Hindawi Publishing Corporation

BioMed Research International

Volume 2013, Article ID 354017, 7 pages
http://dx.doi.org/10.1155/2013/354017

Research Article
Relationship between Occlusal Force Distribution and the
Activity of Masseter and Anterior Temporalis Muscles in
Asymptomatic Young Adults

Aneta Wieczorek,1 Jolanta Loster,1 and Bartlomiej W. Loster2

1
Department of Dental Prosthetics, Institute of Dentistry, Jagiellonian University, 31-155 Kraków, Poland
2
Department of Orthodontics, Institute of Dentistry, Jagiellonian University, 31-155 Kraków, Poland

Correspondence should be addressed to Aneta Wieczorek; [email protected]

Received 7 September 2012; Revised 10 October 2012; Accepted 18 October 2012

Academic Editor: George Perry

Copyright © 2013 Aneta Wieczorek et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.

Healthy subjects have a prevalent side on which they display higher-muscle activity during clenching. e relationship between
symmetry of masseter muscle (MM) and anterior temporalis (TA) muscle activities and occlusion has been evaluated on the basis
of physiological parameters. e aim of the present study was to investigate whether the symmetry of surface EMG (sEMG) activity
in asymptomatic young adults is related to symmetry of occlusal contacts. Material. e study population consisted of seventy-two
18-year-old subjects with no temporomandibular disorder (TMD) symptoms. Method. All the participants underwent an sEMG
recording with an 8-channel electromyograph (BioEMG III). A T-Scan III evolution 7.01 device was used to analyze the occlusal
contact points. Results. e correlation between the activity of right (R) and le (L) TA and the percentage of occlusal contacts was
assessed, but no signi�cant differences were found between the RMM and LMM muscles. e differences in the medium values of
sEMG between males and females were not statistically signi�cant. Equilibrated muscular activity between RTA and LTA occurred
when occlusal contacts reached the percentage of 65% on the le side. Conclusion. e symmetry of sEMG activity in asymptomatic
young adults is not related to symmetry of occlusal contacts.

1. Introduction most oen manifest with a muscular abnormality which

can be analyzed by surface electromyography (sEMG) [2],
e stomatognathic system (SS) is responsible for such func- but Suvinen and Kemppainen concluded that until elec-
tions as speech, chewing, and swallowing, which remain in tromyographic measures are correlated with other multidi-
equilibrium in healthy individuals. Dental treatment should mensional, especially subjective and pain-related methods,
be planned on the basis of history taking followed by a the clinical use of this method for the diagnosis of TMD is
standardized physical examination. If any abnormalities are not at present recommended [3]. Also Klasser and Okeson
detected within the SS, it is important to perform an in- in their comprehensive review produced results which show
depth analysis for additional information [1]. is process that the clinical use of sEMG in the diagnosis and treatment
may be signi�cantly enhanced through the use of techniques of TMD is of limited value [4]. On the other hand, the
that objectively measure SS function and thereby reduce data from other researchers lacked comparative control data,
reliance on the subjective assessment of clinical observations. had small sample sizes, and differences in selection criteria
Rational treatment not only requires a good understanding and methodology [5–7]. According to the critical review of
of the pathogenesis of the diseases concerned but should also Suvinen and Kemppainen, a well-controlled clinical EMG
be based on an accurate diagnosis. It has been repeatedly study, homogeneous in subject age, is required [3].
shown that clinical examination alone can lead to gross e aim of the present study was to carry out such a
errors in diagnosis. Temporomandibular disorders (TMDs) study by investigating whether symmetry of sEMG activity in
2 BioMed Research International

asymptomatic young adults is related to symmetry of occlusal All examinations were performed between 8 am and
contacts. 10 am, just before school. Prior to the examination, the
e null hypothesis assumes that there is a symmetry volunteers were seated for 5 minutes in a quiet place listening
of sEMG activity of the masseter and anterior temporalis to relaxing music. e recordings were made in a quiet
muscles, which is strictly dependent on symmetry of occlusal environment, and external noises were controlled to avoid
contacts as measured by the distribution of forces in relation artifacts caused by smiling or other facial expressions. e
to the maximum force exerted. subjects were informed about the aim of the test so that they
could offer the maximum cooperation. During all examina-
tions, the patient was instructed to sit upright on a chair with
2. Material the head unsupported, with the trunk perpendicular to the
e study population consisted of 18-year-old subjects (44 �oor, both feet on the �oor, hands resting on the lap, and
females and 28 males, total 72) who were invited to par- looking forward. Aer the skin was cleaned with 95% alcohol
ticipate in MNiSW project no. N N403 589139 aimed at and rubbed with abrasive paper, to reduce electrode-skin
evaluating the status of the SS in healthy young individuals. impedance, the recording was performed by the use of bipolar
All the subjects were examined clinically by the same trained surface electrodes (BioFLEX: BioResearch Associates Inc.,
dentist and answered the Polish version of the RDC/TMD Brown Deer, WI, USA), following the manufacturer’s pro-
questionnaire for TMD [8]. e subjects were selected from tocol. e electrodes were placed bilaterally on the subject’s
two high schools in Krakow and were quali�ed for the skin overlying the anterior temporalis, vertically along the
study only if they had no past contact with either of the anterior muscular margin, approximatively over the coronal
researchers involved in the investigation or the instruments suture. For the masseter, the electrodes were placed parallel
under investigation. ese inclusion criteria were set to to muscular �bers, with the upper pole of the electrode at
avoid any potential bias resulting from preconceived ideas the intersection between the tragus-labial commissure and
[1]. e study was initiated aer the subjects had signed the exocanthion-gonion lines, perpendicular to the skin
informed consent forms, and the research program had been surface, according to the technique described by Ferrario
approved by the Ethical Committee of Jagiellonian University and Sforza [10]. A plate ground electrode was secured to
KBET//89B/2009. It was conducted in accordance with the the forehead [11]. Aer the set of sEMG electrodes was
Declaration of Helsinki. positioned, the subject was invited to clench the teeth as
hard as possible, three times for 3 s, with 3 s relaxation
Exclusion criteria were as follows: periodontal pathol- between each clench [12]. All the registrations were repeated
ogy, pain, bleeding and/or 3 mm probing depth, caries or three times. e sEMG examination involved recording the
damaged dental tissues, �xed restorations, past or ongoing occlusion with the use of T-Scan III device. All sEMG and
orthodontic therapy, bruxism diagnosed on the basis of T-Scan measurements were made by one investigator with
parafunctional facets and/or anamnesis of parafunctional expertise in the use of such devices and under continued in-
tooth clenching and/or grinding, neuropathic conditions house training organized by the manufacturer [1].
evaluated, systemic and/or localized maxillofacial disease, e T-Scan III soware automatically chose the still
botox therapy, psychological disorders, and pregnancy [9]. image with the maximal occlusal contact from the �rst clench
e inclusion criteria were as follows: a full dental arch, of selected second registration. e value of the maximal
no symptoms of TMD based on an RDC/TMD examination, voltage obtained in the registration of maximal clenching was
and compatible occlusal and skeletal classes. analyzed. e T-scan III soware automatically calculated the
distribution of occlusal forces, taking 100% of the value at the
3. Method maximum point of distribution of force in occlusal contacts
of an individual during the test. e soware used allows
All the study participants underwent an sEMG recording the maximum occlusal contact and its distribution to the
with a commercially available device—an 8-channel elec- right and le sides in relation to the midline to be displayed.
tromyograph (BioEMG III)—BioPAK Measurement System e study protocol assumed homogeneous analysis of the le
(BioResearch, Inc., Milwaukee, WI, USA). Surface EMG sig- side, where the values of <50% mean occlusion are on the
nals were obtained from four of the 8 channels. A T-Scan III right side and >50% on the le side. e T-Scan III/BioEMG
evolution 7.01 device (Tekscan Inc., South Boston, Ma, USA) Integration Soware showed maximum voltage of muscles
was used to analyze occlusal contact points. e instrument for this moment, bringing data up from the still of T-Scan
was directly interfaced with a computer which presented registration.
the data on a screen during the examination and recorded Aer the sEMG and T-scan examinations, alginate im-
them for further analysis. Additionally, T-Scan III/BioEMG pressions (Kromopan-Zhermapol, Poland) were taken, and
Integration Soware (Tekscan Inc/BioResearch Associates cephalometric radiographs were taken using the ProMax
technology partnership) was applied. is integrates the clin- radiographic unit (Planmeca, Finland, 2005).
ical data from the T-Scan III with the electromyographic data e analysis of occlusal and skeletal classes was made by
of the BioResearch’s EMG unit with which it is compatible. means of plaster study models and cephalometric examina-
is combination of systems makes it possible to record tions. e cephalometric �ndings were analyzed using the
simultaneously the force, timing, and balance of both the Kracovia Composite System (based on Bjork cephalometry)
craniofacial muscles and the occlusion. [13]. For assessing the sagittal jaw relationship, we used the
BioMed Research International 3

T 1: Intraclass correlation coefficient (ICC).

95% Con�dence interval F-Test with true value 0

Intraclass correlation
Lower bound Upper bound Value df1 df2 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃
Average measurements 0.765 0.540 0.890 4.259 23 48 0.000

T 2: e sEMG values for right and le masseters and temporalis anteriors in male and female members of the study group. Mann-
Whitney test.

Male (n = 28) Female (n = 44)

𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃
Mean 𝜇𝜇V SD Min 𝜇𝜇V Max 𝜇𝜇V Mean 𝜇𝜇V SD Min 𝜇𝜇V Max 𝜇𝜇V
RTA 119.93 93.471 15 397 133.14 69.833 25 428 0.06
LTA 92.25 42.655 11 197 108.73 61.428 24 314 0.44
RMM 147.89 97.632 31 355 115.05 74.431 11 347 0.27
LMM 130.46 93.779 27 492 121.45 72.733 42 335 0.69

A�B angle, which was veri�ed by Wits measurements, and For nonnormal data, the nonparametric Mann-Whitney and
jaw length (maxilla and mandible to porion). Jaw length was Kruskal-Wallis tests were used. For normal distribution, the
recorded as a percentage ratio, and this value was used in Student’s 𝑡𝑡-test was used. Intraclass correlation coefficient
some doubtful (borderline) cases. (ICC) was tested using F-test. Statistical signi�cance was set
Measurement variability was assessed by repeated sEMG at 5% (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃).
analyses of two subjects chosen at random. e operator
performed three independent sessions on the following days 5. Results
at this same hour each day and using the same protocol,
namely, that described by Ferrario et al. [14]. A recording (1) Measurement variability was assessed by repeated
lasting 2000 ms was made in each test from the �rst to sEMG analyses of three subjects and tested by com-
the third second. Accuracy and precision were calculated puting the ICC. For all sEMG variability, the ICC was
by means of the protocol used by Ferrario et al., namely, 0.765, showing a good accuracy of the measurements
intraclass correlation coefficient (ICC) analysis [7]. (as shown in Table 1).
Data analysis involved the following steps.
(2) Occlusal and skeletal classes of subjects. Using the
(1) Measurement variability. methodology described above, classes were as follows:
46 subjects were of class I, 19 of class II, and 7 of class
(2) Occlusal and skeletal classes of subjects. III.
(3) e sEMG values in relation to the gender. (3) e sEMG values in relation to the gender. As pre-
(4) SEMG activity. sented in Table 2, the differences between males and
females in medium values of sEMG for the right tem-
(5) Occlusal contacts distribution.
poralis anterior (RTA), le temporalis anterior (LTA),
(6) Relationship between occlusal force distribution and right masseter (RMM), and le masseter (LMM)
sEMG activity. muscles were not statistically signi�cant. erefore,
(7) Division into two groups: more than 50% and less all subsequent calculations were performed regardless
than 50% in relation to the le side. of gender.
(8) Division into three groups: distribution of force in (4) sEMG activity. Surface EMG recordings from the le
occlusal contacts almost equal to 50% (50 ± 0.5%), and right masseter and anterior temporalis muscles
higher than 50.5%, and lower than 49.5% in relation demonstrate statistically signi�cant differences in
to the le side. voltage of the muscles (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃) (Table 3), but
no signi�cant differences between LMM and RMM
(9) Division into three groups: �rst with distribution of muscles (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃).
force in occlusal contacts of 50 ± 5%, the second
(5) Occlusal contacts distribution. e normality of data
higher than 55%, and the third lower than 45% in
was analyzed using the Kolmogorov-Smirnov (with
relation to the le side.
the Lilliefors correction, 𝑃𝑃 𝑃 𝑃𝑃𝑃) and the Shapiro-
Wilk (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃𝑃). Due to insigni�cances, the normal
4. Statistical Analysis distribution of results was analyzed by the use of the
Student’s 𝑡𝑡-test (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃).
All the data were analyzed using the SPSS (Statistical
Package for the Social Sciences) Statistics 17.0 (2008) for In the analysis of the percentage of occlusal force, there
Windows. Data normality was tested using the Kolmogorov- were no signi�cant differences observed between females and
Smirnov (with Lilliefors correction) and Shapiro-Wilk tests. males (Table 4). However, the results showed that in female
4 BioMed Research International

T 3: e sEMG values for right and le masseters and temporalis anteriors. Mann-Whitney test.

Mean 𝜇𝜇V SD Min 𝜇𝜇V Max 𝜇𝜇V 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃

RTA 128.00 79.485 15 428
0.03
LTA 102.32 55.160 11 314
RMM 127.82 85.089 11 355
1.00
LMM 124.96 81.042 27 492

T 4: e percentage of force of occlusal contacts in male and female members of the study group. Student’s t-test.

Gender N Mean % SD 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃

Males 28 48.2 9.4
Interdental contact (le%) 0.074
Females 44 52.3 9.2

Any nonnormal distribution of results was subjected to fur-

5 ther analysis using parametric Mann-Whitney and Kruskal-
Wallis tests. Statistical signi�cance was set at 5% (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃).
Relationship between RTA/LTA

In the next step, any correlation between the activity of right

4 and le temporalis anterior muscles and the percentage of
occlusal contacts was assessed. For this purpose, the results
3 were divided into two groups; those with more than 50%
contacts (𝑛𝑛 𝑛 𝑛𝑛) and those with less than 50% (𝑛𝑛 𝑛 𝑛𝑛).
ॗ  
2 (7) Division into two groups: more than 50% and less
than 50% in relation to the le side. As shown in Table
5, the percentage of occlusal contacts was higher on
1
the right side in the group with interdental contact
values <50%. e mean value of differences between
0 RTA and LTA in the group with a distribution of
20 30 40 50 60 70 forces in occlusal contacts <50% was signi�cantly
Interdental contacts (%) higher (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃𝑃). is is also clearly shown in
F 1: Relationship between RTA and LTA and distribution the data presenting the relationship between RTA
of force in occlusal contacts presented as a percentage in relation and LTA. On the other hand, when the dominance
to the le side. is line is the regression equation; the ratio of of occlusal contacts was on the le side, the right-
RTA/LTA = 2.81 (constant beta) − 0.027 (beta for interproximal sided dominance of the muscle activity was lower, but
contacts) ∗ interproximal contacts. is line shows the direction still signi�cant (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃𝑃). is relation was not
of the relationship, with an increase in contacts between the teeth, signi�cant between le and right masseters.
reducing RTA to LTA ratio. e 𝑅𝑅 squared = 0.95 means that the
change in the value of “interproximal contacts (le%)” at 9.5% is Table 6 shows that the percentage of occlusal contacts
based on changes in the value of “the ratio of RTA/LTA.” was higher on the right side in the group with interdental
contact values <50%. e mean value in differences between
RMM and LMM showed a preponderance of right over le
masseter muscles and, in the group with a distribution of
population, the percentage of occlusal force distribution on force in occlusal contacts >50%, a preponderance of le over
the le side was approximately 52% in comparison to 48% in right masseter muscles. ese values were not statistically
male population. is difference is not statistically signi�cant. signi�cant with the relation between RMM/LMM (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃)
and the differences between RMM and LMM (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃),
(6) Relationship between occlusal force distribution and respectively.
sEMG activity. e correlation between the activity
of the right and le anterior temporalis muscles (8) Division into three groups: distribution of force in
(𝑦𝑦) and the percentage of occlusal contacts (𝑥𝑥) was occlusal contacts almost equal to 50% (50 ± 0.5%),
assessed. As presented in Figure 1, when occlusal higher than 50.5%, and lower than 49.5% in relation
contacts reached the percentage of 65% on the le to the le side.
side, equilibrated muscular activity between RTA and For further analysis of the correlation between occlusal
LTA occurred. A value above 65% indicated increased contacts and symmetry of activity of the temporalis anterior,
activity of the le temporalis anterior muscle. a further division of data was made between occlusal contacts
of 50 ± 0.5% (6 subjects), contacts >50.5% (36 subjects), and
e normality of data was tested using the Kolmogorov- those with <49.5% contacts (30 subjects). Here, the statistical
Smirnov (with Lilliefors correction) and Shapiro-Wilk tests. analysis involved the Kruskal-Wallis test.
BioMed Research International 5

T 5: Results for interdental contacts, in percentages, with the division into more than 50% and less than 50% in relation to the le side
for temporalis anterior muscles. Mann-Whitney test.

Interdental contacts in % N Mean SD Min Max 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃

Le (>50%) 39 1.146 0.6468 0.1 3.9
Relationship between RTA and LTA 0.002
Right (<50%) 33 1.739 0.9344 0.4 4.1
Le (>50%) 39 5.38 𝜇𝜇V 68.518 −145 𝜇𝜇V 268 𝜇𝜇V
Differences between RTA and LTA 0.005
Right (<50%) 33 49.67 𝜇𝜇V 73.495 −79 𝜇𝜇V 299 𝜇𝜇V

T 6: Results for interdental contacts, in percentages, with the division into more than 50% and less than 50% in relation to the le side
for masseter muscles. Mann-Whitney test.

Interdental contacts in % N Mean SD Min Max 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃

Le (>50%) 39 1.059 0.4924 0.1 2.3
Relationship between RMM/LMM 0.82
Right (<50%) 33 1.171 0.6373 0.5 3.2
Le (>50%) 39 −3.09 𝜇𝜇V 70.700 −199 𝜇𝜇V 132 𝜇𝜇V
Differences between RMM and LMM 0.84
Right (<50%) 33 9.92 𝜇𝜇V 69.923 −137 𝜇𝜇V 217 𝜇𝜇V

T 7: Results for interdental contacts, presented in percentages, with data divided into three groups: 50 ± 0.5%, more than 50.5%, and less
than 49.5% in temporalis anterior muscles. Kruskal-Wallis test.

Interdental contacts in % N Mean SD Min Max 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃

Le (>50.5%) 36 1.097 0.4687 0.1 2.4
Relationship between RTA and LTA Right (<49.5%) 30 1.740 0.9640 0.4 4.1 0.016
50 ± 0.5% 6 1.733 1.2707 0.5 3.9
Le (>50.5%) 36 3.17 𝜇𝜇V 49.452 −127 𝜇𝜇V 126 𝜇𝜇V
Differences between RTA and LTA Right (<49.5%) 30 44.90 𝜇𝜇V 71.096 −79 𝜇𝜇V 299 𝜇𝜇V 0.04
50 ± 0.5% 6 64.67 𝜇𝜇V 152.101 −145 𝜇𝜇V 268 𝜇𝜇V

e analysis concerning the percentage of occlusal con- right temporalis anterior muscle activity prevalence
tacts revealed that, in the group with force distributions was demonstrated in the relation of RTA/LTA (𝑃𝑃 𝑃
equaling 50 ± 0.5%, right temporalis anterior muscle activity 0.04) and the difference between RTA and LTA (𝑃𝑃 𝑃
was predominant, (Table 7) and this domination was still 0.012) (Table 9). Only in the group with over 55%
observed when occlusal contacts were more visible on the occlusal contacts on the le side was a signi�cant
right side and even slightly persisted when contacts were dominance of le temporalis anterior muscles activity
mainly present on the le side (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃). e same tendency visible. However, the mean value of the difference
was displayed in the analysis of the relationship between RTA between RTA and LTA was lower (−4.04 ± 54.444) in
and LTA (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃𝑃). comparison with the dominance of occlusal contacts
e analysis concerning le and right masseters is shown on the right side (46.94 ± 52.571).
in Table 8 in relationship to the group with force distributions
>50.5% on the le side, and dominance of le masseter e analysis concerning le and right masseters is shown
muscles was shown. is same tendency was seen in the in Table 10 in relationship to the group with force distri-
group with force distribution <49.5% on the le side with butions >55% according to the le side with dominance of
slight dominance of le masseter muscles. In the group with le masseter muscles. In the group with force distribution
force distributions equaling 50±0.5%, dominance of the right <45% on the le, dominance of le masseter muscles was
masseter muscle was shown. All these results were statistically shown. In the group with force distributions equaling 50±5%,
signi�cant (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃𝑃). dominance of the right masseter was shown. All these results
were not statistically signi�cant (𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃𝑃).
(9) Division into three groups: the �rst with a distribution
of force in occlusal contacts of 50 ± 5%, the second 6. Discussion
higher than 55%, and the third lower than 45% in
relation to the le side. Finally, the data were divided e aim of the study was to investigate whether there was
as follows. e �rst part of the 50±5% group included any correlation between symmetry of masseter and anterior
the examination results of 31 subjects, the second temporal muscles activities and occlusal force distribution
>55% part of 23 subjects, and the third <45% part of in asymptomatic young adults. A search of the literature
18, respectively (Tables 9 and 10). In the �rst group, related to the relationship between the distribution of force
6 BioMed Research International

T 8: Results for interdental contacts, presented in percentages, with data divided into three groups: 50 ± 0.5%, more than 50.5%, and less
than 49.5% in masseter muscles. Kruskal-Wallis test.
Interdental contacts in % N Mean SD Min Max P < 0.05
Le (>50.5%) 36 1.020 0.4909 0.1 2.3
Relationship between RMM and LMM Right (<49.5%) 30 1.114 0.6395 0.5 3.2 0.016
50 ± 0.5% 6 1.635 0.1996 1.4 1.9
Le (>50.5%) 36 −9.29 𝜇𝜇V 69.157 −199 𝜇𝜇V 132 𝜇𝜇V
Differences between RMM and LMM Right (<49.5%) 30 −1.12 𝜇𝜇V 63.064 −137 𝜇𝜇V 217 𝜇𝜇V 0.003
50 ± 0.5% 6 95.83 𝜇𝜇V 42.537 31 𝜇𝜇V 134 𝜇𝜇V

T 9: Interdental contacts in percentages, with data division into three groups: 45%–55%, more than 55%, and less than 45%. Kruskal-
Wallis test.
Interdental contacts in % N Mean SD Min Max 𝑃𝑃 𝑃 𝑃𝑃𝑃𝑃
Le (>55%) 23 1.052 0.5125 0.1 2.4
Relationship between RTA and LTA Right (<45%) 18 1.872 0.9336 0.4 3.8 0.004
45%–55% 31 1.426 0.8706 0.4 4.1
Le (>55%) 23 −4.04 𝜇𝜇V 54.444 −127 𝜇𝜇V 126 𝜇𝜇V
Difference between RTA and LTA Right (<45%) 18 46.94 𝜇𝜇V 52.571 −79 𝜇𝜇V 166 𝜇𝜇V 0.012
45%–55% 31 35.39 𝜇𝜇V 89.949 −145 𝜇𝜇V 299 𝜇𝜇V

T 10: Results for interdental contacts, in percentages, with data divided into three groups: 45%–55%, more than 55%, and less than 45%.
Kruskal-Wallis test.
Intedental contacts in % N Mean SD Min Max P < 0.05
Le (>55%) 23 1.031 0.4320 0.2 2.1
Relationship between RMM and LMM Right (<45%) 18 1.014 0.5623 0.5 2.1 0.267
45%–55% 31 1.226 0.6385 0.1 3.2
Le (>55%) 23 −3.88 𝜇𝜇V 63.938 −199 𝜇𝜇V 132 𝜇𝜇V
Differences between RMM and LMM Right (<45%) 18 −14.81 𝜇𝜇V 56.789 −137 𝜇𝜇V 102 𝜇𝜇V 0.152
45%–55% 31 18.16 𝜇𝜇V 79.737 −180 𝜇𝜇V 217 𝜇𝜇V

in occlusal contacts and sEMG of masseter and anterior side of the temporalis anterior, especially when the percent-
temporalis muscles did not reveal many studies involving a age of interdental contacts is close to 50%. However, in our
comparative age group. At this age (18 years), all 28 teeth are study, there were few subjects with a symmetric distribution
already erupted, bone growth is �nished, or is almost �nished of occlusal force. As mentioned previously, Ferrario et al.
and the teeth have low levels of physiological abrasion. All [5] showed that healthy individuals have a prevalent side on
the subjects in our study had no prior history of orthodontic which they generate higher levels of muscular activity during
treatment or any symptoms of TMD, based on an RDC/TMD bilateral clenching [17]. A higher level of muscular activity
examination. of RTA was demonstrated in our study, and this tendency
It is reasonable to believe that the homogeneity of the was still visible, even when occlusal forces were more evenly
studied sample enhanced the internal validity of the study. As distributed on the le side.
reported by other researchers, we found in our study that the Some studies report that a T-Scan sensor signi�cantly
voltage recorded in the anterior part of the temporalis muscle in�uences sEMG activity of the super�cial masseter muscle,
is higher than in the masseter muscle in healthy subjects. whereas it does not affect the anterior temporalis when
Some researchers have demonstrated asymmetry in clench compared to occlusion in the natural dentition. Some
potentials between le and right muscles [15]. Similarly, researchers suggest that T-Scan is a good tool for chair-side
Suvinen and Kemppainen [3] and Scopel et al. [16], in their analysis of the occlusion [6, 18, 19]. However, the T-scan
investigations, reported that even in the mandibular pos- III system can be integrated with the BioEMG III system.
tural position, asymptomatic muscles were physiologically In this way, synchronized clinical data can be recorded
asymmetrical, and that asymmetry and activity indices of simultaneously. Additionally, the measurements obtained
4% and 17%, respectively, were to be considered as normal. can be comparatively reviewed during playback [20]. For
Moreover, this study showed that most subjects presented a the time being, T-Scan III/BioEMG Integration Soware is
right-side temporalis anterior muscle dominance. considered as the best tool in the market since it allows simul-
On the basis of our study, it may be concluded that in taneous recording analysis of the sEMG of selected muscles
asymptomatic patients, asymmetry tends to affect the right and of the distribution of occlusal force while correlating
BioMed Research International 7

speci�c occlusal moments with speci�c electromyographic during occlusion,” Journal of Oral Rehabilitation, vol. 38, no. 9,
changes. pp. 655–660, 2011.
Analysis of tension of TA and MM muscles in each [7] V. F. Ferrario, G. M. Tartaglia, A. Galletta, G. P. Grassi, and
analyzed occlusal force distribution shows that the right- C. Sforza, “e in�uence of occlusion on jaw and neck muscle
handed tendency of TA muscles can be corrected by the le- activity: a surface EMG study in healthy young adults,” Journal
handed asymmetry of MM muscles. However, this requires of Oral Rehabilitation, vol. 33, no. 5, pp. 341–348, 2006.
further well-designed and controlled research and analysis. [8] M. A. Osiewicz, F. Lobbezoo, B. W. Loster et al., “Badawcze
kryteria diagnostyczne zaburzeń czynnościowych układu
ruchowego narzadu żucia BKD/ZCURNŻ—polska wersja
7. Conclusion dwuosiowego systemu diagnostycznego ZCURNŻ,” Protet
Stomatol, vol. 60, pp. 433–444, 2010.
e null hypothesis that the symmetry of electromyographic
[9] U. Santana-Mora, J. Cudeiro, M. J. Mora-Bermúdez et al.,
activity of masseter and anterior temporalis muscles is strictly
“Changes in EMG activity during clenching in chronic pain
connected with symmetry in occlusal contacts, as measured patients with unilateral temporomandibular disorders,” Jour-
by distribution of forces in relation to the maximum force nal of Electromyography and Kinesiology, vol. 19, no. 6, pp.
exerted, was rejected. e543–e549, 2009.
e symmetry of sEMG activity in asymptomatic young [10] V. F. Ferrario and C. Sforza, “Coordinated electromyographic
adults is not related to symmetry of occlusal contacts. activity of the human masseter and temporalis anterior muscles
during mastication,” European Journal of Oral Sciences, vol. 104,
Con�ict of �nterests no. 5-6, pp. 511–517, 1996.
[11] M. Venegas, J. Valdivia, M. J. Fresno et al., “Clenching and
e authors declare no potential con�ict of interests with grinding: effect on masseter and sternocleidomastoid elec-
respect to the authorship and/or publication of this paper. tromyographic activity in healthy subjects,” Cranio, vol. 27, no.
3, pp. 159–166, 2009.
[12] Z. J. Liu, K. Yamagata, Y. Kasahara, and G. Ito, “Electromyo-
Acknowledgments graphic examination of jaw muscles in relation to symptoms
is study was supported by a grant from the Ministry of and occlusion of patients with temporomandibular joint disor-
Education and Research for Jagiellonian University Medical ders,” Journal of Oral Rehabilitation, vol. 26, no. 1, pp. 33–47,
1999.
College and completed within MNiSW project no. N N403
589139. e authors would like to express their appreciation [13] S. Williams and B. W. Loster, “Cephalometrics rationalised:
presenting the Kracovia Composite System (KCS),” Journal of
to BioResearch (Milwaukee, WI, USA) for their training on
Stomatology, vol. 64, pp. 525–542, 2012.
the BioEMG and T-scan III systems and help with BIO-FLEX
[14] V. F. Ferrario, C. Sforza, A. D’Addona, and A. Miani, “Repro-
sensors and to Tekscan Inc. (South Boston, MA, USA) for
ducibility of electromyographic measures: a statistical analysis,”
the donation of sensors. ey express their sincere thanks to Journal of Oral Rehabilitation, vol. 18, no. 6, pp. 513–521, 1991.
Professor Geoffrey Shaw for his English editing of this script.
[15] V. F. Ferrario, C. Sforza, A. Miani, A. D’Addona, and E. Barbini,
“Electromyographic activity of human masticatory muscles in
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