咀嚼肌功能紊乱和修复专科处理

Masticatory muscle disorders and treatment from the perspective of prosthodontics

咀嚼肌功能紊乱(masticatory muscle disorders,MMD)是颞下颌关节紊乱病各亚型中发病率较高的一类疾病,包括局部肌纤维痛、肌筋膜痛等诊断,表现为咀嚼肌局部疼痛,可在下颌功能活动时加重。MMD是多因素复合致病,咬合异常如咬合创伤、干扰和咬合垂直距离过低等存在诱发或加重MMD的潜在风险,口腔修复治疗中需注意避免引起医源性咬合异常。多数患者的MMD症状可通过综合治疗得以缓解,而口腔修复医师可通过咬合治疗对MMD进行辅助诊断和辅助治疗,通过咬合板、调、义齿修复等手段达到缓解咀嚼肌张力、稳定咬合支持、消除干扰、调整颌位关系等目的,排除MMD的部分风险因素并缩短病程。

Masticatory muscle disorders(MMD)is the biggest subtype of temporomandibular disorders(TMD).Among them,local fibromyalgia and myofascial pain are localized lesions,manifested as masticatory muscle pain,which can be aggravated with jaw function.MMD is caused by a combination of multiple factors.Occlusal disharmony such as occlusal trauma,occlusal interference,and decreased vertical dimension of occlusion have the potential risk of inducing or aggravating the MMD.During prosthodontic treatment,iatrogenic occlusal interference should be avoided.Most patients with MMD can be relieved by comprehensive treatment,and occlusal therapy or prosthodontic treatment is used as an auxiliary means of diagnosis and treatment.By means of occlusal splint,occlusal adjustment and denture restoration,the goal of relieving masticatory muscle tension,stabilizing occlusal support,eliminating occlusal interference and adjusting jaw position can be achieved,so as to eliminate some risk factors of MMD and relief the pain faster.