보튤리늄 A형 독소주사와 교합안정장치 치료에 의한 교근부 안모 변화

Abstract

The purpose of this study is to determine the effect of Botulinum Toxin Type A(BTX A) on bilateral masseter muscle evaluated with Frontal Cephalogram This study was performed on 4H participants, 22 men and 26 women, in the age range of 21 to 35 years with a mean of 25.7years. dental students of Yonsei University and the staff of Yonsei Dental Hospital. Among 4H participants, one subject weren't able to finish the Frontal Cephalogram Measurements through out this study, instead, 47 participants were the final subject to finish their measurements in 6weeks and 12weeks after the BTX-A injection. The participants were subdivided into G Groups- Saline Injection Control Group(A), Bilateral BTX A 25U Injection Group(B), Bilateral BTX A 35U Injection Group(C), Occlusal Biteplane Splint Control Group(D), Bilateral BTX A 25U Injection with Occlusal Biteplane Splint Group(E) and Bilateral BTX A 35U Injection with Occlusal Biteplane Splint Group(F). All the subjects were injected at the most hyperactive area in lower 1/3 of masseteric muscle which were divided into three sections. Frontal Cephalogram measurements of the thickness of the masseteric muscle were performed before BTX A injection and (6 weeks and 12 weeks after the injection. Masseteric muscle measurements were all made at the lower 1/4 position(I, Injection point) of perpendicular line between antegonial notch and top of condyle head divided into four parts in Frontal Cephalogral11. In Occlusal Biteplane Splint Group, the splint was taken off when the X -ray were shot, and all the factors were analyzed with Manova test. The results are summarized as follows: 1. There was no significant differences for the thickness of soft tissue in massetric muscle in Saline Injection Control Group(A) and Occlusal Biteplane Splint Control Group(D) Statistical significance was observed in most of the groups except right site of BTX-A 25U Injection with Occlusal Biteplane Splint Group(E). 2. The Statistical significance for the thickness of soft tissue in massetric muscle was not observed between the group of Occlusal Biteplane Splint Therapy and the group of Non occlusal Biteplane Therapy. 3. The thickness of soft tissue in massetelic muscle was not significantly affected between the Bilateral BTX A 25U Injection Group(B) and Bilateral BTX -A 35U Injection Group(C) 4. Statistical significance was observed between Bilateral BTX-A 25U Injection with Occlusal Biteplane Splint Group(E) and Bilateral BTX - A 35U Injection with Occlusal Biteplane Splint Group(F)(p<0.05). Based on the results stated above. after the injection of BTX -A. the reduction of soft tissue was observed in most of the groups. Dosage of BTX -A induced different result in the group of Occlusal Biteplane Splint Therapy and Non -occlusal Biteplane Splint Therapy, so it was suggested that Occlusal Biteplane Splint amplified the effect of BTX - A. In this study, it was analyzed that BTX -A and Occlusal Biteplane Splint had an effect on reduction of masseteric soft tissue and in the future study the effect of various dosage of BTX - A. the effect of injection site and the effect of BTX - A correlated with bite habit of patient should be researched