Department of Orthodontics, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
J Oral Rehabil. 2010 Feb;37(2):85-92. doi: 10.1111/j.1365-2842.2009.02026.x. Epub 2009 Nov 30.
The purpose of this retrospective study was to investigate the relationship between the unilateral temporomandibular joint (TMJ) osteoarthritis/osteoarthrosis (OA), mandibular asymmetry and electromyographic (EMG) activity of the masticatory muscles. Twenty-two Japanese women (aged 23.2 +/- 5.4 years) and 10 Japanese men (aged 22.4 +/- 2.8 years) exhibiting unilateral TMJ OA were included in this study. Two angular and seven linear measurements were obtained for the analysis of the skeletal hard tissues. The cephalometric measurement values (CV) were normalized using the CV ratio for the evaluation of the degree of mandibular asymmetry. The EMG was recorded during maximal voluntary clenching efforts for 10 s in the intercuspal position. The average values of integral EMG (iEMG) of three trials were normalized using the iEMG ratio for the evaluation of the functional balance of the masticatory muscles. The mandibular midline was shifted to the TMJ OA side with a median value of 9.85 mm. The CV ratio of the ramus height of the TMJ OA side was significantly smaller than that of the non-OA side. For the masseter muscle, the iEMG ratio of the TMJ OA side was significantly larger than that of the non-OA side (P < 0.05). These results suggest that unilateral TMJ OA is related to the dentofacial morphology, thus resulting in a mandibular midline shift to the affected side and it is associated with a masticatory muscle imbalance.
本回顾性研究旨在探讨单侧颞下颌关节(TMJ)骨关节炎/骨关节炎(OA)、下颌不对称与咀嚼肌肌电图(EMG)活动之间的关系。本研究纳入了 22 名日本女性(年龄 23.2±5.4 岁)和 10 名日本男性(年龄 22.4±2.8 岁),他们均患有单侧 TMJ OA。对骨骼硬组织进行了 2 个角度和 7 个线性测量。采用头影测量值(CV)比评估下颌不对称程度。在牙尖交错位进行最大自主紧咬 10 秒,记录 EMG。采用 iEMG 比评估咀嚼肌功能平衡,对 3 次试验的平均积分 EMG(iEMG)值进行归一化。下颌中线向 TMJ OA 侧偏移,中位数为 9.85mm。TMJ OA 侧髁突高度的 CV 比明显小于非 OA 侧。对于咬肌,TMJ OA 侧的 iEMG 比明显大于非 OA 侧(P<0.05)。这些结果表明,单侧 TMJ OA 与牙颌面形态有关,导致下颌中线向患侧偏移,并与咀嚼肌失衡有关。