不同咬合板接触点对颞下颌关节紊乱病咀嚼肌肌电的影响

Effects of Different Occlusal Splints on Masticatory Muscles Electromyography of Temporomandibular Disorders

目的:探讨不同咬合板接触点对颞下颌关节紊乱病(Tempromandibular disorders,TMD)咀嚼肌肌电的影响分析。方法:选取陕西中医药大学附属医院自2016年3月~2019年3月间收治的颞下颌关节紊乱病患者40例,按照佩戴咬合板接触点不同分为两组,A组(18例)咬合板与下前牙呈点状均匀接触;B组(22例)咬合板与对颌牙功能尖呈点状接触,对比佩戴前、后1个月时两组患者双侧颞肌前束(Temporal anterior,TA)和咬肌(Masseter muscle,MM)肌电电位变化。结果:静息状态戴咬合板前两组TA、MM两项指标差异无统计学意义(P>0.05),戴板1个月后两组TA、MM指标均明显下降,组间对比B组患者TA显著高于A组,MM显著低于A组(P<0.05);咬紧状态下戴板一个月后两组患者TA、MM值均明显升高(P<0.05),组间对比A组TA、MM值略高于B组,但对比无统计学意义(P>0.05);戴板后两组视觉模拟评分(Visual analogue scale,VAS)均明显下降,A组评分显著低于B组(P<0.05)。结论:下前牙和舌侧平板呈点状均匀接触的咬合板治疗TMD可更好改善咬肌功能,缓解疼痛症状。

Objective:To investigate the effect of occlusal splints on masticatory muscles electromyography of temporomandibular disorders(TMD).Methods:Forty patients with temporomandibular disorders admitted to Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2016 to March 2019 were enrolled in the study.They were divided into two groups according to the different points of wearing the occlusal splints.Patients in the group A(18 cases)were occluded.The splint and the lower anterior teeth were in point-like uniform contact;In the group B(22 cases),the occlusal splint was in point contact with the function of the right dentition,and the bilateral anterior tibiofibular fascia was compared between the two groups before and after wearing temporal anterior(TA),masseter muscle(MM)changes in masticatory muscles electromyography.Results:There was no significant difference in TA and MM between the two groups before the wearing of the occlusal splint(P>0.05).After one month of wearing the splint,the TA and MM indexes of the two groups were significantly decreased,and the TA of the group B was significantly higher than that of the group B,MM was significantly lower than group A(P<0.05).The TA and MM values of the two groups were significantly increased after one month of wearing the splint(P<0.05),and the TA and MM values of the group A were slightly higher than those of the group B,but the comparison was not statistically significant(P>0.05).The VAS scores of the two groups were significantly decreased after wearing the splint,and the score of group A was significantly lower than that of group B(P<0.05).Conclusion:The treatment of TMD with a occlusal splint and a point-like uniform contact between the lower anterior teeth and the lingual side splint can improve the masticatory muscles function and relieve pain symptoms.