外胚葉性異形成症児の補装用リハビリテーション後の咀嚼能力およびQOL評価について

[Masticatory performance and assessment of life quality of children with ectodermal dysplasia after prosthetic rehabilitation].

抄録

目的:

外胚葉性異形成症（ED）児の補装用リハビリテーション後の咀嚼能力およびLife Qualityの評価を行う。

OBJECTIVE: To evaluate masticatory performance and life quality of children with ectodermal dysplasia (ED) after prosthetic rehabilitation.

研究方法:

外胚葉性形成不全（ED）児6名と健常児18名を対象に、義歯修復を行った。歯ぎしりおよび咀嚼運動中の咬筋（MM）および前側頭筋（TA）の表面筋電図（EMG）を記録した．EMGの振幅，面積，全体の非対称性指数，MM/TAの活動性指数を各段階において比較した．咀嚼効率は分光光度計で測定した．Life QualityはVisual Analogue Scaleアンケートを用いて評価した．

METHODS: Six children with ED received denture restoration and 18 healthy children were involved in this study. The surface electromyography (EMG) of masseter (MM) and anterior temporalis (TA) during clenching and chewing movement were recorded. The EMG amplitude, area, asymmetry index of total and activity index of MM/TA were compared at each stage. The masticatory efficiency was measured with spectrophotometer. The life quality was assessed using visual analogue scale questionnaire.

結果:

ED群における咀嚼時のMMとTAの筋電図振幅は対照群の41.7％と45.6％，面積はそれぞれ35.9％と36.0％であり，MMとTAの非対称性指標は対照群に比べ有意な差があった．食いしばり時の非対称性指数は両群間で有意差を認めたが（P < 0.05），咀嚼時には有意差を認めなかった（P > 0.05）．食いしばり時および咀嚼時のMM/TAの活動指数には，両群間に有意差は認められなかった（P > 0.05）．ED群の咀嚼能率は対照群の67.2%であった．補綴治療後のED児の咀嚼機能スコアは補綴治療前の3倍であり，両群間に差は認められなかった（P＞0.05）．

RESULTS: The EMG amplitude of MM and TA during chewing in ED Group were 41.7% and 45.6% of the control group respectively, the area were 35.9% and 36.0% respectively. Significant difference in asymmetry index of total during clenching was observed between the two groups (P < 0.05) but not during chewing (P > 0.05). The differences of activity index of MM/TA during clenching and chewing between the two groups were not detected (P > 0.05). The masticatory efficiency of ED group was 67.2% of the control group. The score of chewing function in children with ED after prosthetic rehabilitation was three times higher than before, and no difference was present between the two groups (P > 0.05).

結論:

早期の補綴リハビリテーションは，ED患児の咀嚼能力および生活の質を著しく改善することができる．

CONCLUSIONS: Early prosthetic rehabilitation can significantly improve the masticatory performance and life quality of children with ED.