顎関節症の病因論と治療による病態分析:開口時の3次元イメージ解析と治療学的応用

基于颞下颌关节疾病病因和治疗的病理分析：张口过程中的3D图像分析和治疗应用

• 批准号: 14657526
• 负责人: 石川 武憲
• 金额: $ 2.11万
• 依托单位: Hiroshima University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Exploratory Research
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14657526/
• 关键词: 顎関節症; 過剰開口; 開口訓練; EMG; フィードバック法

ヒトの最も進化した徴候は喉頭の下降であり,このために関節包が弛緩し頸椎の垂直化や下顎底の開大などとともに,顎関節症の発生原因として,過剰開口が誘発され,病態発生に関与する.これに伴う頭頚部の各種の随伴症状も問題化を呈することになった。この過剰開口時に生じる顔貌の異常変化を正貌および側貌から映像学的に分析し,治療学的資料を作成すべく,データ収集を行った.対象は,過剰開口癖を有する健常成人,顎関節症患者と悪性や良性腫瘍のために下顎の区域切除や半側切除手術を行った患者などである。これらを健常者群,即時や二次的再建群,下顎区域切除後の非再建群と3群に分類し,側頭筋前部,中部,および後部の各筋束群と咬筋のEMGを測定した.直径6mmの銀塩化銀表面電極を筋線維走行に沿って筋腹中央に電極間距離を20mmとして貼布し,周波数5000Hzで双極誘導し,筋電図解析ソフトAcqKnowledgeにより解析した.前方と側方には,2台のビデオカメラを設置し,毎秒60フレームの速度でコンピューターに取り込み,運動解析ソフトDynas 3D/Gにより3次元的に顎運動を解析し,顎関節症患者の過剰開口時に生じる顔貌変化や顎の偏位,またこれに伴う側頭筋と咬筋への影響を検討した.この結果,過剰開口を行っている患者の顔貌の横幅は,平均4.5mm巾,また最大11mm巾の顔面幅を増加させると同時に,顔全体が菱形を呈した.また,同時に測定したEMGによって,この過剰開口時には,側頭筋や咬筋は異常電位の発生を生じた.区域切除後の再建の有無や健常者群と比較すると,非再建例でのEMGは,咬筋の切除により,咬筋筋電位は減少し,側頭筋の後部筋束は増強した.これは,筋突起切除術併用の関係から側頭筋後部筋束の切離が不完全で残存している可能性や,あるいは側頭筋電位の代償性増強による結果と考えられた.これら結果を上記の各種患者の生理的開口訓練時にfeed backさせ応用すると,有用であることが判明した.

The most advanced symptoms are the reduction of the throat, the relaxation of the vertebrae, the opening of the floor under the verticalization of the vertebrae, the cause of the disease, the opening of the mouth, and the symptoms. All kinds of concomitant symptoms in the department of the hospital showed severe symptoms. When you go through the mouth, you often change the image analysis of medical science, the data of medicine are compiled into medical records, and the medical records are collected. For example, the obsession with open mouth is characterized by normal adults, and the patients with dysphagia are treated with partial resection of the lower extremity area and partial resection. The normal group, that is, the secondary reconstruction group, the non-reconstruction group after the removal of the inferior area, the three groups were classified into three groups, and the tendons in the front, middle and back of the girder were measured by EMG. The diameters of the 6mm polarizers run along the center of the ribs, the distance between the electrodes and the 20mm polarizers, the wave number of the 5000Hz is bipolar, and the ribs are analyzed by AcqKnowledge. In front of you, there are 2 sets of hardware settings, 60 seconds per second, the speed is 60 seconds, and the speed is 60 seconds. The results showed that the average 4.5mm towels, the maximum size of 11mm towels, and the diamond shape of all the patients were similar at the same time. At the same time, make sure that you have to check the EMG temperature at the same time. If you are in the middle of the opening, you will have to pay attention to the power supply. After regional excision, the group of patients with normal tendons was significantly higher than that of patients with normal tendons, while those with normal tendons after regional excision were less than those with normal tendons, and those with normal tendons after regional resection were significantly higher than those without reconstruction. after regional resection, the patients with normal tendons after regional resection were more normal than those with normal tendons, and the posterior tendons of the tendons were strongly strengthened. After the rib protuberance is removed, the rear part of the tendon is removed. The possibility of residual damage is not complete. The electrical potential of the rib is improved. The results showed that the physiological opening of all kinds of patients was confirmed by the use of feed back, which was used to identify the disease.

项目成果

石川武憲: "「ヒト道化に伴う口を科学し直そう」-顎関節症への提言.分症としての舌痛症--感じる唇をもとめてく石川法の開発-"歯界月報. 620. (2003)

Takenori Ishikawa：“‘让我们重新科学地认识与人类小丑有关的口腔’ - 针对颞下颌关节紊乱的建议。舌痛作为一种疾病 - 石川感觉嘴唇方法的发展 -”《牙科月刊》620 (2003)。