Functional activity of the maxillofacial region muscles in children with arthrogryposis multiple congenita

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Abstract

BACKGROUND: Disorders of the maxillofacial region in children with аrthrogryposis multiplex congenita can be congenital or occur as secondary changes. The lower jaw and associated muscles play important roles in the functioning and development of the maxillofacial region. In children with аrthrogryposis multiplex congenita, the functional activity of the muscles of the maxillofacial region has not been studied.

AIM: To estimate the functional activity of the muscles of the maxillofacial region in children with аrthrogryposis multiplex congenita.

MATERIALS AND METHODS: Surface electromyography was used to examine the masticatory and facial muscles of 47 children aged 3–17 years with arthrogryposis (main group) and 20 healthy children with orthognathic bite (control group). The main and control groups were examined by a dentist and had not previously received orthodontic treatment. The bioelectric activities of the temporalis and masseter muscles on the right and left sides were simultaneously registered at rest and during functional tests (opening of the mouth, moving the lower jaw forward, jaw compression, and chewing). The average activity amplitudes were taken into account, and asymmetry coefficients were calculated. The obtained data are statistically processed.

RESULTS: Electromyography results, according to different functional tests, revealed disorders in 65%–88% of children with аrthrogryposis multiplex congenita. In all samples, the tonic activity of the masticatory muscles increased at rest, the amplitude of the activity of masseter and temporalis muscles decreased, signs of an imbalance of the masticatory muscles such as the hyperactivation of the temporalis muscle compared with the masseter muscle with jaw compression and chewing were noted, and muscle asymmetry indices increased. The frequency and degree of functional muscle disorders prevailed in children with deciduous and temporary occlusion.

CONCLUSIONS: Arthrogryposis multiplex congenita in children is characterized by a high frequency of impaired functional activity of the muscles of the maxillofacial region, which can negatively affect bite formation, chewing function, and articulation.

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About the authors

Margarita V. Savina

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Author for correspondence.
Email: drevma@yandex.ru
ORCID iD: 0000-0001-8225-3885
SPIN-code: 5710-4790

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Olga E. Agranovich

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
SPIN-code: 4393-3694
Scopus Author ID: 56913386600
ResearcherId: B-3334-2019

MD, PhD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Anna A. Baindurashvili

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Academician I.P. Pavlov First St. Petersburg State Medical University

Email: korably2001@mail.ru
ORCID iD: 0009-0009-7823-0678
SPIN-code: 1916-0319

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg; Saint Petersburg

Alina S. Farkhullina

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Academician I.P. Pavlov First St. Petersburg State Medical University

Email: a.lish92@mail.ru
ORCID iD: 0009-0007-4680-8303
SPIN-code: 5524-1404

MD, maxillofacial surgeon

Russian Federation, Saint Petersburg; Saint Petersburg

Ekaterina V. Petrova

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: pet_kitten@mail.ru
ORCID iD: 0000-0002-1596-3358
SPIN-code: 2492-1260
Scopus Author ID: 57194563255

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Evgeny D. Blagovechtchenski

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; National Research University Higher School of Economics

Email: eblagovechensky@hse.ru
ORCID iD: 0000-0002-0955-6633
SPIN-code: 2811-5723
Scopus Author ID: 6506349269
ResearcherId: B-5037-2014

PhD, Cand. Sci. (Biol.)

Russian Federation, Saint Petersburg; Moscow

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Supplementary files

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2. Fig. 1. Incidence of disorders of functional activity of the masticatory muscles according to sEMG in pediatric patients with AMC during functional tests

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3. Fig. 2. EMG of the masticatory muscles when the lower jaw moves forward (channel 1, m. temporalis on the right; channel 2, m. masseter on the right; channel 3, m. temporalis on the left; channel 4, m. masseter on the left; scale 250 ms/75 µV): (a) in a 7-year-old child with AMC, according to sEMG, an increase in the bioelectrical activity of m. temporalis on both sides is noted, with pronounced asymmetry in the activity of m. masseter between the right and left sides with higher activity on the left (ASI masseter 75%); (b) in a 7-year-old child in the control group, when the lower jaw moves forward, symmetrical activity is recorded only with m. masseter

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4. Fig. 3. EMG of the masticatory muscles when opening the mouth (channel 1, m. temporalis on the right; channel 2, m. masseter on the right; channel 3, m. temporalis on the left; channel 4, m. masseter on the left; scale 250 ms/40 µV): (a) a 10-year-old child with AMC and limited mouth opening; according to sEMG, the tonic activity of m. temporalis on the left and m. masseter on both sides is increased; (b) tonic activity of the masticatory muscles when opening the mouth in a 10-year-old child in the control group with the recorded symmetrical activity of the m. masseter with an amplitude of lower than 40 μV

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5. Fig. 4. EMG of masticatory muscles with AMC when clenching the jaw (channel 1, m. temporalis on the right; channel 2, m. masseter on the right; channel 3, m. temporalis on the left; channel 4, m. masseter on the left; scale 250 ms/150 μV): (a) EMG of a 7-year-old child with isolated damage to the upper extremities; examination revealed malocclusion, orthognathia, and speech articulation disorders; according to sEMG data, a pronounced asymmetry of the functional activity of m. temporalis and m. masseter (S < D) was noted (ASI total 85%); (b) EMG of a 9-year-old child with a generalized form of arthrogryposis; pronounced imbalance of the masticatory muscles on both sides (D = S) with a predominance of m. temporalis activity (ACI = –52%)

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6. Fig. 5. EMG of the masticatory muscles when a 10-year-old child chews normally (a) and with AMC (b): channel 1, m. temporalis on the right; channel 2, m. masseter on the right; channel 3, m. temporalis on the left; channel 4, m. masseter on the left. Scale 250 ms/500 µV: (a) symmetrical activity of m. temporalis and m. masseter during chewing is normal; (b) in a child with a generalized form of AMC, the bioelectrical activity of m. temporalis prevails compared with the activity of m. masseter on both sides (ACI coefficient = –5), the asymmetry of the functional activity of m. masseter and m. temporalis is pronounced, activity on the left is higher (ASI total 65%)

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