저출력레이저 조사가 측두하악장애환자의 압력통각역치에 미치는 영향
THE EFFECT OF LOW LEVEL LASER THERAPY ON PRESSURE PAIN THRESHOLD IN PATIENTS WITH TEMPOROMANDIBULAR DISORDERS
조경아, 고명연,
소속 상세정보
조경아 ( Cho Kyung-Ah ) - Pusan National University College of Dentistry Department of Oral Medicine
고명연 ( Ko Myung-Yun ) - Pusan National University College of Dentistry Department of Oral Medicine
KMID : 0386219990110010047
Abstract
측두하악장애환자와 정상대조군의 두경부 근육에 있어서 실제 또는 위약 치료에 따른 저출력 레이저의 효과와 측두하악장애환자에서 저출력 레이저의 효과적인 치료기간을 평가하기 위하여, 측두하악장애를 가진 부산대학교 치과대학생 19명과 측두하악장애의 병력이나 증상이 없는 부산대학교 치과대학생 20명을 대상으로 치료전, 치료 2주 및 치료 4주에 구의촉진이 가능한 32 근골격 촉진점의 압력통각역치와 각각의 동통정도와 두개하악지수를 측정하여 다음과 같은 결론을 얻었다.
1. 치료전 환자군의 압력통각역치는 정상대조군 압력통각역치보다 낮았다(p<0.05)
2. 환자군의 압력통각역치는 유의하게 증가하였으며(p(0.05), 레이저 조사-환자군의 증가된 압력통각역치는 레이저 모의조사-환자군의 증가된 압력통각역치보다 더 크게 나타났다.
3. 대조군에서는 레이저 조사나 모의 조사에 의해 압력통각역치의 변화가 없었다.
4. 레이저 조사-환자군의 압력통각역치가 안면근육에서는 치료 2주부터 유의하게 증가하였고 경부근육에서는 치료 4주부터 유의하게 증가하였다(p<0.05).
5. 레이저 조사-환자군에서 동통의 정도와 두개하악지수는 유의하게 감소하였다(p<0.05)
Occlusal therapy including many kinds of occlusal appliances or occlusal adjustment is still major strategy for treatment of temporomandibular disorders (TMD), although its cause has been controversial aside from patients with apparent psychological problems. One of the reason for unspecified and multifactorial etiology of TMD may be that some modern methods which can be clinically available to evaluate occlusal problems such as premature contact, occlusal interference, and asymmetrically distributed bite forces in the dental arch have not been delivered to both clinicians and researchers over the world.
Recently examination of occlusal contacts with teeth in light occlusion by using low-viscous silicone materials and EMG Bio-feedback method has been approved to be useful for detecting even slight premature contact or occlusal interference, which seem difficult to be revealed by previous occlusal examination using articulating papers and many other materials. The method for simultaneous bite force registration on individual tooth contact during heavy clenching with the use of pressure sensitive foil (Dental Prescale, GC Corp. Tokyo, Japan) has been also developed. Previous studies showed typical bite force distribution in normal subjects and suggested that patients with TMD had more asymmetrical bite force distribution compared to those who were free from signs and symptoms of TMD.
The procedures of diagnosis for occlusal problems in TMD patients using these two methods, the concept and indications for selection of treatment strategy and consequent treatment of TMD, including some clinical cases as well as significant scientific researches, will be presented and discussed during the lecture. Furthermore, general features of signs and symptoms of TMD based on more than 400 TMD patients who had been treated in our department will be also mentioned.
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