Tripodakis A P, Smulow J B, Mehta N R, Clark R E
Tufts University, School of Dental Medicine, Boston, Mass, USA.
J Prosthet Dent. 1995 Feb;73(2):190-8. doi: 10.1016/s0022-3913(05)80161-1.
Clinical studies have confirmed the adequate reproducibility of both centric occlusion and centric relation when used as reference positions during treatment; however, the reproducibility of the neuromuscular position has been found inadequate. This study evaluated the location and reproducibility of these three mandibular positions in relation to body posture, sitting and supine, and bilateral muscle activity before and after the insertion of a flat mandibular positioning device equilibrated to balance the muscle functions, as shown by two electromyography biofeedback instruments. Intraoral recordings were made in 11 young subjects with complete natural dentition. Acrylic resin clutches that supported a screw point in the maxillary arch and painted glass in the mandibular arch were used and positioned not to interfere with the occlusion. The distances of the screw scratch from two of the edges of the painted glass were used to measure the anteroposterior and mediolateral locations with a micrometer. The reproducibility was evaluated by measuring the scratch surface by measuring the weight of the print cutouts made from photographs of the scratches taken with a stereoscope. The location and reproducibility of centric occlusion and centric relation were not affected by body posture. A more precise posterior neuromuscular position was obtained in the supine position. The insertion of a mandibular positioning device did not affect centric occlusion but gave a more precise centric relation. Neuromuscular position became as precise as centric occlusion and was located anteroposteriorly between centric occlusion and centric relation.
临床研究已证实,在治疗过程中,当正中咬合和正中关系用作参考位置时,具有足够的可重复性;然而,已发现神经肌肉位置的可重复性不足。本研究评估了这三种下颌位置相对于身体姿势(坐姿和仰卧位)的位置及可重复性,以及在插入一个经平衡以平衡肌肉功能的扁平下颌定位装置前后的双侧肌肉活动,这由两台肌电图生物反馈仪器显示。对11名天然牙列完整的年轻受试者进行口内记录。使用了在上颌弓中支撑一个螺丝点且在下颌弓中有涂漆玻璃的丙烯酸树脂夹,并将其放置在不干扰咬合的位置。用千分尺测量螺丝划痕到涂漆玻璃两条边缘的距离,以测量前后和内外侧位置。通过用立体显微镜拍摄划痕照片制作的印模切口重量来测量划痕表面,从而评估可重复性。正中咬合和正中关系的位置及可重复性不受身体姿势影响。在仰卧位可获得更精确的后部神经肌肉位置。下颌定位装置的插入不影响正中咬合,但能给出更精确的正中关系。神经肌肉位置变得与正中咬合一样精确,且位于正中咬合和正中关系之间的前后位置。