BTS TMJOINT User Manual Download

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115

BTS

Biomedical

BTS

TMJOINT

appendix

electromyography in patients with TMD.

Cranio. 2010 Oct; 28(4):266-73. PubMed PMID: 21032981.

27. Rodrigues-Bigaton D, Berni KC, Almeida AF, Silva MT.

Activity and asymmetry index of masticatory muscles in women with

and without dysfunction temporomandibular.

Electromyogr Clin Neurophysiol. 2010 Nov-Dec;50(7-8):333-8. PMID:

21284371.

28. Krechina EK, Lisovskaia VT, Pogabalo IV.

Electromyographic evaluation of functional status of temporal muscles

and mastication muscles in patients with close position of frontal teeth

in cases of different occlusion. [Article in Russian]

Stomatologiia (Mosk). 2010;89(3):69-71. PMID: 20559240.

29. Botelho AL, Gentil FH, Sforza C, da Silva MA.

Standardization of the electromyographic signal through the maximum

isometric voluntary contraction.

Cranio. 2011 Jan; 29(1):23-31. PubMed PMID: 21370766.

30. Tartaglia GM, Lodetti G, Paiva G, De Felicio CM, Sforza C.

Surface electromyographic assessment of patients with long lasting

temporomandibular joint disorder pain.

J Electromyogr Kinesiol. 2011 Aug;21(4):659-64. Epub 2011 Apr 3.

PubMed PMID: 21463956.

31. Sforza C, Rosati R, De Menezes M, Musto F, Toma M.

EMG analysis of trapezius and masticatory muscles: experimental

protocol and data reproducibility.

Summary of Contents for TMJOINT

Page 1: ...version 3 0 0 user manual english BTS TMJOINT ...

Page 3: ...es regulatory label 12 charger regulatory label 13 warnings 14 copyright 17 introduction 18 general description 18 case contents 20 system components 22 receiving unit 22 wireless EMG probes 23 charger 26 installation 28 user PC minimum configuration 28 connections 28 description of the software on the user PC 29 software installation 29 hardware installation 31 first software use 34 contents ...

Page 4: ...l information 52 trial viewing and report generation area 53 main features of the BTS DCA software 59 new patient 59 new session 59 edit pathology 62 new trial 63 data acquisition 66 edit patient 72 edit session 73 delete patient 74 delete session 75 delete trial 76 more features of the BTS DCA software 77 database and data folder 77 managing files in the recycle bin 80 guide to of the data report...

Page 5: ...ifications 103 wireless probes 103 receiving unit 103 appendix B environmental specifications 105 appendix C power supply and switch off 106 appendix D battery 107 appendix E troubleshooting guide 108 warning invalid trigger mode 108 appendix F declaration of conformity 109 appendix G bibliography 110 ...

Page 6: ......

Page 7: ...discussion of the subject in hand Symbol on the equipment The data appearing next to the manufacturer s symbol refer to the place of manufacture of the equipment itself Symbol on the equipment The FCC simbol refers to the Federal Communication Commission of the USA The device complies with the relevant regulations put forth by the FCC as long as it is operated according to the instructions contain...

Page 8: ...d the parts used are type BF Symbol on the equipment Attention read the information in the users manual carefully before using the equipment Symbol on the equipment The double square indicates that the product is a medical device of II Class In accordance with the law EN 60601 1 Symbol on the equipment CE mark with the code of the Notified Body The CE mark certifies that the product conforms to th...

Page 9: ...the Expert Opinion by IMQ Symbol on the equipment and in the users instructions Symbol for the separate disposal of electrical and electronic equipment in accordance with Directive 2002 96 CE WEEE The equipment belongs to Group 8 medical equipment In force in the nations of the European Union Norway and Switzerland Rx only Symbol for prescription only U S Federal law restricts this device to sale ...

Page 10: ...t to the model number ref to catalogue SN Symbol on the equipment Symbol located next to the series number on the equipment Acronyms used in this manual RU Receiving Unit EMG Electromyography WS Workstation DCA Dental Contact Analyzer POC Percent Overlapping Coefficent MVC Maximum Voluntary Contraction ...

Page 11: ... This device complies with part 15 of the FCC Rules Operation is subject to the following two conditions 1 This device may not cause harmful interference and 2 this device must accept any interference received including interference that may cause undesired operation Modifications not expressly approved by BTS SpA could void the user s authority to operate the equipment under FCC rules ...

Page 12: ... and is classified in the Business to Business sector The symbol of the crossed out rubbish bin indicates that the equipment must not be disposed of in normal domestic waste The regulations for disposal may differ between individual countries in the EU In cases of doubt refer to the respective sales outlet This is a battery powered equipment See Appendix D for information about the batteries used ...

Page 13: ...ed as medical equipment in accordance with European Directive 93 42 CE and its amendments BTS TMJOINT must always be used only for this purpose by qualified persons in an environment suitable for the execution of EMG analyses and respecting the prevailing regulations in the countries in which it is being utilised ...

Page 14: ...12 BTS Biomedical BTS TMJOINT regulatory label Probe ID Receiving Unit Regulatory label EMG Wireless Probes Regulatory label Label on the probes ...

Page 15: ...13 BTS Biomedical BTS TMJOINT regulatory label Label not on actual probes due to size constraints Charger Regulatory label ...

Page 16: ...tive R TTE 99 5 EEC The results of the acquisitions must be assessed by people legally authorised by national law who possess the suitable necessary knowledge of anatomy and muscular function The uses of the device for other purposes and with methodologies different from of those indicated in this manual are not to be considered congruent with the precise use of the device Use the product accordin...

Page 17: ...address to authorized technical support The use of any components different from the original ones declines the conformity of the device The instrument must be used in a medical environment since it has a high level of sensitivity measured voltage levels of between 1 microvolt and 6 millivolt In addition to the users instructions the prescriptions regarding accident prevention and technical regula...

Page 18: ...es lithium ion battery For the battery replacement and disposal please contact the technical support At any rate ensure that device component i e probes receiving unit integrity is never compromised The information contained in this manual is subject to change without notice and does not constitute product specifications or any obligation on the part of BTS S p A ...

Page 19: ...ermission from BTS S p A Unless otherwise specified any reference to companies names data and addresses used in the reproduction of the screens and the examples are purely incidental and has the sole purpose of illustrating the use of the BTS product All trademarks are registered by the respective owners This publication contains reserved information which is the property of BTS S p A The recipien...

Page 20: ...dicated software BTS Dental Contact Analyzer BTS TMJOINT uses surface electromyographic analysis to measure the differential influence of the occlusal function through indices validated and published in scientific literature Specialfeatureofthissystemisthestandardizationoftheelectromyographic signal that is provided by the comparison between two test of clenching done with and without the interpos...

Page 21: ...fficient an index of the symmetric distribution of the muscular activity determined by the occlusion and a TORS torque coefficient to estimate the possible presence of mandibular torque which makes it possible to establish the role of occlusion on muscular balance A third index called IMPACT allows to evaluate the muscular work providing information about the occlusal vertical dimension The second...

Page 22: ...T introduction Case contents Receiving Unit Probes Kit available in 2 versions POC4 include 4 wireless probes POC6 include 6 wireless probes identificative labels available in 4 different colors Probes Charger AC adapter included ...

Page 23: ... Biomedical BTS TMJOINT introduction Set of disposable electrodes USB extension cable User manual You will receive the instructions for use for other possible optional components not mentioned in this manual ...

Page 24: ... system consists of two parts the receiving unit and the wireless EMG probes Receiving unit The receiving unit connected to the PC trough USB allows the WiFi reception of the EMG signal acquired by the wireless probes WiFi transmission system components 7 ...

Page 25: ...ically reducing the time of each session Each probe consists of a mother electrode and a satellite electrode each fitted with a clip The two parts connected via a flexible cable may be positioned as needed by the user at adjustable distance electrodes with variable geometry All probes are also equipped with a solid state memory buffer to prevent data loss for problems due to the WiFi network or du...

Page 26: ...rvals of about 1 minutes it carries out a scan of the frequencies of few seconds During the scan the white LED flashes quickly Active Connected white LED which flashes slowly When the probe and the receiving unit establish a connection the white LED begins to pulse slowly the probe is waiting for commands If the connection is interrupted the probe returns to Active Scanning mode and attempts to re...

Page 27: ...nd is off The same happens when it is in Deep Sleep mode except during the recharging phase in witch the led is steady blue The probes in Deep Sleep mode do not perform any scan cycle but are turned off Is therefore guaranteed energy savings To put the probe in Deep Sleep mode it is necessary to connect them to the Charger switched on or to put them in contact with a magnet for half a second Befor...

Page 28: ...he EMG probes of the system 6 maximum and includes a lodging to store the receiver when not in use for acquisition The EMG probes are connected to the charger using the same clips that normally collect the EMG signal For correct connection simply follow the outline of the probes shown on the base of the Charger At any rate poles connected incorrectly will not recharge ...

Page 29: ... and connect the AC DC adaptor to the mains and turn on the switch located on the rear panel When the Charger is properly connected to the mains and has been turned on the status LED Power will show a steady GREEN light The charging status of the probes is indicated by the status LED of the probes see Wireless Probes Note that inserting the EMG probes into the Charger when it is on these come in D...

Page 30: ...reless probes transmit in real time the acquired data to the receiver connected via USB to the Workstation Connect the receiver to the WS using the USB connector If the morphology of the WS does not allow direct connection of the receiver use the USB extension cable Also verify that the probes are fully charged and ready for use It is required that the probes are disconnected from the charger to b...

Page 31: ...form for an easier interpretation and plotted in a table form with pie charts and histograms It is possible to create report of single trial or to compare two trials such as a pre and a post treatment All the reports once created can be saved and reloaded in a second time Software installation BTS DENTAL CONTACT ANALYZER software is usually pre installed and configured However if it is necessary t...

Page 32: ...n After have accepted the installation terms and chosen the Typical installation click always on Next key until the procedure end Then perform a double click on the CDM20814_Setup exe file and wait for the window that has just opened to close ...

Page 33: ...e they are not already on your PC please download them from the Internet they are free and install them Hardware installation After have performed all the steps above it will be necessary to configure the port for the USB receiver To set the characteristics of the receiver the system requires the receiver to be connected to the PC via a USB port Then clicking the mouse right button on My Computer ...

Page 34: ...inside the Device Manager menu select Ports COM LPT and click the right button on the item below USB Serial Port COMx and select Properties Entering the port properties window it will be displayed the following In which you must select Port Settings ...

Page 35: ...ust set the value of Latency Timer msec equal to 1msec and then click OK returning to the previous screen Also in the Port Settings window click on OK then close the windows remained still open During the setting operations of the COM port take note of the port number that the PC automatically associates to the device because you will need it at the software first start ...

Page 36: ...run the software On the first start it will be asked to choose the preferred language for the interface software once selected you must click on OK When the procedure will be completed the software will start showing the following window On the first start you should check that the correct COM port is set by selecting the Laboratory voice from the tool bar and click Set EMG Device ...

Page 37: ...35 BTS Biomedical BTS TMJOINT installation Clicking on the device settings a new window will open Select the correct COM port number among the voices in the drop box menu Port ...

Page 38: ...ding to the USB receiver and if it is set correctly the fields below will activate showing the MAC Address of the probes associated with the receiver you are using If all of these operations are successful clicking on Update the window will close and you can start using the software ...

Page 39: ...er and the temporalis anterior bundle for both face sides Each probe is numbered and for this protocol we will use the probes from 1 to 4 It is mandatory to follow this sequence probe n 1 right anterior temporalis probe n 2 left anterior temporalis probe n 3 right masseter probe n 4 left masseter Temporalis Anterior Masseter ...

Page 40: ... RIGHT masseter position yourself behind the patient when possible and touch the muscle during the maximum clenching finding its venter The electrode should be applied along the line that connects the external canthus of the eye with the mandibular angle Repeat the procedure also with the LEFT masseter trying to maintain a symmetry of positioning It is recommended to apply in advance the probes on...

Page 41: ...anterior bundles analyzed in the POC 4 protocol We will use the probes from 1 to 6 following this sequence probe n 1 right anterior temporalis probe n 2 left anterior temporalis probe n 3 right masseter probe n 4 left masseter probe n 5 right sternocleidomastoid probe n 6 left sternocleidomastoid For the probes positioning on the masseters and temporal muscles refers Temporalis Anterior Masseter S...

Page 42: ...paragraph To find the RIGHT sternocleidomastoid asks the subject to rotate as much as possible the head to the left the electrodes will be positioned on the muscle so identified Repeat the procedure also with the LEFT sternocleidomastoid trying to maintain a symmetry of positioning ...

Page 43: ... software the following windows will be loaded The windows includes the following main areas the menu bar the tool bar the probe status bar the list of patients in the database provided with a search filter the information related to the patient session or trial selected from the list the area which manages the trial viewing and the report generation ...

Page 44: ...the EMG devices to use The Options menu which allows setting the software languages and the chart property The Help menu which supplies the software version number The following functions can be accessed from the Database pop down menu New Patient to add a new patient to the Database New Session to add a session to the patient already inserted in the Database New Trial to capture or import trials ...

Page 45: ...database menu by selecting the voice Database Data folder it is also possible to select an other Database or create a new one modify the data folder path and select an application to read reports in PDF format The second menu of the menu bar is the Laboratory menu From this menu the voice Set Emg Device may be accessed BTS TMJOINT use an Embedded EMG device for this reason be sure that this option...

Page 46: ...ansmission the Sensors area containing the information related to the 4 or 6 probes depending on the version installed and in particular for each probes is indicated the MAC Address containing the probe identificative code printed on the clip of the same probe the number indicated on the probe label the identificative color of the probe label the name of the muscle associated to that probe All the...

Page 47: ...functions may be accessed Language selection to choose between Italian and English Select this command to call up the window in the figure Click on Save and restart the programme to make the changes effective or close this windows to come back to the previous screen Chart properties to set the visualization parameters of the graphs of the acquired EMG signals and in particular the abscissa unit of...

Page 48: ...voice the following windows may be accessed Click on Save and Exit to make the changes effective or close this windows to come back to the previous screen The last voice is the Help menu From this menu may be selected the voice About that supplies the software version number ...

Page 49: ...Trial to manage the acquisition or import of a trial in an existing session Edit Patient to correct details about a patient Edit Session to modify the information associated with a session Remove Trial to eliminate the selected trial A confirmation is required before proceeding with the operation The deleted trial is moved to the recycle bin Exit to leave the programme Probes status bar The probes...

Page 50: ...of BTS DCA The LED can appear blinking GREEN if the probe is active blinking RED if the probe is not active GRAY if the probe is not enabled It is also possible to know the active probes battery status by clicking on the button marked by the symbol ...

Page 51: ...are startup it appears empty By opening the drop box menu marked with the red ellipse a list of all the patients inserted in the Database will appear Each patient is identified by a surname first name and if available among the patient data by his or her internal code The patients are ordered according to the alphanumeric characters respect the field indicated in the drop box menu Search for in th...

Page 52: ...Code and type in the underlying white box the letters or the numbers to be used as filter i e if you are looking for the patient JOHN SMITH you have to select the Surname search criteria and type the letters S M Once selected a patient from the list it will be loaded in the underlying area and all his sessions and trials will be available for the elaboration organized in tree structure Click the s...

Page 53: ...his patient saved in the PC If the file is not physically present in the current data folder the icon alongside the node is cancelled with a cross The information continues to be present in the database but it is not possible to use them When a node is selected to which data is no longer associated the arrow appears within a prohibited symbol The icon of a full recycle bin at the bottom on the rig...

Page 54: ...ne contains the information related to the patient that are Name Surname Birthdate Click the More patient information button to open a table which records all the information related to that patient To close the table click the Close patient information button The second one contains information related to the trial and in particular Acquisition date Trial notes max 255 This last field can be upda...

Page 55: ...consists of a drop box menu containing all the saved report of the selected patient After selecting a report from the drop box menu the Open button became active By clicking the Open button the application for the PDF reading will be loaded and the selected report will be visualized Trial to process this panel contains all the trials among whom selected the trials for the report generation To inse...

Page 56: ...ch trial loaded The POST label will be assigned to the second trial of the same type loaded while all other trials of this typology loaded after won t be labeled If the type that you are trying to assign to a trial is not compatible with it a warning massage will be displayed For example Before to proceed with the report generation verify that the type assigned to each trial is correct otherwise m...

Page 57: ...ct it and click on CLEAR To remove all the trial from the panel Trial to process is enough to click on the recycled bin icon Once the trial labeling procedure has been properly executed it is possible to create the report by clicking the REPORT button The report could be created only if at least one COT type trial and one CLE trial have been loaded a MASTDX and or MASTSX type trial have been loade...

Page 58: ...day without modify the position of the electrodes such as clench test executed with and without bite Onlythetrialswitchhavebeenmarkedwithacolorcorrespondent to one of the 8 trial typologies among all the trial present in the list Trial to processed will be used to construct the report If all the operation have been executed correctly the window for the report management will be displayed From that...

Page 59: ...preview Print and Save Report buttons the field report PDF name in witch is visualized the report name automatically assigned by the software this name can be modified by the user before to click on Save Report finally there is the Exit button to come back to the main screen of the software Preview of selected trial in this panel in shown a preview of the Trial selected in the panel Trial to proce...

Page 60: ...Biomedical BTS TMJOINT guide to the use of BTS DCA The scale of the y axis can be modified selecting the maximum value to be visualized among the value of the drop box menu mV placed at the right of the panel ...

Page 61: ...nu and tool bar to open the window below To insert a new patient simply fill in the fields and click Add Patient The fields marked with an are mandatory Click on Cancel to come back to the previous screen Any inserted data will be lost main features of the BTS DCA software ...

Page 62: ...open the window below To create a new session simply fill in the fields and click Create Session In particular it is required to give a name to the session to be created This field is mandatory To proceed with the creation of the session the session name must been inserted otherwise the following warning message will be displayed ...

Page 63: ...ck the icon to access the Edit pathology window At the first use of the software the pathology list will be empty It is necessary to insert at least one pathology to proceed with the session creation insert any Note about the session field not mandatory indicate any previous treatment of the patient For both these fields there are 255 characters available modify the session date if different from ...

Page 64: ...tabase are listed in alphabetic order To add a new pathology write the name of the pathology in the field Insert new pathology to add and click the blue arrow to add the pathology to the list To change a pathology Select the pathology from the list The name is shown in the field Modify the selected pathology Modify the name of the pathology Click the icon alongside to apply the change to the list ...

Page 65: ...m the menu and tool bar to open the following window To create a new trial it is possible to make an acquisition or to import a trial acquired in the past In any case it is necessary to select a Type among the voices proposed in the drop box menu for the trial to be created Fill the fields relative to Trial to acquire if you want to proceed with an acquisition or fill the fields relative to Import...

Page 66: ... two arches one for each side CLE6 requires the use of 6 probes placed on the temporal masseter and sternocleidomastoid muscles To the subject it is required to perform a clenching of 5 seconds ROT6 requires the use of 6 probes placed on the temporal masseter and sternocleidomastoid muscles To the subject it is required to perform a series of head rotations MASTRT requires the use of 4 probes plac...

Page 67: ...m the probes status bar of the probes If an acquisition is launched when the receiver is not connected to the PC the following warning message will be displayed When a trial is imported the user can enter some notes that will be saved in the database After selecting the test to be imported the following window will appear Edit the notes and click Add note or if you don t want to enter any notes ...

Page 68: ...e repeated several times to add more trials to the same session Note that the system doesn t allows for two tests with the same name under the same session Once all the required trial were acquired or imported click Close to return to the main screen Data acquisition By clicking on Acquire from New Trial the following screen will be displayed ...

Page 69: ...t allowed for the system The identification label is linked to the muscle is acquired with that specific probe R_TEM for the right temporal muscle L_TEM for the left temporal muscle R_MAS for the right masseter muscle L_MAS for the left masseter muscle R_SCMCL for the right sternocleidomastoid long head muscle L_SCMCL for the left sternocleidomastoid long head muscle In case of inactive probes the...

Page 70: ...start the acquisition all probes required in the selected trial s protocol have to be active Before proceeding with the next steps verify that all the LED corresponding to the probes required by the Protocol are green When everything is ready click on Record to start recording the trial In clenching trials with or without cotton rolls and in chewing tests it is better to start the acquisition just...

Page 71: ...terrupted manually clicking on Stop when the subject executed all the movements required At the end of the trial data will be automatically downloaded when this will be complete a signals acquired preview will be shown It is possible to modify the visualization range to zoom in the signal to evaluate that the trial has been performed properly before save it For clenching trials COT and CLE at the ...

Page 72: ...aied pie charts of the previous ones up to two to allow the verification of the data repeatability If the acquisition is good it is possible to save the trial clicking on Save A window will appear to add if necessary notes related to the trial After edited the notes click on Add note while if notes are not required just close the window Once this operation is done the New Trial window will appear ...

Page 73: ...acquired are not going to be recovered for that reason a window will ask a confirmation about choosing not to save the last acquisition Finally to exit from the acquisition and go back to the New Trial section click on Exit If the last trial has not been saved the following screen will appear Clicking on Yes data will be stored clicking on No the acquisition window will be closed and last trial da...

Page 74: ...ing window Note that to do this a patient must be selected in the database otherwise the following warning message will appear The Edit patient window will show all the selected patient data previously entered It is possible to modify them or add new ones When all changes have been made click on Update patient to save the new data in the database ...

Page 75: ...ftware Se l operazione è andata a buon fine comparirà la seguente finestra Finally to exit without making any changes to the data click on Cancel Any change made will be lost Edit session Select Edit Session from the menu and tool bar to open the following window ...

Page 76: ...tered It is possible to modify them or add new ones When all changes have been made click on Update Session to save the new data in the database To exit without making any changes to the data click on Cancel Any change made will be lost Delete patient To remove a patient from the database select it and choose Delete Patient from the menu bar This operation will move the selected patient in the rec...

Page 77: ...ient must be selected in the database otherwise the following warning message will appear Delete session To remove a session from the database select it and choose Delete Session from the menu bar This operation will move the selected session in the recycled bin together with all the trials related to him A conform to the cancellation will be asked ...

Page 78: ...ing warning message will appear Delete trial To remove a trial from the database select it and choose Delete Trial from the menu bar This operation will move the selected trial in the recycled bin A conform to the cancellation will be asked Note that to do this operation a trial must be selected in the database otherwise the following warning message will appear ...

Page 79: ... Current database shows the path of the database actually selected It is possible to lad an other database or to create a new empty one To create an empty database click the icon Create an empty database a new window in witch enter the name of the new database will appear Click Save to create a new database The Current Database field will more features of the BTS DCA software ...

Page 80: ...tting will be lost when the BTS Dental Contact Analyzer is closed and the default database will be loaded at the next launch of the program To change the data folder Click the Change current data folder icon Select or create the new folder A sub folder will be created automatically in which the files will be saved The name of the subfolder is shown in brackets under Current data folder In the figu...

Page 81: ...the icon Change current folder My Captures Select the new reference folder which will contain all the file required by the software to work properly Also in this case to set the new folder as the default data folder put a check in the Set My Captures folder as default If this is not done the setting will be lost when the BTS Dental Contact Analyzer is closed and the old My Captures folder will be ...

Page 82: ...e file is moved to the recycle bin To access the files held in the recycle bin double click the icon representing the recycled bin which appears in the patient list The following windows will appear In the left side of the panel there are all the data contained in the recycled bin organized per patient with a tree structure By expanding the nodes it is possible to access to sessions and trials ...

Page 83: ...tient main file has been deleted As a result all of the related sessions and trials have also been removed Selecting a node which has been removed updates the patient session and trial information From the Deleted data window it is possible to carry out four different operations This button recovers the selected file When a session is selected all the associated trials will also be recovered When ...

Page 84: ... necessary to select the root file This button recovers all the files in the recycle bin All patients sessions and trials will be available again in the database and the recycle bin will be empty This button permanently eliminates all the files in the recycle bin A confirmation must be given for this operation Confirming the elimination means that the files will no longer be recoverable At the end...

Page 85: ... is automatically generated by the software DCA The results of the data elaborations are organized in tabs INT EXT POC ISTO and MAST Moreover there is an INFO tab for the customization of the printed report INT tab guide to the report data reading ...

Page 86: ...in the same muscular couple It expresses in percentage terms the difference in electrical signal generated by a muscle couple during a maximum voluntary contraction MVC compared to its homologous standardized value If the two homologous muscles of each pair are contracted in perfect symmetry thanks to a functionally balanced dental occlusion the POC result is expected close to 100 While if muscle ...

Page 87: ...0 value and the light gray vertical band indicates the range of normality up to the value 83 both right and left of central line in order to represent the prevalence of right or left muscle activity The blue target refers to the POC index of the anterior temporal POC TA while the red refers to the POC index of the masseters POC MM The POC TA index corresponds to the influence of dental contacts of...

Page 88: ... focus on the molars the masseters record a major contraction respect to the correspondent temporalis Posterior barycenter Instead in the occlusal condition in which the barycenter moves in the anterior lateral areas that means until the first second premolar the temporalis express major contraction forces Anterior barycenter In this case there is a bilateral overload of the joints that with the p...

Page 89: ...ter muscles compared to that of temporal This condition is reversed in the second skeletal class in which the temporal muscles always express a differential electrical activity greater than the masseter s one TORS torsion It provides an estimate of the rotation attitude of the mandible in the horizontal plane when it is in occlusion with the superior maxilla Is obtained from the comparison of the ...

Page 90: ...f the coefficient calculated for the couple anterior temporal right masseter is greater We must not think that there is a real torsion of the mandible because we are under static conditions Any clinical condition which can be likened to pre contact and then to tooth contact sliding is therefore already occurred The TORS index expresses a condition clinically worse because detectable only using ins...

Page 91: ... possible to add a text description that the clinicians want to include in the printable report as a comment of the represented data in the INT tab Add to report checkbox If the check is in the box the INT tab content will be included in the printed report otherwise it will be ignored EXT tab ...

Page 92: ...ding to the patient for whom the report relates The status bars represent the level of electrical intensity measured in the muscle near which are represented Depending on the protocol used 4 or 6 channels 4 or 6 bars are displayed corresponding to the anterior temporal muscles masseters and sternocleidomastoids The muscle that expresses the greater amplitude value of the electric potential percent...

Page 93: ...llow if the amplitude is less than 83 but above 75 red if the width value is less than 75 Similar interpretation for the SCM muscle shown in the figure below as an example The SCM POC is calculated only when using the POC6 protocol ATTIV activation It s a parameter similar to the BAR but computed on the average value of maximum contraction and compared to zero instead of 100 ...

Page 94: ... the second skeletal class in which the index is usually negative For the resolution ofTMJ temporomandibular joint acute pain problems it must be find a condition biomechanically favorable to the discharge of the forces burden on the TMJ that leads to a positivization of this index TORQUE mandibular torque It s a parameter similar to the TORS but compared to zero instead of 100 The resultant force...

Page 95: ...he protocol POC6 which includes the performance of a test of maximum rotation of the head to the right and left in addition to the trials of clenching with and without cotton roll thus with maximum intercuspation Gives the percentage of co contraction of SCM muscle during clenching a cervical load of 0 indicates an absence of recruitment while a value of 100 indicates that the recruitment is maxim...

Page 96: ...AR indexes are normal the IMP index is related to the vertical dimension In this case there are indications on the possibility of raising index higher than normal or reducing index lower than normal the vertical dimension compatibly with the aesthetic condition of the patient Outcome It is possible to add some notes to the report Write them in this box to put them in the printed report Add to repo...

Page 97: ...respectively with and without cottons The third column instead shows the percentage value of the average activity of the 4 muscles as the ratio between the values obtained from the clenching trial without cotton and those with cotton In order to evaluate the occlusal state you must refer to this third column The dark blue sector represents the left temporal muscle activity while the ...

Page 98: ...e activity of the left masseter muscle while the yellow of the one of right With a good neuromuscular balance corresponding to the absence of malocclusion the colors will be equally distributed in the 4 quadrants If you are analyzing two sessions PRE POST the graphs for the second session can be visualized on a second row ISTO tab ...

Page 99: ...onsidering the average value of muscle activity of the clenching trial normalized with respect to the clenching trial execute with cottons in an interval of 25 ms When the white is prevalent there is an activity of the muscle of the right side more pronounced while when is the red to prevail the left side is dominant Is then given information on a possible asymmetry of muscle Regarding the TORS in...

Page 100: ...for the entire duration of the test on one side only Produces as a result a graph about the coordination of masticatory muscles TA and MM while therefore with the POC and the evaluation of the clenching we evaluate the neuromuscular balance Static condition with the mastication protocol we evaluate the neuromuscular coordination Dynamic condition by analyzing the repeatability of the muscular patt...

Page 101: ...atory acts per second ModMed It is the distance from the center of the graph and the center of the ellipse of representation TA Impact uV It is an index of the work done by the anterior temporal muscles during the test MM Impact uV It is an index of the work done by the masseter muscles during the test SMI Index of chewing symmetry It is a unique index not differentiated by side The ideal is a val...

Page 102: ...f desired To do this complete the fields of interest and click on Browse to select the image of your logo directly from your PC or put a check next to None if you do not want to use this option Once you have completed entering the info you need to click on Modify Info to ensure that data is stored and included in the report At first use the fields are empty ...

Page 103: ... the saved data To save these changes it is necessary to click on Modify info The following windows will appear Clicking on Yes to report information will be updated and will no longer be possible to recover previous data If the operation has been successful you will see the following screen If you do not want to save the changes click on Upload Info to reload the last save ...

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Page 105: ...mensions 17x36x8mm mother electrode diameter 17 x 8mm satellite electrode Weight 9g battery included Frequency used ISM band 2 4GHz standard IEEE802 15 4 Input impedance 10 GOhm CMMR 110 dB 50 60Hz Resolution 16bit Acquisition frequency up to 4KHz Sensitivity 1μV Measure accuracy 2 Receiving Unit Connection USB Dimensions 82x44x22 5mm Weight 80 gr Frequency used ISM band appendix A technical speci...

Page 106: ...104 BTS Biomedical BTS TMJOINT appendix 2 4GHz standard IEEE802 15 4 The system is calibrated at the factory No further calibration is required ...

Page 107: ...Operating Temperature 20 45 Operating Humidity 50 80 Relative non condensing Storage and Transport Temperature 0 40 Storage and Transport Humidity 50 80 Relative non condensing Altitude 0m 2000m Degrees of protection provided by the dangerous enclosures of water and dust IEC 60529 IPX0 ...

Page 108: ...ly and switch off The receiving unit is powered by the USB port To switch off the system the following operation must be done Exit from the DCA application Unplug the receiving unit from the USB port Put the probes in Stand By placing them on the Charger ...

Page 109: ...access to the internal circuit components Batteries are equipped with battery protection circuit to over voltage threshold 4 3V under voltage threshold 2 8V short circuits The specific characteristic of the Wireless probes equipped with the battery are Quantity 1 per each EMG probe Technology lithium polymer Li Poly Removable NO BTS technical service is required appendix D battery ...

Page 110: ...to it the same port previously assigned to the receiver returning the port setting to the default configuration In these cases it may occur that by launching an acquisition the following warning message may appear In this case to proceed immediately with the acquisition it is necessary to restart the application however the same problem will recur in later acquisitions To resolve this problem you ...

Page 111: ...ntial performance IEC 60601 1 2 Medical Electrical Equipment Part 1 2 General requirements for basic safety and essential performance Collateral standard electromagnetic compatibility Requirements and tests IEC 60601 1 6 Medical Electrical Equipment Part 1 6 General Requirements for basic safety and essential performance collateral Standard Usability EN 62304 Medical device software Software life ...

Page 112: ...Rehabil 1993 3 Ferrario VF Sforza C Biomechanical model of the human mandible in unilateral clench distribution of temporomandibular joint reaction forces between working and balancing sides J Prosthet Dent 1994 Aug 72 2 169 76 PubMed PMID 7932264 4 Ferrario VF Sforza C Coordinated electromyographic activity of the human masseter and temporalis anterior muscles during mastication Eur J Oral Sci 19...

Page 113: ... PubMed PMID 10632841 8 Ferrario VF Sforza C Serrao G Fragnito N Grassi G The influence of different jaw positions on the endurance and electromyographic pattern of the biceps brachii muscle in young adults with different occlusal characteristics J Oral Rehabil 2001 Aug 28 8 732 9 PubMed PMID 11556954 9 Ferrario VF Marciandi PV Tartaglia GM Dellavia C Sforza C Neuromuscular evaluation of post orth...

Page 114: ... Neuromuscular coordination of masticatory muscles in subjects with two types of implant supported prostheses Clin Oral Implants Res 2004 Apr 15 2 219 25 PubMed PMID 15008934 14 Ferrario VF Sforza C Zanotti G Tartaglia GM Maximal bite forces in healthy young adults as predicted by surface electromyography J Dent 2004 Aug 32 6 451 7 PubMed PMID 15240063 15 Ferrario VF Tartaglia GM Galletta A Grassi...

Page 115: ...ub 2007 Feb 13 PMID 17298492 19 Ries LG Alves MC Bérzin F Asymmetric activationoftemporalis masseter andsternocleidomastoid muscles in temporomandibular disorder patients Cranio 2008 Jan 26 1 59 64 PMID 18290526 20 Tartaglia GM Moreira Rodrigues da Silva MA Bottini S Sforza C Ferrario VF Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for tempo...

Page 116: ...a M Leopardi S Alonzi M Lucci V Parziale C Chimenti Effetti immediati di uno splint di stabilizzazione sull attività dei muscoli masticatori in pazienti disfunzionali Immediate effects of an occlusal splint of stabilization on the masticatory muscles activity in disfunctional patients Ortognatodonzia Italiana vol 16 2 2009 25 Sforza C Montagna S Rosati R DE Menezes M Immediateeffectofanelastomeric...

Page 117: ...h close position of frontal teeth in cases of different occlusion Article in Russian Stomatologiia Mosk 2010 89 3 69 71 PMID 20559240 29 Botelho AL Gentil FH Sforza C da Silva MA Standardizationoftheelectromyographicsignalthroughthemaximum isometric voluntary contraction Cranio 2011 Jan 29 1 23 31 PubMed PMID 21370766 30 Tartaglia GM Lodetti G Paiva G De Felicio CM Sforza C Surface electromyograph...

Page 118: ...pub 2011 Feb 18 PMID 21332571 32 De Felício CM Ferreira CL Medeiros AP Rodrigues Da Silva MA Tartaglia GM Sforza C Electromyographic indices orofacial myofunctional status and temporomandibular disorders severity A correlation study J Electromyogr Kinesiol 2012 Apr 22 2 266 72 Epub 2011 Dec 27 PubMed PMID 22206640 ...

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Page 120: ...Forlanini 40 20024 Garbagnate M se MI Italy tel 39 02 366 490 00 fax 39 02 366 490 24 R D centre via della Croce Rossa 11 35129 Padova PD Italy tel 39 049 981 5500 fax 39 049 792 9260 www btsbioengineering com info bts it ...

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