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VOLUME 20 , ISSUE 12 ( December, 2019 ) > List of Articles

ORIGINAL RESEARCH

Treatment of Temporomandibular Disorders of Muscular Origin with a Silicon Oral Device (Alifix®): Electromyographic Analysis

Alessandro Nanussi, Giulia Costa, Marco Baldoni

Keywords : Alifix, Electromyography, Muscle pain, Oral osteopathy, Temporomandibular disorders

Citation Information : Nanussi A, Costa G, Baldoni M. Treatment of Temporomandibular Disorders of Muscular Origin with a Silicon Oral Device (Alifix®): Electromyographic Analysis. J Contemp Dent Pract 2019; 20 (12):1367-1374.

DOI: 10.5005/jp-journals-10024-2704

License: CC BY-NC 4.0

Published Online: 00-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: The aim of this work was to evaluate if the use of a silicone device for muscular rebalancing (Alifix®) can be useful in treating of temporomandibular disorders (TMD) of muscular origin and improving the electromyographic indexes of the chewing muscles. Materials and methods: Thirteen patients (11 F and 2 M aged between 24 years and 65 years) with TMD of muscular origin according to diagnostic criteria (DC)/TMD were involved. At the first visit (T0), each patient reported the pain intensity of masseters and temporal muscles. A surface electromyography (EMG) was performed using Teethan® (Teethan S.p.A.) and then Alifix® was delivered instructing the patient on its use. Each subject was visited again after 1 month (T1) and 2 months (T2). New EMG had been made at T1 and T2, and patients were asked again to report the pain intensity. Statistical analysis was calculated between T0 and T1, T1 and T2, and T0 and T2 for all EMG, and muscle pain measurements by Wilcoxon test with statistical significance p < 0.05. Results: Regarding the pain values between T0 and T1, T1 and T2, and T0 and T2, the difference is statistically significant, since the intensity of pain between T0 and T2 is decreased, if not disappeared, in 90% of cases. The use of Alifix® also determined a gradual improvement in the values of the EMG indexes, which, however, is not statistically significant. Conclusion: The effectiveness of Alifix® is demonstrated clinically but not at an instrumental level. Further studies involving a larger sample and taking longer therapy duration are needed. Clinical significance: Alifix® works by improving the blood circulation of the muscle, which allows the removal of catabolites with a consequent reduction of the algic symptomatology and promotes a greater supply of oxygen. It also encourages a conversion of IIA type muscle fibers into slow-twitch type I fibers that are more resistant to neuromuscular fatigue.


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  1. Cairns BE. Pathophysiology of TMD pain-basic mechanisms and their implications for pharmacotherapy. J Oral Rehabil 2010;37(6):391–410. DOI: 10.1111/j.1365-2842.2010.02074.x.
  2. Douglas CR, Avoglio JL, de Oliveira H. Stomatognathic adaptive motor syndrome is the correct diagnosis for temporomandibular disorders. Med Hypotheses 2010;74(4):710–718. DOI: 10.1016/j.mehy.2009.10.028.
  3. Ferrario VF, Sforza C, Tartaglia GM, et al. Immediate effect of a stabilization splint on masticatory muscle activity in temporomandibular disorder patients. J Oral Rehabil 2002;29(9): 810–815. DOI: 10.1046/j.1365-2842.2002.00927.x.
  4. Ferrario VF, Tartaglia GM, Luraghi FE, et al. The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders. Man Ther 2007;12(4):372–379. DOI: 10.1016/j.math.2006.07.013.
  5. Landulpho AB, E Silva WAB, E Silva FA, et al. Electromyographic evaluation of masseter and anterior temporalis muscles in patients with temporomandibular disorders following interocclusal appliance treatment. J Oral Rehabil 2004;31(2):95–98. DOI: 10.1046/j.0305-182x.2003.01204.x.
  6. Suvinen TI, Reade PC, Kononen M, et al. Vertical jaw separation and masseter muscle electromyographic activity: a comparative study between asymptomatic controls and patients with temporomandibular pain and dysfunction. J Oral Rehabil 2003;30(8): 765–772. DOI: 10.1046/j.1365-2842.2003.01114.x.
  7. DeVocht JW, Long CR, Zeitler DL, et al. Chiropractic treatment of temporomandibular disorders using the activator adjusting instrument: a prospective case series. J Manipulative Physiol Ther 2003;26(7):421–425. DOI: 10.1016/S0161-4754(03)00096-4.
  8. Tartaglia GM, Moreira Rodrigues da Silva MA, Bottini S, et al. Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups. Man Ther 2008;13(5):434–440. DOI: 10.1016/j.math.2007.05.011.
  9. Roark AL, Glaros AG, O'Mahony AM. Effects of interocclusal appliances on EMG activity during parafunctional tooth contact. J Oral Rehabil 2003;30(6):573–577. DOI: 10.1046/j.1365-2842.2003.01139.x.
  10. Venino PM, Citterio CL, Pellegatta A, et al. A micro-computed tomography evaluation of the shaping ability of two nickel-titanium instruments, hyflex EDM and protaper next. J Endod 2017;43(4): 628–632. DOI: 10.1016/j.joen.2016.11.022.
  11. Maddalone M, Ferrari M, Stanizzi A, et al. Use of miniscrew implants in orthodontic distal movement. Dental Cadmos 2010;78(8):97–105.
  12. Maddalone M, Ferrari M, Barrila’ S, et al. Intrusive mechanics in orthodontics with the use of TAD's. Dental Cadmos 2010;78(7):97–106.
  13. Kovalenko A, Slabkovskaya A, Drobysheva N, et al. The association between the psychological status and the severity of facial deformity in orthognathic patients. Angle Orthodontist 2012;82(3):396–402. DOI: 10.2319/060211-363.1.
  14. Citterio F, Pellegatta A, Citterio CL, et al. Analysis of the apical constriction using micro-computed tomography and anatomical sections. Giornale Italiano di Endodonzia 2014;28:41–45.
  15. Maddalone M, Gagliani M, Citterio CL, et al. Prevalence of vertical root fractures in teeth planned for apical surgery. A retrospective cohort study. Int Endod J 2018;51(9):969–974. DOI: 10.1111/iej.12910.
  16. Khudanov BO, Abdullaev JR, Bottenberg P, et al. Evaluation of the fluoride releasing and recharging abilities of various fissure sealants. Oral Health Prev Dent 2018; 96–103. DOI: 10.3290/j.ohpd.a39823.
  17. Caccianiga G, Paiusco A, Perillo L, et al. Does low-level laser therapy enhance the efficiency of orthodontic dental alignment? results from a randomized pilot study. Photomed Laser Surg 2017;35(8):421–426. DOI: 10.1089/pho.2016.4215.
  18. Porcaro G, Busa A, Bianco E, et al. Use of a partial-thickness flap for guided bone regeneration in the upper jaw. J Contemp Dent Pract 2017;18(12):1117–1121. DOI: 10.5005/jp-journals-10024-2186.
  19. Porcaro G, Tremolizzo L, Appollonio I, et al. Persistent hiccup reflex activation as a complication of dental implant surgery: a case report. Oxf Med Case Reports 2018;2018(6):199–201.
  20. Galluzzi F, Pignataro L, Maddalone M, et al. Recurrences of surgery for antrochoanal polyps in children: a systematic review. Int J Pediatr Otorhinolaryngol 2018;106:26–30. DOI: 10.1016/j.ijporl.2017.12.035.
  21. Ambu E, Citterio CL, Pellegatta A, et al. The use of limited CBCT in the early diagnosis of root vertical fracture: a case report. Glob J Oral Sci 2018;4:18–24.
  22. Kogawa EM, Calderon PS, Lauris JRP, et al. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil 2006;33(8):559–565. DOI: 10.1111/j.1365-2842.2006.01619.x.
  23. Kiliaridis S, Tzakis MG, Carlsson GE. Effects of fatigue and chewing training on maximal bite force and endurance. Am J Orthod Dentofacial Orthop 1995;107(4):372–378. DOI: 10.1016/s0889-5406(95)70089-7.
  24. Thompson DJ, Throckmorton GS, Buschang PH. The effects of isometric exercise on maximum voluntary bite forces and jaw muscle strength and endurance. J Oral Rehabil 2001;28(10):909–917. DOI: 10.1046/j.1365-2842.2001.00772.x.
  25. Masumoto N, Yamaguchi K, Fujimoto S. Daily chewing gum exercise for stabilizing the vertical occlusion. J Oral Rehabil 2009;36(12): 857–863. DOI: 10.1111/j.1365-2842.2009.02010.x.
  26. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group. J Oral Facial Pain Headache 2014;28(1):6–27. DOI: 10.11607/jop.1151.
  27. Ferrario VF, Tartaglia GM, Galletta A, et al. The influence of occlusion on jaw and neck muscle activity: a surface EMG study in healthy young adults. J Oral Rehabil 2006;33(5):341–348. DOI: 10.1111/j.1365-2842.2005.01558.x.
  28. Catanzariti JF, Debuse T, Duquesnoy B. Chronic neck pain and masticatory dysfunction. Joint Bone Spine 2005;72(6):515–519. DOI: 10.1016/j.jbspin.2004.10.007.
  29. Pimenta Ferreira CL, Bellistri G, De Felicio CM, et al. Patients with myogenic temporomandibular disorders have reduced oxygen extraction in the masseter muscle. Clin Oral Invest 2017;21(5): 1509–1518. DOI: 10.1007/s00784-016-1912-2.
  30. Grünheid T, Langenbach GEJ, Korfage JAM, et al. The adaptive response of jaw muscles to varying functional demands. Eur J Orthod 2009;31(6):596–612. DOI: 10.1093/ejo/cjp093.
  31. Davis NW. Modulation of ATP-sensitive K+ channel in skeletal muscle by intracellular protons. Nature 1990;343(6256):375–377. DOI: 10.1038/343375a0.
  32. Manabe Y, Gollisch KSC, Holton L, et al. Exercise training-induced adaptations associated with increases in skeletal muscle glycogen content. FEBS J 2013;280(3):916–926. DOI: 10.1111/febs. 12085.
  33. Carini F, Longoni S, Pisapia V, et al. Implant-supported prostheses with temporomandibular joint reproduction after hemimandibular resection: a case report. Ann Stomatol (Roma) 2014;5(Suppl 2 to No 2):1–9.
  34. Hruby RJ. The total body approach to the osteopathic management of temporomandibular joint dysfunction. J Am Osteopath Assoc 1985;85(8):502–510.
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