透明保持器对颞下颌关节髁突位置及相关肌肉肌电图的影响

【作者】 陈慧霞；

【导师】 陈文静；

【作者基本信息】 南京医科大学 ， 口腔临床医学， 2007， 硕士

【摘要】 第一部分透明保持器对颞肌、咬肌肌电的影响目的：观察透明保持器对颞肌、咬肌肌电电位的改变情况，从而探讨透明保持器对颞下颌关节(temporomandibular joint，TMJ)的影响。方法：根据筛选标准选择健康受试者，制作透明保持器。采用神经肌肉电生理仪(Keypoint 2000，VD公司，USA)对受试者进行检测，记录透明保持器戴入前后不同状态下颞肌(temporalis muscle，TM)、咬肌(masseter muscle，MM)的肌电电位值，并进行统计分析。结果：透明保持器戴入后下颌姿势位时颞肌、咬肌的肌电电位值均较未戴前明显增高(P＜0.05)。受试者发[s]、[z]音时肌电值也较未戴透明保持器前明显增高(P＜0.05)，发[a]音时无显著性差异(P＞0.05)。颞肌、咬肌均得到了相似的结果。结论：透明保持器的戴用将会对颞肌、咬肌肌电电位造成影响，但该影响是否会导致颞下颌关节疾病的发生，尚需要进一步的观察。第二部分透明保持器戴入前后髁突位置变化的初步研究目的：初步研究透明保持器戴入前后髁突位置的变化。方法：对15名健康受试者拍摄透明保持器戴入前后下颌姿势位(mandible posture position，MPP)时的颞下颌关节侧位体层片，并利用计算机技术对关节间隙进行面积测量及线性测量，并进行统计分析。结果：透明保持器戴入后髁突向前下方移位，对logE(P／A)值进行统计分析发现，二者存在显著差异(P＜0.01)。面积测量和线性测量得到了相似的结果。结论：透明保持器戴入前后，髁突位置发生了显著变化，髁突从基本中性位前移到前移位。但戴用不同时间后的改变情况有待进一步的研究。更多还原

【Abstract】 Part1The influence of clear thermoplastic retainer on the electromyography of temporalis muscle and masseter muscleObjective: To investigate the influence of clear thermoplastic retainer on the EMG of TM、MM and to explore the role of clear thermoplastic retainer in the etiology of temporomandibular diseases.Methods: Choose people according to the standards, fabricate an acceptable clear thermoplastic retainer for everyone. Then decide the situation by preliminary experiment. The EMG of TM、MM was studied before and after clear thermoplastic retainer was wore. Analysis of variance was used to evaluate the differences.Results: The EMG activity of TM、MM, viewed in mandible posture position(MPP), was higher after clear thermoplastic retainer was wore (P＜0.05). The EMG activity of the muscles increased when the patient said [S] and [Z] after the retainer was wore (P＜0.05). The EMG activity of the muscles didn’t change so much when the patient said [a] after the retainer was wore (P＞0.05).Conclusion: Clear thermoplastics retainer has effect on the EMG of TM、MM, but whether it plays a role in temporomandibular diseases need further observation. Part 2A primary study of condylar position change before and after clear thermoplastic retainer was woreObjective: The study primarily evaluates whether condylar position changed before and after clear thermoplastic retainer was wore.Method: The temporomandibular joints(TMJs) of 15 healthy people, without TMD, were viewed in MPP with TMJ lateral tomography before and after clear thermoplastic retainer was wore. Computer technique was used to evaluate tomograms: areal and linear changes of the anterior and posterior intra-articular joint spaces were measured. Analysis of variance was used to evaluate the differences.Results: After the clear thermoplastic retainer was wore, condyle moved forward. LogE (P/A) valuses were analyzed, the differences between them were found significant(p＜0.01). Two methods used to analyze the tomograms produced similar results.Conclusion: With the limitions of this study ,significant changes in the condylar position occurred after clear thermoplastic retainer was wore. Condyle moved from medial positions to anterior positions, but the changes after clear thermoplastic retainer was used for different times need further observation.更多还原