横浜の歯科・歯医者 横浜山手デンタルクリニック海外学会誌への投稿
英文
ABSTRACT
Objective This research attempted to confirm the possibility that the lateral pterygoid muscle (LPM) functions with the TMJ during bruxism to position the condyles at the same three-dimensional level, and interacts with blood circulation to and from the brain to create a circulation pump effect to the pterygoid plexus under certain conditions. I also attempted to find new criteria for performing occlusal alterations, and to provide further proof action of the LPM during bruxism.
Study Selection T1 weighted, STIR MRI images were obtain from 29 patients in this MRI analysis, and were used to determine the angle between the LPM and the molar occlusal plane, as well as the area of the pterygoid plexus. CBCT images were also obtained for 8 of the subjects that showed the angle between the LPM and the molar occlusal plane (OP).
Results The 29 subjects were classified as normal when the angle was less than 27 degrees. In addition, subjects with a pterygoid plexus area between 55 mm2 and 295 mm2 were also classified as normal. CBCT of the 8 subjects showed that the bilateral condylar processes, which had been at different levels before treatment, were brought into alignment.
Conclusions Biomechanical cantilever movements improve recovery, but may also make the pathology, deformations and dislocations worse. Also, an appropriate angle between the LPM and OP affects the blood circulation pump.
日本語訳
本研究の目的は、ブラキシズム時に四大咀嚼筋の中で翼突筋静脈叢の血液循環に対して最も大きな影響を与える筋が外側翼突筋であることを臨床上鑑みて、その時の筋機能をTMJ付近と脳の内外の血液循環の相互作用について明らかにした。さらに一定の条件があればブラキシズム時における外側翼突筋機能が左右の下顎頭の位置を三次元的に同一レベルとさせる相互作用についても明らかにした。
実験には被験者合計37名が参加した。MRI検査と分析には29名が参加した。MRI分析における被験者は、脳ドックのために任意に来院した患者である。T1強調STIR法によるMRI画像が取得され、これを外側翼突筋と大臼歯咬合平面とのなす角度についてまた、翼突筋静脈叢の面積についての分析に使用した。CBCT分析の８名の被験者は、めまい、慢性頭痛、顔面痛、頚部・肩・腰の痛みなどの不定愁訴を訴え、Craniomandibular Cervical Spine Disorder（CCD）であると著者が診断した患者であった。
被験者は、Doi Balanced Home Position Therapyを受け、CBCT画像をこの治療前と後に撮影し、外側翼突筋と大臼歯咬合平面のなす角度と下顎頭の位置の改善について分析した。