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咀嚼肌活动在咀嚼肌源性颞下颌关节紊乱病患者中的预测因素。

Predictors of the masticatory muscle activity during chewing in patients with myogenous temporomandibular disorder.

机构信息

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Karamanoğlu Mehmetbey University, Karaman, Turkey.

Kamil Özdağ Faculty of Science, Department of Mathematics, Karamanoğlu Mehmetbey University, Karaman, Turkey.

出版信息

Clin Oral Investig. 2023 Nov;27(11):6547-6558. doi: 10.1007/s00784-023-05260-3. Epub 2023 Sep 22.

Abstract

OBJECTIVES

The aim of the study was to identify predictors of the masticatory muscle activity during chewing (MMA) of the masseter and temporalis anterior (TA) muscles in patients with unilateral myogenous temporomandibular disorder (mTMD).

MATERIALS AND METHODS

This observational and cross-sectional study included 109 patients diagnosed with unilateral mTMD. Surface electromyography was used to separately evaluate the MMA of the masseter and TA on the affected and unaffected sides. Also, pain intensity (with a visual analog scale), pressure pain threshold (with an algometer), active pain-free maximum mouth opening and temporomandibular joint lateral movements (with a ruler), cervical range of motions (with a goniometer), and TMD severity (with a Fonseca Anamnestic Index) were assessed. Various statistical methods were used to predict the MMA of the masseter and TA, including standard, forward, and best subsets multiple regression models.

RESULTS

While there were significant correlations between the MMA of the masseter and TA and pain intensity, pressure pain threshold values, and TMD severity, they were not found with other variables. These parameters were also predictive factors for MMA of both muscles (p < 0.05).

CONCLUSIONS

According to the present study, pain intensity, muscle and joint tenderness, and the severity of the disorder are predictive factors for MMA of the masseter and TA muscles in patients with mTMD. It is recommended that these parameters be considered when establishing clinical evaluation and treatment programs focusing on MMA in patients with mTMD.

CLINICAL RELEVANCE

The pain intensity, masticatory muscles and TMJ tenderness, and disorder severity are predictors for MMA of the masseter and TA in patients with mTMD. Pain intensity has the most significant importance.

摘要

目的

本研究旨在确定单侧肌源性颞下颌关节紊乱病(mTMD)患者咀嚼时(MMA)咀嚼肌(包括咬肌和颞肌前束)活动的预测因子。

材料和方法

本观察性和横断面研究纳入了 109 例单侧 mTMD 患者。使用表面肌电图分别评估患侧和健侧的咬肌和颞肌前束的 MMA。同时,评估疼痛强度(采用视觉模拟评分法)、压痛阈值(采用压力计)、主动无痛最大张口度和颞下颌关节侧向运动(采用直尺)、颈椎活动度(采用量角器)以及 TMD 严重程度(采用 Fonseca 病史指数)。采用标准、正向和最佳子集多元回归模型等多种统计方法预测咬肌和颞肌前束的 MMA。

结果

尽管咬肌和颞肌前束的 MMA 与疼痛强度、压痛阈值值和 TMD 严重程度之间存在显著相关性,但与其他变量之间没有相关性。这些参数也是两块肌肉 MMA 的预测因素(p<0.05)。

结论

根据本研究,疼痛强度、肌肉和关节压痛以及疾病的严重程度是 mTMD 患者咬肌和颞肌前束 MMA 的预测因子。建议在为 mTMD 患者制定以 MMA 为重点的临床评估和治疗计划时考虑这些参数。

临床意义

疼痛强度、咀嚼肌和 TMJ 压痛以及疾病严重程度是 mTMD 患者咬肌和颞肌前束 MMA 的预测因子。疼痛强度具有最重要的意义。

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