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目的 定量测量前方牵引前后唇腭裂术后替牙期反(牙合)患者的咀嚼运动,探索患者口颌系统功能的变化.方法 前方牵引治疗前后对15例完全性唇腭裂术后替牙期反验患者进行单侧咀嚼的颞肌前部、咬肌肌电图检查和下颌运动检查,以咀嚼侧为功能侧,对侧为非功能侧.比较前牵引前后功能侧和非功能侧肌电值差异.结果 前牵引前后左侧咀嚼时功能侧颞肌前部和咬肌肌电值分别由45.57(26.75,67.84)和62.37(45.76,72.45) mV增至80.24(72.31,91.36)和90.35(78.94,110.45) mV,右侧咀嚼时功能侧颞肌前部和咬肌肌电值分别由45.25(37.34,57.42)和67.53(59.65,80.53) mV增至73.56(59.63,94.80)和87.97(72.35,99.79) mV,前牵引前后差异均有统计学意义(P＜0.05);前牵引前后非功能侧颞肌前部和咬肌肌电值均无明显变化(P＜0.05).右侧咀嚼时咀嚼循环轨迹水平向和垂直向范围增加(P＜0.05).结论 前方牵引治疗后随着前后牙反(牙合)的解除,咀嚼肌肌电活性增高,右侧咀嚼时水平向和垂直向运动范围增加.

Objective To quantitatively measure the masticatory movement and to investigate the change of stomatognathic function in patients with cleft lip and palate.Methods Fifteen patients with complete cleft lip and palate were selected.Electromyography of bilateral anterior temporalis and masseter was measured and mandibular movement was examined during masticatory movement before and after maxillary protraction.Results After treatment,the activity of masticatory muscles in the functional side was increased significantly.In the unilateral mastication side (left) and the right side,the activities of anterior temporalis increased from 45.57(26.75,67.84) mV to 80.24(72.31,91.36) mV and from 45.25(37.34,57.42) mV to 73.56 (59.63,94.80) mV,respectively.In the unilateral mastication side (left) and the right side,the activities of masseter increased from 62.37 (45.76,72.45) mV to 90.35 (78.94,110.45) mV and from 67.53(59.65,80.53) mV to 87.97(72.35,99.79) mV,respectively.No significant increment in the balance side was found during masticatory movement.The masticatory trajectory was not changed significantly.The width of lateral and vertical scale of right side mastication increased significantly (P ＜0.05).Conclusions After the treatment,the activity of masticatory muscles increased significantly,and the width of lateral and vertical scale of right side mastication increased significantly.