title: Management and control of isotonic contraction generated stress: evaluation of masseter muscle deformation pattern by means of ecography.
abstract: OBJECTIVE
  The objective of the following study is to observe the behavior of the six layers of the masseter during an isometric contraction at maximum exertion with the deformation pattern analysis method.
  
  
  METHODS
  This study has been conducted by use of an ultrasound machine (MicrUs ext-1H Telemed Medical Systems Milano) and a linear probe (L12-5l40S-3 5-12 MHz 40 mm) which allowed us to record a video (DCM) comprised of 45 frames per second. The probe was fixed to a brace and the patient was asked to clench their teeth as hard as possible, obtain the muscle's maximum exertion, for 5 seconds three times, with 30 seconds intervals in between. Both right and left masseter muscles were analyzed. Then we applied to the resulting video a software (Mudy 1.7.7.2 AMID Sulmona Italy) for the analysis of muscle deformation patterns (contraction, dilatation, cross-plane, vertical strain, horizontal strain, vertical shear, horizontal shear, horizontal displacement, vertical displacement). The number of videos of masseter muscles in contraction at maximum exertion due to dental clenching made during this research is around 12,000. Out of these we chose 1,200 videos which examine 200 patients (100 females, 100 males).
  
  
  RESULTS
  The analysis of the deformation patterns of the masseter allows us to observe how the six layers of the muscle have different and specific functions each, which vary depending on the applied force (application point, magnitude and direction) so that we find it impossible to assign to one of the three sections of the muscle a mechanical predominance. Therefore it appears that the three parts of the muscle have specific and synergistic tasks.
authors.affiliation: Medica Libra, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Busato
authors.affiliation: Department of Radiology, Hospital San Raffaele Turro, Milano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Balconi
authors.affiliation: Medica Libra, Milano, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Vismara
authors.affiliation: Fondazione Apostolo, Merate, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bertelè
authors.affiliation: President and Founder of Siach - The International Society of Surgical Anatomy.
authors.forename: G
authors.initials: G
authors.lastname: Garo
authors.affiliation: Director of Siach, Aesthetic Surgeon, Perugia, Italy.
authors.forename: D
authors.initials: D
authors.lastname: DE Gregorio
keywords: deformation analysis pattern method; massete muscle; strain; ultrasound