Clinical study on changes and adaptations of physiological functions after orthognathic surgery

(A)颧舌肌(GG)的吸气活动与紧张性活动相叠加，以维持上呼吸道(UA)的通畅。然而，具有呼吸相关活动的单个GG马达单元(MU)的放电特性仍有待确定。在8只成年男性中，在自然头位和30ﾟ仰卧位下，记录了24只有呼吸相关放电的GG小鼠的单单位活动。吸气MU(IMU)在吸气时表现为时相活动，而吸气-呼气MU(IEMU)则表现为吸气时相活动叠加紧张性活动。30ﾟ仰卧位时，吸气时IMU的放电持续时间和瞬间放电频率(1FF)显著增加。虽然IEMU的1FF在30ﾟ仰卧位时也显著增加，但在吸气和呼气时没有显著差异。棘波间期分析显示…(1)为了研究下颌前突患者术后口咽结构的形态变化，对25例接受手术和/或颌面外科治疗的下颌前突患者进行了研究。分别于术前、术后3个月、6个月、1年拍摄4张标准化头颅侧位片。UA结构的形态变化是按性别纵向评价的。术后3个月和6个月时，男女患者的咽部前后宽度参数均显著降低，术后1年，女性患者的咽部前后宽度参数趋于恢复到术前水平，而男性患者则无此趋势。术后1年男性舌骨明显下降，女性无明显变化。术后男性舌骨与第三椎体之间的距离逐渐减小，而女性则无明显变化。术后1年，男性下咽横截面积显著减少，而女性则无明显变化。这些结果表明，手术后男性和女性UA形态发生了不同的变化。为了补偿术后骨骼的变化，男性和女性似乎以不同的方式做出了反应，以保持功能性的UA。(2)为了提取下颌前突患者保持期间的特征三维牙颌面变化，并阐明影响术后咬合稳定性的形态因素，我们使用了7名成年患者。利用头颅侧位片和正位片，三维分析义齿和骨骼成分的变化，以及固位过程中前牙合的变化。结果表明，在三维牙颌面畸形患者中，保持前牙合在垂直方向上的长期稳定性是非常重要的。C)(1)为了探讨性别、年龄、一般关节活动度等病因与TMJ紊乱的关系，110例正畸患者接受了治疗。78名女性中有50名和32名男性中有17名出现了TMJ障碍的症状。在TMJ障碍的患病率方面没有观察到显著的性别差异。而TMJ、肌肉疼痛和张口困难在女性患者中的发生率高于男性患者。随着年龄的增长，患TMJ障碍的相对风险显著。关节活动度评分越高，患TMJ紊乱的风险也越高。(2)对174例颌骨畸形患者进行问卷调查和铸型调查。报告的现在或过去的TMJ障碍的频率为77.6%。没有观察到性别差异。TMJ障碍在不同年龄组中的发生率，最小的为15岁，其次为5岁的递增年龄组，各年龄组之间无显著差异。在135例有症状的患者中，49例(36.3%)仅报告一种TM障碍症状，86例(63.7%)报告两种或两种以上症状。在潜在的病因和历史事件方面，有症状的患者比无症状的患者更容易出现姿势不佳和创伤经历。不同咬合形态类型间TMJ紊乱发生率差异无统计学意义。较少

A) The genioglossus (GG) muscle shows a phasic inspiratory activity superimposed on tonic activity to maintain upper airway (UA) patency. However, discharge properties of single GG motor unit (MU) with respiratory-related activity remain to be determined. Single unit activities of 24 GG MUs with respiratory-related discharge were recorded during spontaneous nasal breathing in both the natural head position and 30ﾟ head-up position in 8 adult males. The inspiratory MU (IMU) showed the phasic activity during inspiration, whereas the inspiratory-expiratory MU (IEMU) showed the phasic inspiratory activity superimposed on the tonic activity. The firing duration and instantaneous firing frequency (1FF) of the IMU during inspiration significantly increased in the 30ﾟ head-up position. Although the 1FF of the IEMU also significantly increased in the 30ﾟ head-up position, there was no significant difference between inspiratory and expiratory phases. An interspike interval analysis demonstrated … More that the functional divergence of the IMU and IEMU.B) (1) To investigate morphologic changes in oropharyngeal structures in mandibular prognathic patients after or thognathic surgery, 25 patients with mandibular prognathism who had undergone surgical and or thognathic treatment were used. A set of 4 standardized lateral cephalograms were obtained from each subject preoperatively and at 3 months, 6 months, and I year postoperatively. Morphologic changes in UA structures were evaluated longitudinally by gender. Parameters of the anteroposterior width of the pharynx significantly decreased at 3 and 6 months in both genders, and these parameters tended to rebound to the preoperative values 1 year postoperatively in females, but not in males. The hyoid hone significantly descended inferiorly 1 year postoperatively in males, white there were no significant changes in females. The distance between the hyoid bone and the third vertebra gradually decreased in males postoperatively ; however, there were no significant changes in females. The cross-sectional area of the hypopharynx significantly decreased 1 year postoperatively in males, but not in females. These results indicate that the UA morphology changed differently in males and females following surgery. To compensate fro skeletal changes following surgery, it appears that males and females responded in differently ways to preserve a functional UA.(2) To extract characteristic three-dimensional dentofacial changes during retention and to clarify morphological factors affecting the stability of postoperative occlusion in mandibular prognathic patients with open bite and asymmetry, 7 adult patients were used. Changes in denture and skeletal components, and anterior occlusion during retention were analyzed three-dimensionally using the lateral and frontal cephalograms. Results indicated that it was important to maintain long-term stability of the anterior occlusion in the vertical dimension in patients with three-dimensional dentofacial deformity.C) (1) To investigate the relationship between the etiologic factors such as gender, age, and general joint mobility and temporomandibular joint (TMJ) disorders, 110 orthodontic patients were used. Fifty of 78 females and 17 of 32 males showed symptoms of TMJ disorders. No significant gender difference was observed in the prevalence of TMJ disorders. However, TMJ and muscular pain and difficulty in mouth opening were more frequently observed in female symptomatic patients than male patients. There was a significant relative risk of TMJ disorders associated with increasing age. Higher score of general joint mobility was also significantly associated with an increased risk of TMJ disorders. (2) The frequency of TMJ disorders in 174 patients with jaw deformities was surveyed by questionnaires and dental casts. The frequency of reported present or past TMJ disorders was 77.6%. No difference by gender was observed. When the frequency of TMJ disorders in different age groups was examined, the youngest being 15 years of age followed by others at increasing age intervals of 5 years, there was no significant difference between age groups. Among 135 symptomatic patients, 49 patients (36.3%) reported only one symptom of TM) disorders, while 86 patients (63.7%) reported two or more symptoms. As for potential etiologic factors and historical events, poor posture and experience of trauma were more frequently observed among symptomatic patients than asymptomatic patients. There was no significant difference in the frequency of TMJ disorders between different occlusomorphologic types. Less