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Cureus May 2024Some conditions known as temporomandibular disorders (TMDs) affect surrounding muscles and jaw joints. In dentistry, there has been discussion and research on the... (Review)
Review
Some conditions known as temporomandibular disorders (TMDs) affect surrounding muscles and jaw joints. In dentistry, there has been discussion and research on the connection between TMDs and occlusion, which is how the upper and lower teeth meet. Although some dental experts have proposed a direct link between TMDs and occlusion, the specifics of this relationship are still unclear and have many facets. More particularly, the research facets of "occlusion" remain one of the most contentious subjects in TMDs. This abstract aims to provide an overview of TMDs and occlusion, summarizing the key points from the literature. The etiological factors contributing to the TMDs, including occlusal, psychological, and hormonal factors, are also analyzed. The second part of the article includes the concept of malocclusion, emphasizing its significance in masticatory function and overall health. Anterior open and posterior open bites and the potential influence of occlusal factors on TMDs are elucidated.
PubMed: 38919245
DOI: 10.7759/cureus.61108 -
BMC Oral Health Jun 2024Symmetrical and coordinated dental and alveolar arches are crucial for achieving proper occlusion. This study aimed to explore the association between dental and...
BACKGROUND
Symmetrical and coordinated dental and alveolar arches are crucial for achieving proper occlusion. This study aimed to explore the association between dental and dentoalveolar arch forms in children with both normal occlusion and malocclusion.
METHODS
209 normal occlusion subjects (5-13 years, mean 8.48 years) and 199 malocclusion subjects (5-12 years, mean 8.19 years) were included. The dentoalveolar arch form was characterized by the smoothest projected curve representing the layered contour of the buccal alveolar bone, referred to as the LiLo curve. Subsequently, a polynomial function was utilized to assess dental and dentoalveolar arch forms. To facilitate separate analyses of shape (depth/width ratio) and size (depth and width), the widths of dental and dentoalveolar arch forms were normalized. The normalized dental and dentoalveolar arch forms (shapes) were further classified into 6 groups, termed dental/dentoalveolar arch clusters, using the k-means algorithm.
RESULTS
The association between dental and dentoalveolar arch clusters was found to be one-to-many rather than one-to-one. The mismatch between dental and dentoalveolar arch forms is common in malocclusion, affecting 11.4% of the maxilla and 9.2% of the mandible, respectively.
CONCLUSIONS
There are large individual variations in the association between dental and dentoalveolar arch forms. Early orthodontic treatment may play an active role in coordinating the relationship between the dental and dentoalveolar arch forms.
Topics: Humans; Child; Cross-Sectional Studies; Dental Arch; Malocclusion; Female; Male; Child, Preschool; Adolescent; Alveolar Process; Dental Occlusion
PubMed: 38918757
DOI: 10.1186/s12903-024-04515-z -
Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Orthodontic Anchorage Procedures; Molar, Third; Malocclusion, Angle Class III; Female; Tooth Movement Techniques; Orthodontic Appliance Design; Male; Adolescent
PubMed: 38917041
DOI: No ID Found -
Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Orthodontic Wires; Orthodontic Appliance Design; Female; Tooth Movement Techniques; Dental Alloys; Malocclusion; Male; Adolescent
PubMed: 38917040
DOI: No ID Found -
BMC Oral Health Jun 2024The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in...
BACKGROUND
The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA).
METHODS
The sample consisted of 30 individuals (8-11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05.
RESULTS
The analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1.
CONCLUSION
The findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment's safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation.
Topics: Humans; Mandibular Condyle; Malocclusion, Angle Class III; Female; Male; Cone-Beam Computed Tomography; Child; Palatal Expansion Technique; Fractals
PubMed: 38915000
DOI: 10.1186/s12903-024-04506-0 -
BMC Oral Health Jun 2024This paper aimed to explore the prevalence of temporomandibular disorders (TMDs) signs/symptoms, and to investigate the possible link between signs/symptoms of TMDs and...
BACKGROUND
This paper aimed to explore the prevalence of temporomandibular disorders (TMDs) signs/symptoms, and to investigate the possible link between signs/symptoms of TMDs and mouth breathing (MB) by evaluating along with other risk factors, in a Turkish subpopulation of children and adolescence.
METHODS
This study was conducted with the archival data of the patients who applied with orthodontic complaints. Data on demographic characteristics, family-related factors, systemic status, occlusion, breathing patterns, oral habits, and bruxism were retrieved from the archival records.
RESULTS
Nine hundred forty-five children and adolescents with a mean age of 14.82 ± 2.06 years were included in the study. Of the participants, 66% were girls, 60.4% were delivered by C-section, 8.4% of the participants had at least one systemic disease, 9.2% of the participants had allergy, and 4.3% of the participants' parents were divorced, 18.7% have an oral habit, 6.6% have bruxism, 29.8% have malocclusion and 14.1% have MB. Eight-point-five percent of participants have signs/symptoms of TMD. Among them 2.9% have pain, 3.7% have joint sounds, 1.4% have deflection, and 3.9% have deviation. Evaluation of the risk factors revealed a significant relation between the signs/symptoms of TMD and bruxism (OR 8.07 95% CI 4.36-14.92), gender (OR 2.01 95% CI 1.13-3.59), marital status of parents (OR 2.62 95% CI 1.07-6.42), and MB (OR 3.26 95% CI 1.86-5.71).
CONCLUSIONS
According to the study's findings, girls and those with bruxism, divorced parents, and MB behavior are more likely to have signs/symptoms of TMD. Age found to have significant effect on the occurrence of the signs/symptoms of TMD alone, but together with other factors the effect of the age is disappeared. Early screening and intervention of MB as well as the signs/symptoms of TMD can help to limit detrimental effects of these conditions on growth, and quality of life of children and adolescents.
Topics: Humans; Female; Adolescent; Male; Turkey; Cross-Sectional Studies; Temporomandibular Joint Disorders; Child; Mouth Breathing; Risk Factors; Prevalence; Bruxism; Malocclusion; Facial Pain; Hypersensitivity
PubMed: 38914975
DOI: 10.1186/s12903-024-04482-5 -
Journal of Maxillofacial and Oral... Jun 2024Facial anthropometric data vary significantly within the Indian population due to the racial, ethnic and geographic diversity. The anthropometric data of a given ethnic... (Review)
Review
OBJECTIVE
Facial anthropometric data vary significantly within the Indian population due to the racial, ethnic and geographic diversity. The anthropometric data of a given ethnic community may not match the other due to diverse ethnic variations, and hence, this study is intended to review the facial anthropometric data pertaining to the diverse Indian populace through a systematic literature survey.
MATERIALS AND METHOD
An electronic search done on Medline, Embase and Central databases was utilized to conduct a systematic review of literature. The available data were analyzed based on the various esthetic subunits of the face. The following inclusion criteria were considered: (1) studies depicting the anthropometric data of any ethnic group identified as belonging to India, (2) studies originating from Indian subcontinent, (3) studies which included data of male and female subjects separately and (4) articles in English language only. The following exclusion criteria were considered: (1) atudies conducted on participants with severe malocclusion, developmental craniofacial anomalies, post-traumatic facial deformities or with a history of previous craniofacial or cosmetic surgery, (2) studies which did not specify the anthropometric landmarks used to obtain the measurements, (3) studies in which the statistical analysis was not provided, or if data were grouped across genders and (4) editorials, commentaries, case reports, systematic reviews, meta-analyses and articles not available in English language.
RESULTS
Twenty-one articles met the inclusion criteria. Majority of the Indians, particularly men, seem to have a mesoproscopic facial phenotype. The vertical and horizontal facial dimensions of the Indian male are comparably larger than the Indian female. There is sexual dimorphism among the Indian population with regard to the upper and lower thirds of the face, with little or no gender difference as regards the middle third of the face. It was observed that the nasal dimensions of the Indian race were not compatible with that of the occidental, oriental or the western race. The overall facial structure and the upper half of the face were critical in determining facial attractiveness in Indian males while the lower half of the face and the mandibular contour were critical in determining facial attractiveness in females.
CONCLUSION
It is observed that there is a paucity of facial anthropometric data for the Indian population considering the ethnic, racial and geographic diversity. Since the prevalence of craniofacial anomalies and dentofacial deformities in India is high and thus the scope for corrective surgery, it is important to compile baseline facial anthropometric data based on the ethnic diversity of the Indian population.
PubMed: 38911415
DOI: 10.1007/s12663-024-02185-6 -
Cureus May 2024Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical...
Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical objectives in the treatment of TMJ ankylosis are to establish joint movement, prevent relapse, and achieve normal growth and development. Here, we present an operated case ofsurgical correction of mandibular hypoplasia; however, the patient came back after three years due to unsatisfactory results and underwent bilateral coronoidectomy and gap arthroplasty. Bones were osteotomized at the LeFort I level and the maxillary segment was down-fractured and mobilized to bring into occlusion with the mandible. In the present case, the lower pharyngeal airway changed from 5 mm pre-treatment to 10 mm post-treatment, and the facial angle was changed from 73 to 84 post-treatment. Assessment of the pharyngeal airway is done with a high suspicion of obstructive sleep apnea and facial deformity is mandatory in the management of TMJ ankylosis.
PubMed: 38910750
DOI: 10.7759/cureus.60857 -
Medicina Oral, Patologia Oral Y Cirugia... Jun 2024This study aimed to investigate the effectiveness of combining sevoflurane with remifentanil, esmolol, or nitroglycerin for hypotensive anesthesia and determine the...
BACKGROUND
This study aimed to investigate the effectiveness of combining sevoflurane with remifentanil, esmolol, or nitroglycerin for hypotensive anesthesia and determine the suitable hypotensive anesthesia method for orthognathic surgery.
MATERIAL AND METHODS
This retrospective study included 60 patients who underwent orthognathic surgery for developmental malocclusion. They were divided into three groups based on the hypotensive agent preferences: Group 1 (n = 20), sevoflurane and remifentanil; Group 2 (n = 20), sevoflurane and esmolol; Group 3 (n = 20), sevoflurane and nitroglycerin. Bleeding volume, heart rate, systolic, diastolic, and mean arterial blood pressure were recorded at certain times during the perioperative period, including at stages with increased stress levels in the body, such as incision and osteotomy. The patients' blood pressure, analgesic consumption and pain level were recorded in the postoperative period.
RESULTS
Bleeding volume, surgery satisfaction related to bleeding, and total operation time did not differ significantly between groups. Intraoperatively, heart rates were significantly higher in Group 3 than in Groups 1 and 2 (p = 0.001). However, hemodynamic stability was similar in Groups 1 and 2. Postoperatively, analgesic consumption, pain levels, and blood pressure dynamics did not differ significantly between groups (p > 0.05).
CONCLUSIONS
Based on this study's results, it was concluded that infusing remifentanil, esmolol, or nitroglycerin with sevoflurane during orthognathic surgery successfully achieved the targeted hypotensive anesthesia and can be considered alternative methods. The decision on which method to use should consider the patient's overall health status and additional medical conditions.
PubMed: 38907646
DOI: 10.4317/medoral.26662 -
American Journal of Orthodontics and... Jun 2024This study aimed to analyze the comprehensive maxillofacial features of patients with skeletal Class III malocclusion and facial asymmetry to develop a classification...
INTRODUCTION
This study aimed to analyze the comprehensive maxillofacial features of patients with skeletal Class III malocclusion and facial asymmetry to develop a classification system for diagnosis and surgical planning.
METHODS
A total of 161 adult patients were included, with 121 patients in the asymmetry group (menton deviation >2 mm) and 40 patients in the symmetry group (menton deviation ≤2 mm). Twenty-eight variables were determined, including transverse translation, roll and yaw of each facial unit, transverse width, mandibular morphology, and transverse dental compensation. Principal component (PC) analysis was conducted to extract PCs, and cluster analysis was performed using these components to classify the asymmetry group. A decision tree was constructed on the basis of the clustering results.
RESULTS
Six PCs were extracted, explaining 80.622% of the data variability. The asymmetry group was classified into 4 subgroups: (1) atypical type (15.7%) showed an opposite roll direction of maxillary dentition than of menton deviation; (2) compound type (34.71%) demonstrated significant ramus height differences, maxillary roll, and mandibular roll and yaw; (3) mandibular yaw type (44.63%) showed slight mandibular yaw without mandibular morphology asymmetry; and (4) maxillary-shift type (4.96%) shared similarities with the compound type but showed significant maxillary translation. The classification and regression tree model achieved a prediction accuracy of up to 85.11%.
CONCLUSIONS
This study identified 4 distinct phenotypes using cluster analysis and proposed tailored treatment recommendations on the basis of their specific characteristics. The classification results emphasized the importance of spatial displacement features, especially mandibular yaw, in diagnosing facial asymmetry. The established classification and regression tree model enables clinicians to identify patients conveniently.
PubMed: 38904566
DOI: 10.1016/j.ajodo.2024.05.012