Villalón Pablo, Arzola Juan Francisco, Valdivia José, Fresno María Javiera, Santander Hugo, Gutiérrez Mario Felipe, Miralles Rodolfo
Oral Rehabilitation Department of Andrés Bello University, Chile.
Cranio. 2013 Apr;31(2):84-91. doi: 10.1179/crn.2013.015.
There are limited studies about the effects of occlusal appliance (OA) after three months of use. This study aimed to compare myofascial pain (MP) according to RDC/TMD, craniocervical relationships (CR) and masseter and temporalis bilateral electromyographic (EMG) activity, before and after three months of occlusal appliance use. Nineteen patients participated in this study. Cephalometric and RDC/TMD diagnostics were performed previously (baseline) and at the end of the study period (three months). EMG recordings at clinical mandibular rest position (MRP), during swallowing of saliva (SW) and during maximum voluntary clenching (MVC) were performed as follows: after one hour of use of an OA; after three months of using the OA for a minimum of 16 hours each day; and immediately after removal from the mouth. MP was relieved in all patients at the end of the study period. CR did not change significantly between baseline and after removal of the OA at the end of the study period. EMG activity during MRP, SW, and MVC decreased in both muscles after one hour using the OA and maintained the same level for the three-month period. When comparing baseline versus final EMG activity without OA, a significant decrease was only observed in the masseter muscle. The results observed in the present study are relevant to clinicians because they imply that the therapeutic effect of OA does not significantly affect the homeostasis of the craniocervical system.
关于咬合器（OA）使用三个月后的效果，相关研究有限。本研究旨在比较咬合器使用三个月前后，根据RDC/TMD评估的肌筋膜疼痛（MP）、颅颈关系（CR）以及咬肌和颞肌双侧肌电图（EMG）活动情况。19名患者参与了本研究。在研究之前（基线）以及研究期结束时（三个月）进行了头影测量和RDC/TMD诊断。在临床下颌休息位（MRP）、吞咽唾液（SW）以及最大自主紧咬（MVC）时进行肌电图记录，记录时间如下：使用OA一小时后；每天使用OA至少16小时达三个月后；以及从口中取出OA后立即记录。在研究期结束时，所有患者的MP均得到缓解。在基线与研究期结束时取出OA后，CR没有显著变化。使用OA一小时后，MRP、SW和MVC期间的EMG活动在两块肌肉中均降低，并在三个月期间保持在同一水平。在比较未使用OA时的基线与最终EMG活动时，仅在咬肌中观察到显著下降。本研究中观察到的结果对临床医生具有参考价值，因为这表明OA的治疗效果不会显著影响颅颈系统的稳态。
