Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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The Chewing Efficiency of Occlusal Stabilization Appliances by Anatomy of the Occlusal Surface

교합안정장치 교합면의 모양에 따른 저작효율

  • Im, Yeong-Gwan (Dept. of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Choi, Choong-Ho (Dept. of Preventive Dentistry, School of Dentistry, Chonnam National University, Dental Science Research Institute) ;
  • Kim, Jae-Hyeong (Dept. of Oral Medicine, School of Dentistry, Chonnam National University, Dental Science Research Institute) ;
  • Rhee, Chong-Ouk (Dept. of Food Science & Technology, Chonnam National University) ;
  • Kim, Byung-Gook (Dept. of Oral Medicine, School of Dentistry, Chonnam National University, Dental Science Research Institute)
  • 임영관 (전남대학교 치의학전문대학원 구강내과학교실) ;
  • 최충호 (전남대학교 치의학전문대학원 예방치과학교실, 전남대학교 치의학연구소) ;
  • 김재형 (전남대학교 치의학전문대학원 구강내과학교실, 전남대학교 치의학연구소) ;
  • 이종욱 (전남대학교 농업생명과학대학 식품공학과) ;
  • 김병국 (전남대학교 치의학전문대학원 구강내과학교실, 전남대학교 치의학연구소)
  • Published : 2005.09.30
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Abstract

Occlusal appliance therapy has been proven to be very useful and effective in reducing signs and symptoms of patients with TMD. However, there are no reports about the masticatory efficiency of the occlusal appliance. The purpose of this study was, first, to investigate the masticatory efficiency of the conventional stabilization appliance experimentally in normal healthy subjects, by comparing it with that of their natural dentition; and, second, to develop a modified stabilization appliance as an attempt to increase masticatory efficiency. Eleven subjects (mean age 25.3 years, range from 23 to 33) participated in this study. Six were men and five were women. They were healthy and had complete or near―complete natural dentition, and did not present with signs or symptoms of TMD. Two kinds of occlusal appliances―the conventional flat maxillary stabilization appliance (i.e., FSA) and a modified maxillary stabilization appliance with additional anatomic structures on its occlusal surface (i.e., ASA)―were made for every subject. Subjects chewed peanuts that were selected as a food to test the three masticatory conditions of the natural dentition, the ASA, and the FSA. The number of chewing strokes was counted during each 1-minute chewing period. Chewed peanut boluses were recovered and their hardness was measured by texture analysis. Statistical tests were performed. The following results were obtained. 1. The masticatory efficiency of the FSA was 38.6 percent that of the natural dentition. The efficiency of the ASA was 78.2 percent that of the natural dentition. 2. The number of chewing strokes in the natural dentition condition was measured to be 1.5 strokes per second. It decreased to 90 percent in the ASA and FSA conditions. These results indicate that the ASA could serve an improved masticatory capacity as well as its therapeutic effects in TMD. A clinical application of the ASA should be considered to extend the management of TMD patients.

교합장치요법은 측두하악장애 환자의 증상과 징후를 감소시키는데 매우 효과적인 방법으로 밝혀져 있다. 교합장치의 저작효율에 관한 보고는 아직 없는 실정이다. 이 연구의 목적은 정상인에서 실험적으로 자연치열과 비교한 교합안정장치의 저작 효율을 조사하고, 개선된 저작 효율을 가진 변형된 교합안정장치를 개발하는 것이었다. 열한명의 연구대상자(평균 연령 25.3세, 연령 범위 23-33세)가 실험에 참여했다. 이 중 남자는 6명, 여자는 5명 이었다. 이들은 완전하거나 거의 완전한 자연치열을 가지고 있고 측두하악장애의 증상과 징후가 없는 건강한 사람들이었다. 기존의 편평한 교합면이 있는 상악 교합안정장치(FSA) 및 교합면에 부가적으로 해부학적인 구조가 있는 변형된 교합안정장치(ASA)의 2종의 교합장치를 각 대상자마다 제작하였다. 자연치열, ASA 및 FSA의 3가지 저작 조건에서 연구대상자들이 시험식품으로 선택된 땅콩을 저작하도록 하였다. 1분간의 저작기간 동안 저작주기 회수를 세었다. 저작된 땅콩 식괴를 회수하고 조직감 분석을 통해 경도를 측정하였다. 경도와 저작주기 회수에 대하여 통계분석을 시행하였으며, 다음과 같은 결과를 얻었다. 1. FSA의 저작효율은 자연치열의 38.6%에 해당하였다. ASA의 저작효율은 자연치열의 78.2%에 해당하였다. 2. 자연치열의 저작조건에서의 저작주기 회수는 초당 1.5회로 측정되었으며, 이는 ASA와 FSA의 조건에서 약 90%로 감소되었다. 이러한 결과는 ASA가 측두하악장애에서의 치료효과뿐만 아니라 향상된 저작기능을 수행할 수 있도록 함을 보여주었다. TMD 환자의 치료에 ASA의 임상적 사용을 긍정적으로 고려할 수 있을 것이다.

Keywords

References

  1. Helkimo E, Carlsson GE, and Carmeli Y. Bite force in patients with functional disturbances of the masticatory system. J Oral Rehabil 1975;2:397-406 https://doi.org/10.1111/j.1365-2842.1975.tb01539.x
  2. Molin C. Vertical isometric muscle forces of the mandibule. A comparative study of subjects with and without manifest mandibular pain dysfunction syndrome. Acta Odontol Scand 1972;30:485-499 https://doi.org/10.3109/00016357209002499
  3. Christensen LV. Jaw muscles fatigue and pains induced by experimental tooth clenching: a review. J Oral Rehabil 1981;8:27-36 https://doi.org/10.1111/j.1365-2842.1981.tb00472.x
  4. Mongini F and Tempia-Valenta G. A graphic and statistical analysis of the chewing movements in function and dysfunction. Cranio 1984;2:125-134
  5. Agerberg G and Carlsson GE. Chewing ability in relation to dental and general health: Analyses of data obtained from a questionnaire. Acta Odontol Scand 1981;39:147-153 https://doi.org/10.3109/00016358109162273
  6. Tzakis MG, Dahlstrom L and Haraldson T. Evaluation of masticatory function before and after treatment in patients with craniomandibular disorders. J Craniomandib Disord 1992;6:267-272
  7. Carraro JJ and Caffesse RG. Effect of occlusal splints on TMJ symptomatology. J Prosthet Dent 1978;40: 563-566 https://doi.org/10.1016/0022-3913(78)90094-X
  8. Okeson JP, Kemper JT and Moody PM. A study of the use of occlusion splints in the treatment of acute and chronic patients with craniomandibular disorders. J Prosthet Dent 1982;48:708-712 https://doi.org/10.1016/S0022-3913(82)80034-6
  9. Okeson JP. Management of temporomandibular disorders and occlusion. 5th ed., Philadelphia, 2003, Mosby, p.373
  10. Wilkinson T, Hansson TL, McNeill C and Marcel T. A comparison of the success of 24-hour occlusal splint therapy versus nocturnal occlusal splint therapy in reducing craniomandibular disorders. J Craniomandib Disord 1992;6:64
  11. Okeson JP. Management of temporomandibular disorders and occlusion. 5th ed., Philadelphia, 2003, Mosby, p.519
  12. Jo Y, Hobo S, and Takayama H. Occlusion. Seoul, 1996, Koon Ja publishing Inc., pp.30-37
  13. Bradly RM. Essentials of oral physiology. St. Louis, 1995, Mosby Inc., p.188
  14. Wilding RJC. The association between chewing efficiency and occlusal contact area in man. Arch Oral Biol 1993;38:589-596 https://doi.org/10.1016/0003-9969(93)90124-5
  15. Carlsson GE. Masticatory efficiency: the effect of age, the loss of teeth and prosthetic rehabilitation. Int Dent J 1984;34:93-97
  16. Manly RS and Braley LC. Masticatory performance and efficiency. J Dent Res 1950;29:448-462 https://doi.org/10.1177/00220345500290040701
  17. Manly RS and Vinton P. A survey of the chewing ability of denture wearers J Dent Res 1951;30: 314-321 https://doi.org/10.1177/00220345510300030301
  18. Manly RS. Factors affecting masticatory performance and efficiency among young adults. J Dent Res 1951;30:874-882 https://doi.org/10.1177/00220345510300062001
  19. Kapur KK and Soman SD. Masticatory performance and efficiency in denture wearers. J Prosthet Dent 1964;14:687-694 https://doi.org/10.1016/0022-3913(64)90203-3
  20. Helkimo E, Carlsson GE and Helkimo M. Chewing efficiency and state of dentition. Acta Odontol Scand 1978;36:33-41 https://doi.org/10.3109/00016357809026364
  21. Rissin L, House JE, Manly RS and Kapur KK. Clinical comparison of masticatory performance and electromyographic activity of patients with complete dentures, overdentures, and natural teeth. J Prosthet Dent 1978;39: 508-511 https://doi.org/10.1016/S0022-3913(78)80181-4
  22. Luke DA and Lucas PW. Chewing efficiency in relation to occlusal and other variations in the natural human dentition. Br Dent J 1985;159:401-403 https://doi.org/10.1038/sj.bdj.4805742
  23. Lucas PW, Luke DA, Voon FCT, et al. Food breakdown patterns produced by human subjects possessing artificial and natural teeth. J Oral Rehabil 1986;13:205-214 https://doi.org/10.1111/j.1365-2842.1986.tb00652.x
  24. Tzakis MG, Kiliaridis S and Carlsson GE. Effect of chewing training on masticatory efficiency. Acta Odontol Scand 1989;47:355-360 https://doi.org/10.3109/00016358909004803
  25. Tzakis MG, Dahlstrom L and Haraldson T. Evaluation of masticatory function before and after treatment in patients with craniomandibular disorders. J Craniomandib Disord 1992;6:267-272
  26. Hirai T, Ishijima T, Koshino H and Anzai T. Age-related change of masticatory function in complete denture wearers: evaluation by a sieving method with peanuts and a food intake questionnaire method. Int J Prosthodont 1994;7:454-460
  27. Agerberg G and Carlsson GE. Chewing ability in relation to dental and general health: Analysis of data obtained from a questionnaire. Acta Odontol Scand 1981;39:147-153 https://doi.org/10.3109/00016358109162273
  28. Helkimo E, Carlsson GE and Helkimo M. Bite force and state of dentition. Acta Odontol Scand 1977;35: 297-303 https://doi.org/10.3109/00016357709064128
  29. Haraldson T, Karlsson U and Carlsson GE. Bite force and oral function in complete denture wearers. J Oral Rehabil 1979;6:41- https://doi.org/10.1111/j.1365-2842.1979.tb00403.x
  30. Gibbs CH, Mahan PE, Lundeen HC, etc. Occlusal forces during chewing-Influences of biting strength and food consistency. J Prosthet Dent 1981;46: 561-567 https://doi.org/10.1016/0022-3913(81)90247-X
  31. Heath MR. The effect of maximum biting force and bone loss upon masticatory function and bone loss upon masticatory function and dietary selection of the elderly. Int Dent J 1982;32:345-356
  32. Mioche L and Peyron MA. Bite force displayed during assessment of hardness in various texture contexts. Arch Oral Biol 1995;40:415-423 https://doi.org/10.1016/0003-9969(94)00190-M
  33. Rissin L, House JE, Manly RS and Kapur KK. Clinical comparison of masticatory performance and electromyographic activity of patients with complete dentures, overdentures, and natural teeth. J Prosthet Dent 1978;39: 508-511 https://doi.org/10.1016/S0022-3913(78)80181-4
  34. Tallgren A, Holden S, Lang BR et al. Jaw muscle activity in complete denture wearers-a longitudinal electromyographic study. J Prosthet Dent 1980;44: 123- https://doi.org/10.1016/0022-3913(80)90122-5
  35. Tallgren A, Holden S, Lang BR et al. Correlations between EMG jaw muscle activity and facial morphology in complete denture wearers. J Oral Rehabil 1983;10:105-120 https://doi.org/10.1111/j.1365-2842.1983.tb00105.x
  36. Karkazis HC and Kossioni AE. Re-examination of the surface EMG activity of the masseter muscle in young adults during chewing of two test foods. J Oral Rehabil 1997;24:216-223 https://doi.org/10.1111/j.1365-2842.1997.tb00316.x
  37. Rilo B, Silva JL, Gude F and Santana U. Myoelectric activity during unilateral chewing in healthy subjects: Cycle duration and order of muscle activation. J Prosthet Dent 1998;80:462-466 https://doi.org/10.1016/S0022-3913(98)70012-5
  38. Horio T and Kawamura Y. Effects of texture of food on chewing patterns in the human subject. J Oral Rehabil 1989;16:177-183 https://doi.org/10.1111/j.1365-2842.1989.tb01331.x
  39. Mioche L, Bourdiol P and Monier S. Chewing behaviour and bolus formation during mastication of meat with different textures. Arch Oral Biol 2003;48:193-200 https://doi.org/10.1016/S0003-9969(03)00002-5
  40. Lindquist LW and Carlsson GE. Changes in masticatory function in complete denture wearers after insertion of bridges on osseointegrated implants in the lower jaw. Adv Biomaterials 1982;4:151
  41. Lambrecht JR. The influence of occlusal contact area on chewing performance. J Prosthet Dent 1965;15: 444-450 https://doi.org/10.1016/S0022-3913(65)80012-9
  42. Wilding RJC. The association between chewing efficiency and occlusal contact area in man. Archs Oral Biol 1993;38:589-596 https://doi.org/10.1016/0003-9969(93)90124-5
  43. Bourdiol P and Mioche L. Correlations between functional and occlusal tooth-surface areas and food texture during natural chewing sequences in humans. Arch Oral Biol 2000;45:691-699 https://doi.org/10.1016/S0003-9969(00)00027-3
  44. Fernandes CP, Psarras V, Freitas LB and Ahlgren J. Jaw-closing muscles: electromyographic activity of human subjects with reduced periodontal support. J Oral Rehabil 1994;21:165-175 https://doi.org/10.1111/j.1365-2842.1994.tb01135.x