Department of Dentistry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
Spec Care Dentist. 2021 Sep;41(5):572-578. doi: 10.1111/scd.12594. Epub 2021 Apr 7.
To present an occlusal splint effective for alleviating masticatory disturbance in Duchenne muscular dystrophy (DMD).
A 13-year-old male DMD patient with masticatory disturbance presented with an open bite, with occlusal contact only between the first and second molars bilaterally and reduced masticatory performance. We applied an occlusal splint that achieved occlusal contact for all teeth and monitored its effects on masticatory function over 6 years. The occlusal splint increased occlusal contact points from 11 to 60. Although occlusal force remained at 13.9-16 kg, masticatory performance increased, and the number of mastication strokes increased from 124 to 169. Masseter muscle activity decreased from 76.8% to 33.4% maximum voluntary contraction (MVC) and digastric muscle activity increased from 8.7% to 18.0% MVC. Time from start of peanut mastication to swallowing decreased, and the vertical mastication cycle diameter and its width on the habitual side increased.
Masticatory disturbance in a DMD patient was alleviated using an occlusal splint. The number of mastication strokes and the digastric to masseter muscle activity ratio were increased. Furthermore, the mastication cycle was enlarged, which increased masticatory movement. As masseter muscle activity during mastication decreased, the occlusal splint likely reduced muscle fatigue during masticatory movement.
介绍一种用于缓解杜氏肌营养不良症(DMD)咀嚼障碍的咬合夹板。
一名 13 岁男性 DMD 患者出现咀嚼障碍,表现为开合,双侧仅第一和第二磨牙有咬合接触,咀嚼功能下降。我们应用了一个咬合夹板,实现了所有牙齿的咬合接触,并在 6 年内监测其对咀嚼功能的影响。咬合夹板将咬合接触点从 11 个增加到 60 个。尽管咬合力仍保持在 13.9-16 公斤,但咀嚼性能提高,咀嚼次数从 124 次增加到 169 次。咀嚼肌活动从最大自主收缩(MVC)的 76.8%降至 33.4%,二腹肌活动从 MVC 的 8.7%增加到 18.0%。从开始咀嚼花生到吞咽的时间缩短,习惯性侧的垂直咀嚼周期直径及其宽度增加。
使用咬合夹板缓解了 DMD 患者的咀嚼障碍。咀嚼次数和二腹肌与咀嚼肌活动的比值增加。此外,咀嚼周期扩大,增加了咀嚼运动。由于咀嚼运动期间咀嚼肌活动减少,咬合夹板可能减少了咀嚼运动时的肌肉疲劳。