Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden Physiology Section, Department of Integrative Medical Biology, Umeå University, Umeå, Sweden.
J Clin Periodontol. 2011 Apr;38(4):395-404. doi: 10.1111/j.1600-051X.2010.01697.x. Epub 2011 Jan 12.
We aimed to determine whether people with implant-supported bridges in both jaws, thus lacking periodontal receptors, adjust jaw muscle activity to food hardness during mastication.
Thirteen participants with implant-supported bridges in both jaws and 13 with natural dentition chewed and swallowed soft and hard gelatine-based model foods, while electromyographic (EMG) activity of the masseter and temporal muscles was recorded bilaterally together with the position of the mandible. Data were compared by using a mixed-design anova model and a P-value<0.05 was considered statistically significant.
The number of chewing cycles and the duration of the masticatory sequence increased with food hardness in both groups, whereas vertical and lateral amplitude of the jaw movements, and the jaw-opening velocity, increased significantly with food hardness only for the dentate group. Although both groups adapted the EMG activity to the hardness of the food, the implant participants showed a significantly weaker increase in EMG activity with increased food hardness early during the masticatory sequence than the dentate participants did. In addition, the implant group showed significantly less reduction of muscle activity during the progression of the masticatory sequence than the dentate group.
People with implant-supported bridges show an impaired adaptation of the muscle activity to food hardness during mastication. We suggest that a lack of sensory signals from periodontal mechanoreceptors accounts for the impairment.
我们旨在确定上下颌均植入支持桥(因此缺乏牙周感受器)的患者在咀嚼时是否能够根据食物硬度调整颌骨肌肉活动。
13 名上下颌均植入支持桥的患者和 13 名具有天然牙列的患者咀嚼和吞咽软、硬明胶模型食物,同时记录双侧咀嚼肌(咬肌和颞肌)的肌电图(EMG)活动和下颌位置。采用混合设计方差分析模型进行比较,P 值<0.05 为统计学显著差异。
两组患者的咀嚼周期数和咀嚼序列持续时间随食物硬度的增加而增加,而颌骨运动的垂直和侧向幅度以及颌开口速度仅在有牙组中随食物硬度显著增加。尽管两组患者均根据食物硬度调整了 EMG 活动,但与有牙组相比,植入组在咀嚼序列早期食物硬度增加时,EMG 活动的增加明显较弱。此外,植入组在咀嚼序列进行过程中肌肉活动的减少明显少于有牙组。
上下颌均植入支持桥的患者在咀嚼过程中对食物硬度的肌肉活动适应性受损。我们认为,牙周机械感受器缺乏感觉信号解释了这种损伤。