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第三磨牙手术后颌面部肌肉肌电图活动及疼痛的变化

Changes in jaw muscle EMG activity and pain after third molar surgery.

作者信息

Ernberg M, Schopka J H, Fougeront N, Svensson P

机构信息

Department of Clinical Oral Physiology, Aarhus University, Aarhus, Denmark.

出版信息

J Oral Rehabil. 2007 Jan;34(1):15-26. doi: 10.1111/j.1365-2842.2006.01695.x.

Abstract

Limited jaw-opening capacity is frequently encountered following third molar surgery and may impair function. The aim of this study was to investigate the electromyographic (EMG) activity in jaw muscles after third molar surgery to obtain more insight into the mechanisms of restrictions in jaw opening. Twenty subjects were examined before, 24 h and 1 week after surgery. Ten healthy controls were subjected to the same examination at two different occasions for intersession variability. The EMG activity of the masseter and anterior digastricus muscles was recorded at different jaw positions and during maximum voluntary clenching. Pain intensity was assessed at rest and during movements. The EMG activity in the jaw muscles increased with opening level (P < 0.01), but did not change after surgery. In contrast, the EMG activity during clenching was decreased in all muscles after surgery (P < 0.05). The pain intensity after surgery increased with jaw opening level (P < 0.001), but was in general not correlated to EMG level. Pain intensity during clenching was increased after surgery (P < 0.001), but not correlated to EMG level. The EMG activity did not change between visits in the control group. In conclusion, the results indicate that third molar surgery does not influence the EMG activity in the masseter and anterior digastricus muscles during various levels of static jaw opening, but decreases the EMG activity during clenching. However, these changes are not influenced by pain intensity. The results have implications for the understanding of the phenomenon of trismus.

摘要

在第三磨牙手术后,张口受限的情况经常出现,这可能会损害功能。本研究的目的是调查第三磨牙手术后颌骨肌肉的肌电图(EMG)活动,以便更深入地了解张口受限的机制。对20名受试者在手术前、术后24小时和1周进行了检查。10名健康对照者在两个不同时间接受相同检查,以评估检查间的变异性。在不同颌位以及最大自主紧咬时记录咬肌和二腹肌前腹的肌电图活动。在静息和运动时评估疼痛强度。颌骨肌肉的肌电图活动随张口程度增加(P < 0.01),但手术后没有变化。相比之下,手术后所有肌肉在紧咬时的肌电图活动均降低(P < 0.05)。手术后疼痛强度随张口程度增加(P < 0.001),但总体上与肌电图水平无关。紧咬时的疼痛强度在手术后增加(P < 0.001),但与肌电图水平无关。对照组在不同检查之间肌电图活动没有变化。总之,结果表明第三磨牙手术在不同程度的静态张口时不影响咬肌和二腹肌前腹的肌电图活动,但会降低紧咬时的肌电图活动。然而,这些变化不受疼痛强度的影响。这些结果对理解牙关紧闭现象具有启示意义。

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