咬合支持丧失患者修复前后咀嚼肌表面肌电分析

摘要

目的:探讨咬合支持丧失患者修复前后咀嚼肌肌电的变化.方法:对24例咬合支持丧失患者进行常规修复,记录不同时期双侧咬肌和颞肌前束在下颌姿势位及牙尖交错紧咬位时的肌电活动,分析肌电幅值、不对称指数及咬肌/颞肌活动指数的变化.结果:(1)修复前后下颌姿势位肌电变化,咬肌肌电幅值和不对称指数在不同时期无明显变化(P＞0.05)；颞肌肌电幅值和不对称指数在义齿戴用3个月以上后显著小于义齿早期(P＜0.05)；咬肌/颞肌前束活动指数在各时期均小于0.(2)修复后牙尖交错位紧咬时肌电变化,咬肌及颞肌前束肌电幅值在戴牙3个月后显著高于戴牙早期(P＜0.05)；不对称指数与初戴牙时接近(P＞0.05),较戴牙1周及1个月显著减小(P＜0.05).咬肌/颞肌前束活动指数值在各时期均接近0.结论:咬合支持丧失患者进行咬合重建过程中,咀嚼肌肌电活动在不同时期有所变化.肌电测量可为咬合重建效果的评价提供参考.%Objective:To investigate the changes in surface electromyography (sEMG) activity of masticatory muscles before and after occlusal rehabilitation in patients without occlusal support.Methods:24 patients without occlusal support were selected and conducted with regularly occlusal rehabilitation.The sEMG of masseter muscle (MM) and anterior temporalis muscle (TA) at mandibular postural position (MPP) and during clenching at intercuspal position (ICP) were separately recorded in different stages.The changes of the mean amplitude (MA) of sEMG,the asymmetry indexes (AsI) of bilateral MM,TA and total masticatory muscles(AsMM,AsTA,Astot),activity indexes (AcI) of MM/TA in each stage were analyzed.Results:1.The changes in sEMG activity before and after restoration at MPP:MA and AsI of MM had no significant difference in different stages (P＞ 0.05).MA and AsI of TA after using 3 months were significantly higher than using early stage.AcI of MM/TA was negative at every stage (P＜ 0.05).2.The changes in sEMG activity before and after restoration at MPP:MA of MM and TA was significantly increased after using three months (P＜ 0.05).Each AsI was close to first wearing (P＞0.05),but significantly lower than 1 week and 1 month after restoration (P＜0.05).AcI of MM/TA were close to 0.Conclusion:The sEMG ofmasticatory muscles changed at different stages ofprothetic rehabilitation in patients without occlusal support,sEMG can provide reference for evaluation of effect of occlusal rehabilitation.