하악운동시 Occlusal Splint의 설계가 교근활성도에 미치는 영향에 관한 근전도학적 연구

Abstract

[한글]

현재 치과임상에서 교합병 (occlusal disease)치료에 occlusal splint가 많이 이용되고 있는바, 상용하는 설계에 따라 occlusal splint를 제작하여 장착시킨 후, 자연치아의 교합형태 및 splint의 교합형태, 그리고 장착기간에 따른 근신경반응을 비교 관찰하였다.

저자는 교합상태가 정상적인 23-26세의 남자대학생 30명을 대상으로 5명씩 6군으로 분류하여, 세 가지의 서로 다른 형태로 설계된 occlusal splint론 각각 장착시킨 후, 하악운동시 장착기간에 따라 전교근 및 후교근의 활성도를 2-channel 1510A Electromyograph(

Hewlett Packard사 제품)를 이용하여 측정 분석한 결과 다음과 같은 결론을 얻었다.

1. 모든 연구대상군에서 중심교합시에는 장착 3일후 근활성도가 감소하였으나, occlusal splint를 제거한 2주후에는 장착전과 유사한 근활성도를 나타냈다.

2. 모든 연구대상군에서 연하시 및 하악안정위에서는 occlusal splint를 장착전과 장학시 및 제거후에 근활성도의 차이가 거의 없었다.

3. 모든 연구대상군에서 하악의 각 운동간에는 근활성도의 차이를 나타냈다. 즉, 근활성도는 중심교합에서 가장 높았고, 우측측방운동, 좌측측방운동, 연하작용시, 하악안정위 순으로나타났으며, colusal splint를 장착시 및 계거후에도 이 순위는 동일하였다.

4. 전 치아를 피개하고 cuspid-protected occlusion인 splint를 장착한 Ⅰ군과 Ⅳ군에서는 중심교합시 장착 3일후 근활성도의 감소를 보였으나, 다른 하악운동시에는 장착전과 비교하여 근활성도의 차이가 없었다.

5. 6전치를 피개하고 anterior group function인 splint를 장착한 Ⅱ군과 Ⅴ군에서는 중심교합시 장착3일후, 다른 군에 비하여 근활성도의 현저한 감소를 나타냈다.

6. 자연치아의 교합형태가 partial group function이며, 전치아를 피개하고 group function인 splint를 장착한 Ⅲ군에서는 좌, 우측측방운동시 장착3일후에 근활성도의 현저한 증가를 보였다.

7. 자연치아의 교합형태가 group functien이며, 전 치아를 피개하고 group function인 splint를 장착한 Ⅵ군에서는 중심교합시 장착3일후 근활성도의 감소를 보였으나, 다른하악운동시에는 장착전과 비교하여 근활성도외 차이가 없었다.

[영문]

The effectiveness of occlusal splints huts been related to the avoidance of the disturbing input of coolusal interference on the neuromuscluar mechanism of the masticatory system. The purpose of this study was to investigate the influence of on occlusal splint on masseter muscle resulted by the different splint design.

The electromygams were made on 30 male college students aged 23 to 26 years with normal occlusion for six mandibular movenments and those subjects were devided into six groups by the occlusal pattern in natural dentition, the extent of tooth coverage and the occlusal pattern in splint.

The electromyographic studies were carried out with 2-channel 1510A Electromyograph(Hewlett Packard Co.) and the periods of observation were: before wear : 3 days, 2 weeks, 4 weeks after wear : and 3 days, 2 weeks after removal of the occlusal splint.

The recordings were subjected to statistical analysis to determine the mean, the standard error and the significant difference.

The following results were obtained;

1. In all groups, the activities of masseter muscle were reduced after 3 days with splint, but there was no significant difference in 2 weeks after removal during biting into centric occlusion.

2. In all groups, there was no significant difference of the masseter muscle activities during swallowing and rest position before wear, in wear and after removal of the splint.

3. In all groups, there was no significant difference of the masseter muscle activities between the other movements. The masseter muscle activities skewed the highest level during biting into centric occlusion and next is right lateral excursion, left lateral excursion. swallowing, rest position, respectively and

appeared the same order in wear, after removal of the splint.

4. In group Ⅰ and Ⅳ, the activities of masseter muscle were reduced after 3 days with splint during biting into centric occlusion, but there was no significant difference during the other movements.

5. In group Ⅱ and Ⅴ, the activities of masseter muscle were reduced significantly compared with the other groups after 3 days with splint during biting into centric occlusion.

6. In group Ⅲ, the activities of masseter muscle were increased significantly after 3 days with splint during right and left lateral excursions.

7. In group Ⅵ, the activities of masseter muscle were reduced after 3 days with splint during biting into centric occlusion, but there was no significant difference during the other movements.