Функціональна активність власне жувальних м’язів при інтактних зубних рядах, а також при дефектах і деформаціях зубних рядів

Abstract

У статті представлені результати досліджень функціональної активності власне жувальних м’язів у пацієнтів з інтактними зубними рядами, а також які мають дефекти і деформації зубних рядів. Усього обстежено 324 пацієнта. Вивчений ступінь функціональних порушень і вплив різних ортопедичних конструкцій на процес перебудови зубних рядів. Це дало змогу обґрунтувати клінічні підходи до вибору плану лікування хворих із вторинними деформаціями зубних рядів. В статье представлены результаты исследований функциональной активности собственно жевательных мышцу пациентов с интактными зубными рядами, а также имеющих дефекты и деформации зубных рядов. Всего обследовано 324 пациента. Изучена степень функциональных нарушений и влияние различных ортопедических конструкций на процесс перестройки зубных рядов. Это позволило обосновать клинические подходы к выбору плана лечения больных с вторичными деформациями зубных рядов. The research findings of the masticatory muscles functional activity in patients with intact dentitions as well as defects and deformations of dentitions were presented in the article. The comprehensive examination was carried out to achieve the aim of investigation. The examination group included 324 patients with intact dentitions (control group), and loss of teeth, as well as various forms of dentition deformation, aged from 21 to 40 years without pathological changes of periodontium. To reveal disorders of functional activity of the masticatory muscles in case of dentition defects and deformations, the examination of the control group patients with intact dentitions was carried out. While analysing the electromyograms it was determined: 1) amplitude in pV; 2) activity time (AT); 3) time of rest (RT); 4) ratio AT / RT. The asymmetry of masticatory muscles activity was observed when recording EMG, that indicated serious disorders of the masticatory apparatus functioning. The degree of functional disorders and the effect of different prostheses on adjustment process of dentitions have been studied. The research findings enabled to substantiate the clinical approaches to the choice of the treatment plan of patients with secondary deformities of dentition. The quantitative and statistical assessment of EMG has determined that mastication of 1 cm3 of bread (functional test) by intact dentitions is characterized by eaqual distribution of activity time and rest time in one dynamic cycle on the average: 0.32 and 0.36 seconds (activity coefficient - K= 0.89). The number of masticatory movements was within 30 in 1 functional test. Analysis of EMG records in case of spontaneous mastication enabled to determine certain qualitative changes, namely, clear division of the record structure, that is, the change of excitation periods with the periods of relative bioelectrical rest. Excitation power was growing up to the middle of the activity peak, gradually approaching its end. The mastication process involved masticatory muscles of both sides without pronounced functional asymmetry. The research data provided the criterion for comparative evaluation of masticatory muscles in various pathological conditions - defects of dentition and its deformations). In case of dentition deficiency, the number of mastication movements was increased by 14.1%, the duration of mastication period - by 11.8%. The functional studies of hemodynamics with 3 degrees of dentition deformation have been conducted by the authors. The electromyographic study has determined that the number of mastication movements was increased in general in 1.5-2 times. The increase of deformation degree provided their greatest number. The time of bioelectric activity has increased by 0.07-0.10 seconds compared with intact dentitions. The asymmetry in functional activity of the masticatory and temporal muscles has occured. Consequently, the electromyographic study of masticatory muscles has determined that the loss of teeth and dentition deformation caused the disorder in synchronicity of theirfunctioning and the time for mastication process was increased. All these changes are compensatory-adaptive in the masticatory apparatus functioning in case of structural disorders.