한국인 성인의 교근 두께에 관한 초음파검사적 연구

이연희,차봉근,박인우 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.2

일반적으로 골의 형태와 구조는 부착 근육의 활성과 밀접한 관련이 있다고 알려져 있으며,특히 악안면 형태와 저작근 기능과의 관계는 많은 임상 및 동물 실험을 통해 연구되어 왔다. 초음파검사는 임상적 적용이 용이하고 비용이 저렴할 뿐만 아니라 환자에 대한 유해성이 적어 의학분야의 여러 영역에서 널리 이용되고 있다. 이 연구의 목적은 교근의 두께와 악안면 골격 형태와의 상관성을 평가하는 것으로, 강릉대학교 치과대학 남학생 35명과 여학생 15명을 대상으로 하였다. 교근의 두께 측정에는 7.57MHz의 고해상도 직선 탐촉자에 의한 초음파진단장치가 사용되었고, 악안면 골격 형태의 결정은 측방 두부계측방사선사진 분석을 통해 이루어졌다. 이상의 계측치로부터 얻어진 결론은 다음과 같다. 1.남자에서 교근의 평균 두께는 안정 상태에서는 13.8±1.71mm,최대 교합 상태에서 14.8±1.77mm였으며 여자에서는 안정 상태에서 11.6±1.58mm, 최대 교합 상태에서 12.4±1.47mm로 나타났다. 2.교근의 두께는 남녀모두 안정 상태보다 최대 교합 상태에서 유의하게 증가하였다(P<0.05). 3.교근의 두께는 안정 상태와 최대 교합 상태 모두에서 남자가 여자보다 유의하게 두꺼웠다(P<0.05). 4.교근의 두께는 남자에서 안정 상태와 최대 교합 상태 모두 하악평면각과는 음의 상관 관계가 있고 하악지 고경, 전두개저 길이와는 양의 상관 관계가 있음을 알 수 있었다(P<0.05). 5.여자에서는 교근 두께와 유의한 상관 관계가 있는 두부계측방사선사진 분석 항목을 찾을 수 없었다(P<0.05), 이로써 초음파검사는 악골 근육의 기능을 평가하는 전통적인 방법에 대해 추가적인 정보를 제공해 줄 수 있을 것으로 사료된다. It is widely accepted that the shape and structure of bone are closely related to the activity of attached muscle. Numerous clinical and animal experimental studies indicated the significant effects of masticatory muscle function on maxillofacial mofhology. Recently, the development of ultrasonography has spread throughout different fields of medicine. In the clinical examinations, ultrasonography is a convenient, inexpensive technique to apply with accurate and reliable results. The aim of this study is to assess the thickness of the masseter muscle and its correlation to maxillofacial skeleton by examining 35 male and 15 female dental students at Kangnung National University. The masseter muscle thickness of the subjects were measured by ultrasonographic scanning with a 7.5MHz linear probe, and their maxillofacial morphology were investigated by lateral cephalometric radiographs. The relationship between the masseter muscle thickness and maxillofacial morphology of normal adult was statistically analyzed, and the following results were obtained. 1.The average thickness of male masseter muscle was 13.8± 1.71mm in the relaxed state and 14.8 ± 1.77mm at maximal clenching state, while that of female was 11.6±1.58mm and 12.4±1.47mm, respectively. Ethnic difference in thickness of the masseter muscle and maxillofacial skeleton was found when the results of many researchers were compared with those of this study. 2.The thickness of the masseter muscle in both sexes increased significantly at maximal clenching state than in relaxed state(P<0.05). 3.The masseter muscle thickness of male was greater than that of female both in the relaxed state and maximal clenching states(P<0.05). 4.In males, the thickness of the masseter muscle was negatively correlated with the mandibular plane angle and positively correlated wish the mandibular ramus height and antenor cranial base length(P<0.05). It may suggest that the male with thicker masseter muscle has smaller facial divergence. 5.No significant correlation was found between the masseter muscle thickness and maxillofacial morphology in females(P<0.05). Therefore, these data suggest that ultrasonography can add valuable information to the conventional examinations of masseter muscle function.

A Study on the Difference in Masseter Muscle Tone and Stiffness in Chronic Stroke Patients Using MyotonPRO

조용훈,채연희,김민주,김선아,신현성,한보운,박신준 국제물리치료연구학회 2022 Journal of International Academy of Physical Ther Vol.13 No.3

Background: For the rehabilitation of stroke patients, it is necessary to confirm the differences in the mechanical properties of the paretic- and non-pareticside masseter muscles. Objectives: To investigate the muscle tone and stiffness of masseter muscles in patients with chronic stroke. Design: A case study. Methods: This study included 20 stroke patients. Muscle tone and stiffness of the paretic and non-paretic masseter muscles in stroke patients were measured using MyotonPRO. Measurements were performed under relaxation and masseter muscle contraction conditions. Results: There was no significant difference in the muscle tone and stiffness of the paretic and non-paretic side masseter muscles in the relaxation conditions (P>.05). In male, left hemiplegia, right hemiplegia and infatction, the nonparetic side masseter muscles showed significantly increased than musle tone and stiffness of the paretic side masseter muscles in the contraction (P<.05). In female and hemorrhage, the non-paretic side masseter muscles showed significantly increased than musle tone the paretic side masseter muscles in the contraction (P<.05). Conclusion: The muscle tone and stiffness were lower on the paretic side than on the non-paretic side during masseter muscle contraction in stroke patients; thus, muscle strengthening training was required.

A Reproducible and Reliable Method for Measuring Masseter Muscle Thickness in Maximal Bite Force Using Ultrasonography

박현정,유선경,서요섭,유지원 대한안면통증∙구강내과학회 2022 Journal of Oral Medicine and Pain Vol.47 No.4

Purpose: The purpose of this study is to develop a reproducible and reliable method for evaluating the masseter’s functional state by measuring the masseter muscle with ultrasonography (US). Methods: Nineteen healthy adults (9 males, 10 females) were the subjects of this study. During US scanning, the image was taken from the thickest part of the masseter muscle in the image. To evaluate changes in thickness during masseter function, US images were taken of the participant’s masseter muscle at rest and during clenching. In this study, US scanning was conducted using two approaches to compare the difference in masseter muscle thickness determined when inducing maximum bite force (MBF). Results: All 19 subjects completed US scanning of the masseter muscle at rest and during clenching under the conventional method and the articulation paper method. There was no difference in masseter muscle thickness measured at rest. However, the thickness of the masseter muscles determined by the articulation paper during jaw clenching was greater than that measured by the conventional method. Conclusions: In conclusion, using the US for masseter muscle evaluation can offer objective and functional information on the masseter muscle. A standardized US scanning method needs to be developed to obtain reproducible and reliable information on the masseter muscle at rest and during clenching. In particular, generating MBF using an articulation paper can be a reproducible and reliable method of measuring the functional state of the masseter muscle.

토끼의 하악각절제 후 동반되는 교근의 위축

송홍식 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.2

In order to get information about the changes of masseter muscle when operation is performed on the mandible angle area, we classified seventy white New Zealand rabbits into group O & group D. In the group O, we performed unilateral ostectomy of mandible angle, while in the group D, we dissected unilateral masseter muscle on the mandible abgle area. Then, we compared morphological, histological and histochemical changes of masseter muscle with those of opposite, normal, control masseter muscle. We examined every five rabbit in each group at the following postoperative weeks: 1wk, 2wks, 4wks, 6wks, 8wks, 12wks, 24wks. In the group D, there were no remarkable changes on all examinations. In the group O, there was 30% decrease of experimental muscle mass compared with normal side. On examination of muscle fiber types, decrease of type Ⅰ fibers and increase of type ⅡA, ⅡB fibers were significantly noticed (P〈0.05). Each experimental muscle fiber became more irregularly and angularly shaped and mean fiber areas were also reduced. Sarcomere length of muscle fibers on the operated side was significantly reduced to 80% values of controls (P〈0.05) during the first four weeks, but after six weeks it was lengthened to control values. Collagen and fibrin did not show much difference between experimental and control muscles. All of the above findings imply that masseter muscle atrophy after ostectomy of mandible angle is not due to connective tissue changes but to individual muscle fiber atrophy accompanied with functional adaptation of sarcomeres and changes of muscle fiber type.

턱관절장애 유무에 따른 깨물근, 목빗근의 두께 및 근긴장도, 최대 입벌림 범위의 비교 및 상관성 연구

이근효 ( Lee Keunhyo ),천승철 ( Chon Seungchul ) 대한통합의학회 2020 대한통합의학회지 Vol.8 No.3

Purpose : Temporomandibular joint disorder (TMJD) is often accompanied by pain and limited range of motion of the jaw joint, which affect patients’ quality of life and result in hypertrophy or hyperactivity of the muscles around the jaw joint. In this study, we compared the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and the jaw range of motion in individuals with and without TMJD. Correlation comparison was performed on the results of the TMJD group. Methods : This study included 40 patients; 20 patients were assigned to an experimental group (TMJD group) and 20 to a control group (non-TMJD group). Ultrasonography, myotonometry, and measurements performed with digital Vernier calipers were used to determine the changes in muscle thickness, muscle tone, and maximum jaw opening, respectively. The independent t-test was used for intergroup comparison of data, and Pearson correlation coefficients were used to compare correlations in the TMJD group results. Results : We observed a significant intergroup difference in the masseter and SCM thickness during the relaxed and clenched phases (p<.05). A significant intergroup difference was also observed in maximum jaw opening (p<.05). With regard to muscle tone, we observed a significant intergroup difference in frequency (p=.011) and stiffness (p=.011) of the masseter, as well as in the frequency (p=.009) and stiffness (p=.026) of the SCM. We observed a moderate negative correlation (r=-.524) between maximum jaw opening and the frequency of the masseter. Additionally, we observed a moderately negative correlation between jaw opening and muscle stiffness (r=-.321). Conclusion : Planning exercise programs to treat patients with TMJD who present with pain should focus on efforts to reduce muscle thickness and achieve muscle relaxation (to reduce muscle tension) for improved jaw range of motion.

The Relationship of Rat Superficial and Deep Masseter Muscles Fibre and Sarcomere Lengths to the Tetanic Force-Length Curve

Borromeo, G.L.,Luff, A.R. Korean Academy of Oral Biology and the UCLA Dental 2002 International Journal of Oral Biology Vol.27 No.2

The masseter muscle is one of the most important jaw clsion muscles in the rat. The lengths over which superficial and deep portions of rat masseter muscles can function and how these lengths are related to the force-length relationship of these muscles were determined. Three different static jaw positions were chosen to establish the outermost limits of the chewing cycle. Fibre and sarcomere length ranges of the superficial and deep masseter muscles were found to differ in all three jaw positions. The deep portion of the masseter muscle functions through a length range equivalent to 40% optimum force on the ascending limb of the force-length relationship to the equivalent of 50% optimum force on the descending limb. The superficial masseter muscle only functions on the ascending limb of the force-length relationship with optimum force generated when the jaw is maximally opened. It is clear that the superficial and deep masseter muscle of the rat function differently and hence they should regarded as two distinctly separate muscles.

교합력, 교근과 두개안면골 형태의 관계 : 두부규격방사선사진과 초음파진단영상 분석

이미숙,최영철,최성철,김광철 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.3

교합력과 교근의 두께 및 면적 그리고 두개안변골 형태 간의 연관성을 평가하고자 하였다. 성인 141명의 교합력 측정,측방 및 후전방 두부규격방사선사진 그리고 교근 표층의 초음파진단영상을 촬영한 후, 이들 간의 관계를 통계분석으로 비교,평가하였다. 교합력과 두개안면골의 형태간에는 남녀 모두 유의한 상관관계가 있으며,교합력과 교근 간에는 남녀 모두 유의한 상관관계가 없었다. 그러나 교근은 남자의 두개안면골 형태에서 유의한 상관관계를 보였고, 특히 교근의 두께 및 면적이 증가할수록 상악너비가 유의하게 감소하게 나타났다. 이는 남자의 교합력은 심층 교근과 관계가 크고,여자의 교합력은 표층 교근과 관계가 큰 것이 원인으로 판단된다. The aim of this study was to investigate the relationships between bite force, masseter muscle and craniofacial morphology. 141 individuals were included. Bite forces were measured with a bite force transducer(SKT 2004). The facial morphology of the samples was evaluated on the Lateral and PA cephalometric radiographs(Asahi CX-90 SP). Ultrasonographic images were obtained for 36 individuals (Logiq 500). General status of the subjects were also measured for investigating possible relationships. Their relationships were analyzed by means of t-test. Pearson's correlation coefficients and simple regression analysis, In conclusion, bite force of molar was significantly correlated with craniofacial morphology for males and females, but not to masseter muscles. The masseter muscle for males had a significant correlation with craniofacial morphology. The unexpected negative correlations between size of masseter muscle and maxillary width was revealed for males. One possible way to arrive at a plausible explanation for the correlation between masster muscle, bite force and craniofacial morphology of males were the deep layer of masseter muscle had a great influence on males and the superficial layer of masseter muscle had a great influence on females.

고주파를 이용한 교근 축소술 소개 및 증례보고

지유진,이덕원,Jee, Yu-Jin,Lee, Deok-Won 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.5

Asians tend to have prominent mandibular angle. The causes of wide lower third of the facial contour are obtuse mandibular angle and hypertrophy of masseter muscles. In cases of hypertrophy of masseter muscles, conventional treatment intends to the contraction of masseter muscle. Recently, volumetric reduction of masseter muscles using botulinum toxin type A injection and radiofrequency (RF) reduction have been introduced. The use of RF energy for masseter muscle reduction is known as a safe, simple, and effective method for aesthetic lower facial contouring. The purpose of this study is to present the effects of RF reduction applied to hypertrophy of masseter muscles, to review and to encourage RF practices in oral and maxillofacial region.

Evaluation of MAPK pathway activation in brainstem induced by the masseter muscle inflammation

Michiko Nakatsuka,Shunji Kumabe,Shoko Gamoh,Hironori Akiyama,주성숙,김지연,Katsura Ueda,Yoshifumi Matsuda,Kimishige Shimizutani,신제원,Yasutomo Iwai 대한구강해부학회 2014 대한구강해부학회지 Vol.35 No.1

To evaluate the inflammatory hyperalgesia induced by noxious stimulation of the masticatory muscles, we performed an immunohistochemical study on the expressions of phosphorylated-p38 (p-p38) mitogen activated-protein kinase (MAPK) and the distribution of activated microglia in the trigeminal subnucleus caudalis (Vc). The left masseter muscle (LMM) of Sprague Dawley rats (male, 250 g, n=60) was stimulated in the following methods: 1) L-L group (control); the LMM was injected with lipopolysaccharide (LPS, 2 μg/kg, 100μl) on the 1st day of the experiment. On day 2, the same site was injected with the LPS again. 2) L-S6 group (experimental); the LMM was injected with LPS (2 μg/kg, 100μl) on the 1st day of the experiment. On day 2, the same site was injected with 6 % sodium chloride solution (S6, 100 μl, 5 times per 90 min). Rats were allowed to survive for 1 day, 7 days or 14 days after the last injection. The brainstems were dissected and cut with a cryostat (at 30 μm thickness). These specimens were investigated with anti-TNFα (masseter muscle), the bradykinin receptor B2 (BKRB2, masseter muscle), anti-p-p38 MAPK (brainstem) and anti-Iba1 (ionized calcium-binding adapter molecule 1: Iba1, a marker for microglial activity; brainstem) enzyme-labeled antibody method. The specimens were observed and evaluated using a light microscope(LM) mounted with an Olympus FX380 3CCD digital camera system connected with a FLvFs software (Flovel Image Filling System, Tokyo, Japan). In both groups, the TNF-α and the BKRB2-immunoreactive (IR) cells were observed until 7 days after stimulation. In the experimental group, the LM histology indicates that p-p38 MAPK and Iba1-IR cells were particularly localized in the left Vc until 14 days after stimulation. In the experimental group, 7 days or 14 days after nociception, the p-p38 MAPK-IR cells were recognized in the contralateral and ipsilateral in the Vc. The results suggest that the prolonged MAPK activity in the Vc is related to central sensitization in chronic pain of the masseter muscle.

초음파영상을 이용한 정상 교근의 평가

황형주,김규태,최용석,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.2

Purpose : To assess the internal echo intensity and morphological variability of masseter muscles on ultrasonography and to establish diagnostic criterion of estimation. Materials and Methods : Participants consisted of 50 young adults (male 25, female 25) without pathologic conditions and with full natural dentitions. Sonographic examinations were done with real time ultrasound equipment as Logiq 500 (GE Medical Systems, Seoul, Korea) at 3 parts according to lines paralleling with ala-tragus line as reference line. The thickness and area of masseter muscles according to reference line in cross-sectional images were measured at rest and at maximum contraction. The visibility and width of the internal echogenic intensity of the masseter muscles were also assessed and the muscle appearance was classified into 4 types. Data were statistically analyzed by paired t-test and x²-test. Results : 1. When comparing the thickness and area of masseter muscles concerning with gender, there was few significant difference between right and left sides, however, there were significant differences between males and females except for the greatest thickness of left side. 2. The changes of the greatest thickness and the area between rest and maximum contraction showed that the part of the least thickness manifested more increase at maximum contraction. 3. Each part the manifestations of the internal echogenic intensity of the masseter muscles were different depending on the locations. But there was no statistically significance. Conclusion : Changes of muscles thickness with contraction and internal echogenic intensity with locations showed great disparity within the masseter muscles, which will be diagnostic criteria for pathophysiologic and anatomic changes of masseter muscles.