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牙列完整患者与传统及种植支持的固定和可摘义齿佩戴者咀嚼肌的肌电图评估——比较模型食物的初步报告

Electromyographic evaluation of masticatory muscles in dentate patients versus conventional and implant-supported fixed and removable denture wearers- a preliminary report comparing model foods.

作者信息

Uram-Tuculescu Sorin, Cooper Lyndon F, Foegeding E Allen, Vinyard Christopher J, De Kok Ingeborg J, Essick Gregory

出版信息

Int J Prosthodont. 2015 Jan-Feb;28(1):79-92. doi: 10.11607/ijp.3931.

Abstract

PURPOSE

To evaluate differences in masticatory muscle function during chewing of model foods designed to differ in fracture strength between dentate subjects (n = 5, ages 59 to 68 years) versus patients treated with a maxillary conventional complete denture opposing natural dentition or one of the following types of mandibular complete dentures: conventional, implant-supported overdenture, implant-supported fixed denture (n = 20, ages 45 to 83 years). The authors hypothesized that denture wearers would differ in duration of chewing, frequency of chewing, and masticatory muscle activity while preparing a bolus for swallowing.

MATERIALS AND METHODS

Surface electromyography was recorded bilaterally from the masseter, anterior temporalis, and anterior digastric. Masticatory muscle activity was evaluated using scaled values of the area under the electromyographic curve, while subjects chewed agar-based model foods with different fracture strengths. Chewing duration and frequency also were calculated from electromyographic recordings. Mixed model analysis of variance with "subject" as a random factor was used during statistical analysis. Logarithmic transformation was required to achieve normalization of residuals for the duration of chewing and the relative masticatory muscles activity, but not for the chewing frequency.

RESULTS

Relative masticatory muscle activity was 2.57 times higher for the denture wearers than for the dentate subjects during chewing of model foods (P < .0001). The reduction in masticatory muscle activity from the 1st to the 10th chewing cycle was proportionally less in magnitude and occurred more gradually for denture wearers compared to dentate subjects. While chewing sequence duration increased with food fracture strength, it did not differ significantly in treatment versus dentate groups. Chewing cycle frequency did not differ between groups or with food fracture strength.

CONCLUSIONS

The observed increases in relative masticatory muscle activity for denture wearers compared to the dentate subjects during oral food processing likely reflect supplemental mechanical efforts to accommodate the use of dentures for preparing a bolus for swallowing.

摘要

目的

评估在咀嚼具有不同断裂强度的模型食物时,牙列完整受试者(n = 5,年龄59至68岁)与接受上颌传统全口义齿修复并与天然牙列相对、或以下类型下颌全口义齿之一修复的患者(n = 20,年龄45至83岁)之间咀嚼肌功能的差异。作者假设,义齿佩戴者在准备吞咽食团时,咀嚼持续时间、咀嚼频率和咀嚼肌活动会有所不同。

材料与方法

双侧记录咬肌、颞肌前束和二腹肌前腹的表面肌电图。在受试者咀嚼具有不同断裂强度的琼脂基模型食物时,使用肌电图曲线下面积的标度值评估咀嚼肌活动。咀嚼持续时间和频率也根据肌电图记录进行计算。统计分析采用以“受试者”为随机因素的混合模型方差分析。咀嚼持续时间和相对咀嚼肌活动的残差需要进行对数转换以实现正态化,但咀嚼频率不需要。

结果

在咀嚼模型食物时,义齿佩戴者的相对咀嚼肌活动比牙列完整受试者高2.57倍(P <.0001)。与牙列完整受试者相比,义齿佩戴者从第1次到第10次咀嚼周期咀嚼肌活动的降低幅度相对较小,且发生得更为缓慢。虽然咀嚼序列持续时间随食物断裂强度增加,但治疗组与牙列完整组之间无显著差异。各组之间以及咀嚼周期频率与食物断裂强度之间均无差异。

结论

在口腔食物加工过程中,与牙列完整受试者相比,义齿佩戴者观察到的相对咀嚼肌活动增加,可能反映了为适应使用义齿准备吞咽食团而进行的额外机械努力。

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