Ueda Hiroshi, Almeida Fernanda R, Chen Hui, Lowe Alan A
Division of Orthodontics, Department of Oral Health Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Orthod Dentofacial Orthop. 2009 Apr;135(4):430.e1-7; discussion 430-1. doi: 10.1016/j.ajodo.2008.12.013.
The aim of this study was to compare the effects on objective occlusal function of 2 types of jaw exercises during oral appliance therapy in patients with obstructive sleep apnea (OSA).
Sixteen consecutive subjects with snoring or OSA undergoing oral appliance therapy were included in this study; the results were based on 10 patients who completed it. The patients were randomized to start with either a jig exercise or stretching movements for 1 month; after 1 month without exercise, they crossed over to the other exercise for 1 month. An occlusal diagnostic system that consisted of a pressure-sensitive sheet and an image scanner was used to evaluate occlusal contact area and bite force.
Both exercises produced significant increases in occlusal contact area and bite force in the morning compared with the period of no exercise. At night, the molar region had significant improvements in occlusal contact area and bite force only during stretching movements. We found no significant differences between the 2 exercises, but stretching movements tended to be more effective in the molar region, whereas the jig exercise tended to be more effective in the anterior region.
Jaw exercises might help relieve masticatory muscle stiffness and accelerate the repositioning of the mandible to the normal position, in addition to inhibiting or minimizing the occlusal functional changes in predisposed patients.
本研究的目的是比较阻塞性睡眠呼吸暂停(OSA)患者在口腔矫治器治疗期间两种类型的颌部运动对客观咬合功能的影响。
本研究纳入了16名连续接受口腔矫治器治疗的打鼾或OSA患者;结果基于10名完成研究的患者。患者被随机分为先进行1个月的跳板式运动或伸展运动;在1个月不运动后,他们交叉进行另一种运动1个月。使用由压敏片和图像扫描仪组成的咬合诊断系统来评估咬合接触面积和咬合力。
与不运动期间相比,两种运动在早晨均使咬合接触面积和咬合力显著增加。在夜间,仅在伸展运动期间磨牙区的咬合接触面积和咬合力有显著改善。我们发现两种运动之间无显著差异,但伸展运动在磨牙区往往更有效,而跳板式运动在前牙区往往更有效。
颌部运动可能有助于缓解咀嚼肌僵硬,并加速下颌骨重新定位到正常位置,此外还能抑制或最小化易感患者的咬合功能变化。