Avaliação da função muscular em usuários de prótese total dupla
Abstract
O objetivo deste estudo foi avaliar, através da eletromiografia, o comportamento da atividade muscular resultante do uso da técnica Convencional para obtenção de equilíbrio em prótese total dupla. Doze pacientes totalmente edêntulos, livres de sinais e sintomas de disfunção temporomandibular com no mínimo cinco anos de uso de próteses totais, foram selecionados. Os pacientes tiveram suas próteses substituídas por novas próteses e o equilíbrio articular obtido através do estabelecimento de contatos interferentes entre dentes artificiais. O padrão da atividade eletromiográfica (EMG) foi mensurado com o eletromiógrafo Myosystem Iâ (Prosecon Ltda) nos músculos temporais (porção anterior) e masseteres nas posições de repouso (R) e na contração isométrica em máxima intercuspidação (CIMI), em quatro tempos: T0 – instalação; T1 – 1° mês; T2 – 2° mês; T3 – 3° mês de uso das próteses. O sinal eletromiográfico foi condicionado por um filtro digital passa faixa e analisado em relação a sua amplitude através do RMS (Root Mean Square). Observou-se pequenas alterações nos valores da atividade EMG dos músculos temporais e masseteres na posição de R. Na posição de CIMI os músculos temporais apresentaram valores finais menores que os iniciais, e situação inversa foi observada para os masseteres, com valores finais maiores que os iniciais. A análise dos dados através do teste de Friedman não mostrou diferenças estatísticamente significantes (p < 0.05) entre os tempos avaliados. Conclui-se que a técnica Convencional, no período avaliado, não proporcionou equilíbrio dos músculos mastigatórios estudados.
UNITERMOS: prótese total; eletromiografia; oclusão dentária balanceada; dente artificial.
SUMMARY
The aim of this study was to evaluate, by electromyography, the patterns of muscular activity as a result of the use of a conventional technique to obtain balance in double complete dentures. Twelve patients totally edentulous free of signs and symptoms of temporomandibular joint disorders (TMJ) and wearing complete denture for at least five years, were selected. The conventional technique was used and the interference contacts between artificial teeth were responsible for the balance. The muscular activity pattern was measured by electromyographic (EMG) activity of anterior temporal and masseter muscles during mandibular rest (R) and maximal biting in intercuspidal position (CIMI) at four times: T0 – installation; T1 – 1st month; T2 – 2nd month; T3 – 3rd month of prosthesis use. Electromyographic signs were collected with Myosystem I® (Prosecon Ltda) conditioned through of digital filter pass band and analyzed in relation to RMS (Root Mean Square). During mandibular rest, small alterations in the EMG activity values were observed at the anterior temporal and masseter muscles. In CIMI position, the anterior temporal muscle showed final values smaller than the initial ones, differently from the masseter muscles that showed final values greater than the initial ones. The Friedman test in the evaluated times did not show any significant statistical differences (p < 0,05). This way, we concluded that the conventional technique, during the evaluation period, did not provide the balance of the masticatory muscles studied.
UNITERMS: complete denture; electromyography; dental occlusion, balanced; artificial tooth.
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