안면 비대칭 환자의 수직 안모 유형과 이하두정 두부방사선 규격사진 계측치 및 표면 근전도의 상관성에 대한 연구
A study on the correlations between facial biotype, submentovertex cephalometric measurements and surface EMG activity in patients with facial asymmetry
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안면 비대칭 환자의 진단분석에 이용할 수 있는 이하두정 두부방사선 규격사진과 표면 근전도 검사 자료는 통용화된 진단분석법 부재 등의 이유로 제한적으로 사용되고 있다. 그러나 여타 진단분석법과 비교할 때, 수직 안모 유형의 평가 등 차별적인 정보를 얻을 수 있어 이에 대한 연구가 필요하리라 보인다. 본 연구의 목적은 안면 비대칭을 보이는 60명을 대상으로 이하두정 두부방사선 규격사진 및 저작근의 표면 근전도를 측정하여 수직 안모 유형과의 연관성 및 안면 비대칭과의 연관성을 평가하고자 함이다. 이하두정 두부방사선 규격사진 계측치 중 radiographic corpus length는 비편위측이 큰 값을 보였고 (p < 0.001), 유의성은 없었으나 gonion to interspinosum axis는 편위측이 크고, gonion과 하악과두의 위치는 비편위측이 편위측에 비해 전방에 위치하였다 (p = 0.07). 안정시 편위측 전측두근의 근활성은 비편위측보다 높은 것으로 나타났다 (p < 0.01). 또한 최대 폐구 시 교근의 활성은 유의성이 없었으나 비편위측에 비해 편위측이 큰 값을 보였다 (p = 0.09). Facial index와 intercondylar axes angle은 양의 상관관계를 보였다 (p < 0.01). 최대 폐구 시 편위측 및 비편위측의 교근의 활성은 facial index와 양의 상관관계를 보였다 (p < 0.05). 이상의 결과를 통해 골격성 안면 비대칭을 보이는 환자에서 이하두정 두부방사선 규격사진과 표면 근전도 검사를 통해 비대칭 양상의 평가와 더불어 수직 안모 유형의 평가 또한 가능한 것으로 생각된다.
Abstract
Although the submentovertex radiograph and surface EMG are not often used due to the difficulty of interpretation, they are accepted as useful diagnostic and analytic aids for skeletal asymmetry. There have been reports which state that they were also useful for the evaluation of vertical skeletal relations. The purpose of this study was to evaluate the correlations between EMG data, measurements from submentovertex radiographs, facial types and facial asymmetry following examination of 60 asymmetric patients. The radiographic corpus length were greater in the nonaffected sides (p < 0.001), gonion to interspinosum axis were greater in the affected sides and the mandibular condyle and gonion were located more anteriorly in the non-affected sides than in the affected sides but not significant (p = 0.07). The activity of the anterior temporal muscle in rest position was higher in the affected sides than in the non-affected sides (p < 0.01). The activity of the masseter muscle at maximum clenching was found to be nonsignificant but it was higher in the affected sides than in the non-affected sides (p = 0.09). There was positive correlation between facial index and the intercondylar axes angle (p < 0.01). There was positive correlation between masseter muscle activity in maximum occlusion and facial index in the affected and non-affected sides (p < 0.05). The results demonstrate that the submentovertex radiograph and EMG can provide useful information for the evaluation of horizontal and vertical skeletal relations.
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