles has not been extensively analysed. In the present study, we examined the effects of the restriction of fetal jaw movement on the temporalis muscle, a major masticatory muscle, in mice by suturing the maxilla and mandible (sutured group) using an exo utero development system. We compared the morphology of the temporalis muscle between sutured, sham-operated and normal in utero groups. At embryonic day (E) 18.5, the volume of muscle fibres, but not that of connective tissue, in the temporalis muscle was decreased in the sutured group. The E18.5 temporalis muscle in the sutured group appeared morphologically similar to that of the E17.5 in utero group, except for frequent muscle fibre irregularities. By transmission electron microscopy, in the sutured group, the myofibrils were immature and scattered, the nuclei appeared comparatively immature, the mitochondria were expanded in volume with fewer cristae, and cytoplasmic inclusion bodies were frequently observed. Expression of Myf-6, a late myogenic transcription factor, by real-time RT-PCR was not significantly different between the sutured and sham-operated groups. These findings demonstrated approximately 1-day delay in the morphological development of the temporalis muscle in the sutured group, and some abnormalities were observed, although Myf-6 level was not affected in the sutured group. The present study revealed that the prenatal jaw movement influences the development of the temporalis muscle.

Morphological observation of the medial pterygoid muscle by the superimposition of images obtained by lateral cephalogram and MRI

OBJECTIVE

To observe the morphological relationship between the maxillofacial skeleton and medial pterygoid muscle by superimposing images constructed by MRI on a cephalogram.

DESIGN

Cross-sectional study.

SETTING

The Departments of Maxillofacial Orthognathics and Orthodontics, Tokyo Medical and Dental University.

PARTICIPANTS

Sixteen patients (5 males and 11 females, aged between 13.5 and 27.5 years) with various craniofacial skeletal patterns, who were about to start orthodontic treatment.

METHODS

Lateral cephalometric radiographs and MRI scans were obtained and their images uploaded to a computer using a digitizer. The area of the medial pterygoid muscle was selected by binarization from the MRI. The mid-sagittal-plane MRI with a complete superimposed sagittal image of the medial pterygoid muscle was superimposed on the cephalogram using anatomical structures situated in the mid-sagittal plane of the head and shapes that could be identified from both the radiograph and the MRI image.

RESULTS

These combined images showed various shapes of the medial pterygoid muscle. The inclination axis of the medial pterygoid muscle was correlated with various cephalometric variables including SNB (r=0.658), Facial angle (r=0.601), ramus inclination (r=0.676) and Ba-Po% (r=0.585). The volume of the medial pterygoid muscle was also correlated with cephalometric variables such as ramus inclination (r=0.453), Ba-Nmm (r=0.676), Ba-Po% (depth) (r=0.447), Ar-Go% (depth) (r=0.444) and Ar-Go% (actual length) (r=0.532).

CONCLUSIONS

Morphometric analysis using a superimposed image of the medial pterygoid muscle produced from a cephalogram and MRI may help explain the influence of the medial pterygoid muscle inclination axis and volume on the shape of the mandibular bone, especially the shape of the ramus.

A 3-dimensional method for analyzing facial soft-tissue morphology of patients with jaw deformities

INTRODUCTION

Traditional cephalometric radiographs can analyze facial soft-tissues 2 dimensionally. Because they cannot provide information about the nose, lips, cheeks, and mouth, another method is needed to analyze these soft tissues. We introduce a new method for analyzing the 3-dimensional (3D) shape and size of facial soft-tissue morphology.

METHODS

A 3D average face model was constructed based on 3D computed tomography images of Japanese male and female adult volunteers who had well-balanced faces and normal occlusions. To test the feasibility of evaluating the quantitative effects of surgery, preoperative and postoperative 3D computed tomography images of facial soft tissues of 1 man and 1 woman were superimposed on the average faces.

RESULTS

This quantitative assessment provided a comprehensive evaluation of the characteristics that separate size and shape. It was possible to view the superimposed images from any desired angle on a personal computer.

CONCLUSIONS

This method provides easy-to-understand information for patients and appears to be useful for clinical diagnosis and pretreatment and posttreatment soft-tissue morphologic evaluations of patients with jaw deformities.

3D segmentation and quantification of a masticatory muscle from MR data using patient-specific models and matching distributions

A method is proposed for 3D segmentation and quantification of the masseter muscle from magnetic resonance (MR) images, which is often performed in pre-surgical planning and diagnosis. Because of a lack of suitable automatic techniques, a common practice is for clinicians to manually trace out all relevant regions from the image slices which is extremely time-consuming. The proposed method allows significant time savings. In the proposed method, a patient-specific masseter model is built from a test dataset after determining the dominant slices that represent the salient features of the 3D muscle shape from training datasets. Segmentation is carried out only on these slices in the test dataset, with shape-based interpolation then applied to build the patient-specific model, which serves as a coarse segmentation of the masseter. This is first refined by matching the intensity distribution within the masseter volume against the distribution estimated from the segmentations in the dominant slices, and further refined through boundary analysis where the homogeneity of the intensities of the boundary pixels is analyzed and outliers removed. It was observed that the left and right masseter muscles' volumes in young adults (28.54 and 27.72 cm(3)) are higher than those of older (ethnic group removed) adults (23.16 and 22.13 cm(3)). Evaluation indicates good agreement between the segmentations and manual tracings, with average overlap indexes for the left and right masseters at 86.6% and 87.5% respectively.

A comparison of human jaw muscle cross-sectional area and volume in long- and short-face subjects, using MRI

OBJECTIVE

In humans, the vertical craniofacial dimensions vary significantly with the size of the jaw muscles, which are regarded as important controlling factors of craniofacial growth. The functional relevance of the maximum cross-sectional area (CSA), indicating maximum muscle strength, is questionable since peak forces are generated only a fraction of the day. Alternatively, muscle volume (indicating the generated loads) might be a more meaningful functional variable. Therefore, the aim of this study was to investigate if jaw muscle volume is stronger related with vertical craniofacial dimensions than with jaw muscle CSA.

DESIGN

Thirty-one adult healthy subjects with varying vertical craniofacial morphology participated in this study. Axial magnetic resonance imaging (MRI) scans were used for segmentation of the masseter (Mas) and medial pterygoid muscles (MPM). This enabled measurements of the muscle CSA and volume. Cephalometric analysis was performed using lateral radiographs. With factor analysis, the number of cephalometric variables was reduced into two factors that represented the anterior face height and the posterior face height (PFH), respectively. Subsequently, mutual relationships between these factors and muscular variables were assessed using a multiple regression analysis.

RESULTS

It was found that vertical craniofacial dimensions were significantly better (up to 12%) related with muscle volume rather than with CSA. Furthermore, it was shown that especially the PFH factor was significantly correlated with the Mas and MPM.

CONCLUSION

Vertical craniofacial dimensions are stronger related with jaw muscle volume than with CSA. Tentatively, it can be assumed that the generated muscle loads, rather than maximum forces, influence vertical craniofacial growth.

Outer shape changes of human masseter with contraction by ultrasound morphometry

OBJECTIVE

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

DESIGN

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

RESULTS

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

CONCLUSION

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