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Risciotti E, Squadrito N, Montanari D, Iannello G, Macca U, Tallarico M, Cervino G, Fiorillo L. Digital Protocol to Record Occlusal Analysis in Prosthodontics: A Pilot Study. J Clin Med 2024; 13:1370. [PMID: 38592229 PMCID: PMC10931913 DOI: 10.3390/jcm13051370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Digital technologies enable the accurate replication of occlusion, which is pivotal for stability in maximum intercuspation and dynamic occlusion. CAD softwares generates standardized occlusal morphologies requiring significant adjustments. The consideration of individual mandibular movements during restoration leads to better functional integration. This pilot study evaluates the efficacy of a novel, fully digital protocol for occlusal analysis recording in prosthodontics. Methods: Patients needing single or multiple metal-free restorations were included. Teeth underwent horizontal finish line preparation, while restorations on implants were either directly screwed or used multi-unit abutments. A digital impression (Trios 3 Intraoral Scanner) captured the mouth's elements. Dynamic occlusion was recorded via Patient Specific Motion (PSM). After the placement and functionalization of temporary restorations, subsequent scans included various elements, and CAD software (Dental system) was used for the restoration design. Restorations were milled in monolithic zirconia, pressed from CAD/CAM-milled wax, and sintered. Results: An evaluation of 52 restorations in 37 patients indicated high accuracy in restorations manufactured via the fully digital workflow. Monolithic zirconia was predominantly used. Subtractive (17.3%) and additive (7.7%) occlusal adjustments were mainly chairside. Conclusion: This study underscores the efficacy of meticulous verification measures and a centric contact system in reducing the need for clinical occlusal refinements in prosthetic restorations.
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Affiliation(s)
| | | | | | | | - Ugo Macca
- Private Practice, 96100 Siracusa, Italy;
| | - Marco Tallarico
- School of Dentistry, University of Sassari, 07100 Sassari, Italy;
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
- Department of Dental Cell Research, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, India
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
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sonnahalli NK, Shetty PP, Chowdhary R. Hybrid tracer - A modified novel extra oral tracer. J Oral Biol Craniofac Res 2022; 12:859-862. [PMID: 36203859 PMCID: PMC9530952 DOI: 10.1016/j.jobcr.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/10/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Gothic arch Tracing has been a common modality in the recording of centric jaw relation. There has been two ways of recording the gothic tracing. They are extra oral and intra oral tracing. Among the extra oral tracers hight tracers are the most used tracers. Aim Intra-oral and extra-oral tracers have a number of individual advantages and limitations. With the idea to overcome the short comings of both the tracers, hybrid tracers were made. Hybrid tracers could be a good alternative to the Hight-tracer in recording centric relation and can provide better clinical and teaching experience to the students. Methodology The hybrid tracer is a two-component assembly, upper and lower component. The upper component has a central bearing plate and stylus in continuation with the central bearing plate. The lower component has central bearing device with three central bearing points one anteriorly and two posteriorly, and it has a tracing platform (15 × 35 mm) in continuation with the central bearing device. The length of these upper and lower components ismade to confine within the incisal rod of semi adjustable articulator. Result hybrid tracers showed more accuracy while recording the centric jaw relation. There was more stability and equalization of pressure during the movement due to a tripod effect of three screws. Hence it provided more precise recording and being less technique sensitive. It was also more comfortable and acceptable by the patient. Conclusion hybrid tracers hence will provide more accuracy and precision in recording of horizontal jaw relation. This will in turn help in fabricating a successful prosthesis and enhance the well-being of the patient. This tracer will also be significant in institutions for educational purpose. Clinical implication Hybrid tracers are simple, non-technique sensitive, provide balance, equalization of pressure, stabilize the occlusal rims well, are close to the centre of rotation providing precise record and provide easy access and visibility to the operator which will help the operator in guiding the patient well for a correct jaw relation.
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Affiliation(s)
| | - Prajna P Shetty
- Rajarajeshwari Dental College and Hospital, Bangalore, India
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Škaričić J, Čimić S, Kraljević-Šimunković S, Vuletić M, Dulčić N. Influence of Occlusal Splint on Mandibular Movements in Patients with Bruxism: a Comparative Pilot Study. Acta Stomatol Croat 2020; 54:322-332. [PMID: 33132395 PMCID: PMC7586893 DOI: 10.15644/asc54/3/10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective The objective of this pilot study was to examine the impact of occlusal splint treatment on mandibular border movements and the condyle position in subjects with bruxism. Materials and methods The study included 9 subjects diagnosed with bruxism (mean age 28.7) and 9 subjects in the control group (mean age 30.5). All subjects were adults, eugnathic, and with a dentoalveolar Angle Class I, without prosthetic restorations, previous or current orthodontic treatments, a systemic disease or previous surgical interventions in the temporomandibular joint. All experimental and control group subjects were provided with a standardized relaxation occlusal splint, which they wore for 8 weeks. During this time, an initial and three additional measurements of incisal opening (IO), left condyle opening (OLC), right condyle opening (ORC), left laterotrusion (LLI) and right laterotrusion (LRI) (after 2, 4 and 8 weeks) were performed using an Arcus Digamma II (Kavo) ultrasound device for mandibular movements recording. Using the same instrument, the condylar position during protrusion, left and right laterotrusion, and in the centric relation position (CR) was analyzed initially and after 8 weeks using the maximum intercuspation as reference point. Continuous variables were described using basic statistical parameters, and the statistical significance of differences between the variables was checked by the t-test and χ2 test (p <0.05). Results The values of IO, OLC, ORC, LLI and LRI increased after 8 weeks of wearing, with the highest increase for OLC, by 13.8%. No statistically significant difference (p <0.05) was found for any changes in movements. Changes in the condyle position during all movements and those in the CR were higher in the experimental group for 10 out of 14 measured parameters compared to the control group. A statistically significant difference was established for 5 out of 14 measured parameters after the occlusal splint treatment. Conclusions The results of this pilot study have proven the influence of the occlusal splint treatment on mandibular border movements in subjects with bruxism by increasing the range of movements. Also the changes of the condyle position in subjects with bruxism were greater compared to those in healthy subjects.
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Affiliation(s)
- Josip Škaričić
- Private practice; PhD student, School of Dental Medicine, University of Zagreb, Croatia
| | - Samir Čimić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | | | - Marko Vuletić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, University Dental Clinic
| | - Nikša Dulčić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
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Čelar A, Gahleitner A, Lettner S, Freudenthaler J. Estimated functional space of centric condyle positions in temporomandibular joints of asymptomatic individuals using MRI. Sci Rep 2019; 9:15599. [PMID: 31666649 PMCID: PMC6821742 DOI: 10.1038/s41598-019-52081-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/10/2019] [Indexed: 02/08/2023] Open
Abstract
Magnetic resonance imaging (MRI) studies on centric condyle positions lack 3D comparisons of guided and unguided methods, which are used for accomplishing centric relation reference positions. The purpose of this study was to describe the space, in which mandibular condyles are placed in vivo by dental intercuspation, Dawson’s bimanual manipulation, and neuromuscular position. Twenty asymptomatic individuals aged 23 to 37 years underwent separate bite registrations using bimanual manipulation and the unguided neuromuscular technique. Subsequent 3-Tesla MRI scans of both temporomandibular joints yielded 3D data of the most superior condylar points at maximum intercuspation and both centric relation positions. We found concentric condyle positions in maximum intercuspation but considerable variation of condyle position after bimanual manipulation and neuromuscular technique. Their 95% predictive confidence ellipses overlapped substantially and created a space of reference positions. Its smallest volume averaged 2 mm3 for a minimal convex hull (95% confidence interval 1.1–3.2) and 3.5 mm3 for a minimal ellipsoid hull (95% confidence interval 1.8–5.4). Visualized in vivo by MRI, condyle positions at bimanual manipulation and neuromuscular position were not predictable and showed substantial variation in asymptomatic subjects. Clinicians should be aware of the functional space and its effect on dental intercuspation.
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Affiliation(s)
- Aleš Čelar
- Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Wien, Austria.
| | - André Gahleitner
- Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Wien, Austria
| | - Stefan Lettner
- Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Wien, Austria
| | - Josef Freudenthaler
- Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Wien, Austria
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Qu F, Du X, Liu WC. 3D-printed custom trays with a Gothic arch for centric relation recording and definitive impression making for complete dentures: A dental technique. J Prosthet Dent 2018; 121:32-36. [PMID: 30006221 DOI: 10.1016/j.prosdent.2018.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/18/2018] [Accepted: 01/18/2018] [Indexed: 11/28/2022]
Abstract
An appliance was designed and fabricated by using computer-aided design and computer-aided manufacturing (CAD-CAM) and 3-dimensional (3D) printing to combine a custom tray with an intraoral Gothic arch. This helped simplify centric relation recording and combined definitive impression making and centric relation recording into a single step.
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Affiliation(s)
- Fang Qu
- Postgraduate student, Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Xue Du
- Postgraduate student, Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Wei-Cai Liu
- Associate Professor, Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
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Karani J, Idrisi A, Mistry S, Badwaik P, Pai A, Yadav S. Comparative evaluation of the depth of curve of Spee between individuals with normal dentition and individuals with occlusal wear using conventional and digital software analysis techniques: An in vivo study. J Indian Prosthodont Soc 2018; 18:61-67. [PMID: 29430144 PMCID: PMC5799971 DOI: 10.4103/jips.jips_168_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 12/07/2017] [Indexed: 11/20/2022] Open
Abstract
Objectives: The objective of this study is to evaluate and compare the depth of curve of Spee in normal dentitions and dentitions with occlusal wear using conventional and digital software techniques. Materials and Methods: A total of 70 healthy human subjects were selected for this study in an age group of 20–50 years. Group A includes the stone models (dental casts) of 35 individuals with healthy (nonattrited) dentition. Group B includes stone models of 35 individuals with occlusal wear (generalized attrited) dentition. Two methods were used for measuring the curve of Spee, i.e., conventional method and three-dimensional digital analysis method. Results: Depth of the curve of Spee between these two groups was statistically the same. The Digital software analysis (Method II) gives more accurate readings when compared with the Conventional (Method I) of measuring the depth of the curve of Spee. Conclusion: Depth of curve of Spee is maintained through the life. There is no statistical difference in depth of curve of Spee between the two groups and digital method give more accurate measurements.
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Affiliation(s)
- Jyoti Karani
- Department of Prosthodontics, Terna Dental College, Mumbai, Maharashtra, India
| | - Arshad Idrisi
- Department of Prosthodontics, Terna Dental College, Mumbai, Maharashtra, India
| | - Saloni Mistry
- Department of Prosthodontics, Terna Dental College, Mumbai, Maharashtra, India
| | - Praveen Badwaik
- Department of Prosthodontics, Terna Dental College, Mumbai, Maharashtra, India
| | - Ashutosh Pai
- Department of Prosthodontics, Terna Dental College, Mumbai, Maharashtra, India
| | - Sangeeta Yadav
- Department of Prosthodontics, Terna Dental College, Mumbai, Maharashtra, India
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Ultra-low frequency transcutaneous electric nerve stimulation does not affect the centric relation registration. Cranio 2017; 36:19-28. [DOI: 10.1080/08869634.2016.1278107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Zorn A, Peroz I. Electronic central bearing point as registration method in individuals with and without temporomandibular disorders. Clin Oral Investig 2016; 20:2421-2427. [PMID: 26832779 DOI: 10.1007/s00784-016-1735-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to examine different central bearing point methods in patients with and without temporomandibular disorders (TMD) by an experienced and unexperienced examiner. MATERIAL AND METHODS The 20 fully dentulous subjects were screened for TMD based on the Research Diagnostic Criteria for TMD and distinguished into functional impaired and functional healthy groups. The mandibular relationship was recorded by an electronic central bearing tracing device (IPR-System, IPR GmbH, Oldenburg, Germany) with an integrated pressure sensor. Three bite registration methods were performed using this device: initial neuromuscular position, final neuromuscular position after dynamic sequences with the intraoral pin (=neuromuscular deprogramming), and centric relation guided manually by an experienced and an unexperienced examiner. RESULTS The neuromuscular positions before and after neuromuscular deprogramming were not significantly different (paired t test as a group comparison test: transverse: p = 0.369; sagittal: p = 0.486). Both positions were significantly anterior in comparison to the manually guided centric relation (paired t test as a group comparison test: p < 0.0001). The neuromuscular positions before and after deprogramming tend to have high scattering values. CONCLUSION By means of the central bearing point method, the manually guided centric relation is the one which is sufficiently reproducible. It seems doubtful to take the significant anterior neuromuscular position for a definite reconstruction. CLINICAL RELEVANCE Using the central bearing point method, the manually guided centric relation should be preferred, whereas the neuromuscular position should not be used for definite reconstructions.
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Affiliation(s)
- Antje Zorn
- Charité - Universitätsmedizin Berlin, CC3, Department of Prosthodontics, Gerodontology and Craniomandibular Disorders, Aßmannshauserstraße 4-6, 14197, Berlin, Germany
| | - Ingrid Peroz
- Charité - Universitätsmedizin Berlin, CC3, Department of Prosthodontics, Gerodontology and Craniomandibular Disorders, Aßmannshauserstraße 4-6, 14197, Berlin, Germany.
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Ballastreire MCFF, Carmo GG, Fantini SM. Reliability of the anterior functional device in recording the centric relations of patients with posterior tooth loss. J Prosthet Dent 2015; 114:560-5. [PMID: 26119015 DOI: 10.1016/j.prosdent.2014.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 12/09/2014] [Accepted: 12/10/2014] [Indexed: 11/28/2022]
Abstract
STATEMENT OF THE PROBLEM The recording of centric relations (CRs) in patients with posterior tooth loss is a process that is subject to inaccuracy. A number of techniques and devices, including the anterior functional device (AFD), have been developed in the pursuit of better results. PURPOSE The purpose of this in vivo study was to evaluate the reliability of the AFD for the recording of the CR in participants with different types of posterior tooth loss. MATERIAL AND METHODS Two CR records were obtained (CR1, CR2), and 2 maximal intercuspal position records were obtained (MIP1, MIP2) by a single operator at intervals of 5 minutes. This study included 45 participants of both sexes aged between 18 and 65 years who were divided into 3 groups. The first group had intercalated tooth loss (n=19), the second group had distal extensions (n=11), and the third group had no tooth loss (n=15). The distance between the CR and MIP was termed the condylar displacement and was measured in millimeters in the vertical, horizontal, and transversal planes with a condylar position indicator (CPI). The condylar displacements between the CR and MIP in both stages of the study (D1 and D2) were compared with the CPI after mounting the casts on a semiadjustable articulator. Repeated-measures analyses of variance with one factor were used to compare the records for each group in each of the planes: right vertical (RV), left vertical (LV), horizontal right (HR), horizontal left (HL), and transverse (T) (α=.05). No significant differences between the records in any of the planes (RV, LV, HR, HL, or T) were observed; thus, the means of the records of each plane were used to compare the groups (the intercalated tooth loss, distal extension, and no tooth loss groups). The means of the records of the HR and HL planes were compared by ANOVA because the data were normally distributed. The means of the records of the RV, LV, and T planes were compared by using nonparametric Kruskal-Wallis tests because the data were non-normally distributed. RESULTS No statistically significant difference (P >.05) was found between the condylar displacements for any of the studied variables in the 3 considered groups: RV (.512), LV (.690), HR (.179), HL (.494), and T (.644). CONCLUSIONS Repeatability of the condylar displacement was observed between the CR and MIP (D1, D2), which indicates the reliability of the AFD method for recording the CR in participants with posterior tooth loss. The AFD was demonstrated to be a user-friendly tool and permitted the recording and evaluation of excursive movements with tracings.
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Affiliation(s)
- Maria C F F Ballastreire
- Graduate student, Department of Orthodontics, School of Odontology, University of São Paulo (FOUSP), São Paulo, Brazil.
| | - Giselle G Carmo
- Graduate student, Department of Orthodontics School of Odontology, University of São Paulo (FOUSP), São Paulo, Brazil
| | - Solange M Fantini
- Professor, Department of Orthodontics, School of Odontology, University of São Paulo (FOUSP), São Paulo, Brazil
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Lin KC, Wagner SA. An Efficient and Cost-Effective Technique to Construct an Intraoral Central Bearing Tracing Device. J Prosthodont 2015; 24:511-4. [DOI: 10.1111/jopr.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kevin C. Lin
- Department of Integrated Reconstructive Dental Sciences; University of the Pacific Arthur A. Dugoni School of Dentistry; San Francisco CA
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The influence of different registration positions on condyle displacement in symptomatic patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:312-8. [PMID: 24528791 DOI: 10.1016/j.oooo.2013.11.498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/13/2013] [Accepted: 11/18/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate effects of different registration positions on the condyle-disk position changes in the mandibular fossa in symptomatic individuals. STUDY DESIGN Vertical and sagittal condyle position and thickness of the bilaminar zone were measured by magnetic resonance imaging during maximal intercuspation (MI) and with jigs in Gothic arch tracing guided centric relation (DIR method [Dynamics and Intraoral Registration]) and retruded contact position (RCP). Participants were 26 patients seeking treatment for temporomandibular disorders. Condyle and disk position in the fossa were calculated in the parasagittal plane. RESULTS Significant differences were found for MI, DIR, and RCP for thickness of bilaminar zone and sagittal condyle position, dependent on diagnosis and registration position for vertical and sagittal condyle position and thickness of bilaminar zone. CONCLUSIONS DIR position ensures the widest posterior space for the retrodiskal tissues and the slightest sagittal difference between condyle zenith and glenoid fossa.
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Abstract
Occlusion is the foundation for clinical success in fixed, removable, and implant prosthodontic treatment. Understanding those principles is critical when restoring a patient's occlusion. Many philosophies, devices, and theories of occlusion have evolved based on anecdotal clinical observations and applied geometric perceptions. The literature has reported these classic and contemporary occlusal concepts. As evidence-based dentistry emerged, it championed scrutiny of previously held beliefs, resulting in the abandonment of many pragmatic, yet beneficial occlusal procedures. The impetus toward scientific discovery, whereby factual information might be universally applied in dental education and clinical practice, has renewed interest in occlusal studies.
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Affiliation(s)
- Jonathan P Wiens
- Department of Restorative Dentistry, University of Detroit Mercy, School of Dentistry, Detroit, MI 48208, USA.
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