偏侧咀嚼诱发因素去除后的咀嚼功能及干预效果分析

发布时间：2017-12-31 10:34

本文关键词：偏侧咀嚼诱发因素去除后的咀嚼功能及干预效果分析　出处：《皖南医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过口腔流行病学调查筛选出偏侧咀嚼患者,旨对去除诱发因素6个月后的偏侧咀嚼患者进行肌电图和咀嚼效率分析,了解常规去除诱因治疗后患者的咀嚼功能改善情况;结合分析结果随机对部分偏侧咀嚼患者进行干预性治疗,分析比较干预治疗前后咀嚼肌肌电活动和咀嚼效率的变化,探讨干预治疗的效果,为此类患者是否需要进行进一步干预治疗提供相应的实验依据。方法:1)采用口腔专科检查和问诊相结合的方法于2013年11—12月在皖南医学院口腔医学专业235名学生中筛选出76名偏侧咀嚼患者,从中随机选择30名设为偏侧咀嚼组,其中男15人,女15人,年龄(19.3±0.5)岁,其中左偏侧咀嚼者17例,右偏侧咀嚼者13例。同时随机选择双侧咀嚼组为正常对照(n=30,男15人,女15人),年龄(19.6±0.3)岁。实验前六个月已去除造成偏侧咀嚼的常见诱发因素。用肌电图仪分别记录双侧咀嚼组和偏侧咀嚼组在下颌姿势位、最大开闭口运动和咀嚼运动时的咬肌、二腹肌前腹表面肌电图,进行相关参数分析。用吸光度法分别检测两组在随意咀嚼、左侧咀嚼、右侧咀嚼三种咀嚼方式下的吸光度值,并进行比较分析。2)将偏侧咀嚼者随机分为干预组和非干预组,六个月后分别记录这两组在下颌姿势位、最大开闭口运动和咀嚼运动时的咬肌、二腹肌前腹肌电图及随意咀嚼效率,进行比较分析。结果:1)偏侧咀嚼组最大开闭口运动中右二腹肌前腹(RDA)平均肌电值低于双侧咀嚼组(P0.01),咀嚼运动中右咬肌(RMM)平均肌电值低于双侧咀嚼组(P0.05)。2)偏侧咀嚼组最大开闭口运动中左二腹肌前腹(LDA)、右二腹肌前腹(RDA)平均肌电峰值低于双侧咀嚼组(P0.05),咀嚼运动中左咬肌(LMM)、右咬肌(RMM)平均肌电峰值低于双侧咀嚼组(P0.05)。3)偏侧咀嚼组在下颌姿势位、最大开闭口运动和咀嚼运动时咬肌活动不对称指数高于双侧咀嚼组(p0.05),最大开闭口、咀嚼运动时二腹肌前腹活动不对称指数高于双侧咀嚼组(p0.05)。4)偏侧咀嚼干预组干预后最大开闭口运动中rda平均肌电值显著高于干预前(p0.05),咀嚼运动中rmm平均肌电值较干预前有所升高(p0.05);干预组干预后在咀嚼运动中lda平均肌电值高于非干预组(p0.05)。5)偏侧咀嚼干预组干预后最大开闭口运动中lda、rda平均肌电峰值显著高于干预前(p0.05),咀嚼运动中lmm、rmm平均肌电峰值较干预前有所升高(p0.05);干预组干预后在最大开闭口运动中lda平均肌电峰值显著高于非干预组(p0.05)。6)偏侧咀嚼干预组干预后在下颌姿势位、最大开闭口运动和咀嚼运动时咬肌活动不对称指数低于干预前(p0.05),最大开闭口、咀嚼运动时二腹肌前腹活动不对称指数较干预前显著降低(p0.05);干预组干预后咬肌、二腹肌前腹活动不对称指数低于非干预组(p0.05)。7)偏侧咀嚼组的吸光度值与双侧咀嚼组比较有显著性差异(p0.01)。同时,在偏侧咀嚼组中,左偏侧咀嚼者的随意咀嚼、左侧咀嚼吸光度值均高于右侧咀嚼的吸光度值(p0.05);而右偏侧咀嚼者的随意咀嚼、右侧咀嚼吸光度值均高于左侧咀嚼的吸光度值(p0.05)。8)偏侧咀嚼干预组干预后的随意咀嚼效率显著高于干预前(p0.05);干预组干预后随意咀嚼效率显著高于非干预组(p0.01)。结论:1)偏侧咀嚼者去除诱发因素后测定的rmm、rda的平均肌电值、lmm、rmm、lda、rda的平均肌电峰值仍低于双侧咀嚼者,下颌姿势位、最大开闭口运动、咀嚼运动时的咬肌活动存在不对称性,最大开闭口运动和咀嚼运动时的二腹肌活动存在不对称性,随意咀嚼效率低于双侧咀嚼者。以上均提示常规的去诱因治疗不能真正达到恢复双侧咀嚼功能的目的。2)偏侧咀嚼者行干预性治疗后咬肌和二腹肌前腹的平均肌电值、平均肌电峰值明显升高,咬肌、二腹肌活动对称性显著改善,咀嚼效率明显提高,说明患者咀嚼功能得到了一定程度的改善。
[Abstract]:Objective: To study the oral epidemiological survey screened Hemimastication patients, aims for unilateral removal of the predisposing factors of 6 months after the patients were chewing EMG and masticatory efficiency analysis, understand the routine removal of incentives after treatment of patients with masticatory function improvement; combined with the results of the random part of Hemimastication patients for the treatment. Analysis and comparison of intervention before and after the treatment of masticatory muscle EMG activity of masticatory efficiency and change of therapeutic effects, such as whether patients need further intervention to provide experimental basis for the corresponding treatment. Methods: 1) using the method of oral examination and interrogation combined chewing in 2013 11 - December in Wangnan Medical College Stomatology 235 the student identified 76 patients of unilateral chewing, group side from 30 randomly selected, including 15 male and 15 female, age (19.3 + 0.5) years old, the Hemimastication left 17 cases, right Hemimastication in 13 cases. At the same time randomly selected bilateral chewing group was normal control (n=30, male 15, female 15), age (19.6 + 0.3) years old. The first six months has caused removal of common causative factors Hemimastication. With the electromyography were recorded in bilateral chewing group and Hemimastication group in the mandibular position and the largest open close movement and mastication of the masseter muscle, two abdominal anterior abdominal surface electromyography, related parameters were analyzed. The two groups were detected in a casual chew, chew on the left side by spectrophotometry, absorbance of three kinds of chewing chewing on the right side of the value, and comparative analysis of.2) will Hemimastication were randomly divided into intervention group and non intervention group. After six months of the two groups were recorded in the mandibular position and the largest open close movement and mastication of the masseter muscle, abdominal muscle and abdominal electrocardiogram before two free chewing efficiency, compare Analysis. Results: 1) Hemimastication group the maximum opening and closing movement right anterior abdominal muscle two (RDA) value is lower than the average EMG of bilateral chewing group (P0.01), the right masseter chewing movement (RMM) value is lower than the average EMG of bilateral chewing group (P0.05).2) Hemimastication group the largest open close movement of Naka Saji before the abdominal muscle (LDA), two right anterior abdominal muscles (RDA) the average EMG peak was lower than the bilateral chewing group (P0.05), the left masseter chewing movement (LMM), the right masseter muscle (RMM) average EMG peak lower than bilateral chewing group (P0.05).3) Hemimastication group in the mandibular position and the largest open close movement and masticatory movement when the masseter muscle activity asymmetry index is higher than that of bilateral chewing group (P0.05), the maximum opening and closing, mastication two abdominal ventral asymmetry index is higher than that of bilateral chewing activity group (P0.05).4) Hemimastication intervention group the largest open close movement in RDA average EMG values were significantly higher than before (P0.05), Masticatory movement RMM average EMG values increased compared with before intervention (P0.05); the intervention group in the masticatory movement LDA average EMG value is higher than the non intervention group (P0.05).5) Hemimastication intervention group the largest open close movement in LDA RDA, the average peak EMG was significantly higher than that before the intervention (P0.05). Masticatory movement LMM, RMM average EMG peak increased compared with before intervention (P0.05); the intervention group in the opening and closing movement LDA average EMG peak was higher than that in the non intervention group at the maximum (P0.05).6) Hemimastication intervention group in the mandibular position and the largest open close movement and masseter muscle activity during mastication the asymmetry index was lower than that before intervention (P0.05), the maximum opening and closing, mastication two abdominal anterior abdominal activity asymmetry index was significantly lower than before intervention (P0.05); intervention group two masseter, anterior abdominal muscle activity asymmetry index was lower than that of non intervention group (P0.05 ).7) absorbance Hemimastication group was compared between the group and the bilateral mastication (P0.01). At the same time, in Hemimastication group, left Hemimastication are free to chew, chew on the left side were higher than the absorbance absorbance value (P0.05) on the right side of chewing; free to chew while the right side chewing subjects the absorbance values were higher than the right chewing chewing left the value of absorbance (P0.05).8) Hemimastication intervention group randomly masticatory efficiency were significantly higher than before (P0.05); the intervention group was significantly higher than that of free chewing efficiency in non intervention group (P0.01). Conclusion: 1) Hemimastication was removed by after RMM, the average EMG values of RDA, LMM, RMM, LDA, RDA is still lower than the average peak EMG of bilateral chewing, mandibular position, maximum opening and closing movement, the masseter muscle activity during mastication is asymmetric, the opening and closing movement and two abdominal muscles during mastication Activity is asymmetric, freely chewing efficiency is lower than the bilateral chewing. All suggest that in order to cause treatment cannot reach the purpose of bilateral masticatory function recovery.2) Hemimastication average EMG for intervention treatment of masseter and anterior abdominal muscle two values, the average peak EMG increased significantly, masseter muscle, abdominal muscle activity two symmetry improved, masticatory efficiency improved significantly, indicating the masticatory function has been improved to some extent.

【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R782.6

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