The clinical usefulness of surface electromyography in the diagnosis and treatment of temporomandibular disorders

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http://jada.ada.org/cgi/reprint/137/6/763?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=bruxism&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

The clinical usefulness of surface electromyography in the diagnosis and treatment of temporomandibular disorders
J Am Dent Assoc, Vol 137, No 6, 763-771.
Gary D. Klasser, DMD and Jeffrey P. Okeson, DMD

Abstract
Background. This article presents a comprehensive review of the recent literature regarding the scientific support for the use of surface electromyography (SEMG) in diagnosing and treating temporomandibular disorders (TMDs).

Types of Studies Reviewed. The authors conducted a Medline search involving human studies using the key words "surface electromyography or electromyography" and "masticatory muscles or temporomandibular disorders or craniomandibular disorders." They also reviewed relevant articles regarding the clinical usefulness of SEMG based on reliability, validity, sensitivity and specificity, as well as additional references included in some of the articles.

Results. The clinical use of SEMG in the diagnosis and treatment of TMD is of limited value when one considers reliability, validity, sensitivity and specificity as measurement standards. SEMG does not appear to contribute any additional information beyond what can be obtained from the patient history, clinical examination and, if needed, appropriate imaging.

Conclusions. Clinically, the determination of the presence or absence of TMD does not appear to be enhanced by the use of SEMG. However, the modality may be useful in a meticulously controlled research setting.

Clinical Implications. SEMG has limited value in the detection or management of TMD and in some instances may lead to unnecessary dental therapy as a solution for those disorders.

Key Words: Surface electromyography; reliability; validity; sensitivity; specificity; biological factors; technical factors

The first reports describing the use of surface electromyography (SEMG) in dentistry were published in the 1950s.1Ò7 Since then, interest in this subject has ebbed and flowed over the years. While the usefulness of SEMG has been debated, few studies offer data that help the clinician understand the role of SEMG in the practice of dentistry. In fact, SEMGÌs diagnostic reliability and validity, as well as its therapeutic value, have been questioned.8Ò10

In this article, we review the recent literature regarding SEMG to determine scientifically the clinical usefulness of SEMG in the diagnosis and treatment of temporomandibular disorders (TMDs).

© 2006 American Dental Association