###### Abstract  
This study aims to evaluate the functional variations of the electromyographic response and clinical symptomatology in TMD patients. This study has been performed and compared before and after the application of a therapeutic protocol based on the use of an oral device working on the proper mandibular repositioning through the proprioceptive-based lingual re-education called \"Lingual Ring\". Between January to December 2016, 32 TMD patients have been recruited out of a series of 321 individuals recruited at the Neurosensorial and Motorial Surgery Department, in Palermo (Italy). All the patients underwent the Surface Electromyography (sEMG) of Masseter and Temporal muscles, with different registrations at T0, T1, T2, and T3; to evaluate the variations of the Electromyographic values, it was assigned the application of the Lingual Ring as the only therapy. The study demonstrated a neat rebalancing of the EMG tracks and important improvements with the TMD related issues. The clinical responses, due to the treatment at the end of the therapeutic protocol, were: absence or reduction of muscular or articular pain; absence or reduction of articular pain; absence or reduction of the cephalgia. Hence, significant results, both clinical and in terms of instrumental EMG, were assessed. We can affirm that the adopted methodology allowed the monitoring of the Electromyographic variation and clinical symptoms. Moreover, the usage of the \"Lingual Ring device\" allowed to carry out a simple and immediate therapeutic protocol that is minimally invasive, ensuring a clear rebalancing of the EMG tracks as well as the TMD related pain. langual ring; medical devices; temporomandibular disorders (TMDs); muscular pain +
Footnote †: journal: Medical  
easy to apply test that allows to simultaneously record the potential of several muscles. The electrical activity recorded is directly related to the activity of the muscles [5; 6; 7]. This specific functional examination is also suitable for evaluating the efficacy of physiotherapeutic, surgical, or pharmacological treatments [8]. The numerous advantages of this technique have allowed the creation of low-cost sEMG devices, some of which have been widely validated by several scientific research groups [9; 10; 11]. The Surface Electromyography (sEMG) analysis is useful to investigate the main functional activities of the masticatory muscles, especially in subjects affected by temporomandibular disorders (TMD), where the muscular balance is frequently altered [12; 13; 14]. Interestingly, the Surface Electromyography can clearly describe the muscular activity to better understand specific alterations between different muscular groups over time [15; 16; 17; 18; 19]. In this study, the sEMG has been used as a reliable and repeatable method to investigate the functional alterations between different muscular groups over time. More specifically, sEMG has recorded the activity of Masseter and Temporal muscles at three different times (before, during, and after therapy), to assess the efficacy of a novel therapeutic protocol. The therapeutic protocol was based on a new preformed occlusal device called \"Lingual Ring\" and commercially identified with the name \"_Ripara_\" [20; 21; 22]: we must highlight that this device has been created by the same authors of this paper. This device has been created with the aim of obtaining the repositioning of the articular discs through the induction of proper movements of the masticatory muscles and the tongue. _Ripara_ differs from other \"Bites\" or \"Splints\" [23], as it is based on the re-education of the tongue through a lingual ring: basically, the tongue is the only support where the device is applied, triggering the muscular balancing among Masseter and Temporal muscles [24; 25; 26].