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系統識別號 U0007-0208201112392900
論文名稱(中文) 肉毒桿菌注射後人類咬肌之功能及體積變化
校院名稱 臺北醫學大學
系所名稱(中) 牙醫學系碩博士班
系所名稱(英) School of Dentistry
學年度 99
學期 2
出版年 100
研究生(中文) 郭嫚茹
研究生(英文) Man-Ju Kuo
學號 M204096005
學位類別 碩士
語文別 中文
口試日期 2011-06-22
論文頁數 66頁
口試委員 委員-蕭裕源
指導教授-蔡吉陽
共同指導教授-楊良友
中文關鍵字 人類  A型肉毒桿菌  肌電圖  MRI  咬力  咬肌 
英文關鍵字 human  Botulinum type A  EMG  MRI  Biteforce  Masseter muscle 
學科別分類
中文摘要 過去十年來已有許多研究將肉毒桿菌神經毒素(Botulinum toxin type A)運用在美容醫學的範疇,利用肉毒桿菌本身阻擋神經末稍乙醯膽鹼的釋放,造成肌肉癱瘓來使肌肉放鬆,進而達到去除皺紋的效果。而與齒顎矯正學較有關係的,便是利用肉毒桿菌治療咬肌肥大的病例。
咬肌發達的患者常伴隨著方臉型以及前牙齒列深咬的發生,在肉毒桿菌尚未普及運用之前,改善咬肌肥大的方法通常需以手術切除肥大的咬肌,或是用電燒去除神經的支配,使咬肌萎縮,然而這些方式會有以下的缺點:手術麻醉的風險,某些後遺症如:疤痕的產生、手術後臉型的不對稱。而今可經由注射肉毒桿菌素,造成咬肌萎縮,藉以影響下三分之一臉部的顏面外觀。然而,施打肉毒桿菌素於咬肌,是否會造成咬肌功能實質的影響與體積變化則少見於以往的研究。因此,本實驗將藉由磁振造影(以下簡稱MRI)與肌電圖的測量,實際量化比較肉毒桿菌素注射前後,成年男女咬肌的體積與功能之變化。
論文目次 目錄
謝誌
中文摘要…………………………………………………………………I
英文摘要……………………………………………… ………………Ⅳ
目錄………………………………………………………………… Ⅶ

第一章 緒論……………………………………………………………1
第一節 研究動機……………………………………………………2
第二節 研究目的……………………………………………………2
第三節 研究假設……………………………………………………2

第二章 文獻查證………………………………………………………5
第一節 咀嚼肌對顱顏發育及結構的影響………………………6
第二節 肉毒桿菌神經毒素作用之機轉…………………………… 9
第三節 肌電圖的基本原理………………………………………..13
第四節 肌電圖與咬力的相關性……………………………………17
第五節 肉毒桿菌神經毒素作用後肌電圖訊號的變化……………18
第六節 磁振造影的基本原理………………………………………19
第三章 研究材料與方法………………………………………………20
第一節 研究對象……………………………………………………21
第二節 研究材料……………………………………………………22
第三節 研究設計及步驟……………………………………………23
第四節 統計方式……………………………………………………29

第四章 結果與討論……………………………………………………30
第五章 結論……………………………………………………………36
第六章 參考資料………………………………………………………38
第七章 附表……………………………………………………………46
第八章 附圖……………………………………………………………57
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