Electromyography and bite force studies of muscular function and dysfunction in masticatory muscles

Electromyographic (EMG) activity versus bite force was studied during a gradually increased isometric contraction up to maximal effort for patients with painful masseter muscles and referents. The masseter muscle, the anterior temporal muscle and the descending part of the trapezius muscle were chosen for the recordings. Bite force was registered with a bite force sensor placed between the first molars. The effects of double blind intramuscular injections of lidocaine and saline in the patients' masseter muscle were evaluated by EMG versus bite force and by assessments of discomfort. EMG activity during unilateral chewing was compared in terms of relative masticatory force between referents and patients by amplitude probability distribution analysis. Regression analyses showed intra-individually steeper slopes for high force levels than for low force levels for the masseter muscle. This was not observed for the anterior temporal muscle. These differences in slopes of the EMG versus force regressions for the masseter muscle and the anterior temporal muscle could be due to differences in recruitment pattern. The same intra-individual relationship between low and high force levels was found for referents and patients. An increased activity, especially among the patients, was found for the descending part of the trapezius muscle during stronger activity of the mandibular elevators. The EMG versus force relationship for low force levels of the masseter muscle was less steep after an intramuscular injection of lidocaine but not after saline. Both solutions for injection had a positive effect on the patients' assessments of discomfort one week after the injection. Three days after injection the patients who received lidocaine experienced a reduction in muscular discomfort. This reduction was not found among patients receiving saline. The amplitude probability distribution analysis revealed that the patients used greater relative masticatory forces than the referents during the chewing of an almond for all probability levels analysed below the peak load of the masseter muscles. Rough estimates of the peak masticatory forces in Newton (N) were for chewing an almond 364 N (referents); 373 N (patients) and for gum-chewing 239 N (referents); 238 N (patients) as regards the masseter muscle. The values were similar for the anterior temporal muscle.digitalisering@um