Pihut Małgorzata E, Margielewicz Jerzy, Kijak Edward, Wiśniewska Grażyna
Department of Prosthodontics, Jagiellonian University Medical College, Kraków, Poland.
Department of Logistics and Mechanical Handling, Faculty of Transport, Silesian University of Technology, Katowice, Poland.
Adv Clin Exp Med. 2017 May-Jun;26(3):455-460. doi: 10.17219/acem/62216.
Temporomandibular joint dysfunction is often related to excessive load in the stomatognathic system.
The objective of the model tests, using numeric calculations, was to assess the articular disc loads in the temporomandibular joints after prosthetic and pharmacological treatment of functional disorders of the masticatory organ.
The study involved 10 patients, aged 21-48 years, of both sexes, randomly selected from a group of 120 patients treated with relaxation occlusal splints (60 patients, group I) and intramuscular injection of botulinum toxin type A (60 patients, group II), suffering from temporomandibular joint dysfunction with the dominant muscle component. In all subjects, a specialized functional examination was carried out. Treatment groups: occlusal splint therapy (group I) and intramuscular injection of botulinum toxin type A (group II). An assessment of the loads of 4 disc zones of the temporomandibular joints was carried out based on the results of clinical studies (phase I of the study), and numeric model tests (phase II). In the representatives of the study groups (5 patients in each group), measurements of occlusal forces and an evaluation of tension of the masseter and temporalis muscle were performed.
The results of the average load values for all evaluated zones of the right and left articular disc differ in a statistically significant way in favor of group II, with the exception of the external mid part of the discs. In the case of the anterior of the right disc, the load was lower in patients belonging to group I than in those obtained in group II.
Botulinum toxin type A significantly reduces the loads within the temporomandibular joints, generated by masseter muscle hypertonia.
颞下颌关节功能障碍通常与口颌系统负荷过重有关。
本模型试验采用数值计算方法，旨在评估咀嚼器官功能障碍经修复和药物治疗后颞下颌关节内关节盘的负荷情况。
本研究纳入了10例年龄在21至48岁之间的患者，男女不限，从120例患有以肌肉因素为主的颞下颌关节功能障碍患者中随机选取，这些患者接受了松弛咬合夹板治疗（60例，第一组）和A型肉毒杆菌毒素肌肉注射治疗（60例，第二组）。对所有受试者进行了专门的功能检查。治疗组：咬合夹板治疗（第一组）和A型肉毒杆菌毒素肌肉注射（第二组）。基于临床研究结果（研究的第一阶段）和数值模型试验（第二阶段），对颞下颌关节4个盘区的负荷进行了评估。在研究组的代表（每组5例患者）中，进行了咬合力测量和咬肌及颞肌张力评估。
除关节盘外侧中部外，左右关节盘所有评估区域的平均负荷值结果在统计学上有显著差异，有利于第二组。对于右侧关节盘前部，第一组患者的负荷低于第二组。
A型肉毒杆菌毒素可显著降低咬肌高张力引起的颞下颌关节内负荷。
