Abstract
Purpose: to evaluate the effectiveness of the developed physical therapy program based on the parameters of the electromyographic study of the masticatory muscles of patients with bruxism. Material. The control group consisted of 32 people without burdened dental status. Group 1 consisted of 31 people with bruxism, which was corrected with individual relaxing splints. Group 2 consisted of 32 people with bruxism, in whom, in addition to splints, a physical therapy program was applied - therapeutic exercises, massage, post-isometric relaxation, kinesiological taping for masticatory muscles, muscles of the face, neck, cervical collar zone, back, shoulder, electromyostimulation of masticatory muscles; autorelaxation sessions according to Schultz; patient education. The purpose of the program was: normalization of the strength and tone of the muscles of the face and neck; reduction of discomfort; improvement of chewing function; improving the quality of life. The effectiveness of the program was evaluated based on the results of electromyography. Results. In patients with bruxism, signs of bilateral increased bioelectric activity of the masticatory and temporal muscles at rest and during functional load were determined by their average amplitude, with the preference of masticatory muscle activity when determining symmetry indices based on the results of electromyography. The program of complex physical therapy demonstrated a statistically significantly better effect (p<0.05) on the studied indicators of bioelectric activity of the masticatory and temporal muscles compared to the group of patients who underwent rehabilitation with the use of passive splint therapy. During the re-examination, it was established that in both studied groups there was an improvement in the condition of the patients relative to the initial level, but with an advantage in the individuals of group 2. At rest, the activity of the masticatory muscles on the right side decreased statistically significantly (p<0.05) compared to the initial level in group 1 by 23.8%, group 2 by 47.4%; on the left side – by 22.6% and 41.7%, respectively. The average activity of the temporal muscles in group 1 did not change (p>0.05); in group 2, it decreased on the right side by 25.9%, on the left side by 33.3% (p<0.05). Indices of symmetry of masticatory and temporal muscle activity at rest continued to characterize the relatively symmetrical tension of these groups; there was a decrease in the activity preference of masticatory muscles over temporal muscles - in group 1 by 18.5%, in group 2 - by 23.3% (р<0.05). A statistically significant improvement compared to the initial result (p<0.05) was achieved in both groups according to the results with functional load. The improvement of activity of the masticatory muscles on the right side was 23.1% in group 1, 23.5% in group 2 (р<0.05); from the left - 46.8% and 48.8%, respectively (p<0.05). The reduction of excessive bioelectric activity due to CA of the temporal muscles was 16.1% on the right side in group 1, 14.0% on the left side, and 36.1% and 40.9%, respectively, in group 2 (р<0.05). Symmetry of occlusion also improved - in group 1 by 9.7%, in group 2 - by 15.1%. Conclusions. Means of physical therapy improve the effectiveness of dental interventions, therefore, it is advisable to use them to reduce the severity of pathological high bioelectric activity of the masticatory muscles, which is the basis for improving the functioning of the orofacial zone in patients with bruxism.
Published Version
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