Application of digital mandibular movement record and masticatory muscle electromyography in the evaluation of stomatognathic function in patients with mandibular tumor

  • Jing WANG ,
  • Jun-peng CHEN ,
  • Yang WANG ,
  • Xiang-liang XU ,
  • Chuan-bin GUO
Expand
  • Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China

Received date: 2019-03-18

  Online published: 2019-06-26

Supported by

Supported by the Fundamental Research Funds for the Central Universities: Peking University Clinical Scientist Program (BMU2019LCKCJ009) and Youth Fund of Peking University School and Hospital of Stomatology (PKUSS20180202)

Abstract

Objective: To study the clinical characteristics of mandibular movement and masticatory muscle function in preoperative and postoperative patients with unilateral mandibular tumors in the region of mandibular body and ramus by combining digital mandibular movement records with electromyography, and to preliminarily explore the relationship and mechanism between movement and masticatory muscle function.Methods: Six preoperative patients with tumor in unilateral body and ramus of mandible were included, and three postoperative patients with unilateral segmental resection and reconstruction of mandibular bone were included. The mandibular movement recording system and surface electromyography system were used to collect the movement trajectory of the patients’ mandibular marginal movement and chewing movement, and the surface electromyography of bilateral masseter and temporalis was recorded concurrently. The surface electromyography of bilateral masseter and temporalis was collected when the patients were at relaxation and at maximal voluntary clenching (MVC). The motion trajectory was observed on the digital virtual model, and the motion amplitude and direction of mandibular marginal movements were analyzed. The characteristics of masticatory electromyogram (EMG) activity in affected and unaffected sides at relaxation, MVC and bilateral mastication were analyzed, and the asymmetry indexes and activity indexes were calculated. Results: The preoperative mean maximum opening of the patients was (35.20±6.87) mm. Three patients had mild mouth opening limitation, and all the patients’ mouth opening trajectory was skewed to the affected side. During lateral movements, the mean range of motion of the affected side [(10.34±1.27) mm] and that of the healthy side [(6.94±2.41) mm] were significantly different. The maximum opening of the postoperative patients was (30.65±17.32) mm, and the mandibular marginal movement characteristics were consistent with those of the patients before surgery. During MVC in the preoperative patients, the median EMG activities of the masseter muscle [44.20 (5.70, 197.90) μV] and the temporalis muscle [42.15 (22.90, 155.00) μV] on the affected side were slightly lower than those of the masseter [45.60 (7.50, 235.40) μV] and the temporalis muscle [63.30 (44.10, 126.70) μV] on the healthy side. In the postoperative patients, individualized changes occurred. Some patients suffered from weakened electromyographic activity on the affected side, while some other ones showed hyperelectromyographic activity on the affected side.Conclusion: Both benign and malignant tumors as well as their surgery can cause abnormal mandibular movements and change of electromyographic activity of bilateral masseter and temporalis muscles.

Cite this article

Jing WANG , Jun-peng CHEN , Yang WANG , Xiang-liang XU , Chuan-bin GUO . Application of digital mandibular movement record and masticatory muscle electromyography in the evaluation of stomatognathic function in patients with mandibular tumor[J]. Journal of Peking University(Health Sciences), 2019 , 51(3) : 571 -578 . DOI: 10.19723/j.issn.1671-167X.2019.03.029

References

[1] 袁道英, 杨佑成, 宋冰 . 下颌骨髁状突骨软骨瘤一例报告[J]. 中华肿瘤防治杂志, 2007,14(22):1759-1760.
[2] Krause I, Eisenstein B, Davidovits M , et al. Maxillomandibular brown tumor: a rare complication of chronic renal failure[J]. Pediatr Nephrol, 2000,14(6):499-501.
[3] Park SR, chung SM, Lim JY , et al. Giant cell tumor of the mandible[J]. Clin Exp Otorhinolaryngol, 2012,5(1):49-52.
[4] 徐保华, 史宗道 . 下颌髁突原发肿瘤:附12例报告[J]. 实用口腔医学杂志, 2001,17(3):249-250.
[5] Marunick MT, Mathog RH . Mastication in patients treated for head and neck cancer: a pilot study.[J]. J Prosthet Dent, 1990,63(5):566-573.
[6] Hidalgo DA . Fibula free flap: a new method of mandible reconstruction[J]. Plast Reconstr Surg, 1989,84(1):71-79.
[7] Urken ML, Buchbinder D, Weinberg H , et al. Functional evaluation following microvascular oromandibular reconstruction of the oral cancer patient: a comparative study of reconstructed and nonreconstructed patients[J]. Laryngoscope, 1991,101(9):935-950.
[8] Lee R, Slevin N, Musgrove B , et al. Prediction of post-treatment trismus in head and neck cancer patients[J]. Br J Oral Maxillofac Surg, 2012,50(4):328-332.
[9] Kreeft AM, Krap M, Wismeijer D , et al. Oral function after maxillectomy and reconstruction with an obturator[J]. Int J Oral Max Surg, 2012,41(11):1387-1392.
[10] Akashi M, Shibuya Y, Takahashi S , et al. Four-dimensional computed tomography evaluation of jaw movement following mandibular reconstruction: a pilot study[J]. J Cranio Maxill Surg, 2016,44(5):637-641.
[11] Haraguchi M, Mukohyama H, Reisberg DJ , et al. Electromyographic activity of masticatory muscles and mandibular movemet during function in marginal mandibulectomy patients[J]. J Med Dent Sci, 2003,50(4):257-264.
[12] Yen CI, Chou PY, Chen CH , et al. Kinematic, kinetic and surface electromyography analysis following zygomatic fracture reconstruction[J]. J Med Biol Eng, 2017,37(4):468-473.
[13] Ishida S, Shibuya Y, Kobayashi M , et al. Assessing stomatognathic performance after mandibulectomy according to the method of mandibular reconstruction[J]. Int J Oral Max Surg, 2015,44(8):948-955.
[14] 樊英显, 孙宏晨, 徐勇忠 . 颞下颔关节紊乱综合征患者咀嚼肌肌电分析[J]. 口腔医学研究, 1994(3):149-150.
[15] Campillo B, Martín C, Palma JC , et al. Electromyographic activity of the jaw muscles and mandibular kinematics in young adults with theoretically ideal dental occlusion: reference values[J]. Med Oral Patol Oral Cir Bucal, 2017,22(3):e383-e391.
[16] 黄超, 许向亮, 孙玉春 , 等. 下颌髁突功能面三维运动轨迹的初步推算和模拟[J]. 中华口腔医学杂志, 2018,53(10):669-673.
Outlines

/