The effects of pain from the mandibular joint and muscles on masticatory motor behaviour in man

Abstract

Habitual chewing of a coherent bolus was studied in 12 dentate subjects with painful mandibular-joint disorders and 12 healthy, dentate controls. Bilateral electromyograms of jaw elevators, and jaw movement, were recorded for three complete masticatory sequences. Computer analysis was used to classify chewing movements as continuous or discontinuous. Root-mean-square (r.m.s.), myoelectric signal amplitudes were computed for each of four jaw elevators. Although discontinuous chewing cycles were significantly more frequent in painful function (p = 0.001), they also occurred in pain-free function, a finding which reduces their diagnostic significance. During painless and painful function, r.m.s. activities did not differ statistically when elevators acted as agonists on both the dominant and non-dominant chewing side (p > 0.1). When used as antagonists, such as during jaw opening, the elevators had greater mean peak activities during painful than painless function (p = 0.0001). Variability in maximum gape was greater during painful than painless function (p = 0.001), but peak maximum gapes in complete masticatory sequences were not affected by pain, and neither were minimum interocclusal gapes. More frequent reshaping and repositioning of the bolus in the presence of pain could explain these differences between painful and pain-free function.