Muftuoglu Ozge, Akturk Ezgi Sunal, Eren Hakan, Gorurgoz Cansu, Karasu Hakan Alpay, Orhan Kaan, Akat Bora, Memikoglu Tulin Ufuk Toygar
Department of Orthodontics, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey.
Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, İstanbul, Turkey.
Clin Oral Investig. 2023 Jul;27(7):3855-3861. doi: 10.1007/s00784-023-05004-3. Epub 2023 Apr 6.
To evaluate changes in the masseter muscle after orthognathic surgery using electromyography (EMG), ultrasonography (US), and ultrasound elastography (USE) in individuals with skeletal class III anomaly over long-term follow-up and compare with a control group.
The study group included 29 patients with class III dentofacial deformities scheduled to undergo orthodontic treatment and orthognathic surgery. The control group included 20 individuals with dental class I occlusion. Assessment of the masseter muscles using EMG, US, and USE was performed before orthognathic surgery (T1) and at postoperative 3 months (T2) and 1 year (T3) in the study group, and at a single time point in the control group. All assessments were performed at rest and during maximum clenching. Masseter muscle activity, dimension, and hardness were analyzed.
Electromyographic activity of the masseter muscle during maximum clenching was increased at postoperative 1 year but did not reach control group values. On ultrasonography, the masseter muscle showed minimal changes in dimension at postoperative 1 year compared to preoperative values and remained below control group values. The postoperative increase in masseter muscle hardness at rest and during maximum clenching persisted at postoperative 1 year.
The results of this study suggest that after orthognathic surgery, additional interventions and much longer follow-up are needed to ensure better muscle adaptation to the new occlusion and skeletal morphology.
All assessment methods are useful for comprehensively evaluating changes in the masticatory muscles after orthognathic surgery.
通过肌电图(EMG)、超声(US)和超声弹性成像(USE)技术,对长期随访的骨骼Ⅲ类错畸形患者正颌手术后咬肌的变化进行评估,并与对照组进行比较。
研究组包括29例计划接受正畸治疗和正颌手术的Ⅲ类牙颌面畸形患者。对照组包括20例Ⅰ类牙合患者。研究组在正颌手术前(T1)、术后3个月(T2)和1年(T3),以及对照组在单一时间点,采用EMG、US和USE对咬肌进行评估。所有评估均在静息状态和最大紧咬时进行。分析咬肌的活动、尺寸和硬度。
术后1年最大紧咬时咬肌的肌电活动增加,但未达到对照组水平。超声检查显示,术后1年咬肌尺寸与术前相比变化最小,且仍低于对照组。术后静息状态和最大紧咬时咬肌硬度的增加在术后1年持续存在。
本研究结果表明,正颌手术后,需要额外的干预措施和更长时间的随访,以确保肌肉更好地适应新的咬合和骨骼形态。
所有评估方法对于全面评估正颌手术后咀嚼肌的变化均有用。