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管乐器发声对男性乐器演奏者颞下颌系统的影响。

Impact of sound production by wind instruments on the temporomandibular system of male instrumentalists.

作者信息

Pampel Michael, Jakstat Holger A, Ahlers Oliver M

机构信息

Dentist Implantology Periodontology TMD-Centre Private Practice, Coburg, Germany.

Poliklinik für Zahnärztliche Prothetik und Werkstoffkunde, Universität Leipzig, Leipzig, Germany.

出版信息

Work. 2014;48(1):27-35. doi: 10.3233/WOR-131621.

Abstract

BACKGROUND

Playing a wind instrument can be either a reason for overuse or a protecting factor against certain diseases. Some individuals have many findings but low morbidity while others have few findings but high morbidity. This contradictory phenomenon should be researched.

OBJECTIVE

The temporomandibular system (TMS) is a functional unit which comprises the mandible, associated muscles and bilateral joints with the temporal bone. The TMS is responsible for the generation of sound when wind instruments are played. Over the long-term and with intensive usage, this causes changes in the musculature and in the temporomandibular joint (TMJ) of wind musicians, often resulting in temporomandibular disorders (TMD). The aim of this study is to examine evidence that TMD constitute an occupational disease in wind musicians.

PARTICIPANTS

TMD patients and wind musicians were examined by dental clinical functional analysis. 102 male subjects were divided into three groups: "healthy" individuals, wind musicians, and patients with TMD.

METHODS

Dental Examination was carried out based on focused inclusion of the research diagnostic criteria - TMD [1,7]. Findings were evaluated for statistical significance by first transferring data into a digital database [2,15], then generating T-Test und Wilcoxon-Test when non-Gaussian distribution appears and applying the Mann-Whitney rank sum test using Sigmaplot Version 1.1 software (Systat Software Inc, Washington, USA).

RESULTS

The evaluation revealed that wind instrument musicians show a high incidence of developing TMD as the researchers found almost 100% morbidity regarding parafunctional habits and preauricular muscle pain of each adult and highly active musician. The result is highly significant (p< 0.001) for protrusion distance of the mandible.

CONCLUSIONS

A higher prevalence of functional disorders of the musculoskeletal system has previously been demonstrated in wind musicians. New research results and the typical functions of various wind instruments provide evidence that playing a wind instrument generates occupational risks to the TMS.

摘要

背景

吹奏管乐器可能是过度使用的原因,也可能是预防某些疾病的保护因素。有些人有很多症状但发病率低,而另一些人症状少但发病率高。这种矛盾现象值得研究。

目的

颞下颌系统(TMS)是一个功能单元,由下颌骨、相关肌肉以及与颞骨相连的双侧关节组成。吹奏管乐器时,TMS负责发声。长期高强度使用会导致管乐器演奏者的肌肉组织和颞下颌关节(TMJ)发生变化,常引发颞下颌关节紊乱病(TMD)。本研究旨在检验TMD是否构成管乐器演奏者的职业病。

参与者

通过口腔临床功能分析对TMD患者和管乐器演奏者进行检查。102名男性受试者分为三组:“健康”个体、管乐器演奏者和TMD患者。

方法

根据研究诊断标准——TMD[1,7]进行重点纳入的口腔检查。首先将数据输入数字数据库[2,15],然后在出现非高斯分布时进行T检验和威尔科克森检验,并使用SigmaPlot 1.1版软件(美国华盛顿Systat软件公司)进行曼-惠特尼秩和检验,对结果进行统计学意义评估。

结果

评估显示,管乐器演奏者患TMD的发生率很高,因为研究人员发现,几乎每位成年且演奏活跃的音乐家在副功能习惯和耳前肌疼痛方面的发病率都达到了100%。下颌前伸距离的结果具有高度统计学意义(p<0.001)。

结论

此前已证明管乐器演奏者肌肉骨骼系统功能障碍的患病率较高。新的研究结果以及各种管乐器的典型功能表明,吹奏管乐器会给TMS带来职业风险。

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