Kawai Nobuhiko, Shibata Manami, Watanabe Masahiko, Horiuchi Shinya, Fushima Kenji, Tanaka Eiji
Division of Orthodontics, Department of Highly Advanced Stomatology, Graduate School of Dentistry, Kanagawa Dental University, Kanagawa, Japan.
Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
J Dent Sci. 2020 Dec;15(4):419-425. doi: 10.1016/j.jds.2020.01.006. Epub 2020 Apr 7.
BACKGROUND/PURPOSE: Even after surgical orthodontic treatment, the level of masticatory function in patients with jaw deformities is still lower than that of healthy subjects. The purpose of this study was to evaluate the effects of functional training program using gum chewing exercise after orthognathic surgery on masticatory function in patients with mandibular prognathism.
The study subjects were 16 patients with mandibular prognathism who underwent orthognathic surgery and 8 individuals with normal occlusion. Patients were divided into two groups (training group and non-training group; n = 8 per group). Functional training included gum chewing exercise and patient-education about masticatory function. The training; gum chewing exercise of 5 min twice a day for 90 days, started at 3 months after surgery. For each subject, electromyographic activities of masseter and temporalis muscles during maximum voluntary clenching (MVC) and jaw movement during gum chewing were recorded before and after surgical orthodontic treatment. Two parameters; activity index (AI: ratio of activity of masseter and temporalis muscles) and error index (EI: ratio of the number of abnormal chewing patterns), were used.
In the training group, the AI value during MVC increased significantly and the EI value during gam chewing decreased significantly after surgical orthodontic treatment (AI: p < 0.01; EI: p < 0.01), indicating the improvement of activity balance of masseter and temporalis muscles and conversion of the jaw movement from abnormal to normal pattern (p < 0.01).
Our findings suggested that functional training using the gum chewing and patient-education exercise improved masticatory function in patients with mandibular prognathism.
背景/目的:即使经过外科正畸治疗,颌骨畸形患者的咀嚼功能水平仍低于健康受试者。本研究的目的是评估正颌外科手术后使用口香糖咀嚼运动的功能训练计划对下颌前突患者咀嚼功能的影响。
研究对象为16例接受正颌外科手术的下颌前突患者和8例咬合正常的个体。患者分为两组(训练组和非训练组;每组n = 8)。功能训练包括口香糖咀嚼运动和关于咀嚼功能的患者教育。训练从术后3个月开始,每天两次,每次5分钟,持续90天。对于每个受试者,在外科正畸治疗前后记录最大自主紧咬(MVC)时咬肌和颞肌的肌电活动以及咀嚼口香糖时的下颌运动。使用两个参数:活动指数(AI:咬肌和颞肌活动的比率)和误差指数(EI:异常咀嚼模式数量的比率)。
在训练组中,外科正畸治疗后MVC期间的AI值显著增加,咀嚼口香糖期间的EI值显著降低(AI:p < 0.01;EI:p < 0.01),表明咬肌和颞肌的活动平衡得到改善,下颌运动从异常模式转变为正常模式(p < 0.01)。
我们的研究结果表明,使用口香糖咀嚼和患者教育运动的功能训练改善了下颌前突患者的咀嚼功能。