2种咬合板治疗颞下颌关节紊乱病的临床疗效分析  

Effect of two different kinds of occlusal splints on temporomandibular disorders

作　　者：陈婷[1] 廖天安[1] 詹若军[1] 吴丽娜[1] 

机构地区：[1]海南省人民医院口腔修复科,海南海口570102

出　　处：《上海口腔医学》2013年第5期547-550,共4页Shanghai Journal of Stomatology

基　　金：海南省自然科学基金(310126)~~

摘　　要：目的:研究松弛型咬合板和稳定型咬合板治疗颞下颌关节紊乱病(TMD)的疗效。方法:选择以口颌面部疼痛为主诉的TMD患者68例(急性30例,慢性38例),每组分别戴用松弛型咬合板和稳定型咬合板,比较分析治疗前、后颞肌前束(TA)、咬肌(MM)肌电值及关节疼痛强度的变化。采用SPSS 11.0软件包对数据进行方差分析和t检验。结果:①静息状态下,2种咬合板治疗后,患者双侧TA及MM肌电电位均较治疗前显著下降(P<0.05)。②紧咬状态下,松弛型咬合板治疗的急性组患者双侧TA及MM肌电电位均较治疗前显著上升,而慢性组患者仅双侧MM肌电电位较治疗前显著上升(P<0.05);稳定型咬合板治疗组患者双侧TA肌电电位治疗前后无显著差异,仅双侧MM肌电电位较治疗前显著上升。③2种咬合板治疗后,患者疼痛指数均较治疗前显著下降;但松弛型咬合板治疗后,在功能状态下,急性组患者疼痛缓解的程度更显著。结论:松弛型和稳定型咬合板均对咀嚼肌有松弛作用,能缓解TMD疼痛,但松弛型咬合板治疗急性TMD患者的疗效更加显著。PURPOSE： To investigate the effect of relaxed splint and stabilized splint on the treatment of temporomandibular disorders （TMD）. METHODS： A total of 68 TMD patients were divided into 2 groups （30 patients with acute pain and 38 patients with chronic pain） and treated with relaxed splint or stabilized splint. Visual analog scale （VAS） scores and eleetromyography （EMG） of bilateral anterior temporal muscle （TA） and masseter muscle （MM） were recorded before treatment and 1 month after treatment. The data was analyzed using variance analysis and student＇s t test with SPSS11.0 software package. RESULTS： At rest position, patients＇ EMG decreased remarkably （P〈0.05） after both kinds of splints treatment. During maximal voluntary clench, the EMG of masticatory muscle （TA, MM） of patients with acute pain and EMG of MM of patients with chronic pain increased significantly after relaxed splint treatment （P〈0.05）, but only EMG of MM increased significantly after stabilization splint treatment （P〈0.05）. Patients＇ VAS scores decreased remarkably after both kinds of splints treatment （P〈0.05）, but during function, patients＇ acute pain eased remarkably after relaxed splint treatment （P〈0.05）. CONCLUSIONS： The relaxed splint and stabilized splint can relax the masticatory muscles and ease TMD pain, but relaxed splint has significant effect on the treatment of acute TMD patients. Supported by Natural Science Foundation of Hainan Province （310126）.

关 键 词：颞下颌关节紊乱病 咬合板 肌电图 

分 类 号：R782.6[医药卫生—口腔医学]