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目的分析牙周非手术治疗对广泛型侵袭性牙周炎(generalized aggressive periodontitis,GAgP)患者咀嚼肌功能的影响。方法选择2013年6月至2014年12月在中国医科大学口腔医学院·附属口腔医院牙周科门诊经锥形束CT(CBCT)扫描并诊断为GAgP患者30例。根据牙槽骨高度(AB)与牙齿高度(AC)的比值(AB/AC),将患者分为A组(15例,AB/AC≥50%)和B组(15例,AB/AC<50%)。检测患者牙周探诊深度(probing depth,PD)和临床附着丧失(clinical attachment loss,CAL)。采用Bio EMGⅡ表面肌电仪对牙周非手术治疗前和治疗后GAgP患者咀嚼肌肌电值进行测量,对患者牙周炎症程度与咬肌束在下颌牙尖交错(intercuspal position,ICP)最大紧咬位时肌电值进行相关性分析,并比较牙周非手术治疗前后颞肌前束和咬肌肌电值变化。结果在ICP最大紧咬位时,A组患者的咬肌肌电值[(69.22±22.33)μV]大于B组患者的咬肌肌电值[(35.31±13.15)μV],两组差异有统计学意义(P<0.05)。GAgP患者的咬肌肌电值与后牙区牙齿AB/AC的值呈正相关(r=0.731,P=0.002)。GAgP患者经牙周非手术治疗后,ICP最大紧咬位时咬肌和颞肌前束的肌电值均发生显著变化,与治疗前比较差异均有统计学意义(均P<0.05)。结论 GAgP患者牙槽骨丧失越多,其咀嚼肌功能越差;牙周非手术治疗可有效提高GAgP患者咀嚼肌功能。
Objective To analyze the effect of periodontal non-surgical treatment on masticatory muscle function in patients with generalized aggressive periodontitis (GAgP). Methods From June 2013 to December 2014, 30 patients with GAgP were diagnosed by cone beam CT (CBCT) at the periodontal clinic of Stomatology Hospital Affiliated Stomatology Hospital of China Medical University from June 2013 to December 2014. The patients were divided into group A (15 cases, AB / AC≥50%) and group B (15 cases, AB / AC < 50%). The patient’s probing depth (PD) and clinical attachment loss (CAL) were detected. The EMG Ⅱ surface EMG instrument was used to measure the EMG of masticatory muscles in GAgP patients before and after periodontal non-surgical treatment. The extent of periodontal inflammation and the maximal tightness of masseter muscle bundles in intercuspal position (ICP) Biting position EMG correlation analysis, and compare non-surgical periodontal before and after the anterior fascia and masseter muscle EMG changes. Results The masseter muscle EMG in group A was significantly higher than that in group B [(35.31 ± 13.15) μV], the difference was statistically significant Significance (P <0.05). The masseter muscle EMG of GAgP patients was positively correlated with AB / AC of teeth in the posterior teeth (r = 0.731, P = 0.002). After periodontal nonsurgical treatment, the myoelectric changes of masseter and anterior temporalis muscle of GAgP patients with significant maxillary clenching position were significantly different (all P <0.05). Conclusions The more alveolar bone lost in GAgP patients, the worse the masticatory muscle function. Periodontal non-surgical treatment can effectively improve the masticatory muscle function in patients with GAgP.