英國2007年1月；下頜前移式口腔矯治器對阻塞性睡眠窒息症患者
Volume 27 Issue 1 Page 47-53, January 2007 Clinical Physiology and Functional Imaging
The effect of mandibular advancement appliances on awake upper airway and masticatory muscle activity in patients with obstructive sleep apnoea
Ama Johal, Gulsharondip Gill, Anthony Ferman and Kieron McLaughlin
Oral Growth and Development, Institute of Dentistry, Bart's and The London Queen Mary's School of Medicine and Dentistry, University of London, London, UK
Abstract摘要
Background: There is little understanding of how dental appliances, designed to posture the mandible forwards, act on pharyngeal airway dilatory and masticatory muscles in patients with obstructive sleep apnoea (OSA). This study evaluates, in a prospective cohort design, the effect of mandibular advancement splints (MAS) on awake genioglossus (GG), geniohyoid (GH) and masseter (M) muscle activity.
Methods
Fifty OSA patients received a custom-made removable Herbst MAS appliance, adjusted for maximum therapeutic benefit, as judged by subjective improvement. Awake electromyographic (EMG) activity was recorded at baseline and with the MAS in situ, by using bipolar surface electrodes in patients seated upright and in the natural head position. The lower splint was modified to facilitate the placement of the intra-oral bipolar surface electrodes used to record GG EMG activity.
Results
Significant increases in GG (P = 0·041), GH (P<0·001) and M (P<0·001) muscle activity accompanied placement of the MAS.
Conclusions
These findings support the contention of a physiological role, which may act to augment the anatomical action of MAS.
英國2007年1月
下頜前移式口腔矯治器對阻塞性睡眠窒息症患者的意識到的上氣道和咀嚼肌肌電活性的影響
Abstract摘要
背景：學界目前幾乎不瞭解用來讓下頜前部擺出特定姿勢的口腔矯治器如何影響阻塞性睡眠窒息症患者的咽氣道和咀嚼肌。本研究以一項前瞻性世代設計評估下頜前置夾板(MAS)對意識到的頦舌肌、頦舌骨肌、咬肌的肌電活性有何影響。
Methods方法
為50位阻塞性睡眠窒息症患者裝上量身打造的可撤型Herbst（譯註：發明者名）下頜前移式矯治器；為了獲得最大療效，可視個人進步情況調整此矯治器。藉由使用雙極表面電極於挺直坐著且頭部姿勢自然的患者身上，記錄在基準線的、在裝有下頜前置夾板時的意識到的肌電活性。修改較下的夾板，以利定位用來記錄頦舌肌肌電活性的口內雙極表面電極。
Results結果
下頜前置夾板定位後，頦舌肌(P = 0·041)、頦舌骨肌(P<0·001)、咬肌(P<0·001)的肌電活性明顯增加。
Conclusions結論
這些發現支持認為下頜前置夾板在生理上有所作用的論點，此一在生理上的有所作用可能擴大下頜前置夾板在結構上的作用。