中国实用口腔科杂志

中国实用口腔科杂志

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稳定型咬合板配合咬合重建治疗咀嚼肌疼痛疗效评价

白露a，马红梅b，吴琳a   

  1. 中国医科大学口腔医学院·附属口腔医院a修复一科，b 综合科，辽宁  沈阳  110002
  • 出版日期:2018-11-15 发布日期:2018-12-12
  • 基金资助:

    辽宁省中央引导地方科技发展专项项目（2017108001）

  • Online:2018-11-15 Published:2018-12-12

摘要：

目的　评价稳定型咬合板配合咬合重建治疗咀嚼肌疼痛的疗效。方法　选取2016年9月至2018年5月于中国医科大学附属口腔医院综合科及修复一科行稳定型咬合板及咬合重建序列治疗的咀嚼肌疼痛患者20例。分析治疗前（T0期）、佩戴咬合板3个月后（T1期）、咬合重建完成即刻（T2期）及咬合重建完成3个月后（T3期）的疼痛视觉模拟评分（visual analogue scale，VAS）、肌电图及Friction颞下颌关节紊乱指数的变化。结果　T1、T2、T3期患者VAS评分、下颌姿势位时颞肌咬肌的肌电活性、颞肌咬肌不对称指数及Friction颞下颌关节紊乱指数均较T0期显著降低，差异有统计学意义（均P < 0.05）；最大紧咬牙时颞肌咬肌的肌电活性较T0期明显增高，差异有统计学意义（均P < 0.05）。T1、T2、T3期患者之间的VAS评分、颞肌咬肌的肌电活性、颞肌咬肌不对称指数及Friction颞下颌关节紊乱指数差异无统计学意义（均P > 0.05）。结论　稳定型咬合板可有效治疗咀嚼肌疼痛，咬合重建序列治疗能很好维持其疗效。

关键词: 稳定型咬合板, 咬合重建, 咀嚼肌疼痛, 肌电图

Abstract:

Objective　To observe and analyze the clinical effect of the stabilization splint and the occlusal reconstruction treatment on patients with masticatory muscle pain. Methods　Totally 20 patients with masticatory muscle pain who visited General Department and Prosthodontics Department of Affiliated Stomatology Hospital of China Medical University from September 2016 to May 2018 were given the stabilization splint therapy and the occlusal reconstruction treatment. Analyze the visual analogue scale（VAS），electromyographic pattern and Friction temporomandibular joint dysfunction index before treatment（T0），three months after the stabilization splint therapy（T1），when occlusal reconstruction was finished（T2）and three months later（T3）. Results　Statistical analysis showed that VAS，the electromyographic signal of anterior temporalis and masseters in mandibular postural position，asymmetry index of masseter muscles and temporalis muscles and Friction temporomandibular joint dysfunction index in T1，T2 and T3 were significantly lower than those in T0（P < 0.05）. The electromyographic signal were dramatically increased in intercuspal position （P < 0.05）. No significant difference was shown in VAS，the electromyographic signal of anterior temporalis and masseters，asymmetry index of masseter muscles and temporalis muscles，or Friction temporomandibular joint dysfunction index in T1，T2 and T3（P > 0.05）. Conclusion　The stabilization splint therapy is effective on patients with masticatory muscle pain，and the occlusal reconstruction treatment is able to maintain these effects.

Key words: stabilization splint, occlusal reconstruction, masticatory muscle pain, electromyographic pattern