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颞下颌关节紊乱病患者在咀嚼和磨牙过程中自然正中侧方咬合接触时的肌电活动评估。

Assessment of electromyographic activity in patients with temporomandibular disorders and natural mediotrusive occlusal contact during chewing and tooth grinding.

作者信息

Fuentes Aler D, Sforza Chiarella, Miralles Rodolfo, Ferreira Cláudia L, Mapelli Andrea, Lodetti Gianluigi, Martin Conchita

机构信息

a Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile.

b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.

出版信息

Cranio. 2017 May;35(3):152-161. doi: 10.1080/08869634.2016.1173312. Epub 2016 Apr 22.

Abstract

OBJECTIVES

The aim of this study was to investigate whether the presence of a natural mediotrusive contact influences electromyographic (EMG) pattern activity in patients with temporomandibular disorders (TMDs).

METHOD

Bilateral surface EMG activity of the anterior temporalis (AT), masseter (MM), and sternocleidomastoid (SCM) muscles was recorded in 43 subjects during unilateral chewing and tooth grinding. Thirteen patients had TMD and a natural mediotrusive contact (Group 1), 15 had TMD without a natural mediotrusive contact (Group 2), and 15 were healthy subjects without mediotrusive contacts (Group 3). All subjects were examined according to the Research Diagnostic Criteria for TMD (RDC/TMD). All EMG values were standardized as the percentage of EMG activity recorded during maximum isometric contraction on cotton rolls.

RESULTS

EMG activity from all muscles measured showed no significant differences between groups during chewing and grinding. Overall, in all groups, the EMG activity during chewing was higher in the working side than the non-working side in AT and MM muscles. During grinding, these differences were only found in masseter muscles (mainly in eccentric grinding). SCM EMG activity did not show significant differences during chewing and grinding tasks. Symmetry, muscular balance, and absence of lateral jaw displacement were common findings in all groups.

DISCUSSION

EMG results suggest that the contribution of a natural mediotrusive occlusal contact to EMG patterns in TMD patients is minor. Therefore, the elimination of this occlusal feature for therapeutic purposes could be not indicated.

摘要

目的

本研究旨在调查自然正中侧方接触的存在是否会影响颞下颌关节紊乱病(TMD)患者的肌电图(EMG)模式活动。

方法

在43名受试者单侧咀嚼和磨牙过程中,记录颞肌前束(AT)、咬肌(MM)和胸锁乳突肌(SCM)的双侧表面肌电活动。13例TMD患者存在自然正中侧方接触(第1组),15例TMD患者无自然正中侧方接触(第2组),15名健康受试者无正中侧方接触(第3组)。所有受试者均根据颞下颌关节紊乱病研究诊断标准(RDC/TMD)进行检查。所有肌电值均标准化为棉卷最大等长收缩时记录的肌电活动百分比。

结果

在咀嚼和磨牙过程中,所有测量肌肉的肌电活动在各组之间均无显著差异。总体而言,在所有组中,AT和MM肌肉在咀嚼时工作侧的肌电活动高于非工作侧。在磨牙过程中,这些差异仅在咬肌中发现(主要在离心磨牙时)。在咀嚼和磨牙任务中,SCM的肌电活动没有显著差异。所有组中常见的表现为对称性、肌肉平衡和无侧方颌位移。

讨论

肌电图结果表明,自然正中侧方咬合接触对TMD患者肌电图模式的影响较小。因此,出于治疗目的而消除这种咬合特征可能并无必要。

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