咬合重建对牙齿重度磨耗患者咀嚼运动模式的影响  

Effects of Occlusal Rehabilitation on Chewing Patterns of Patients with Severe Tooth Wear

作　　者：周崇阳[1] 杨朝晖[1] 冯海兰[2] 

机构地区：[1]北京大学口腔医院特诊科,北京100081 [2]北京大学口腔医院修复科,北京100081

出　　处：《华西口腔医学杂志》2007年第3期242-245,共4页West China Journal of Stomatology

基　　金：卫生部临床学科重点资助项目(97020217)

摘　　要：目的探讨咬合重建修复对不同类型的牙齿重度磨耗患者咀嚼运动模式的影响。方法选择29例牙齿重度磨耗进行咬合重建修复的患者,根据后牙咬合支持状态分成后牙支持完全组(试验Ⅰ组,15例)和后牙支持不全组(试验Ⅱ组,14例),分别测量修复前、过渡修复1个月及永久修复1个月后咀嚼运动时嚼肌、颞肌前束和颞肌后束的表面肌电图,并选择15例正常人作为对照组,分析咀嚼周期、咀嚼运动活动期与间歇期比值及肌电积分值的变化。结果修复前,试验Ⅰ组和Ⅱ组患者的咀嚼周期与对照组之间无统计学差异(P>0.05);试验Ⅱ组活动期与间歇期比值明显高于对照组,而颞肌前束的肌电积分值低于对照组(P<0.05)。过渡修复及永久修复后,试验Ⅰ组和Ⅱ组的咀嚼周期有逐步缩短的趋势。过渡修复时,Ⅰ组患者活动期与间歇期比值和肌电积分值较修复前均有下降(P<0.05);Ⅱ组患者活动期与间歇期比值较修复前下降(P<0.05),肌电积分值的变化则不明显(P>0.05)。永久修复后,Ⅰ组患者活动期与间歇期比值和肌电积分值较过渡修复时的变化均无统计学意义(P>0.05);Ⅱ组患者活动期与间歇期比值较过渡修复时进一步下降,肌电积分值则明显提高(P<0.01)。结论咬合重建修复能明显改善重度磨耗患者咀嚼运动循环模式,提高咀嚼肌活动强度。Objective To investigate the effects of occlusal rehabilitation on chewing patterns of patients with extensive tooth wear. Methods 29 patients with severe tooth wear were selected and divided into two groups： Group I with complete posterior tooth support（15 cases） and group Ⅱ with one-side or both side posterior support lost（14 cases）. 15 normal old persons were also selected as control group. The surface electromyography（EMG） of masseter（MM）, anterior temporalis（TA） and posterior temporalis（TP） during chewing movement were recorded in the stage of pre-treatment, 1 month after temporary restoration and 1 month after permanent restoration. The EMG activity, total cycle duration （TCD） and ratio of activation period to relaxation period CAP/RP） of chewing cycles were measured and compared. Results 1）Before treatment, the TCD of these two groups were longer than normal group, but the differences were not significant（P〉0.05）. All of the AP/RPs of MM, TA and TP in group Ⅱ were significantly higher than that of normal group（P〈0.01）, and EMG activity of TA of group Ⅱ was significantly lower than normal（P〈0.05）. 2）After temporary restoration, the TCD of both groups were slightly shortened, while the AP/RP of these two groups were significantly decreased. EMG activities of MM and TP in group Ⅰ were both significantly lower than that in pre-treatment stage. 3）After permanent restoration, the TCD of group Ⅰ were significantly lower than that in temporary restoration stage （P〈0.01）. In group Ⅱ, the TCD was continuously slightly shortened, while the AP/R_P were significantly lower （P〈0.01） and EMG activities were significantly higher（P〈0.01） than that in the temporary restoration stage. Conclusion Occlusal rehabilitation could obviously change the chewing patterns and the EMG activities of patients with severe tooth wear.

关 键 词：重度磨耗 咀嚼运动 肌电图 咬合重建 

分 类 号：R782.2[医药卫生—口腔医学]