CAJ | 학술논문

磨牙症的病因分为外周神经因素和中枢神经因素，(牙合)因素在磨牙症中只起一小部分作用。磨牙症与睡眠觉醒有关并受多种中枢神经化学递质的影响。中枢神经化学递质可能打乱了基底神经节的直接和间接输出通道的平衡，从而打乱咀嚼肌协调运动，引发磨牙症。左旋多巴、溴隐亭和普萘洛尔可抑制磨牙活动，肉毒杆菌毒素可降低磨牙的频率和磨牙诱发的疼痛。可乐定可抑制磨牙症患者的快速动眼（REM）期，磨牙症患者尿儿茶酚胺水平较健康者高。有人认为磨牙症患者的睡眠效率低于健康人，有人认为磨牙症患者有正常的睡眠结构和质量；有人认为磨牙症常发生于睡眠的第2阶段和REM期，有人认为磨牙症均匀分布于REM期和非快速动眼（NREM）期；有人认为，磨牙症多数发生于NREM浅睡眠期，少数发生于REM期，有人认为磨牙症是继发于微觉醒的异常口腔活动。个性、焦虑等心理社会因素也是磨牙症重要的影响因素。磨牙症患者有较高的生活压力和焦虑，磨牙症程度重者，其工作和生活压力也重。本文就磨牙症的中枢神经病理生理因素和精神心理因素等研究进展作一综述。
마아증적병인분위외주신경인소화중추신경인소，(아합)인소재마아증중지기일소부분작용。마아증여수면각성유관병수다충중추신경화학체질적영향。중추신경화학체질가능타란료기저신경절적직접화간접수출통도적평형，종이타란저작기협조운동，인발마아증。좌선다파、추은정화보내락이가억제마아활동，육독간균독소가강저마아적빈솔화마아유발적동통。가악정가억제마아증환자적쾌속동안（REM）기，마아증환자뇨인다분알수평교건강자고。유인인위마아증환자적수면효솔저우건강인，유인인위마아증환자유정상적수면결구화질량；유인인위마아증상발생우수면적제2계단화REM기，유인인위마아증균균분포우REM기화비쾌속동안（NREM）기；유인인위，마아증다수발생우NREM천수면기，소수발생우REM기，유인인위마아증시계발우미각성적이상구강활동。개성、초필등심리사회인소야시마아증중요적영향인소。마아증환자유교고적생활압력화초필，마아증정도중자，기공작화생활압력야중。본문취마아증적중추신경병리생리인소화정신심리인소등연구진전작일종술。
The causes of bruxism are divided into peripheral factors and central factors, occlusal factors are known to only play a minor role. Bruxism is associated with sleep micro-arousal and appears to be modulated by various neurotransmitters in the central nervous system. These neurotransmitters may be disturbed the balance between the direct and indirect pathways of the basal ganglia which are involved in the coordination of movements of masticatory muscle in bruxers. L-dopa, bromocriptine and propranolol can inhibit bruxism activity, botulinum toxin injections can reduce the frequency of bruxism events and decrease bruxism-induced pain levels, clonidine can inhibits the rapid eye movement(REM) of bruxism patients and the levels of catecholamines are higher in bruxers. Some authors think that bruxism patients with lower sleep efficiency, but some think that bruxism patients have normal sleep structure and quality; some people think that bruxism occurred more frequently in stage 2 and REM, some think bruxism episodes are equally distributed between non-rapid eye movement(NREM) and REM sleep, but some also think bruxism are mainly occurred in light sleep and seldom occurred in REM, moreover some think that bruxism is a abnormal oral activities that secondary to sleep micro-arousal. Psychological factors like personality and anxiety are also frequently mentioned in relation to bruxism. Bruxism patients have higher life stress and anxiety, the person that severe bruxism, their work and life pressure is more heavier. In this paper, A central factors of bruxism is reviewed in detail concerning their pathophysiological and psychosocial aspects.