Raoul Gwénaël, Rowlerson Anthea, Sciote James, Codaccioni Emmanuel, Stevens Laurence, Maurage Claude-Alain, Duhamel Alain, Ferri Joël
Université Lille Nord de France, UDSL, Lille, France.
J Craniofac Surg. 2011 May;22(3):1093-8. doi: 10.1097/SCS.0b013e3182107766.
Human jaw dysmorphologies are frequent and often affect young patients, resulting in malocclusion of teeth and inappropriate jaw relationships. Treatment is performed by means of orthodontics with orthognathic surgery as required. Mandibular asymmetry is one of the most frequent dysmorphologies, but in many cases, the specific cause is unknown.In healthy patients who were undergoing orthognathic surgery for correction of malocclusion, we tested the hypothesis that masseter muscle phenotype composition, which determines contractile properties, was different between sides in patients with mandibular asymmetry but not in those without mandibular asymmetry. After cephalometric analysis, 50 patients from whom we obtained samples of both right and left masseter muscles were separated into 2 groups: with or without mandibular lateral deviation. Samples were immunostained with myosin-isoform-specific antibodies to identify 4 skeletal muscle fiber types, and their fiber areas and proportions were measured. Two-tailed Wilcoxon test for paired samples was used to compare the 4 fiber-type compositions by means of percent occupancy and mean fiber area on both sides. Patients with mandibular asymmetry were associated with a significant increase of type II fiber occupancy (P = 0.0035) on the same side as the deviation. This finding that masseter muscle phenotype is significantly linked to mandibular asymmetry is of relevance to physiotherapeutic and surgical managements of jaw discrepancies and merits further investigation in the light of its possible role in the etiology of this condition.
人类颌骨畸形很常见,且常常影响年轻患者,导致牙齿咬合不正和颌骨关系异常。治疗方法是根据需要通过正畸和正颌手术进行。下颌不对称是最常见的畸形之一,但在许多情况下,具体病因尚不清楚。在因矫正咬合不正而接受正颌手术的健康患者中,我们检验了这样一个假设:决定收缩特性的咬肌表型组成在有下颌不对称的患者两侧不同,而在无下颌不对称的患者中两侧相同。经过头影测量分析后,我们从50名患者身上获取了左右咬肌样本,并将其分为两组:有或无下颌侧偏。样本用肌球蛋白异构体特异性抗体进行免疫染色,以识别4种骨骼肌纤维类型,并测量其纤维面积和比例。采用配对样本的双尾Wilcoxon检验,通过两侧的占有率百分比和平均纤维面积来比较4种纤维类型的组成。下颌不对称患者患侧的II型纤维占有率显著增加(P = 0.0035)。这一发现表明咬肌表型与下颌不对称显著相关,这对于颌骨差异的物理治疗和手术管理具有重要意义,鉴于其在这种情况病因学中可能发挥的作用,值得进一步研究。