Journal of Electromyography and Kinesiology 28 (2016) 199–207

Contents lists available at ScienceDirect

Journal of Electromyography and Kinesiology

journal homepage: www.elsevier.com/locate/jelekin

An investigation on the simultaneously recorded occlusion contact

and surface electromyographic activity for patients with unilateral
temporomandibular disorders pain
Bao-Yong Li, Li-Juan Zhou, Shao-Xiong Guo, Yuan Zhang, Lei Lu, Mei-Qing Wang ⇑
State Key Laboratory of Military Stomatology, Department of Oral Anatomy and Physiology, School of Stomatology, The Fourth Military Medical University, Xi’an, China

a r t i c l e i n f o a b s t r a c t

Article history: The present study examined if unilateral pain from temporomandibular disorders (TMD) was associated
Received 10 May 2015 with the occlusion contacts and surface electromyographic (SEMG) activities of jaw-closing muscles.
Received in revised form 9 October 2015 Eleven patients with unilateral TMD pain and 20 healthy volunteers who all had Angle’s Class-I occlu-
Accepted 10 November 2015
sions were enrolled. The numbers and load distributions of the occlusion contacts and the SEMG activities
of the anterior temporalis (TA) muscles and masseters muscles (MM) during maximal voluntary clench-
ing (MVC) in the centric and eccentric positions were simultaneously recorded on both sides. The pain
Keywords:
Occlusal contact
was not associated with occlusal contact numbers or load distributions. The SEMG activities of the
Bite force pain-side TA and bilateral MM were lower during centric MVC compared with controls. The SEMG
Jaw-closing muscle activities of the non-pain-side TA and the normalized SEMG activities of the bilateral TAs and MMs were
T-Scan higher during protrusive MVC (p < 0.05). During pain-side MVC, the normalized SEMG activities of the
Electromyography working-side MM and balancing-side TA were higher than those of the controls. In conclusion, the
TMD pain side was not associated with the occlusal contacts, but the patients with TMD had TA and
MM SEMG activities during different tasks that differed from controls and that did not seem related to
the pain side.
Ó 2015 Elsevier Ltd. All rights reserved.

1. Introduction
Orofacial pain is a main symptom of temporomandibular
disorders (TMD), which are common (Suvinen et al., 2005;
Scrivani et al., 2008). Occlusion interference, which contributes
to mandibular dysfunction (Egermark-Eriksson et al., 1983),
increases periodontal membrane pressure and stimulates peri-
odontal afferent fiber mechanoreceptors to regulate the excessive
contraction of jaw muscles during chewing or clenching (Wang
and Mehta, 2013). The hyperactivity of jaw muscles, which may
cause partial lactic acid accumulation and muscle fatigue, increases
the risk of TMD (Kerstein, 2010). Artificial premature contact,
which reduces the muscular activity of the anterior and posterior
temporal muscles on the working side and increases the activity
on the nonworking side (Baba et al., 1996, 2000), results in the
temporary oral maxillofacial dysfunction (Xie et al., 2013). Hence,
⇑ Corresponding author at: State Key Laboratory of Military Stomatology,
Department of Oral Anatomy and Physiology and TMD School of Stomatology,
The Fourth Military Medical University, Changlexi Road 145, Xi’an 710032, China.
Tel.: +86 29 84776144; fax: +86 29 83286858.
E-mail address: mqwang@fmmu.edu.cn (M.-Q. Wang).
the association of TMD pain with either dental occlusion or the
electromyographic (EMG) activity of jaw-closing muscles is of
interest to dentists.
Because occlusion varies greatly in the population, it is difficult
to morphologically differentiate functional abnormal occlusion
from normal occlusion. In the Glossary of Prosthodontic Terms
(2005), occlusal interference is defined as any tooth contact that
inhibits the remaining occluding surfaces from achieving stable
and harmonious contacts. Clinically, protrusive interferences,
which are the occlusal contacts in the posterior section during
protrusive clenching, and lateral excursive interferences, which
are the contacts in the balancing half of the dental arches during
lateral excursive clenching, contribute to TMD (Ramfjord, 1961;
Kiliaridis et al., 2000; Craddock and Youngson, 2004). However,
these interferences have been observed in patients with malocclu-
sion after orthodontic treatment (Olsson and Lindqvist, 2002;
Dincer et al., 2003). Whether the posterior contacts during protru-
sion and/or the mediotrusive contacts during lateral excursion are
associated with TMD pain is not clear.
It is unclear how occlusion contributes to TMD because
occlusion varies greatly and because of the remarkable ability
of the jaws and teeth to adapt to and tolerate changes in the

http://dx.doi.org/10.1016/j.jelekin.2015.11.002
1050-6411/Ó 2015 Elsevier Ltd. All rights reserved.
200 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207

biomechanical dental environment (Peck, 2015). This adaptability
usually results in variable patterns of muscular contraction. Sur-
face EMG (SEMG) activity is widely used to evaluate jaw-closing
muscles. The T-Scan III occlusal analysis system, which measures
the occlusal contact numbers and load distributions, can be used
with an electromyograph to compare the concurrent occlusions
and SEMG features of the jaw-closing muscles in patients with
TMD pain and controls (Wang et al., 2013; Kerstein, 1995;
Kerstein and Radke, 2012).
In this study, we examined the relationships of the numbers
and load distributions of occlusion and the simultaneous SEMG
recordings of the anterior temporalis (TA) muscle and masseter
muscle (MM) during centric, protrusive, and lateral excursive
clenching on both sides in patients with unilateral TMD pain and
asymptomatic volunteer controls.
2. Materials and methods
2.1. Subjects
Eleven female patients with unilateral TMD pain who were
16–33 years old [mean: 23 ± 5.9 years] were consecutively
recruited from the TMD and Oral Facial Pain Clinic of Qindu Oral
Hospital in Xi’an, China from January 2013 to January 2014. Five
patients in this group had 1 TMD symptom (orofacial pain). Five
patients had 2 TMD symptoms: 4 had orofacial pain and limited
mouth opening without clinically detectable clicking (opening
lengths: 22 mm, 22 mm, 27 mm, and 24 mm), and 1 had orofacial
pain and temporomandibular joint (TMJ) clicking. One patient had
the following 3 TMD symptoms: orofacial pain, limited mouth
opening (opening length, 29 mm), and TMJ clicking. The degree
of orofacial pain was evaluated with a 10-cm-long visual analog
scale. The lowest point on the scale (0 cm) indicated no pain, and
the highest point (10 cm) indicated the worst imaginable pain. The
mean value of the patients on the visual analog scale was
3.6 ± 1.75. All 11 patients had myalgia, and 3 also had TMJ arthral-
gia. In these 11 patients, 3 had bilateral canine-protected
occlusions (CPO) with only canine contact on the working side
during lateral excursive clenching, 4 had bilateral group function
occlusion (GFO) with more than 2 posterior teeth in contact on
the working side during lateral excursive clenching, and 4 had
CPO on one side and GFO on the other side (Table 1). None of these
TMD patients showed limited protrusive or lateral excursive move-
ments that prevented them from reaching to the anterior or lateral
edge-to-edge positions. The additional inclusion criteria were the
following: (1) Permanent teeth with Angle’s Class-I first molar
relationships; (2) No obvious malocclusion in the anterior and
posterior dental arches, including severe dental crowding, deep
overbite, deep overjet, crossbite, or open bite; and (3) Symptom
duration of over 3 months. The exclusion criteria were as follows:
(1) Known history of bruxism; (2) History of orofacial trauma; (3)
Tooth restoration or missing tooth, except for the third molar(s);
(4) Obvious periodontal problems that were determined during a
clinical examination (by BY); or (5) Past or ongoing orthodontic
treatment or orthognathic surgery.
The control group consisted of 20 healthy female volunteers
who were 20–31 years old (mean: 26 ± 3.2 years) and who satis-
fied the exclusion criteria for the TMD patients. They all had
permanent dentition with Angle’s Class-I relationships without
obvious malocclusions (dental casts assessed by BY) or detectable
symptoms or signs of TMD. Seven had bilateral CPO, 9 had bilateral
GFO, and 4 had CPO on one side and GFO on the other.
Dental casts were produced for every subject. During testing,
the subject sat in a chair with a backrest with their feet flat on
the floor, head upright, and eyes fixed on a target that was 2 m
in front of them. The Frankfort horizontal plane was parallel to
the ground (Wang et al., 2013). Before the formal tests, the occlu-
sion tasks were explained to all of the subjects with their dental
casts, and they practiced the tasks in front of a mirror under the
guidance of the examiner until they successfully performed the
task at least 5 times. All of the participants signed consent forms.
This experiment was approved by the Institutional Review Board
of The Fourth Military Medical University, Xi’an, China.
2.2. Recording devices
The SEMG activities of the TAs and MMs were recorded as pre-
viously described (Wang et al., 2013). Briefly, the skin was locally
prepared with 95% ethyl alcohol. The bipolar electrodes (electrode
polar area, 100 mm2; inter-electrode distance, 20 mm; electrode
base, 38  16 mm self-adhesive conductive polyester; BioFLEX,
Bioresearch Associates, Inc., Milwaukee, WI, USA) were adhered

Table 1
The clinical symptom in TMD group and lateral occlusal contact pattern in 2 groups. L = left side; R = right side; CPO = canine protected occlusion; GFO = group function occlusion.

ID Control group TMD group

Age Left Lateral Right Lateral Age Course of Mouth Side VAS Side with Left Lateral Right Lateral
(years) occlusion contact occlusion contact (years) the opening with TMJ occlusion contact occlusion contact
pattern pattern Disease length (mm) Pain sound pattern pattern
1 24 CPO GFO 33 5m 37 L 2 / CPO GFO
2 30 GFO CPO 22 3m 40 R 2 / GFO GFO
3 31 GFO GFO 16 3m 22(L) L 4 / GFO GFO
4 25 GFO CPO 16 1.5 year 34 L 2 / CPO CPO
5 28 GFO CPO 17 6m 22(L) L 4 / GFO CPO
6 23 GFO GFO 20 1 year 36 L 5 / GFO GFO
7 25 CPO CPO 24 3m 32 L 3 L GFO CPO
8 31 GFO GFO 27 1 year 27(R) R 4 / GFO GFO
9 25 CPO CPO 26 4 year 24(L) L 8 / CPO CPO
10 30 GFO GFO 32 5 year 29(R) R 3 R CPO CPO
11 28 CPO CPO 23 7 year 38 R 3 / CPO GFO
12 24 GFO GFO
13 27 GFO GFO
14 28 CPO CPO
15 28 CPO CPO
16 28 GFO GFO
17 31 GFO GFO
18 20 GFO GFO
19 23 CPO CPO
20 24 CPO CPO
 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207 201

Fig. 1. Examples of the T-Scan/surface electromyographic (SEMG) recordings during maximal voluntary clenching (MVC) at the intercuspal position (ICP), protrusive position
(Pro), left (LP) and right side (RP) lateral excursive edge-to-edge positions. Left side image: T-Scan data. The values of percentage represent the maximal relative biting force in
left and right side of anterior and posterior section of arch. Right side image: surface electromyographic (SEMG) activity of right and left side anterior temporalis (TAR and
TAL, respectively) and masseter muscles (MMR and MML, respectively).
202 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207

Table 2 to the surfaces of the TA and MM bellies with the electrode axis
Distribution of the occlusion contact numbers on different sections of dental arch parallel to the muscle fiber direction. No additional paste or gel
with different levels of loading in the 2 groups.
was required. The reference electrode (38  32 mm; Bioresearch
Red Yellow Green Blue Associates, Inc.) was placed on the back of the neck.
Control The SEMG signals were recorded with multichannel electromyo-
ICP Left 1.1. 1.1 4.3 3.4 graphy (BioEMG III and BioPAK, version 6.0, Bioresearch Associates,
Right 0.7 1.0 4.2 4.2 Inc.). The analog EMG signal was amplified differentially with a
Pro Anterior 1.1 0.7 0.8 0.2 fixed gain of 5000 and within a peak-to-peak input range
Posterior 0 0.1 0.2 0.3 of ±2000 lV and digitized with 16-bit resolution at a 1000-Hz A/D
LP Working-side 1.1 0.6 0.4 0.3 sampling frequency. The theoretical resolution was 0.03 lV with a
Balancing-side 0.1 0.2 0.2 0.2 differential amplifier with a high common mode rejection ratio over
RP Working-side 1.1 0.5 0.4 0.5 130 dB at 60 Hz, an input impedance of 1012 X, a maximum
Balancing-side 0.1 0.1 0.2 0.2 signal-to-noise ratio of 106–1, filtered bandwidth in the
frequency range of 20–1000 Hz (low pass, 6 dB/octave; high pass,
TMD
ICP Pain-side 1.1 1.0 5.2 3.0 12 dB/octave), and an additional 20-dB band-stop in an intelligent
Non-pain-side 0.8 1.6 5.0 3.2 software digital filter for common 50/60-Hz interferences.
Pro Anterior 1.0 0.4 1.3 0.8 The T-Scan III occlusion analysis system (software version 6.0;
Posterior 0.1 0.2 0.1 0.7 Tekscan, Inc., South Boston, MA, USA) recorded the numbers and
Pain-side Working-side 1 0.4 0.7 0.9 load distributions of the occlusion contacts. The sheet sensor (HD
Balancing-side 0.1 0.1 0 0.3 recording sensor, Tekscan, Inc.) was 60-lm thick when com-
Non-pain-side Working-side 1 0.5 0.4 0.6 pressed (Kerstein, 2004; Kerstein and Radke, 2006). The recordings
Balancing-side 0.1 0.1 0.1 0.1 were made in Turbo Mode, during which the sensor was scanned in
0.003-s increments to maximize the timing resolution of the
Note: Biting force level is ordered as red > yellow > green > blue.
recorded occlusal contact data. Sensor sensitivity adjustments

Fig. 2. Graphs showing the mean (±SD) of the number of contacts (a), the Biting-Force-Distributions (b), and the values (mean ± SD) of the surface electromyographic (SEMG)
activity of the anterior temporalis (TA) (c) and masseter muscles (MM) (d) from left and right side in control group and from pain-side and non-pain-side in TMD group when
performing maximal voluntary clenching (MVC) on the intercuspal position (ICP). ANOVA and SNK-q, *: p < 0.05.
 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207 203

Fig. 3. Graphs showing the number of contacts (a, Wilcoxon rank-sum test), the Biting-Force-Distributions (b, Wilcoxon rank-sum test) in the anterior and posterior sections,
and the values (mean ± SD) of the surface electromyographic (SEMG) activity (c and d) and normalized SEMG activity (e and f) of the anterior temporalis (TA) and masseter
muscles (MM) (c, d, e, f, ANOVA and SNK-q test) from left and right side in control group and from pain-side and non-pain-side in TMD group during maximal voluntary
clenching on the protrusive position (Pro). *: p < 0.05; **: p < 0.01.

were performed according to the operator manual before formal
recording in order to fit the individual’s force level within the sen-
sor’s responsiveness. Briefly, the number of red-color codes, which
represent the highest magnitude of contact force, was adjusted to
be less than five (Kerstein and Radke, 2006). The T-Scan III data and
EMG contractile activity levels of the bilateral TA and MM were
simultaneously recorded (Kerstein and Radke, 2012).
Similar to our previous report (Wang et al., 2013), each subject
was asked to close their mouth from the rest position so they could
perform maximal voluntary clenching (MVC) in the intercuspal
position (ICP) as fast as possible. The parameters that were
analyzed included the following: (1) The relative biting force:
The ratio of the biting force at a particular time to the maximal bit-
ing force during that task; (2) The numbers of occlusal contacts:
The recording sensitivity was adapted to each subject, the number
of each colored spot (red, yellow, green, and blue) was counted,
and the contact number was the total of all 4 colored spots; (3)
Biting-Force-Distribution in different dental sections: The left and
right arch halves were examined separately for centric and lateral
excursive tasks, while the anterior and posterior components were
examined separately for protrusive tasks at the distal margin of the
mandibular canine, which was marked on the T-Scan sensor and
confirmed by the examiner (BY) with preset testing before the
tasks.
204 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207

2.3. Test procedures and tasks
Four tasks were randomly conducted and recorded in each
subject. As shown in Fig. 1, these tasks included closing the mouth
from the rest position in order to perform the MVC as quickly as
possible in the ICP, which is also called the centric occlusion
position, and the data were recorded as ICP-MVC (#1); in the
protrusive edge-to-edge contact position, which were recorded as
Pro-MVC (#2); and in the left or right edge-to-edge position, which
were recorded as LP-MVC (#3) or RP-MVC (#4). Each task was per-
formed twice. The data from the anterior/posterior sections during
the Pro-MVC task and the left/right halves of the dental arch in
volunteers or on the pain/non-pain TMD side in patients during
ICP-MVC, LP-MVC, and RP-MVC tasks were statistically analyzed.
Each recording took approximately 10 s, with a 2-min resting
interval between the 2 repeated tasks and a 5-min interval
between the different tasks to prevent muscle fatigue. The total
testing time for each subject was approximately 25 min. For more
details, please see our previous report (Wang et al., 2013).
2.4. Data collection
Each recording was sampled from the start of the third s to the
end of the eighth s for a total of 6 s. Each task was repeated twice in
a blinded fashion by the first author (BY). There was high agree-
ment (r, 0.774–0.989, P < 0.01) and no significant difference
between the repeated tasks (paired t-test, P > 0.05), which implied
that no significant fatigue/pain was induced. The mean of the two
repeated measurements was used as the data in the statistical
analysis. When the SEMG activity was analyzed, 5 time points from
each SEMG recording were selected, and 10 time point values from
2 repeated recordings were averaged to represent the original

Fig. 4. Graphs showing of the number of contacts (a; Wilcoxon rank-sum test and Kruskal–Wallis H test) and Biting-Force-Distributions (b; Wilcoxon rank-sum test and
Kruskal–Wallis H test), and the values (mean ± SD) of the surface electromyographic (SEMG) activity (c) and normalized SEMG activity (d) of the anterior temporalis (TA) and
masseter muscles (MM) (d and f) on the working side and balancing side during maximal voluntary clenching with left (LP) or right (RP) side unilateral occlusal support (c, d,
e, f: the independent sample mean t-test, or ANOVA and SNK-q test) *: P < 0.05, **: P < 0.01. Key: L/R = maximum voluntary clenching on left/right excursive position in
control group; P/N = maximum voluntary clenching on pain-side/non-pain-side excursive position in TMD group.
 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207
SEMG activity of that task. To minimize the possible variations
within subjects, the normalized values of SEMG (N-SEMG), which
was the ratio of the SEMG value from each sampling point to the
value of MVC in ICP, were compared.
2.5. Statistical analysis
SPSS 13.0 software (IBM Corporation, Armonk, NY, USA) was
used to analyze the differences in the numbers of contacts,
Biting-Force-Distributions, and SEMG values between each side
of the patients with TMD pain and the control group.
Kolmogorov–Smirnov Tests were first used to check for normal
distributions. If the data were normally distributed, independent-
sample t-tests were used for 2-group comparisons. Mixed analyses
of variance models were used for multi-group comparisons, in
which side was the within-subjects variable and group was the
between-subjects factor. When significance was found, specific
comparisons were made between subgroups with Student–New
man–Keuls-q tests. However, if the data were not normally dis-
tributed, Wilcoxon rank-sum tests were used for 2-group compar-
isons, and Kruskal–Wallis H tests were used for multi-group
comparisons. The level of significance was set at p < 0.05 for all
of the statistical tests.
3. Results
3.1. ICP-MVC
No statistical differences were observed in the numbers of
occlusion contacts, Biting-Force-Distributions, or SEMG activities
of the TAs and MMs (Table 2 and Fig. 2a, b) between the left
and right in the control group or between the pain-side and
non-pain-side in the TMD group.
The SEMG activity of the pain-side TA in the TMD group was
lower than that in the control group (Fig. 2c, p < 0.05). The SEMG
activities of the pain-side and non-pain-side MMs in the TMD
group were lower than that of the left MM in the control group
(Fig. 2d, p < 0.05).
3.2. Pro-MVC
The number of occlusal contacts and Biting-Force-Distributions
were significantly increased in the anterior arch than in the poste-
rior arch during Pro-MVC in the TMD and control groups, without
group differences (Table 2 and Fig. 3a, b, p < 0.01). The SEMG activ-
ities or normalized activities exhibited no differences for TA and
MM side in the TMD and control groups.
No group difference was found for MM SEMG activity (Fig. 3d),
but the non-pain-side TA SEMG activity was higher in the TMD
group than in the control group (Fig. 3c, p < 0.05). However, most
of the TA and MM normalized SEMG values in the TMD group were
higher than those in the control group (Fig. 3e and f, p < 0.05,
p < 0.01, respectively).
3.3. LP-MVC and RP-MVC
The numbers of occlusal contacts, Biting-Force-Distributions,
and TA SEMG activities and normalized SEMG activities were
higher on the working side compared with the balancing side in
the control and TMD groups (Table 2 and Fig. 4a–c, e, p < 0.01). In
the controls, the MM SEMG activities and normalized SEMG activ-
ities were lower on the working side compared with the balancing
side (Fig. 4d and f, p < 0.01). The normalized SEMG values in the
TMD group seemed to have the same regularity (Fig. 4f, p < 0.05),
205
but the MM SEMG activities did not differ between the working
and balancing sides (Fig. 4d).
The numbers of occlusal contacts, Biting-Force-Distributions,
and TA and MM SEMG activities did not differ between the TMD
and control groups on the working or balancing side (Fig. 4). For
the normalized TA SEMG activity, when MVC was performed on
the pain-side, the balancing side TA was higher than when MVC
was performed on the right side in controls. When MVC was
performed on the non-pain-side, the balancing side TA was higher
than when MVC was performed on the left and right sides in con-
trols (Fig. 4e, p < 0.05). For the normalized MM SEMG activity,
when MVC was performed on the pain-side, the working side
MM was higher than when MVC was performed on the left and
right side in controls. When MVC was performed on the non-
pain-side, the normalized SEMG activities of the working side
MM were higher than when MVC was performed on the left side
in controls (Fig. 4f, p < 0.05).
4. Discussion
By simultaneously examining occlusion and SEMG activity, the
current results did not find pain-side-related occlusal contact loca-
tions or loading distributions or SEMG activity in the jaw-closing
muscles during centric and eccentric MVC in this group of patients
with Angle Class-I TMD unilateral pain. SEMG activity did differ
between the TMD patients and healthy controls. For example, the
SEMG activities of the left and right MM and the pain-side TA were
lower during ICP MVC, while the non-pain-side TA activity was
higher during protrusive MVC. The working side MM showed less
SEMG activity during lateral MVC compared with the balancing
side in the healthy controls, and this difference was not found in
TMD patients, either with pain-side or non-pain-side MVC. How-
ever, the normalized SEMG values were higher in the left and right
TA and MM during protrusive MVC and balancing-side TA and
working side MM during lateral MVC in the TMD group compared
with controls. The discrepancy in the normalized SEMG values and
the raw SEMG activities was attributed to the lower values of the
raw SEMG activity in TMD pain patients during ICP-MVC. Overall,
the SEMG differences in this group of TMD patients seemed less
symptom-related.
The association of occlusion and SEMG activity has been
reported in many studies (Wood and Tobias, 1984; MacDonald
and Hannam, 1984; Ferrario et al., 2002). Less SEMG activity is
thought to be protective by avoiding harmful loading on small
numbers of contacts (Proschel and Raum, 2001). Premature
contact(s) reduce SEMG activities in the anterior and posterior
temporal muscles on the ipsilateral side during centric MVC
(Baba et al., 1996, 2000). However, the current data indicated a
higher level of normalized SEMG activity during protrusive and
lateral excursive MVC in TMD pain patients, although the results
were less pain-side related.
To make the sample homogeneous, only patients with Angle’s
Class I occlusions and well-arranged dentitions were enrolled. This
may have resulted in a failure to analyze some occlusion contact
features, such as the crossbite relationship. The following addi-
tional limitations in this study should be noted. (1) Because the
edge-to-edge positions (Caro et al., 2005; Wang et al., 2011,
2013), like exaggerated chewing motion and border movements
(Wang and Mehta, 2013), standardize the tests, they are widely
used to detect occlusal function and jaw muscle activities, even
though they are not usually physiological. (2) An effect of the
sensor on the occlusion measurements cannot be ruled out. (3)
The present EMG analysis was limited to the TA and MM muscles,
and other jaw-closing muscles were not examined. (4) The sample
size was limited.
206 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207

In conclusion, these patients with unilateral TMD pain and
Angle’s Class-I relationship showed no pain-side-associated fea-
tures of occlusion and unclear pain-side-associated changes of
SEMG activity in MM and TA during centric and eccentric MVC.
Competing interests
We have no conflicts of interest to disclose.
Acknowledgements
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We would like to acknowledge the help of Qi Deng, Lu Liu,

Chen-Chen Liang, Rong Li, Xiao-Xue Bai, Meng He, Yuan-Yuan Baoyong Li received the B.S. (2003) and the M.S.
Ren, and Lei Zhang in department of Temporomandibular disorder degree (2007) in Medical Science from the Fourth
Military Medical University. He is currently attending
and Orofacial Pain, School of Stomatology, the Fourth Military
to his Ph.D. in Oral Anatomy and Physiology at the
Medical University for clinical assistance during the course of this Fourth Military Medical University. His clinical and
research work. The participation of volunteers was greatly appreci- research interests are correlations between occlusion
ated. The study was financed by grants from the Nature Science and temporomandibular disorders.
Foundation of China (NSFC) No. 81271169.

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 B.-Y. Li et al. / Journal of Electromyography and Kinesiology 28 (2016) 199–207 207

Lei Lu received the B.S. (2008), the M.S. degree Dr. Meiqing Wang is the Chief Professor in Dept. Oral
(2011) and PhD (2014) in Medical Science from the Anatomy and Physiology and TMJ, College of
Fourth Military Medical University. Her clinical and Stomatology, Fourth Military Medical University. She
research interests are Mechanism, Diagnosis and is an occlusionist and specialist in temporo-
Management of Temporomandibular Disorders. mandibular disorders (TMD). She treats over 30 TMD
patients per week from 1997. She have published
more than 200 papers, including over 40 English
papers to expression her scientific view point that
occlusion takes a role in TMD. She has also edited and
published 4 books in Chinese on Oral Anatomy and
Physiology and Occlusion. She has supervised more
than 50 postgraduate students. She has won the
awards of Education Progress in Military (1997), the
Science and Technology Progress in Military (Second
Class, 2003) and in Shanxi Province (First Class, 2005). She was honoured as the
Excellent Teacher of Chinese Military Schools (1998, 2006 and 2010). She is now the
vice president of the Society of TMD and Occlusion and the president of Occlusion
Branch, Chinese Stomatological Association (CSA). She is now the editorial board
member of J Bone Mineral Res, J Oral Rehabil and CRANIO.