Johal Ama, Gill Gulsharondip, Ferman Anthony, McLaughlin Kieron
Oral Growth and Development, Institute of Dentistry, Bart's and The London Queen Mary's School of Medicine and Dentistry, University of London, London, UK.
Clin Physiol Funct Imaging. 2007 Jan;27(1):47-53. doi: 10.1111/j.1475-097X.2007.00714.x.
There is little understanding of how dental appliances, designed to posture the mandible forwards, act on pharyngeal airway dilatory and masticatory muscles in patients with obstructive sleep apnoea (OSA). This study evaluates, in a prospective cohort design, the effect of mandibular advancement splints (MAS) on awake genioglossus (GG), geniohyoid (GH) and masseter (M) muscle activity.
Fifty OSA patients received a custom-made removable Herbst MAS appliance, adjusted for maximum therapeutic benefit, as judged by subjective improvement. Awake electromyographic (EMG) activity was recorded at baseline and with the MAS in situ, by using bipolar surface electrodes in patients seated upright and in the natural head position. The lower splint was modified to facilitate the placement of the intra-oral bipolar surface electrodes used to record GG EMG activity.
Significant increases in GG (P = 0.041), GH (P<0.001) and M (P<0.001) muscle activity accompanied placement of the MAS.
These findings support the contention of a physiological role, which may act to augment the anatomical action of MAS.
对于旨在使下颌骨向前移位的牙科矫治器如何作用于阻塞性睡眠呼吸暂停（OSA）患者的咽部气道扩张肌和咀嚼肌，人们了解甚少。本研究以前瞻性队列设计评估下颌前移矫治器（MAS）对清醒状态下颏舌肌（GG）、颏舌骨肌（GH）和咬肌（M）肌肉活动的影响。
50例OSA患者接受了定制的可摘式Herbst MAS矫治器，根据主观改善情况进行调整以获得最大治疗效益。通过使用双极表面电极，在患者直立且处于自然头位时，于基线状态和佩戴MAS时记录清醒状态下的肌电图（EMG）活动。对下矫治器进行了改良，以方便放置用于记录GG肌电活动的口腔内双极表面电极。
佩戴MAS后，GG肌（P = 0.041）、GH肌（P<0.001）和M肌（P<0.001）的肌肉活动显著增加。
这些发现支持了MAS具有生理作用的观点，该作用可能增强MAS的解剖学作用。
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