ORAL MOTOR AND SENSORY FUNCTIONS IN DENTURE WEARERS

拟议的两项研究的主要目的是确定 A)感觉运动功能与咀嚼之间的相互关系 齿状齿患者的表现、食物选择和患者满意度 和假牙佩戴者；以及b)肌电生物反馈程序对 建立类似双侧肌肉活动的咀嚼模式 义齿佩戴者及其对咀嚼功能的影响 性能、食物选择和患者满意度。 在研究1中，140名义齿患者的义齿临床上可以接受。 将分为低位咀嚼和高位咀嚼两组 性能。有28颗或更多牙齿的70名有牙齿的人作为对照组 将为以下项目提供参考值和可变性估计 评估感觉、运动和知觉功能的变化， 咀嚼性能等指标。医疗和牙科 病史、临床口腔和义齿评估及主观评价 将收集对食物偏好和满意度的评分。客观化 测量咀嚼性能，咬肌肌电活动，咬合力， 触觉和两点辨别阈值，立体识别能力， 将测定唾液分泌率和口腔清除能力。这个 牙科受试者与义齿佩戴者高、中、低位牙位的比较 对口腔感觉的任何改变都要进行低绩效的评估， 义齿佩戴者的运动和知觉功能及其对 咀嚼性能、患者满意度和食物选择。 在研究II中，肌电生物反馈程序的效果，以产生 咀嚼效率的双边咀嚼模式将是 对90名咀嚼能力低下的义齿佩戴者进行评估。 患者将被随机分成45人的对照组或试验组 生物反馈组45人。双侧咬肌肌电活动 在患者执行咬合力和偏爱侧时进行记录 用花生进行吞咽阈值咀嚼试验。实验性的 然后小组将参加每两周一次的肌电生物反馈会议 八个星期。生物反馈计划将被设计成改变 咀嚼模式，使患者学会应用相等的咬肌 双边活动。对照组将遵循相同的时间表 每两周一次，为期八周。他们将得到指示，以 双侧咀嚼，不会收到生物反馈。演出 测试和主观评估将在四周后重新进行 在八周的训练期结束时，此后在 三个月。

The primary objectives of the proposed two studies are to ascertain the: a) interrelationships between sensorimotor functions and masticatory performance, food selection and patient satisfaction in dentate persons and denture wearers; and b) influence of an EMG biofeedback program to establish a chewing pattern of similar bilateral muscle activity in denture wearers and the effects of this change on their masticatory performance, food selection, and patient satisfaction. In Study 1, 140 denture patients with clinically acceptable dentures will be divided into two equal groups of low and high masticatory performance. A control group of 70 dentate persons with 28 or more teeth will provide the reference values and estimates of variability for assessing alterations of sensory, motor and perceptual functions, masticatory performance and other measures. Medical and dental histories, clinical orofacial and denture evaluations and subjective ratings of food preference and satisfaction will be collected. Objective measures of masticatory performance, masseter EMG activity, bite force, tactile and two-point discrimination thresholds, stereognostic ability, salivary secretion rates and oral clearance ability will be made. The comparisons between dentate subjects and denture wearers with high and low performance will be made to assess any alterations in oral sensory, motor and perceptual functions in denture wearers and their impact on masticatory performance, patient satisfaction and food selection. In Study II, the effects of an EMG biofeedback program, to produce a bilateral pattern of chewing effort on masticatory efficiency will be evaluated in 90 denture wearers with low masticatory performance. Patients will be randomized into a control group of 45 or an experimental biofeedback group of 45 persons. Bilateral masseter EMG activity will be recorded while the patients perform bite force and preferred side and swallowing threshold masticatory tests with peanuts. The experimental group will then participate in bi-weekly EMG biofeedback sessions for eight weeks. The biofeedback program will be designed to alter the chewing pattern so that patients learn to apply equal masseter muscle activity bilaterally. The control group will follow the same schedule of bi-weekly sessions for eight weeks. They will be given instructions to chew bilaterally and will not receive the biofeedback. The performance tests and subjective evaluations will be repeated after four weeks of training, at the end of the eight week training period and thereafter at three months.