Craniomandibular pain, oral parafunctions, and psychological stress in a longitudinal case study
Craniomandibular pain, oral parafunctions, and psychological stress in a longitudinal case study
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DOI：
10.1111/j.1365-2842.2004.01313.x
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发表时间：
2004-08-01
影响因子：
2.9
通讯作者：
Naeije, M
中科院分区：
文献类型：
--
作者：
Selms, MKA;Lobbezoo, F;Naeije, M
在一个单一的案例研究中，最常见的建议贡献因素，即口腔功能障碍和心理压力，进行了更详细的研究。在为期13周的研究期间，完成了问卷调查，其中包括颌骨肌肉疼痛，磨牙行为以及经历/预期的压力。在大约40%的夜间，使用单通道肌电图（EMG）记录夜间咀嚼肌活动（NMMA）。使用最大自愿收缩水平10%的检测阈值，对每记录小时的NMMA事件数量进行评分。这个阈值是在另一项单独的研究中建立的，该研究将肌电图与多导睡眠图进行比较。逐步回归分析表明，64%的早晨下颌肌肉疼痛可以用晚上下颌肌肉疼痛来解释，另外2%的人可以用饮酒来解释。反过来，晚上下巴肌肉疼痛的原因有56%是白天的咬牙，还有6%是舌头的真空吸吮。最后，30%的人认为白天的咬牙切齿是由经历过的压力造成的。夜间记录的数据显示，NMMA的变化与早晨下颌肌肉疼痛的变化无关。这个案例研究证实了经历过的压力可能与白天紧咬牙齿有关，反过来又与晚上和早上的下颌肌肉疼痛有关。
In a single case study, the most frequently suggested contributing factors to craniomandibular pain, viz., oral parafunctions and psychological stress, were studied in more detail. During a 13-week study period, questionnaires were completed, in which, among others, jaw muscle pain, bruxism behaviour, and experienced/anticipated stress were noted. During about 40% of the nights, nocturnal masticatory muscle activity (NMMA) was recorded, using single-channel electromyography (EMG). The number of NMMA events per recorded hour was scored, using a detection threshold of 10% of the maximum voluntary contraction level. This threshold was established in a separate study, in which EMG was compared with polysomnography. Stepwise regression analyses indicated, that morning jaw muscle pain could be explained by evening jaw muscle pain for 64% and by alcohol intake for another 2%. In turn, evening jaw muscle pain was explained by daytime clenching for 56% and by vacuum sucking of the tongue for an additional 6%. Finally, daytime clenching was significantly explained by experienced stress for 30%. Data of the recorded nights showed, that variations in NMMA did not contribute to variations in morning jaw muscle pain. This case study corroborates the paradigm that experienced stress may be related to daytime clenching and, in turn, to evening and morning jaw muscle pain.