Postgraduate student, Discipline of Orthodontics, Faculty of Dentistry, Sydney Dental Hospital, University of Sydney, Sydney, Australia.
Am J Orthod Dentofacial Orthop. 2013 Sep;144(3):357-67. doi: 10.1016/j.ajodo.2013.04.015.
The muscles of mastication are important in positioning the mandible and can therefore affect the patency of the upper airway. The aim of this study was to determine whether resting masticatory muscle activity influences the response to mandibular advancement splint treatment in patients with obstructive sleep apnea.
Thirty-eight adult patients with obstructive sleep apnea were recruited for the study. Baseline electromyographic activities of the right anterior and posterior temporalis, masseter, and submandibular muscles were recorded with surface electrodes while the patients were awake, in the upright and supine positions, with the jaw in the postural position, and with and without a mandibular advancement splint. Muscle activity of the patients with obstructive sleep apnea was compared between responders (apnea-hypopnea index change ≥50%, and <10 events per hour) and nonresponders (apnea-hypopnea index change <50%) to mandibular advancement splint treatment.
There were 18 responders and 20 nonresponders to mandibular advancement splint treatment. The responders had a trend for increased muscle activity in all muscle groups and scenarios. The resting muscle activity of the submandibular and masseter muscles while lying at rest and of the submandibular and posterior temporalis muscles while lying with the mandibular advancement splint in place were significantly greater (P <0.05) in the responders than in the nonresponders.
Inherent baseline differences in muscle activity between responders and nonresponders to mandibular advancement splint treatment in adults with obstructive sleep apnea were observed. This preliminary study suggests that there might be a correlation between responsiveness with mandibular advancement splint treatment and baseline muscle activity.
咀嚼肌在定位下颌方面很重要，因此会影响上气道的通畅性。本研究旨在确定静息咀嚼肌活动是否会影响阻塞性睡眠呼吸暂停患者对下颌前伸矫治器治疗的反应。
本研究共纳入 38 名成人阻塞性睡眠呼吸暂停患者。使用表面电极记录患者清醒时、直立和仰卧位时、下颌处于姿势位时以及佩戴和不佩戴下颌前伸矫治器时右侧前、后颞肌、咬肌和颏下肌的基线肌电活动。比较下颌前伸矫治器治疗对阻塞性睡眠呼吸暂停患者的疗效（呼吸暂停低通气指数变化≥50%，且<10 次/小时）和无反应者（呼吸暂停低通气指数变化<50%）的肌电活动。
18 名患者对下颌前伸矫治器治疗有反应，20 名患者无反应。有反应者在所有肌肉群和情况下的肌肉活动均有增加趋势。仰卧位休息时颏下肌和咬肌以及下颌前伸矫治器在位时颏下肌和后颞肌的静息肌肉活动在有反应者中显著高于无反应者（P<0.05）。
在成人阻塞性睡眠呼吸暂停患者中，观察到对下颌前伸矫治器治疗有反应者和无反应者之间基线肌肉活动存在固有差异。这项初步研究表明，下颌前伸矫治器治疗的反应性与基线肌肉活动之间可能存在相关性。
