本文選題：偏側(cè)咀嚼 + 咀嚼肌��； 參考：《皖南醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的：通過口腔流行病學(xué)調(diào)查篩選出偏側(cè)咀嚼患者，分析偏側(cè)咀嚼發(fā)生率；通過下頜運(yùn)動軌跡描記(Electrognathography，簡稱EGN)和咀嚼肌表面肌電圖（Electromyogram，簡稱EMG）同步檢測技術(shù)，比較偏側(cè)咀嚼和正常咀嚼人群在下頜運(yùn)動中的運(yùn)動軌跡和肌電情況，分析偏側(cè)咀嚼患者的下頜運(yùn)動特性，為進(jìn)一步研究偏側(cè)咀嚼的運(yùn)動控制機(jī)制奠定基礎(chǔ)，并為臨床診斷、預(yù)防和盡早糾正患者偏側(cè)咀嚼習(xí)慣提供相應(yīng)的實驗依據(jù)。 方法：1）流行病學(xué)調(diào)查：采取整群抽樣的方法抽取皖南醫(yī)學(xué)院口腔醫(yī)學(xué)專業(yè)2011～2012級在校本科學(xué)生263人（男性127人，女性136人，年齡19.64±1.17歲）進(jìn)行口腔檢查，分析偏側(cè)咀嚼的檢出率。2）篩選病例并分組，進(jìn)行肌電圖與下頜運(yùn)動軌跡的同步檢測與分析：在檢查出的89例偏側(cè)咀嚼者中隨機(jī)選擇30例（男15例，女15例）作為實驗組，同時隨機(jī)選擇雙側(cè)咀嚼30例（男15例，，女15例）作為對照組。用PowerLab8/30八通道多用途生理記錄儀和下頜運(yùn)動軌跡描記儀（Mandibular kinesiograph，簡稱MKG）同步記錄雙側(cè)咀嚼組和偏側(cè)咀嚼者在下頜姿勢位、最大張閉口運(yùn)動和咀嚼運(yùn)動時的咬肌、二腹肌前腹的肌電圖和下頜切點運(yùn)動軌跡，進(jìn)行統(tǒng)計學(xué)分析。 結(jié)果：1）263名學(xué)生中有89人（男性44人，女性45人，平均年齡19.53±1.13歲）存在偏側(cè)咀嚼習(xí)慣，發(fā)生率為33.84%；不同性別檢出率差異無統(tǒng)計學(xué)意義。2）雙側(cè)咀嚼組不同性別間咬肌、二腹肌前腹的不對稱指數(shù)差異無統(tǒng)計學(xué)意義，偏側(cè)咀嚼組不同性別間咀嚼運(yùn)動中咬肌活動不對稱指數(shù)有顯著性差異（P＜0.01）。雙側(cè)咀嚼組不同性別間同名咬肌、二腹肌前腹的平均肌電峰值（Amp）差異無統(tǒng)計學(xué)意義，偏側(cè)咀嚼組不同性別間大張口運(yùn)動中左二腹肌前腹平均肌電峰值有顯著性差異（P＜0.01）。3）偏側(cè)咀嚼組在下頜姿勢位、最大張閉口運(yùn)動和咀嚼運(yùn)動中咬肌活動不對稱指數(shù)高于雙側(cè)咀嚼組（P0.05），下頜姿勢位、咀嚼運(yùn)動時二腹肌前腹活動對稱性低于雙側(cè)咀嚼組（P0.05）。偏側(cè)咀嚼組大張口運(yùn)動中LDA、RDA平均肌電峰值低于雙側(cè)咀嚼組（P＜0.05），咀嚼運(yùn)動中LMM平均肌電峰值低于雙側(cè)咀嚼組（P＜0.05）。4）偏側(cè)咀嚼組在大張口運(yùn)動時開閉口軌跡多數(shù)分離，開口型、開牙合時間與與雙側(cè)咀嚼組相比差異有統(tǒng)計學(xué)意義（P0.05）；咀嚼運(yùn)動時下頜切點運(yùn)動軌跡形態(tài)不順暢，開口相與閉口相軌跡分布不均，開牙合時間與雙側(cè)咀嚼組相比差異有統(tǒng)計學(xué)意義（P0.05），閉牙合至牙尖交錯位的形態(tài)與雙側(cè)咀嚼組相比差異有統(tǒng)計學(xué)意義（P0.05）。5）雙側(cè)咀嚼組不同性別間下頜姿勢位、最大張閉口運(yùn)動和咀嚼運(yùn)動時下頜切點運(yùn)動軌跡參數(shù)差異無統(tǒng)計學(xué)意義，偏側(cè)咀嚼組不同性別間在大張口運(yùn)動時水平位移差異有統(tǒng)計學(xué)意義（P0.05）。6）偏側(cè)咀嚼組張閉口運(yùn)動時垂直向位移和矢狀向位移顯著低于雙側(cè)咀嚼組（P0.01）、咀嚼運(yùn)動左側(cè)位移低于雙側(cè)咀嚼組（P0.05）；偏側(cè)咀嚼組咀嚼運(yùn)動時前后向位移高于雙側(cè)咀嚼組（P0.05）。7）雙側(cè)咀嚼組咀嚼運(yùn)動時咬肌Amp與最大閉口速度、垂直向位移呈顯著正相關(guān)關(guān)系；偏側(cè)咀嚼組MPP時左二腹肌前腹Amp與最大閉口速度、前后向位移呈顯著正相關(guān)關(guān)系，大張口運(yùn)動中咬肌Amp與右側(cè)方位移呈顯著正相關(guān)關(guān)系，咀嚼運(yùn)動中左咬肌Amp與最大閉口速度、垂直向位移、水平向位移、矢狀向位移呈顯著正相關(guān)關(guān)系。 結(jié)論：1）偏側(cè)咀嚼的檢出率是33.84%，不同性別檢出率差異無統(tǒng)計學(xué)意義。2）偏側(cè)咀嚼者在下頜姿勢位、大張口運(yùn)動和咀嚼運(yùn)動中的咬肌活動存在不對稱性，下頜姿勢位、咀嚼運(yùn)動中二腹肌前腹活動存在不對稱性。3）偏側(cè)咀嚼組LDA、RDA、LMM的平均肌電峰值降低。4）偏側(cè)咀嚼組咀嚼運(yùn)動中軌跡形態(tài)曲線相對紊亂，開閉口相也集中于一側(cè)，67%的人群近牙尖交錯位時閉口相呈凹面型，開牙合時間縮短；大張口運(yùn)動中開口型多數(shù)偏向工作側(cè)，50%的人群開閉口軌跡分離，開口度減小。5）偏側(cè)咀嚼組大張口運(yùn)動中咬肌Amp與右側(cè)方位移，咀嚼運(yùn)動中左咬肌Amp與垂直向位移、水平向位移、矢狀向位移存在正相關(guān)性，說明偏側(cè)咀嚼導(dǎo)致肌肉性能的改變的同時引起運(yùn)動軌跡的異常。
[Abstract]:Objective: to screen the lateral masticatory patients through the oral epidemiological survey and analyze the incidence of lateral mastication, and to compare the movement track in the mandibular movement by the Electrognathography (EGN) and the Electromyogram (EMG). The characteristics of mandibular movement in patients with lateral mastication are analyzed to provide a basis for further study of the mechanism of lateral mastication, and to provide the basis for clinical diagnosis, prevention and early correction of patients' lateral masticatory habits.
Methods: 1) epidemiological investigation: 263 students (127 men, 136 women, 19.64 + 1.17 years old) in stomatology of Wangnan Medical College were selected by cluster sampling. The oral examination was performed, the detection rate of partial mastication was.2) and the cases were divided into groups. Electromyography and mandibular movement were carried out. Synchronous detection and analysis: 30 cases (15 men and 15 women) were selected as the experimental group randomly, and 30 cases (15 men and 15 women) were selected as the control group at random. The PowerLab8/30 eight channel multipurpose physiological recorder and the mandibular motion tracer (Mandibular kinesiograph, MKG) were used as the control group. The simultaneous recording of bilateral masticatory and lateral masticator at the position of the mandibular position, the masseter muscles at the maximum closure and masticatory movement, the electromyography of the anterior abdomen of the two abdominal muscles and the trajectory of the mandibular incisor point, were statistically analyzed.
Results: 1) of the 263 students, 89 (male 44, female 45, 19.53 + 1.13 years old) had partial chewing habits, the incidence rate was 33.84%, the difference of gender detection rate was not statistically significant.2). There was no difference between the same sex masseter muscle in the bilateral masticatory group and the asymmetric index of the anterior abdomen of two abdominal muscles, and the difference of the side masticatory group was different. There was a significant difference in the asymmetric index of the masseter muscle activity in the chewing exercise (P < 0.01). There was no significant difference in the average EMG peak (Amp) difference between the two masticatory groups in bilateral mastication group and the average EMG peak (Amp) in the anterior abdomen of the abdominal muscles. There was a significant difference in the average electromyography peak of the left two ventral muscles in the lateral masticatory group (P < 0.01). 3) the asymmetry index of the masseter movement in the mandibular position was higher than that in the bilateral masticatory group (P0.05), the postural position of the mandible, and the symmetry of the anterior abdominal motion of the two abdominal muscles in the masticatory movement was lower than that of the bilateral mastication group (P0.05). The average peak of the muscle electromyography in the partial mastication group was lower than that of the bilateral mastication group (LDA), and the peak value of the EMG was lower than that of bilateral mastication. Group (P < 0.05), the average EMG peak of LMM in masticatory exercise was lower than that of bilateral chewing group (P < 0.05).4). Most of the opening and closing trajectories of the lateral masticatory group were separated, the opening type and opening time were statistically significant (P0.05) compared with the bilateral masticatory group (P0.05); the shape of the mandibular incisor movement was not smooth and the opening phase in the chewing movement. The difference between the opening time and the bilateral masticatory group was statistically significant (P0.05). There was a significant difference between the occlusion and the bilateral masticatory groups (P0.05).5). The mandibular position in the bilateral masticatory group, the maximum closure movement and the chewing movement of the mandibular point movement. There was no statistical significance in the difference of trajectory parameters. There was significant difference in horizontal displacement between the masticatory groups in the lateral mastication group (P0.05).6) the vertical displacement and sagittal displacement of the lateral masticatory group were significantly lower than that in the bilateral masticatory group (P0.01), the left displacement of masticatory movement was lower than that of the bilateral masticatory group (P0.05); The front and back displacement of chewing group was higher than that of bilateral masticatory group (P0.05).7) the masseter muscle Amp and maximum closure velocity were significantly correlated with the maximum closure velocity in the chewing group of bilateral chewing group. The anterior ventral Amp in the left two abdominal muscles and the maximum closing velocity, the front and back displacement showed significant positive correlation, and the A in the masseter muscle during the large mouth movement. There was a significant positive correlation between MP and the right azimuth movement. The Amp of the left masseter muscle was positively correlated with the maximum closure velocity, vertical displacement, horizontal displacement and sagittal displacement in the masticatory movement.
Conclusion: 1) the detection rate of lateral mastication is 33.84%, there is no significant difference in the detection rate of different sex.2) the lateral masticatory position in the mandibular position, the asymmetry of the masseter movement in the large mouth movement and masticatory movement, the mandibular position, the asymmetric.3 in the anterior belly of the two abdominal muscles in the masticatory movement, and the lateral masticatory group LDA, RDA, LMM level The peak of average EMG decreased.4) the trajectory shape curve of the masticatory movement in the lateral masticatory group was relatively disordered, and the opening and closing phase was also concentrated on one side. The closure phase of the proximal tooth tip in 67% of the population was concave, the opening time shortened; the open opening pattern in the large opening movement was biased toward the working side, the opening orbit of the 50% population was separated and the opening decreased.5). In the lateral masticatory group, the Amp and the right orientation of the masseter muscle were moved. There was a positive correlation between the left masseter Amp and the vertical displacement, the horizontal displacement and the sagittal displacement in the masticatory movement, which indicated that the lateral mastication resulted in the change of the muscle performance and the abnormal movement track.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R782.6

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