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Neck function in rhythmic jaw activities
Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Previous studies in animals and humans show anatomic and physiological connections between the trigeminal and cervical regions. This investigation tested the hypothesis of a functional integration between the human jaw and neck motor systems in rhythmic jaw activities. By means of a wireless optoelectronic 3-D movement recording system, spatiotemporal characteristics of mandibular and head-neck movements were studied during rhythmic jaw opening-closing and chewing tasks, in healthy and in individuals with pain and dysfunction in the jaw and neck region following neck trauma, Whiplash-associated Disorders (WAD). As a basis, a methodological study evaluated the applicability of skin and teeth attached reflex markers fixed to the lower jaw and to the head in optoelectronic recording of chewing movements.

The results showed concomitant and coordinated mandibular and head movements during rhythmic jaw tasks. The start of the head movement generally preceded the start of the mandibular movement. For chewing, larger size and harder texture of bolus were associated with larger head extension and larger amplitude of both mandibular and head movements. Immobilization of the head by mechanical fixation deranged jaw motor behaviour with regard to speed and amplitude of mandibular movements. Even with head fixation, muscle activity was present in neck muscles during activities. Compared to healthy subjects, WAD individuals showed smaller amplitudes and disturbed coordination of mandibular and head movements. Furthermore, a dynamic load test showed a reduced endurance during chewing in the WAD group.

In conclusion, the results suggest that optimal jaw function requires free unrestricted head-neck movements and support the hypothesis of a close functional relationship between the jaw and the neck regions in rhythmic jaw activities. A new concept for human jaw function is proposed, in which "functional jaw movements" are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. The finding of an association between neck injury and disturbed jaw behaviour suggest that assessment and management of neck injured patients should include jaw function.

Place, publisher, year, edition, pages
Klinisk oral fysiologi, Umeå Universitet , 2004. , 54 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 86
Keyword [en]
chewing, head, human, jaw, mandible, motor control, movement, neck, temporomandibular disorders, whiplash injury
Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-359OAI: oai:DiVA.org:umu-359DiVA: diva2:143236
Public defence
2004-12-17, Sal B, 1D, 9 tr, Norrlands Universitetssjukhus, Umeå, 09:00 (English)
Opponent
Available from: 2004-11-12 Created: 2004-11-12 Last updated: 2010-06-23Bibliographically approved
List of papers
1. Evaluation of skin- versus teeth-attached markers in wireless optoelectronic recordings of chewing movements in man
Open this publication in new window or tab >>Evaluation of skin- versus teeth-attached markers in wireless optoelectronic recordings of chewing movements in man
1998 (English)In: Journal of Oral Rehabilitation, ISSN 0305-182X, Vol. 25, no 7, 527-534 p.Article in journal (Refereed) Published
Abstract [en]

This study evaluated the applicability of skin- and teeth-attached reflex markers fixed to the mandible and the head for optoelectronic recording of chewing movements. Markers were attached to the upper and lower incisors and to the skin on the forehead, the bridge of the nose, the tip of the nose and the chin in seven subjects. Chewing movements were recorded in three dimensions using a high-resolution system for wireless optoelectronic recording. Skin markers were systematically displaced due to skin stretch. The largest displacement was observed for the chin marker, whereas minor displacement was found for markers located on the forehead and the bridge of the nose. In repeated recordings, the smallest intra-individual variation in displacement was found for the marker on the bridge of the nose. In spite of relatively large displacement for the chin marker, the temporal estimates of the mandibular movement were not affected. Teeth markers were found to significantly increase the vertical mouth opening, although the duration of the chewing cycle was unaffected. This indicates an increase in chewing velocity. We suggest that markers located on the bridge of the nose are acceptable for recordings of chewing movements. Skin markers on the chin can be reliably used for temporal analysis. They are also acceptable for spatial analysis if an intra-individual variability of 2 mm is allowed. Teeth-attached markers may significantly influence the natural chewing behavior. Thus, both types of marker systems have advantages as well as disadvantages with regard to the accuracy of the chewing movement analysis. Selection of a marker system should be based on the aims of the study.

Identifiers
urn:nbn:se:umu:diva-4225 (URN)10.1046/j.1365-2842.1998.00292.x (DOI)9722099 (PubMedID)
Available from: 2004-11-12 Created: 2004-11-12 Last updated: 2009-12-15Bibliographically approved
2. Co-ordinated mandibular and head-neck movements during rhythmic jaw activities in man.
Open this publication in new window or tab >>Co-ordinated mandibular and head-neck movements during rhythmic jaw activities in man.
2000 (English)In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 79, no 6, 1378-1384 p.Article in journal (Refereed) Published
Abstract [en]

Recent observations in man of concomitant mandibular and head movements during single maximal jaw-opening/-closing tasks suggest a close functional relationship between the mandibular and the head-neck motor systems. This study was aimed at further testing of the hypothesis of a functional integration between the human jaw and neck regions. Spatiotemporal characteristics of mandibular and associated head movements were evaluated for 3 different modes of rhythmic jaw activities: self-paced continuous maximal jaw-opening/-closing movements, paced continuous maximal jaw-opening/-closing movements at 50 cycles/minute, and unilateral chewing. Mandibular and head-neck movements were simultaneously recorded in 12 healthy young adults, by means of a wireless opto-electronic system for 3-D movement recordings, with retro-reflective markers attached to the lower (mandible) and upper (head) incisors. The results showed that rhythmic mandibular movements were paralleled by head movements. An initial change in head position (head extension) was seen at the start of the first jaw-movement cycle, and this adjusted head position was retained during the following cycles. In addition to this prevailing head extension, the maximal jaw-opening/-closing cycles were paralleled by head extension-flexion movements, and in general the start of these head movements preceded the start of the mandibular movements. The results support the idea of a functional relationship between the temporomandibular and the cranio-cervical neuromuscular systems. We therefore suggest a new concept for human jaw function, in which "functional jaw movements" are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital, and cervical spine joints.

Identifiers
urn:nbn:se:umu:diva-30281 (URN)10.1177/00220345000790060501 (DOI)10890716 (PubMedID)
Available from: 2009-12-15 Created: 2009-12-15 Last updated: 2017-12-12
3. Head movements during chewing: relation to size and texture of bolus
Open this publication in new window or tab >>Head movements during chewing: relation to size and texture of bolus
2004 (English)In: Journal of Dental Research, ISSN 0022-0345, Vol. 83, no 11, 864-868 p.Article in journal (Refereed) Published
Abstract [en]

Coordinated mandibular and head-neck movements during jaw opening-closing activities suggest a close functional linkage between the jaw and the neck regions. The present study investigated whether size and texture of bolus can influene head-neck behaviour during chewing. Using an optoelectronic 3-D recording technique, we analyzed concomitant mandibular and head-neck movements in 12 healthy adults chewing small (3 g) and large (9 g) boluses of chewing gum and Optosil®. The main finding was a head extension during chewing, the amount of which was related mainly to bolus size. Furthermore, each chewing cycle was accompanied not only by mandibular movements, but also by head extension-flexion movements. Larger head movement amplitudes were correlated with larger size and, to some extent, also with harder texture of the bolus. The results suggest that head-neck behaviour during chewing is modulated in response to changes in jaw sensory-motor input.

Keyword
Bolus, chewing, head, neck, jaw
Identifiers
urn:nbn:se:umu:diva-13025 (URN)10.1177/154405910408301108 (DOI)15505237 (PubMedID)
Available from: 2008-01-31 Created: 2008-01-31 Last updated: 2009-08-18Bibliographically approved
4. Head Immobilization can Impair Jaw Function
Open this publication in new window or tab >>Head Immobilization can Impair Jaw Function
2006 (English)In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, no 11, 1001-1005 p.Article in journal (Refereed) Published
Abstract [en]

Findings that jaw-opening/-closing relies on both mandibular and head movements suggest that jaw and neck muscles are jointly activated in jaw function. This study tested the hypothesis that rhythmic jaw activities involve an active repositioning of the head, and that head fixation can impair jaw function. Concomitant mandiular and head-neck movements were recorded during rhythmic jaw activities in 12 healthy adults, with and without fixation of the head. In four participants, the movement recording was combined with simultaneous registration of myoelectric activity in jaw and neck muscles. The results showed neck muscle activity during jaw opening with and without head fixation. Notably, head fixation led to reduced mandibular movements and shorter duration of jaw-opening/-closing cycles. The findings suggest recruitment of neck muscles in jaw activities, and that head fixation can impair jaw function. The results underline the jaw and neck neuromuscular relationship in jaw function.

Keyword
Human, head, neck, jaw, movement
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-13244 (URN)10.1177/154405910608501105 (DOI)17062739 (PubMedID)
Available from: 2008-01-31 Created: 2008-01-31 Last updated: 2010-06-23Bibliographically approved
5. Disturbed jaw behavior in whiplash-associated disorders during rhythmic jaw movements.
Open this publication in new window or tab >>Disturbed jaw behavior in whiplash-associated disorders during rhythmic jaw movements.
2002 (English)In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 81, no 11, 747-751 p.Article in journal (Refereed) Published
Abstract [en]

As shown previously, "functional jaw movements" are the result of coordinated activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital, and cervical spine joints. In this study, the effect of neck trauma on natural jaw function was evaluated in 12 individuals suffering from whiplash-associated disorders (WAD). Spatiotemporal characteristics of mandibular and concomitant head movements were evaluated for three different modes of rhythmic jaw activities: self-paced continuous maximal jaw-opening/-closing movements, paced continuous maximal jaw-opening/-closing movements at 50 cycles/minute, and unilateral chewing. Compared with healthy subjects, the WAD group showed smaller magnitude and altered coordination pattern (a change in temporal relations) of mandibular and head movements. In conclusion, these results show that neck trauma can derange integrated jaw and neck behavior, and underline the functional coupling between the jaw and head-neck motor systems.

Identifiers
urn:nbn:se:umu:diva-30283 (URN)10.1177/154405910208101105 (DOI)12407088 (PubMedID)
Available from: 2009-12-15 Created: 2009-12-15 Last updated: 2017-12-12
6. Endurance during chewing in whiplash-associated disorders and TMD
Open this publication in new window or tab >>Endurance during chewing in whiplash-associated disorders and TMD
2004 (English)In: Journal of Dental Research, ISSN 0022-0345, Vol. 83, no 12, 946-950 p.Article in journal (Refereed) Published
Abstract [en]

We have previously shown an association between neck injury and disturbed jaw function. This stydy tested the hypothesis of a relationship between neck injury and impaired endurance during chewing. Fifty patients with whiplash-associated disorders (WAD) were compared with 50 temporomandibular disorders (TMD) patients and 50 healthy subjects. Endurance was evaluated during unilateral chewing of gum for 5 min when participants reported fatigue and pain. Whereas all healthy subjects completed the task, ¼ of the TMD and a majority of the WAD patients discontinued the task. A majority of the WAD patients also reported fatigue and pain. These findings suggest an association between neck injury and reduced functional capacity of the jaw motor system. From the results, we propose that routine examination of WAD patients should include jaw function and that an endurance test as described in this study could also be a useful tool for non-dental professionals.

Keyword
Chewing, endurance, head, neck, whiplash, injury
Identifiers
urn:nbn:se:umu:diva-13019 (URN)10.1177/154405910408301211 (DOI)15557403 (PubMedID)
Available from: 2008-01-31 Created: 2008-01-31 Last updated: 2009-12-15Bibliographically approved

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