肌位咬合板对颅颌功能紊乱者咀嚼肌肌电图的影响

Influence of muscular position splint on masticatory muscle activity in patients with craniomandibular disorders

目的：研究肌位咬合板对颅颌功能紊乱（ Ｃ Ｍ Ｄ）患者咀嚼肌肌电的影响，探讨其作用机理。方法：采用美国 Ｅ Ｍ２ 型肌电仪记录１０２ 例患者带咬合板前后的姿势位（ Ｍ Ｐ Ｐ）及牙尖交错位（ Ｉ Ｃ Ｐ）最大紧咬时的肌电变化。结果：（１）即刻戴入咬合板后颞肌前束（ Ｔ Ａ）与嚼肌（ Ｍ Ｍ）的 Ｍ Ｐ Ｐ高电位明显降低（ Ｐ＜ ０．０５）；治疗后不戴咬合板复查， Ｔ Ａ、颞肌后束（ Ｔ Ｐ）和 Ｍ Ｍ 肌紧张缓解。（２）戴咬合板紧咬双侧 Ｔ Ａ、 Ｔ Ｐ 和 Ｍ Ｍ 的肌电活动显著减小（ Ｐ＜ ０．０５）， Ｍ Ｍ 的肌电活动对称性明显提高（ Ｐ＜ ０．０５），活动指数显著增加（ Ｐ＜０．０５）。结论：肌位咬合板能明显降低升颌肌最大紧咬的肌电活动，提高嚼肌的肌电活动对称性及活动指数。

?Objective: To investigate the effect of muscular position splint on masticatory muscle activity in patients with craniomandibular disoders (CMD). Methods: The electromyography(EMG) of bilateral anterior temporalis (TA),posterior temporalis(TP),masseter muscle(MM)and anterior digastric (DA) was taken in 102 CMD patients before treatment, immediately after inserting the splint and 3 to 6 months later without splint in situ . Results: (1)Hyperactivity of TA,TP and MM at postural position was significantly reduced with the splint in situ and after treatment ( P <0.05) (2)With the insertion of splint the EMG activity of TA,MM and TP during maximal clenching was dramatically reduced ( P <0.05), the asymmetry index of MM was obviously decreased and the activity index of MM was significantly increased ( P <0.05). Conclusion: The muscular position splint may decrease the hyperactivity of elevators.