骨性III类错牙合畸形患者正颌手术前后咀嚼肌功能变化的初步研究  

A primary study of masticatory muscle function on skeletal Class III malocclusal patients before and after orthognathic surgery

作　　者：蔡鸣[1] 沈国芳[1] 郁春华[2] 陈玉琴[2] 

机构地区：[1]上海第二医科大学附属第九人民医院口腔医学院口腔颌面外科,上海200011 [2]上海第二医科大学附属第九人民医院口腔医学院口腔修复科,上海200011

出　　处：《中国口腔颌面外科杂志》2005年第1期10-14,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:应用肌电图仪评价骨性III类错牙合畸形患者正颌手术前后咀嚼肌功能的变化。方法:收集16例骨性III类错牙合畸形需正颌手术病例和20例正常牙合对照组,应用MedelecSynergy肌电图仪分别在静息放松、正中紧咬、前伸、开口、侧方和咀嚼运动时,测定双侧颞肌前束、咬肌和二腹肌前腹的表面募集电位,并计算其肌不对称指数运动。病例组在术后3个月和6个月时重复测定,采用t检验进行统计学分析,并与对照组进行比较。结果:手术前病例组咀嚼肌电位小于对照组,尤以紧咬和咀嚼时差异显著(P<0.05),肌不对称指数与对照组无差异。术后3个月时,部分肌功能恢复,但紧咬和咀嚼时募集电位下降显著(P<0.001),肌不对称指数也增大,提示此时肌功能尚未完全恢复。术后6个月各种功能运动时的募集电位均大于术前水平,肌不对称指数则基本小于术前水平,说明肌功能有所改善。结论:骨性III类错牙合畸形患者手术前咀嚼肌功能弱于对照组,正颌手术矫正了颌骨位置和咬合关系,改善了患者的咀嚼肌功能。PURPOSE: To evaluate the functional change of masticatory muscles on skeletal Class III malocclusal patients after orthognathic surgery by electromyogram. METHODS: 16 skeletal Class III malocclusal patients and 20 healthy students with normal occlusion were included in this study. EMG measurements were performed on bilateral temporalis anterior muscle, masseter muscle and digastric anterior muscle by Medelec Synergy Electromyogram. The EMG data were examined during rest position, centric clenching,mouth opening,protrusive movement,laterotrusive movement and chewing. Amplitude of recruitment, lasting time of recruitment when chewing and the asymmetric index of masticatory muscle were used to analyze the patients EMG results. The same measurements were repeated on patients group 3 months and 6 months postoperatively. Student's t test was used for statistical analysis. RESULTS: The results showed that there were some differences of amplitude of recruitment between patient group and control group, significant differences were observed in clenching and chewing movement(P<0.05).Amplitude of recruitment in mouth opening, protrusive movement and laterotrusive movement increased by 3 months postoperatively, however the EMG results were decreased and statistical differences were found between preoperative level in clenching and chewing movement(P<0.001). Statistical differences were not found in asymmetric index of all three muscles. By 6 months postoperatively, amplitude of recruitment were increased and asymmetric index were decreased which indicated the functional improvement of the muscles we measured after surgery. CONCLUSION: It is concluded that there were some functional differences of masticatory muscle between skeletal Class III malocclusal patients and normal occlusal people. Orthognathic surgery and rigid internal fixation method bring the patients a healthy occlusal relation which benefit the masticatory muscle function. [

关 键 词：骨性Ⅲ类错He畸形 肌电图 正颌外科 咀嚼功能 

分 类 号：R782.2.3[医药卫生—口腔医学]