总义齿、覆盖义齿和种植覆盖义齿修复后咀嚼肌功能活动的比较研究  

A comparative study of masticatory muscle function in patients with CD, COD or IOD

作　　者：谢秋菲[1] 陈利[1] 杨朝晖[1] 冯海兰[1] 

机构地区：[1]北京大学口腔医学院修复科,100081

出　　处：《现代口腔医学杂志》2004年第4期320-323,共4页Journal of Modern Stomatology

基　　金：国家教委启动基金项目资助

摘　　要：目的　比较总义齿 (CD)、覆盖义齿 (COD)和种植覆盖义齿 (IOD)修复后患者嚼肌和颞肌前后束肌电活动 ;用咀嚼肌的收缩模式和协同方式分析肌电活动的差异。方法　分别选取CD、COD修复后的患者各 14例和IOD修复后的患者 12例 ,记录左右侧嚼肌、颞肌前束、颞肌后束在下颌休息位、大力咬合和咀嚼小枣和杏仁时的肌电图。测量肌电活动的幅值 (A值 )、电位方向转折次数 (T值 )、积分值 (Ar值 )。结果　COD组在咀嚼枣时颞肌前束的A值显著高于IOD组和CD组 ,Ar值显著高于CD组 (P <0 .0 5 ) ,颞肌后束的T值显著高于CD组和IOD组 (P <0 .0 5 )。三组患者在休息状态下和咀嚼运动的活动期 ,嚼肌与颞肌Ar值差值的均值均为负值 ;大力咬合时CD组为正值 ,IOD组和COD组均为负值。大力咬合和咀嚼周期活动期差值的绝对值为COD组显著高于IOD组和CD组 (P <0 .0 5 )。结论　CD修复后患者咀嚼肌在不同的咀嚼运动中多采用不固定用力方式 ,咀嚼肌的收缩模式有产生疲劳的趋势 ;IOD修复和COD修复后则具有相对高效的收缩模式。Objective To analyze electric activities of masticatory muscles in complete denture(CD), complete overdenture(COD), and implant-supported overdenture(IOD) wearers and to assess their patterns of maticatory muscle activity.Methods Fourteen patients with CD,14 with COD and 12 with IOD were randomly selected to participate in the study.The amplitude,turns,and integrated value of surface electromyogram of the masseter,anterior and posterior temporal muscles were recorded and measured with a MEB-5508K electromyograph at rest and clenching and chewing of almonds and jujubes.Results During jujube chewing, the amplitude of anterior temporal muscle of patients with COD was significantly greater than those of patients with IOD and CD (p<0.05),and so was the turns of posterior temporal muscle.The area of anterior temporal muscle of COD patients was significantly larger than that of patients with CD.At rest and habitual chewing,the difference in area between masseter and temporal muscles of three groups was negative,but when clenching,the difference was positive in the group CD and negative in group COD and IOD.The absolute difference of group COD was significantly greater than those of other two groups when chewing and clenching (P< 0.05 ). Conclusion The masticatory muscles of patients with CD are prone to fatigue in chewing,while the muscle activities of the CODs and IODs demonstrate a relatively effective contraction pattern.When clenching and habitual chewing,the most of patients with COD and IOD adopt a fixed muscle activity pattern,but the CDs using an unfixed muscle activity pattern.

关 键 词：颞肌 修复后 咀嚼肌 患者 IOD 肌电活动 种植覆盖义齿 r值 收缩 电位 

分 类 号：R783.6[医药卫生—口腔医学]