Temporomandibular disorders: referred cranio-cervico-facial clinic.
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The bond between temporomandibular disorders and referred craniofacial symptomatology is more and more evident. In it subsists the prevailing necessity of understanding the temporomandibular disorders and the cranio-cervico-facial referred symptomatology from a neurophysiologic and muscle-skeletal perspective contained in the stomatognatic system. Diagnosis in head and neck areas is difficult because of its complex anatomy. Some painful craniofacial syndromes exhibit the same symptoms although they don.t seem objectively possible and that is what confuses the specialist and the patient. Pain in the head and the neck is one of the most complex to diagnose because of its varied origins that can be neurological, vascular, muscular, ligamental and bony. This article seeks to show some reasonable anatomical and pathophysiological connections of this muscle-skeletal disorder expressed with symptoms like tinnitus, otic fullness, otalgia and migraine among others. Disciplines in health such as neurology, the otolaryngology and dentistry share common anatomical and pathophysiological roads constructed in an increased muscular activity that generates muscle-skeletal disorders and is difficult to locate referred craniofacial symptomatology. This revision aspires to sensitize the medical specialist and the odontologist in the understanding of the important interdisciplinary handling in the detection of this disorder. This offers better tools in the conservative therapy phase of this craniofacial referred symptomatology. (+info)
A functional morphological approach to the scaling of the feeding system in the African catfish, Clarias gariepinus.
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Effects of size are pervasive and affect nearly all aspects of the biology of animals and plants. Theoretical scaling models have been developed to predict the effects of size on the functioning of musculo-skeletal systems. Although numerous experimental studies have investigated the effects of size on the movements of skeletal elements during locomotion and feeding in vertebrates, relatively little is known about the scaling of the muscles and bones responsible for the actual movements. Here, we examine the scaling of external morphology, skeletal elements of the feeding system, and a number of cranial muscles to understand how this may affect the movements observed during suction feeding in the African catfish, Clarias gariepinus. The results show that neither the head nor the cranial elements themselves scale according to geometric similarity models. Relative to head size, distinct changes in the mass and configuration of the feeding structures takes place. Unexpectedly, different cranial muscles show different scaling patterns that ultimately all lead to a positive allometry of muscle cross-sectional area relative to fish head size. This suggests that (1) the scaling of the cranial elements cannot be predicted a priori based on the scaling of external head dimensions and (2) the scaling of the feeding system is optimised towards high force output in the larger animals. An analysis of the consequences of the observed changes in morphology with size on performance traits, including bite force and jaw closing velocity, suggests a tight link between the scaling of the feeding system and the natural diet of these fish. Whereas for smaller size classes the system is tuned towards high bite forces, for animals with cranial lengths greater than 65 mm the scaling of the feeding system appears to be dictated by the hydrodynamic constraints on suction feeding. (+info)
Burst characteristics of daily jaw muscle activity in juvenile rabbits.
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Muscle activation varies with different behaviors and can be quantified by the level and duration of activity bursts. Jaw muscles undergo large anatomical changes during maturation, which are presumably associated with changes in daily muscle function. Our aim was to examine the daily burst number, burst length distribution and duty time (fraction of the day during which a muscle was active) of the jaw muscles of juvenile male rabbits (Oryctolagus cuniculus). A radio-telemetric device was implanted to record muscle activity continuously from the digastric, superficial and deep masseter, medial pterygoid and temporalis during maturation week 9-14. Daily burst characteristics and duty times were determined for activations, including both powerful and non-powerful motor behavior. All muscles showed constant burst numbers, mean burst lengths and duty times during the recording period. Including all behavior, the temporalis showed significantly larger daily burst numbers (205,000) and duty times (18.2%) than the superficial and deep masseter (90,000; 7.5%). Burst numbers and duty times were similar for the digastric (120,000; 11.1%) and medial pterygoid (115,000; 10.4%). The temporalis and deep masseter showed many short low activity bursts (0.05 s), the digastric showed many long bursts (0.09 s). For activations during powerful behaviors the superficial masseter and medial pterygoid had the largest burst numbers and duty times. Both muscles showed similar burst characteristics for all activation levels. It was concluded that activation of the jaw muscles is differently controlled during powerful and non-powerful motor behaviors and the functional organization of motor control patterns does not vary from 9 to 14 weeks of age. (+info)
Voluntary control of human jaw stiffness.
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Recent studies of human arm movement have suggested that the control of stiffness may be important both for maintaining stability and for achieving differences in movement accuracy. In the present study, we have examined the voluntary control of postural stiffness in 3D in the human jaw. The goal is to address the possible role of stiffness control in both stabilizing the jaw and in achieving the differential precision requirements of speech sounds. We previously showed that patterns of kinematic variability in speech are systematically related to the stiffness of the jaw. If the nervous system uses stiffness control as a means to regulate kinematic variation in speech, it should also be possible to show that subjects can voluntarily modify jaw stiffness. Using a robotic device, a series of force pulses was applied to the jaw to elicit changes in stiffness to resist displacement. Three orthogonal directions and three magnitudes of forces were tested. In all conditions, subjects increased the magnitude of jaw stiffness to resist the effects of the applied forces. Apart from the horizontal direction, greater increases in stiffness were observed when larger forces were applied. Moreover, subjects differentially increased jaw stiffness along a vertical axis to counteract disturbances in this direction. The observed changes in the magnitude of stiffness in different directions suggest an ability to control the pattern of stiffness of the jaw. The results are interpreted as evidence that jaw stiffness can be adjusted voluntarily, and thus may play a role in stabilizing the jaw and in controlling movement variation in the orofacial system. (+info)
Cranial kinesis in palaeognathous birds.
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Cranial kinesis in birds is induced by muscles located caudal on the cranium. These forces are transferred onto the moveable parts of the skull via the Pterygoid-Palatinum Complex (PPC). This bony structure therefore plays an essential role in cranial kinesis. In palaeognathous birds the morphology of the PPC is remarkably different from that of neognathous birds and is thought to be related to the specific type of cranial kinesis in palaeognaths known as central rhynchokinesis. We determined whether clear bending zones as found in neognaths are present in the upper bill of paleognaths, and measured bending forces opposing elevation of the upper bill. A static force model was used to calculate the opening forces that can be produced by some of the palaeognathous species. We found that no clear bending zones are present in the upper bill, and bending is expected to occur over the whole length of the upper bill. Muscle forces are more than sufficient to overcome bending forces and to elevate the upper bill. The resistance against bending by the bony elements alone is very low, which might indicate that bending of bony elements can occur during food handling when muscles are not used to stabilise the upper bill. Model calculations suggest that the large processi basipterygoidei play a role in stabilizing the skull elements, when birds have to resist external opening forces on the upper bill as might occur during tearing leafs from plants. We conclude that the specific morphology of the palaeognathous upper bill and PPC are not designed for active cranial kinesis, but are adapted to resist external forces that might cause unwanted elevation of the upper bill during feeding. (+info)
Developmental changes in craniofacial morphology in subjects with Duchenne muscular dystrophy.
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Lateral cephalometric radiographs of 35 Japanese male patients suffering from Duchenne muscular dystrophy (DMD) were taken longitudinally from 10 to 20 years of age. Eighteen landmarks were placed and 15 angles and four linear distances calculated. Profile diagrams (profilograms) were produced to analyse changes in craniofacial morphological growth in the DMD subjects. The measurements were then compared with Japanese standards. In young patients with DMD, compared with the controls, the following were observed: a large gonial angle; clockwise rotation of the mandible; short sagittal length of the cranial base and protrusion of the upper incisors. In adult patients, the maxillary alveolus and the upper incisors were protruded, compared with the controls. Overbite in DMD subjects also showed a tendency to decrease. In the controls, mandibular growth direction tended to be straight down and forward, while in patients with DMD, the growth direction was down until approximately 16 years of age and, after that, a forward vector of growth was apparent. As a result, the tendency towards a clockwise rotation of the mandible in the adults was less than in the young patients. These findings showed that DMD significantly affects craniofacial morphology. (+info)
The relationship between observations and measures of oral and pharyngeal residue from videofluorography and scintigraphy.
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We examined measures of oral and pharyngeal residues from scintigraphic studies and estimates/observations from videofluorographic (modified barium swallow) studies taken on the same day but not concurrently in 16 dysphagic patients of varying etiologies presenting with oral and/or pharyngeal dysphagia. Oral and pharyngeal residuals following the swallow were quantified scintigraphically and were then compared with measures of residuals obtained from the modified barium swallow. Estimates of oral and pharyngeal residues from the modified barium swallows were generated by a trained observer who was blinded to the scintigraphic data. Positive and significant Spearman correlations between oral and pharyngeal residue measures from scintigraphy and observations of oral and pharyngeal residues from modified barium swallows were found. This supports the validity of observations of oral and pharyngeal residues in clinical studies. Limitations of these observations are discussed. (+info)
Mandibular mechanics after osteotomy and distraction appliance placement I: Postoperative mobility of the osteotomy site.
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PURPOSE: Fixation at the osteotomy site for mandibular distraction osteogenesis (DO) is probably not rigid, especially during mastication. Micromotion may affect the course of DO. This study aimed to measure the mobility of the fresh distractor-fixed osteotomy site in response to mastication and masticatory muscle stimulation. MATERIALS AND METHODS: Twenty-eight domestic pigs, 6 to 8 weeks old, underwent osteotomy of the right mandible and placement of a distractor appliance. Immediately after surgery, displacement at 3 different locations (superior-lateral, inferior-lateral, and inferior-medial) of the osteotomy site was assessed using ultrasound piezoelectric crystals or differential variable reluctance transducers (DVRTs). The amount of lengthening or shortening at each location was measured during mastication and muscle stimulation. Displacement was also measured for bilateral osteotomy during muscle stimulation from a subgroup of 12 pigs. RESULTS: The osteotomy site demonstrated significant mobility during power strokes of mastication with an average magnitude of 0.3 to 0.4 mm. Distinct patterns of displacement were associated with different locations, and the patterns varied between chewing sides. The most common pattern was lengthening at the superior-lateral and shortening at both inferior sites. Similar amounts of displacement were observed during the stimulation of jaw-closers (masseter and medial pterygoid), but the patterns produced by these muscles did not completely explain the masticatory pattern. Opening the osteotomy to 1.5 mm did not alter the displacements observed during muscle stimulation. Bilateral osteotomy tended to decrease displacement. CONCLUSIONS: The study demonstrates that during mastication and masticatory muscle stimulation, an acute mandibular osteotomy site is mobile despite fixation by a distractor appliance. (+info)