Evaluation of Masticatory Muscle Response To Clear Aligner Therapy Using Ambulatory Electromyographic Recording

02/05/2022 11:54 Evaluation of masticatory muscle response to clear aligner therapy using ambulatory electromyographic recording - America…
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ORIGINAL ARTICLE |
VOLUME 159, ISSUE 1, E25-E33, JANUARY 01, 2021
Evaluation of masticatory muscle response to clear aligner

therapy using ambulatory electromyographic recording
Tiantong Lou • Johnny Tran • Tommaso Castroflorio • Ali Tassi • Iacopo Cioffi  
Published: November 21, 2020 • DOI: https://doi.org/10.1016/j.ajodo.2020.08.012
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Highlights
• Clear aligner therapy (CAT) produces a transient increase in masticatory muscle activity.
• Trait anxiety is associated with an increase in masticatory muscle activity during

CAT.
• Healthy temporomandibular disorder-free subjects adapt well to CAT.
Introduction
Patients undergoing clear aligner therapy (CAT) report muscle tenderness and produce
wear
facets on their aligner trays. However, little is known about the masticatory
muscle response to

clear aligners. Here, we measured the activity of the masseter
during CAT using ambulatory  
https://www.ajodo.org/article/S0889-5406(20)30578-3/fulltext 1/16
electromyography. We also explored whether psychological

traits modulate the masticatory
muscle response to CAT.
Methods
Using portable data loggers, we recorded the electromyographic (EMG) activity in the
right
masseter muscle of 17 healthy adults without temporomandibular disorder (16
females, 1 male;
mean age ± standard deviation, 35.3 ± 17.6 years) commencing treatment
with CAT over
4 weeks, under the following conditions: week 1 without aligners (baseline),
week 2 with a
passive aligner (dummy), week 3 with their first active aligner (active1),
and week 4 with their
second active aligner (active2). We used a mixed-effect model
to test differences in EMG activity
over the 4-weeks and a general linear model to
test the effect of psychological traits on EMG
activity.
Results
The EMG activity of the masseter increased significantly with aligners compared with
baseline.
The largest relative increase in EMG activity was seen during the dummy
(152%; P <0.001) and
active1 (155%; P <0.001) stages. During active2, the activity of the masseter decreased
significantly
toward baseline levels. Participants' trait anxiety was positively associated with
increases in EMG activity (P = 0.027).
Conclusions
CAT is associated with a transient increase in masticatory muscle activity, possibly
because of
an increase in wake-time parafunctional tooth clenching. Temporomandibular
disorder-free
patients adapt well to CAT as the masticatory muscle activity decreases
toward baseline levels
after 2 weeks.
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Article Info
Publication History
Published online: November 21, 2020
Accepted:
August 2020
Received in revised form:
August 2020
Received:
May 2020
Footnotes
Iacopo Cioffi received the award by Align Technology to perform the research study described in
the manuscript. Tommaso Castroflorio reported grants from Align Technology outside the
submitted work. Johnny Tran, Tiantong Lou, and Ali Tassi declare no conflicts of interest.
  
This research was supported by Align Technology ( North American Research Award 2017; PI,
Iacopo Cioffi).
Identification
DOI: https://doi.org/10.1016/j.ajodo.2020.08.012
Copyright
© 2020 by the American Association of Orthodontists. All rights reserved.
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02/05/2022 11:54 Evaluation of masticatory muscle response to clear aligner therapy using ambulatory electromyographic recording - America…

Evaluation of masticatory muscle response to clear aligner

• Trait anxiety is associated with an increase in masticatory muscle activity during

• Healthy temporomandibular disorder-free subjects adapt well to CAT.

electromyography. We also explored whether psychological

To read this article in full you will need to make a payment

Purchase one-time access:

Academic and Personal

Corporate R&D Professionals

One-time access price info

Subscribe to American Journal of Orthodontics and Dentofacial Orthopedics

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Register: Create an account

Institutional Access: Sign in to ScienceDirect

2. Ziuchkovski J.P. • Fields H.W. • Johnston W.M. • Lindsey D.T.

3. Rosvall M.D. • Fields H.W. • Ziuchkovski J. • Rosenstiel S.F. • Johnston W.M.

4. Nedwed V. • Miethke R.R.

5. White D.W. • Julien K.C. • Jacob H. • Campbell P.M. • Buschang P.H.

6. Miller K.B. • McGorray S.P. • Womack R. • Quintero J.C. • Perelmuter M. •

7. Fujiyama K. • Honjo T. • Suzuki M. • Matsuoka S. • Deguchi T.

8. Shalish M. • Cooper-Kazaz R. • Ivgi I. • Canetti L. • Tsur B. • Bachar E. • et al.

 The adaptive•response of jaw muscles

Eur J Orthod. 2009; 31: 596-612

10. Adams G.R. • Hather B.M. • Baldwin K.M. • Dudley G.A.

11. Hather B.M. • Tesch P.A. • Buchanan P. • Dudley G.A.

12. Svensson P. • Wang K.L. • Sessle B.J. • Arendt-Nielsen L.

14. Schupp W. • Haubrich J. • Neumann I.

16. Farzanegan F. • Zebarjad S.M. • Alizadeh S. • Ahrari F.

17. Furstman L. • Bernick S.

18. Manfredini D. • Lobbezoo F.

20. Endo H. • Kanemura K. • Tanabe N. • Takebe J.

21. Cioffi I. • Landino D. • Donnarumma V. • Castroflorio T. • Lobbezoo F. •

22. Tahara Y. • Sakurai K. • Ando T.

23. Castroflorio T. • Bracco P. • Farina D.

25. Klasser G.D. • Okeson J.P.

27. Stohler C.S. • Zhang X. • Lund J.P.

28. Abekura H. • Kotani H. • Tokuyama H. • Hamada T.

29. Clark G.T. • Beemsterboer P.L. • Jacobson R.

30. Torisu T. • Wang K. • Svensson P. • De Laat A. • Fujii H. • Arendt-Nielsen L.

31. Sforza C. • Zanotti G. • Mantovani E. • Ferrario V.F.

32. Castroflorio T. • Falla D. • Tartaglia G.M. • Sforza C. • Deregibus A.

33. Gonzalez Y.M. • Schiffman E. • Gordon S.M. • Seago B. • Truelove E.L. •

34. Schiffman E. • Ohrbach R. • Truelove E. • Look J. • Anderson G. • Goulet J.P. •

Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and

35. Markiewicz M.R. • Ohrbach R. • McCall Jr., W.D.

36. Spielberger C. • Gorssuch R. • Lushene P. • Vagg P. • Jacobs G.

37. Barsky A.J. • Goodson J.D. • Lane R.S. • Cleary P.D.

38. Beck A.T.

The somatosensory amplification scale and its relationship to hypochondriasis.

40. Nakao M. • Barsky A.J. • Nishikitani M. • Yano E. • Murata K.

41. Castroflorio T. • Farina D. • Bottin A. • Debernardi C. • Bracco P. • Merletti R. • et al.

42. Michelotti A. • Farella M. • Gallo L.M. • Veltri A. • Palla S. • Martina R.

43. Goldstein R.E. • Auclair Clark W.

44. Miyawaki S. • Katayama A. • Tanimoto Y. • Araki Y. • Fujii A. • Yashiro K. • et al.

Am J Orthod Dentofacial Orthop. 2004; 126: 367-370

45. Palla S. • Klineberg I.

46. Chow J.C. • Cioffi I.

47. Dao T.T. • Lavigne G.J.

48. Greene C.S. • Menchel H.F.

49. Al-Quran F.A. • Lyons M.F.

50. Okeson J.P.

51. Condo' R. • Pazzini L. • Cerroni L. • Pasquantonio G. • Lagana' G. • Pecora A. •