BECKER ET AL
Fig. 1. Prefabricated anterior bite stop ready for relining on
patient’s maxillary incisors.
ducted or were attending a continuing education
course. No attempt was made to differentiate between
patients with signs and symptoms of a temporo-
mandibular disorder (TMD) and nonpatients. The only
information given to the volunteer subjects was that a
study was being conducted to test the effect of a ready-
made bite splint on EMG activity.
Viade Products, Inc. (Camarillo, California) anterior
bite stops (Fig. 1) were used. The bite stop design, for
which the prototype was designed by Dr Keith Thorn-
ton, makes it applicable to a wide variety of occlusal
conditions such as anterior open occlusal relationship
and deep bites with no modification. Red stick impres-
sion compound (Kerr Mfg, Romulus, Mich.) was
warmed over a flame, placed inside the bite stop and
applied to the maxillary incisors. While the compound
was still warm, the subject closed onto the bite stop
that leveled the occluding surface so the maximum
number of mandibular incisors touched evenly. The
anterior-posterior angulation was controlled during
this procedure so that the mandibular incisors occlud-
ed with the bite splint at a 90-degree angle (Fig. 2).
PROCEDURES
EMG measurements were recorded with the K61
diagnostic system (Myo-tronics, Inc, Seattle, Wash.).
The area around the tested muscles was cleansed with a
2 × 2 gauze moistened with alcohol. Subjects were
asked to contract the muscles while the operator pal-
pated the muscle with 2 fingers to precisely position the
electrode. Electrodes were placed over each muscle and
an additional electrode was placed on the neck as a
ground. The subject was instructed to sit comfortably,
place both feet on the floor, and rest his/her arms on a
lap pillow.
EMG activity of temporalis anterior (TA), tempo-
ralis posterior (TP), masseter (MM), and digastric ante-
JULY 1999
THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 2. Bite stop relined with red stick modeling compound
on maxillary incisors. Mandibular incisors occlude flat plat-
form at right angle.
rior (DA) was measured using the EMG instrument.
EMG activity was measured when the subject clenched
and then bruxed eccentrically on his/her own natural
dentition. Clenching involved biting firmly together in
maximum intercuspation with no lateral or protrusive
movements. Grinding involved biting firmly but with
lateral and protrusive movements. EMG activity during
these clenching and grinding activities was measured
again after the anterior bite stop was applied to the sub-
ject’s maxillary incisors.
EMG activity was recorded while clenching with-
out the bite stop for 3 seconds. Grinding without the
bite stop was then performed for 3 seconds. The bite
stop was then inserted on the teeth and EMG activity
was recorded while clenching with the bite stop for
3 seconds. Grinding with the bite stop was then per-
formed for 3 seconds and EMG activity recorded.
Before each test the subject was asked to relax with the
teeth apart for 15 seconds. An example of the data
provided by the EMG program for 1 subject is illus-
trated in Figures 3 and 4.
RESULTS
Means and standard deviations of facial EMG activ-
ity are presented in Table I.1 A 2 × 2 × 4 analysis of
variance (ANOVA) was performed where the indepen-
dent variables were task (clench vs grind), intervention
(splint vs no-splint), and site (DA vs TA vs TP vs MM).
The effect of the 3-way interaction was significant
(F3,87 = 30.97; P<.001). Because the homogeneity of
variance assumption was violated, a Greenhouse-
Geisser correction was applied and this effect remained
significant.
The means presented in Table I suggest that the
reduction in TA, TP, and MM EMG activity related to
the splint was more pronounced when clenching than
grinding. This was confirmed by significant task-by-
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