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Dental Clinics of North America Apr 2023Throughout the recorded history in the literature of temporomandibular disorders (TMD) there have been a variety of opinions as to its primary cause. Those supporting an... (Review)
Review
Throughout the recorded history in the literature of temporomandibular disorders (TMD) there have been a variety of opinions as to its primary cause. Those supporting an occlusal basis of TMD opined that occlusal dysfunction is either the primary cause for or a significant etiopathogenic factor in the causation of TMD. Most of the current literature, however, points to evidence in another direction and questions the causal role of occlusion and occlusal disharmony in TMD etiopathogenesis. Recognition of this evidence-based literature is paramount in eliminating and preventing the chances of overtreatment of patients with TMD.
Topics: Humans; Malocclusion; Dental Occlusion; Temporomandibular Joint Disorders
PubMed: 36965932
DOI: 10.1016/j.cden.2022.11.002 -
Quintessence International (Berlin,... Apr 2022The term temporomandibular disorders (TMDs) encompasses a variety of disorders of the temporomandibular joint (TMJD) and the associated musculature (MMD). Occlusion and... (Review)
Review
OBJECTIVE
The term temporomandibular disorders (TMDs) encompasses a variety of disorders of the temporomandibular joint (TMJD) and the associated musculature (MMD). Occlusion and its role in the genesis of TMDs is one of the most controversial topics in this arena. The objective of the narrative review was to summarize the implications of TMDs and its relationship to dental occlusion in two scenarios: 1) TMD as an etiologic factor in dental occlusal changes; 2) The role of dental occlusion as a causative factor in the genesis of TMDs.
DATA SOURCES
Indexed databases were searched from January 1951 to August 2021 using the terms TMJ, TMD, temporomandibular disorders, temporomandibular joint, and dental occlusion.
CONCLUSION
There is lack of good primary research evaluating true association and showing the cause-and-effect relationship between dental occlusion and TMD. Systematic reviews suggest that the role of occlusion as a primary factor in the genesis of TMDs is low to very low. However, a variety of TMDs can lead to secondary changes in dental occlusion. Distinction between the two is paramount for successful management.
Topics: Dental Occlusion; Humans; Temporomandibular Joint Disorders
PubMed: 35274511
DOI: 10.3290/j.qi.b2793201 -
Geriatrics & Gerontology International Jun 2020Oral frailty is defined as a decrease in oral function accompanied by a decrease in mental and physical functions. Studies showing that people with oral frailty are at... (Review)
Review
Oral frailty is defined as a decrease in oral function accompanied by a decrease in mental and physical functions. Studies showing that people with oral frailty are at high risk of physical frailty, sarcopenia, severe conditions requiring nursing care and death have been reported in Japan. An increase in life expectancy and maintenance of teeth result in a decrease in the effect of the number of teeth. In contrast, a decrease in oral function as a result of aging has been suggested to have major effects on dysfunction and mortality risk. The present report is a narrative review of major clinical studies on the relationships of the number of teeth, dentures, occlusion and oral function with longevity, with the aim of providing information for future studies centered on oral function in Japan or overseas. This review clearly shows the relationships of the number of teeth, dentures, and occlusion with health and longevity. Recent studies have shown that, besides maintenance of the number of teeth, attempting to maintain or increase oral function, having a good diet and maintaining nutritional status are all linked to general health. Decreased oral function is a major risk factor for developing malnutrition and sarcopenia. Oral frailty, a new concept that has been recently introduced in Japan, is considered to have major effects on dental and oral health policies in Japan, in the old-age group, and is expected to be reflected in the dental and oral health policies of various countries, as they also predict increased life expectancies. Geriatr Gerontol Int 2020; ••: ••-••.
Topics: Aged; Aged, 80 and over; Dental Occlusion; Dentures; Female; Frail Elderly; Frailty; Humans; Japan; Longevity; Male; Oral Health; Tooth; Tooth Loss
PubMed: 32307825
DOI: 10.1111/ggi.13921 -
Journal of Prosthodontics : Official... Jan 2021A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained... (Review)
Review
A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained research interest in dentistry over the past decade. In prosthodontics, the virtual articulator should be considered as an additional diagnostic and treatment planning tool to the mechanical articulator, especially in complex cases involving alterations to the vertical dimension of occlusion. Numerous authors have reported on the available digital methodologies used for the assembly of virtual arch models in a virtual articulator, focusing their attention on topics such as the virtual facebow and digital occlusal registration. To correctly simulate jaw movement, the jaw models have to be digitalized and properly mounted on the virtual articulator. The aim of this review was to discuss the current knowledge surrounding the various techniques and methodologies related to virtual mounting in dentistry, and whether virtual articulators will become commonplace in clinical practice in the future. This review also traces the history of the virtual articulator up to its current state and discusses recently developed approaches and workflows for virtual mounting based on current knowledge and technological devices.
Topics: Dental Articulators; Dental Occlusion; Jaw Relation Record; Models, Dental; Patient Care Planning; Prosthodontics; Vertical Dimension
PubMed: 32827222
DOI: 10.1111/jopr.13240 -
Journal of Prosthodontics : Official... Apr 2021Multiple clinical studies have been published comparing different philosophies of complete denture occlusion and different types of denture teeth. However, it is unclear... (Review)
Review
PURPOSE
Multiple clinical studies have been published comparing different philosophies of complete denture occlusion and different types of denture teeth. However, it is unclear whether comparable data are available for occlusal schemes used with removable partial dentures (RPDs). Therefore, this review investigated the dental literature related to occlusal schemes for RPDs.
MATERIALS AND METHODS
A PubMed search of English language articles was performed using the term "removable partial denture, occlusion" with 765 results. When the term "occlusion in removable partial prosthodontics" was used there were 784 results. Seventy-four articles were identified using the different search term of "RPD, occlusion" while use of the term "occlusal scheme, with removable partial dentures" listed 18 publications. The term "removable partial denture, occlusion, literature reviews" produced 38 potential publications related to the topic. Using the term "removable partial denture occlusion systematic review" resulted in 2 citations. Using the term "RPD occlusion literature review" resulted in one foreign language manuscript whereas using the term "RPD occlusion systematic review" resulted in one article unrelated to dentistry. The term "clinical studies of RPD occlusion" produced 5 results with none related to the topic. There were 23 results using the term "clinical studies of removable partial denture occlusion" with one potentially related to RPD occlusal schemes.
RESULTS
A review of the titles and abstracts revealed 12 articles that appeared to contain specific information about the occlusal scheme used with RPDs. Following a detailed review of those publications, only 4 contained recommendations for RPD occlusion and were included in this review. The available information regarding the recommendations for occlusal schemes in these articles was based on expert opinion. A decision was made to include a hand search of 9 textbooks containing varying amounts of information related to occlusal schemes for RPDs, but no evidence-based references related to RPD occlusal schemes were found in the textbooks. Since this entire review is based on expert opinion, no attempt was made to critique the opinions expressed by these authors but rather to present their perspectives for evaluation by readers.
CONCLUSIONS
The occlusion developed with RPDs should be physiologically harmonious, allowing the supporting structures to remain in a good state of health with functional stress distributed among all the occluding teeth. Multiple authors indicate the occlusion in maximum intercuspation/centric occlusion should incorporate bilateral posterior contacts with no deflective occlusal contacts. When most occlusal contacts on natural teeth are missing, it has been proposed that extension base RPDs have their occlusal contacts developed in centric occlusion. Regarding eccentric occlusal relationships, a balanced occlusal scheme has been recommended by multiple authors with one author advocating use of a lingualized balanced. An anterior guided (canine-protected) occlusion has also been recommended when the canines are present and not periodontally compromised. When RPDs oppose a complete denture, several authors indicate a bilateral balanced occlusion should be used to help stabilize the complete denture.
Topics: Dental Occlusion; Dental Occlusion, Balanced; Denture Design; Denture, Complete; Denture, Partial, Removable
PubMed: 33783088
DOI: 10.1111/jopr.13313 -
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 -
L' Orthodontie Francaise Jun 2020Since 1907, the international community has used Angle's classification to assess the mesio-distal relationships of the dental arches. It is the basis of the diagnosis...
Since 1907, the international community has used Angle's classification to assess the mesio-distal relationships of the dental arches. It is the basis of the diagnosis of malocclusion in the sagittal dimension and indicates or not an orthodontic correction treatment. This work was aimed to inventory the classification methods of malocclusions used today. Indices of treatment need were also presented because they are based on one or more occlusal anomalies to indicate treatment. The classifications were criticized and the contribution of a functional analysis based on the use of the trilogy setting, centering and guiding was detailed. The type of anomalies (skeletal and dental) must be completed by the analysis of the occlusal anomaly of setting (centering or guiding) and of the category of occlusion (functional occlusion, functional malocclusion or pathogenic malocclusion), ie its possible pathogenic impact on orofacial structures. A consensus on the classification of occlusal anomalies is necessary in order to better identify the anomalies and their global repercussions, and to better define the needs for orthodontic treatment.
Topics: Dental Occlusion; Humans; Malocclusion
PubMed: 33146134
DOI: 10.1684/orthodfr.2020.11 -
British Dental Journal Oct 2022The articulatory system comprises the temporomandibular joints (TMJs), intra-articular discs, mandibular/jaw muscles and occlusion. In the simplest terms, the TMJ is the... (Review)
Review
The articulatory system comprises the temporomandibular joints (TMJs), intra-articular discs, mandibular/jaw muscles and occlusion. In the simplest terms, the TMJ is the articulation between the upper and lower jaws. The teeth form the contacts between the upper and lower jaws and the muscles are the motors that move the mandible. This system is unique in that the TMJs are paired; any stimulus that affects one joint or any other single part of the articulatory system can have a 'knock-on effect' in the rest of the system.It is important to have a good understanding of anatomy, not only to be able to differentiate between what is physiological and what is pathological, but also to understand the objectives of some treatment options. Sound knowledge of anatomy is essential and an appreciation of the anatomical features associated with the TMJ can serve as a foundation for understanding the clinical management of temporomandibular disorders.This article reviews the functional anatomical features of the articulatory system with a look at the clinical significance of this anatomy.
Topics: Dental Occlusion; Humans; Jaw; Mandible; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 36241801
DOI: 10.1038/s41415-022-5082-0 -
Journal of Prosthodontics : Official... Apr 2021Patients in need of extensive prosthodontic treatment may need restoration of their occlusal vertical dimension (OVD) due to tooth wear, tooth loss, or changes that have... (Review)
Review
PURPOSE
Patients in need of extensive prosthodontic treatment may need restoration of their occlusal vertical dimension (OVD) due to tooth wear, tooth loss, or changes that have occurred to existing prostheses over time. Prosthodontic treatment is based on the clinical application of the available evidence regarding interocclusal distance (IOD), the positional stability of rest vertical dimension (RVD), and the effect of altering the OVD. Hence, the purpose of this consensus document is to examine available data related to IOD, RVD, and alteration of the OVD.
MATERIALS AND METHODS
The search was limited to Clinical trials, Randomized Controlled Trials, Systematic Reviews and Meta-analyses. Key words were healthy patient, mean, range, interocclusal rest distance; healthy patient, mean, range, freeway space; and dentistry, interocclusal gap, and no citations appeared. Dentistry, interocclusal distance, revealed 5 not relevant citations. Dentistry, inter occlusal rest space, and dentistry, interocclusal rest distance, both had the same single not relevant citation. Dentistry, freeway space revealed over 7,000 citations. Dentistry, occlusal vertical dimension, revealed 253 citations, 7 of which were related to the search question but only 1 which was different from the previous search. Mandible, rest vertical dimension, age changes, found 7 citations, none relative to the question. Expanding the search to include journal article found 260 citations with only one relevant to the question. Mandible, rest vertical dimension, alteration, harm revealed no citations; mandible, occlusal vertical dimension, alteration, revealed 15 citations, 1 of which was relevant; mandible, occlusal vertical dimension, changes, revealed 75 citations, none of which were relevant; mandible, occlusal vertical dimension, rehabilitation revealed 10 citations, none of which were relevant. Expanding the search strategy to include Journal article, mandible, occlusal vertical dimension, alteration, received 159 citations, 4 of which were relevant; mandible, occlusal vertical dimension, restoration revealed 208 citations, 1 of which was relevant. Numerous other articles were culled by going through the reference lists of the aforementioned articles.
RESULTS
For IOD, 27 articles were found relevant to the search question, which confirmed a mean of 3.0 mm with ranges from 1 to 9 mm. Five articles revealed little evidence as to whether the RVD changes during life. For OVD, 20 articles, including 4 systematic reviews, revealed some evidence that skeletal growth continues from mid adolescence into mid adulthood; strong anecdotal evidence that some unopposed teeth will continue to erupt; no clinical evidence to support the concept that abraded teeth in occlusion in a patient with bruxism will undergo continuous eruption; and some evidence from clinical case reports that restoring OVD in patients with severe abrasion is a successful treatment.
CONCLUSIONS
There is a range of dimensions for the interocclusal distance (IOD) with many normal dental patients functioning with a higher or lower IOD than the commonly used 3.0 mm average dimension. The resting vertical dimension (RVD) is a 3-dimensional range with little evidence related to changes in the RVD during life. However, aging can cause a decrease in muscle tone which could affect the RVD. The restoration of the OVD can be successfully accomplished if proper diagnosis and treatment planning are performed.
Topics: Adult; Consensus; Dental Occlusion; Humans; Mandible; Prosthodontics; Vertical Dimension
PubMed: 33783090
DOI: 10.1111/jopr.13315 -
Journal of Prosthodontics : Official... Apr 2021The occlusal scheme required for an edentulous patient is controversial. The purpose of this Best Evidence Consensus Statement was to evaluate the existing complete... (Review)
Review
PURPOSE
The occlusal scheme required for an edentulous patient is controversial. The purpose of this Best Evidence Consensus Statement was to evaluate the existing complete denture literature related to occlusal schemes.
MATERIALS AND METHODS
A literature search was limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Studies (RCT) and Clinical Trials. Key Words were: Complete dentures, occlusion, harm; Complete dentures, occlusion alveolar bone loss; Complete dentures, occlusion, stability; Complete dentures, occlusion. Additional related articles were culled from the authors' library and reference lists in the articles found in the PubMed searches.
RESULTS
Of the 165 articles that met the initial search criteria, 34 related to the focus questions and were evaluated and rated.
CONCLUSIONS
There is strong support that the average denture patient, with good residual ridges and no neuromuscular problems, will function adequately with a properly fabricated complete denture regardless of the occlusal scheme. There is neither strong support for or against bilateral balanced occlusal schemes as it relates to patient satisfaction, preference or chewing ability. There is some support for increased alveolar bone loss with complete dentures that have a non-balanced occlusion. There is a need for bilateral balanced occlusal schemes for patients presenting with loss of stability and retention as a result of their presenting conditions (PDI III and IV).
Topics: Consensus; Dental Occlusion; Dental Occlusion, Balanced; Denture Design; Denture, Complete; Humans; Mastication
PubMed: 33336857
DOI: 10.1111/jopr.13309