Influence of muscle contraction and jaw movement speed on the estimation of chewing force from elevator muscle EMG
Identifieur interne : 007D40 ( Istex/Curation ); précédent : 007D39; suivant : 007D41Influence of muscle contraction and jaw movement speed on the estimation of chewing force from elevator muscle EMG
Auteurs : P. Pröschel [Allemagne] ; H. Rinne [Allemagne] ; T. Morneburg [Allemagne]Source :
- Journal of Oral Rehabilitation [ 0305-182X ] ; 2002-09.
Descripteurs français
- Wicri :
- geographic : Pays-Bas.
English descriptors
- KwdEn :
- Academic centre, Anterior temporalis, Anticipatory activity, Apnoea, Appliance, Arbitrary moulding, Arthrogenous origin, Auscultation, Bennett movement, Bennett side shift, Bilateral, Bilateral clenching, Bilateral measurement, Blackwell, Blackwell science, Bosman department, Botulinum toxin, Bres, Bruxers, Bruxism, Bruxism time index, Central incisor, Centre, Cervical, Cervical spine, Clenching, Clinical assessment, Clinical signs, Complete dentures, Contraction episodes, Contraction time, Contralateral side, Control appliance, Control group, Corresponding amas, Craniomandibular, Craniomandibular disorders, Crown height, Daily stress, Deformation displacement, Dental research, Dentine exposure, Dentistry, Dentistry amsterdam, Denture, Diagnostic criteria, Different design, Different foods, Digastric, Disorder, Edentate people, Edentulous, Edentulous patients, Experimental muscle pain, Experimental occlusal interference, Facial pain, Flemish adolescent girls, Food resistance, Force transducer, Full dentures, Functional impression trays, Functional impressions, Glenoid fossa, Haemodynamic changes, Healthy subjects, Horizontal forces, Hospital anxiety, Hydrodynamic stimulation, Implant, Incisor, Interference period, Interobserver reliability, Interrater reliability, Item scores, Laryngeal, Laryngeal elevation, Laryngeal vibration, Lateral, Lateral pterygoid muscles, Life quality, Little modulation, Local anaesthesia, Local application, Local craniomandibular pain, Lower ridge region, Lower ridge resorption, Magnetic resonance imaging, Main complaint, Mandible, Mandibular, Mandibular contact movements, Mandibular movement, Mandibular movements, Mandibular posture, Masseter, Masseter muscle activity, Masseter muscles, Masticatory, Masticatory muscle palpation, Masticatory muscles, Masticatory performance, Masticatory system, Mcgill pain questionnaire, Molar, Mouth opening, Multiple regression analysis, Muscle activity, Myofascial pain, Myogenous, Myogenous pain, Naeije department, Narrow occlusal surface, Natural environment, Nerve responses, Netherlands, Occlusal, Occlusal anatomy, Occlusal appliance therapy, Occlusal surface, Occlusal tooth, Odds ratio, Okayama university, Oral function, Oral habits, Oral physiology, Oral rehabilitation, Other techniques, Other variables, Outcome variables, Pain intensity, Painful body areas, Palatal, Palatal appliances, Palpation, Patient group, Periodontal receptors, Personality characteristics, Physiology, Physiotherapeutic treatment modalities, Physiotherapy, Physiotherapy group, Positive effect, Posterior digastric, Posterior digastric muscle palpation, Posterior part, Posterior temporalis, Predictor variables, Premature contact, Present study, Pressure onset, Previous study, Prosthetic dentistry, Prosthodontics, Psychological characteristics, Psychological distress, Psychological factors, Psychosomatic disorders, Pulpal blood circulation, Randomized, Recent studies, Recurrent headache, Reliability, Removable prosthodontics, Replacement dentures, Ridge incisal edge, Right masseter muscle, Ring rates, Risk factors, Sagittal distance, Several types, Side mandible, Spearman correlation, Splint therapy, Stabilization appliance, Statistical analysis, Sternocleidomastoid muscles, Stimulation cavity, Stomatognathic physiology, Such treatment, Superior laryngeal nerve, Supramedullary region, Symptom, Temporal muscles, Temporalis, Temporalis muscle, Temporomandibular, Temporomandibular disorders, Temporomandibular joints, Tongue motion, Tooth plastic rims, Treatment contrast, Treatment demand, Treatment effect, Treatment group, Treatment need, Treatment outcome, Twitch force, Unilateral, Unilateral clenching, Vallon department, Vertical distance, Visual analogue scale, Visual analogue scales, Visual feedback, Younger persons.
- Teeft :
- Academic centre, Anterior temporalis, Anticipatory activity, Apnoea, Appliance, Arbitrary moulding, Arthrogenous origin, Auscultation, Bennett movement, Bennett side shift, Bilateral, Bilateral clenching, Bilateral measurement, Blackwell, Blackwell science, Bosman department, Botulinum toxin, Bres, Bruxers, Bruxism, Bruxism time index, Central incisor, Centre, Cervical, Cervical spine, Clenching, Clinical assessment, Clinical signs, Complete dentures, Contraction episodes, Contraction time, Contralateral side, Control appliance, Control group, Corresponding amas, Craniomandibular, Craniomandibular disorders, Crown height, Daily stress, Deformation displacement, Dental research, Dentine exposure, Dentistry, Dentistry amsterdam, Denture, Diagnostic criteria, Different design, Different foods, Digastric, Disorder, Edentate people, Edentulous, Edentulous patients, Experimental muscle pain, Experimental occlusal interference, Facial pain, Flemish adolescent girls, Food resistance, Force transducer, Full dentures, Functional impression trays, Functional impressions, Glenoid fossa, Haemodynamic changes, Healthy subjects, Horizontal forces, Hospital anxiety, Hydrodynamic stimulation, Implant, Incisor, Interference period, Interobserver reliability, Interrater reliability, Item scores, Laryngeal, Laryngeal elevation, Laryngeal vibration, Lateral, Lateral pterygoid muscles, Life quality, Little modulation, Local anaesthesia, Local application, Local craniomandibular pain, Lower ridge region, Lower ridge resorption, Magnetic resonance imaging, Main complaint, Mandible, Mandibular, Mandibular contact movements, Mandibular movement, Mandibular movements, Mandibular posture, Masseter, Masseter muscle activity, Masseter muscles, Masticatory, Masticatory muscle palpation, Masticatory muscles, Masticatory performance, Masticatory system, Mcgill pain questionnaire, Molar, Mouth opening, Multiple regression analysis, Muscle activity, Myofascial pain, Myogenous, Myogenous pain, Naeije department, Narrow occlusal surface, Natural environment, Nerve responses, Netherlands, Occlusal, Occlusal anatomy, Occlusal appliance therapy, Occlusal surface, Occlusal tooth, Odds ratio, Okayama university, Oral function, Oral habits, Oral physiology, Oral rehabilitation, Other techniques, Other variables, Outcome variables, Pain intensity, Painful body areas, Palatal, Palatal appliances, Palpation, Patient group, Periodontal receptors, Personality characteristics, Physiology, Physiotherapeutic treatment modalities, Physiotherapy, Physiotherapy group, Positive effect, Posterior digastric, Posterior digastric muscle palpation, Posterior part, Posterior temporalis, Predictor variables, Premature contact, Present study, Pressure onset, Previous study, Prosthetic dentistry, Prosthodontics, Psychological characteristics, Psychological distress, Psychological factors, Psychosomatic disorders, Pulpal blood circulation, Randomized, Recent studies, Recurrent headache, Reliability, Removable prosthodontics, Replacement dentures, Ridge incisal edge, Right masseter muscle, Ring rates, Risk factors, Sagittal distance, Several types, Side mandible, Spearman correlation, Splint therapy, Stabilization appliance, Statistical analysis, Sternocleidomastoid muscles, Stimulation cavity, Stomatognathic physiology, Such treatment, Superior laryngeal nerve, Supramedullary region, Symptom, Temporal muscles, Temporalis, Temporalis muscle, Temporomandibular, Temporomandibular disorders, Temporomandibular joints, Tongue motion, Tooth plastic rims, Treatment contrast, Treatment demand, Treatment effect, Treatment group, Treatment need, Treatment outcome, Twitch force, Unilateral, Unilateral clenching, Vallon department, Vertical distance, Visual analogue scale, Visual analogue scales, Visual feedback, Younger persons.
Abstract
Recent studies have shown that an additional muscle activity (AMA) in chewing was responsible for excessive masticatory forces that had been estimated from isometric bite force–activity relations. Our aim was to test the thesis that this AMA could be identical to the speed‐dependent ‘anticipatory activity’ that was found in symmetrical jaw closing (Abbink et al., 1999). In this case, forces estimated from EMG should be realistic for slow mastication, but should strongly increase with faster chewing movements. In 56 dentate volunteers the activities of bilateral masseter and anterior temporal muscles were measured during (a) right‐sided chewing, (b) right‐sided isometric clenching on a bite fork with alternating loads. These biting tasks were carried out with slow, habitual and fast contraction/movement speeds (30, 64, 102 cycles min−1). Masticatory forces were estimated for each speed by putting activities found in task (a) into bite force/activity relations obtained from task (b). In slow and habitual mastication, activities of the working side masseter were equal and exceeded the corresponding clenching activities by factors of 2·8 and 2·4, respectively (P < 0·001). Consequently, forces estimated from slow (680 N) and habitual (695 N) chewing did not differ significantly and were unrealistically high. These estimated forces and hence the corresponding AMAs did not depend on the speed movement in the same way as the anticipatory activity described inAbbink et al. (1999). In contrast, forces estimated from fast chewing (811 N) were significantly higher (P < 0·001) and corresponding AMAs qualitatively behaved like anticipatory activities. In conclusion, the AMA in chewing could be explained by anticipatory muscle activity for high movement speeds. In slow and habitual chewing however, the AMA may contain amounts of activity with a different origin.
Url:
DOI: 10.1046/j.1365-2842.2002.01026_17.x
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Academic centre</term>
<term>Anterior temporalis</term>
<term>Anticipatory activity</term>
<term>Apnoea</term>
<term>Appliance</term>
<term>Arbitrary moulding</term>
<term>Arthrogenous origin</term>
<term>Auscultation</term>
<term>Bennett movement</term>
<term>Bennett side shift</term>
<term>Bilateral</term>
<term>Bilateral clenching</term>
<term>Bilateral measurement</term>
<term>Blackwell</term>
<term>Blackwell science</term>
<term>Bosman department</term>
<term>Botulinum toxin</term>
<term>Bres</term>
<term>Bruxers</term>
<term>Bruxism</term>
<term>Bruxism time index</term>
<term>Central incisor</term>
<term>Centre</term>
<term>Cervical</term>
<term>Cervical spine</term>
<term>Clenching</term>
<term>Clinical assessment</term>
<term>Clinical signs</term>
<term>Complete dentures</term>
<term>Contraction episodes</term>
<term>Contraction time</term>
<term>Contralateral side</term>
<term>Control appliance</term>
<term>Control group</term>
<term>Corresponding amas</term>
<term>Craniomandibular</term>
<term>Craniomandibular disorders</term>
<term>Crown height</term>
<term>Daily stress</term>
<term>Deformation displacement</term>
<term>Dental research</term>
<term>Dentine exposure</term>
<term>Dentistry</term>
<term>Dentistry amsterdam</term>
<term>Denture</term>
<term>Diagnostic criteria</term>
<term>Different design</term>
<term>Different foods</term>
<term>Digastric</term>
<term>Disorder</term>
<term>Edentate people</term>
<term>Edentulous</term>
<term>Edentulous patients</term>
<term>Experimental muscle pain</term>
<term>Experimental occlusal interference</term>
<term>Facial pain</term>
<term>Flemish adolescent girls</term>
<term>Food resistance</term>
<term>Force transducer</term>
<term>Full dentures</term>
<term>Functional impression trays</term>
<term>Functional impressions</term>
<term>Glenoid fossa</term>
<term>Haemodynamic changes</term>
<term>Healthy subjects</term>
<term>Horizontal forces</term>
<term>Hospital anxiety</term>
<term>Hydrodynamic stimulation</term>
<term>Implant</term>
<term>Incisor</term>
<term>Interference period</term>
<term>Interobserver reliability</term>
<term>Interrater reliability</term>
<term>Item scores</term>
<term>Laryngeal</term>
<term>Laryngeal elevation</term>
<term>Laryngeal vibration</term>
<term>Lateral</term>
<term>Lateral pterygoid muscles</term>
<term>Life quality</term>
<term>Little modulation</term>
<term>Local anaesthesia</term>
<term>Local application</term>
<term>Local craniomandibular pain</term>
<term>Lower ridge region</term>
<term>Lower ridge resorption</term>
<term>Magnetic resonance imaging</term>
<term>Main complaint</term>
<term>Mandible</term>
<term>Mandibular</term>
<term>Mandibular contact movements</term>
<term>Mandibular movement</term>
<term>Mandibular movements</term>
<term>Mandibular posture</term>
<term>Masseter</term>
<term>Masseter muscle activity</term>
<term>Masseter muscles</term>
<term>Masticatory</term>
<term>Masticatory muscle palpation</term>
<term>Masticatory muscles</term>
<term>Masticatory performance</term>
<term>Masticatory system</term>
<term>Mcgill pain questionnaire</term>
<term>Molar</term>
<term>Mouth opening</term>
<term>Multiple regression analysis</term>
<term>Muscle activity</term>
<term>Myofascial pain</term>
<term>Myogenous</term>
<term>Myogenous pain</term>
<term>Naeije department</term>
<term>Narrow occlusal surface</term>
<term>Natural environment</term>
<term>Nerve responses</term>
<term>Netherlands</term>
<term>Occlusal</term>
<term>Occlusal anatomy</term>
<term>Occlusal appliance therapy</term>
<term>Occlusal surface</term>
<term>Occlusal tooth</term>
<term>Odds ratio</term>
<term>Okayama university</term>
<term>Oral function</term>
<term>Oral habits</term>
<term>Oral physiology</term>
<term>Oral rehabilitation</term>
<term>Other techniques</term>
<term>Other variables</term>
<term>Outcome variables</term>
<term>Pain intensity</term>
<term>Painful body areas</term>
<term>Palatal</term>
<term>Palatal appliances</term>
<term>Palpation</term>
<term>Patient group</term>
<term>Periodontal receptors</term>
<term>Personality characteristics</term>
<term>Physiology</term>
<term>Physiotherapeutic treatment modalities</term>
<term>Physiotherapy</term>
<term>Physiotherapy group</term>
<term>Positive effect</term>
<term>Posterior digastric</term>
<term>Posterior digastric muscle palpation</term>
<term>Posterior part</term>
<term>Posterior temporalis</term>
<term>Predictor variables</term>
<term>Premature contact</term>
<term>Present study</term>
<term>Pressure onset</term>
<term>Previous study</term>
<term>Prosthetic dentistry</term>
<term>Prosthodontics</term>
<term>Psychological characteristics</term>
<term>Psychological distress</term>
<term>Psychological factors</term>
<term>Psychosomatic disorders</term>
<term>Pulpal blood circulation</term>
<term>Randomized</term>
<term>Recent studies</term>
<term>Recurrent headache</term>
<term>Reliability</term>
<term>Removable prosthodontics</term>
<term>Replacement dentures</term>
<term>Ridge incisal edge</term>
<term>Right masseter muscle</term>
<term>Ring rates</term>
<term>Risk factors</term>
<term>Sagittal distance</term>
<term>Several types</term>
<term>Side mandible</term>
<term>Spearman correlation</term>
<term>Splint therapy</term>
<term>Stabilization appliance</term>
<term>Statistical analysis</term>
<term>Sternocleidomastoid muscles</term>
<term>Stimulation cavity</term>
<term>Stomatognathic physiology</term>
<term>Such treatment</term>
<term>Superior laryngeal nerve</term>
<term>Supramedullary region</term>
<term>Symptom</term>
<term>Temporal muscles</term>
<term>Temporalis</term>
<term>Temporalis muscle</term>
<term>Temporomandibular</term>
<term>Temporomandibular disorders</term>
<term>Temporomandibular joints</term>
<term>Tongue motion</term>
<term>Tooth plastic rims</term>
<term>Treatment contrast</term>
<term>Treatment demand</term>
<term>Treatment effect</term>
<term>Treatment group</term>
<term>Treatment need</term>
<term>Treatment outcome</term>
<term>Twitch force</term>
<term>Unilateral</term>
<term>Unilateral clenching</term>
<term>Vallon department</term>
<term>Vertical distance</term>
<term>Visual analogue scale</term>
<term>Visual analogue scales</term>
<term>Visual feedback</term>
<term>Younger persons</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Academic centre</term>
<term>Anterior temporalis</term>
<term>Anticipatory activity</term>
<term>Apnoea</term>
<term>Appliance</term>
<term>Arbitrary moulding</term>
<term>Arthrogenous origin</term>
<term>Auscultation</term>
<term>Bennett movement</term>
<term>Bennett side shift</term>
<term>Bilateral</term>
<term>Bilateral clenching</term>
<term>Bilateral measurement</term>
<term>Blackwell</term>
<term>Blackwell science</term>
<term>Bosman department</term>
<term>Botulinum toxin</term>
<term>Bres</term>
<term>Bruxers</term>
<term>Bruxism</term>
<term>Bruxism time index</term>
<term>Central incisor</term>
<term>Centre</term>
<term>Cervical</term>
<term>Cervical spine</term>
<term>Clenching</term>
<term>Clinical assessment</term>
<term>Clinical signs</term>
<term>Complete dentures</term>
<term>Contraction episodes</term>
<term>Contraction time</term>
<term>Contralateral side</term>
<term>Control appliance</term>
<term>Control group</term>
<term>Corresponding amas</term>
<term>Craniomandibular</term>
<term>Craniomandibular disorders</term>
<term>Crown height</term>
<term>Daily stress</term>
<term>Deformation displacement</term>
<term>Dental research</term>
<term>Dentine exposure</term>
<term>Dentistry</term>
<term>Dentistry amsterdam</term>
<term>Denture</term>
<term>Diagnostic criteria</term>
<term>Different design</term>
<term>Different foods</term>
<term>Digastric</term>
<term>Disorder</term>
<term>Edentate people</term>
<term>Edentulous</term>
<term>Edentulous patients</term>
<term>Experimental muscle pain</term>
<term>Experimental occlusal interference</term>
<term>Facial pain</term>
<term>Flemish adolescent girls</term>
<term>Food resistance</term>
<term>Force transducer</term>
<term>Full dentures</term>
<term>Functional impression trays</term>
<term>Functional impressions</term>
<term>Glenoid fossa</term>
<term>Haemodynamic changes</term>
<term>Healthy subjects</term>
<term>Horizontal forces</term>
<term>Hospital anxiety</term>
<term>Hydrodynamic stimulation</term>
<term>Implant</term>
<term>Incisor</term>
<term>Interference period</term>
<term>Interobserver reliability</term>
<term>Interrater reliability</term>
<term>Item scores</term>
<term>Laryngeal</term>
<term>Laryngeal elevation</term>
<term>Laryngeal vibration</term>
<term>Lateral</term>
<term>Lateral pterygoid muscles</term>
<term>Life quality</term>
<term>Little modulation</term>
<term>Local anaesthesia</term>
<term>Local application</term>
<term>Local craniomandibular pain</term>
<term>Lower ridge region</term>
<term>Lower ridge resorption</term>
<term>Magnetic resonance imaging</term>
<term>Main complaint</term>
<term>Mandible</term>
<term>Mandibular</term>
<term>Mandibular contact movements</term>
<term>Mandibular movement</term>
<term>Mandibular movements</term>
<term>Mandibular posture</term>
<term>Masseter</term>
<term>Masseter muscle activity</term>
<term>Masseter muscles</term>
<term>Masticatory</term>
<term>Masticatory muscle palpation</term>
<term>Masticatory muscles</term>
<term>Masticatory performance</term>
<term>Masticatory system</term>
<term>Mcgill pain questionnaire</term>
<term>Molar</term>
<term>Mouth opening</term>
<term>Multiple regression analysis</term>
<term>Muscle activity</term>
<term>Myofascial pain</term>
<term>Myogenous</term>
<term>Myogenous pain</term>
<term>Naeije department</term>
<term>Narrow occlusal surface</term>
<term>Natural environment</term>
<term>Nerve responses</term>
<term>Netherlands</term>
<term>Occlusal</term>
<term>Occlusal anatomy</term>
<term>Occlusal appliance therapy</term>
<term>Occlusal surface</term>
<term>Occlusal tooth</term>
<term>Odds ratio</term>
<term>Okayama university</term>
<term>Oral function</term>
<term>Oral habits</term>
<term>Oral physiology</term>
<term>Oral rehabilitation</term>
<term>Other techniques</term>
<term>Other variables</term>
<term>Outcome variables</term>
<term>Pain intensity</term>
<term>Painful body areas</term>
<term>Palatal</term>
<term>Palatal appliances</term>
<term>Palpation</term>
<term>Patient group</term>
<term>Periodontal receptors</term>
<term>Personality characteristics</term>
<term>Physiology</term>
<term>Physiotherapeutic treatment modalities</term>
<term>Physiotherapy</term>
<term>Physiotherapy group</term>
<term>Positive effect</term>
<term>Posterior digastric</term>
<term>Posterior digastric muscle palpation</term>
<term>Posterior part</term>
<term>Posterior temporalis</term>
<term>Predictor variables</term>
<term>Premature contact</term>
<term>Present study</term>
<term>Pressure onset</term>
<term>Previous study</term>
<term>Prosthetic dentistry</term>
<term>Prosthodontics</term>
<term>Psychological characteristics</term>
<term>Psychological distress</term>
<term>Psychological factors</term>
<term>Psychosomatic disorders</term>
<term>Pulpal blood circulation</term>
<term>Randomized</term>
<term>Recent studies</term>
<term>Recurrent headache</term>
<term>Reliability</term>
<term>Removable prosthodontics</term>
<term>Replacement dentures</term>
<term>Ridge incisal edge</term>
<term>Right masseter muscle</term>
<term>Ring rates</term>
<term>Risk factors</term>
<term>Sagittal distance</term>
<term>Several types</term>
<term>Side mandible</term>
<term>Spearman correlation</term>
<term>Splint therapy</term>
<term>Stabilization appliance</term>
<term>Statistical analysis</term>
<term>Sternocleidomastoid muscles</term>
<term>Stimulation cavity</term>
<term>Stomatognathic physiology</term>
<term>Such treatment</term>
<term>Superior laryngeal nerve</term>
<term>Supramedullary region</term>
<term>Symptom</term>
<term>Temporal muscles</term>
<term>Temporalis</term>
<term>Temporalis muscle</term>
<term>Temporomandibular</term>
<term>Temporomandibular disorders</term>
<term>Temporomandibular joints</term>
<term>Tongue motion</term>
<term>Tooth plastic rims</term>
<term>Treatment contrast</term>
<term>Treatment demand</term>
<term>Treatment effect</term>
<term>Treatment group</term>
<term>Treatment need</term>
<term>Treatment outcome</term>
<term>Twitch force</term>
<term>Unilateral</term>
<term>Unilateral clenching</term>
<term>Vallon department</term>
<term>Vertical distance</term>
<term>Visual analogue scale</term>
<term>Visual analogue scales</term>
<term>Visual feedback</term>
<term>Younger persons</term>
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<front><div type="abstract" xml:lang="en">Recent studies have shown that an additional muscle activity (AMA) in chewing was responsible for excessive masticatory forces that had been estimated from isometric bite force–activity relations. Our aim was to test the thesis that this AMA could be identical to the speed‐dependent ‘anticipatory activity’ that was found in symmetrical jaw closing (Abbink et al., 1999). In this case, forces estimated from EMG should be realistic for slow mastication, but should strongly increase with faster chewing movements. In 56 dentate volunteers the activities of bilateral masseter and anterior temporal muscles were measured during (a) right‐sided chewing, (b) right‐sided isometric clenching on a bite fork with alternating loads. These biting tasks were carried out with slow, habitual and fast contraction/movement speeds (30, 64, 102 cycles min−1). Masticatory forces were estimated for each speed by putting activities found in task (a) into bite force/activity relations obtained from task (b). In slow and habitual mastication, activities of the working side masseter were equal and exceeded the corresponding clenching activities by factors of 2·8 and 2·4, respectively (P < 0·001). Consequently, forces estimated from slow (680 N) and habitual (695 N) chewing did not differ significantly and were unrealistically high. These estimated forces and hence the corresponding AMAs did not depend on the speed movement in the same way as the anticipatory activity described inAbbink et al. (1999). In contrast, forces estimated from fast chewing (811 N) were significantly higher (P < 0·001) and corresponding AMAs qualitatively behaved like anticipatory activities. In conclusion, the AMA in chewing could be explained by anticipatory muscle activity for high movement speeds. In slow and habitual chewing however, the AMA may contain amounts of activity with a different origin.</div>
</front>
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