提高咬合垂直高度與吞嚥時舌頭形態變化之關係

The relationship between increasing occlusal vertical dimension and tongue movement during swallowing

曾柏喬(Po-Chiao Tseng)

指導教授 ： 林哲堂

共同指導教授 ： 彭建綸(Chien-Lun Peng)

臺北醫學大學/口腔醫學院/牙醫學系碩博士班/碩士(2008年)

https://doi.org/10.6831/TMU.2008.00011

摘要

製作義齒過程中取得合適的咬合垂直高度(Occlusal vertical dimension)是很重要的。學者提出許多如何取得合適咬合垂直高度的方法，包括靜止垂直距離、吞嚥、側顱分析、發音及面部分析。但是並沒有學者利用超音波來觀察提高咬合垂直高度在吞嚥時舌頭的變化。10位牙醫學系學生(平均年齡26.6歲)參與實驗。利用光聚合性樹脂製作口內裝置來提高咬合垂直高度(提高3、6、9mm)。利用口腔超音波B+M模式防震測量技術(Computer-aided B mode plus M mode ultrasonography combined with the cushion scanning technique)測試受測者於咬合垂直高度在提高不同高度下，吞嚥時舌頭的變化。結果顯示在咬合垂直高度提高3mm下，吞嚥總時間及吞嚥振幅沒有統計上明顯差異存在。在咬合垂直高度提高6mm下，吞嚥總時間及吞嚥振幅相較於對照組有統計上差異存在( p=0.0443及p=0.0098)。咬合垂直高度提高9mm下，總吞嚥時間於戴入後立即測量、戴入1及3個小時後於統計上有明顯差異存在( p=0.0272，p=0.0174，p=0.0173)。吞嚥振幅於戴入後立即測量、戴入1、3及6個小時後於統計上有明顯差異存在( p=0.0039，p=0.0038，p=0.0018， p=0.0286)。在咬合垂直高度提高下，吞嚥總時間及吞嚥振幅有延長的現象產生，且吞嚥時舌頭能夠漸漸產生適應的現象。

關鍵字

咬合垂直高度 ； 吞嚥 ； 超音波

並列摘要

To determine an optimal occlusal vertical dimension (OVD) is important in fabricating complete denture. Many methods have been proposed to establish a proper occlusal vertical dimension, such as using the rest of vertical dimension, swallowing methods, cephalometric radiography, speaking methods, and facial analysis. However, none of them has been widely recognized as the optimal. In this study a new approach using ultrasound was tested with the aim to determine scientifically the optimal occlusal vertical dimension. 10 volunteers (average 26.6) were enclosed to this study. The occlusal vertical dimension of each volunteer was raised by a custom made splint with the height of 3, 6, 9 minimeters respectively. The swallowings of every volunteer in different vertical dimensions were examined by the computer-aided B mode plus M mode ultrasonography combined with the cushion scanning technique. The result showed that no significant difference to total-duration and amplitude of swallowing at 3mm increasing height of OVD. The total-duration and amplitude of swallowing at 6mm increasing height of OVD were significantly higher than control group at immediate placement. (p=0.0443 and p=0.0098) Moreover, The duration of swallowing at 9mm increasing height of OVD were significantly higher than control group at immediate placement,1 and 3 hours later.(p=0.0272, p=0.0174, p=0.0173) The amplitude of swallowing at 9mm increasing height of OVD were also significantly higher than control group at immediate placement,1、3 and 6 hours later(p=0.0039, p=0.0038, p=0.0018, p=0.0286).Increasing occlusal vertical dimension would change the swallowing duration and amplitude. Furthermore, tongue could gradually adapt to the different occlusal vertical dimensions.

並列關鍵字

occlusal vertical dimension ； swallowing ； ultrasound

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