矯正疼痛對下顎運動速度之影響
The Effect of the Orthodontically Induced Pain on the Mandibular Movement Velocity
中文摘要
因為矯正治療中牙齒的移動，可能會引起牙齒的不適與疼痛而影響到正常的下 顎功能，本研究是討論此矯正疼痛是否已經影響到正常的下顎功能。本研究在三 十位成年受測者之單側第一大臼齒的近心側及遠心側各置放一條齒間分離器 ( separator )來當做矯正疼痛的引發工具，然後用下顎運動圖 Mandibular Kinesiograph (MKG)來測量下顎三度空間未置放齒間分離器與放置後五天內 下顎運動速度之變化。疼痛的評估以視覺類比尺度(VAS)來作記錄，K6 測量的 項目包括了疼痛程度與平均張口速度、最大張口速度、平均閉口速度、最大閉口 速度及最終閉口瞬間速度之關係。
結果發現大部份的受測者會因齒間分離器而產生不同程度的疼痛，且疼痛高峰 期會出現在後牙齒間分離器置放後的第二天與第三天間；但在疼痛程度與下顎 運動速度之變化方面，其相關性並不高，約有一半以上的受測者因放置後牙齒 間分離器所產生之疼痛對下顎運動速度的影響並不大，僅呈現低度相關，故齒 間分離器所產生之疼痛並不至於造成下顎之運動速度之改變。齒間分離器的放置 可能的確使牙齒產生移位，因而使牙齒的咬合狀態產生改變，所以使得下顎最 大閉口速度發生變化，但就整體下顎運動速度來說其變化是極為小的。
英文摘要
The fear of pain is one of the key factors that discourage a patient from seeking orthodontic treatment . Orthodontic pain will decrease the muscular activity in EMG studies . Changes in masseter muscle activity during orthodontic treatment were probably due to discomfort , pain or alteration in occlusal relationship produced by tooth movement . But , we still do not understand that the pain due to orthodontic appliances will affect the function of jaws movement or not . The purpose of this study is to determine the effect of orthodontic pain on the velocity of mandibular movement on thirty subjects . The subjects ( 18 males and 12 females , ranging from 32 to 23 years old ) were observed by using a Myotonics Kinesiograph K-6 Model for the measurement of jaw motion velocity before and after the insertion of orthodontic posterior separators first day , second day , third day , fifth day , and fifth day after the separators was removed . The continuous opening — closing strokes five times were recorded and processed to evaluate the following parameters : 1. the maximal opening and closing velocity , 2. the
average opening and closing velocity ,and 3. the maximal velocity before tooth contact . The measurement of orthodontic pain were evaluated by visual analog
scales ( VAS ) . Average velocity of five consecutive mandibular movement strokes of the five days were compared with VAS by Pearson Correlation . Neither the opening velocity nor the closing velocity were affected by inserting separators . The maximal closing velocity of fifth day , and after the separators were removed were different from the first day just before the separators were placed ( p — level
< 0.05 ) . In conclusion , the mandibular opening velocity , closing velocity , and the maximal velocity before tooth contact were not affected by orthodontic posterior separators .
