Kumar Abhishek, Castrillon Eduardo, Trulsson Mats, Svensson Krister G, Svensson Peter
Section of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allé 8, Box 4064, 141 04, Huddinge, Sweden.
SCON | Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden.
Clin Oral Investig. 2017 Mar;21(2):613-626. doi: 10.1007/s00784-016-1939-4. Epub 2016 Aug 27.
The study was designed to investigate if alteration of different orofacial afferent inputs would have different effects on oral fine motor control and to test the hypothesis that reduced afferent inputs will increase the variability of bite force values and jaw muscle activity, and repeated training with splitting of food morsel in conditions with reduced afferent inputs would decrease the variability and lead to optimization of bite force values and jaw muscle activity.
Forty-five healthy volunteers participated in a single experimental session and were equally divided into incisal, mucosal, and block anesthesia groups. The participants performed six series (with ten trials) of a standardized hold and split task after the intervention with local anesthesia was made in the respective groups. The hold and split forces along with the corresponding jaw muscle activity were recorded and compared to a reference group.
The hold force and the electromyographic (EMG) activity of the masseter muscles during the hold phase were significantly higher in the incisal and block anesthesia group, as compared to the reference group (P < 0.001). However, there was no significant effect of groups on the split force (P = 0.975) but a significant decrease in the EMG activity of right masseter in mucosal anesthesia group as compared to the reference group (P = 0.006). The results also revealed that there was no significant effect of local anesthesia on the variability of the hold and split force (P < 0.677). However, there was a significant decrease in the variability of EMG activity of the jaw closing muscles in the block anesthesia group as compared to the reference group (P < 0.041), during the hold phase and a significant increase in the variability of EMG activity of right masseter in the mucosal anesthesia group (P = 0.021) along with a significant increase in the EMG activity of anterior temporalis muscle in the incisal anesthesia group, compared to the reference group (P = 0.018), during the split phase.
The results of the present study indicated that altering different orofacial afferent inputs may have different effects on some aspects of oral fine motor control. Further, inhibition of afferent inputs from the orofacial or periodontal mechanoreceptors did not increase the variability of bite force values and jaw muscle activity; indicating that the relative precision of the oral fine motor task was not compromised inspite of the anesthesia. The results also suggest the propensity of optimization of bite force values and jaw muscle activity due to repeated splitting of the food morsels, inspite of alteration of sensory inputs.
Skill acquisition following a change in oral sensory environment is crucial for understanding how humans learn and re-learn oral motor behaviors and the kind of adaptation that takes place after successful oral rehabilitation procedures.
本研究旨在调查不同口腔面部传入输入的改变是否会对口腔精细运动控制产生不同影响,并检验以下假设:传入输入减少会增加咬力值和颌肌活动的变异性,并且在传入输入减少的情况下对食物小块进行分割的重复训练会降低变异性并导致咬力值和颌肌活动的优化。
45名健康志愿者参加了单次实验,并被平均分为切牙麻醉组、黏膜麻醉组和阻滞麻醉组。在各小组进行局部麻醉干预后,参与者进行了六组(每组十次试验)标准化的握持和分割任务。记录握持力和分割力以及相应的颌肌活动,并与参照组进行比较。
与参照组相比,切牙麻醉组和阻滞麻醉组在握持阶段的握持力和咬肌肌电图(EMG)活动显著更高(P < 0.001)。然而,各小组对分割力没有显著影响(P = 0.975),但与参照组相比,黏膜麻醉组右侧咬肌的EMG活动显著降低(P = 0.006)。结果还显示,局部麻醉对握持力和分割力的变异性没有显著影响(P < 0.677)。然而,与参照组相比,阻滞麻醉组在握持阶段颌骨闭合肌的EMG活动变异性显著降低(P < 0.041),在分割阶段,黏膜麻醉组右侧咬肌的EMG活动变异性显著增加(P = 0.021),与参照组相比,切牙麻醉组颞肌前束的EMG活动显著增加(P = 0.018)。
本研究结果表明,改变不同的口腔面部传入输入可能会对口腔精细运动控制的某些方面产生不同影响。此外,抑制来自口腔面部或牙周机械感受器的传入输入并不会增加咬力值和颌肌活动的变异性;这表明尽管进行了麻醉,口腔精细运动任务的相对精度并未受到影响。结果还表明,尽管感觉输入发生了改变,但由于对食物小块进行重复分割,咬力值和颌肌活动仍有优化的倾向。
口腔感觉环境改变后的技能习得对于理解人类如何学习和重新学习口腔运动行为以及成功的口腔康复程序后发生的适应类型至关重要。