《口腔颌面外科杂志》 ›› 2025, Vol. 35 ›› Issue (3): 199-204. doi: 10.12439/kqhm.1005-4979.2025.03.005

• 临床研究 • 上一篇    下一篇

颞下颌关节盘锚固术对咀嚼肌表面肌电特征影响的临床研究

林宇翔,李晨曦,龚忠诚   

  1. 新疆医科大学第一附属医院(附属口腔医院)口腔颌面肿瘤外科,新疆维吾尔自治区口腔医学研究所,乌鲁木齐 830054

  • 出版日期:2025-06-28 上线日期:2025-06-26

Clinical study on the effect of temporomandibular joint disc anchorage on surface electromyographic characteristics of the masticatory muscles

LIN Yuxiang, LI Chenxi, GONG Zhongcheng   

  1. Department of Oral and Maxillofacial Oncology & Surgery, the First Affiliated Hospital of Xinjiang Medical University, School and Hospital of Stomatology, Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054, China

  • Published:2025-06-28 Online:2025-06-26

摘要:

目的:评估颞下颌关节盘锚固术(disc anchorageDA)对咀嚼肌表面肌电(surface electromyographysEMG)特征的影响及其临床疗效。方法:收集202212月至2024 1月期间关节盘不可复性前移位(anterior disc displacement without reductionADDwoR)并行 DA 的患者 23 例,比较患者术前、术后 3 个月、术后 6 个月的大张口时、咀嚼时、耳前区疼痛及咀嚼肌压痛的视觉模拟评分法(visual analogue scaleVAS)评分,最大张口度(maximal interincisal openingMIO),下颌边缘运动(border movementBM)距离和颞肌前束(anterior temporalisTA)、咬肌(masseter muscleMMsEMG 平均幅值。结果:术后 6 个月,患者 MIO 较术前增加(P<0.05),BM 距离较术前无明显变化,大张口时及耳前区VAS 评分较手术前降低(P<0.05)。单侧 DA 患者,非手术侧术后 6 个月 TA sEMG 平均幅值较术前及术后 3 个月升高,手术侧术后 6 个月 TA sEMG 平均幅值较术后 3 个月升高(P<0.05);非手术侧术后 6 个月 MM sEMG 平均幅值较术前及术后 3 个月升高,手术侧术后 6 个月 MM sEMG 平均幅值较术后 3 个月升高,术前及术后 6 个月非手术侧 MM sEMG平均幅值均高于同时期手术侧,术后 3 个月时低于手术侧(P<0.05)。双侧 DA 患者,术后 3 个月 TA sEMG 平均幅值较术前下降(P<0.05),MM sEMG 平均幅值在术后 3 个月较术前下降,术后 6 个月上升并高于术前水平(P<0.05)。结论:DA 可减轻 ADDwoR 患者疼痛,改善下颌运动功能,使 sEMG 趋近平衡稳定,临床疗效良好。

关键词:

颞肌, 咬肌, 边缘运动, 关节盘锚固术, 表面肌电

Abstract:

Objective: To evaluate the effect of temporomandibular joint disc anchorage (DA) on the surface electromyography (sEMG) characteristics of the masticatory muscles and its clinical outcome. Methods: A total of twenty-three patients with anterior disc displacement without reduction (ADDwoR) who underwent temporomandibular joint disc anchorage (DA) between December 2022 and January 2024 were collected to compare their preoperative, 3-month postoperative, and 6-month postoperative maximal interincisal opening (MIO), visual analogue scale (VAS) scores, mandibular border movement (BM) distance, and sEMG of anterior temporalis (TA) and masseter muscle (MM). Results: Patients' MIO increased at 6 months postoperatively compared with preoperative levels (P<0.05), BM distance did not change significantly, VAS scores during wide mouth opening and in the preauricular region decreased compared with preoperative levels (P<0.05). In unilateral DA patients,the mean amplitude of TA sEMG was higher at 6 months postoperatively than that at 3 months postoperatively (P<0.05). At 6 months postoperatively, the mean MM sEMG amplitude was elevated on the non-operative side compared with preoperative and 3-month postoperative levels, and was reduced on the operative side compared with 3-month postoperative levels. The non-operative side showed higher amplitude than the operative side both preoperative and 6 months postoperatively, and lower amplitude at 3 months postoperatively (P<0.05). In bilateral DA patients, the mean TA sEMG amplitude decreased at 3 months postoperatively compared with preoperative levels (P<0.05), and the mean MM sEMG amplitude decreased at 3 months postoperatively compared with preoperative levels, but increased and was higher than the preoperative levels at 6 months postoperatively (P<0.05). Conclusion: DA can reduce the pain of ADDwoR patients, improve the mandibular motor function, and make the sEMG tend to be balanced and stable, with good clinical efficacy.

Key words:

temporal muscle, masseter muscle, border movement, disc anchorage, surface electromyography

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