Valutazione elettromiografica ed elettrognatografica del trattamento ortodontico-chirurgico

Abstract

Objectives Electromyography and electrognatography are very useful to assess neuromuscular function in the diagnosis and treatment of patients during orthodontic surgical treatment. The aim of this work is to evaluate both neuromuscular function and mandibular movements in 70 patients undergoing orthodontic surgical treatment. Material and methods During the orthodontic surgical treatment all patients were submitted to usual clinical and radiographic exams and to periodical electromyographic and electrokinesiographic evaluations. The test group consisted of 70 patients (27 men and 43 women) at the end of growth. Electromiography and kinesiography were performed at the time of diagnosis, at the beginning of orthodontic therapy, periodically during orthodontic treatment before surgery, the day before surgery, during the intermaxillary block, at the removal of the fixation, during orthodontic treatment after surgery, at the removal of orthodontic appliance and the during follow up. The instruments used in this research were a Freely electromiograph and a K6-I EMG electromiograph and electrognatograph. The anterior temporal and the masseter muscles were tested. The control group consisted of adult patients with skeletal class I, with no temporomandibular disorders and no previous orthodontic or surgical-orthodontic treatments. Mandibular movements were assessed by a Myotronics K6-1 kinesiograph. The results were statistically analyzed by t test and ANOVA test. Results At the beginning of treatment the patients of the test group showed a malocclusion-compensating balance. During orthodontic treatment before surgery electromyographic and electrognathographic values started to worsen and continued to worsen until surgery. They improved during orthodontic treatment after surgery. After removing orthodontic appliances, electromyographic values improved and reached optimal values. Recover of mandibular movements was also satisfying even if it took a longer time than muscular rehabilitation. At the end of the treatment maximum mandibular opening was still smaller than before treatment. Conclusions This study confirms that functional rehabilitation of patients during orthodontic-surgical treatment is timely and good. Functional evaluation is important to reduce as much as possible a faulty neuromuscular activity that may cause a relapse; it also helps clinicians to control treatment and results.