Chewing Patterns and Muscular Activation in Deep Bite Malocclusion

Maria Grazia Piancino, Alessandro Tortarolo, Laura Di Benedetto, Vito Crincoli, Deborah Falla, Maria Grazia Piancino, Alessandro Tortarolo, Laura Di Benedetto, Vito Crincoli, Deborah Falla

Abstract

Background: Deep bite, a frequent malocclusion with a high relapse rate, is associated with craniofacial features that need to be considered in the course of orthodontic treatment.

Methods: This study included 81 patients with deep bite malocclusion (11.4 ± 1.1 [yr.mo]; M = 32 and F = 49), and 14 age- and gender-matched controls (9.11 ± 1 [yr.mo]; M = 5 and F = 9). The patients with deep bite malocclusion were treated with functional therapy. The chewing cycles and masticatory muscle EMG activity were recorded concomitantly before treatment in both groups (n = 95). Following correction of the malocclusion, a second recording took place (n = 25).

Results: The kinematic variables showed the same dependency on bolus hardness in those with deep bite and in the controls. The masticatory muscle EMG activity was increased in those with deep bite, but decreased as a result of functional treatment. The chewing patterns showed a tendency towards a reduced lateral component, which significantly increased after treatment, indicating that functional therapy impacts the neuromuscular coordination of mastication, as well as dental positioning.

Conclusions: Deep bite is a complex malocclusion, involving alterations in chewing and masticatory muscle activity. Orthognathodontic treatment should not only consider and correct the teeth position, but should also address muscular hyperactivity.

Keywords: Function Generating Bite; chewing pattern; deep bite; jaw muscles; surface EMG.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Deep bite in a mixed dentition patient.
Figure 2
Figure 2
The masticatory kinematic pattern in the frontal plane (central plot), and the EMG envelope of the right and left masseter, plotted versus the vertical jaw displacement of a patient with deep bite malocclusion, during chewing of a hard bolus on the right side. The solid line, green for the opening pattern and red for the closing pattern, represents the average chewing cycle of 3 trials, lasting 10 s each; the black lines represent the standard deviation over the average cycle. Top: image of the deep bite malocclusion of one of the patients. Note the very high activity and the narrow pattern with very low standard deviation, especially in the occlusal phase of the closing pattern, indicating that the dental malocclusion and the hyperactivation of the masseter muscles restrict the mandibular movements. This is a functional malocclusion; the teeth position is the consequence of the cranial and muscular structure. mV, millivolt; RMM, right masseter muscle; LMM, left masseter muscle.
Figure 3
Figure 3
(A) Maximum lateral excursion in deep bite patients compared to controls, showing a tendency towards a smaller lateral component in the malocclusion group. (B) Maximum lateral excursion in deep bite patients, before and after treatment with FGB, showing a significant increase in the lateral component of the chewing pattern. ** p < 0.01.
Figure 4
Figure 4
(A) Peak EMG amplitude of masseter and temporalis anterior (data merged) in deep bite patients compared to controls, showing significantly higher activity associated with malocclusion. (B) Peak EMG activity of masseter and temporalis anterior (data merged) in deep bite patients, before and after treatment with FGB, showing a significant reduction in muscular activity after correction of the malocclusion. * p < 0.05.

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