• 作者： 許榮仁; 王若松; 蕭裕源
• 作者服務機構： 國立台灣大學附設醫院牙科; 國立台灣大學醫學院牙醫學系
• 中文摘要： 本報告的目的在探討實驗性置入之工作側干擾物對夜間有磨牙習慣者其咀嚼系統的健康狀態及咀嚼行為的影響。受測者共13位，9為男性，4位女性，年齡介於18至31歲，選取條件為六個月內無咀嚼肌或顎關節疼痛的經驗，且臨床模型檢查及知我認知皆顯示有夜間磨牙習慣。在咬合模型上製作金屬干擾物，此干擾物以特殊樹脂黏著於習慣咬側之上顎第二小臼齒及第一大臼齒咬合面，以干擾受測者之工作側運動路徑而不影響中心咬合。 在金屬干擾物裝置前（WO），裝置後立（WI），裝置後一天（W2），一個禮拜（W3），和一個月（W4），各以光電系統記錄受測者之咀嚼運動，並檢查咀嚼肌及顎關節之健康狀態。結果顯示60％受測者金屬干擾物脫落，金屬干擾物維持一個月的5位受測者之80％有對咬牙磨損，40％輕微牙齒搖動。但沒有任何受測者有咀嚼肌或顎關節疼痛之現象。在咀嚼行為方面，一般而言，咀嚼開閉口路徑向非干擾側偏移，運動範圍變窄，且傾向垂直咀嚼。統計分析發現受測者的咀嚼行為對干擾物出現兩種主要反應模式：第一種為逃避性閉口路徑（佔完成W3受測者之67％），第二種為逃避性（16.5％），和趨近性（16.5％）之開口路徑。在開口速率方面，裝置干擾物前，69％受測者顯示較大平均閉口速率，平均差值為11.9mm/sec，六位完成一週受測者之80％此差級關係在W1，W2發生改變，而在W3或W4有回復之現象。 根據上述發現，初步結論，夜間磨牙者在置入工作側咬合干擾後，雖改變咀嚼行為，但不致立即引發顎肌症。
• 英文摘要： The present study aimed to test the effects of experimentally placed working side interference onnocturnal bruxers with regard to the health and chewing motor behaviors of the masticatory system. Thirteenasymptomatic nocturnal bruxers, nine males and four females, aged 18-31 years old, were selected accordingto the including criteria. A metal overlay was fabricated and bonded on the tips and lingual inclines ofbuccal cusps of the upper second premolar and first molar of the habitual chewing side. It discluded theeccentric contacts without disturbing the centric occlusion. A light emitting diode system was used to recordthe chewing motor behaviors before (WO), immediately after (WI), one day after (W2), one week after (W3),and one month after (W4) placement of the working side interference. The healthy states of masticatorymuscles and TMJs were examined at each session. The results showed: I. High overlay debonding rate(60%). Among five subjects who were observed over 25 days, 80% showed grinding facets, and 40% showedgrade I mobility on the overlay opposing teeth. None of the subjects complained of muscle or joint painin the one month follow-up period. 2. The chewing movements shifted toward the non-interfered side withnarrowed and vertical chews after placement of overlays. Two major responded chewing patterns werefound according to the results of statistical analysis. 3. Sixty-nine per cent of the subjects showed highermean closing velocity than the mean opening velocity at the WO session. For six subjects who were observedafter at least W3 sessions, 80％ showed disturbed relationships between the mean closing and opening velocityat WI and/or W2 sessions. The authors concluded that the addition of working side interference mayalter the chewing motor behaviors. However, it seldom induces muscle and joint problems on bruxers.
• 中文關鍵字： working side interference; nocturnal bruxer.
• 英文關鍵字： --