Effect of dry needling and instrumental myofascial release on masticatory, facial, and cervical muscles of patients with temporomandibular disorders of muscular origin.

Background: To evaluate the effectiveness of dry needling (DN) and instrumental myofascial release (IMR) therapies in the cervico-cranio-mandibular system through pain, bite force, and distribution of occlusal contacts in patients with muscular temporomandibular disorders. Material and Methods: Thirty patients were divided into treatment groups: DN (n=15) and IMR (n=15). Therapeutic efficacy regarding pain perception and tolerance of masticatory, facial, and cervical muscles, bite force, and distribution of occlusal contacts were analyzed in this observational longitudinal clinical study pre/post-intervention and pre/post one month of therapeutic intervention. The data were tabulated and statistically analyzed (repeated measures and Bonferroni post-hoc test, p<0.05). Results: There was a statistically significant difference in pain between the groups in the comparison of pre- and post-intervention with effect on time versus intervention in the head and neck. Pain perception and tolerance showed a statistical effect of time on the temporal, suboccipital, sternocleidomastoid, mental (right and left), right masseter, and left trapezius muscles. There was a statistically significant effect of the intervention on the mentalis, supraorbital, and infraorbital (right and left) muscles. There was a statistically significant effect of the interaction on the upper masseter (right and left), anterior temporal (left), suboccipital, sternocleidomastoid, and mentalis (left) muscles. There was an increase in post-intervention molar bite force in the groups, with a statistical effect on time versus intervention in the right and left regions. Contact of occlusal forces at the maxilla/mandible interface showed a difference between the mean times on teeth 26-36 after versus 1 month after the intervention. Conclusions: The two therapeutic techniques are viable for the treatment of muscular temporomandibular disorders; however, IMR proved to be more effective immediately after the intervention and after one month. Key words:Temporomandibular disorders, pain, masticatory muscles, facial muscles, cervical muscles, dry needling, instrumental myofascial release.

Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy.

The aging process affects the entire human body, including the stomatognathic system, and can trigger not only occlusal but also postural imbalances involving other muscular chains. Hippotherapy has been used to promote cervical, postural, and balance control in individuals with diverse impairments. The present study used electromyography to evaluate the masseter and temporal muscles in an elderly population pre- and post-hippotherapy. Participants included 17 individuals, mean age 66,5±7 years. Electromyographic recording of the bilateral masseter and temporal muscles was performed during the postural resting condition and activities that involved the active participation of these muscles in different conditions. The practitioner performed no other type of activity or exercise during the intervention because the objective is to evaluate the effect of the three-dimensional movement provided by the horse. Raw electromyographic data were tabulated using commercially available software (IBM® SPSS® Statistics 234.0) and subjected to statistical analysis, in which p ≤ 0.05 was considered to be statistically significant. Post-hippotherapy, there was lower electromyographic activity for the masseter and temporalis muscles in all the static mandibular tasks, with significant effect for time for the right temporal muscle (p = 0.038), the left temporal muscle (p = 0.028) and in the all dynamic mandibular tasks for the left temporal muscle (p = 0.025) and the left masseter muscle (p = 0.027). Hippotherapy promotes a reduction in the myoelectric activity of the masticatory muscles of elderly individuals.

Osteoarthrosis: Analyze of the Molar Bite Force, Thickness and Masticatory Efficiency.

Osteoarthrosis is a disorder of synovial joints, resulting from destruction of the cartilage and subchondral bone. The present study is aimed to investigate the molar bite force, thickness and efficiency of the masseter and temporalis muscles of subjects with osteoarthrosis. A total of forty-eight subjects participated in the study. They were distributed into two groups: with osteoarthrosis (n=24) and asymptomatic controls (n=24). Subjects were analyzed on the basis of maximal molar bite force (right and left side), thickness (mandibular rest and dental clenching in maximal voluntary contraction) and electromyographic activity of masticatory cycles through the linear envelope integral in habitual (raisins and peanuts) and non-habitual (Parafilm M) chewing of the masseter and temporalis muscles. All the data were analyzed statistically using t-test with a significance level of p≤0.05. There was no difference between groups in maximal molar bite force, muscle thickness and non-habitual chewing. Differences were found on the raisins (p=0.02) and peanuts (p=0.05) chewing for right temporal muscle, with reduced masticatory muscle efficiency in osteoarthrosis subjects. This study showed that osteoarthrosis induces negative changes in habitual chewing, highlighting the efficiency of the right temporalis muscles. The greater temporal muscle activity in subjects with osteoarthrosis may compromise chewing and consequently the nutritional status of adult subjects.