下颌前突患者咀嚼功能与颅面形态学的相关性分析

Naoya Fukamachi, K. Sakaue, K. Kurihara, Ryo Abe, T. Ono, I. Saito
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At the initial examination, lateral cephalograms were taken and analyzed. Masticatory performance was assessed by a fully automatic measuring system (Tokyo-koden, Tokyo, Japan) using a testing gummy jelly (UHAMikakuto, Osaka, Japan). Chewing time was measured with a stopwatch. Occlusal contact area was measured using a silicone testing material and analyzing device (BiteEye, GC, Tokyo, Japan). Maximum bite force was also measured by using an occlusal force meter (Morita, Osaka, Japan). Wilcoxon's rank sum test was used for comparing the masticatory performance, occlusal contact area and maximum bite force between the two groups. Spearman's rank correlation coefficient was used to evaluate the relationship between masticatory performance and craniofacial morphology. Results : Masticatory performance, occlusal contact area and maximum bite force were significantly lower in the patient group than in the control group. These results suggest that remarkable skeletal discrepancy and lack of tooth contact in the anterior regions and lateral segments may yield a decrease in occlusal contact area, maximum bite force and masticatory performance. A negative correlation was found between masticatory performance and gonial angle and ANS-Me, whereas a positive correlation was found between masticatory performance and chewing time. These findings suggest that the load on the masticatory muscles was reduced in patients with mandibular prognathism due to a decrease in masticatory performance, resulting in the opening of the gonial angle which is the attachment area of the masseter muscle, and in the enlargement of anterior lower facial height. Conclusions : A close relationship between masticatory 1)新潟大学大学院医歯学総合研究科歯科矯正学分野(主任:齋藤 功教授) 2)新潟大学大学院医歯学総合研究科包括歯科補綴学分野(主任:小野高裕教授) 1)Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences (Chief : Prof. Isao SAITO) 2)Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences(Chief : Prof. Takahiro ONO) 238 日顎変形誌 2019 年 深町 直哉,他 performance and craniofacial morphology was found in the patient group with mandibular prognathism. 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引用次数: 0

摘要

目的:以往对下颌前伸症患者咀嚼功能的研究从咬合接触面积、下颌运动和咀嚼肌活动等方面进行了研究。然而,由于缺乏一种快速简便的方法,关于下颌前突患者客观咀嚼功能与颅面形态关系的报道很少。本研究旨在利用全自动系统研究下颌前突患者咀嚼功能与颅面形态的关系。对象与方法:10例下颌前突患者(年龄:16.6±1.3岁)和10例正常咬合的志愿者(年龄:24.1±2.6岁)作为对照。在初步检查时,采取侧位脑电图并进行分析。咀嚼性能由全自动测量系统(Tokyo-koden, Tokyo, Japan)评估,使用测试软糖果冻(UHAMikakuto, Osaka, Japan)。咀嚼时间用秒表测量。使用硅胶测试材料和分析设备(BiteEye, GC, Tokyo, Japan)测量咬合接触面积。使用咬合力计测量最大咬合力(Morita, Osaka, Japan)。采用Wilcoxon秩和检验比较两组的咀嚼性能、咬合接触面积和最大咬合力。采用Spearman等级相关系数评价咀嚼功能与颅面形态的关系。结果:患者组咀嚼性能、咬合接触面积、最大咬合力明显低于对照组。这些结果表明,明显的骨骼差异和牙齿在前区和侧段缺乏接触可能导致咬合接触面积,最大咬合力和咀嚼性能下降。咀嚼性能与角和ANS-Me呈负相关,与咀嚼时间呈正相关。上述结果提示,下颌前突患者咀嚼功能下降,咀嚼肌负荷减少,导致咬肌附着区角角开口,面部前下高度增大。结论:肌1)之间的密切关系新潟大学大学院医歯学総合研究科歯科矯正学分野(主任:齋藤功教授)2)新潟大学大学院医歯学総合研究科包括歯科補綴学分野(主任:小野高裕教授)1)正畸分工,新泻大学医学和牙科科学研究生院(首席Isao齐藤教授):2)分工全面假牙修复术,新泻大学医学和牙科科学研究生院(首席:Takahiro ONO教授(238)在下颌前突患者组中发现了表现和颅面形态。全自动测量系统可以在短时间内客观定量地评价患者的咀嚼功能。
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Correlations Between Masticatory Performance by a Fully Automated Analyzing System and Craniofacial Morphology in Patients with Mandibular Prognathism
Purpose : Previous studies on masticatory function in patients with mandibular prognathism have examined various aspects such as occlusal contact area, mandibular movement, and masticatory muscle activity. However, there have been few reports on the relationship between objective masticatory performance and craniofacial morphology in patients with mandibular prognathism due to the lack of a quick and simple method. This study aimed to clarify the relationship between masticatory performance and craniofacial morphology for patients with mandibular prognathism by using a fully automatic system. Subjects and Methods : Ten patients with mandibular prognathism (age : 16.6±1.3 years) and 10 volunteers with individual normal occlusion (age : 24.1±2.6 years) as controls were enrolled in this study. At the initial examination, lateral cephalograms were taken and analyzed. Masticatory performance was assessed by a fully automatic measuring system (Tokyo-koden, Tokyo, Japan) using a testing gummy jelly (UHAMikakuto, Osaka, Japan). Chewing time was measured with a stopwatch. Occlusal contact area was measured using a silicone testing material and analyzing device (BiteEye, GC, Tokyo, Japan). Maximum bite force was also measured by using an occlusal force meter (Morita, Osaka, Japan). Wilcoxon's rank sum test was used for comparing the masticatory performance, occlusal contact area and maximum bite force between the two groups. Spearman's rank correlation coefficient was used to evaluate the relationship between masticatory performance and craniofacial morphology. Results : Masticatory performance, occlusal contact area and maximum bite force were significantly lower in the patient group than in the control group. These results suggest that remarkable skeletal discrepancy and lack of tooth contact in the anterior regions and lateral segments may yield a decrease in occlusal contact area, maximum bite force and masticatory performance. A negative correlation was found between masticatory performance and gonial angle and ANS-Me, whereas a positive correlation was found between masticatory performance and chewing time. These findings suggest that the load on the masticatory muscles was reduced in patients with mandibular prognathism due to a decrease in masticatory performance, resulting in the opening of the gonial angle which is the attachment area of the masseter muscle, and in the enlargement of anterior lower facial height. Conclusions : A close relationship between masticatory 1)新潟大学大学院医歯学総合研究科歯科矯正学分野(主任:齋藤 功教授) 2)新潟大学大学院医歯学総合研究科包括歯科補綴学分野(主任:小野高裕教授) 1)Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences (Chief : Prof. Isao SAITO) 2)Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences(Chief : Prof. Takahiro ONO) 238 日顎変形誌 2019 年 深町 直哉,他 performance and craniofacial morphology was found in the patient group with mandibular prognathism. The fully automatic measuring system is considered to be useful for evaluating masticatory performance in patients objectively and quantitatively in a short time.
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