Reichardt G, Miyakawa Y, Otsuka T, Sato S
Private Dental Office "Ihre Zahnärzte", Landhausstrasse 74, 70190 Stuttgart, Germany ; Department of Craniofacial Growth and Developmental Dentistry, Kanagawa Dental University, 82 Inaoka-cho, 238-8580 Yokosuka, Kanagawa Japan.
Int J Stomatol Occlusion Med. 2013;6(4):134-139. doi: 10.1007/s12548-013-0093-8. Epub 2013 Sep 17.
The mechanism of action of occlusal splints used for the successful treatment of temporomandibular disorders (TMD) remains unclear and controversial.
The aim of this study was to observe the mandibular response during sleep bruxism (SB) on the elimination of occlusal influences by using a flat anterior and lateral guidance splint (FGS).
Any changes in mandibular movement patterns and condylar position with the introduction of this tool were measured. Current SB activity on the natural dentition was evaluated using a Brux Checker® (BC) and compared with the activity after insertion of an FGS in 153 subjects.
The spatial mandibular position changed individually with a tendency toward forward and downward movement. The insertion of an FGS led to a change in the topographical condyle-fossa relationship and seemed to create an "unloading" condition for the temporomandibular joint. It was found that increased angulation of the maxillar incisors was responsible for altered muscular activity during sleep.
The masticatory organ appears to self-regulate and to provide an oral behavior modification, which may be more physiological using the FGS as a compensating factor. In this context, it is assumed that sleep bruxism in terms of parafunctional activity is a physiological function of the masticatory organ. The results of this study indicate the importance of controlling anterior guidance in the functional reconstruction of human occlusion.
用于成功治疗颞下颌关节紊乱病（TMD）的牙合垫作用机制仍不明确且存在争议。
本研究的目的是通过使用平坦型前牙及侧方引导牙合垫（FGS）观察睡眠磨牙症（SB）期间下颌在消除牙合干扰时的反应。
测量引入该工具后下颌运动模式和髁突位置的任何变化。使用磨牙监测仪（BC）评估天然牙列上当前的SB活动，并将153名受试者佩戴FGS后的活动与之进行比较。
下颌空间位置个体性改变，有向前下方移动的趋势。FGS的佩戴导致髁突 - 关节窝地形关系发生变化，似乎为颞下颌关节创造了一种“卸载”状态。研究发现上颌切牙角度增加是睡眠期间肌肉活动改变的原因。
咀嚼器官似乎能自我调节并提供一种口腔行为改变，使用FGS作为补偿因素可能更符合生理。在此背景下，假定就副功能活动而言，睡眠磨牙症是咀嚼器官的一种生理功能。本研究结果表明在人类咬合功能重建中控制前牙引导的重要性。
