Comparative study of excitation patterns in the masseter muscle before and after orthognathic surgery

This study was designed to inquire into changes occurring in the electromyographic activity throughout the masseter muscle after orthognathic surgical treatment of various bite anomalies. A total of 32 adult patients showing distinct class II (n = 15) or class III malocclusions (n = 17) were entered into the investigation. All patients had monopolar surface electromyograms of the masseter muscle taken prior to presurgical orthodontic treatment and after removal of their orthodontic appliances after surgery. Twenty eugnathic adult patients served as controls. Unlike bipolar lead readings, simultaneous sampling from 16 electrodes permits the registration of the overall excitation pattern in the entire muscle. Recordings were taken during clenching, chewing and protrusion of the lower jaw against a defined force. Comparison with preoperative EMGs proved postsurgical distribution of excitation in class 11 patients to approximate the excitation pattern of eugnathic patients. By contrast, correction in class III malocclusions produced a shift in excitation maxima in the sense of a cranial advance. Harmonization, as evident in class II patients, did not occur. The postoperative discords in masseter excitation patterns, as observed after correction of class III anomalies, are indicative of the risk of relapse and the prolonged phase of retention associated with these conditions.