Electromyographic indices, orofacial myofunctional status and temporomandibular disorders severity: A correlation study

This study examined whether there is an association between surface electromyography (EMG) of masticatory muscles, orofacial myofunction status and temporomandibular disorder (TMD) severity scores. Forty-two women with TMD (mean 30 years, SD 8) and 18 healthy women (mean 26 years, SD 6) were examined. According to the Research Diagnostic Criteria for TMD (RDC/TMD), all patients had myogenous disorders plus disk displacements with reduction. Surface EMG of masseter and temporal muscles was performed during maximum teeth clenching either on cotton rolls or in intercuspal position. Standardized EMG indices were obtained. Validated protocols were used to determine the perception severity of TMD and to assess orofacial myofunctional status. TMD patients showed more asymmetry between right and left muscle pairs, and more unbalanced contractile activities of contralateral masseter and temporal muscles (p < 0.05, t-test), worse orofacial myofunction status and higher TMD severity scores (p < 0.05, Mann-Whitney test) than healthy subjects. Spearman coefficient revealed significant correlations between EMG indices, orofacial myofunctional status and TMD severity (p < 0.05). In conclusion, these methods will provide useful information for TMD diagnosis and future therapeutic planning. (C) 2011 Elsevier Ltd. All rights reserved.

Validity of the 'protocol of oro-facial myofunctional evaluation with scores' for young and adult subjects

The aims of this study were to analyse the validity, sensitivity and specificity of the protocol of oro-facial myofunctional evaluation with scores (OMES) for oro-facial myofunctional disorder (OMD) diagnosis in young and adult subjects. Eighty subjects were examined. The OMES was validated against the Nordic Orofacial Test-Screening (NOT-S) protocol (criterion validity) (Spearman correlation test). The construct validity was tested by analysis of the ability of the OMES (i) to differentiate healthy subjects (n = 22) from temporomandibular disorder (TMD) patients (n = 22), which frequently have OMD (MannWhitney test) and (ii) to measure the changes that occurred in a subgroup with TMD between the period before and after oro-facial myofunctional therapy (T group, n = 15) (Wilcoxon test). Two speech therapists trained with the OMES participated as examiners (E). There was a statistically significant correlation between the OMES and NOT-S protocols, which was negative because the two scales are inverse (r = -0.86, P < 0.01). There was a significant difference between the healthy and TMD subjects regarding the oro-facial myofunctional status (OMES total score, P = 0.003). After therapy, the T group showed improvement in the oro-facial myofunctional status (OMES total score, P = 0.001). Inter- and intra-examiner agreement was moderate, and the reliability coefficients ranged from good to excellent. The OMES protocol presented mean sensitivity and specificity = 0.80, positive predictive value = 0.76 and negative predictive value = 0.84. Conclusion: The OMES protocol is valid and reliable for clinical evaluation of young and adult subjects, among them patients with TMD.

High prevalence of orofacial complaints in patients with fibromyalgia: a case-control study

Objective. The aim of this study was to investigate the orofacial complaints and characteristics of patients with fibromyalgia syndrome (FS) compared with controls. Study Design. We evaluated 25 patients diagnosed with FS compared with 25 gender-and age-matched controls by using a detailed clinical protocol for orofacial pain diagnosis and dental examination. Results. FS patients had a higher frequency of temporomandibular disorders (TMD), masticatory complaints, pain with mandibular movements, and pain upon palpation of the head and neck area. There were no significant differences related to the dental exam. Conclusions. Orofacial complaints including TMD may be present either as symptoms of FS or as a comorbidity associated with this condition. A comprehensive evaluation of patients with FS is necessary to identify the need for specific treatments for orofacial complaints. Future studies, especially those with longitudinal design, should clarify whether a cause-effect relationship exists between orofacial complaints and fibromyalgia. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:e29-e34)