Tortopidis D, Lyons M F, Baxendale R H
Dental School, University of Glasgow, Scotland.
J Oral Rehabil. 1999 Apr;26(4):321-8. doi: 10.1046/j.1365-2842.1999.00383.x.
It is well known that bite force and EMG activity are considerably reduced in edentulous patients, but the susceptibility of their jaw-closing muscles to localized fatigue is less certain. This information is even less clear for edentulous subjects who have TMD. Eleven healthy edentulous subjects and 10 edentulous subjects with TMD participated in this study. Maximum bite force was measured first, with the transducer placed on the canine-first premolar region bilaterally, and then two rapid relaxations were made from a brief voluntary clench to 50% of maximum. A sustained voluntary clench of 50% of maximum was then maintained and endurance time was noted. EMG was recorded from both masseter muscles and the median frequency of the power spectrum of the EMG from 2 s at the beginning of the sustained clench and 2 s at the end was subsequently calculated. Two more rapid relaxations from brief clenches were performed immediately after the sustained clench. The mean maximum bite force in the healthy group was 115 N (SD +/-41) and in the TMD group was 75 N (SD +/-22), this difference being significant (P = 0.0013). The mean endurance time in the healthy group was 86 s (SD +/-51) and in the TMD group was 63 s (SD +/-20). The percentage change in the median frequency in the healthy group as a result of the sustained contraction was 6% (left) and 8.6% (right) and in the TMD group was 13.9% (left) and 12.8% (right). The percentage change in the mean relaxation half time for the healthy group was 28.5% and for the TMD group was 72%, a significant difference (P = 0.0046). It was apparent that the maximum bite force was low in edentulous subjects and was further reduced in edentulous TMD subjects; endurance time was reduced in TMD subjects; fatigue resistance of the masseter muscles was reduced in TMD subjects.
众所周知,无牙颌患者的咬合力和肌电图活动会显著降低,但其闭口肌对局部疲劳的易感性尚不确定。对于患有颞下颌关节紊乱病(TMD)的无牙颌受试者来说,这一信息甚至更不明确。11名健康的无牙颌受试者和10名患有TMD的无牙颌受试者参与了本研究。首先测量最大咬合力,将传感器双侧放置在尖牙-第一前磨牙区域,然后从短暂的自主咬紧状态快速放松两次至最大咬合力的50%。接着保持最大咬合力50%的持续自主咬紧状态,并记录耐力时间。从双侧咬肌记录肌电图,并计算持续咬紧开始后2秒和结束后2秒肌电图功率谱的中位频率。在持续咬紧后立即从短暂咬紧状态再进行两次快速放松。健康组的平均最大咬合力为115 N(标准差±41),TMD组为75 N(标准差±22),差异具有统计学意义(P = 0.0013)。健康组的平均耐力时间为86秒(标准差±51),TMD组为63秒(标准差±20)。健康组由于持续收缩导致的中位频率变化百分比为左侧6%,右侧8.6%,TMD组为左侧13.9%,右侧12.8%。健康组平均放松半衰期的变化百分比为28.5%,TMD组为72%,差异具有统计学意义(P = 0.0046)。显然,无牙颌受试者的最大咬合力较低,患有TMD的无牙颌受试者的咬合力进一步降低;TMD受试者的耐力时间缩短;TMD受试者咬肌的抗疲劳能力降低。