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[국내논문] 구강악습관이 저작근 및 안면표정근의 경직도 및 탄성도에 미치는 영향
Effects of Oral Parafunction on the Stiffness and Elasticity in the Muscles of the Mastication and Facial Expression 원문보기

대한구강내과학회지 = Korean journal of oral medicine, v.33 no.1 = no.70, 2008년, pp.85 - 95  

김승기 (단국대학교 치과대학 구강내과학교실) ,  김미은 (단국대학교 치과대학 구강내과학교실) ,  김기석 (단국대학교 치과대학 구강내과학교실)

초록
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구강안면통증의 주원인의 하나인 측두하악장애는 다양한 기여요인에 의해 발생하거나 악화되는데, 특히 이갈이, 이악물기 등의 비기능적 구강악습관은 중요한 기여요인으로 고려된다. 구강악습관과 저작근의 관련성에 대해서는 근전도 등을 이용한 연구가 이루어져왔으나, 안면표정근에 미치는 영향에 대해서는 연구된 바가 거의 없다. 그러므로 본 연구는 근육의 탄성도과 경직도를 정량적으로 평가할 수 있는 촉각센서(tactile sensor)를 이용하여 구강악습관이 저작근과 안면표정근에 미치는 영향을 평가하고자 하였다. 건강하고 건전한 치열을 가지고 있으며 Class I 교합관계의 정상골격인 지원자10명(20대 남성)을 연구대상으로 선택하여 촉각센서(Venustron II, Axiom Co, 일본)를 이용하여 이완 상태와 편측 이악물기(피검자가 선호하는 측의 제1대구치 부위에서 교합측정기를 50Kg force의 힘으로 깨문 상태), 턱내밀기(전치 상하절단연이 만나는 위치까지 턱을 내민 상태), 입술힘주기(치아는 닿지 않는 상태에서 입술만 꼭 다문 상태) 상태에서 저작근과 안면표정근의 경직도와 탄성도를 측정하였다. 측정근육은 측두근 전부, 교근(이상 저작근), 전두근, 하안륜근, 대관골근, 상 하 구륜근, 이근(이상 안면표정근)이었다. 통계처리를 위해 paired t-test, correlation coefficients, ANOVA 및 multiple comparison t-tests을 사용하였다. 편측 이악물기를 할 때 측정한 모든 근육에서 경직도와 탄성도는 좌우 차이를 보이지 않고 높은 상관관계를 보였다. 교근은 편측 이악물기 뿐만 아니라 턱내밀기, 입술힘주기의 시행된 모든 구강악습관에 의해 경직도가 증가하고 탄성도는 감소하였다(p<0.05). 측두근과 대관골근은 편측 이악물기의 영향을 받았으며, 상 하구륜근 및 이근의 경직도와 탄성도는 입술힘주기에 의해 크게 변화하였다(p<0.05). 본 연구의 결과는 편측 이악물기, 턱내밀기, 입술힘주기 같은 구강악습관은 저작근뿐만 아니라 안면표정근, 특히 구강주위근육에도 영향을 준다는 것을 보여준다.

Abstract AI-Helper 아이콘AI-Helper

The purpose of this study was to evaluate the effects of oral habits on the muscles of mastication and facial expression by means of two parameters: muscle stiffness and elasticity. 10 healthy, fully-dentate male subjects in their twenties were selected for this study; all had normal Class I occlusa...

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제안 방법

  • The purpose of this study was to evaluate the effects of oral habits on the muscles of mastication and facial expression by means of two parameters: muscle stiffness and elasticity.
  • To minimize the influence on muscle condition to be evaluated, the exclusion criteria included followings; those with malocclusion including bimaxillary protrusion, anterior open bite and anterior deep bite, TMD, missing teeth (except wisdom teeth) or extensive bridge-work (≥ 3-unit bridge-work), and serious dental caries and periodontal diseases.
  • Oral habits experimentally performed were clenching, jaw thrust and lip bracing habits. In order to maintain a constant clenching force exerted during measuring the muscles, all the subjects were asked to clench with a force of 50 kg while clenching a bite force recorder placed on between the first molars on their preferred sides, which was defined as unilateral clenching in this study. The bite force recorder used had biting portion with a width of 20 mm and a thickness of 4 mm.
  • The distance moved by the sensor probefor each muscle was determined separately in regards with the thickness of muscle and relation with adjacent structures; 8 mm for Mm and Zm, 5 mm for OOrs and OOri, and 3 mm for the rest. The examinations were performed bilaterally for each muscle. Fig 2-1 and 2-2 shows hysteresis curves from the muscle measurement with the tactile sensor.
  • Each measurement per muscle was performed two times and their average values were collected for data analyses. An interval of 3 min was given for each examination and rest period of 30 min was also given before performing each oral habit in order to minimize muscle tiredness.
  • A hysteresis curve composed of two parts, which are formed when the sensor pushes down(bottom) and then retracts(top),6) was obtained through each examination against the two masticatory and six different facial expression muscles while oral habit was performing (Fig 2-1,2). The slope of the tangent of the hysteresis curve (∆f/∆x) is defined as stiffness of the muscle being measured and the distance between the two parts as its elasticity.
  • To the best of our knowledge, as there existed very few studies concerning a relation of oral habit with facial expression muscles, this study aimed to investigate effects of oral habits on the facial expression muscles as well as the masticatory muscles using two parameters of muscle stiffness and elasticity with a tactile sensor.
  • There were several methodological aspects to be concerned in this study. The first problem was to identify the facial expression muscles to be measured. Previous studies on facial musculature with EMG8,25) demonstrated the high inter- and intra-individual variability in location and morphology of the individual muscles, as well as in the overlying soft tissue.
  • 8,26) In this regard, it is thought that the tactile sensor will be a simple and easy way to evaluate the specific facial muscle in clinical setting. Specific measuring sites for facial expression muscles tested in this study were determined based on the anatomical knowledge from textbook and previous EMG studies. To lessen individual's variability, all the subjects in this study were selected from healthy young male in their twenties.

대상 데이터

  • 10 healthy, fully-dentate men in their twenties (mean age of 23.4±2.0 years) were voluntarily selected for this study.
  • To lessen individual's variability, all the subjects in this study were selected from healthy young male in their twenties.

데이터처리

  • The values indicating stiffness and elasticity of each muscle in varied oral condition was obtained from its hysteresis curve and their mean values from the two examinations were compared. The values obtained from unilateral clenching were compared between the clenching and non-clenching sides of the jaw by paired t-tests and their correlation coefficients were investigated. One-way ANOVA was also used to determine the influence of oral habits on the masticatory and facial muscles.
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참고문헌 (30)

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  9. Nozomi T, Toshimichi I, Kazunori Y. Electromyographic activity of lower lip muscles when chewing with the lips in contact and apart. Angle Orthod 2004;74:31-36 

  10. Jacinto-Goncalves SR, Gaviao MB, Berzin F, de Oliveira AS, Semeguini TA. Electro-myographic activity of perioral muscle in breastfed and nonbreastfed children. J Clin Pediatr Dent 2004;29:57-62 

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