Journal of Oral Medicine and Pain

  • 제31권1호
  • /
  • Pages.69-77
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  • 2006
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  • 2288-9272(pISSN)
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  • 2383-8493(eISSN)
대한안면통증구강내과학회 (Korean Academy of Orofacial Pain and Oral Medicine)
권호 표지

교근 부위의 보툴리눔 독소 주사가 저작근의 근전도 및 악기능에 미치는 영향

Short-term Effect of Botulinum Toxin Injection on the Surface EMG of Masticatory Muscles and Jaw Function

  • 이정윤 (서울대학교 치과대학 구강내과진단학교실) ;
  • 박희경 (국립과학수사연구소 법의학과 법치의학실) ;
  • 정진우 (서울대학교 치과대학 구강내과진단학교실)
  • Lee, Jeong-Yun (Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University) ;
  • Park, Hee-Kyung (Section of Forensic Dentistry, Department of Forensic Medicine, National Institute of Scientific Investigation) ;
  • Chung, Jin-Woo (Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University)
  • 발행 : 2006.03.30
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초록

저작근과 관련하여 나타나는 여러 운동장애의 치료나 심미적인 목적으로 교근 부위에 보툴리눔 독소를 주사하는 방법이 널리 이용되고 있다. 그러나 보툴리눔 독소의 교근 부위 주사가 다른 저작근의 근전도와 악기능에 어떠한 영향을 미치는 지에 대한 자료는 부족하다. 이에 본 연구에서는 측두하악관절장애 등 하악의 기능 이상을 가지고 있지 않는 건강한 성인남녀 14명을 대상으로 양측 교근에 각각 80 unit씩의 보툴리눔 독소 A(Dysport, Ipsen, Wrexham, UK)를 주사한 5 명의 실험군과 같은 위치에 같은 양의 생리식염수를 주사한 9 명의 대조군에서 주사 전과 주사 후 3 주까지 매주 교근과 전측두근의 표면 근전도를 측정하고, 국문판 악기능제한지수(Jaw Functional Limitation Scale) 설문지를 이용하여 악기능제한 정도를 평가하여 비교 분석하였다. 교근의 근전도는 실험군에서 주사 후 1주부터 감소하기 시작하여 3주 동안 지속적인 감소를 나타냈으며, 전측두근의 근전도는 유의한 변화를 나타내지 않았다. 악기능제한지수는 저작지수와 전반적 악기능 지수가 실험군에서 보툴리눔 독소 주사 후 1 주째에 증가한 뒤 점차 회복하는 양상을 보였으며, 개구지수와 대화 및 감정표현 영역 기능제한지수는 통계적으로 유의한 변화를 보이지 않았다. 이러한 결과로부터 교근에 시행하는 보툴리눔 독소 주사는 교근의 활성을 지속적으로 저하시키지만 전측두근의 활성에는 영향을 미치지 않았으며, 주관적 저작기능을 단기적으로 저하시키나, 근활성의 저하가 지속되는 과정에서도 주관적 저작기능은 짧은 기간 내에 회복됨을 알 수 있었다.

Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.

키워드

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