RW-Splint对安氏Ⅱ类错牙合伴TMD患者咀嚼肌肌电的影响

目的:探讨安氏Ⅱ类错牙合畸形伴TMD患者经RW-Splint治疗1周和2个月后咀嚼肌肌电活动的改变。方法:采用EMGⅡ型表面肌电测量仪分别对12名患者RW-splint治疗前、治疗后1周及2个月的咀嚼肌肌电活动进行检测。结果:RW-splint治疗1周后患者的颞肌前束、咬肌在下颌姿势位、最大紧咬牙尖交错位时肌电幅值差异均无统计学意义;治疗2个月后最大紧咬牙尖交错位时颞肌前束、咬肌的肌电幅值的肌电幅值均降低,差异有统计学意义(P＜0.05),且颞肌前束的肌电幅值大于咬肌的肌电幅值,差异有统计学意义(P＜0.05)。但患者下颌姿势位时颞肌前束、咬肌肌电幅值差异均无统计学意义。结论:RW-splint通过戴用时间的加长能降低咀嚼肌的肌电值,但改善其对称性作用不明显,可能与RW-splint改变了患者的牙位而呈现出原本有的早接触或牙合干扰有关。     

儿童替牙期骨性AngleⅢ类错(牙合)咀嚼肌肌电研究

目的:研究儿童替牙期骨性AngleⅢ类错(牙合)与正常(牙合)的咀嚼肌肌电变化规律.方法:对20例替牙期AngleⅢ类骨性错(牙合)儿童及20名正常(牙合)儿童进行咀嚼肌肌电图检查,测量嚼肌深浅层和颞肌前后束在姿势位、牙尖交错咬合位、前伸运动边缘位、后退运动边缘位的肌电活动,所得数据进行统计学分析.结果:骨性安氏Ⅲ类错(牙合)姿势位嚼肌与颞肌的肌电活动均大于正常(牙合);牙尖交错咬合位嚼肌、颞肌肌电位均较正常(牙合)小;下颌前伸时颞肌前束肌电显著性高于正常(牙合);下颌后退时,嚼肌显著性高于正常(牙合).结论:替牙期AngleⅢ类骨性错(牙合)肌电有其特征性,提示早期矫治替牙期AngleⅢ类骨性错(牙合)不仅能解决美观问题,更有利于改善咀嚼肌收缩功能,减少肌功能对颅面形态的不良影响.     

头位左倾和右倾变化对咀嚼肌肌电的影响

目的：研究不同的头位变化对咀嚼肌肌电活动的影响。方法：以30例健康正常[牙合]受试者为研究对象，通过肌电图仪（EMG）测试下颌姿势位和牙尖交错位最大紧咬时，5种头位姿势的颞肌前束（TA）、颞肌后束（TP）、咬肌（MM）、二腹肌前腹（DA）的肌电幅值，并对结果进行统计学分析。结果：下颌姿势位和紧咬位时，与正中头位相比，头左倾和右倾状态时咀嚼肌的肌电值变化无显著性差异（P〉0．05）。结论：咀嚼肌在头位左倾和右倾变化过程中所受影响不大。     

单侧后牙反(牙合)患者的咀嚼肌肌电图分析

目的: 通过对单侧后牙反(牙合)患者咀嚼肌肌电检查,分析单侧后牙反(牙合)对咀嚼功能的影响.方法:用肌电图仪记录20 例(男11 例,女 9 例)单侧后牙反(牙合)患者和20 例(男10 例,女10 例)正常对照组在下颌姿势位、紧咬和双侧咀嚼时咬肌和颞肌前束的肌电数据.计算咬肌的活动不对称指数(ASMM)和颞肌前束的活动不对称指数(ASTA),然后进行统计学分析.结果:在紧咬和双侧咀嚼时,单侧后牙反(牙合)组咬肌和颞肌前束肌电值明显低于对照组(P＜0.05),反(牙合)侧明显低于非反(牙合)侧;单侧后牙反(牙合)组与对照组ASMM和ASTA在紧咬和双侧咀嚼时有显著性差异(P＜0.05);单个后牙反(牙合)组与多个后牙反(牙合)组ASMM和ASTA在紧咬和双侧咀嚼时有显著性差异(P＜0.05).结论:单侧后牙反(牙合)对咀嚼肌功能有明显的影响,应对其进行积极治疗.     

牙齿重度磨耗患者咀嚼肌肌电的实验研究

目的 :研究重度牙齿磨耗 (TW )患者咀嚼肌的肌电活动 ,探讨不同类型牙合磨耗患者咀嚼肌受损的肌电表现。方法 :以 15例中老年重度牙齿磨耗患者为研究对象 ,通过肌电图仪 (EMG)测试下颌姿势位和牙尖交错位最大紧咬时颞肌前束 (TA)、咬肌 (MM )、二腹肌前腹 (DA )的肌电幅值 ;并以 8例正常牙合患者的咀嚼肌肌电幅值作为对照。结果 :姿势位时 ,磨耗Ⅰ、Ⅱ、Ⅲ组患者TA、MM、DA的平均肌电幅值高于对照组 ,TA、MM的肌电幅值增高显著大于对照组 (P <0 .0 1) ;ICP最大紧咬时 ,Ⅰ、Ⅱ、Ⅲ组患者TA、MM、DA平均肌电幅值降低 ,MM、DA肌电幅值与对照组比较有显著性差异 (分别为P <0 .0 1,P <0 .0 5 )。结论 :牙齿磨耗患者有肌紧张存在 ,Ⅲ型磨耗导致的不均匀接触对咬肌的损伤较大     

广泛型侵袭性牙周炎患者咀嚼肌肌电特征研究

目的:分析广泛型侵袭性牙周炎(GAgP)患者咀嚼肌肌电活动,并以正常人为对照,探讨GAgP患者咀嚼肌肌电表现及对咀嚼肌功能的影响。方法:测量并记录正常组和牙周炎组双侧颞肌前束(TA)、咬肌(MM)、二腹肌前腹(DA)及胸锁乳突肌(SCM)在下颌不同位置时肌电值。利用配套软件进行肌电值分析,获得连续肌电值的平均值,计算肌电值不对称指数。比较两组咀嚼肌肌电值有无统计学差异;比较两组在最大紧咬时,TA和MM肌电值不对称指数有无统计学差异。结果:在下颌姿势位时,牙周炎组的TA、MM、DA和SCM的肌电值均大于正常组;在牙尖交错位( ICP)最大紧咬时,牙周炎组TA、MM肌电值均小于正常组(P＜0.001);在下颌姿势位时,牙周炎TA、MM、DA和SCM均有微小肌电活动,其中TA＞MM＞DA;最大紧咬时TA＞MM;前伸运动时DA＞MM＞TA;后退位时 DA＞MM,TA＞MM,差异均有统计学意义(P＜0.05);ICP最大紧咬时,牙周炎组较正常组左右侧TA和MM肌电值不对称指数高,并且存在统计学差异(P＜0.05)。结论:GAgP患者因牙周组织受损而降低了咀嚼功能,存在咀嚼活动不平衡及肌肉功能异常。     

牙周基础治疗和咬合调整对嚼肌和颞肌肌电活动的影响

运用肌电图机对13例慢性牙周炎患者,在牙周基础治疗和系统调(牙合)前后,嚼肌和颞肌的肌电图进行了定量分析。结果表明,基础治疗后4周,切刃位和正中(牙合)位时大力紧咬的肌电波峰值明显增大;肌电/(牙合)力比值减小,咀嚼肌功能活动的效率提高;咀嚼时肌电图的时间参数活动期缩短,间歇期相对延长。调(牙合)后4周,上述指标进一步明显改善,正中(牙合)位时最大咬合耐力增强,咀嚼时肌电波峰值明显增大,肌电波的稳定性明显提高。     

线性(牙合)总义齿肌电图的研究

目的 通过肌电图测试了解线性（牙合）总义齿和解剖式（牙合）总义齿修复患者的咀嚼肌肌电活动。方法 利用EMG对30例线性（牙合）总义齿和30例解剖式（牙合）总义齿修复患者测量双侧嚼肌和颞肌前束在正中颌位大力咬合及咀嚼循环时的肌电图。结果 在正中颌位大力咬合时，线性袷总义齿修复组颞肌前束肌电值高于解剖式袷总义齿修复组，尤以牙槽嵴吸收严重的患者最为明显（P〈0．05）；在咀嚼运动循环中，线性（牙合）总义齿咀嚼周期的间歇期短于解剖式（牙合）总义齿（P〈0．05）。结论 线性（牙合）总义齿修复有利于咀嚼肌功能的发挥。     

对全口义齿患者颞肌和嚼肌肌电的一年定期观察

<正> 全口义齿患者的(牙合)力和咀嚼效率均明显低于有牙者。(牙合)力反应了咀嚼肌的功能。全口义齿患者(牙合)力或咀嚼肌功能的降低与组织化学所见的肌纤维类型不同分布相一致,它归结于萎缩。这可能是由于牙颌系统功能改变所致。修复全口义齿后,由于咀嚼功能逐步恢复和提高,咀嚼肌功能亦逐渐得以提高。本课题对15例无牙患者戴用全口义齿后,采用微机-EMG处理系统,对患者两侧的颞肌前束和嚼肌进行1年的定期肌电检测,并经微机处理,作出肌电的定量报告,以分析戴全口义齿者,不同时期颞肌和嚼肌功能的变化规律。     

功能性矫治器矫治安氏Ⅱ类1分类错牙合儿童咀嚼肌肌电活动的…

通过功能性矫治器矫治安氏Ⅱ类分类错牙合，对患者咀嚼肌肌电活动进行观察，以探讨矫形治疗过程中咀嚼肌功能活动的变化及其规律。结果表明功能矫治器作用机理之可能是通过下颌姿势位的改变，刺激了前伸肌群，抑制了后收肌群，使异常的肌肉功能型恢复到正常。     

The relationship between the severity of periodontitis and occlusal conditions monitored by the K6 Diagnostic System®

SUMMARY The occlusal conditions of periodontitis patients were investigated by using a computerized monitoring device. Thirty-three mild to severe periodontitis patients were enrolled in the study and they were categorized into three groups by their periodontitis severity. Each subject answered a preliminary questionnaire, received routine dental examinations, and underwent MKG/EMG tests using the K6 Diagnostic System. Clinical manifestations of periodontitis were confirmed by the questionnaire and the routine clinical examinations. According to the MKG tests, the traces of maximum opening distance and vertical freeway space showed no significant statistical difference among the groups. However, the velocity of terminal tooth contact was significantly delayed in the severe periodontitis group. According to the EMG tests, there was no significant difference in the rest mode EMG activities, but the function mode EMG activities significantly weakened in the severe periodontitis group. These results showed that severe periodontitis patients had poor occlusal conditions that might have been triggered by the instability of centric occlusion due to attachment loss.     

[牙合]垫对牙齿重度磨耗患者口颌功能影响的临床研究

目的：研究殆垫对牙齿重度磨耗患者口颌功能的影响。方法：用殆垫恢复10例牙齿重度磨耗患者的垂直距离,分别检测治疗前、治疗后1个月、3个月、6个月的咬合平衡性、咬肌及颞肌前束的肌电幅值、颌位及殆的稳定性以及边缘运动的平滑度及对称性的变化。结果：①咬合平衡性、颌位及胎的稳定性以及边缘运动轨迹的平滑度及对称性在治疗后呈逐渐改善趋势,治疗6个月后80％的患者恢复正常;②治疗后各组的息止位肌电幅值均较治疗前显著降低（P〈0．05）,正中颌位紧咬时肌电幅值在治疗后3个月组和6个月组较治疗前显著增加（P〈O．05）。结论：通过6个月的治疗和观察,聆垫对重度磨耗患者的口颌功能的影响呈现持续改善趋势。     

EMG and pain severity evaluation in patients with TMD using two different occlusal devices

PURPOSE: The purpose of this study was to compare the electromyographic (EMG) activity level and signs and symptoms in patients with myogenous temporomandibular disorders (TMD) treated with two different types of occlusal devices. MATERIALS AND METHODS: Eleven TMD patients were treated with maxillary occlusal devices. The first group received a flat-plane stabilization occlusal device, while the second group received an anatomic occlusal device that maintained the anatomy of the original occlusal surfaces. The severity of signs and symptoms and the masseter EMG activity were recorded and evaluated before treatment and at 72 hours, 2 weeks, and 4 weeks following the delivery of the occlusal device. EMG activity was measured during maximum clenching and during chewing on the right and left sides. The EMG was also recorded for seven normal subjects as a control group. RESULTS: All patients showed reduction of reported and clinically found muscle pain, with no statistically significant differences between the two groups. A reduction in the EMG activity level at maximum clenching was seen in both patient groups, but was significant only with the anatomic occlusal device. Mean EMG activity during chewing was highly variable within and between groups. CONCLUSION: The subjective and objective improvements with both types of occlusal devices suggest that either type of occlusal device can be beneficial to TMD patients.     

牙周炎基础治疗对咬合力和牙周状况影响的观察

目的 探讨牙周基础治疗对慢性牙周炎(CP)牙周状况和最大咬合力的影响。方法 重度CP病例27例,每病例双侧磨牙各选择一患牙(初诊患牙牙周袋≥5mm,牙松动度≤Ⅱ度),随机分为龈上洁治组(S组)和根面平整组(P组)。S组患牙给予龈上洁治、碘氧液冲洗疗法;P组患牙予以龈上洁治、根面平整和碘氧液冲洗疗法。分别在治疗前和治疗后1、3、6个月测定息牙的咬合力值、龈炎指数(GI)、牙周袋深度(PD)。结果 ①P组治疗后1、3、6个月,最大咬合力值较治疗前有显著性提高(P<0.05);S组与治疗前无显著性差异(P>0.10)。②治疗后1个月,两组的咬合力值无显著性差异(P>0.05);治疗后3、6个月,P组的咬合力显著高于S组(P<0.01);③治疗后3、6个月,P组的GI值、PD值显著低于S组(P<0.001)。结论 洁治、根面平整治疗对于CP患牙的最大咬合力、GI、PD的改善是持续性的,较龈上洁治有显著性差异。     

不同牙合型人群咀嚼肌肌电活动的研究

目的:利用肌电图仪测量不同牙合型人群咀嚼肌肌电活动,分析比较各组人群的咀嚼肌肌电特点和差异。方法:1)选取符合实验标准的自愿者33人,平均年龄21.71岁。分组,正常对照组10人,安氏Ⅰ类错牙合组10人,安氏Ⅱ类错牙合组8人,安氏Ⅲ类错牙合组5人;2)用肌电图仪测量各组人群的测量不同牙合型的咀嚼肌肌电活动;3)用SPSS17.0软件进行统计学分析,得出各组人群的咀嚼肌肌电特点和差异。结果:1)静息状态下,显著性>0.05,各组人群咀嚼肌的电位变化没有显著性差异;2)咀嚼过程中,安氏Ⅲ类错牙合畸形组,与正常对照组、安氏Ⅰ类错牙合畸形组、安氏Ⅱ类错牙合畸形组相比,咬肌的电位值显著性<0.05,存在显著性差异;3)吞咽时,①安氏Ⅱ类错牙合畸形组人群,与正常对照组间咬肌的电位比较,显著性<0.05,存在显著性差异;②安氏Ⅲ类错牙合畸形组人群,与正常对照组、安氏Ⅰ类错牙合畸形组咬肌的电位相比较,显著性<0.05,存在显著性差异;③安氏Ⅲ类错牙合畸形组与其余3组二腹肌电位相比较,显著性<0.05,存在显著性差异。4)不同状态时各组人群两侧咀嚼肌肌电变化不同,存在相关性与差异性。结论:不同牙合型人群在咀嚼和吞咽过程中,咀嚼肌肌电活动有所不同,推断错牙合畸形可影响咀嚼肌的正常功能运动。     

Occlusal adjustment for a physiologically balanced occlusion.

An investigation of the neuromuscular effects of dental contact at the physiologic median occlusal position was conducted before and after occlusal adjustments. Eighteen patients with histories of functional disturbances of the masticatory system, but whose painful symptoms had subsided, were analyzed before and after occlusal adjustments. Nine of the patients with missing teeth received fixed partial dentures and occlusal adjustments. Another group of nine subjects with normal occlusions were used as controls. Electromyographic recordings of the bilateral temporal and masseter muscles enabled quantification of two reflex parameters, the EMG silent period duration, and the mechanical latency of the jaw-opening reflex. Phase-plane traces of jaw-closing velocity as a function of position displayed the repeatability of the median occlusal position. The statistical analysis disclosed that the mean duration of EMG silent periods and latency of the jaw-opening reflex were significantly reduced following the treatment procedures. Within the limits of this study it was concluded that the described occlusal adjustments will reduce the masticatory reflexes evoked at median occlusal position to within the range of normal subjects. Furthermore these changes can be monitored by electrophysical methods.     

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目的比较Ⅰ、Ⅱ、Ⅲ类错验及正畸治疗后患者与个别正常验的咬合力差异,为正畸临床诊断和术后稳定性评价提供参考。方法于2006年1月至2008年12月选择来大连大学附属口腔医院正畸科就诊的无正畸治疗史的Ⅰ、Ⅱ、Ⅲ类错铪患者110例及正畸治疗后患者42例,另选择个别正常矜志愿者28名。采用T-ScanⅡ咬合力分析系统,对其[牙合]力总值进行比较分析。结果Ⅰ、Ⅱ、Ⅲ类错[牙合]的验力总值均低于个别正常[牙合]（P〈0．05）;正畸治疗后患者虽获得良好的咬合关系,[牙合]力总值增加,但与个别正常[牙合]比较,差异仍有统计学意义（P〈0．05）。结论正畸治疗可改善咬合关系,增加[牙合]力总值,但与个别正常[牙合]的[牙合]力总值仍有差异,推断牙齿在建立良好的咬合关系后,仍需要一定时间的咬合面磨合、神经肌肉的改建,才能更好地发挥咬合功能。     

牙周-正畸联合治疗牙周炎致前牙扇形移位疗效观察

目的：评价牙周-正畸联合治疔牙周炎致前牙扇形移位的临床效果。方法：对21例因牙周炎造成前牙扇形移位的患者,经牙周基础治疗,牙周炎症基本控制后,用方丝弓固定正畸方法内收并排齐扇形移位的前牙,同时配合牙周护理及凋精等措施,消除炎症及殆创伤,建立正常的咬合关系。共治疗74颗牙,治疗前后分别记录患牙牙周袋、牙槽骨吸收情况。所得数据采用Ridit分析及X^2检验。结果：经1～2a随访,40岁以下患者牙周袋情况有非常显著改善（P〈0．01）,牙槽骨吸收也有显著改善（P〈0．05）,治疗效果满意。结论：牙周-正畸联合治疗能有效控制牙周炎症．消除he创伤,排齐牙列,并使治疗效果达到长期稳定,但应注意患者年龄不宜超过40岁。     

颞下颌关节盘可复性前移位患者咬合接触特征的研究

目的观察颞下颌关节盘可复性前移位患者的咬合接触特征并比较其与正常人的差异。方法采用T-ScanⅡ咬合分析系统记录30名颞下颌关节盘可复性前移位患者和30名正常人于牙尖交错位和后退接触位时的咬合接触信息并进行统计分析。结果颞下颌关节盘可复性前移位患者在牙尖交错位可出现力中心较大的偏移、两侧接触点不平衡、两侧力不对称、弹响侧接触点数目多于非弹响侧;在后退接触位颞下颌关节盘可复性前移位患者双侧接触点数目有显著差异,单侧接触者显著增多。结论颞下颌关节盘可复性前移位患者咬合接触情况与正常人有显著的差异,提示咬合因素与颞下颌关节盘可复性前移位有密切的关系。     

A preliminary study of maximum voluntary bite force and jaw muscle efficiency in pre-orthognathic surgery patients.

The functional state of dentofacial deformity patients before orthognathic surgery has received relatively little study. In this study, the ability to generate occlusal force was compared between 84 patients before treatment for various dentofacial deformities and 57 controls. Maximal and submaximal bite forces were measured at the incisor and right and left first molar bite positions. Electromyographic activity (EMG) was recorded bilaterally from the anterior temporalis, posterior temporalis, and masseter muscles during each bite. An efficiency ratio was calculated for the jaw muscles by dividing the level of EMG by the occlusal force. There was a reduced ability to generate occlusal forces in the patients before surgery, especially among female patients. The reductions in maximal occlusal force were correlated with reduced efficiency of the jaw muscles.