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The Journal of Contemporary Dental... Jul 2022The purpose of the study was to evaluate the stress on the implant and to assess the denture displacement for locator and bar and clip attachment types in...
AIM
The purpose of the study was to evaluate the stress on the implant and to assess the denture displacement for locator and bar and clip attachment types in implant-assisted obturators.
MATERIALS AND METHODS
A maxillary edentulous experimental model with a maxillectomy defect was made along with an opposing edentulous mandibular model with self-cure acrylic. Two endosseous implants were placed in the maxillary model. Corresponding obturator complete denture was fabricated for the maxillary model and a complete denture for the mandibular. The attachments were positioned on the implants in maxillary model, and their sleeve/clip was placed on intaglio surface of the dentures. The mounted articulator was placed on a loading apparatus, and force was incrementally applied to it. The strain and displacement for both the attachment types were measured and compared using Digital Image Correlation (DIC).
RESULTS
Locator attachment showed the least stress and minimal displacement as compared to bar and clip attachment.
CONCLUSION
The stresses around the implants and displacement of the obturator are affected by the attachment type used. It was found that bar and clip (splinted) showed the maximum stresses around the implant and maximum denture displacement. Locator attachment is the better choice over bar and clip because of its additional retentive features.
CLINICAL SIGNIFICANCE
The advantage of using DIC over the conventional strain gauge analysis is that a full-field data of displacement and strain can be obtained instead of getting a mean value on the small surface where the strain gauge is positioned.
Topics: Humans; Denture, Overlay; Denture Retention; Dental Prosthesis, Implant-Supported; Mouth, Edentulous
PubMed: 36440515
DOI: No ID Found -
BMC Oral Health Nov 2021The scanning of plaster models for three-dimensional (3D) construction requires their rigid fixation in the intercuspal position. Factors such as installation, motion,...
PURPOSE
The scanning of plaster models for three-dimensional (3D) construction requires their rigid fixation in the intercuspal position. Factors such as installation, motion, and scanning procedures influenced the accuracy of this method, which ultimately influence the results. Therefore, the present study attempted to provide an optimal and accurate method with less complex procedures and a more accessible equipment for determining the intercuspal relation in the 3D occlusal construction of dental models.
METHODS
A pair of plastic mounting plates that could be directly attached to a mechanical articulator was designed and 3D printed. Nine axial hemispherical concaves were introduced on the axial surface of each plate. The rigidly fixed maxillary and mandibular dental models were scanned directly. The distances D between nine pairs of concaves on both mounting plates adhered to the maxillary and mandibular sections of the articulator were measured using the three-coordinate measuring machine Faro Edge as the reference. The present study comprised seven test groups varying in number and location. Assessing the reference points from each of the seven groups performed the 3D construction. The Geomagic Studio software was used to construct the concaves of digital casts, and the distances D between the pairs of concaves were measured as test values. Variable differences between D and D were analyzed.
RESULTS
An optimum distribution scheme was obtained for reference point registration by quantitatively evaluating accuracy levels of the 3D constructions of different reference point distribution patterns. This scheme can serve as a reference for related studies and dental clinic operations.
CONCLUSIONS
Three-dimensional construction of the intercuspal relation during scanning of the maxillary and mandibular models with an accuracy of 0.046 mm ± 0.009 mm can be achieved using the improved design of mounting plates.
Topics: Dental Articulators; Humans; Imaging, Three-Dimensional; Mandible; Models, Dental; Software
PubMed: 34732188
DOI: 10.1186/s12903-021-01919-z -
The Journal of Prosthetic Dentistry Jun 2023Digital occlusal analyzers allow the recording of dental contact forces. Some authors assume a unique location for the center of contact forces at the position of...
STATEMENT OF PROBLEM
Digital occlusal analyzers allow the recording of dental contact forces. Some authors assume a unique location for the center of contact forces at the position of maximum intercuspation, while others indicate variations in dental contact forces when recorded at different times of the day. Which approach is more appropriate is unclear.
PURPOSE
The purpose of this in vitro study was to analyze whether a change in the balance of masticatory forces influences the location of the center of contact forces and its magnitude.
MATERIAL AND METHODS
Three different dental casts, selected under dental criteria, were mounted in maximum intercuspation on a semiadjustable articulator equipped with a pattern indicating 9 different force application points (intersection point between 3 longitudinal rows and 3 transverse columns). A force of constant magnitude (169 N) was applied 10 times at each of the application points, and occlusal forces were recorded with a digital occlusal analyzer. Then, two variables were studied: the location of the center of contact forces and its magnitude. Each force application position (9 positions × 3 dental casts=27 in total) was repeated 10 times, and measured data were statistically analyzed with 2-way repeated measures ANOVA (α=.05) test.
RESULTS
The repeatability of the method indicated that the coefficient of variation mean was 0.37% in the location of the center of contact forces and that its magnitude was 3.70%. The 2-way repeated measures ANOVA test revealed statistically significant variations in the location of the center of contact forces and its magnitude, revealing that longitudinal changes of the application point of masticatory forces affected the magnitude of contact forces and that longitudinal and transverse changes of the application point of masticatory forces affected the location of the center of contact forces.
CONCLUSIONS
The location of the center of contact force and its magnitude provided by a digital occlusal analyzer at the position of maximum intercuspation are not necessarily unique to each articulated dental cast. Even if the intensity of the masticatory force remains unchanged, changes in its lateral or longitudinal balance also influence the result of the occlusion forces.
Topics: Bite Force; Dental Occlusion; Dental Articulators
PubMed: 37003941
DOI: 10.1016/j.prosdent.2023.03.007 -
Journal of Esthetic and Restorative... May 2024The purpose of this article was to introduce a method for the digital application of three-dimensional (3D) diagnosis and treatment with a virtual articulator and 3D...
OBJECTIVE
The purpose of this article was to introduce a method for the digital application of three-dimensional (3D) diagnosis and treatment with a virtual articulator and 3D data.
CLINICAL CONSIDERATION
With the use of cone-beam computed tomography (CBCT) and intraoral and facial scans, we can create a virtual articulator and evaluate the mandibular position in maximum intercuspation and centric-related occlusion for the patient with an unstable occlusion and temporomandibular disorders (TMD). Based on this, we treated a case using a digital mandibular position indicator (MPI) and fabricated a stabilization splint using a 3D printer. This approach eliminates the traditional impression or model mounting process and the analog face bow transfer. Furthermore, the design of the stabilization splint is accomplished using software.
CONCLUSIONS
The approach outlined in this article offers the potential for a digital diagnosis and treatment process by seamlessly integrating CBCT, intraoral scans, and facial scans with a high degree of accuracy. This may enhance precision in diagnosis and treatment planning, especially for patients with complicated TMD, in addition to facilitating effective communication with orthodontic patients who require thorough attention.
CLINICAL SIGNIFICANCE
Utilizing a virtual articulator and digital MPI for the occlusal evaluation of patients with TMD and unstable occlusion makes it possible to diagnose and analyze the occlusal condition accurately. This approach also allows for precision and efficiency in treatment.
Topics: Humans; Jaw Relation Record; Dental Articulators; Imaging, Three-Dimensional; Models, Dental; Dental Occlusion; Cone-Beam Computed Tomography
PubMed: 38131436
DOI: 10.1111/jerd.13185 -
The Journal of Prosthetic Dentistry Jan 2023Digital systems including intraoral scanners (IOSs) and optical jaw tracking systems can be used to acquire the maxillomandibular relationship at the centric relation...
Differences in maxillomandibular relationship recorded at centric relation when using a conventional method, four intraoral scanners, and a jaw tracking system: A clinical study.
STATEMENT OF PROBLEM
Digital systems including intraoral scanners (IOSs) and optical jaw tracking systems can be used to acquire the maxillomandibular relationship at the centric relation (CR). However, the discrepancy of the maxillomandibular relationship recorded at the CR position when using digital methods remains uncertain.
PURPOSE
The purpose of this clinical study was to compare the accuracy of the maxillomandibular relationship recorded at the CR position using a conventional procedure, 4 different IOSs, and an optical jaw tracking system.
MATERIAL AND METHODS
A completely dentate volunteer was selected. A Kois deprogrammer (KD) was fabricated. Six groups were created based on the technique used to obtain diagnostic casts and record the maxillomandibular relationship at the CR position: conventional procedures (CNV group), 4 IOS groups: TRIOS4 (TRIOS4 group), iTero Element 5D (iTero group), i700 wireless (i700 group), Primescan (Primescan group), and a jaw tracking system (Modjaw) (Modjaw group) (n=10). In the CNV group, conventional diagnostic stone casts were obtained. A facebow record was used to mount the maxillary cast on an articulator (Panadent). The KD was used to obtain a CR record for mounting the mandibular cast, and the mounted casts were digitized by using a scanner (T710) to acquire the reference scans. In the TRIOS group, intraoral scans were obtained and duplicated 10 times. The KD was used to obtain a bilateral virtual occlusal record at the CR position. To acquire the specimens of the iTero, i700, and Primescan groups, the procedures in the TRIOS4 group were followed, but with the corresponding IOS. In the Modjaw group, the KD was used to record and export the maxillomandibular relationship at the CR position. Articulated virtual casts of each group were exported. Thirty-six interlandmark linear measurements were computed on both the reference and experimental scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The data were analyzed by using 1-way ANOVA followed by the pairwise comparison Tukey tests (α=.05).
RESULTS
The trueness and precision of the maxillomandibular relationship record were significantly affected by the technique used (P<.001). The maxillomandibular relationship trueness values from high to low were iTero (0.14 ±0.09 mm), followed by the Modjaw (0.20 ±0.04 mm) and the TRIOS4 (0.22 ±0.09 mm) groups. However, the iTero, Modjaw, and TRIOS4 groups were not significantly different from each other (P>.05). The i700 group obtained the lowest trueness and precision values (0.40 ±0.22 mm) of all groups tested, followed by the Primescan grop (0.26±0.13 mm); however, the i700 and Primescan groups had significantly lower trueness and precision than only the iTero group (P<.05).
CONCLUSIONS
The trueness and precision of the maxillomandibular relationship recorded at the CR position were influenced by the different digital techniques tested.
PubMed: 36682896
DOI: 10.1016/j.prosdent.2022.12.007 -
Quintessence International (Berlin,... Dec 2021The literature review aimed to compile and summarize the results of research relating to the recordings of condylar displacements obtained with extraoral devices, to... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The literature review aimed to compile and summarize the results of research relating to the recordings of condylar displacements obtained with extraoral devices, to guide clinicians to set dental (virtual) articulator parameters. The meta-analysis was undertaken to assess the sagittal condylar inclination (SCI) and transversal condylar inclination (TCI, also known as Bennett angle) values according to horizontal reference planes, movement studied, and patient characteristics: dental status, interocclusal relationship, skeletal pattern, and signs and symptoms of temporomandibular disorders (TMD).
DATA SOURCES
A bibliographic search was conducted in the three following electronic databases: MEDLINE, EMBASE, and Cochrane Library and Best Evidence. The review was restricted to trials involving participants meeting the following criteria: (1) adult, (2) no previous surgery in the temporomandibular region, and (3) no serious comorbidity conditions. Descriptive statistics were calculated for all study groups and were compared by applying a one-way ANOVA.
CONCLUSION
All 20 articles selected corresponded to a total of 933 subjects evaluated. The recording devices and horizontal reference planes had a significant impact on the SCI values. Age, dental status, and the presence of symptoms and signs of TMD in subjects had no influence on SCI values, unlike Angle class II, division 2, the class II sagittal pattern, or the increased vertical skeletal pattern SCI parameters (P < .05). The mean TCI value was 8 degrees and was independent of individual patient characteristics and the extraoral recording device used. For accurate kinematic simulation, the patient's personal plane of reference must be transferred to the system.
Topics: Adult; Dental Articulators; Humans; Jaw Relation Record; Malocclusion, Angle Class II; Mandibular Condyle; Temporomandibular Joint
PubMed: 34235911
DOI: 10.3290/j.qi.b1702361 -
Life (Basel, Switzerland) Jun 2023The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs... (Review)
Review
The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types of CGV measurement protocols-articulators (both arcon and non-arcon) and panoramic radiographs. Additionally, it attempts to determine which of the mentioned methods performs better across several parameters. Several important web databases were searched using search terms derived from medical subject headings (MeSH), using keywords linked to "Arcon articulator", "Condylar guidance angle", "non-arcon articulator", "Panoramic x-ray" and "Radiographic examination", which constituted the first step in the study selection strategy. After completion, the search strategy which initially turned up to 831 papers, eventually ended up with 13 studies. The review and subsequent meta-analysis revealed that panoramic radiographs had noticeably greater efficacy in terms of the CGVs as compared to the articulators in the majority of the studies. Within the articulators, the arcon types recorded slightly higher CGVs than the non-arcon variety owing to the precision of jaw movement simulation in the former. However, further studies are required to validate these findings and establish more precise guidelines for the use of CGV measurement protocols in prosthodontic practice.
PubMed: 37374135
DOI: 10.3390/life13061352 -
Healthcare (Basel, Switzerland) Jun 2022The clinical remount procedure, which involves remounting the dentures on an articulator with interocclusal records, can effectively reduce occlusal discrepancies. This... (Review)
Review
The clinical remount procedure, which involves remounting the dentures on an articulator with interocclusal records, can effectively reduce occlusal discrepancies. This procedure can be applied not only to new dentures but also to those already in service; however, research in this field is still scarce. This narrative review aims to establish a hypothetical mechanism and possible indications and contraindications for this technique as a basis for further research. Current studies have revealed a high prevalence of malocclusion in delivered dentures. Performing a clinical remount on these existing dentures would enhance the oral function of the denture wearer and would enable effective and accurate correction of the accumulated errors in the jaw relationship in a stable working environment. This technique should be performed if a patient has poor masticatory function or occlusion-related complaints. However, performing a clinical remount on dentures with an excessive anterior-posterior discrepancy between the centric relation and the maximal intercuspal position or on dentures with extremely low occlusal vertical dimension, is considered less effective. The clinical remount procedure remains an essential skill both for fabricating quality dentures and maintaining those already in service.
PubMed: 35742118
DOI: 10.3390/healthcare10061067 -
Journal of Clinical Medicine Jan 2023Available knowledge about malocclusion and cephalometric variables and their connection with an increased risk of condylar displacement (CD) is scarce. This article aims... (Review)
Review
The Role of Maxillofacial Structure and Malocclusion on Condylar Displacement in Maximum Intercuspation and Centric Relation in Patients Seeking Orthodontic Treatment-A Scoping Review.
BACKGROUND
Available knowledge about malocclusion and cephalometric variables and their connection with an increased risk of condylar displacement (CD) is scarce. This article aims to present current information on the relationship between centric relation-maximum intercuspal position discrepancies and maxillofacial morphology and malocclusion in patients seeking orthodontic treatment as well as to identify those who require expanded diagnostic evaluation for this disorder.
METHODS
This review analyzed the PubMed, Cochrane Library, Web of Science, and Scopus electronic databases up to February 2022. Keywords and additional manual searches were performed. Literature selection was based the PRISMA-ScR checklist. The JBI Critical Appraisal Tool assessed the methodological quality of included studies.
RESULTS
The databases search provided 2321 studies. A total of 10 studies were included in this review after eligibility criteria and JBI assessment. This review was separated into five parts that evaluated CD correlations depending on the following: maxillofacial structure in different vertical and sagittal skeletal patterns, vertical, horizontal, and transverse malocclusions.
CONCLUSIONS
A hyperdivergent facial skeletal structure is a risk factor for increased CD, particularly in the vertical dimension. The condylar processes are usually displaced in a posteroinferior direction. Further studies are warranted to elucidate the relationship among remaining skeletal and dental malocclusions and the occurrence of CD.
PubMed: 36675620
DOI: 10.3390/jcm12020689 -
Dentistry Journal Nov 2022The aim of this clinical study was to investigate the change in occlusal vertical dimension (OVD) with dental casts mounted on a mechanical articulator using an average...
The aim of this clinical study was to investigate the change in occlusal vertical dimension (OVD) with dental casts mounted on a mechanical articulator using an average axis facebow and on a virtual articulator mounted using the Bonwill triangle and the Balkwill angle and compare these groups with OVD change observed clinically in patients. Casts were obtained from each patient (n = 14) and mounted on a semi-adjustable articulator in the facebow preservation group (FPG) and on a virtual articulator using average anatomic values in the average mounting group (AMG). Customized mandibular anterior splints were virtually designed at an OVD increased by 3, 6, and 9 mm. Digital buccal scans were performed with the anterior devices in the participants’ mouths in the intraoral group (IOG), AMG, and FPG at the different OVD increases accordingly. While no statistically significant differences (p > 0.05) were observed in the posterior interocclusal measurements with the incisal guide pin raised by 3 mm and 6 mm among all groups, a 9 mm increase resulted in a significant difference between AMG and IOG. The interocclusal posterior-to-anterior opening ratio observed clinically was 1:1.575. Increases in OVD up to 6 mm on dental casts mounted using average anatomic values performed similarly to the actual intraoral changes.
PubMed: 36354657
DOI: 10.3390/dj10110212