title: Analysis of masseter deformation patterns during a maximum exertion clenching in patients with unilateral chewing.
abstract: OBJECTIVE
  The aim of the following study is to examine both masseter muscles (left/right) in a group of patients suffering from unilateral chewing during a maximum exertion isometric contraction using the deformation pattern analysis of ultrasound videos and compare them with the results obtained by studying patients with alternate bilateral chewing patterns.
  
  
  METHODS
  This study has been conducted by use of an ultrasound machine and a linear probe which allowed us to record a video (DCM) comprised of 45 frames per second (MicrUs ext-1H Telemed Medical Systems Milano) and a linear probe (L12-5l40S-3 5-12 MHz 40 mm). The probe was fixed to a brace and the patients were 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. We applied to the ultrasound video a dedicated software (Mudy 1.7.7.2 AMID Sulmona Italy) for the analysis of muscle deformation patterns. The total number of patients for this study is 150. Out of this number, 50 belong to Group A, mono lateral chewing on the left side arch, and 50 to Group B, mono lateral chewing on the right side arch. The remains patients belong to Group C, bilateral alternate chewing. The deformation pattern analysis of the skeletal muscles on ultrasound videos allows us to highlight with ease the clear difference in the clenching capabilities and strain management between the dominant masseter and the subordinate masseter in a unilaterally chewing patient.
  
  
  RESULTS
  In the sample investigated both in Group A and Group B the unilateral chewing is associated with a series of parameters (number, shape, volume, position and orientation of the teeth) and is also associated with the extension of the cutting surface really available.
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: masseter muscle; pattern of deformations; strains; ultrasound; unilateral chewing