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Aim and objective: The purpose of this work is to investigate by electromyographic (EMG) surface analysis whether and how the variations in the occlusion due to the correction of the posterior crossbite using a rapid palatal expander (RPE) is accompanied by changes in the activity of the elevator muscles in the pediatric patients. Background: Posterior crossbite is a disgnathic jaw relationship common in patients undergoing growth. In the last 10 years, several studies demonstrated the effectiveness and reproducibility of surface EMG in the objective evaluation of temporal muscle and masseter activity and how this evidence can bean interesting aid in dental clinical practice. Case description: The case subject BF is an 11-year-old boy with a right I class relationship and a left II class relationship treated with a rapid palatal expansion protocol with a turn of the transversal screw twice a day (0.25 mm each turn) for a week. In this case report, EMG was used to evaluate the temporal muscle and masseter activity immediately before, immediately after, and 4 months after the RPE protocol. Conclusion: Four months after the treatment, a condition of well-being and neuromuscular equilibrium such as that of starting was preserved. Clinical significance: Electromyography is a noninvasive exam which evaluates the masticatory muscle activity by facial application of electrodes on masseter and temporal muscles. It can be an interesting aid in orthodontic clinical practice to evaluate preservation of a good muscular balance following orthodontic and orthognathic movements.

Aim and objective: The purpose of this work is to investigate by electromyographic (EMG) surface analysis whether and how the variations in the occlusion due to the correction of the posterior crossbite using a rapid palatal expander (RPE) is accompanied by changes in the activity of the elevator muscles in the pediatric patients. Background: Posterior crossbite is a disgnathic jaw relationship common in patients undergoing growth. In the last 10 years, several studies demonstrated the effectiveness and reproducibility of surface EMG in the objective evaluation of temporal muscle and masseter activity and how this evidence can bean interesting aid in dental clinical practice. Case description: The case subject BF is an 11-year-old boy with a right I class relationship and a left II class relationship treated with a rapid palatal expansion protocol with a turn of the transversal screw twice a day (0.25 mm each turn) for a week. In this case report, EMG was used to evaluate the temporal muscle and masseter activity immediately before, immediately after, and 4 months after the RPE protocol. Conclusion: Four months after the treatment, a condition of well-being and neuromuscular equilibrium such as that of starting was preserved. Clinical significance: Electromyography is a noninvasive exam which evaluates the masticatory muscle activity by facial application of electrodes on masseter and temporal muscles. It can be an interesting aid in orthodontic clinical practice to evaluate preservation of a good muscular balance following orthodontic and orthognathic movements.

Objective: To investigate the action of osteopathic manipulative treatment on the muscular activity of the stomatognathic apparatus by using surface electromyography (sEMG). Material and Methods: Surface electromyography (sEMG) was performed on the masseter and anterior temporalis muscles of 120 subjects (73 F; 47 M), both at time T0 and T2. The sample was divided into three randomized groups of 40 subjects each: control, placebo, and osteopathic manipulative treatment (OMT). In the T1 interval between the two evaluations, the control group was not treated, the placebo group underwent a placebo treatment, and the OMT group underwent manipulative treatment. The mean value of each measurement and its coefficient of variation, between time T0 and T2, were calculated for both the intragroup (OMT, placebo, control) and the intergroup (OMT-placebo, OMT-control). Outcomes: In 40% of the subjects, statistically significant improvements were highlighted in the OMT. Whereas, the statistically significant results of the placebo and control groups were 7.5% and 17.5%, respectively, of which more than 75% moved away from the physiological range, showing a worsening of the muscular activity. This analysis showed statistically significant variations (p ≤ 0.05) in the OMT group compared to the placebo and the control groups. Conclusions: OMT determines variations of the activity of masticatory muscles.

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

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

Aim: the aim of this article is to assess the importance of masticatory muscles balance evaluation before improving vertical dimension through conservative and restorative techniques. It also shows how a multidisciplinary approach is needed to obtain a better result for the patient. Background: Bruxism is defined as the parafunctional activity of grinding or clenching of teeth. Management of severe worn dentition in patients with bruxism is challenging since this condition can lead to loss of tooth structure and occlusal vertical dimension (OVD). In some cases the impossibility to correct the proclination of the maxillary incisors occurs due to the posterior tooth wear. Case Description: an orthodontic alignment was obtained after having improved posterior vertical dimension according to an electromyographical analysis using Teethan® electromyographic system. The activity of anterior temporals and masseters was controlled and balanced by electromyography at every step of the treatment. Conclusion: an unbalanced dental occlusal function can compromise the stability of an orthodontic treatment; it is important an evaluation from different points of view in order to rehabilitate the patient in his complex. Clinical significance: electromyography proved itself to be a useful tool in the hands of the clinician to check the oral muscles balance and to avoid temporomandibular joint (TMJ) overload in restorative dentistry, prosthodontics and orthodontics.

OBJECTIVES. In this work the authors report their clinical experience at the Sport Posture and Gnathology Center of San Gerardo Hospital in Monza. According to their opinion articulating papers are insufficient and occlusal loads should be analized with the help of a computerized analysis system (T-Scan III, Tekscan, Ine, Boston, MA, USA; DL Medica, Milan, Italy). METHODS. Articulating papers are commonly used by dentists to detect areas of contact between maxillary and mandibular teeth when prosthesis or splints are to be balanced. Those traditional methods must be supported by a system allowing a computerized occlusal analysis. RESULTS AND CONCLUSIONS. Computerized occlusal analysis system (T-Scan III) can help dentists whenever occlusal diagnosis and treatment are involved (Implantology, Prosthesis, Orthodontics). The authors show the use of this technology in gnathology and posturology.