A clinical study on relationship between occlusal curve and stomatognathic function.
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概要
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Occlusal curve is a morphologically important factor in the occlusion and is believed to influence the stomatognathic function, especially chewing movements. Excessive occlusal curves are found in some craniomandibular disorders (CMD) patients clinically. However, there have been a few studies about relationship between occlusal curve and stomatognathic function. The purpose of this study is to investigate occlusal curve of CMD patients and relationship between occlusal curve and chewing movements.<BR>Forty healthy subjects and 95 patients with CMD (50 patients with anterior disk displacement with reduction (Click), 25 patients with anterior disk displacement without reduction (Lock) and 20 patients with myofascial pain dysfunction syndrome (MPDS) ) were examined. Their position of cusps was measured by three-dimensional measuring system and occlusal curve was estimated sagittally and laterally. The degree of mandibular sagittal occlusal curve (curve of Spee) was expressed by a second order coefficient of an approximate quadratic curve. Lateral occlusal curve was estimated by comparing the central points of Monson's sphere respectively calculated by the approximation in 4 kinds of cusps, mandibular buccal and lingual cusps and maxillary buccal and lingual cusps. Movements of the incisor point during chewing were recorded with Sirognathograph Analysing System. The parameters of chewing movements consisting of 68 items are divided into 10 categories according to the principal component analysis. The relationship between the degrees of occlusal curve and the principal component scores of 10 categories was analyzed by the multiple regression analysis.<BR>The results were as follows;<BR>1. Patients in Click group and Lock group had more excessive curve of Spee (p<0.05) and more excessive mandibular lateral occlusal curve (p<0.05) than healthy subjects. Additionaly, patients in the Lock group had flatter lateral occlusal curve in maxillary molars (p<0.05) than healthy subjects. Patients in the MPDS group had flatter lateral occlusal curve constituted by maxillary lingual cusps and mandibular buccal cusps (p<0.05) than healthy subjects.<BR>2. Curve of Spee had relation to rhythm, regularity of path, stability of maximum speed of chewing movements and lateral form near and at the occluding point in opening phase of chewing movements. Lateral occlusal curve had relation to lateral and sagittal form of chewing movements near and at the occluding point in closing phase.<BR>The results suggest that a close relationship exists between occlusal curve and stomatognathic function. Occlusal curve should be better estimated when the patients with CMD are examined.
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