磨牙症的中枢神经机制  

Central nervous mechanism of bruxism

作　　者：黄黄[1] 刘伟才[1] 

机构地区：[1]同济大学口腔医学院口腔生物医学及转化医学实验室,上海200072

出　　处：《国际口腔医学杂志》2014年第2期240-244,共5页International Journal of Stomatology

基　　金：国家自然科学基金(30700960);上海市青年科技启明星计划基金(10QA1407400)

摘　　要：磨牙症的病因分为外周神经因素和中枢神经因素,?因素在磨牙症中只起一小部分作用。磨牙症与睡眠觉醒有关并受多种中枢神经化学递质的影响。中枢神经化学递质可能打乱了基底神经节的直接和间接输出通道的平衡,从而打乱咀嚼肌协调运动,引发磨牙症。左旋多巴、溴隐亭和普萘洛尔可抑制磨牙活动,肉毒杆菌毒素可降低磨牙的频率和磨牙诱发的疼痛。可乐定可抑制磨牙症患者的快速动眼(REM)期,磨牙症患者尿儿茶酚胺水平较健康者高。有人认为磨牙症患者的睡眠效率低于健康人,有人认为磨牙症患者有正常的睡眠结构和质量;有人认为磨牙症常发生于睡眠的第2阶段和REM期,有人认为磨牙症均匀分布于REM期和非快速动眼(NREM)期;有人认为,磨牙症多数发生于NREM浅睡眠期,少数发生于REM期,有人认为磨牙症是继发于微觉醒的异常口腔活动。个性、焦虑等心理社会因素也是磨牙症重要的影响因素。磨牙症患者有较高的生活压力和焦虑,磨牙症程度重者,其工作和生活压力也重。本文就磨牙症的中枢神经病理生理因素和精神心理因素等研究进展作一综述。The causes ofbruxism are divided into peripheral factors and central factors, occlusal factors are known to only play a minor role. Bruxism is associated with sleep micro-arousal and appears to be modulated by various neurotransmitters in the central nervous system. These neurotransmitters may be disturbed the balance between the direct and indirect pathways of the basal ganglia which are involved in the coordination of movements of masticatory muscle in bruxers. L-dopa, bromocriptine and propranolol can inhibit bruxism activity, botulinum toxin injections can reduce the frequency of bruxism events and decrease bruxism-induced pain levels, clonidine can inhibits the rapid eye movement（REM） of bruxism patients and the levels of catecholamines are higher in bruxers. Some authors think that bruxism patients with lower sleep efficiency, but some think that bruxism patients have normal sleep structure and quality; some people think that bruxism occurred more frequently in stage 2 and REM, some think bruxism episodes are equally distributed between non-rapid eye movement（NREM） and REM sleep, but some also think bruxism are mainly occurred in light sleep and seldom occurred in REM, moreover some think that bruxism is a abnormal oral activities that secondary to sleep micro-arousal. Psychological factors like personality and anxiety are also frequently mentioned in relation to bruxism. Bruxism patients have higher life stress and anxiety, the person that severe bruxism, their work and life pressure is more heavier. In this paper, A central factors of brnxism is reviewed in detail concerning their pathophysiological and psyehosocial aspects.

关 键 词：磨牙症 病因 病理生理因素 精神心理因素 觉醒 

分 类 号：R78[医药卫生—口腔医学]