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慢性颞下颌关节紊乱病患者的舌肌力量、咀嚼及吞咽功能障碍

Tongue strength, masticatory and swallowing dysfunction in patients with chronic temporomandibular disorder.

作者信息

Marim Geise Carolina, Machado Bárbara Cristina Zanandréa, Trawitzki Luciana Vitaliano Voi, de Felício Cláudia Maria

机构信息

Department of Otorhinolaryngology, Ophthalmology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Brazil.

Craniofacial Research Support Center, University of São Paulo, USP, Ribeirão Preto, SP, Brazil.

出版信息

Physiol Behav. 2019 Oct 15;210:112616. doi: 10.1016/j.physbeh.2019.112616. Epub 2019 Jul 11.

Abstract

BACKGROUND

The possible factors related to functional impairment and limitations in patients with temporomandibular disorders (TMDs) still need to be clarified because recovery of orofacial functions is a goal of their treatment.

OBJECTIVE

To investigate whether chronic TMD patients had any changes in tongue strength, besides the difficulty in chewing and orofacial functional impairment, compared to a control group. Moreover, to examine whether tongue strength, chewing difficulties, and orofacial functions were associated.

METHODS

Twenty-three patients with chronic TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and volunteers without TMD (control group) were compared. Strength measures were obtained using the Iowa Oral Performance Instrument (IOPI) during tongue protrusion (TPS) and swallowing of saliva (SS) tasks. A scale was used to investigate self-reported chewing difficulties, and the orofacial muscles and functions were evaluated using the orofacial myofunctional evaluation with scores protocol (OMES).

RESULTS

Compared to the control group, TMD patients showed reduced TPS and SS, higher difficulty in chewing and worse myofunctional orofacial conditions. Tongue strength was correlated with mastication and swallowing behaviors, as well as with general myofunctional status. Chewing difficulty increased with decreasing tongue strength and with worsening of orofacial muscles and functions.

CONCLUSION

Patients with chronic TMD showed reduced tongue strength and worse masticatory and swallowing functions, and these aspects were interrelated.

CLINICAL RELEVANCE

The present results contribute additional evidence regarding the impairment of orofacial muscles other than jaw elevator muscles in patients with chronic TMD.

摘要

背景

颞下颌关节紊乱病(TMD)患者功能障碍和受限的相关潜在因素仍有待阐明,因为恢复口面部功能是其治疗目标。

目的

与对照组相比,调查慢性TMD患者除咀嚼困难和口面部功能障碍外,舌肌力量是否有变化。此外,检查舌肌力量、咀嚼困难和口面部功能之间是否存在关联。

方法

比较23例根据颞下颌关节紊乱病研究诊断标准(RDC/TMD)诊断的慢性TMD患者和无TMD的志愿者(对照组)。在伸舌(TPS)和吞咽唾液(SS)任务期间,使用爱荷华口腔功能仪(IOPI)获取力量测量值。使用一个量表调查自我报告的咀嚼困难情况,并使用口面部肌功能评估评分方案(OMES)评估口面部肌肉和功能。

结果

与对照组相比,TMD患者的TPS和SS降低,咀嚼困难更大,口面部肌功能状况更差。舌肌力量与咀嚼和吞咽行为以及总体口面部肌功能状态相关。咀嚼困难随着舌肌力量的降低以及口面部肌肉和功能的恶化而增加。

结论

慢性TMD患者舌肌力量降低,咀嚼和吞咽功能更差,且这些方面相互关联。

临床意义

本研究结果为慢性TMD患者除升颌肌外口面部肌肉受损提供了更多证据。

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