| Objective:By electrically detectig the mandibular movement trace and masticatory muscle surface of mild and moderate OSAHS ptients before and after mandibular advancement device treatment, the paper analyzes electrical chaneges in mandibular movement and masticatory muscle surface of patients before and after mandibular advancement device treatment, which provides objective reference and basis for identifying the influence of mandibular advancement device on stomatognathic system.Methods:Twenty OSAHS patients were selected as the subjects, who received mandibular advancement device treatment in Yan’an Hospital Affiliated to Kunming Medical University from Februrary 2014 to September 2015. Seventen of them were males and only three of them was female. Their age was between 25 and 29 and the average age was 45.10. SAM Mandibular movement kinesiograph was used to detect the tac-traceand range of mandible border movement, clicking teeth and masticatory movement of each patient before and after treatment. Movement locus features of processus condyloideus center on coronal plane,horizontal plane and sagittal plane, protracting condyle path inclination,lateral condyle path inclination on the non-working side of sagittal plane and Bennett angle on the non-working side of horizontal plane were detected. Myoelectric apparatus was used for synchronical detection of its masseter muscle and temporal anterior surface myoelectricity changes. SPSS 17.0 software package was used for self-paired t test of data.Results:1.The smoothness, symmetry, repeatability and congruency of point of tangency border movement traceof patients’ mandible were consistent six months before and after MAD treatment.2. Movement tracerange of the largest opening movement, protraction movement and left and right lateral movement of patients’ mandible point of tangency had no obvious changes. Changes had no statistical significance. (P> 0.05)3. Tracerange of patients’mandible point of tangency in bilateral chewing movement changed little six months before and after MAD treatment. The smoothness, continuity, repeatability and regularity of traceimages of coronary plane before and after the treatment were consistent. Before the treatment, the width of chewing ring of patients’ coronary plane was 4.09±1.20mm, but it became 4.14±1.24mm after the treatment. Changes had no statistical significance. (P>0.05)4. The repeatability of derailment and injection curves at the largest opening movement of mandibular condyle center was good six months before and after MAD treatment. Degree of separation of derailment and injection curves on the sigittal plane was consistent before and after the treatment. The movement direction was stable. Trace on coronal plane, horizontal plane and sagittal plane was smooth, which changes had no statistical significance before and after the treatment. The movement trace of mandibular condyle center in lateral movement and protrating movement was roughly symmetrical. The smoothness and repeatability of the curve were good. Its form, smoothness and repeatability six months before and after MAD treatment were consistent.5. Patients’ protracting condyle path inclination, lateral condyle path inclination on the non-working side of sagittal plane and Bennett angle changed little six months before and after MAD treatment. Changes had no statistical significance (P>0.05).6. The regularity of activity period of temporal anterior and masseter myoelectricity in border movement and chewing movement six months before and after MAD treatment was consistent. The coordination of lateral masseter and temporalis was consistent. The symmetry of bilateral homonymous muscle was consistent.7. Amplitude value of bilateral temporal anterior and masseter myoelectricity in border movement and chewing movement of patients’ mandible six months before and after MAD treatment changed little. Changes had no statistical significance (P> 0.05).Conclusion(s):1.Compared with pre-treatment, point of tangency border movement of mandible, tongue movement, chewing cycle kinematics and processus condyloideus centrode had consistent smoothness, regularity and repeatability six months after MAD treatment of mild and moderate OSAHS patients. Its trace range changes had no statistical significance (P>0.05) before and after the treatment. This shows that wearing of MAD had no obvious effects on patients’mandibular movement function.2.Form of mastication ring of the point of tangency of mandible, masticatory muscle EMG regularity and coordination six months after MAD treatment of mild and moderate OSAHS patients were consisitent with pre-treatment. Bilateral temporal anterior and masseter myoelectricity range value had no statistical change (P>0.05) before and after the treatment. This shows that wearing of MAD had no obvious effects on patients’masticatory muscle myoelectricity.3.Clinically, by comprehensive analysis of mandibular movement trace and EMG, the MAD treatment had no influence on stomatognathic system of mild and moderate OSAHS patients, which provides OSAHS treatment in oral cavity clinic with the orectical guidance. |
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