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Quintessence International (Berlin,... Jun 2022Bite force (occlusal force) may play a significant role in patient treatment outcomes. However, as a diagnostic risk assessment tool, it has been examined in the... (Review)
Review
Bite force (occlusal force) may play a significant role in patient treatment outcomes. However, as a diagnostic risk assessment tool, it has been examined in the literature but is not commonly utilized by practicing clinicians and in academic studies. This diagnostic evaluation may assist the dental clinician in planning tooth- and implant-supported restorations, as damage to the tooth, implant, or restoration may be dependent upon a restoration's resistance to loading conditions. The overall bite force has been estimated to be up to 2,000 N, with a clear sexual dimorphism and age dependence. The magnitude of these forces along the dental arch have been shown to be elevated in the posterior compared to the anterior region. The bite force magnitude has been inversely related to the proprioception, as a significant increase in bite force is seen in patients with endodontically treated teeth as compared to their vital teeth. Bite force has been linked to chewing efficiency, quality of life, and implicated in the life expectancy of the restorations. Restoration life expectancies have been associated with the material selection and preparation design parameters, both of which may be affected by masticatory bite force. Treatment planning criteria for preparation strategies affected by bite force include tooth location, material selection, occlusion pathways, and subsequent occlusal reduction amounts. When implants are used in patients with elevated magnitude of bite force, an increase in the number and diameter of the implants as well as occlusions with reduced occlusal tables buccolingually and lighter contacts may be recommended. An understanding of the magnitude and load of a patient's bite force can assist the dental clinician in the design of dental treatments along with other standard risk assessment criteria.
Topics: Bite Force; Dental Care; Dental Occlusion; Humans; Mastication; Quality of Life
PubMed: 35674169
DOI: 10.3290/j.qi.b3044939 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Oct 2023Stomatognathic system rehabilitation (SSR) is an important component of dental implant therapy, involving multiple disciplines and factors. This article focuses on the...
Stomatognathic system rehabilitation (SSR) is an important component of dental implant therapy, involving multiple disciplines and factors. This article focuses on the importance of clinical issues, such as mandibular position, vertical distance, occlusion and temporomandibular joint in SSR, in order to provide reference for dentists in clinical diagnosis and treatment.
Topics: Humans; Dental Implants; Temporomandibular Joint; Stomatognathic System; Dental Occlusion; Temporomandibular Joint Disorders
PubMed: 37818530
DOI: 10.3760/cma.j.cn112144-20230817-00093 -
Otolaryngologic Clinics of North America Dec 2023The goal of mandibular fracture management is to restore form and function. Maxillomandibular fixation, elastic occlusal guidance, and postoperative physiotherapy are... (Review)
Review
The goal of mandibular fracture management is to restore form and function. Maxillomandibular fixation, elastic occlusal guidance, and postoperative physiotherapy are essential elements to optimizing outcomes. Restoration of premorbid occlusion is paramount. Thus, an expert understanding of occlusion, coupled with the application of maxillomandibular techniques to achieve bony reduction with idealized dental occlusion, is required in the proper management of mandible fractures. Postoperatively, complete recovery initially requires elastic occlusal guidance followed by jaw range of motion physiotherapy. Bone healing, an idealized occlusion, and normal jaw range of motion signal success via the restoration of form and function.
Topics: Humans; Dental Occlusion; Jaw Fixation Techniques; Fracture Fixation, Internal; Mandible; Mandibular Fractures; Physical Therapy Modalities
PubMed: 37659861
DOI: 10.1016/j.otc.2023.07.001 -
Clinical Oral Investigations Jul 2023This clinical study aimed to compare the performance of various virtual articulator (VA) mounting procedures in the participants' natural head position (NHP).
OBJECTIVES
This clinical study aimed to compare the performance of various virtual articulator (VA) mounting procedures in the participants' natural head position (NHP).
MATERIALS AND METHODS
Fourteen participants with acceptable dentitions and jaw relationships were recruited in this study registered in the Clinical Trials Registry (#NCT05512455; August 2022). A virtual facebow was designed for virtual mounting and hinge axis measurement. Intraoral scans were obtained, and landmarks were placed on each participant's face to register the horizontal plane in NHP. Six virtual mounting procedures were performed for each participant. The average facebow group (AFG) used an indirect digital procedure by using the average facebow record. The average mounting group (AMG) aligned virtual arch models to VA's average occlusal plane. The smartphone facial scan group (SFG) and professional facial scan group (PFG) used facial scan images with Beyron points and horizontal landmarks, respectively. The cone-beam computed tomography (CBCT) scan group (CTG) used the condyle medial pole, and horizontal landmarks were applied. The kinematic facebow group (KFG) served as the control group, and a direct digital procedure was applied using a kinematic digital facebow and the 3D skull model. Deviations of the reference plane and the hinge axis between the KFG and other groups were calculated. The inter-observer variability in virtual mounting software operation was then evaluated using the interclass correlation coefficient (ICC) test.
RESULTS
In virtual condylar center deviations, the CTG had the lowest condylar deviations. The AFG showed larger condylar deviations than PFG, SFG, and CTG. There was no statistically significant difference between the AFG and the AMG and between the PFG and the SFG. In reference plane deviations, the AMG showed the largest angular deviation (8.23 ± 3.29°), and the AFG was 3.89 ± 2.25°. The angular deviations of PFG, SFG, and CTG were very small (means of each group < 1.00°), and there was no significant difference among them. There was no significant difference between the researchers, and the ICC test showed moderate to excellent reliability for the virtual condylar center and good to excellent reliability for the reference plane in the operation of the virtual mounting software.
CONCLUSIONS
CBCT scan provided the lowest hinge axis deviation in virtual mounting compared to average mounting, facebow record, and facial scans. The performance of the smartphone facial scanner in virtual mounting was similar to that of the professional facial scanner. Direct virtual mounting procedures using horizontal landmarks in NHP accurately recorded the horizontal plane.
CLINICAL RELEVANCE
Direct digital procedures can be reliably used for virtual articulator mounting. The use of a smartphone facial scanner provides a suitable and radiation-free option for clinicians.
Topics: Humans; Dental Articulators; Dental Occlusion; Jaw Relation Record; Maxilla; Reproducibility of Results
PubMed: 37247089
DOI: 10.1007/s00784-023-05028-9 -
Journal of Prosthodontics : Official... Oct 2022To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an... (Review)
Review
PURPOSE
To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an implant-supported mandibular overdenture (ISO).
METHODS
A literature search was performed in seven electronic databases: MEDLINE via PubMed interface, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and AgeLine. The search terms were developed by the primary investigators and the health sciences librarian, who then started with PubMed and adapted the original search strategy for the other databases. Included articles were those that compared the outcomes for mandibular RSOs and those with ISOs, for persons wearing a maxillary complete denture.
RESULTS
Seven articles were included in the review. There were limitations in this review because of small sample sizes, short study durations, and different methodologies. Also, no comparative studies were identified for clinically important outcomes, such as survival rates of abutments, prosthodontics/maintenance problems, and longitudinal cost of care. For prosthodontic complications, patient satisfaction, and ability to clean, no differences were reported. For oral tactile sensibility, RSOs presented significantly improved sensibility, whereas ISOs had higher maximum bite force capability, but the difference was not statistically significant, except when subjects had a cross-bite or a lingualized occlusion.
CONCLUSIONS
The results of this scoping review were not conclusive, except for maximum bite force, where ISOs seem to perform better than RSOs by the measured criteria. ISOs had higher survival rates than RSOs, and required less maintenance, but were more expensive. It was disappointing to find so few studies comparing these clinical treatment modalities, which suggests that either treatment may be clinically acceptable and depends upon a shared decision between patients and their dentists.
Topics: Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Complete; Bite Force; Mandible; Patient Satisfaction; Denture Retention
PubMed: 35187751
DOI: 10.1111/jopr.13498 -
The Journal of Contemporary Dental... Jan 2022To systematically evaluate the literature evidence regarding the suitability of the T-scan occlusal system for implant supported prostheses.
AIM
To systematically evaluate the literature evidence regarding the suitability of the T-scan occlusal system for implant supported prostheses.
MATERIALS AND METHODS
A thorough bibliographic search was conducted on PubMed, Google Scholar, Cochrane library, Web of Science, EMBASE, and Scopus to collect relevant articles published from January 1, 2008 to August 30, 2021, using a combination of the following words: "T-scan," "Implant supported prostheses," and "dental implant" according to the PRISMA guidelines for the focused research question constructed using the PICO criteria. Randomized control trials, prospective studies, retrospective studies on the use of T-scan system in implant-supported prostheses reported in English language were included in the study.
RESULTS
This review consisted of 17 studies and 359 patients rehabilitated with 1,126 implants. In 3 studies, removable types of prostheses were given over implants, and in 14 studies, fixed types of prostheses were given. Nine studies determined the percentage of occlusal force magnitude and occlusion time sequence. Three studies measured the localization of the occlusion center. T-scan was used in two studies to measure the amount of gingival crevicular fluid after occlusal adjustment. The follow-up period ranged from 6 months to 2 years or more.
CONCLUSION
T-scan proved with better results than other occlusal analysis indicators in terms of occlusion measurement, clinical execution, quantify the location and contact timing, and occlusion in 3D with more precision.
CLINICAL SIGNIFICANCE
T-scan occlusal analysis system is widely used in dentistry and there is an increase in the number of studies, so a systematic review evaluating and comparing results is warranted.
Topics: Dental Implants; Dental Occlusion; Dental Prosthesis, Implant-Supported; Humans; Prospective Studies; Retrospective Studies
PubMed: 35656667
DOI: No ID Found -
TheScientificWorldJournal 2021This study aimed at finding out whether anterior teeth angulation and inclination have a relationship with the maxillary teeth and dental arch dimensions.
OBJECTIVES
This study aimed at finding out whether anterior teeth angulation and inclination have a relationship with the maxillary teeth and dental arch dimensions.
METHODS
Fifty study models with normal occlusion were selected from the archive of the Department of Orthodontics at Baghdad Dental Faculty. Maxillary dental arch width and length at different points were determined in addition to measuring anterior teeth angulation, inclination, crown thickness, overjet, overbite, and Bolton's ratios. The unpaired -test and Pearson's correlation coefficient test were used for data analysis.
RESULTS
No statistical gender differences were reported in all measurements except the dental arch widths and length where males had significantly higher mean values. Only the maxillary incisor's inclination showed a direct weak significant correlation with the total arch length.
CONCLUSIONS
The inclination of upper incisors had a minimal effect on increasing dental arch length.
Topics: Adult; Dental Arch; Dental Occlusion; Female; Humans; Male; Maxilla; Tooth; Young Adult
PubMed: 34650346
DOI: 10.1155/2021/8993734 -
Journal of Oral and Maxillofacial... Nov 2022The current standard for mandibular reconstruction is a contour-based approach using a fibular flap offering good cosmetic results but challenging to reconstruct using...
PURPOSE
The current standard for mandibular reconstruction is a contour-based approach using a fibular flap offering good cosmetic results but challenging to reconstruct using dental implants. An iliac flap is more amenable to implant placement and better suited for occlusion-driven reconstruction. We aimed to describe an occlusion-driven workflow that involves the use of digital surgical guides to perform mandibular reconstruction using an iliac flap; we also aimed to compare our results to those we achieved with conventional contour-based reconstruction.
METHODS
This was a retrospective cohort study. All patients who underwent mandibular reconstruction with an iliac flap at our university hospital between September 2017 and December 2019 were considered eligible for the study. The inclusion criteria included mandibular defects after tumor ablation and stable preoperative occlusal relationship. The exclusion criteria were as follows: defects involving the condyle and ramus, temporomandibular joint disease, and obvious preoperative nontumor-related facial asymmetry. To evaluate surgical outcomes, patients were assigned to 2 groups based on the implemented surgical workflow: the occlusion-driven and traditional contour-driven groups. The intermaxillary distance, intermaxillary angle, surface deviation, and implantation rates were compared between the 2 groups. The operating time, length, and number of iliac bone segments were recorded. Intergroup differences were investigated using an independent samples t test and Fisher exact test.
RESULTS
Overall, 24 patients were included (13 in the occlusion-driven group and 11 in the contour-driven group). Implantation rate was higher in the occlusion-driven group (61.5%) compared with the contour-driven group (18.2%; P = .047). The average acceptable intermaxillary distance was greater in the occlusion-driven group (92.3 ± 27.7%) than in the contour-driven group (47.0 ± 47.6%; P = .01). The average intermaxillary angle was 88.2 ± 8.4° in the occlusion-driven group and 76.4 ± 10.3° in the contour-driven group (P < .01).
CONCLUSIONS
Digital surgical guides can precisely transfer virtual surgical planning to real-world mandibular surgery. An occlusion-driven workflow might provide a better intermaxillary jaw relationship than traditional contour-driven surgical procedures, resulting in improved mastication.
Topics: Humans; Bone Transplantation; Free Tissue Flaps; Ilium; Mandible; Mandibular Reconstruction; Plastic Surgery Procedures; Retrospective Studies; Workflow; Dental Occlusion
PubMed: 36007546
DOI: 10.1016/j.joms.2022.07.140 -
American Journal of Orthodontics and... Sep 2022Premolars are the teeth most often extracted to provide space to correct crowding, excessive dental and/or labial protrusion, and to compensate for the sagittal...
INTRODUCTION
Premolars are the teeth most often extracted to provide space to correct crowding, excessive dental and/or labial protrusion, and to compensate for the sagittal discrepancy. After treatment, the extraction spaces have to remain closed. Nevertheless, several studies have shown a tendency for some relapse even in patients finished with an adequate occlusion. Thus, the objective of this study was to compare the stability of extraction space closure of the first and second premolars.
METHODS
Dental casts of 72 patients were digitized using a 3-dimensional scanner (R700; 3Shape, Copenhagen, Denmark) and divided into 2 groups. Group 1 (29 patients; mean age, 13.79 years; 4.57 years after treatment; 116 extraction spaces) was treated with first premolar extractions, and group 2 (43 patients; mean age, 15.20 years; 3.97 years after treatment; 100 extraction spaces) was treated with second premolar extractions. Chi-square tests were used to compare the numbers of open and closed extraction spaces after treatment and at the long-term posttreatment stage. t Tests were used to compare the number of spaces posttreatment and at the long-term posttreatment stages. These tests were also performed in subgroups with completely closed extraction sites posttreatment.
RESULTS
The groups showed similar numbers of extraction sites reopening. The first and second premolar extraction space closure presents a similar tendency for reopening. Considering only the patients that showed completely closed extraction spaces in the final dental models, maxillary extraction space reopening was larger in the first premolar extraction group.
CONCLUSIONS
First and second premolar extraction space closure present similar stability.
Topics: Adolescent; Bicuspid; Cephalometry; Dental Occlusion; Humans; Malocclusion; Maxilla; Tooth Extraction
PubMed: 35534399
DOI: 10.1016/j.ajodo.2021.04.027 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Oct 2023Rehabilitation of complete edentulism is naturally related to temporomandibular joint (TMJ) since the proper functioning of complete denture depends on the normal... (Review)
Review
Rehabilitation of complete edentulism is naturally related to temporomandibular joint (TMJ) since the proper functioning of complete denture depends on the normal movement of TMJ. This review briefly introduced the design of occlusion in complete denture, characteristic of different occlusal patterns, and key points in registration of maxillomandibular relationship and occlusal adjustment. This review emphasized the significance of complete denture restoration to the health of TMJ.
Topics: Humans; Temporomandibular Joint; Temporomandibular Joint Disorders; Dental Occlusion; Occlusal Adjustment; Denture, Complete; Tooth Loss
PubMed: 37818531
DOI: 10.3760/cma.j.cn112144-20230730-00048