Wednesday, July 29, 2009


Due date for data to be completed and submitted for evaluation: August 30th, 2009.
To read more about the purpose and protocols of this study click: http://nmresearchprojects.blogspot.com/

30 clinicians with Myotronics K7 instrumentation comprised the K7 Project No. 1 Team.
41 patient candidates were gathered as the sample size for this study.

We want to recognize the following Clinical Research Associates who participated and contributed to this research project:

1. Kyle Dalton - Conway, Arkansas
2. Roger Anderson – Seattle, Washington
3. Bret Davis, Twin Falls, Idaho
4. Jerry Lim, DDS – Singapore
5. Rich Carroccia - Wilmington, Delaware (2 cases sent)
6. Hoa Nguyen, Ottawa, Ontario
7. Doug Chase, DDS - Santa Rosa, California
8. Ted Hadgis, DDS, Accredited AACD, LVI fellow, Grosse Pointe Woods, Michigan
9. Lawrence M. Stanleigh BSc MSc DDS FADI, Calgary, AB
10. Rashmi Parmar – Maryland (2 cases sent)
11. Art Kwan, DDS - Rocklin, California (2 cases sent)
12. Gary Lederman - Bellmore, New York
13. Chris Mohler, DDS - Beaufort, South Carolina
14. Gregg Ueckert – Austin, Texas
15. Bill Greenberg - Mt. Holly, New Jersey
16. Eric Schikowski - Stow, Ohio
17. Ramin Mehregan, DMD - Canton, Massachucettes (2 cases sent)
18. Karen McCloy - Qld Australia (2 cases sent)
19. Maria Escoto - Miami Beach,Florida
20. Frank Godino - Dana Point, CA
21. Kimlan Bell- Sault Ste. Marie, Ontario
22. Paul Sussman - Rochester, New York
23. Roger Buzbee, Springfield, Missouri
24. Shane Matt, DDS – Austin, Texas
25. Mike O'Gara DDS, FAGD, LVIF- Reno, Nevada
26. Joe Hair, DMD - Douglasville, Georgia
27. Cameron Arnold, BDSc – Queensland, Australia (2 cases sent)
28. Christine Ottersberg, DDS Midlothian, Virginia (2 cases sent)
29. Clayton Chan, DDS, MICCMO - Las Vegas, Nevada (2 cases sent)
30. Joe Willardsen, DDS - Las Vegas, Nevada

OBJECTIVE DATA GATHERED - Baseline for "ASYMPTOMATIC" EMG Profiles as per K7 Project No. 1 data gathering protocols.

Scan 18 Mean Frequency Averages - Asymptomatic Group (41 Candidates)

Scan 18 Mean Frequency - Scaled and Compiled (41 Candidates)
These are the mean frequency patterns that have been recorded during a 10 second clench in habitual CO.  The data has been scaled and overlayed to evaluate for any particular significant patterns. 

Mean Frequency Graph (Raw Data)

Three predominate Mean Frequency Average graphs of all 41 candidates are displayed when scaled and overlayed to the same graph.  Note a smoother even pattern of the asymptomatic 10 second clench.

Asymptomatic clench patterns show a relatively flatter graph with less variable deviations in between the initial clench and the end of the clench.

Mean Frequency Shift Average Graphs (41 asymptomatic candidates)

Data is scaled and overlayed to evaluate for significant patterns of the left anterior temporalis (LTA), right anterior temporalis (RTA), left masseter (LMM) and right masseter (RMM).

The mean frequency averages graphs (see above in red), rather masks these detailed raw data patterns over time. No distinct upward or downward pattern was identified when analyzing the mean frequency averages.


The NMD Research Group – Center for Clinical Research reports the following findings based on the K7 PROJECT NO. 1 - DEFINING THE ASYMPTOMATIC PATIENT using Scan 9 and Scan 18 Pre TENS.

Methods: A population of 41 asymptomatic dental attendees, (11 male and 30 female) of variable ages were recruited and identified as the inclusion criterion was lack of identified symptoms as listed on the K7 Myotronics instrumentation "Occlusal Signs Exam Form". The guidelines for "asymptomatic" was determined by the group and agreed upon for the purpose of the study. Myotronics K7 software was used in this study.

The participants were asked to record Scan's 9, and 18 on a group of "asymptomatic" patients.

Results: Scan 9 and Scan 18 were run in a multiclinic trial with 30 participants and standardized conditions and instructions.  Many of the subjects exhibited facial or occlusal asymmetry. Scan 9 at rest and scan 18 extended clench did not display consistent left/ right symmetry in sEMG amplitude.  There did not appear to be a correlation between lack of symptoms and low sEMG scores as measured in this trial. The muscle groups most commonly elevated were the temporalis, cervical, and digastric groups.

The mean frequency analysis of Scan 18 of these 41 patients resulted in a predominance of downwards and mixed up and down groupings for the muscles tested, with only 7 asymptomatic subjects showing a predominantly upward trend in the frequency analysis. It is not known if or how the predominantly female population of the study may have affected this.
Scan 18 was also subjected to "spectral frequency analysis" and scaled and overlayed.

Asymptomatic clench patterns show a relatively flatter graph with less variable deviations in between the initial clench and the end of the clench. The mean frequency averages graphs rather masks these detailed raw data patterns over time. No clear pattern was determined when analyzing the mean frequency averages.

Discussion: The asymptomatic profile as defined in our K7 project certainly reveals a variation of EMG patterns that I believe will become more meaningful when we do the next project (K7 Project No. 2) with our Symptomatic patients. This way we can compare the two tested groups. Although, in this K7 project it PURPOSELY did not gather Scan 18 after TENS data, because the study is NOT investigating that kind of After TENS scan 18 data. But rather the study was evaluating a baseline recording of the asymptomatic profile using both scan 9 resting EMGS and the noted scan 18 sustained clench muscle fatigue test EMG to lay a foundation as to further determine the hypothesis in the future whether after TENS scan 18 teaching and interpretation on any patient symptomatic or not is truly conveying a reasonable ability to determine fatigue, ascending or descending or even sleep apnea patterns.

(Most of us K7 users understand and know how to do a scan 18 before and after TENS comparison before reading the spectral frequency data…BUT we know there has to me more to this that just up and down arrows and giving an interpretation…is it a correct and proper interpretation?).

Testing this as per the K7 Project No. 1 protocol will allow the NMR group to gather data without any manipulation and influences of other protocols to see what these baseline EMG data indicate as to their relevance to the Asymptomatic patient and then later to test and compare the symptomatic patient. Based on all this data the NM K7 doctors is better prepared to more fully understand for themselves what scan 18 data really means rather than assume the present protocols and advocated teachings are correct.

Clinical impressions: Clinical impressions indicate that scan 18 data outcomes are very much influenced by the quality of the patient’s bite which also influences the status and quality of muscle health. As Jankelson has often indicated, teeth dominate, muscles accommodate and joints accommodate. If teeth dominate, than the scan 9 and 18 data profiles will be an outcome of the dominating/quality of the bite.  Based on observations of scan 18 mean frequency graph patterns wihtin this tested group it appears that various dental dental/molar Class I, Class II, or Class III can play a role in measure outcomes and and the quality of the clench.

Conclusion: The results indicated that there strong variation in the measured Scan 18 clench pattern of the asymptomatic patient. Asymptomatic clench patterns show a relatively flatter graph with less variable deviations in between the initial clench and the end of the clench. Three predominate Mean Frequency Average graphs of all 41 candidates were displayed when scaled and overlayed to the same graph. No distinct upward or downward pattern was identified when analyzing the mean frequency averages. The study indicates that Scan 18 is subject to and influenced by occlusal patterns.

Clinical Implications: Are the findings in this study statistically valid to make a conclusion that Scan 18 is significant and clinically relevant to the clinician's diagnostic and treatment decision making? If this is true, then Scan 18 as is presently advocated may need further investigative study before any claims of relevance can be made to the dental profession. Further protocols and parameters must be established first before scan 18 diagnostic interpretation can be made definitely. Based on this study scan 18 research thus far, there is strong evidence that does not support the correlation of ascending/descending patterns, but in order to prove this hypothesis further studies are required and will be conducted in the same manner as this study on symptomatic patients.

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