“…Oral parafunction and aberrant habits may cause tensile overloading on bilateral masticatory muscles. Our previous study showed that the CRYBA4 protein is significantly expressed in the temporal tendons of patients with MMTAH compared with that in patients with facial deformity (Nakamoto et al., ). It is possible that the upregulation of CRYBA4 is due to tensile stress on the temporal tendons.…”
Section: Discussionmentioning
confidence: 97%
“…fibrinogen fragment D and crystallin beta A4 (CRYBA4)) or downregulated (e.g. myosin light chain 4) in patients with MMTAH but not in patients with facial deformity (Nakamoto et al., ). As parafunctional habits may cause mechanical loading in tendons and muscles, mechanical loading is conjectured to be involved in the onset or development of MMTAH.…”
“…Oral parafunction and aberrant habits may cause tensile overloading on bilateral masticatory muscles. Our previous study showed that the CRYBA4 protein is significantly expressed in the temporal tendons of patients with MMTAH compared with that in patients with facial deformity (Nakamoto et al., ). It is possible that the upregulation of CRYBA4 is due to tensile stress on the temporal tendons.…”
Section: Discussionmentioning
confidence: 97%
“…fibrinogen fragment D and crystallin beta A4 (CRYBA4)) or downregulated (e.g. myosin light chain 4) in patients with MMTAH but not in patients with facial deformity (Nakamoto et al., ). As parafunctional habits may cause mechanical loading in tendons and muscles, mechanical loading is conjectured to be involved in the onset or development of MMTAH.…”
“…A pilot study conducted on one MMTAH patient and one FD patient, using two-dimensional fluorescence difference in gel electrophoresis system, revealed that four proteins were upregulated and three proteins were downregulated [20]. Furthermore, we also performed proteomic analysis of tendons from four test subjects and four control subjects using two-dimensional polyacrylamide gel electrophoresis with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system [21]. We observed that fibrinogen fragment D and β-crystallinA4 (CRYBA4) were upregulated whereas myosin light chain 4 (MYL4) was downregulated in MMTAH patients but not in FD patients.…”
SummaryLimited mouth opening is a common health problem that interferes with eating, makes examination of the oral cavity difficult, and may increase the mortality rate during emergency intubation. Here we introduce a disease designated as masticatory muscle tendon-aponeurosis hyperplasia, which is a new clinical condition of limited mouth opening. Most oral surgeons and dentists are still unaware of this disease condition, thus increasing the risk of incorrect diagnosis as some other disease, such as temporomandibular joint disorder. We will review the clinical features, epidemiology, pathophysiology, etiology, diagnosis, treatment, and prognosis of this disease and also appraise the literature available on the subject.
“…On maximal mouth opening, intraoral palpation along the anterior border of the masseter muscle confirmed a hard cord-like structure, consistent with the findings on MRI. MMTAH, recently established disease category [ 2 – 4 ], was thus diagnosed. Figure 1: The characteristics of MMTAH.…”
Section: Case Reportmentioning
confidence: 99%
“…This condition can interfere with various medical treatments that require access to the oral cavity. Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH), a rare cause of limited mouth opening, is a new disease entity which has been recently established [ 2 – 4 ]. At present, most clinicians are not yet aware of this disease, leading to the risk of misdiagnosis as other diseases, such as masseter muscle hypertrophy and TMDs.…”
Most clinicians throughout the world are probably unaware of the existence of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH), potentially leading to misdiagnoses such as temporomandibular joint disorder (TMD). Here, we introduce this disease from the viewpoint of education. In February 2013, a 39-year-old woman presented with limited mouth opening. Her facial configuration was characterized by a square mandible. There was no evidence of TMD. Magnetic resonance imaging (MRI) showed bilateral enlargement of the masseter muscles. Additionally, a ‘thick’ aponeurosis of the anterior aspect of the masseter muscle was noted bilaterally. On maximal mouth opening, intraoral palpation along the anterior border of the masseter muscle confirmed a hard cord-like structure, consistent with the findings on MRI. MMTAH was diagnosed. When clinicians notice limited mouth opening on oral examination, they should be knowledgeable about diseases associated with limited mouth opening and a square mandibular configuration, such as MMTAH.
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