Actualización del análisis de los movimientos mandibulares a través de articulografía electromagnética / Updating the analysis of mandibular movements through electromagnetic articulography

El objetivo de registrar los movimientos mandibulares es obtener parámetros relevantes que permitan evaluar el estado de la articulación temporomandibular (ATM) y de los músculos involucrados en la masticación. El movimiento mandibular se debe a un conjunto complejo de rotaciones y traslaciones tridimensionales realizadas por la ATM, limitado por los ligamentos y las superficies articulares de estas, y por la morfología y la alineación de los dientes, cuando la mandíbula se desplaza sobre estos límites, se llaman movimientos bordeantes mandibulares. El objetivo de este artículo es realizar una descripción actualizada de los movimientos mandibulares a través de articulografía electromagnética. Los movimientos mandibulares bordeantes se clasifican según el plano del espacio en que se muevan, de esta manera tenemos movimientos bordeantes en el plano sagital, en el plano horizontal y el plano frontal, y en cada plano dibujan un polígono distinto, llamados polígonos de Posselt. Estos polígonos pueden ser registrados mediante Articulografía electromagnética, gracias a esta tecnología también se pueden extraer algunos parámetros interesantes, como por ejemplo: la trayectoria total recorrida por la mandíbula al describir cada polígono, rangos de desplazamiento en cada plano, área total de cada polígono de Posselt. La apertura mandibular se mide como la distancia entre los márgenes incisales de los incisivos centrales superiores e inferiores en apertura máxima más la sobremordida. El análisis de esta es una parte importante del examen clínico en odontología, ya que una apertura limitada puede ser resultado de trastornos en la articulación temporomandibular, fibrosis oral submucosa, enfermedad reumática o trauma facial. Las mediciones tridimensionales que se obtienen gracias a la Articulografía electromagnética, son apropiados para determinar los rangos normales de apertura, su exactitud permite la realización de investigaciones en el área, abriendo un amplio campo en el análisis de los movimientos mandibulares.

SUMMARY: The objective of recording mandibular movements is to obtain relevant parameters that allow the evaluation of the state of the temporomandibular joint (TMJ) and of the muscles involved in mastication. Mandibular movement is due to a complex set of three-dimensional rotations and translations performed by the TMJ, limited by the ligaments and their articular surfaces, and by the morphology and alignment of the teeth, when the mandible moves over these limits, they are called mandibular border movements. The aim of this article is to provide an updated description of mandibular movements through electromagnetic articulography. Mandibular border movements are classified according to the plane of space in which they move, thus we have border movements in the sagittal plane, in the horizontal plane and the frontal plane, and in each plane they draw a different polygon, called Posselt polygons. These polygons can be recorded by electromagnetic articulography, thanks to this technology some interesting parameters can also be extracted, such as: the total trajectory covered by the mandible when describing each polygon, displacement ranges in each plane, total area of each polygon of Posselt. Mandibular opening is measured as the distance between the incisal edges of the upper and lower central incisors at maximum opening plus the overbite. The analysis of mandibular opening is an important part of the clinical examination in dentistry as a preliminary evaluation, since limited opening can be the result of temporomandibular joint disorders, submucous oral fibrosis, rheumatic disease or facial trauma. The three-dimensional measurements that are obtained thanks to the electromagnetic Articulography, are appropriate to determine the normal ranges of opening, its accuracy allows the realization of investigations in the area, opening a wide field in the analysis of mandibular movements. Analysis of mandibular opening is an important part of the clinical examination in dentistry, since limited opening can be the result of temporomandibular joint disorders, oral submucous fibrosis, rheumatic disease, or facial trauma. Analysis of mandibular opening is an important part of the clinical examination in dentistry, since limited opening can be the result of temporomandibular joint disorders, oral submucous fibrosis, rheumatic disease, or facial trauma. The three-dimensional measurements that are obtained thanks to the electromagnetic Articulography, are appropriate to determine the normal ranges of opening, its accuracy allows the realization of investigations in the area, opening a wide field in the analysis of mandibular movements.

Dimensión vertical de la cara en adultos con diferentes relaciones oclusales / Vertical dimension of face in adults with different Angle class

RESUMEN: Se ha postulado que la posición postural mandibular (PPM) no presentaría la menor actividad electromiográfica (EMG) de los músculos masetero y temporal, y que esta menor actividad se encontraría en una apertura mayor. El objetivo de este estudio fue analizar la PPM en pacientes con diferentes relaciones oclusales y según tipo de método de posicionamiento, relacionándolo con la actividad EMG de los músculos Masetero y Temporal, además del registro de la actividad EMG en diferentes aperturas orales. Se analizó una muestra de 25 adultos de 18 a 28 años. Estos fueron clasificados según su sexo y clasificación de Angle. Se realizaron simultáneamente registros de EMG de superficie -masetero y porción anterior del temporal- y de EMA -posición de la mandíbula respecto al maxilar obteniendo distancia y ángulo- en diferentes posiciones mandibulares: PPM-considerando método sin comando y de deglución- y apertura gradual hasta alcanzar la máxima apertura. Se realizó un análisis estadístico descriptivo. La menor PPM obtenida fue de 1,0 ± 0,6 mm en mujeres Clase III y utilizando la técnica sin comando; el mayor fue de 2,5 ± 0,2 mm en mujeres Clase II y utilizando la técnica de deglución. La apertura angular presentó menor variabilidad que las distancias lineales. La actividad de los músculos Maseteros derecho e izquierdo presentaron valores similares entre sí, al igual que en los rangos de apertura hasta 30 mm en hombres y mujeres y en las diferentes relaciones oclusales. La actividad de los Temporales para hombres y mujeres y en las diferentes relaciones oclusales mostraron variaciones importantes entre derecha e izquierda y en los diferentes grados de apertura. La técnica presentada permitió el estudio de la dimensión vertical y aperturas orales a través de EMA y EMG.

SUMMARY: It has been postulated that the mandibular postural position (MPP) could not present the lower electromyographic activity (EMG) of the Masseter and Temporal muscles, and that the lower activity could be found in a larger opening. The objective of this study was to analyze the PPM in patients with different occlusal relationships and according to the positioning method, relating it to the EMG activity of the Masseter and Temporal muscles, in addition to recording the EMG activity in different oral openings. A sample of 25 adults aged 18 to 28 years was analyzed. Participants were classified according to their sex and Angle classification. Simultaneous recordings of surface EMG -Masseter and anterior portion of the Temporal- and EMA -position of the Mandible with respect to the Maxilla obtaining distance and angle- were performed in different mandibular positions: PPM-considering the method "without command" and "swallowing"- and gradual opening until the maximum opening is reached. A descriptive statistical analysis was performed. The lowest PPM obtained was 1.0 ± 0.6 mm in Class III women and using the "without command" method; the largest was 2.5 ± 0.2 mm in Class II women and using the "swallowing" method. The angular opening presented less variability than the linear distances. The activity of the right and left masseter muscles presented similar values, as well as in the opening ranges up to 30 mm in men and women and in the different occlusal relationships. The activity of the Temporals for men and women and in the different occlusal relationships showed important variations between right and left and in the different degrees of opening. The presented technique allowed the study of the vertical dimension and oral openings through EMA and EMG.

Análisis cinemático de la masticación de alimentos duros y blandos en participantes dentados utilizando articulografía electromagnética 3D / Kinematic analysis of hard and soft food mastication in dentate participants using 3D electromagnetic articulography

RESUMEN: Diversos estudios reportan que el tipo de alimento influye directamente en los patrones cinemáticos de la masticación. El objetivo de este estudio fue analizar y comparar los ciclos masticatorios de participantes adultos y completamente dentados durante la masticación de alimentos de diferente textura y dureza (maní y zanahoria) utilizando articulografía electromagnética 3D. Se evaluaron 11 participantes sanos (5 hombres; 6 mujeres), de 31,9 ± 5,2 años de edad. Mediante articulografía electromagnética 3D, se registró la masticación de dos alimentos de prueba (maní y zanahoria). Los datos de movimiento mandibular fueron procesados con MATLAB® y obteniendo diferentes parámetros-frecuencia masticatoria en ciclos por segundo, velocidad de descenso y ascenso mandibular, área de las proyecciones de cada ciclo masticatorio en los tres planos del espacio-que fueron comparados según tipo de alimento y género de los participantes. Se encontraron diferencias estadísticamente significativas entre las áreas de los ciclos masticatorios en el plano horizontal según tipo de alimento, siendo mayor para la masticación de zanahoria (P=,003). Así mismo, se detectaron diferencias estadísticamente significativas entre las áreas sagitales de los ciclos entre hombres y mujeres, siendo mayor en mujeres (P=,042). Nuestros resultados concuerdan con otros estudios que afirman que la textura del alimento influye en las características cinemáticas de los ciclos masticatorios.

SUMMARY: Several studies report that the type of food directly influences the kinematic patterns of mastication. The aim of this study was to analyze and compare the chewing cycles of adult and fully dentate participants during the mastication of foods of different texture and hardness (peanuts and carrots) using 3D electromagnetic articulography. Eleven healthy participants (5 men; 6 women), 31.9 ± 5.2 years old, were evaluated. By means of 3D electromagnetic articulography, the mastication of two test foods (peanuts and carrots) was recorded. The data associated to mandibular movement were processed with MATLAB® obtaining different parameters-masticatory frequency in cycles per second, mandibular descent and ascent rate, area of the projections of each masticatory cycle in the three planes of space-which were compared according to type of food and sex of the participants. Statistically significant differences were found between the areas of the masticatory cycles in the horizontal plane according to type of food, being greater for carrots (P=.003). Likewise, statistically significant differences were detected between the sagittal areas of the cycles between men and women, being greater in women (P=.042). Our results agree with other studies that affirm that the texture of the food influences the kinematic characteristics of the masticatory cycles.

Description of acoustic and articulatory parameters of vowels in mapudungun speakers: pilot study / Descripción de parámetros acusticos y articulatorios de las vocales en hablantes de mapudungun: estudio piloto

Mapudungun is a language used by Mapuche people in some regions of Chile and Argentina. The aim of this study was to describe the vowel phonemes with regard to the articulatory parameters (position of the tongue with respect to the palate and jaw opening) and acoustic parameters (f0, F1, F2 and F3) in Mapudungun speakers in the Region of La Araucanía. The vocalic phonemes of Mapudungun are six, where the first five are similar to those used in Spanish (/a e i o u/), to which is added a sixth vowel (/ɨ/) with its vocalic allophones (/ɨ/) and [Ә]. Three Mapudungun speakers were evaluated. The tongue movements were collected by Electromagnetic Articulography 3D and the data were processed with MATLAB and PRAAT software. It was possible to describe the trajectory of each third of the tongue during the production of the vowels. It was observed that the sixth vowel /Ә/ had minimal jaw opening during its pronunciation. In addition, the characteristic of /Ә/ as an unrounded mid-central vowel was corroborated. In this study, the tongue of mapudungun speakers was in a more posterior position than the found in other studies.

El Mapudungun es un lenguaje utilizado por los mapuches en algunas regiones de Chile y Argentina. El objetivo de este estudio fue describir los fonemas vocálicos respecto a los parámetros articulatorios (posición de la lengua respecto al paladar y apertura mandibular) y los parámetros acústicos (f0, F1, F2 y F3) en hablantes de Mapudungun en la Región de La Araucanía, los fonemas vocálicos de Mapudungun son seis, donde los primeros cinco son similares a los utilizados en español (/a e i o u /), a los que se agrega una sexta vocal (/ɨ/) con sus alófonos vocálicos [ɨ] y [Ә]. Se evaluaron tres hablantes de Mapudungun. Los movimientos de la lengua fueron registrados por Articulografía Electromagnética 3D y los datos fueron procesados con el software MATLAB y PRAAT. Fue posible describir la trayectoria de cada tercio de la lengua durante la producción de las vocales. Se observó que la sexta vocal /Ә/ tenía una apertura mínima de la mandíbula durante su pronunciación. Además, se corroboró la característica de /Ә/ como vocal central media no redondeada. En este estudio, la lengua de los hablantes de mapudungun estaba en una posición más posterior que la encontrada en otros estudios.

Characteristics of Mandibular Movement and Mastication in Older Adults with Removable Dental Prostheses: Three-Dimensional Analysis / Características de Movimientos Mandibulares y Masticación en Adultos Mayores con Prótesis Dental Removible: un Análisis Tridimensional

ABSTRACT: Aging is a dynamic process that includes various alterations in the oral cavity, with tooth loss being the most frequent. Rehabilitative treatment may include removable or fixed prostheses and implants. The aim of this study was to describe the geometric (trajectory, ranges, areas) and kinematic (speed) characteristics of the mandibular and masticatory movements threedimensionally in participants with dental prostheses. A sample of 10 participants with removable prosthetic rehabilitation was divided into three groups (complete, atypical and overdenture) the characteristics of mandibular movements bordering and chewing with 3D Electromagnetic Articulography were measured. The Posselt polygonin was obtained, the frontal and sagittal plans, its areas, trajectories and ranges are analyzed. The masticatory movements were analyzed in the area of each cycle, the frequency, the speed and the reason between the masticatory cycle and the bordering movements, no significant differences between the groups. Subjects with dental prostheses, regardless of the type, they showed low of motion (border and functional) compared to dentate subjects with no functional alterations whose values have been reported in the literature. The subjects with overdenture have values closer to what is described for young dentate subjects.

RESUMEN: El envejecimiento es un proceso dinámico que incluye varias alteraciones en la cavidad oral, siendo la pérdida de dientes la más frecuente. El tratamiento de rehabilitación puede incluir prótesis fijas o removibles y/o implantes. El objetivo de este estudio fue describir las características geométricas (trayectoria, rangos, áreas) y cinemáticas (velocidad) de los movimientos mandibulares y masticatorios en participantes con prótesis dentales realizando un análisis en tres dimensiones. Se consideró una muestra de 10 participantes con rehabilitación protésica y se dividió en tres grupos (prótesis total, atípica e implantosoportada), se midieron las características de los movimientos mandibulares bordeantes y masticatorios con articulografía electromagnética 3D. Se obtuvo el polígono Posselt en los planos frontal y sagital, se analizaron sus áreas, trayectorias y rangos. Se analizaron los movimientos masticatorios en cuanto al área de cada ciclo, la frecuencia, la velocidad y la razón entre el área el ciclo masticatorio y los movimientos bordeantes, sin diferencias significativas entre los grupos. Los sujetos con prótesis dentales, independientemente del tipo, mostraron disminución de movimiento (bordeante y funcional) en comparación con los sujetos dentados sin alteraciones funcionales cuyos valores se han informado en la literatura. Los sujetos con prótesis implantosoportada tienen valores más cercanos a lo que se describe para sujetos jóvenes dentados.

Relación entre Síntomas de Trastornos Témporomandibulares Auto-Reportados y el Movimiento Mandibular de Sujetos Adultos Jóvenes / Relationship Between Symptoms of Self-Reported Temporomandibular Disorders and Mandibular Movement of Young Adult Subjects

RESUMEN: Tanto la limitación del movimiento mandibular como el auto reporte de síntomas de trastornos témporomandibulares (TTM) son utilizados como elementos para el diagnóstico de pacientes en la clínica. Sin embargo, la relación entre la presencia de síntomas y el movimiento mandibular no está del todo clara. Por ello, el objetivo de este estudio fue relacionar la presencia de síntomas asociados a TTM con el movimiento mandibular en una muestra de sujetos adultos jóvenes y sanos. En este estudio exploratorio participaron 40 estudiantes de Odontología, médicamente sanos, con arco dentario maxilar y mandibular continuo y completo (hasta el primer molar). A cada uno se les solicitó responder un cuestionario de auto-reporte de síntomas asociados a TTM recomendado por la American Academy of Orofacial Pain (AAOP). También se realizó un registro y análisis de sus movimientos mandibulares utilizando articulografía electromagnética 3D, con el objetivo de correlacionar la presencia de síntomas con el rango y trayectoria de apertura, y el área comprendida en lo que se describe como polígono de Posselt en el plano frontal y sagital. No se encontraron diferencias significativas entre las respuestas a cada pregunta entre hombres y mujeres. De acuerdo a las respuestas y según Delcanho (1994), 12 participantes resultaron necesitar una evaluación más exhaustiva. En este grupo se encontró que el área del polígono de Posselt en el plano frontal, fue significativamente menor que el de aquellos participantes que no requieren una evaluación más exhaustiva (p=0,003). Los valores de la trayectoria de apertura mandibular varían según de que síntoma se trate. Los principales síntomas que afectarían los valores de los movimientos bordeantes son la "dificultad para abrir la boca" y el "ruido en las articulaciones mandibulares". Con este estudio, hemos puesto de manifiesto que la limitación del movimiento mandibular como signo de TTM debe evaluarse con cautela, debido a que según la presencia de determinados síntomas y otras características de los sujetos (como el sexo), su valor podría variar.

ABSTRACT: Both the limitation of mandibular movement and the self-report of symptoms of temporomandibular disorders (TMD) are used for the diagnosis of patients in clinical diagnosis. However, the relationship between the symptoms and mandibular movement is not entirely clear. Therefore, the objective of this study was to relate the presence of symptoms associated with TMD with mandibular movement in a sample of young and healthy adult subjects. This exploratory study involved 40 medically healthy dentistry students with a continuous and complete maxillary and mandibular arch (up to the first molar). Each subject was asked to answer a self-report questionnaire for symptoms associated with TTM recommended by the American Academy of Orofacial Pain (AAOP). We also recorded and analyzed their mandibular movements using 3D electromagnetic articulography, with the aim of correlating the presence of symptoms with the range and trajectory of opening, and the area included in what is described as a polygon of Posselt in the frontal and sagittal plane. No significant differences were found between the answers to each question between men and women. According to the responses and to Delcanho, 12 participants turned out to need a more exhaustive evaluation. In this group it was found that the area of the Posselt polygon in the frontal plane was significantly smaller than that of those participants who did not require a more extensive evaluation (p = 0.003). The values of the mandibular opening path vary depending on the symptom involved. The main symptoms that would affect the values of the bordering movements are the "difficulty to open the mouth" and "noise in the mandibular joints". With this study, we have shown that the limitation of mandibular movement as a sign of TMD should be assessed with caution, as, according to the presence of certain symptoms and other characteristics of subjects (such as sex), its value may vary.

Articulatory Kinematic Characteristics during Speech Production for Individuals with Dysarthria: A Study Based on Electromagnetic Articulography / 中国康复理论与实践

@#Objective:To explore the kinematics characteristics of articulators (including lips, tongue and jaw) during articulation in dysarthric individuals post brain injury by using electromagnetic articulography (electromagnetic articulography, EMA). Methods:From October, 2017 to October, 2018, six eligible individuals with dysarthria were recruited as dysarthria group, and ten age-gender matched healthy adults were recruited as healthy control group. Both groups received EMA assessment, and the dysarthria group was assessed with Chinese modified version of Frenchay Dysarthria Assessment before EMA assessment. To track and record kinematic parameters data (including duration, velocity, acceleration, distance) and displacement movement trajectories, a series of sensors were attached on the participant's lips, tongue (tip, blade and back of tongue) and jaw, the reference sensor was attached on the bridge of nose, all of the sensors were along midsagittal plane. During EMA assessment, each participant was received syllable repetition task, which containing consonants (/d/, /t/, /j/, /q/, /g/, /k/, /b/, /p/) at word initial position and vowels (/a/, /ia/, /iu/), to produce the single word with the Chinese linguistic meaning, every syllable produced was repeated three times. Then Praat software and Matlab software were used to process acoustic and kinematic data, so as to compare the differences of articulatory kinematic performance between two groups. Results:The outcome of the Frenchay Dysarthria Assessment indicated that the severity of dysarthria was from moderate to extreme severe. EMA assessment demonstrated that, compared with the healthy control group, the dysarthria group showed a reduction of velocity, acceleration and distance of tongue and lip movement (<italic>t</italic> > 2.422, <italic>P</italic> < 0.05), and longer duration of tongue tip, tongue back and jaw movement (<italic>t</italic> > 3.369, <italic>P</italic> < 0.05). There was no statistical difference in duration of tongue blade and lip movement (<italic>t</italic> < 2.146, <italic>P</italic> > 0.05), the same as the velocity, acceleration and distance of jaw movement between two groups (<italic>t</italic> < 1.016, <italic>P</italic> > 0.05). Image analysis of kinematics parameters and synchronous audio data showed that, compared with the healthy control group, the dysarthria group varied unstably in velocity and acceleration, and the audio data showed that, when repeated /da/ three times, the duration of each syllable was not equal. The coordination of articulation movement displacement in the anterior-posterior dimension and inferior-superior dimension was poor, there were significant differences in visual inspection of movement trajectories between two groups, and a smaller displacement was found in the anterior-posterior dimension in the dysarthric group. Conclusion:EMA assessment has significant advantages in evaluating kinematics parameters quantitatively, which could reveal the kinematics characteristics of articulators.

Application of 3D Electromagnetic Articulography in Dentistry: Mastication and Deglutition Analysis. Protocol Report / Aplicación de la Articulografía Electromagnética 3D en Odontología: Análisis de la Masticación y Deglución. Reporte de Protocolo

ABSTRACT: The Stomatognathic System (SS) is an integrated and coordinated morphofunctional unit, consisting of skeletal, muscular, angiological, nervous, glandular and dental structures that work in harmony to perform different functions such as chewing, swallowing, speaking, breathing, tasting and esthetics. The study of SS physiology is crucial to achieving a correct maintenance of its normal function or restoration. Thus, we developed a protocol to record mandibular movement, chewing and swallowing (saliva and water) by using the 3D-electromagnetic articulograph AG501 at the Oral Physiology Laboratory of the Research Centre for Dental Sciences (CICO). This tool has been used for decades in speech and phonetic research and it is able to record, present and evaluate articulated structure movement data in real time. The articulograph provides an ordered data matrix (values ??for the x, y, z axes, among others) for the recorded movement, which is stored in binary files that can be processed by different software. One of these is MATLAB®, allowing us to perform a quick, clear and understandable analysis. The existence of a standardized methodology for recording allows an accurate description of the stages to perform different types of measurements according to the researcher's objective. This has opened the way for a new type of oral physiology analysis based on study reproducibility, which is considered one of the bases of scientific methodology.

RESUMEN: El Sistema Estomatognático es una unidad morfo-funcional integrada y coordinada, constituida por estructuras esqueléticas, musculares, angiológicas, nerviosas, glandulares y dentales que actúan en armonía para realizar diferentes funciones como la masticación, deglución, fonoarticulación, respiración, degustación y estética. Es importante el estudio de la fisiología del SE para lograr un correcto mantenimiento de su función normal, o para la restauración de este. Es así como en el Laboratorio de Fisiología Oral del Centro de Investigación en Ciencias Odontológicas (CICO) hemos desarrollado un protocolo para el registro del movimiento mandibular, masticación y deglución (saliva y agua), utilizando el articulógrafo electromagnético 3D AG501, el cual ha sido utilizado desde hace décadas en la investigación del habla y la fonética y que es capaz de grabar, presentar y evaluar en tiempo real datos del movimiento de estructuras articuladas. El articulógrafo provee de una matriz de datos ordenados (valores para los ejes x, y, z, entre otros) para el movimiento registrado, el cual se almacena en archivos binarios que pueden procesarse a través de diferentes softwares. Uno de ellos es MATLAB®, el cual nos permite realizar un análisis de forma rápida, clara y comprensible. La existencia de una estandarización metodológica de registro, permite describir de forma exacta las etapas para llevar a cabo distintos tipos de mediciones según el objetivo del investigador. De esta forma se abre la puerta a una nueva forma de análisis en la fisiología oral que se sustenta en la reproducibilidad de la investigación que es considerada una de las bases de la metodología científica.

An acoustic-articulatory study of the nasal finals in students with and without hearing loss / 生物医学工程学杂志

The central aim of this experiment was to compare the articulatory and acoustic characteristics of students with normal hearing (NH) and school aged children with hearing loss (HL), and to explore the articulatory-acoustic relations during the nasal finals. Fourteen HL and 10 control group were enrolled in this study, and the data of 4 HL students were removed because of their high pronunciation error rate. Data were collected using an electromagnetic articulography. The acoustic data and kinematics data of nasal finals were extracted by the phonetics and data processing software, and all data were analyzed by test and correlation analysis. The paper shows that, the difference was statistically significant ( <0.05 or <0.01) in different vowels under the first two formant frequencies (F1, F2), the tongue position and the articulatory-acoustic relations between HL and NH group. The HL group's vertical movement data-F1 relations in /en/ and /eng/ are same as NH group. The conclusion of this study about participants with HL can provide support for speech healing training at increasing pronunciation accuracy in HL participants.