- 作者: 蕭裕源; 陳坤智
- 作者服務機構: 國立臺灣大學醫學院牙醫學系
- 中文摘要: 本報告研究15名顎關節肌肉障礙症(顎肌症)及15名正常人之咀嚼運動。利用同步化肌電圖及咀嚼運動記錄器進行單粒花生單側咀嚼之肌活動觀察。顎肌症患者有顎關節及咀嚼肌之疼痛或壓痛症狀,開口時有限制,或開閉口時有關節噪音發生,唯彼等皆有完整的齒列和沒有明顯干擾的咬合狀態。結果發現,顎肌症組需較多次的嚼破花生的動作(約為5:3),在牙齒接觸前的肌活動時間(DMC)也較長(約為250msec:220msec)。單側咀嚼時的左右側肌之DMC沒有明顯的差別,咀嚼前期的DMC比後期者長。顎肌症組的肌活動總時間(DTM)和咀嚼時牙齒接觸時間(DTC)皆比正常組稍長 ,但統計上的差別不顯著。初期研磨期的DTC明顯地比咀嚼後期為短,DMC在初期比後期長,DTM的此類差別則不明顯。顎肌症組的最大閉口速率(約為135mm/sec)及平均速率(約為30mm/sec)顯著地比正常組人(約為170mm/sec及40mm/sec)為慢,開口速率方面則無明顯差異。基於以上發現所下的初步結論是:(1)無明顯咬合干擾時,顎肌症者與正常人的DTM及DTC並沒有很明顯的統計差異,此結果或可顯示咀嚼運動中,齒牙接 觸時間及肌活動總時間受咬合狀態及食物種類的影響較大,而閉口速率及齒牙接觸前肌活動時間受肌和關節疼痛情形 的影響較大。(2)閉口速率的差異甚為顯著,顯示顎肌症患者在咀嚼時因顎關節及咀嚼肌的疼痛使得下顎之閉合減緩,以避免急促的上 下顎牙齒或硬物的接觸。
- 英文摘要: A synchronized system of EMG and jaw motion tracking device was used to observe some chewingparameters of jaw elevator muscles in IS patients with temporomandibular joint and muscle pain dysfunc-tion syndrome (TMJ) and IS normal subjects. Duration of tooth contact (DTC), duration of muscle con-traction before tooth contact (DMC), total duration of muscle contraction (DTM) and velocity of jawmovement during peanut chewing were observed. Symptoms of the TMJ patients included pain and ten-derness at joints and muscles, and limitation and clicking at joints during jaw movements. It was found thatthe TMJ patients needed more numerous breaking off strokes before trituration at the occlusal level. Therewas a longer DMC in the earlier trituration period and TMJ patients had longer DMC than in normals. Nodifference was found between right and left side chewing or between temporalis and masseter muscles.DTM in the TMJ group was only slightly longer than in normals and the difference between early and latechewing periods was statistically not significant. DTC was only slightly shorter in the TMJ group while thedifference between early and late chewing periods in both groups was significant. The average and maxi-mum closing velocities were significantly lower in the TMJ group in both right and left chewing. The dif-ference in the opening phase was not as significant. It was concluded that DMC and jaw closing velocity aremore sensitive parameters than DTM and DTC on the diagnosis of TMJ dysfunction with or without occlu-sal interference. DTM and DTC are parameters more closely related to the influence of occlusal factors. Itseems that pain and discomfort of the muscles and joints prevent the jaw from quick closure and the eleva-tor muscles need more time to adjust the jaw to close into the centric position.
- 中文關鍵字: matication; TMJ/muscle pain dysfunction; EMG; jaw movement
- 英文關鍵字: --