[국내논문]저작근통 환자에서 저작근 및 안면표정근의 경도와 탄성도 평가 Stiffness and Elasticity of the Masticatory and Facial Expression Muscles in Patients with the Masticatory Muscle Pain원문보기
저작근장애 환자의 근육 평가를 위해 촉진과 압력통각역치가 주로 이용되어 왔으나, 본 연구는 근육의 경도와 탄성도을 정량적으로 측정할 수 있는 촉각센서를 이용하여 저작근을 평가하고, 저작근장애가 안면표정근에 영향을 미칠 수 있는지 조사하고자 하였다. 연구 대상은 단국대학교 치과병원 구강내과를 내원한 환자 중 편측 교근에 통증과 압통이 있는 저작근장애 환자 27명으로서 평균연령 $36.4{\pm}13.8$세였다. 근통 외에 턱관절의 이상이나 다른 통증 질환을 함께 가진 환자는 제외하였다. 촉각센서는 Venustron(Axiom Co., JAPAN)을 사용하여 전측두근, 교근, 전두근, 하안륜근, 대관골근, 상하구륜근, 이근에 대한 경도와 탄성도를 측정하였다. 이환측과 비이환측의 근육 경도와 탄성도를 비교하였으며 진단에 따라 국소근동통군과 근막동통군으로 분류하여 비교하였고, 6개월을 기준으로 급성군과 만성군으로 나누어 비교하였다. 편측 저작근장애가 있는 환자의 이환측과 비이환측을 비교했을 때 이환측의 교근과 대관골근에서 근육 경도가 유의성 있게 증가하였고 탄성도는 유의성 있게 감소하였다(p<0.05). 급성군과 만성군, 국소근동통군과 근막동통군 사이에는 유의한 차이없이 이환측 교근과 대관골근에서 경도가 증가하고 탄성도는 감소하였다. 이상의 결과는 교근에 발생한 저작근통은 교근 뿐아니라 안면표정근인 대관골근의 탄성도과 경도에도 영향을 줄 수 있음을 보여준다.
저작근장애 환자의 근육 평가를 위해 촉진과 압력통각역치가 주로 이용되어 왔으나, 본 연구는 근육의 경도와 탄성도을 정량적으로 측정할 수 있는 촉각센서를 이용하여 저작근을 평가하고, 저작근장애가 안면표정근에 영향을 미칠 수 있는지 조사하고자 하였다. 연구 대상은 단국대학교 치과병원 구강내과를 내원한 환자 중 편측 교근에 통증과 압통이 있는 저작근장애 환자 27명으로서 평균연령 $36.4{\pm}13.8$세였다. 근통 외에 턱관절의 이상이나 다른 통증 질환을 함께 가진 환자는 제외하였다. 촉각센서는 Venustron(Axiom Co., JAPAN)을 사용하여 전측두근, 교근, 전두근, 하안륜근, 대관골근, 상하구륜근, 이근에 대한 경도와 탄성도를 측정하였다. 이환측과 비이환측의 근육 경도와 탄성도를 비교하였으며 진단에 따라 국소근동통군과 근막동통군으로 분류하여 비교하였고, 6개월을 기준으로 급성군과 만성군으로 나누어 비교하였다. 편측 저작근장애가 있는 환자의 이환측과 비이환측을 비교했을 때 이환측의 교근과 대관골근에서 근육 경도가 유의성 있게 증가하였고 탄성도는 유의성 있게 감소하였다(p<0.05). 급성군과 만성군, 국소근동통군과 근막동통군 사이에는 유의한 차이없이 이환측 교근과 대관골근에서 경도가 증가하고 탄성도는 감소하였다. 이상의 결과는 교근에 발생한 저작근통은 교근 뿐아니라 안면표정근인 대관골근의 탄성도과 경도에도 영향을 줄 수 있음을 보여준다.
This study aimed to assess stiffness and elasticity of the masticatory muscle in the patients with the masticatory muscle pain using a tactile sensor and to investigate whether the masticatory muscle pain affects the facial expression muscles. From those who visited Department of Oral Medicine in Da...
This study aimed to assess stiffness and elasticity of the masticatory muscle in the patients with the masticatory muscle pain using a tactile sensor and to investigate whether the masticatory muscle pain affects the facial expression muscles. From those who visited Department of Oral Medicine in Dankook University Dental Hospital, 27 patients presenting with unilateral muscle pain and tenderness in the masseter muscle (Ms) were selected (mean age: $36.4{\pm}13.8$ years). Exclusion criterion was those who also had temporomandibular joint (TMJ) disorders or any neurological pain. Muscle stiffness and elasticity for the muscles of mastication and facial expression was investigated with the tactile sensor (Venustron, Axiom Co., JAPAN) and the muscles measured were the Ms, anterior temporal muscle (Ta), frontalis (Fr), inferior orbicularis oculi (Ooci), zygomaticus major (Zm), superior and inferior orbicularis oris (Oors, Oori) and mentalis (Mn). t-tests was used to compare side difference in muscle stiffness and elasticity. Side differences were also compared between diagnostic groups (local muscle soreness (LMS) vs myofascial pain syndrome (MPS) and between acute (< 6M) and chronic ($\geq$ 6M) groups. This study showed that Ms and Zm at affected side exhibited significantly increased stiffness and decreased elasticity as compared to the unaffected side.(p<0.05) There was no significant difference between local muscle soreness and myofascial pain syndrome groups and between acute and chronic groups. The results of this study suggests that masticatory muscle pain in Ms can affect muscle stiffness and elasticity not only for Ms but also for Zm, the facial expression muscle.
This study aimed to assess stiffness and elasticity of the masticatory muscle in the patients with the masticatory muscle pain using a tactile sensor and to investigate whether the masticatory muscle pain affects the facial expression muscles. From those who visited Department of Oral Medicine in Dankook University Dental Hospital, 27 patients presenting with unilateral muscle pain and tenderness in the masseter muscle (Ms) were selected (mean age: $36.4{\pm}13.8$ years). Exclusion criterion was those who also had temporomandibular joint (TMJ) disorders or any neurological pain. Muscle stiffness and elasticity for the muscles of mastication and facial expression was investigated with the tactile sensor (Venustron, Axiom Co., JAPAN) and the muscles measured were the Ms, anterior temporal muscle (Ta), frontalis (Fr), inferior orbicularis oculi (Ooci), zygomaticus major (Zm), superior and inferior orbicularis oris (Oors, Oori) and mentalis (Mn). t-tests was used to compare side difference in muscle stiffness and elasticity. Side differences were also compared between diagnostic groups (local muscle soreness (LMS) vs myofascial pain syndrome (MPS) and between acute (< 6M) and chronic ($\geq$ 6M) groups. This study showed that Ms and Zm at affected side exhibited significantly increased stiffness and decreased elasticity as compared to the unaffected side.(p<0.05) There was no significant difference between local muscle soreness and myofascial pain syndrome groups and between acute and chronic groups. The results of this study suggests that masticatory muscle pain in Ms can affect muscle stiffness and elasticity not only for Ms but also for Zm, the facial expression muscle.
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문제 정의
There existed few studies concerning muscle evaluation with the parameters of muscle stiffness and elasticity in the patients with masticatory muscle pain. Therefore, the purposes of this study were to assess stiffness and elasticity of the masticatory muscles in the patients with the masticatory muscle pain using a tactile sensor and to investigate whether masticatory muscle pain affects the facial expression muscles.
제안 방법
All the subjects were divided into LMS group and MPS groups according to their diagnosis and acute(<6M) and chronic(≥ 6M) groups based on duration of their symptoms.
The distance moved by the sensor probe for each muscle was determined separately in regards with the thickness of muscle and relation with adjacent structures; 8mm for Ms and Zm, 5mm for Oors and Oori, and 3mm for the rest of them. The examinations were performed bilaterally for each muscle for comparison between affected and unaffected sides.
2. Diagram of masticatory and facial muscles examined for the study.
This study aimed to assess masticatory muscle in the patients with the masticatory muscle pain using by two parameters of the muscle stiffness and elasticity with a tactile sensor. Because of inaccessibility of a tactile sensor to the medial and lateral pterygoid muscles, the subjects in this study confined to those who had pain and tenderness in the Ms and some of them also had Ta pain.
대상 데이터
Of those who visited department of Oral Medicine in Dankook University Dental Hospital, 27 subjects with unilateral muscle pain and tenderness in the masseter muscle (Ms) were selected for this study. 7 of them also presented with pain and tenderness in the anterior temporal muscle (Ta).
성능/효과
This study showed that Ms and Zm exhibited significantly increased stiffness and decreased elasticity at the affected side compared with the unaffected side.(p<0.
From these studies, it is assumed that Zm is positively correlated with Ms, suggesting that clinicians’ attention needs to be paid to both the masticatory and facial expression muscles, although no significant side difference was found in other facial expression muscles in this study.
Kim et al23) investigated effects of oral parafunction on the stiffness and elasticity in the muscles of the mastication and facial expression and concluded that not only the masticatory muscles but also facial expression muscles could be considerably influenced by parafunctional activities such as unilateral clenching, jaw thrust and lip bracing. According to the results of their study, experimentally-induced unilateral clenching highly increased muscle stiffness of Ms, which resulted in significant difference as compared with relaxation and other parafunction including jaw thrusting and lip bracing. Zm also changed in a similar manner.
05) There was no significant difference between LMS and MPS and between acute and chronic groups. Based on the result of this study, it is assumed that masticatory muscle pain in Ms can affect muscle stiffness and elasticity not only for Ms but also for Zm, the facial expression muscle.
후속연구
Although some of the subjects reported oral habit such as clenching and bruxism in this study, a relation of muscle stiffness and elasticity with the oral habit was not assessed. A further study needs to be performed in order to evaluate a relation of the muscles of mastication and facial expression with severity of oral habit.
This finding may be partly due to small-sized sample in this study. A further study with a large population needs to be performed in the near future.
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