对咬合障碍和慢性全身性牙周炎患者咀嚼肌群状况的神经生理学评估

D. Domenyuk, B. N. Davydov, T. Kochkonyan, A. V. Kokareva, J. I. Glushanyan, O. Ivanyuta, S. Domenyuk
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引用次数: 0

摘要

背景。最近,牙科医生和生理学家的兴趣集中在开发一套信息丰富的计算机化技术,用于客观分析牙面装置的功能状态。在进行功能诊断检查方面取得一定的成功,有助于为全身牙周炎和咬合过早接触患者的综合治疗制定算法。根据下颌静态和动态条件下慢性全身性牙周炎和咬合紊乱患者的肌肉生物电活动参数,研究牙面装置的功能状态。研究对象包括 37 名牙周临床健康、生理性咬合和无咬合障碍的患者(第 1 组)和 45 名生理性咬合、全身慢性牙周炎和咬合接触过早的患者(第 2 组)。功能性方法包括使用 T-Scan® III 计算机咬合分析系统对咬合关系进行电子登记,以及使用 Bio-EMG® III 肌电图对咀嚼肌的生物电活动进行研究,并进行标准功能测试。与第一组患者相比,第二组患者的咀嚼肌功能活动被诊断为神经肌肉不协调。在进行 "最大意志压缩 "测试时,颞肌和咀嚼肌的生物电位值在统计学上显著增加。慢性泛发性牙周炎和咬合过早接触患者颅颌面肌肉的协调工作受到干扰,表现为咀嚼肌群的生物电位在静止状态下有明显的统计学意义的增加,在功能负荷时生物电位下降,对称性和协同性的数值与第一组患者的相似数值相比有所降低。
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Neurophysiological assessment of the condition of the masticatory muscle group in patients with occlusion disorders and chronic generalized periodontitis
Background. Recently, the interest of dentists and physiologists has been focused on the development of a set of informative computerized techniques for an objective analysis of the functional state of the dentofacial apparatus. Achieving certain successes in conducting functional diagnostic examinations contributes to the development of algorithms for complex treatment of patients with generalized periodontitis and premature occlusal contacts.Goal. Study of the functional state of the dentofacial apparatus according to the parameters of bioelectrical activity of muscles in patients with chronic generalized periodontitis and occlusal disorders in static and dynamic conditions of the lower jaw.Materials and methods. The study involved 37 people with clinically healthy periodontium, physiological occlusion, and absence of occlusal disorders (Group 1) and 45 patients with physiological types of occlusion, generalized chronic periodontitis and premature occlusal contacts (Group 2). Functional methods included electronic registration of occlusal relationships with the T-Scan® III computer occlusion analysis system and study of the bioelectrical activity of the masticatory muscles using the Bio-EMG® III electromyography using standard functional tests.Results. In patients of group 2, in comparison with patients of group 1, neuromuscular discoordination of the functional activity of the masticatory muscles was diagnosed. This condition is confirmed by the asymmetry and lack of muscle synergy when performing the “Maximum volitional compression” test, an improvement in the symmetry of the work of the muscles of the same name on the right and left sides and the synergy of the work of the muscles of the right and left masticatory groups, as well as a statistically significant increase in the values of biopotentials m. temporalis and m. masseter during the “Maximum volitional compression on rollers” test.Conclusions. Disturbances in the coordinated work of the muscles of the craniofacial region in patients with chronic generalized periodontitis and premature occlusal contacts are realized in a statistically significant increase in the biopotentials of the masticatory muscle group at rest, a decrease in biopotentials during functional loading, as well as a reduction in the values of symmetry and synergy in relation to similar values patients of group 1.
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