case_images: PMC3806511_01
case_images: Jaw Motion Analysis system mounted on subject. Courtesy of Zebris Medical GmbH.
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case_images: fig2
case_images: Spatial analysis of the lower jaw was determined in conjunction with SEMG using the Jaw Motion Analysis system (JMA) from Zebris Medical GmbH (Figure 2).
case_images: SEMG activity of the bilateral temporalis anterior (TA), masseter (MAS) suprahyoid (DIG), and lateral pterygoids (LP) at the initial baseline/postural resting position (Pre-TENS).
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case_images: fig3
case_images: After SEMG electrode placement was completed, baseline/postural resting values of each site were recorded (Figure 3).
case_images: Recorded during jaw protrusion against resistance while the teeth are separated. Baseline values of the lateral pterygoids were normalized to this maximal effort.
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case_images: fig4
case_images: With the teeth apart where maxillary and mandibular incisal position was even, a recording during a 2 second maximally resisted protrusive effort was performed (Figure 4).
case_images: SEMG activity of the bilateral temporalis anterior (TA), masseter (MAS) suprahyoid (DIG), and lateral pterygoids (RLP/LLPT) after 25 minutes of ULF-TENS. Recording demonstrates that baseline levels from all sites are low and balanced.
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case_images: fig5
case_images: Technologies, Inc.) for 25 minutes, the subject was seated in a comfortable head-supported upright position with the Frankfort horizontal plane parallel to the floor and an additional baseline recording was taken to ensure that relaxation of all muscles was achieved (Figure 5). Then, the physiologic rest position was determined utilizing a traditional protocol as described by Hickman et al..
case_images: Spatial position of the lower jaw combined with bilateral SEMG activity of the temporalis anterior (TA), masseter (MAS), suprahyoid (DIG), and lateral pterygoid (LPT) sites. Coordinates listed are representative of mandibular position relative to centric occlusion and physiologic rest.
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case_images: fig6
case_images: Physiologic rest position of the mandible may be described as a position assumed by the mandible within the physiologic window (Figure 6). As the masticatory muscles are stimulated to contract, under the influence of ULF-TENS, the mandible is propelled through interocclusal rest (freeway space) forming an extended computed trajectory (Figure 6).
case_images: Spatial position of the lower jaw combined with bilateral activity of the temporalis anterior (TA), masseter (MAS), suprahyoid (DIG), and lateral pterygoid (LPT) sites. Coordinates listed are representative of mandibular position relative to centric occlusion and physiologic rest and were documented during the "burst" of suprahyoid (DIG) activity, and determined to be "Maximum Physiologic Opening".
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case_images: fig7
case_images: Mazzocco (Figure 7). Maximum physiologic opening was obtained by having the subject slowly open the mouth until suprahyoid or lateral pterygoid SEMG activity demonstrated a consistent elevation in excess of physiologic rest activity. The spatial position when either the lateral pterygoid or suprahyoids demonstrated a consistent "burst" of activity above physiologic rest values was documented (Figure 7).
case_images: Spatial position of the lower jaw combined with bilateral activity of the temporalis anterior (TA), masseter (MAS), suprahyoid (DIG), and lateral pterygoid (LPT) sites. Coordinates listed are representative of mandibular position relative to centric occlusion and physiologic rest and were documented during the "burst" of LPT activity and determined to be "Maximum Physiologic Closing".
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case_images: PMC3806511_01_CRIM.MEDICINE2013-698397.008.jpg
case_images: fig8
case_images: The spatial position where the lateral pterygoid, masseter or, temporalis anterior sites demonstrated a consistent "burst" above 2% MVC was documented (Figure 8).
case_images: Spatial position of the lower jaw combined with bilateral activity of the temporalis anterior (TA), masseter (MAS), suprahyoid (DIG), and lateral pterygoid (LPT) sites. Coordinates listed are representative of mandibular position relative to centric occlusion and physiologic rest and were documented during the "burst" of LP activity and determined to be "Maximum Physiologic Protrusion".
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case_images: fig9