Does retruded mandible or TMJ compression cause the increased muscle activity

What is usually the main culprit? And how do we relax the muscles?

I know antegonial notching is a sign of hyperactive masseter where the jaw bone is deformed. I am just wondering what is causing the hyperactivity in the first place? Does retruded mandible or TMJ compression cause the increased muscle activity (and how)? What is usually the main culprit? And how do we relax the muscles?

Discussion

Donat Lewandowski
jaw clenching …one of the most common factors… and stress

Donat Lewandowski
how to relax muscles? do not clench teeth, control stress, do sports, physio, relaxant drugs, proper occlussion

Annette Smith
not easy to do at all

Donat Lewandowski
Annette Smith if you expect easy things you should stop any treatment

Annette Smith
Donat Lewandowski believe me I don’t expect it. nothing has been easy with this

E Joi Camacho Yabut
Yes it’s not easy, but Everything needs a lot of patience. Give yourself time to heal. Positive thinking and meditations can help a lot!

Annette Smith
Ejoi C Tubay they told me a year

Donat Lewandowski
Annette Smith and won’t be. Often even it will be impossible…or too late , or not on time… just hope and hard work….and a lot of money

E Joi Camacho Yabut
Nobody can tell when… just be patient and everything will fall into its proper place in due time. Just relax, take a deep breath, say a prayer and then smile 😊

Annette Smith
I’ve been praying. I have lots of hope and been doing anything I can. controlling stress is impossible. But i’m trying. That’s what makes me clench.

E Joi Camacho Yabut
Stress can be fairly managed. We all have it and it’s all normal, it’s a given fact in our lives…but how to handle and how to deal with it is different from one to the other. Different outlooks, difference approach, different perspective.I can say based on my experience and what I advise also to others who are at least getting better now. I pray that you may find yours too and you will… God bless.🙏🏻😊

Annette Smith
Ejoi C Tubay thank you

E Joi Camacho Yabut
You’re welcome 😊

Donat Lewandowski
Ejoi C Tubay to be honest the most difficult cases are the ones after surgery on face…. the rest are easier but still not so easy..so if a patient got tmjd and didn’t undergo any surgeru he will treat it one day almost for sure

E Joi Camacho Yabut
Yes indeed

Donat Lewandowski
Cheow Chuan Tan could you show frontal view of that VR ? I see very big masseter attachment on the jaw.. Typical for people who clench teeth

Donat Lewandowski
not good quality.. if the head is well positioned on that picture,,, you have overloaded right side….do you eat more often using your right side ?

Sean Tan
My mandible is deviated to the right. I used to chew on the right side, now I am training to use the left side.

Clayton A. Chan
Cheow Chuan Tan clear indication of posterior vertical deficiency in the posterior regions causing masseter muscles to over work…this is where the masseter muscles are attached…at the gonial angle of the mandible and inserts into the zygoma.

Donat Lewandowski
Cheow Chuan Tan so measure the distances between condyles and fossa… on the right should be smaller – compressed disc.. Good to have MRI of the jotins

Sean Tan
Clayton A. Chan Are there also simple indicators for posterior vertical deficiency? I can see the deficiency on my right side (I think due to maxillary cant i.e. flared upper teeth and lingually tilted lower teeth), and the right side also looks more compressed. Overworking masseter might also be an indicator itself, but the hyperactivity, as you said, can be also due to anterior premature occlusal contacts .. Or is the deficiency only obvious when we think in terms of the myo-trajectory, which I am not familiar with yet. Thanks.

Clayton A. Chan
Use of proper dental myomonitor TENS combined with K7 jaw tracking is the best way to see these deficiencies in the dimensions you are trying to determine. That is the best and only way I know of that produces objective evidence. I would not under estimate the value of quality myomonitor J5 TENS with skilled technique combined with K7 abilities. It’s powerful, unfortunately criticized by some with little complete knowledge of such

Amelie Giraud
Clayton A. Chan i also have a deficiency of vertical in the back régions (4 bicuspid extractions and back molar pulled out). What I don’t understand, is that this loss of vertical has different conséquences whether i’m wearing the splint or not. Without splint: i feel like i’m only biting on the back. With it (my dentist Greg Yount saw that I need vertical on the splint, because on the EMGs biting on my splint would not recruit properetly the masticatory muscles, while they would be normally recruited with a cotton roll on the back), I’m biting more on the front, but still there are little holes on my splint on the back region (completely at the bottom of the orthotic, boss sides)… So how come a loss of vertical can be expressed on the splint by not biting on the back enough, while it’s the opposite (onoly biting on the back) without splint…?

Sean Tan
Does forward positioning of the mandible always relaxes the masseter?

Clayton A. Chan
Cheow Chuan Tan I have been watching your insightful postings…you have a scientific yet practical way of thinking mind. I applaud you. Way to go. Re: your question. A forward positioning of the mandible typically will relax temporalis muscles when the mandible is opening/closing posterior to the myo-trajectory. This can be confirmed with resting EMG studies. Masseter muscles are relaxed when they no longer have anterior premature occlusal contacts that contribute to a torquing action of the mandible during closure – anterior region first tooth contact will cause masseter strain and tension, (eg. facial cheek soreness). Now you are thinking GNMly.

Donat Lewandowski
Clayton A. Chan posterior premature contact makes temporal muscles more overloaded ?

Clayton A. Chan
Yes, that is true! Donat Lewandowski

Clayton A. Chan
Over loaded second bicuspid first molar regions can do the same to the temporalis muscles.

Donat Lewandowski
Clayton A. Chan so people with opened bite may have quite relaxed masseters but very overloaded temporalis ? If we cut masseter, would temporalis push the jaw back ? or it should stay in the same position?

Clayton A. Chan
Donat Lewandowski No always…sometimes masseter, temporalis, SCM, shouder/trapezius, occipital regions and corner of lower border of mandible are classical regions that most dentists can’t seem to understand or resolve …but they should if they understand occlusion properly. Mandible will function in the proper healthy unforced position when muscles are not straining…but even more importantly, if removes the abnormal occlusal signaling first the muscles of the jaw will allow the mandible to function where it wants to. Rule: Anytime a patient has pain, joint derangements, and or masticatory dysfunctions stemming from abnormal occlusal prematurities…..will always close posterior to the optimal myo-trajectory. You to are super insightful….keen and very observant….

Donat Lewandowski
Clayton A. Chan thx, but still I do not know how exactly works temporalis, Does it try to push back the jaw a bit, while masseter pulls forward a bit – balanced action ? I wonder what would happen if we suddenly cut off the masseter (cancer patient)

Sean Tan
Am I right that during jaw closing, the molars should contact first (maybe at CR) followed by forward sliding and upward rotation of the mandible into MIP? And Clayton A. Chan was saying that the masseter are strained, if during jaw closing, the anterior teeth contact first followed by distal movement/rotation (torque) of the jaw?

Donat Lewandowski
Cheow Chuan Tan i think all teeth should contact at the same time… no ?

Clayton A. Chan
Donat Lewandowski I don’t believe temporalis muscles pushes or pulls…it reacts and naturally posteriorizes the mandible when any occlusal interference or prematurity exists. There is not need to think of cutting any muscle…think removing the occlusal prematurity first and watch what happens to the muscles they calm down… This is why I always adjust occlusion or orthotics with myomonitor TENS…when you don’t, spastic muscles will naturally pull to whatever side the sense and feel an occlusal prematurity….then the adjustment will get all off and goofed up badly.

Donat Lewandowski
Clayton A. Chan so why we have masseters if one muscle is enough 😉 just to have more power to crush hard food ?

Clayton A. Chan
I consider temporalis as more of a posturing muscles, sure it has some closing capacity…but masseters are really good closing muscles. They are not good a positioning the mandible.

Donat Lewandowski
Clayton A. Chan for more than 2 years I have slight premature contact on the right side, but the jaw was in proper position, after surgery everything crashed. My dentist says I had compensated issue before surgery, and the surgery was aa trigger point. So after surgery the masseter was weaker (cut attachment) and I still had premature contact, so theoretically the temporalis worked stronger….perhaps this is explanation why my right condyle went 1mm back

Clayton A. Chan
That is good reason why I always use Myomonitor TENs to deprogram and relax muscles first and then make any occlusal alterations or occlusal treatment with TENS “on” to keep from assuming muscles are all functioning properly when they may not be without TENS.

Clayton A. Chan
Few dentists recognize this critical point. Small things matter…never assume jaw closes normally if muscles are tight and hyperactive. One may get the wrong marks identified in the mouth and adjust the wrong spots…

Donat Lewandowski
Clayton A. Chan I had those things. TENS , K7. The dentist told me my right temporalis is the strongest muscle with such bite.. open bite. So if a patient has open bite, he very likely has temporalis stronger, right ?

Clayton A. Chan
Anterior open bite can come from many things…but the posterior occlusal contacts that are in constant functional contact will lead to hyper active temporalis, hyper active SCMs, occipital, unresolving masseter tension and pain or soreness at lower corner of inside of mandible in the lower posterior regions. Typical TMD anterior open bite scenario….