肯氏Ⅰ、Ⅱ类牙列缺损患者RPD修复前后下颌运动的临床研究
Clinical Study of Mandibular Movement Pre and Post RPD Treatment among Subjects with Dentition Defects of KennedyⅠorⅡ
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摘要: [摘要]目的 为可摘局部义齿(removable partial denture, RPD)疗效评价寻找一种参考依据.方法 根据患者有无RPD修复史分为Ⅰ、Ⅱ2组,Ⅰ组患者从未行RPD修复.采用SAM下颌运动轨迹仪和肌电仪同步检测RPD修复前后患者下颌运动轨迹,双侧咬肌及颞肌前束表面肌电;分光光度计检测患者咀嚼效率.结果 RPD修复6月后:(1)患者咀嚼环形态规整,幅度增大,Ⅰ组冠状面咀嚼环宽度由(0.73±0.34)mm增至(2.58±1.01 )mm(P<0.05);(2)下颌边缘运动时,轨迹规律性提高,Ⅱ组最大开口轨迹范围由(31.51±6.37)mm增至(61.95±12.42)mm,前伸运动由(4.22±2.85)mm增至(8.38±1.13)mm(P<0.05);(3)咀嚼肌肌电周期改善;(4)咀嚼效率提高(P<0.05).结论 下颌运动轨迹和咀嚼肌EMG可作为RPD疗效评价的参考依据.Abstract: [Abstract]Objective To provide an objective reference to evaluate the efficacy of the RPD restoration. Methods According to the RPD restored history, patients were divided into 2 groups:groupⅠand groupⅡ.Patients in groupⅠhad never restored their missing teeth before.The SAM axioquick recorder was used to record mandibular motion track and rang pre and post RPD treatment. Simultaneously,we recorded the surficial myoelectricity of bilateral masseter and temporalis. At last,we measured one minute masticatory efficiency of each subject by light absorption method.Results(1)The range of chewing movement increased 6 months after RPD treatment,the incisal path showed a good regularity and repeatability in the frontal plane. The width of chewing ring increased from(0.73±0.34)mm to(2.58±1.01)mm(P<0.05)in group Ⅰ. (2)During border movement,the motion track showed a better smoothness,repetitiveness than previous. The range of opening increased from(31.51±6.37)mm to(61.95±12.42)mm while protrusion increasing from(4.22±2.85)mm to 8.38±1.13mm(P<0.05) among the subjects with restorative history. (3)All cases' abnormal EMG activity were relieved, while the coordination improving. (4)Two groups' chewing efficiency were improved obviously(P<<0.05). Conclusion Clinical application of mandibular trajectory and EMG of masticatory muscle can provide an objective reference to evaluate the efficacy of the RPD restoration.
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