title: Assessment of thickness and function of masticatory and cervical muscles in adults with and without temporomandibular disorders.
abstract: OBJECTIVE
  The aim of this study was to evaluate the maximal bite force (MBF), electromyographic (EMG) activity and thickness of the masseter, anterior part of the temporalis and sternocleidomastoid (SCM) muscles in a group of young adults with and without temporomandibular disorders (TMDs).
  
  
  METHODS
  Nineteen individuals comprised the TMD group (6 males/13 females, aged 25.4±3.8 years), classified based on the Research Diagnostic Criteria for TMD (RDC/TMD), and 19 comprised the control group (6 males/13 females, aged 24.1±3.6 years). The MBF was determined with a transducer placed between the dental arches at the first molars level (N). The muscles were evaluated bilaterally at rest and during maximal voluntary clenching (MVC) by assessing EMG activity and performing ultrasonography (USG). The mean values of these measures for both sides of the mouth were used. The normality of the distributions was assessed by the Shapiro-Wilks test. Variables between groups and genders were compared using two-way factorial ANOVA test and correlated using the Spearman coefficient (α=0.05). Unpaired t test was used to compare variables between TMD subgroups. Logistic regression analysis was used to identify the variables associated with the presence of TMD.
  
  
  RESULTS
  MBF, EMG and USG data were similar among clinical groups and among TMD subgroups. The thickness of masseter and SCM muscles in the relaxed and clenching states were significantly higher in males than females. On the other hand, the EMG of the temporalis muscle in the rest state was significantly higher in females than males. Additionally, the MBF was positively correlated with the USG characteristics of masseter and SCM muscles, as well as with the EMG activity of masseter and temporalis muscles in the TMD group. In this group, there was also a positive correlation between the thickness of the masseter muscle and its activity. On the other hand, the thickness of the SCM muscle was negatively correlated with its activity. A lower MBF was independently associated with the presence of TMD.
  
  
  CONCLUSIONS
  Subjects with TMD exhibited similar values of MBF, thickness and electrical activity of masticatory and cervical muscles when compared with controls; positive correlations observed between these variables may suggest a muscular alteration in TMD patients and a co-activation of masticatory and cervical muscles during mandibular movement. This fact may also be confirmed by the negative association between bite forces and presence of TMD.
authors.affiliation: Department of Morphology, Piracicaba Dental School, University of Campinas, Av Limeira 901, Piracicaba, SP, Brazil.
authors.forename: Paulinne Junqueira Silva Andresen
authors.initials: PJ
authors.lastname: Strini
authors.forename: Polyanne Junqueira Silva Andresen
authors.initials: PJ
authors.lastname: Strini
authors.forename: Taís de Souza
authors.initials: Tde S
authors.lastname: Barbosa
authors.forename: Maria Beatriz Duarte
authors.initials: MB
authors.lastname: Gavião
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001732:Bite Force; D016022:Case-Control Studies; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology; D009334:Neck Muscles / Q000502:physiology* / Q000503:physiopathology; D012044:Regression Analysis; D012737:Sex Factors; D013703:Temporal Muscle / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography
keywords: Bite force; Electromyography; Masticatory muscles; Sternocleidomastoid; Temporomandibular disorders; Ultrasonography