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Indian Journal of Otolaryngology and... Jun 2024Osteochondroma (OC) is an uncommon reason for the mandibular condyle to grow excessively. Usually unilateral, it can impact the entire mandible, the condyle and ramus,...
Osteochondroma (OC) is an uncommon reason for the mandibular condyle to grow excessively. Usually unilateral, it can impact the entire mandible, the condyle and ramus, or just the condyle. It is a bony projection covered in cartilage that protrudes from the damaged bone's exterior. Condylar OC are more prevalent as a result of endochondral ossification-related development. The most notable characteristic is the gradual asymmetry of the face over time. Clinical symptoms of the patient include pain, asymmetry, malocclusion, partial or total hearing loss, trismus, and hypomobility of the TMJ. We report a case of 40-year-old male patient complaining of reduced mouth opening since last 10 years. Clinical examination revealed gross facial asymmetry, hard swelling over right TMJ, jaw deviation towards left side, restricted mouth opening of 3 mm and deranged occlusion. An irregular radiopaque mass was seen over the right condylar region in OPG. A large, hyperdense mass that obliterated the sigmoid notch and extended medially to the right condyle was visible on CT scans. Using a pre-auricular Alkayat-Bramley technique, the mass was surgically removed. Occlusal corrections and jaw physiotherapy were then administered. On follow up, deviation was corrected and adequate mouth opening was achieved.
PubMed: 38883440
DOI: 10.1007/s12070-023-04469-8 -
Journal of Pharmacy & Bioallied Sciences Apr 2024This study aimed to conduct a human study to determine the incidence of postobturation pain using different parameters. In this cross-sectional study, 240 patients were...
Incidence of Postoperative Pain After Single- and Multiple-Visit Root Canal Treatment in Patients Reporting in the Conservative Dentistry and Endodontics Outpatient Department of a Tertiary Care Hospital: A Cross-Sectional Study.
This study aimed to conduct a human study to determine the incidence of postobturation pain using different parameters. In this cross-sectional study, 240 patients were included, which were equally allocated into two groups: single visit and multiple visit, 120 in each. Patients in both the single and multiple visits were further categorized into two subgroups, subgroup 1-no occlusal reduction and subgroup 2-occlusion reduction each having 60 patients. Corresponding to the type of visit, patients were followed by the role of medication into two groups, subgroup 1-both analgesics and antibiotics, subgroup 2-only analgesics, and subgroup 3-no medication. Following this approach and the criteria of the study, patients' performa was made, and based on this performa, the intensity of subjective symptoms, particularly postobturation pain, was determined using the visual analog scale (VAS). The data were then analyzed using the Chi-square test. Results were such that a single visit, no occlusal reduction, and only analgesics will be better for patients with irreversible pulpitis as chosen in the present study. Within the limitations of the present study, it can be concluded that single-sitting root canal treatment should be preferred over multiple sitting where there is no periapical inflammation; also, the occlusal reduction could be exempted from the same. To relieve the patient from postoperative pain where complete debridement is possible, antibiotics can be excluded from the regimen and only analgesics could be prescribed.
PubMed: 38882820
DOI: 10.4103/jpbs.jpbs_524_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Class II malocclusions are a common orthodontic problem, often requiring comprehensive treatment to achieve proper occlusion and facial harmony. Early orthodontic...
BACKGROUND
Class II malocclusions are a common orthodontic problem, often requiring comprehensive treatment to achieve proper occlusion and facial harmony. Early orthodontic intervention in the mixed dentition phase has been advocated to address these issues.
MATERIALS AND METHODS
A retrospective analysis was conducted on a cohort of 150 patients with class II malocclusions who underwent early orthodontic treatment between the ages of 7 and 10 years. The treatment included fixed or removable appliances, headgear, and functional appliances, depending on individual needs. Records of their initial malocclusion severity, treatment modalities, and long-term follow-up data (mean follow-up duration of 10 years) were collected and analyzed. Stability was assessed by evaluating overjet and overbite changes from post-treatment to the long-term follow-up.
RESULTS
The initial mean overjet and overbite values were 8.5 mm and 4.0 mm, respectively. Following early orthodontic intervention, these values were significantly reduced to 3.0 mm and 1.5 mm, respectively ( < 0.001). At the long-term follow-up, the mean overjet and overbite remained stable at 3.2 mm and 1.6 mm, respectively. Analysis revealed that 85% of patients maintained their corrected class II occlusion within clinically acceptable limits, while 15% experienced minor relapse requiring minimal additional treatment.
CONCLUSION
Early orthodontic treatment in class II malocclusions can lead to significant improvements in overjet and overbite, and these corrections tend to remain stable over the long term.
PubMed: 38882812
DOI: 10.4103/jpbs.jpbs_1171_23 -
Computers in Biology and Medicine Jun 2024Alterations in occlusal features may have significant consequences, ranging from dental aesthetics to health issues. Temporomandibular joint disorders (TMDs) are often...
Alterations in occlusal features may have significant consequences, ranging from dental aesthetics to health issues. Temporomandibular joint disorders (TMDs) are often associated with joint overload, and the correlation between occlusal features and TMDs has been thoroughly discussed. In current work, we introduced a novel stomatognathic model that aligns well with in vivo experimental measurements, specifically designed to decouple the impact of occlusal contact and periodontal ligament (PDL) negative feedback on temporomandibular joint (TMJ) loading. Utilizing an in-silico approach, the simulation analysis included six symmetric occlusal contact scenarios. Furthermore, a biomechanical lever model was employed to clarify the mechanical mechanism and investigate the multi-factorial effects of TMJ overload. These findings indicate that anterior shifts in the occlusal centre lead to increased TMJ loading, particularly in occlusal contact cases with anteroposterior changes. Considering the symmetrical distribution of occlusal contact, mediolateral alterations had a more modest effect on TMJ loading. Additionally, potential negative feedback activated by principal strain of periodontal could not only alleviate joint load but also diminish occlusal force. These investigations enhance our understanding of the intricate interactions between masticatory muscles, occlusal forces, and joint contact forces, thereby providing motivation for future comprehensive studies on TMJ biomechanical overload.
PubMed: 38878405
DOI: 10.1016/j.compbiomed.2024.108725 -
Evidence-based Dentistry Jun 2024A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were...
DATA SOURCES
A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were searched.
STUDY SELECTION
Journal articles published between January 2007 and January 2023 were identified. Studies that assessed malocclusion indices and oral function were included. Non-English articles and irrelevant studies were excluded. A total of 480 articles were identified. Following exclusion, 29 articles were included in the systematic review.
DATA EXTRACTION AND SYNTHESIS
Data was compiled using Microsoft Excel. Information from each article was extracted including study design, evaluation criteria of malocclusion and oral function, and findings. Studies were assessed using the STROBE GRADE approach. The results were compiled in a brief narrative review investigating the type and strength of the association between malocclusion and ingestion.
RESULTS
Malocclusion was recorded using Index of Treatment Need, Dental Aesthetic Index, Goslon Yardstick Index, Index of Complexity Outcomes and Need, Peer Assessment Rating, Angle's classification, Specific Severity Score, dental inter-arch relation and cephalometric analysis. Ingestion was measured by bite force, electromyography, mixing ability index, bolus granulometric analysis, video analysis of kinetic parameters during mastication, and subjective questionnaires. Of the 29 articles identified, 20 demonstrated a negative impact of malocclusion on oral ingestion, highlighting impaired masticatory efficiency, bite force and subjective difficulties. Eight studies found no significant association. One study, which used two questionnaires, found a significant relationship between eating and malocclusion using one questionnaire but not the other.
DISCUSSION
Limitations in current research methodologies were identified, particularly the heterogeneity in assessment tools. The indicators used to assess ingestion and malocclusion are flawed, with questionable reliability. No study was able to identify which features or severity of malocclusion impact ingestion. The relationship between ingestion and malocclusion could not be quantified and the need for longitudinal and case report studies was deemed essential to establish causality.
CONCLUSION
This review underscores the importance of considering how malocclusion impacts function in orthodontic treatment planning. Future research should focus on standardised assessment methods for measuring malocclusion and oral ingestion to establish the nature of the relationship between the two. This will ultimately guide orthodontic intervention aiming to enhance oral function.
Topics: Humans; Malocclusion; Eating; Mastication; Bite Force
PubMed: 38849573
DOI: 10.1038/s41432-024-01021-7 -
American Journal of Orthodontics and... Jun 2024This study aimed to design an artificial intelligence (AI) system for dental occlusion classification using intraoral photographs. Moreover, the performance of this...
Designing an artificial intelligence system for dental occlusion classification using intraoral photographs: A comparative analysis between artificial intelligence-based and clinical diagnoses.
INTRODUCTION
This study aimed to design an artificial intelligence (AI) system for dental occlusion classification using intraoral photographs. Moreover, the performance of this system was compared with that of an expert clinician.
METHODS
This study included 948 adult patients with permanent dentition who presented to the Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, during 2022-2023. The intraoral photographs taken from the patients in left, right, and frontal views (3 photographs for each patient) were collected and underwent augmentation, and about 7500 final photographs were obtained. Moreover, the patients were clinically examined by an expert orthodontist for malocclusion, overjet, and overbite and were classified into 6 groups: Class I, Class II, half-cusp Class II, Super Class I, Class III, and unclassifiable. In addition, a multistage neural network system was created and trained using the photographs of 700 patients. Then, it was used to classify the remaining 248 patients using their intraoral photographs. Finally, its performance was compared with that of the expert clinician. All statistical analyses were performed using the Stata software (version 17; Stata Corp, College Station, Tex).
RESULTS
The accuracy, precision, recall, and F1 score of the AI system in the malocclusion classification of molars were calculated to be 93.1%, 88.6%, 91.2%, and 89.7%, respectively, whereas the AI system had an accuracy, precision, recall, and F1 score of 89.1%, 88.8%, 91.42%, and 89.8% for malocclusion classification of canines, respectively. Moreover, the mean absolute error of the AI system accuracy was 1.98 ± 2.11 for overjet and 1.28 ± 1.60 for overbite classifications.
CONCLUSIONS
AI exhibited remarkable performance in detecting all classes of malocclusion, which was higher than that of orthodontists, especially in predicting angle classification. However, its performance was not acceptable in overjet and overbite measurement compared with expert orthodontists.
PubMed: 38842962
DOI: 10.1016/j.ajodo.2024.03.012 -
BMC Oral Health Jun 2024Tooth avulsion represents the most severe form of dental trauma, necessitating tooth replantation as the primary treatment. However, the risk of replacement root...
BACKGROUND
Tooth avulsion represents the most severe form of dental trauma, necessitating tooth replantation as the primary treatment. However, the risk of replacement root resorption (RRR) poses a significant threat to tooth retention following replantation. This study preliminarily aimed to investigate the effect of physiological occlusal force on RRR after the replantation of avulsed teeth and to explore the potential underlying mechanisms.
METHODS
Thirty-six 4-week-old male Sprague-Dawley rats underwent extraction and immediate replantation of their left maxillary molars. The rats were randomly divided into two major groups: the occluded (n = 18) group, where the opposite mandibular teeth were preserved; non-occluded (n = 18) group, where the opposite mandibular teeth were extracted. Within each major group, there were three subgroups corresponding to 7 days, 14 days, and 2 months, resulting in a total of six subgroups, (n = 6 per subgroup). The right maxillary first molars served as the normal control. Various periodontal characteristics were assessed using haematoxylin-eosin (H&E), tartrate-resistant acid phosphatase (TRAP) staining, and micro-computed tomography (micro-CT).
RESULTS
Histological staining revealed that under occlusal force, the early stage (day 7) after tooth replantation mainly manifested as root surface resorption, especially in the non-occluded group, which gradually diminished over time. Cementum and periodontal ligament (PDL) repair was observed on day 14. Micro-CT analysis indicated a significant decrease in PDL width in the non-occluded group two months after replantation, consistent with the histological findings, signifying severe RRR in the non-occluded group.
CONCLUSIONS
This study provides preliminary evidence that physiological occlusal force may attenuate osteoclastogenesis during the early stage of tooth replantation, thereby reducing the occurrence of RRR and promoting periodontal healing.
Topics: Animals; Root Resorption; Tooth Replantation; Male; Rats, Sprague-Dawley; Tooth Avulsion; Rats; Bite Force; X-Ray Microtomography; Molar
PubMed: 38840089
DOI: 10.1186/s12903-024-04394-4 -
The Journal of Oral Implantology Jun 2024This study analyzed the stress distributions on zygomatic and dental implants placed in the zygomatic bone, supporting bones, and superstructures under occlusal loads... (Comparative Study)
Comparative Study
This study analyzed the stress distributions on zygomatic and dental implants placed in the zygomatic bone, supporting bones, and superstructures under occlusal loads after maxillary reconstruction with obturator prostheses. A total of 12 scenarios of 3-dimensional finite element models were constructed based on computerized tomography scans of a hemimaxillectomy patient. Two obturator prostheses were analyzed for each model. A total force of 600 N was applied from the palatal to buccal bones at an angle of 45°. The maximum and minimum principal stress values for bone and von Mises stress values for dental implants and prostheses were calculated. When zygomatic implants were applied to the defect area, the maximum principal stresses were similar in intensity to the other models; however, the minimum principal stress values were higher than in scenarios without zygomatic implants. In models that used zygomatic implants in the defect area, von Mises stress levels were significantly higher in zygomatic implants than in dental implants. In scenarios where the prosthesis was supported by tissue in the nondefect area, the maximum and minimum principal stress values on cortical bone were higher than in scenarios where implants were applied to defect and nondefect areas. In patients who lack an alveolar crest after maxillectomy, a custom bar-retained prosthesis placed on the dental implant should reduce stress on the zygomatic bone. The stress was higher on zygomatic implants without alveolar crest support than on dental implants.
Topics: Humans; Finite Element Analysis; Zygoma; Maxilla; Dental Implants; Palatal Obturators; Imaging, Three-Dimensional; Dental Stress Analysis; Bite Force; Biomechanical Phenomena; Computer Simulation; Stress, Mechanical; Cortical Bone; Tomography, X-Ray Computed; Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported
PubMed: 38839068
DOI: 10.1563/aaid-joi-D-24-00008 -
The Journal of Prosthetic Dentistry Jun 2024When using conventional methods, centric occlusion (CO) can be determined on conventional gypsum casts that are mounted in an analog articulator at centric relation...
When using conventional methods, centric occlusion (CO) can be determined on conventional gypsum casts that are mounted in an analog articulator at centric relation (CR). In the digital environment, intraoral scanners (IOSs) can be used to record maxillary and mandibular scans articulated in CR. However, a digital protocol to locate the CO on articulated intraoral digital scans at CR by using computer-aided design (CAD) programs is needed. The present manuscript describes a straightforward technique to record CR by combining an IOS and a Kois deprogrammer. Afterwards, the acquired digital data are imported into a CAD program to locate CO. The technique includes a complete digital protocol to locate CO by using 3 different CAD programs: open-access non-dental, open-access dental, and dental CAD program.
PubMed: 38834391
DOI: 10.1016/j.prosdent.2024.05.002 -
BDJ Open Jun 2024Dental implantation has emerged as an efficient substitute for missing teeth, which is essential for restoring oral function and aesthetics. Compared to traditional...
INTRODUCTION
Dental implantation has emerged as an efficient substitute for missing teeth, which is essential for restoring oral function and aesthetics. Compared to traditional denture repair approaches, dental implants offer better stability and sustainability. The position, angle, and depth of dental implants are crucial factors for their long-term success and necessitate high-precision operation and technical support.
METHOD
We propose an integrated dual-arm high-precision oral implant surgery navigation positioning system and a corresponding control strategy. Compared with traditional implant robots, the integrated dual-arm design greatly shortens the preparation time before surgery and simplifies the operation process. We propose a novel control flow and module for the proposed structure, including an Occluded Target Tracking Module (OTTM) for occlusion tracking, a Planting Plan Development Module (PPDM) for generating implant plans, and a Path Formulation Module (PFM) for controlling the movement path of the two robot arms.
RESULT
Under the coordinated control of the aforementioned modules, the robot achieved excellent accuracy in clinical trials. The average angular error and entry point error for five patients who underwent implant surgery using the proposed robot were 2.1° and 0.39 mm, respectively.
CONCLUSION
In essence, our study introduces an integrated dual-arm high-precision navigation system for oral implant surgery, resolving issues like lengthy preoperative preparation and static surgical planning. Clinical results confirm its efficacy, emphasizing its accuracy and precision in guiding oral implant procedures.
PubMed: 38830840
DOI: 10.1038/s41405-024-00231-6