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악관절원판장애 환자에서 교합안정장치 치료후의 저작계 기능개선에 관한 연구

Issue Date
1997
Description
치의학과/박사
Abstract
[한글] 악관절원판장애 환자에서 교합안정장치요법에 의한 보존적 치료후의 저작계 기능의 개선정도와 환자 개개인의 특성과의 관련성을 알아보기 위하여 복원성 관절원판변위군 25명과 비복원성 관절원판변위군 25명을 대상으로 치료전과 치료후에 Mandibular Kinesiograph와 EMG를 이용하여 하악의 개폐구운동, 연하운동, 연하 및 저작운동시의 운동량과 운동경로, 속도 및 측두근, 교근의 근활성도를 측정하여 비교분석하고 치료전 검사항목과의 상관관계를 조사하여 다음과 같은 결과를 얻었다. 1. 최대개폐구운동검사에서 복원성 관절원판변위군에서는 최대개구량(p<0.01), 절치간 거리(p<0.05), 개구속도(p<0.01)가 증가했고, 비복원성 관절원판변위군에서는 최대개구량(p<0.01), 개폐구속도(p<0.01), 치아접촉시의 속도(p<0.05)가 증가했다. 2. 저작운동검사에서는 복원성, 비복원성 절원판면위군 모두 저작시의 개구량이 증가했고(p<0.01), 저작형태도 정상군과 유사해졌다. 3. 전측두근과 교근의 근활성도검사에서는 안정위, empty clenching, cotton roll clenching에서 치료후 근활성도가 감소했다(p<0.05). 4. 관절잡음의 지속기간, 교합접촉점의 수, 동통의 강도와 지속기간, 이갈이의 유무가 치료후 하악운동의 개선과 상관관계가 있었다(p<0.05). 5. 관절잡음의 지속기간, 교합접촉점의 수, 부하검사결과, 동통의 강도와 지속기간, 이갈이의 유무가 치료후 저작근 근활성도의 감소와 상관관계가 있었다(p<0.05). 결론적으로 악관절원판장애 환자에서 교합안정장치에 의한 치료후에 하악의 운동량이 증가하였고, 저작근의 근활성도가 감소하여 저작계의 기능이 개선되었으며, 치료전의 객관적인 검사항목들이 치료후 하악운동의 개선과 저작근 근활성도의 감소에 영향을 주었음을 알 수있었다.
[영문] This study was performed to evaluate the effectiveness of occlusal bite plane splint in 50 patients with disc derangement disorder. The mandibular kinesiographic and electromyographic measurements before and after treatments were recorded, and the differences were analyzed by different patient groups(disc displacement with reduction and disc displacement without reduction). The relationship between these differences and individual characteristics were compared. The results were as follows: 1. In maximum open-close cycle after treatment, the amount of maximum mouth opening(p<0.01), interincisal distance(p<0.05), and opening velocity(p<0.01) was increased within the disc displacement with reduction The amount of maximal mouth opening(p<0.01), open-closing velocity(p<0.01), and tooth contact velocity(p<0.05) was increased in the patient group with disc displacement without reduction 2. In the chewing cycle after treatment, the amount of mouth opening was increased within both the disc displacement with and without reduction(p<0.01). The chewing pattern was changed similar to normal. 3. After treatment, the difference of temporalis and masseteric muscle activities was significant in resting, empty clenching and cotton roll clenching(p<0.05) after treatment. 4. The improvement of mandibular movement after treatment had a correlationship with the duration of clicking sound, numbers of occlusal contact in maximum intercuspation, intensity and duration of pain, and existence of bruxism(p<0.05). 5. The decrease of EMG activity on the temporalis and masseteric muscles had a correlationship with the duration of clicking sound, numbers of occlusal contact in maximum intercuspation, results of loading test, intensity and duration of pain, and the existence of bruxism(p<0.05). In conclusion, the masticatory function after treatment with occlusal bite plane splint in 50 patients with temporomandibular joint disc derangement disorder was improved and individual characteristics had an effect on the improvements by occlusal bite plane splint therapy.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/125558
Appears in Collections:
2. 학위논문 > 2. College of Dentistry (치과대학) > 박사
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