牙周非手术治疗对广泛型侵袭性牙周炎患者咀嚼肌功能影响研究

Study of the influence of periodontal nonoperative therapy on function of masticatory muscles in advanced aggressive periodontitis

目的分析牙周非手术治疗对广泛型侵袭性牙周炎(generalized aggressive periodontitis,GAgP)患者咀嚼肌功能的影响。方法选择2013年6月至2014年12月在中国医科大学口腔医学院·附属口腔医院牙周科门诊经锥形束CT(CBCT)扫描并诊断为GAgP患者30例。根据牙槽骨高度(AB)与牙齿高度(AC)的比值(AB/AC),将患者分为A组(15例,AB/AC≥50%)和B组(15例,AB/AC<50%)。检测患者牙周探诊深度(probing depth,PD)和临床附着丧失(clinical attachment loss,CAL)。采用Bio EMGⅡ表面肌电仪对牙周非手术治疗前和治疗后GAgP患者咀嚼肌肌电值进行测量,对患者牙周炎症程度与咬肌束在下颌牙尖交错(intercuspal position,ICP)最大紧咬位时肌电值进行相关性分析,并比较牙周非手术治疗前后颞肌前束和咬肌肌电值变化。结果在ICP最大紧咬位时,A组患者的咬肌肌电值[(69.22±22.33)μV]大于B组患者的咬肌肌电值[(35.31±13.15)μV],两组差异有统计学意义(P<0.05)。GAgP患者的咬肌肌电值与后牙区牙齿AB/AC的值呈正相关(r=0.731,P=0.002)。GAgP患者经牙周非手术治疗后,ICP最大紧咬位时咬肌和颞肌前束的肌电值均发生显著变化,与治疗前比较差异均有统计学意义(均P<0.05)。结论 GAgP患者牙槽骨丧失越多,其咀嚼肌功能越差;牙周非手术治疗可有效提高GAgP患者咀嚼肌功能。

Objective To analyze the influence of periodontal nonoperative therapy on function of masticatory muscles in generalized advanced aggressive periodontitis（GAgP）.Methods Randomly select 30 subjects who have been diagnosed with GAgP in Department of Periodontics,Stomatological Hospital of China Medical University by cone-beam computed tomography（CBCT）from June 2013 to December 2014. According to the ratio of AB/AC[the height of alveolar bone（AB）and teeth heigh（tAC）],the patients were divided into group A（15 cases,AB/AC value ≥ 50%）and group B（15 cases,AB/AC value 50%）. The probing depth（PD）and the clinical attachment leve（lCAL）of subjects were recorded. Measure the changes of electromyographic value of temporal muscle and masseter muscle of GAgP patients before and after periodontal nonoperative therapy using surface electromyography（Bio EMG Ⅱ）. Analyze the correlation of degree of inflammatory reaction with EMG value of masseter muscle in the intercuspal position（ICP）. Compare the electricity value change of temporalis muscle and masseter muscle before and after periodontal nonoperative therapy.Results In ICP state,the electricity value of masseter muscle of group A[（69.22 ± 22.33）μV]was greater than groupB[（35.31 ± 13.15）μV]. There was statistical difference between the two groups（P 〈0.05）. There was positive correlation between the electricity value of masseter muscle and the AB/AC value of posterior sextants in GAgP patients（r = 0.731,P =0.002）. In ICP state,after the periodontal nonopera-tive therapy,the electricity value of masseter muscle and temporal muscle of GAgP patients had significant change.There was statistical difference compared with before treatmen（tP 〈0.05）.Conclusion In GAgP patients,the more alveolar bone defected,the less function of the masticatory muscles present. Periodontal nonoperative therapy can effectively improve the performence of masticatory muscles.