- 學位論文
以標準化測試食物評估軟食咀嚼效率 並探討下顎運動與咬合型態對於軟食咀嚼效率的影響
Evaluation of soft food mixing efficiency with standardized test food, and the effect of jaw motion and occlusal morphology on soft food mixing efficiency
摘要
本研究的目的乃建立標準化的軟質測試食物以評估軟食咀嚼效率，並探討軟食咀嚼效率與下顎運動、臼齒咬合型態的關係。實驗受試者為二十六位年輕男性及女性（男性十三位，女性十三位），所有受試者皆具有完整齒列，無牙齒結構的缺失或牙周疾病，無牙橋贗復物與任何顳顎關節或咀嚼肌肉障礙的現象，且其咬合分類上皆屬安格氏第一類咬合(Angle’s class I)。實驗用的標準化測試物為包含hydroxylapatite (HA) 顆粒之無糖口香糖塊。受試者坐在沒有頭靠的椅子上以其慣用側依一定之節奏（每一秒咬一下）咀嚼測試物，咀嚼嚼次分別為咀嚼五次、十次、十五次、二十次、二十五次、三十次，其順序採隨機分配。依咀嚼後口香糖中HA顆粒之分佈均勻度來判斷其混合效率值。經確定最佳觀測咀嚼效率之嚼次後，使用BioPAK顎運動追蹤器（EGN）觀察咀嚼時之下顎運動。受試者坐在沒有頭靠的椅子上以其慣用側依一定節奏（每一秒咬一下）咀嚼測試食物三十次。為瞭解臼齒咬合面型態對咀嚼效率之影響，印取受試者慣用側上顎牙齒模型，並計算其頰腭咬頭間之臼齒咬合截面面積（OCA，occlusal cut-surface area）。 先利用此一口香糖測試物進行咀嚼測試，口香糖內的HA分散均勻度隨著嚼次增加而增加，當嚼次超過二十五次之後HA分散均勻度便不再增加。男性受試者咀嚼時之側向位移量及向工作側最大速度大於女性受試者 （p < 0.05）；男性受試者比女性受試者有較大的正面觀咀嚼週期之水平位移（p < 0.05）。下顎運動範圍（包括垂直、前後、左右三個方向）隨嚼次增加而減小，各方向上的瞬間最大速度也隨嚼次增加而減少，但向平衡側之瞬間最大速度並未隨嚼次而改變。此外側面觀咀嚼週期的水平位移也隨嚼次增加而減少向後的位移量。比較下顎正面觀咀嚼週期型態與慣用側臼齒咬合截面面積，沒有發現相關性。 配戴BioPAK EGN進行咀嚼測試，女性受試者相較於男性，配戴EGN時其軟食咀嚼效率變差（p < 0.05）。 使用主成分分析法（principle component analysis）分析下顎運動、慣用側臼齒咬合截面面積(OCA)和性別與軟食咀嚼效率的關係，在固定咀嚼節奏的情況下（每秒一週期），下顎運動的範圍越寬，即垂直、前後、左右三個方向的位移量越大，其軟食咀嚼效率越佳。對於軟食咀嚼而言，咀嚼週期水平寬度比角度來得重要（eigenvector: F-C-W = 0.23, F-C-A = 0.14; S-C-W = 0.18, S-C-A = 0.10）。不同性別其下顎運動範圍的差異才是造成軟食咀嚼效率優劣的主要因素。相較於其他的變項，慣用側的臼齒咬合截面面積對於軟食咀嚼效率的影響很小。
並列摘要
The purpose of this study was to evaluate the soft food mixing efficiency by using a newly developed standardized test food. And evaluate the relationship between the soft food mixing efficiency, jaw motion and dental occlusal morphology. Twenty six young adults (thirteen male and thirteen female) were included in this study. All subjects had Angle’s Class I complete dentition, no dental defect or periodontal disease, no denture restoration other than single crowns and no TM joint or masticatory muscle disorders. The test food was a chewing gum block containing hydroxylapatite (HA) particles. All subjects sat in the chair without head rest, and chewed with their preferred side teeth under a constant rhythm (60Hz). Sessions of 5, 10, 15, 20, 25 and 30 chewing strokes was performed randomly. After each chewing, the HA homogeneity within the gum bolus was calculated and defined as mixing efficiency. The chewing movement of 30 chewing strokes was recorded with sironathograph (BioPAK JT3 system). Also, for the observation of occlusal contact area effects on the soft food mixing efficiency, stone model of the functional side first molar was obtained and sectioned. The occlusal cut-surface area (OCA) of preferred side was measured. It was found that, the HA homogeneity within the chewed gum bolus was increased as chewing stroke numbers increased. The HA homogeneity stopped to increase after 25 chews. The influence of the jaw movement recording system on chewing efficiency was found more evident in female subjects. There was significantly wider lateral displacement in male subjects (p < 0.05). Also, the maximum velocity to the working side and fontal chewing cycle horizontal displacement were significantly larger in male subjects (p < 0.05). The jaw motion parameters, including 3 dimensional displacements (vertical, anteroposterior and left-right), 3 dimensional maximum opening and closing velocity were decreased as chewing processing, except the maximum velocity to the balancing side. Also the sagittal chewing cycle horizontal displacement was decreased as chewing processing. There were no significant correlations between fontal chewing cycle parameters (including frontal cycle displacement, frontal cycle angle and frontal cycle width) and OCA (R2 < 0.05, p > 0.05). Under the design of this study (using the arbitrary rhythm: 60Hz), the range of jaw motion (vertical, anteroposterior and left-right displacement) were larger, the soft food mixing efficiency were better. For soft food mixing efficiency, the chewing cycle horizontal width was much important than chewing cycle angle (eigenvector: F-C-W = 0.23, F-C-A = 0.14; S-C-W = 0.18, S-C-A = 0.10). The jaw motion difference between male and female subjects was the key factor to make differnet mixing efficiency. Compared with other parameters, the OCA had smaller effect to soft food mixing efficiency.
參考文獻
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