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颞下颌关节紊乱病患者咬肌肌电图检查与症状及咬合关系的研究

Electromyographic examination of jaw muscles in relation to symptoms and occlusion of patients with temporomandibular joint disorders.

作者信息

Liu Z J, Yamagata K, Kasahara Y, Ito G

机构信息

Department of Orthodontics, School of Dentistry, University of Washington, Seattle 98195, USA.

出版信息

J Oral Rehabil. 1999 Jan;26(1):33-47. doi: 10.1046/j.1365-2842.1999.00356.x.

Abstract

Clinical/occlusal scores and jaw-muscle EMGs were recorded in 24 TMD symptomatic (group S) and 20 normal (group N) subjects to evaluate the significance of EMG parameters and their clinical associations. Results indicated: (1) integrated EMG activity (IEMG) was larger at the rest position (RP) in anterior temporalis (Ta) but smaller at maximal voluntary clenching (MVC) in masseter (Ma) and Ta, and the ratios of IEMG at 70%MVC to the corresponding bite force (70%BF) were greater in group S; (2) mean power frequency (MPF) were almost the same in both groups but its shift was more rapid in group S; (3) silent period duration (SPD) was longer in group S; (4) asymmetry indices for SPD and silent period latency (SPL) were larger in group S; (5) muscle pain was associated negatively with IEMG at MVC and 70%BF but positively with IEMGs at RP and 70%MVC, and impaired jaw movements were associated negatively with the above EMG values; (6) muscle pain was positively associated with SPD in Ma, while joint pain and sound showed positive and negative associations with SPD, respectively; (7) associations between occlusion and EMG parameters were found more in group N. These findings verify: (1) jaw elevators in TMD may have hyper-tonic activities and a weak functional efficiency; (2) jaw muscles in TMD may become easily fatigued following a functional effort, and less relaxed following a muscle twitch; (3) the severity of pain could not be reflected in EMG activities, but impaired jaw movement may increase tonic activity and decrease functional effort; (4) TMD symptoms may alter the functional adaptation of jaw-muscle activities and occlusion.

摘要

对24名颞下颌关节紊乱病有症状的受试者(S组)和20名正常受试者(N组)记录临床/咬合评分和颌面部肌肉肌电图,以评估肌电图参数的意义及其临床相关性。结果表明:(1)颞肌前束(Ta)在静息位(RP)时的积分肌电活动(IEMG)较大,而咬肌(Ma)和Ta在最大自主紧咬(MVC)时的IEMG较小,且S组中70%MVC时的IEMG与相应咬合力(70%BF)的比值更大;(2)两组的平均功率频率(MPF)几乎相同,但S组的MPF变化更快;(3)S组的静息期时长(SPD)更长;(4)S组中SPD和静息期潜伏期(SPL)的不对称指数更大;(5)肌肉疼痛与MVC和70%BF时的IEMG呈负相关,但与RP和70%MVC时的IEMG呈正相关,而颌运动障碍与上述肌电图值呈负相关;(6)Ma肌的肌肉疼痛与SPD呈正相关,而关节疼痛和弹响分别与SPD呈正相关和负相关;(7)N组中咬合与肌电图参数之间的关联更多。这些发现证实:(1)颞下颌关节紊乱病患者的升颌肌可能存在高张力活动且功能效率低下;(2)颞下颌关节紊乱病患者的颌面部肌肉在功能活动后可能更容易疲劳,在肌肉抽搐后放松程度更低;(3)疼痛的严重程度不能通过肌电图活动反映出来,但颌运动障碍可能会增加紧张性活动并降低功能效率;(4)颞下颌关节紊乱病症状可能会改变颌面部肌肉活动和咬合的功能适应性。

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