中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (5): 457-462.doi: 10.19438/j.cjoms.2025.05.005

• 论著 • 上一篇    下一篇

单侧颞下颌关节前移位患者咀嚼肌肌电活动与盘移位的关系

朱妍1, 李敏涵1, 何佳颖1, 王变2, 杨驰1,*, 马志贵1,*   

  1. 1.上海交通大学医学院附属第九人民医院 口腔外科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,中国医学科学院口腔颌面再生医学创新单元,上海 200011;
    2.上海交通大学医学院附属第九人民医院 辅助生殖科,上海 200011
  • 收稿日期:2025-01-22 修回日期:2025-03-12 发布日期:2025-10-10
  • 通讯作者: 马志贵,E-mail: mazhigui1984@163.com;杨驰,E-mail: yangchi1963@hotmail.com。*共同通信作者
  • 作者简介:朱妍（1997-）,女,硕士研究生,E-mail: enidzhu123111@163.com
  • 基金资助:
    国家自然科学基金（81800932）; 上海市重中之重研究中心（2022ZZ01017）; 中国医学科学院医学与健康科技创新工程项目资助（2019-I2M-5-037）; 中国牙病防治基金会重点项目（A2023-002）; 上海交通大学医学院附属第九人民医院横向科研项目（KQHX2024-05）; 上海交通大学医学院附属第九人民医院优秀青年基金（JYYQ016）

Relationship between masticatory electromyographic activity and disk displacement in patients with unilateral anterior temporomandibular joint displacement

Zhu Yan1, Li Minhan1, He Jiaying1, Wang Bian2, Yang Chi1, Ma Zhigui1   

  1. 1. Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology; Chinese Academy of Medical Sciences, Oral and Maxillofacial Regenerative Medicine Innovation Unit. Shanghai 200011;
    2. Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2025-01-22 Revised:2025-03-12 Published:2025-10-10

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摘要： 目的: 探讨单侧颞下颌关节前移位(UADD)患者颞肌和咬肌肌电活动的变化。方法: 选择2021年1月—2024年2月在上海交通大学医学院附属第九人民医院接受颞下颌关节（TMJ）核磁共振和针极肌电图（nEMG）检查的患者136例。其中,双侧TMJ盘-髁关系正常者74例（对照组）,磁共振确诊为UADD的患者62例（UADD组）。比较两组患者运动单位电位 (MUP)波幅、时长等指标,并进行UADD与咀嚼肌肌电活动异常的相关性分析。结果: 咬肌和颞肌异常肌电活动的出现均与颞下颌关节盘前移位有关（P<0.001),且TMJ病变等级越严重,咬肌和颞肌出现紊乱的可能性越大。UADD组患侧咬肌波幅和波程均显著高于对照组(P<0.05）,且波程延长趋势与波幅异常一致,提示UADD组患侧咬肌神经源性活动异常增强;而UADD组患侧颞肌波幅（P=0.096）及波程（P=0.079）均未显著偏离对照组,但异常方向与咬肌一致。结论: 单侧颞下颌关节前移位与咀嚼肌电活动异常存在高度相关性,对咀嚼肌肌电紊乱患者应注意单侧颞下颌关节盘前移位潜在风险的可能性。

关键词: 颞下颌关节, 关节盘前移位, 咀嚼肌电活动, 针极肌电图

Abstract: PURPOSE: To investigate the changes in the electromyographic activity of the temporalis and occlusal muscles in patients with unilateral anterior displacement (UADD) of the temporomandibular joint (TMJ) compared with those with normal TMJ disc-condylar relationship. METHODS: A total of 136 patients who underwent TMJ magnetic resonance imaging and needle electromyography (nEMG) examinations at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2021 to February 2024 were selected. Among them, there were 74 cases with normal bilateral TMJ disc-condylar relationship (control group), and 62 patients diagnosed with UADD by TMJ magnetic resonance imaging (UADD group). The indicators such as the amplitude and duration of motor unit potential (MUP) in the two groups of patients were compared, and the correlation analysis between UADD and abnormal electromyographic activity of the masticatory muscles was conducted. RESULTS: The occurrence of abnormal electromyographic activities of the masseter muscle and temporal muscle was both related to the anterior displacement of the temporomandibular joint disc(P<0.001), and the more severe the TMJ lesion grade was, the greater the possibility of disorder in the masseter muscle and temporal muscle. The amplitude and wave length of the masseter muscle on the affected side in the UADD group were significantly higher than those in the control group(P<0.05), and the trend of wave length extension was consistent with the abnormal amplitude, suggesting that the neurogenic activity of the masseter muscle on the affected side in the UADD group was abnormally enhanced. However, in the UADD group, the amplitude(P=0.096) and wave length(P=0.079) of the temporal muscle on the affected side did not significantly deviate from the control group, but the abnormal direction was consistent with that of the masseter muscle. CONCLUSIONS: There is a high correlation between unilateral anterior displacement of the temporomandibular joint and abnormal masticatory electromyographic activity. Clinically, for patients with masticatory muscle electromyographic disorders, attention should be paid to the possibility of potential risks of unilateral anterior displacement of the temporomandibular joint disc.

Key words: Temporomandibular joint, Anterior displacement of the articular disk, Masticatory electromyographic activity, Needle electromyography

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