-
American Journal of Orthodontics and... Dec 2020Patients and parents want shorter treatment times, but it is unclear whether they would compromise outcome quality to shorten treatment. The purpose of this study was to...
INTRODUCTION
Patients and parents want shorter treatment times, but it is unclear whether they would compromise outcome quality to shorten treatment. The purpose of this study was to compare orthodontists' and parents' perceptions of finished occlusion and their willingness to extend treatment time to achieve improved outcomes. The effects of elapsed treatment time and patient compliance were also investigated.
METHODS
Parallel surveys for orthodontists (n = 1000) and parents (n = 750) displayed simulated treatment outcomes of well-aligned teeth with occlusions in 1 mm increments from 3 mm Class III to 3 mm Class II. Participants rated their preferences on a visual analogue scale (VAS; 0-100) and specified whether they would extend treatment, and for how long, to improve the occlusion.
RESULTS
Two hundred thirty-three orthodontists (23%) and 243 parents (32%) responded. Despite differences between the scores given (P < 0.0001), both groups rated Class I occlusion most acceptable (mean VAS = 93.9 and 80.7, respectively) and 3 mm Class III malocclusion least acceptable (mean VAS = 25.9 and 40.9, respectively). Parents were willing to extend treatment more often and for a greater time than orthodontists to improve results (P < 0.0001). In addition, parents were less willing to terminate treatment early (P < 0.05). Both groups perceived existing outcomes as more acceptable if the patient was noncompliant (P < 0.05), but elapsed time in treatment had no significant effect on ratings.
CONCLUSIONS
For outcomes with well-aligned teeth, orthodontists and parents agreed on what the most and least acceptable occlusal relationships were. To achieve better outcomes, parents were willing to extend treatment duration more often and for a greater time than were orthodontists. In addition, parents were less willing than orthodontists to terminate treatment early.
Topics: Attitude of Health Personnel; Dental Occlusion; Humans; Malocclusion, Angle Class III; Orthodontics; Orthodontists; Parents
PubMed: 33010979
DOI: 10.1016/j.ajodo.2019.10.022 -
Clinical Implant Dentistry and Related... Aug 2023The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and... (Review)
Review
BACKGROUND
The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex.
PURPOSE
To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease.
MATERIALS AND METHODS
This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry.
RESULTS AND CONCLUSIONS
Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
Topics: Humans; Dental Implants; Peri-Implantitis; Dental Prosthesis, Implant-Supported; Dental Occlusion; Causality
PubMed: 36373771
DOI: 10.1111/cid.13152 -
Stomatologiia 2022The aim is to study of the accuracy of the virtual reposition of the mandible (LF) by comparing the virtual and real position of the LF heads, as well as the analysis of...
OBJECTIVE
The aim is to study of the accuracy of the virtual reposition of the mandible (LF) by comparing the virtual and real position of the LF heads, as well as the analysis of factors contributing to the occurrence of errors.
MATERIAL AND METHODS
An experimental model of a human skull with a movable LF was made of radiopaque material. The resulting computed tomogram (CT) of the upper and lower jaws and temporomandibular joint (TMJ) was combined with dental scans of dental rows and CT scans and a report on the position of the heads of the LF was obtained. Then the LF was shifted to another position and this position was fixed. Optical bite recorders were obtained using an intraoral scanner. An experimental model with a fixed new position of the LF was placed in a tomograph and repeated CT was obtained. In the program, according to optical registers, a virtual reposition of the LF was carried out. The correspondence of the virtual and real position of the mandibular heads was compared.
RESULTS
The absolute difference of glenoid fossa space between the actual and virtual reconstruction was 0.542±0.3354 mm in the anterior joint section (M±δ, M - average mean, δ - standard deviation); for the upper joint section - 0.309±0.2246 mm; and 0.260±0.1862 mm for the posterior section. The integral indicator of surface coincidence (q) when the virtual and actual position are directly compared was 0.296±0.1254 (s.u.).
CONCLUSION
The total margin of error depends on the following factors: repeated scanning error (teeth arches and bite scans), repeated CBCT error, a combination of scan and CBCT error, a combination of teeth arch scan and bite scan error, error of TMJ separation. The latter two factors were the most significant.
Topics: Dental Arch; Dental Occlusion; Humans; Imaging, Three-Dimensional; Mandible; Temporomandibular Joint; Tomography, X-Ray Computed
PubMed: 35943501
DOI: 10.17116/stomat202210104153 -
Journal of Prosthodontic Research Jan 2023Purpose This literature review aimed to investigate predictability of re-establishment of the occlusion following placement of restorations at an increased OVD, duration... (Review)
Review
Purpose This literature review aimed to investigate predictability of re-establishment of the occlusion following placement of restorations at an increased OVD, duration and to assess the quality of the available evidence.Methods An electronic search of articles using MEDLINE (1946-01/2019), EMBASE (1974-01/2019) and the Cochrane databases was undertaken. Search terms included dental restoration, vertical dimension and time. Studies involving placement of restorations at an increased OVD and recorded the time taken for the occlusion to re-establish were included. Eligibility assessments were carried out independently by two reviewers who also undertook independent extraction of predefined data fields, including study quality indicators.Results The search provided 61 results with 11 being relevant. A further 5 papers were identified for full text analysis. 4 papers used similar data from previous studies and 3 were excluded after full text assessment.. A final total of 9 papers were included in the review. It was indicated that the technique of placing restorations at an increased OVD appears to be clinically predictable in terms of re-establishment of occlusion and appears to occur most rapidly in younger patients.Conclusions The time taken for the occlusion to re-establish was between 15 days to 24 months. However, there is a need for prospective studies to evaluate the process in terms of success, predictive variables and specifically how long the process takes and this information would be helpful for both clinicians and patients, so that they know what to expect before embarking on a treatment.
Topics: Humans; Vertical Dimension; Dental Occlusion; Prospective Studies
PubMed: 35185109
DOI: 10.2186/jpr.JPR_D_21_00106 -
Medical Hypotheses Sep 2019There is large support in literature linking tinnitus to dental occlusion and temporomandibular joint disorders (TMD). However, there is no model to explain such a link....
There is large support in literature linking tinnitus to dental occlusion and temporomandibular joint disorders (TMD). However, there is no model to explain such a link. This hypothesis explains how the fusimotor system of the muscles innervated by the trigeminal motor nucleus is affected by inadequacies in the occlusion of the teeth that cause changes in posture and movement of the mandible. Reptile to mammal evolution shows that stomatognathic structures underwent changes related to mastication. Among several changes, there was the appearance of a new articulation between the mandible and skull: the temporomandibular joint. The bones of the old reptile joint, quadrate-articular, have detached from the mandible and are part of the middle ear bone chain. The former becomes the incus and the latter the malleus. This bone change also carried the tensor tympani and its trigeminal motor innervation. Inadequate occlusal contacts give rise to an adapted function of the mandible and the most common compensatory muscular response is hypertonia involving all mandibular muscles, including the tensor tympani. A fundamental clinical feature that demonstrates the involvement of the trigeminal fusimotor system is the characteristic pain by palpation, but no pain on the mandibular movement. Muscle pain is always felt in the dermatome innervated by the mandibular branch of the trigeminal nerve, which carries the motor fibers, reported as tightening, similar to cramp, and has regular behavior in intensity, duration and frequency. In addition, the patient has increased musculature volume, detected by palpation of certain anatomical landmarks, but with loss of functional efficiency. The neuromotor control of the mandibular movements is poor and when asked to make lateral jaw movement touching the teeth, it is common to observe that the patient moves the lips, eyes, and even turns the head in the same direction as the movement. There is also difficulty eating hard foods and talking fast. Tongue biting while chewing is frequent, meaning that these non-physiological events surpass protective reflex circuits. The report of ear pain, tinnitus, blocked ear sensation and sudden hearing loss is common in such patients, compatible with the tonic contraction of the tensor tympani. The fusimotor system hypothesis is able to explain all events related to the symptoms and helps to establish a correct diagnosis for certain types of hearing disorders.
Topics: Biological Evolution; Dental Occlusion; Humans; Hyperkinesis; Mandible; Mastication; Models, Theoretical; Movement; Temporal Muscle; Temporomandibular Joint; Temporomandibular Joint Disorders; Tensor Tympani; Tinnitus; Tooth; Trigeminal Motor Nucleus
PubMed: 31383322
DOI: 10.1016/j.mehy.2019.109280 -
Journal of Prosthodontics : Official... Apr 2021Numerous studies have focused on the various complications with implant-retained restorations and a common thread in these publications is the potential for occlusal... (Review)
Review
PURPOSE
Numerous studies have focused on the various complications with implant-retained restorations and a common thread in these publications is the potential for occlusal overload. The purpose of this Best Evidence Consensus Statement on implant occlusal schemes was to review the literature to determine the level of scientific evidence upon which the articles are based.
MATERIALS AND METHODS
Limiting the search to Clinical trials, Randomized Controlled Trials, Systematic Reviews, Meta-analyses, the key words: dental implants, occlusion, found no citations. Expanding the search to Journal articles found 1,483 results, 20 of which pertained to the question. Doing a similar search including Journal Articles, the key words: dental implants and occlusal scheme found 47 citations, 17 of which were pertinent to the question.
RESULTS
After eliminating duplicates and non-relevant articles, 15 were included in the review. Nineteen additional articles were culled by going through the reference lists in the aforementioned articles.
CONCLUSIONS
There is a lack of scientific evidence regarding the occlusal scheme utilized with implant restorations that will minimize or eliminate complications. In light of this lack of scientific evidence, the style of occlusion a practitioner utilizes with tooth or mucosal supported prostheses may be used with implant-supported restorations until compelling evidence dictates otherwise.
Topics: Consensus; Dental Implants; Dental Occlusion; Dental Prosthesis, Implant-Supported; Dental Restoration Failure
PubMed: 33783094
DOI: 10.1111/jopr.13319 -
L' Orthodontie Francaise Jun 2020Standard TMJ is the key to the morphology of the face as it enables the occlusive function and spatially situates the chin. The diagnosis of the temporomandibular joint... (Review)
Review
Standard TMJ is the key to the morphology of the face as it enables the occlusive function and spatially situates the chin. The diagnosis of the temporomandibular joint disorders is made intricate not only by the multifactorial etiology of these pathologies but also by the difficulty to comprehend the pain felt by the patient. Through a review of the literature and our respective practices (over 30 years) and teachings, this article surveys the main principles of temporomandibular joint disorder. As numerous writers have focused on the problems created by TMJ pathologies, it's only natural that various therapeutic approaches be suggested. What primarily matters is that they lead to a stabilization of the occlusion. As far as diagnosis is concerned, only a precise and rigorous protocol - followed by everyone - can produce a therapeutic result that would be acceptable for each patient. The orthodontist can and must be the coordinator of the cross-disciplinary team. He steps in over 72 % of temporomandibular joint disorder cases and proposes the most conservative, cheapest, and the best cost/benefit ratio for the patient.
Topics: Dental Occlusion; Humans; Male; Pain; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 33146135
DOI: 10.1684/orthodfr.2020.12 -
Journal of Oral Biosciences Jun 2022The development of dentition begins in the embryonic oral cavity and progresses in the branchial arches and alveolar bone. Continuous cellular and molecular crosstalk... (Review)
Review
BACKGROUND
The development of dentition begins in the embryonic oral cavity and progresses in the branchial arches and alveolar bone. Continuous cellular and molecular crosstalk occurs during crown formation, after which the tooth germ begins to migrate apically through the alveolar process into the oral cavity. It eventually comes in contact with its antagonist in the contralateral jaw to establish functional occlusion. Any defect in either step can result in delayed tooth development, the spectrum of which varies from a congenitally missing tooth to an impacted tooth (infraocclusion) with an eruption problem, both of which can impair oral function.
HIGHLIGHT
Congenitally missing teeth or eruption problems may result from genetic mutations. Several different mutations have been identified, each causing a distinct phenotype. Thus, it is imperative that medical providers understand the fundamentals of these genetic principles that govern such dental diseases.
CONCLUSION
In this review, we focus on several diseases, including congenitally missing teeth and tooth eruption problems. We review these diseases with aspect to their association with a particular syndrome, as well as independently in a non-syndromic capacity. We also review previously identified genetic mutations and discuss the possible mechanisms that cause individual phenotypes by analyzing previous investigations. We also discuss future prospects of how genetic diagnosis and precision medicine could impact the clinical environment in the field of dentistry.
ETHICAL APPROVAL
Present study has been carried out in accordance with The Code of Ethics of the World Medical Association and approved by Institutional Review Board of Osaka University Graduate School of Dentistry.
Topics: Crowns; Dental Occlusion; Dentition; Humans; Tooth; Tooth Eruption
PubMed: 35231627
DOI: 10.1016/j.job.2022.02.005 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Jan 2021Occlusal dysesthesia (OD) or phantom bite syndrome refers to a persistent complaint of uncomfortable bite sensation with no obvious occlusal discrepancy. OD is a rare...
Occlusal dysesthesia (OD) or phantom bite syndrome refers to a persistent complaint of uncomfortable bite sensation with no obvious occlusal discrepancy. OD is a rare condition, and is usually associated with emotional distress and triggered by dental treatments. The diagnosis and management of OD patients still remains a major challenge for dental practitioners and affected patients. This topical review aims to describe the properties, etiologies, diagnosis, managements and prognosis of OD comprehensively.
Topics: Bite Force; Dental Occlusion; Dentists; Humans; Malocclusion; Paresthesia; Professional Role
PubMed: 34645246
DOI: 10.3760/cma.j.cn112144-20200328-00175 -
Journal of Oral Rehabilitation Jun 2021Common impressions cannot accurately duplicate the dental occlusion under occlusal force due to tooth displacement and mandibular deformation. To establish new methods...
Common impressions cannot accurately duplicate the dental occlusion under occlusal force due to tooth displacement and mandibular deformation. To establish new methods to construct virtual intercuspal occlusion and assess their construction accuracy. The intraoral occlusal contacts of posterior teeth of 15 subjects were recorded with 8 μm and 100 μm articulating paper, respectively, and the marked teeth and buccal bite data were scanned with an intraoral scanner. The virtual dental occlusions were separately determined by buccal bite registration (BBR) method, and 3 new methods, namely segmented tooth registration (STR), occlusal contact areas (marked by 8 μm articulating paper) registration (OCR) and mixing registration (MR) methods. With the intraoral contact areas marked by 100 μm articulating paper set as reference and contact areas of the 4 virtual occlusions as tests, sensitivity, positive predictive value (PPV) and the ratio of overlapping areas were calculated. Kruskal-Wallis test or 1-way ANOVA was used to analyse the difference among groups. The sensitivity ranged from 0.69 to 0.94 and the PPV from 0.67 to 0.90. Sensitivity of OCR group and PPV of STR and OCR groups were different from that of BBR group at overlapping threshold of 50% (P = .028, .028 and .006). There was statistical difference of the ratio of overlapping areas over reference areas, and the values of STR and OCR groups were higher than that of BBR group (P = .045 and .021). The ability of STR and OCR methods to construct virtual intercuspal occlusion was better than BBR method.
Topics: Bite Force; Dental Occlusion; Humans; Jaw Relation Record; Mandible; Tooth
PubMed: 33486815
DOI: 10.1111/joor.13153