Kerstein Robert B, Radke John
a Former faculty, Tufts University School of Dental Medicine , Department of Restorative Dentistry , Boston , MA , USA.
b BioResearch Associates Inc. , Milwaukee , WI , USA.
Cranio. 2017 May;35(3):135-151. doi: 10.1080/08869634.2016.1190526. Epub 2016 Jun 22.
Studies involving electrognathographic (EGN) recordings of chewing improvements obtained following occlusal adjustment therapy are rare, as most studies lack 'chewing' within the research. The objectives of this study were to determine if reducing long Disclusion Time to short Disclusion Time with the immediate complete anterior guidance development (ICAGD) coronoplasty in symptomatic subjects altered their average chewing pattern (ACP) and their muscle function.
Twenty-nine muscularly symptomatic subjects underwent simultaneous EMG and EGN recordings of right and left gum chewing, before and after the ICAGD coronoplasty. Statistical differences in the mean Disclusion Time, the mean muscle contraction cycle, and the mean ACP resultant from ICAGD underwent the Student's paired t-test (α = 0.05).
Disclusion Time reductions from ICAGD were significant (2.11-0.45 s. p = 0.0000). Post-ICAGD muscle changes were significant in the mean area (p = 0.000001), the peak amplitude (p = 0.00005), the time to peak contraction (p < 0.000004), the time to 50% peak contraction (p < 0.00001), and in the decreased number of silent periods per side (right p < 0.0000002; left p < 0.0000006). Post-ICAGD ACP changes were also significant; the terminal chewing position became closer to centric occlusion (p < 0.002), the maximum and average chewing velocities increased (p < 0.002; p < 0.00005), the opening and closing times, the cycle time, and the occlusal contact time all decreased (p < 0.004-0.0001).
The average chewing pattern (ACP) shape, speed, consistency, muscular coordination, and vertical opening improvements can be significantly improved in muscularly dysfunctional TMD patients within one week's time of undergoing the ICAGD enameloplasty. Computer-measured and guided occlusal adjustments quickly and physiologically improved chewing, without requiring the patients to wear pre- or post-treatment appliances.
涉及咬合调整治疗后咀嚼改善的肌电图(EGN)记录的研究很少,因为大多数研究在研究中缺乏“咀嚼”相关内容。本研究的目的是确定在有症状的受试者中,通过即刻完全前导发育(ICAGD)牙冠成形术将长的非咬合时间缩短为短的非咬合时间是否会改变他们的平均咀嚼模式(ACP)和肌肉功能。
29名有肌肉症状的受试者在ICAGD牙冠成形术前后同时进行了左右牙龈咀嚼的肌电图(EMG)和肌电图(EGN)记录。对ICAGD导致的平均非咬合时间、平均肌肉收缩周期和平均ACP的统计差异进行了学生配对t检验(α = 0.05)。
ICAGD导致的非咬合时间缩短显著(2.11 - 0.45秒,p = 0.0000)。ICAGD后肌肉变化在平均面积(p = 0.000001)、峰值幅度(p = 0.00005)、达到峰值收缩的时间(p < 0.000004)、达到50%峰值收缩的时间(p < 0.00001)以及每侧静息期数量减少方面均有显著意义(右侧p < 0.0000002;左侧p < 0.0000006)。ICAGD后ACP变化也很显著;终末咀嚼位置更接近正中咬合(p < 0.002),最大和平均咀嚼速度增加(p < 0.002;p < 0.00005),开合时间、周期时间和咬合接触时间均减少(p < 0.004 - 0.0001)。
在有肌肉功能障碍的颞下颌关节紊乱病(TMD)患者接受ICAGD牙釉质成形术一周内,平均咀嚼模式(ACP)的形状、速度、一致性、肌肉协调性和垂直开口改善可得到显著改善。计算机测量和引导的咬合调整能快速且生理性地改善咀嚼,无需患者佩戴治疗前或治疗后的矫治器。