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Journal of Prosthodontics : Official... Jul 2023Centric relation (CR) is a universally recognized term and an acceptable reference position with a long history of success. The problem is that there is little consensus... (Review)
Review
PURPOSE
Centric relation (CR) is a universally recognized term and an acceptable reference position with a long history of success. The problem is that there is little consensus as to its definition or the method of recording it, and this has created an uprising to abolish it.
METHODS
A review of pertinent literature related to its definition, method of recording, anatomic considerations, and long-standing principles was conducted.
RESULTS
Centric relation is an established term but there are valid concerns over its definition and method of recording. There is consensus on using it as a restorative position in a patient in need of full-arch reconstruction, and there is no substantive clinical research to contradict this. If a clinician decides to use a different position, it should have a different name.
CONCLUSIONS
Centric relation is a reproducible reference position that can be utilized for diagnostic and restorative dental procedures with substantial scientific evidence to support that premise. There are numerous well-documented techniques, all of which are intermaxillary, that can replicate the position. There is little scientific evidence to support a premise as to where the exact position of the condyle should be in relation to the fossa.
Topics: Humans; Centric Relation; Consensus; Dental Occlusion, Centric; Jaw Relation Record; Mandibular Condyle
PubMed: 36074517
DOI: 10.1111/jopr.13603 -
Indian Journal of Ophthalmology Jul 2023Infections of orbit and periorbita are frequent, leading to significant morbidity. Orbital cellulitis is more common in children and young adults. At any age, infection... (Review)
Review
Infections of orbit and periorbita are frequent, leading to significant morbidity. Orbital cellulitis is more common in children and young adults. At any age, infection from the neighboring ethmoid sinuses is a likely cause and is thought to result from anatomical characteristics like thin medial wall, lack of lymphatics, orbital foramina, and septic thrombophlebitis of the valveless veins between the two. Other causes are trauma, orbital foreign bodies, preexisting dental infections, dental procedures, maxillofacial surgeries, Open Reduction and Internal Fixation (ORIF), and retinal buckling procedures. The septum is a natural barrier to the passage of microorganisms. Orbital infections are caused by Gram-positive, Gram-negative organisms and anaerobes in adults and in children, usually by Staphylococcus aureus or Streptococcus species. Individuals older than 15 years of age are more likely to harbor polymicrobial infections. Signs include diffuse lid edema with or without erythema, chemosis, proptosis, and ophthalmoplegia. It is an ocular emergency requiring admission, intravenous antibiotics, and sometimes surgical intervention. Computed tomography (CT) and magnetic resonance imaging (MRI) are the main modalities to identify the extent, route of spread from adjacent structures, and poor response to intravenous antibiotics and to confirm the presence of complications. If orbital cellulitis is secondary to sinus infection, drainage of pus and establishment of ventilation to the sinus are imperative. Loss of vision can occur due to orbital abscess, cavernous sinus thrombosis, optic neuritis, central retinal artery occlusion, and exposure keratopathy, and possible systemic sequelae include meningitis, intracranial abscess, osteomyelitis, and death. The article was written by authors after a thorough literature search in the PubMed-indexed journals.
Topics: Child; Young Adult; Humans; Orbital Cellulitis; Abscess; Orbit; Exophthalmos; Anti-Bacterial Agents
PubMed: 37417106
DOI: 10.4103/IJO.IJO_3283_22 -
Journal of Plastic, Reconstructive &... Jul 2023Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations...
BACKGROUND
Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations and challenges for further pursuit. We propose Fibula Jaw-during-Admission (JDA) as a solution.
MATERIALS AND METHODS
From 2019 to 2021, six patients received fibula "Jaw-during-Admission." Segmental mandibulectomy, fibula transfer, and immediate dental implantation were performed simultaneously during a single surgery. Intraoral scans were used to fabricate temporary light occlusion contact dental prostheses while on the ward prior to discharge during the first and second week post operation. The prostheses were installed before discharge and changed to permanent ones with normal occlusal contact in the clinic at about six months after X-ray confirmation of bone healing.
RESULTS
All six surgeries succeeded. Four patients received palatal muco-periosteal graft after debridement of peri-implant overgrown granulation tissue. Follow-up ranged from 12 to 34 months (average 21.2 months) and revealed good function and appearance in all patients.
CONCLUSION
Fibula JDA is superior to the Fibula JIAD approach for simultaneous mandibular reconstruction with fibula and dental rehabilitation. There is no need for postoperative intermaxillary fixation. The surgery can be performed more reliably with less stress. It provides an additional opportunity for dental rehabilitation if initial dental prosthesis installation during JIAD fails. Postreconstruction intraoral scans provide greater precision and more flexibility in milling dental prosthesis which are mapped to the reconstructed mandible during the postoperative period.
Topics: Humans; Fibula; Mandible; Plastic Surgery Procedures; Mandibular Osteotomy; Mandibular Reconstruction; Bone Transplantation; Dental Implantation, Endosseous; Free Tissue Flaps
PubMed: 37207438
DOI: 10.1016/j.bjps.2023.01.010 -
European Journal of Dentistry Jul 2023This study aimed to evaluate the effectiveness of conventional occlusal analysis in contrast with digital occlusal analysis in natural dentition. Occlusal analysis...
This study aimed to evaluate the effectiveness of conventional occlusal analysis in contrast with digital occlusal analysis in natural dentition. Occlusal analysis allows the identification of normal and abnormal occlusal contact points that alter the craniomandibular cervical system. We searched for articles with keywords [[dental occlusion]], [[natural dentition]], [[occlusal adjustment]], [[Immediate Complete Anterior Guidance Development]] [[mastication]], [[bite force]], [[premature contact]], [[occlusal balance]] [[articulating paper]]], [[spray]], [[Occlusal contacts]], and [[bite strength]]. They were considered observational , odds ratio and case control studies. We found 189 items. After evaluating the abstracts and full texts of the articles, 10 papers met the inclusion criteria. It was found that occlusal analysis allows the identification of the relationship between poor occlusion and the sensitivity of the teeth due to occlusal trauma, which is also related to temporomandibular joint pain in dynamic occlusion. The contacts of greater strength were observed in nonfunctional cusps, 48%, without ruling out the functional cusps, 24%. Despite being the universal method of occlusal control to date, the use of joint paper, remains subjective compared to the digital occlusal control device. Posture is considered directly related to occlusal trauma and temporomandibular disorders; without proper occlusal analysis, a clear diagnosis of the patient's joint condition cannot be obtained. Digital occlusal analysis is more objective than traditional occlusal analysis.
PubMed: 36252609
DOI: 10.1055/s-0042-1755626 -
Journal of Esthetic and Restorative... Jul 2023Within the development of digital technologies, dental professionals aim to integrate virtual diagnostic articulated casts obtained by using intraoral scanners (IOSs),... (Review)
Review
OBJECTIVES
Within the development of digital technologies, dental professionals aim to integrate virtual diagnostic articulated casts obtained by using intraoral scanners (IOSs), the mandibular motion of the patient recorded by using an optical jaw tracking system, and the information provided by computerized occlusal analysis systems. This article describes the various digital technologies available for obtaining the digital occlusion of a patient and outlines its challenges and limitations.
OVERVIEW
The factors that influence the accuracy of the maxillomandibular relationship of diagnostic casts obtained by using IOSs are reviewed, as well as the occurrence of occlusal collisions or mesh interpenetrations. Different jaw tracking systems with varying digital technologies including ultrasonic systems, photometric devices, and artificial intelligence algorithms are reviewed. Computerized occlusal analysis systems for detecting occlusal contacts in a time sequential manner with the pressure distribution on the occlusal surfaces are reviewed.
CONCLUSIONS
Digital technologies provide powerful diagnostic and design tools for prosthodontic care. However, the accuracy of these digital technologies for acquiring and analyzing the static and dynamic occlusion need to be further analyzed.
CLINICAL SIGNIFICANCE
Efficiently implementing digital technologies into dental practice requires an understanding of the limitations and state of current development of the digital acquisition methods for digitizing the static and dynamic occlusion of a patient by using IOSs, digital jaw trackers, and computerized occlusal analysis devices.
Topics: Humans; Digital Technology; Artificial Intelligence; Dental Occlusion; Mandible; Models, Dental; Imaging, Three-Dimensional; Computer-Aided Design; Dental Impression Technique
PubMed: 37021739
DOI: 10.1111/jerd.13044 -
The Journal of Clinical Pediatric... Sep 2023Stainless steel crowns (SSCs) are the preferred restoration of pediatric dentists for children requiring a pediatric dental rehabilitation due to their low cost and...
Stainless steel crowns (SSCs) are the preferred restoration of pediatric dentists for children requiring a pediatric dental rehabilitation due to their low cost and durability. Despite low technique sensitivity SSC placement can be challenging in some clinical situations including when placed on primary canines. Primary canines restored with SSCs often result in premature contacts and posterior open bite making acquiring an "as the patient presented" (ATPP) occlusion difficult when providing a pediatric dental rehabilitation. Opening of the posterior occlusion due to premature canine contact in a dental rehabilitation is often viewed as unavoidable. This technique article describes a simple method to address this clinical situation and reviews basic principles and techniques for placing SSCs.
Topics: Child; Humans; Dentists; Open Bite
PubMed: 37732429
DOI: 10.22514/jocpd.2023.047 -
Atlas of the Oral and Maxillofacial... Mar 2024The field of non-surgical esthetic procedures has witnessed a significant surge in demand in recent years, with neuromodulators, skin treatments, and dermal fillers... (Review)
Review
The field of non-surgical esthetic procedures has witnessed a significant surge in demand in recent years, with neuromodulators, skin treatments, and dermal fillers contributing significantly to the industry's growth. These procedures have become increasingly popular, reflecting the broader acceptance of esthetic enhancements in society. Neuromodulators play a pivotal role in facial rejuvenation, but they require precise knowledge of facial anatomy to optimize results and prevent complications. They include rare hypersensitivity reactions, local injection reactions, and brow and eyelid ptosis. Dermal fillers, both non-permanent and permanent, are widely used to restore volume and improve facial contours. However, they also carry risks, including bruising, temporary edema, and lumps. Permanent fillers present higher complication rates, and their use should be approached with caution. Vascular occlusion is a rare but severe complication associated with dermal fillers. To mitigate these risks, practitioners must have a comprehensive understanding of their compositions and potential complications. Overall, while non-surgical esthetic procedures offer remarkable results with minimal downtime, the importance of training, anatomic knowledge, and effective complication management cannot be overstated in ensuring patient safety and satisfaction in this evolving field of medicine.
Topics: Humans; Dermal Fillers; Cosmetic Techniques; Hyaluronic Acid; Esthetics, Dental; Injections, Subcutaneous; Neurotransmitter Agents; Rejuvenation
PubMed: 38307636
DOI: 10.1016/j.cxom.2023.10.005 -
Oral and Maxillofacial Surgery Clinics... Nov 2023Dental and dentoalveolar injuries are common in the pediatric population. Management is predicated on the type of tooth injured (primary or permanent), extent of injury,... (Review)
Review
Dental and dentoalveolar injuries are common in the pediatric population. Management is predicated on the type of tooth injured (primary or permanent), extent of injury, the dental and behavioral age of the patient, and ability of the patient to tolerate treatment. Although many dental injuries occur in isolation, a systematic evaluation of the patient is mandatory to confirm the absence of basal bone fractures of the maxilla or mandible, traumatic brain injury, cervical spine injury, and/or facial soft tissue injury. Long-term follow-up is paramount to achieving a functional occlusion and optimal dental health following injury.
Topics: Child; Humans; Tooth Injuries; Tooth Avulsion; Tooth Fractures
PubMed: 37640587
DOI: 10.1016/j.coms.2023.06.002