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外科正畸治疗对骨性III类患者咀嚼功能的影响。

Influence of surgical orthodontic treatment on masticatory function in skeletal Class III patients.

作者信息

Kubota T, Yagi T, Tomonari H, Ikemori T, Miyawaki S

机构信息

Department of Orthodontics and Dentofacial Orthopedics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Department of Orthodontics Dentistry, Medical and Dental Hospital, Kagoshima University, Kagoshima, Japan.

出版信息

J Oral Rehabil. 2015 Oct;42(10):733-41. doi: 10.1111/joor.12307. Epub 2015 May 15.

Abstract

Skeletal Class III patients exhibit malocclusion characterised by Angle Class III and anterior crossbite, and their occlusion shows total or partially lateral crossbite of the posterior teeth. Most patients exhibit lower bite force and muscle activity than non-affected subjects. While orthognathic surgery may help improve masticatory function in these patients, its effects have not been fully elucidated. The aims of the study were to evaluate jaw movement and the electromyographic (EMG) activity of masticatory muscles before and after orthognathic treatment in skeletal Class III patients in comparison with control subjects with normal occlusion. Jaw movement variables and EMG data were recorded in 14 female patients with skeletal Class III malocclusion and 15 female controls with good occlusion. Significant changes in jaw movement, from a chopping to a grinding pattern, were observed after orthognathic treatment (closing angle P < 0.01; cycle width P < 0.01), rendering jaw movement in the patient group similar to that of the control group. However, the grinding pattern in the patient group was not as broad as that of controls. The activity indexes, indicating the relative contributions of the masseter and temporalis muscles (where a negative value corresponds to relatively more temporalis activity and vice versa) changed from negative to positive after treatment (P < 0.05), becoming similar to those of control subjects. Our findings suggest that orthognathic treatment in skeletal Class III patients improves the masticatory chewing pattern and muscle activity. However, the chewing pattern remains incomplete compared with controls.

摘要

骨性III类患者表现出以安氏III类错牙合和前牙反牙合为特征的错牙合畸形,其咬合表现为后牙全部或部分侧方反牙合。大多数患者的咬合力和肌肉活动低于未受影响的受试者。虽然正颌手术可能有助于改善这些患者的咀嚼功能,但其效果尚未完全阐明。本研究的目的是评估骨性III类患者正颌治疗前后的颌骨运动和咀嚼肌的肌电图(EMG)活动,并与咬合正常的对照受试者进行比较。记录了14例骨性III类错牙合畸形女性患者和15例咬合良好的女性对照者的颌骨运动变量和EMG数据。正颌治疗后观察到颌骨运动有显著变化,从切碎模式转变为研磨模式(闭口角度P<0.01;周期宽度P<0.01),使患者组的颌骨运动与对照组相似。然而,患者组的研磨模式不如对照组广泛。表示咬肌和颞肌相对贡献的活动指数(负值对应于相对更多的颞肌活动,反之亦然)在治疗后从负值变为正值(P<0.05),变得与对照受试者相似。我们的研究结果表明,骨性III类患者的正颌治疗改善了咀嚼模式和肌肉活动。然而,与对照组相比,咀嚼模式仍不完整。

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