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Watted N, Lone IM, Zohud O, Midlej K, Proff P, Iraqi FA. Comprehensive Deciphering the Complexity of the Deep Bite: Insight from Animal Model to Human Subjects. J Pers Med 2023; 13:1472. [PMID: 37888083 PMCID: PMC10608509 DOI: 10.3390/jpm13101472] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
Deep bite is a malocclusion phenotype, defined as the misalignment in the vertical dimension of teeth and jaws and characterized by excessive overlap of the upper front teeth over the lower front teeth. Numerous factors, including genetics, environmental factors, and behavioral ones, might contribute to deep bite. In this study, we discuss the current clinical treatment strategies for deep bite, summarize the already published findings of genetic analysis associated with this complex phenotype, and their constraints. Finally, we propose a comprehensive roadmap to facilitate investigations for determining the genetic bases of this complex phenotype development. Initially, human deep bite phenotype, genetics of human deep bite, the prevalence of human deep bite, diagnosis, and treatment of human deep bite were the search terms for published publications. Here, we discuss these findings and their limitations and our view on future strategies for studying the genetic bases of this complex phenotype. New preventative and treatment methods for this widespread dental issue can be developed with the help of an understanding of the genetic and epigenetic variables that influence malocclusion. Additionally, malocclusion treatment may benefit from technological developments like 3D printing and computer-aided design and manufacture (CAD/CAM). These technologies enable the development of personalized surgical and orthodontic guidelines, enhancing the accuracy and effectiveness of treatment. Overall, the most significant results for the patient can only be achieved with a customized treatment plan created by an experienced orthodontic professional. To design a plan that meets the patient's specific requirements and expectations, open communication between the patient and the orthodontist is essential. Here, we propose to conduct a genome-wide association study (GWAS), RNAseq analysis, integrating GWAS and expression quantitative trait loci (eQTL), micro and small RNA, and long noncoding RNA analysis in tissues associated with deep bite malocclusion in human, and complement it by the same approaches in the collaborative cross (CC) mouse model which offer a novel platform for identifying genetic factors as a cause of deep bite in mice, and subsequently can then be translated to humans. An additional direct outcome of this study is discovering novel genetic elements to advance our knowledge of how this malocclusion phenotype develops and open the venue for early identification of patients carrying the susceptible genetic factors so that we can offer early prevention and treatment strategies, a step towards applying a personalized medicine approach.
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Affiliation(s)
- Nezar Watted
- Center for Dentistry Research and Aesthetics, Jatt 45911, Israel;
- Department of Orthodontics, Faculty of Dentistry, Arab America University, Jenin 919000, Palestine
- Gathering for Prosperity Initiative, Jatt 45911, Israel
| | - Iqbal M. Lone
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel; (I.M.L.); (O.Z.)
| | - Osayd Zohud
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel; (I.M.L.); (O.Z.)
| | - Kareem Midlej
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel; (I.M.L.); (O.Z.)
| | - Peter Proff
- University Hospital of Regensburg, Department of Orthodontics, University of Regensburg, 93053 Regensburg, Germany
| | - Fuad A. Iraqi
- Gathering for Prosperity Initiative, Jatt 45911, Israel
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel; (I.M.L.); (O.Z.)
- University Hospital of Regensburg, Department of Orthodontics, University of Regensburg, 93053 Regensburg, Germany
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Chen Y, Li Y, Li L, Luo N, Zhang X, Dai H, Zhou J. Evaluation of condyle-fossa relationships in skeletal Class I malocclusion with variable degrees of deep overbite and open bite. Cranio 2022:1-12. [PMID: 36154613 DOI: 10.1080/08869634.2022.2126918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To compare the temporomandibular joint (TMJ) position and shape between skeletal Class I subjects with different degrees of deep overbite or open bite and unaffected peers. METHODS Cone beam computed tomography (CBCT) images of 90 participants, equally divided into deep bite, open bite, and control groups (DBG, OBG, and CG, respectively), were analyzed. The DBG and OBG were further subdivided into three subgroups based on the severity. Linear and angular measurements were used to determine the positional and morphological characteristics of the TMJ. RESULTS DBG showed significantly larger superior joint space, anterior inclination of the condyle, and articular eminence inclination than CG and OBG. The severity of deep bite and open bite significantly influenced the TMJ position and morphology. CONCLUSION In severe deep overbite and open bite cases, there were considerable alterations in TMJ components, most likely as a result of functional demands.
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Affiliation(s)
- Yanxi Chen
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Ying Li
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Lingfeng Li
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Nan Luo
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Xiaoya Zhang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Hongwei Dai
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Department of Orthodontics, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jianping Zhou
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Department of Orthodontics, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Bech K, Fogh FM, Lauridsen EF, Sonnesen L. Temporomandibular disorders, bite force and osseous changes of the temporomandibular joints in patients with hypermobile Ehlers-Danlos syndrome compared to a healthy control group. J Oral Rehabil 2022; 49:872-883. [PMID: 35694904 PMCID: PMC9544469 DOI: 10.1111/joor.13348] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/09/2022] [Accepted: 06/02/2022] [Indexed: 12/02/2022]
Abstract
Background Ehlers‐Danlos syndrome (EDS) is a hereditary disorder that affects the connective tissue and collagen structures in the body characterised by joint hypermobility, skin hyperextensibility and tissue fragility. Objective The aim was to investigate temporomandibular disorders (TMD), bite force, teeth in occlusal contact and osseous changes of the temporomandibular joints (TMJs) in 26 patients with hypermobile EDS (hEDS), differentiated by a genetic test, compared to 39 healthy controls. Methods Clinical examination according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), radiological examinations of the TMJs by cone‐beam‐computed tomographic (CBCT) scans, registration of bite force and teeth in occlusal contact was performed. Statistical analyses included Fisher's Exact Test, multiple logistic and linear regression models adjusted for age, gender and Body Mass Index (BMI). Results Single symptoms and signs of TMD occurred significantly more often in hEDS (p = .002; p = .001; p = .003; p = <.0001; p = .012) and maximum mouth opening was significantly smaller in hEDS compared to controls (p = <.0001). The DC/TMD diagnosis myalgia, myofascial pain with referral, arthralgia, headache attributed to TMD, disc displacement disorders and degenerative joint disease occurred significantly more often in hEDS compared to controls (p = .000; p = .008; p = .003; p = .000; p = <.0001; p = .010, respectively). No significant differences were found in bite force and in teeth in occlusal contact between the groups (p > .05). On CBCT of the TMJs, subcortical sclerosis occurred significantly more often in hEDS compared to controls (p = .005). Conclusion Symptoms and signs of TMD and osseous changes of the TMJs occurred significantly more often in hEDS. Bite force and teeth in occlusal contact were comparable to controls.
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Affiliation(s)
- Karen Bech
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frederikke Maria Fogh
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eva Fejerskov Lauridsen
- Resource Center for Rare Oral Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Liselotte Sonnesen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Alyafrusee ES, Alhammadi MS, Almaqrami BS, Abdulqader AA, Alsomairi MA, Alhadad SA, Liling R. Three-dimensional assessment of temporomandibular joint in skeletal Class I malocclusion with variable degrees of overbite and overjet. Cranio 2022:1-11. [PMID: 35102813 DOI: 10.1080/08869634.2022.2028114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To three-dimensionally evaluate the position and morphology of the TMJ in skeletal Class I with variable degrees of overbite and overjet in comparison with normal peers. METHODS Pretreatment CBCT scans of 126 adults were retrieved. Based on the severity of overjet and overbite, the sample was divided into three main groups and six subgroups (18 patients each): the first group with a normal overbite and variable overjet degree and the second group with normal overjet and variable overbite degree. These six subgroups were compared with a third control group of normal overjet and overbite. RESULTS There were significant differences in vertical condylar position, vertical and anteroposterior condylar inclinations, condylar height, and significant posterior condylar positioning in severe deep overbite, compared with the control group. CONCLUSION There were significant changes in the TMJ components in severe deep overbite cases. Therefore, sever deep overbite could be considered a predisposing factor for temporomandibular disorders.
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Affiliation(s)
- Enas Senan Alyafrusee
- Orthodontic Department, School of Stomatology, Lanzhou University, Lanzhou, China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Maged Sultan Alhammadi
- Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, Faculty of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Bushra Sufyan Almaqrami
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
- Department of Orthodontics, Hubei-most Klos & Klobm, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Abbas Ahmed Abdulqader
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Majedh Abdo Alsomairi
- Orthodontic Department, School of Stomatology, Lanzhou University, Lanzhou, China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
- Department of Orthodontics,School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Saba Ahmed Alhadad
- Orthodontic Department, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Ren Liling
- Orthodontic Department, School of Stomatology, Lanzhou University, Lanzhou, China
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Bite Force, Occlusal Contact and Pain in Orthodontic Patients during Fixed-Appliance Treatment. Dent J (Basel) 2022; 10:dj10020014. [PMID: 35200240 PMCID: PMC8871092 DOI: 10.3390/dj10020014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 01/14/2023] Open
Abstract
Previously, bite force, occlusal contact and pain were investigated in orthodontic patients with moderate-to-severe malocclusion, but not in patients with minor malocclusion. The purpose of this study was to investigate changes in bite force, teeth in occlusal contact and pain in orthodontic patients with minor crowding before orthodontic treatment (T0), after bonding (T1), during treatment (T2), post-treatment (T3) and during retention (T4). In total, 27 patients (21 females, 6 males, median age 15.3 years) with neutral occlusion and normal craniofacial morphology were treated with non-extractions and fixed appliances. Differences in the registered data were analysed by a mixed linear model with repeated measures. Bite force and teeth in occlusal contact significantly decreased between T0 and T1 (p < 0.0001, respectively) and between T0 and T2 (p < 0.01, respectively). Bite force and teeth in occlusal contact significantly increased between T1 and T4 (p < 0.05, p < 0.0001, p < 0.001, respectively) and between T2 and T4 (p < 0.05, p < 0.0001, p < 0.01, respectively). No significant difference in pain was found. The results indicate that bite force and teeth in occlusal contact significantly decreased during treatment and reached baseline level at retention. The findings may prove valuable for informing orthodontic patients with minor malocclusion.
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Gaballah K, Alkubaisy A, Baker AA, Bawzeer A, Awad R. Revisiting the Risk Factors for Multiple Symptoms of Temporomandibular Disorders: A structured Cross-sectional Study. Open Dent J 2020. [DOI: 10.2174/1874210602014010503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The risk factors for Temporomandibular Disorders (TMD) are extensively studied, but the results showed no consistency. Only a small proportion of patients with TMD are likely to seek help and require treatment. Those individuals tend to present with multiple symptoms. This cohort of patients was not well investigated.
Objective:
The study aimed to examine the association between possible risk factors for presentation with multiple TMD symptoms.
Methods:
A population-based, cross-sectional study was conducted across 2101 individuals with an age range of 19-60 years. The condition was assessed via a detailed questionnaire comprising symptoms, habits, dental history, general health, sleep patterns, along with the completion of the Hospital Anxiety and Depression (HAD) scale, followed by an examination of the hypothesized clinical signs. The obtained data were tabulated and characterized the study population in a descriptive analysis in forms of percentages and frequencies. The significance level was set at P-value less than or equal to 0.005. The chi-squared test was implemented to assess the relationship between the multiple TMD symptoms reported and the potential risk factors.
Results:
Most participants reported a variable amount of stress. Moreover, 1528 (72.7 percent) mentioned abnormalities in sleep. About 80 percent had at least one TMD-related symptom. The multiple symptoms of TMD were identified among the 741 individuals. The following risk factors demonstrated association with a robust statistical significance (P=0.00), 1) occupation, 2) sleeping problems, 3) health concerns, 4) traumatic dental treatment, 5) various somatic symptoms, and 6) elevated HAD scale. When the outcomes of the clinical examination were analyzed, the statistical assessment could link soft tissue changes, namely; the cheek ridging and tongue indentations (P 0.00), with multiple symptoms of the condition.
Conclusion:
Multiple TMD symptoms were prevalent among individuals with elevated stress, abnormal sleep pattern, traumatic dental treatment, elevated HAD scale. The results highlighted the importance of psychological factors in the pathogenesis of TMD.
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Mollabashi V, Heidari A, Ebrahimi Zadeh H, Seyed Tabib M. The study of facial morphology in patients with vertical growth pattern (hyperdivergent) lacking or showing temporomandibular disorders symptoms. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:233-237. [PMID: 31614226 DOI: 10.1016/j.jormas.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/26/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
AIM According to the large number of studies, there seems to be a significant relation between hyperdivergence growth pattern and temporomandibular disorders. However, it is not clearly scrutinized which morphological factors can contribute to the development of temporomandibular disorders. The aim of this study was to investigate the relation between some skeletal and facial morphologic features of hyperdivergent facial growth pattern patients and temporomandibular disorders. MATERIALS AND METHODS This case-control study was performed on a population of 50 patients including 25 patients with temporomandibular disorder and 25 non- temporomandibular disorder individuals aged between 15-30 years with hyperdivergent growth pattern (Frankfurt Mandibualr plane angle between 28 and 35 degree). Two groups of symptomatic and asymptomatic patients (case and control) were matched for age and gender. In order to evaluate the skeletal and dental variables, lateral cephalometries was taken and traced after obtaining written consent from the patients. The measured variables were A point to Nasion to B point, Frankfurt plane to Nasion to Pogonion, Nasion to A point to Pogonion, Sella to Gnathion to Frankfurt plan, Articular point to Gonion-Menton, Sella to Articular point to Gonion, Palatal plane to Mandibular plane, and Articular point to Gonion angles. The intervals of Basion to Nasion, Sella to Basion, Gonion to Menton, and amounts of Anterior facial height meas, Upper Anterior facial height ratio to Lower Anterior facial height, posterior facial height, overjet, and overbite Data were analyzed by Chi2 test, t-test, and multivariate test. RESULTS According to the descriptive statistics, the age of the control and case groups averaged 21.12±1.99 and 21.63±1.58 years respectively. Among the people referred to the dental school, the frequency of males and females in the control and case groups were 6, 7 and 19, 18 respectively. The results of t-test and multivariate tests indicated significant differences between the two variables of overbite and mandibular length. CONCLUSION The present study revealed increased overbite (dental feature) and mandibular length (skeletal feature) is more likely to be associated with a higher risk of temporomandibular disorders joint disease in patients with hyperdivergent facial growth pattern. CLINICAL SIGNIFICANCE Treatment of the deep bite condition can be helpful in improving temporomandibular disorder.
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Affiliation(s)
- Vahid Mollabashi
- Department of Orthodontics, Dental Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Ali Heidari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Hosna Ebrahimi Zadeh
- Department of Restorative and Cosmetic Dentistry, School of Dentistry, Shahid Behesti University of Medical Sciences, Tehran, Iran.
| | - Maryam Seyed Tabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Khayat N, Winocur E, Emodi Perelman A, Friedman-Rubin P, Gafni Y, Shpack N. The prevalence of posterior crossbite, deep bite, and sleep or awake bruxism in temporomandibular disorder (TMD) patients compared to a non-TMD population: A retrospective study. Cranio 2019; 39:398-404. [PMID: 31370774 DOI: 10.1080/08869634.2019.1650217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To assess the prevalence of posterior crossbite and/or deep bite among patients diagnosed with temporomandibular disorders (TMD) compared to a non-TMD population.Methods: Four hundred ninety-four patients were enrolled: 345 with TMD according to the diagnostic criteria for TMD and 149 without TMD (control group). The chi-square test was used for statistical analysis.Results: A statistically significant association was found between sleep and awake bruxism and painful TMDs (p < .001 for both), but not with disc displacement. There was no association between posterior crossbite and/or deep bite with either painful TMD or disc displacement.Conclusion: Within the study limitations, sleep bruxism and awake bruxism may be related to pain in the TMD, and the severity of a deep overbite and presence of a unilateral or bilateral posterior crossbite should not be considered risk factors or as having any effect on the pain associated with TMD and/or disc displacement.
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Affiliation(s)
- Naser Khayat
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ephraim Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alona Emodi Perelman
- Department of Oral Rehabilitation, The Maurice and Gabriela School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pessia Friedman-Rubin
- Department of Oral Rehabilitation, The Maurice and Gabriela School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yosef Gafni
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Shpack
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Perrotta S, Bucci R, Simeon V, Martina S, Michelotti A, Valletta R. Prevalence of malocclusion, oral parafunctions and temporomandibular disorder-pain in Italian schoolchildren: An epidemiological study. J Oral Rehabil 2019; 46:611-616. [PMID: 30892729 DOI: 10.1111/joor.12794] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/27/2019] [Accepted: 03/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The prevalence of malocclusion, temporomandibular disorders (TMD) and oral parafunctions is highly debated in children population. OBJECTIVES To investigate the prevalence of malocclusion, self-reported oral parafunctions and TMD-pain in Italian schoolchildren and to assess the association between the examined factors. METHODS A total of 700 children aged 9-11 years were selected among six public schools in Campania region (Italy). Molar relationship, overjet, overbite and cross-bite were assessed through a clinical examination. Furthermore, the subjects were demanded to fill in a validated questionnaire for TMD-pain screening and the short form of the Oral Behaviours Checklist. Descriptive statistics were used to report the frequencies. The associations between occlusal traits, oral parafunctions and TMD-pain were analysed with a Pearson chi-square test, as expressed by odds ratio and 95% confidence intervals. The significance level was set at P < 0.05. RESULTS Molar Class I was the most frequently encountered molar relationship, followed by molar Class II, subdivision and molar Class III. Increased overjet was more common than negative overjet. Posterior cross-bite was observed in 12% of children. TMD-pain was recorded in 14.7% of subjects. High frequency of oral parafunctions was reported in 21.3% of subjects. A significant association was found between TMD-pain and negative overbite. Cross-bite and high frequency of oral parafunctions were associated with TMD-pain. CONCLUSION The current results show that malocclusion, self-reported oral parafunctions and TMD-pain are frequent findings among Italian schoolchildren and that some occlusal factors and high frequency of oral parafunctions might be associated with TMD-pain.
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Affiliation(s)
- Stefania Perrotta
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Rosaria Bucci
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Vittorio Simeon
- Department of Mental Health and Preventive Medicine, Medical Statistics Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano Martina
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Ambra Michelotti
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Rosa Valletta
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
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Fang CY, Yu JH, Chang CC, Hsu JT, Lee YC, Huang HL. Effects of short-term acupuncture treatment on occlusal force and mandibular movement in patients with deep-bite malocclusion. J Dent Sci 2019; 14:81-86. [PMID: 30988883 PMCID: PMC6445974 DOI: 10.1016/j.jds.2018.11.003] [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] [Received: 09/05/2018] [Revised: 11/02/2018] [Indexed: 10/29/2022] Open
Abstract
Background/purpose Acupuncture is well known to be effective for pain relief and muscle relaxation, and hence it is feasible that acupuncture treatment could change the occlusal forces and mandibular movements in subjects with deep-bite malocclusion. The purpose of this research was to determine the distribution of occlusal force and the border movement of the mandible in patients with deep-bite malocclusion before and after acupuncture treatment. Materials and methods This study involved 17 volunteers with deep-bite malocclusion and aged 20-30 years. Before and after acupuncture treatment, the distribution of the occlusal-force percentage at each tooth was measured and the percentage biting force in the first molar area during maximal clenching was recorded. Additionally, the mandibular movements including the maximum mouth opening and maximum lateral border movement were also evaluated. All of the data were analyzed statistically using the Wilcoxon signed-rank test. Results The percentage biting force at the first molar differed significantly between before and after the acupuncture treatments (P = 0.017). However, no treatment effects were seen for the maximum mouth opening and the maximum lateral border movement. Conclusion: Although the mandibular border movements did not change significantly, this study has confirmed that acupuncture treatment may become an alternative choice on improving the occlusal force of deep-bite patients.
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Affiliation(s)
- Chih-Yu Fang
- School of Dentistry, China Medical University, No. 91 Hsueh-Shih Rd., Taichung 40402, Taiwan
| | - Jian-Hong Yu
- School of Dentistry, China Medical University, No. 91 Hsueh-Shih Rd., Taichung 40402, Taiwan.,Department of Orthodontics, China Medical University Hospital, No. 2, Yude Rd., Taichung 40447, Taiwan
| | - Chia-Chi Chang
- Department of Chinese Medicine, China Medical University Hospital, No. 2, Yude Rd., Taichung 40447, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, No. 91 Hsueh-Shih Rd., Taichung 40402, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, 500 Lioufeng Rd., Wufeng, Taichung 41354, Taiwan
| | - Yu-Chen Lee
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, No. 2, Yude Rd., Taichung 40447, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, No. 91 Hsueh-Shih Rd., Taichung 40402, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, 500 Lioufeng Rd., Wufeng, Taichung 41354, Taiwan
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Khayat NAR, Shpack N, Emodi Perelman A, Friedman-Rubin P, Yaghmour R, Winocur E. Association between posterior crossbite and/or deep bite and temporomandibular disorders among Palestinian adolescents: A sex comparison. Cranio 2019; 39:29-34. [PMID: 30729883 DOI: 10.1080/08869634.2019.1574962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To assess the prevalence of temporomandibular disorders (TMDs) and posterior crossbite and/or deep bite and any possible association between them. Methods: One thousand-nineteen adolescents responded to a questionnaire regarding oral habits and TMD symptoms. Afterwards, they were diagnosed according to the Axis I of the DC/TMD and underwent a dental examination. The chi-square test was used for statistical analysis. Results: A significant association was found between posterior crossbite and some TMD diagnosis, but no association was found between deep bite and TMD, nor between occlusal diagnosis and bruxism. TMDs were more prevalent in girls. There was a significant sex difference (more among females) in the prevalence of painful TMDs. Conclusion: Posterior crossbite in the adolescent population analyzed may be related to TMDs, in contrary to deep-bite. The presence of posterior crossbite may have different impact on TMD findings between the sexes.
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Affiliation(s)
- Naser Azmi Rushdi Khayat
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Nir Shpack
- Department of Orthodontics, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Alona Emodi Perelman
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Pessia Friedman-Rubin
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Reem Yaghmour
- Department of Biology, Faculty of Medicine and Technology, Alquds University , Palestine
| | - Ephraim Winocur
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University , Tel Aviv, Israel
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12
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Michelotti A. An interview with Ambrosina Michelotti. Dental Press J Orthod 2018; 23:22-29. [PMID: 29898154 PMCID: PMC6018446 DOI: 10.1590/2177-6709.23.2.022-029.int] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/15/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ambrosina Michelotti
- » Graduated in Dentistry (DDS) in 1984. » Specialist in Orthodontics (1991). » Professor in pregraduate and postgraduate courses in Orthodontics and TMD at the University of Naples Federico II. » Associate professor in Clinical Gnathology. » Responsible of the Master course on "Orofacial Pain and Temporomandibular Disorders" at the University of Naples Federico II. » Published more than 100 papers in Italian and international journals, and has lectured extensively around the world. » President of the European Academy of Craniomandibular Disorders (2010). » President of the Neuroscience group of IADR (International Association for Dental Research) (2011). » President of SIDA (Società Italiana Disfunzioni ed Algie Temporomandibolari; 2012-2013). » President of the RDC/TMD Consortium at the IADR (2013-2014). » Associate Editor of the European Journal of Oral Science. » Associate Editor of the Journal of Oral Rehabilitation. » Member of the editorial board of the European Journal of Orthodontics. »Referee of several national and international journals
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13
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Ukra A, Foster Page LA, Thomson WM, Knight RG, Farella M. Self-report of temporomandibular joint clicking and psychological factors: is there an association? J Oral Rehabil 2017; 44:511-516. [PMID: 28386913 DOI: 10.1111/joor.12514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
The objectives of this study were to test the hypothesis that self-reported TMJ clicking sounds in adolescents are positively associated with non-specific somatic symptoms, self-perception of body image and care-seeking behaviour. A cross-sectional study was carried out in 353 young adolescents (48·4% females) recruited from community (N = 272) and orthodontic clinic (N = 81) settings. Assessments included self-reported TMJ clicking, non-specific physical symptoms, body image concerns and for the clinic sample only, the source of motivation for treatment. TMJ sounds were self-reported by 19% of the sample and were associated with higher scores for non-specific physical symptoms and body image concerns (P < 0·001). Adolescents who were self-motivated to seek orthodontic treatment had greater scores for non-specific physical symptoms, more body image concerns and tended to report TMJ sounds more often (26·3% and 7·7% respectively; P = 0·41) than those who were solely parent/family-motivated to seek treatment. Self-reported TMJ sounds in adolescents were associated with a propensity to somatisation and concerns with body image. Care-seeking adolescents have greater non-specific physical symptoms and body image concerns and tend to report more frequent TMJ sounds.
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Affiliation(s)
- A Ukra
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - L A Foster Page
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - W M Thomson
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - R G Knight
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - M Farella
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
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Svensson P, Kumar A. Assessment of risk factors for oro-facial pain and recent developments in classification: implications for management. J Oral Rehabil 2016; 43:977-989. [PMID: 27690281 DOI: 10.1111/joor.12447] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 02/06/2023]
Abstract
Oro-facial pain research has during the last decades provided important novel insights into the basic underlying mechanisms, the need for standardised diagnostic procedures and classification systems, and multiple treatment options for successful rehabilitation of the patient in pain. Notwithstanding the significant progress in our knowledge spanning from molecules to chair, there may also be limitations in our ability to integrate and interpret the tremendous amount of new data and information, in particular in terms of the clinical implications and overriding conceptual models for oro-facial pain. The aim of the present narrative review is to briefly summarise some of the current thoughts on oro-facial pain mechanisms and recent attempts to identify biomarkers and risk factors leading to the proposal of a new risk assessment diagram for oro-facial pain (RADOP) and a provocative new concept based on stochastic variation between multiple risk factors. Finally, the implications for novel management strategies will briefly be discussed.
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Affiliation(s)
- P Svensson
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University, Aarhus, Denmark
| | - A Kumar
- Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University, Aarhus, Denmark
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15
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Luca L, Manfredini D, Arveda N, Rossi L, Siciliani G. A cone-beam computerized tomography assessment of the relationship between upper incisors inclination and articular eminence features in orthodontically untreated patients with different facial type. J World Fed Orthod 2016. [DOI: 10.1016/j.ejwf.2016.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Takeuchi M, Saruta J, Kato M, Sugimoto M, Kamata Y, Shimizu T, To M, Kawata T, Igarashi H, Tsukinoki K. Features of occlusal state in female Japanese patients with migraine: a case-controlled study. Cranio 2016; 34:382-387. [PMID: 27101875 DOI: 10.1080/08869634.2015.1106808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The prevalence rate of migraines is 8.4%; it is mostly diagnosed in women at 20s to 40s, and is known to cause major physical and mental disruption to daily life. This study was conducted on women aged between their 20s and 40s, in order to investigate the possible differences in the features of the occlusal state between a migraine and a non-migraine (control) group. METHODS Age-matched female patients with migraine (n = 60) diagnosed by headache specialists and healthy controls (n = 57) were enrolled. Dental casts were used to evaluate some features. RESULTS The maxillary and mandibular dentition casts from the migraine group showed significantly characteristic findings in their Angle's classification, overjet, and deviation in the anterior tooth midline, compared to the control group. DISCUSSION The results relating occlusal state to both tension-related headaches and migraines, which have different pathogeneses, suggest the possibility of dental intervention to improve the symptoms of primary headaches.
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Affiliation(s)
- Mifumi Takeuchi
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Juri Saruta
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan.,b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Momoko Kato
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Masahiro Sugimoto
- b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan.,d Institute for Advanced Biosciences , Keio University , Tsuruoka , Japan
| | - Yohei Kamata
- c Department of Comprehensive Dentistry, Yokohama Clinic , Kanagawa Dental University , Yokohama , Japan
| | - Tomoko Shimizu
- c Department of Comprehensive Dentistry, Yokohama Clinic , Kanagawa Dental University , Yokohama , Japan
| | - Masahiro To
- b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Toshitsugu Kawata
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | | | - Keiichi Tsukinoki
- b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
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Luther F, Layton S, McDonald F. WITHDRAWN: Orthodontics for treating temporomandibular joint (TMJ) disorders. Cochrane Database Syst Rev 2016; 2016:CD006541. [PMID: 26741357 PMCID: PMC10653018 DOI: 10.1002/14651858.cd006541.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Cochrane Oral Health Group withdrew this review as of Issue 1, 2016. The review is out of date and does not meet current Cochrane methodological standards. It will be superseded by a new Cochrane review on Occlusal interventions for managing temporomandibular disorders. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Friedy Luther
- University of SheffieldThe School of Clinical Dentistry19 Claremont CrescentSheffieldUKS10 2TA
| | | | - Fraser McDonald
- King's College London Dental Institute, King's College LondonDepartment of OrthodonticsFloor 22, Guy's TowerSt Thomas StreetLondonUKSE1 9RT
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Silvola AS, Tolvanen M, Rusanen J, Sipilä K, Lahti S, Pirttiniemi P. Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion? Acta Odontol Scand 2015; 74:44-50. [PMID: 25936383 DOI: 10.3109/00016357.2015.1040063] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The aim was to evaluate the relationships of changes in facial pain, temporomandibular disorders (TMDs) and oral health-related quality-of-life (OHRQoL) in adults who underwent orthodontic or orthodontic/surgical treatment. METHODS Sixty-four patients (46 women, 18 men, range 18-64 years) with severe malocclusion and functional problems were treated in Oulu University Hospital. Of these, 44 underwent orthodontic-surgical and 20 orthodontic treatment. Data were collected with questionnaires and clinical stomatognathic examinations before and on average 3 years after treatment. The OHRQoL was measured with OHIP-14 (The Oral Health Impact Profile), the intensity of facial pain with the Visual Analogue Scale (VAS) and the severity of TMD with the Helkimo's anamnestic (Ai) and clinical (Di) dysfunction indices. RESULTS A significant improvement was found in facial pain, signs and symptoms of TMD and OHRQoL after the treatment (p < 0.05). The decrease in VAS was associated with improvement in OHIP-14 severity (r = 0.296, p = 0.019). The correlations between changes in OHIP-14 severity and Ai and Di were not statistically significant. CONCLUSION Treatment of severe malocclusion seemed to improve OHRQoL via decreased facial pain. Decreased facial pain was associated especially with improved OHRQoL dimensions of physical pain, physical disability and social disability.
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Affiliation(s)
- Anna-Sofia Silvola
- a 1 Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, MRC, Oulu University Hospital , Oulu, Finland
| | - Mimmi Tolvanen
- b 2 Department of Community Dentistry, Institute of Dentistry, University of Turku , Turku, Finland
| | - Jaana Rusanen
- a 1 Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, MRC, Oulu University Hospital , Oulu, Finland
| | - Kirsi Sipilä
- c 3 Institute of Dentistry, University of Eastern Finland , Kuopio, Finland
- d 4 Kuopio University Hospital , Kuopio, Finland
| | - Satu Lahti
- b 2 Department of Community Dentistry, Institute of Dentistry, University of Turku , Turku, Finland
| | - Pertti Pirttiniemi
- a 1 Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, MRC, Oulu University Hospital , Oulu, Finland
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Deguchi T, Terao F, Aonuma T, Kataoka T, Sugawara Y, Yamashiro T, Takano-Yamamoto T. Outcome assessment of lingual and labial appliances compared with cephalometric analysis, peer assessment rating, and objective grading system in Angle Class II extraction cases. Angle Orthod 2015; 85:400-407. [PMID: 25153130 PMCID: PMC8612439 DOI: 10.2319/031014-173.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 07/01/2014] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE To validate our hypothesis that there would be significant differences in treatment outcomes, including cephalometric values, degree of root resorption, occlusal indices, and functional aspect, between cases treated with labial and lingual appliances. MATERIALS AND METHODS Twenty-four consecutively treated Class II cases with extractions and lingual appliance were compared with 25 matched cases treated with extraction and labial appliance. Orthodontic treatment outcomes were evaluated by cephalometric analysis, peer assessment rating, and an objective grading system (OGS). Additionally, functional analysis was also performed in both groups after orthodontic treatment. Statistical comparison was performed using the Wilcoxon signed rank test within the groups, and the Mann-Whitney U-test was used to compare between the labial and lingual groups. RESULTS The only significant difference between the groups was that the interincisal angle was larger in the lingual group than in the labial group. OGS evaluation showed that control over root angulation was significantly worse in the lingual group than in the labial group. There was no significant difference between groups in the amount of root resorption or in functional evaluation. CONCLUSIONS Generally, lingual appliances offer comparable treatment results to those obtained with labial appliances. However, care should be taken with lingual appliances because they are more prone to produce uprighted incisors and root angulation.
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Affiliation(s)
- Toru Deguchi
- Associate Professor, Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, Ohio; and Adjunct Instructor, Division of Orthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Fumie Terao
- Assistant Professor, Department of Orthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Tomo Aonuma
- Graduate Student, Division of Orthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Tomoki Kataoka
- Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuyo Sugawara
- Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takashi Yamashiro
- Professor and Chair, Division of Orthodontics, Department of Orthodontics and Dentofacial Orthopedics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Teruko Takano-Yamamoto
- Professor and Chair, Division of Orthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Tinastepe N, Oral K. Investigation of the Relationship between Increased Vertical Overlap with Minimum Horizontal Overlap and the Signs of Temporomandibular Disorders. J Prosthodont 2015; 24:463-8. [PMID: 25556905 DOI: 10.1111/jopr.12249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to test the null hypothesis that there was no relationship between increased vertical overlap (vertical overlap ≥4 mm) with minimal horizontal overlap (horizontal overlap ≤2 mm) and the signs of temporomandibular disorders. MATERIALS AND METHODS Thirty participants (20 women, aged 20 to 45 years) with increased vertical overlap and minimal horizontal overlap, and 30 participants (20 women, aged 20 to 45 years) with no contact between the anterior teeth (control group) were examined. Diagnoses, psychological status (depression and nonspesific physical symptoms), and chronic pain severity were judged according to the Research Diagnostic Criteria for Temporomandibular Disorders and then compared. For statistical analysis of quantitative data, along with the descriptive statistical methods (mean, standard deviation, frequency), Student's t-test was used to compare parameters that reflected a normal distribution. Comparison of qualitative data between groups was performed using Chi-square and Fisher's exact tests. The level of significance was set at p < 0.05. RESULTS In this study, deviation upon maximum opening was found significantly more frequently in the increased vertical overlap group than in the control group (p < 0.05). Tenderness upon palpation of lateral pterygoid muscles was observed more often in the increased vertical overlap group compared with the control group (p < 0.05). Opening-closing joint sounds occurred significantly more often in the increased vertical overlap group than in the control group (p = 0.050). CONCLUSION Within the limitations of this study, deviation upon maximum opening, tenderness of lateral pterygoid muscles (upon palpation), and opening-closing joint sounds occurred more often in the increased vertical overlap occlusions with minimum horizontal overlap compared to the control groups. These results indicated that clinicians should pay special attention to the tempormandibuar joint status of patients with significant vertical overlap anteriorly and position of the incisors when performing dental treatments that require reestablishment of incisor relationships.
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Affiliation(s)
- Neslihan Tinastepe
- Department of Prosthodontics, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Koray Oral
- Department of Prosthodontics, Yeditepe University School of Dentistry, Istanbul, Turkey
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Jain RK, Kumar SP, Manjula WS. Comparison of intrusion effects on maxillary incisors among mini implant anchorage, j-hook headgear and utility arch. J Clin Diagn Res 2014; 8:ZC21-4. [PMID: 25177631 DOI: 10.7860/jcdr/2014/8339.4554] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 05/01/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intrusion of maxillary incisors is one of the most important and difficult tooth movements to achieve as a part of orthodontic therapy. A variety of techniques were used in the past to intrude the maxillary incisors before the emergence of mini implants in Orthodontics. Mini implants are temporary anchorage devices used to produce various tooth movements. The research was carried out to evaluate and compare the efficiency of producing intrusion of maxillary incisors using mini implants, utility arch and j- hook headgear. MATERIALS AND METHODS The study was conducted on 30 subjects divided into 3 Groups equally. Group 1- mini implant anchorage, Group 2 - j- hooks headgear and Group 3- utility arch were used for intrusion of the maxillary incisors. Conventional lateral cephalograms were taken before treatment and at the end of intrusion. Five cephalometric parameters were used to measure the amount of intrusion attained in each Group. Intra Group comparisons were done using student t-test and inter Group comparisons were done using ANOVA The duration of intrusion was four months in all the three Groups. RESULTS In Group 1 the mean average intrusion attained was 2.1 mm, the mean average intrusion attained in Group 2 was 0.7 mm, and the mean average intrusion achieved in Group 3 was 1.4 mm with a side effect of 0.75 mm of molar extrusion. CONCLUSION Although, both mini implants and utility arch can be used to attain significant amounts of incisor intrusion but using mini implants will produce true intrusion without any other side effects.
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Affiliation(s)
- Ravindra Kumar Jain
- Senior Lecturer, Department of Orthodontics, College of Dental Surgery, Saveetha University , Chennai, India
| | - Sridhar Prem Kumar
- Assistant Professor, Department of Orthodontics, The Tamilnadu Government Dental College and Hospitals , Chennai, India
| | - W S Manjula
- Professor, Department of Orthodontics, Balaji Dental College , Chennai, India
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de Oliveira RH, Hallak JEC, Siéssere S, de Sousa LG, Semprini M, de Sena MF, Osorio FDL, Nunes EA, Pinto JP, Regalo SCH. Electromyographic analysis of masseter and temporal muscles, bite force, masticatory efficiency in medicated individuals with schizophrenia and mood disorders compared with healthy controls. J Oral Rehabil 2014; 41:399-408. [PMID: 24661123 DOI: 10.1111/joor.12164] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 12/21/2022]
Abstract
This study aimed to comparatively analyse the electromyographic activity of the masseter and temporal muscles at rest and during mandible postural clinical conditions (right and left laterality, protrusion and maximum voluntary contraction), right and left maximum molar bite forces and the masticatory efficiency of individuals with schizophrenia or mood disorders - all medicated (medicated groups) compared with control group (healthy volunteers) via electromyography. Individuals were distributed into three groups: Group I (Schizophrenia - 20 individuals), Group II (mood disorders - 20 individuals) and Group III (Control - 40 individuals). Basically, the results were only statistically significant for the clinical mandible conditions and bite force. The most unsatisfactory results were observed in the medicated groups in relation to the control group. The group with mood disorders obtained the most unsatisfactory results compared with the group with schizophrenia. It was suggested by these observations that the association of mood disorders and schizophrenia with medication has negatively affected the stomatognathic system in relation to controls when the electromyography and bite force were used for the analysis.
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Affiliation(s)
- R H de Oliveira
- Departament of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo and INCT Translational Medicine (CNPq), Ribeirão Preto, Brazil
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Sonnesen L, Svensson P. Jaw-motor effects of experimental jaw-muscle pain and stress in patients with deep bite and matched control subjects. Arch Oral Biol 2013; 58:1491-7. [DOI: 10.1016/j.archoralbio.2013.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
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Zuaiter S, Robin O, Gebeile-Chauty S, Raberin M. [Does dental class II division 2 predispose to temporomandibular disorders?]. Orthod Fr 2013; 84:277-285. [PMID: 23993369 DOI: 10.1051/orthodfr/2013052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 02/14/2013] [Indexed: 06/02/2023]
Abstract
Because of its anatomical/physiological characteristics, the Class II division 2 (class II, div. 2) is one of the malocclusions considered as a possible risk factor for Temporomandibular disorders (TMD). A literature review was conducted from the electronic databases of Medline and Elsevier Masson, through the year 2010, in order to clarify the relationships that may exist between Class II division 2 and TMD. This research helped identify 50 articles: 7 articles specifically concerned the Class II div. 2, 37 articles concerned some of the characteristics of the Class II div. 2, considered individually (Class II, deep bite, retroclined maxillary incisors, mandibular retrognathism) and 6 articles orthodontic treatment. From the conclusions of these studies, the Class II, div. 2 does not appear to represent a significant risk factor for TMD. The clearest association would involve mandibular retrognathism and the risk of articular disk displacement. However, given the low number of articles published on this topic, the methodological variability and the contradictory results, it is difficult to identify reliable conclusions and, consequently, the therapeutic indications for the treatment of Class II div. 2 patients with TMD.
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Affiliation(s)
- Shireen Zuaiter
- Unité fonctionnelle Algies et dysfonctions de l'appareil manducateur, Service d'Odontologie, CHU de Lyon, 6-8 place Depéret, 69007 Lyon, France
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Pullinger A. Establishing better biological models to understand occlusion. I: TM joint anatomic relationships. J Oral Rehabil 2013; 40:296-318. [PMID: 23489248 DOI: 10.1111/joor.12032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Abstract
Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ) condyle-fossa position with normal and abnormal function are still contentious issues. Clinical opinions can be strong, but support in most published data (mostly univariate) is problematic. Distribution overlap, low sensitivity and specificity are a common basis to reject any useful prediction value. Notwithstanding, a relationship of form with function is a basic tenet of biology. These are multifactor problems, but the questions mostly have not been analysed as such. This review moves the question forward by focusing on TM joint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint. Multifactor analysis allows the data to speak for itself and reduces bias. Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated, backed up by stepwise logistic regression. Explained variance, R(2), predicting normals from pooled TMJ patients was 32·6%, sensitivity 67·9%, specificity 85·7%; 37% versus disc displacement with reduction; and 28·8% versus disc displacement without reduction. Significant osseous organisational differences between TM joints with clicking and locking suggest that this is not necessarily a single disease continuum. However, a subset of joints with clicking contained characteristics of joints with locking that might contribute to symptom progression versus resistance. Moderately strong models confirm there is a relationship between TMJ osseous organisation and function, but it should not be overstated. More than one model of normals and of TM derangement organisation is revealed. The implications to clinical decision-making are discussed.
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Affiliation(s)
- A Pullinger
- UCLA School of Dentistry, Los Angeles, CA 90024-1668, USA.
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Iodice G, Danzi G, Cimino R, Paduano S, Michelotti A. Association between posterior crossbite, masticatory muscle pain, and disc displacement: a systematic review. Eur J Orthod 2013; 35:737-44. [DOI: 10.1093/ejo/cjt024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Almăşan OC, Băciuţ M, Almăşan HA, Bran S, Lascu L, Iancu M, Băciuţ G. Skeletal pattern in subjects with temporomandibular joint disorders. Arch Med Sci 2013; 9:118-26. [PMID: 23515361 PMCID: PMC3598125 DOI: 10.5114/aoms.2013.33072] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 04/15/2011] [Accepted: 05/11/2011] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. MATERIAL AND METHODS Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). RESULTS Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. CONCLUSIONS Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD.
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Affiliation(s)
- Oana Cristina Almăşan
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Mihaela Băciuţ
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Horea Artimoniu Almăşan
- Department of Cranio-Maxillofacial Surgery, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Liana Lascu
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Grigore Băciuţ
- Department of Cranio-Maxillofacial Surgery, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
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A review of the oral health-related evidence that supports the orthodontic treatment need indices. Prog Orthod 2012; 13:314-25. [PMID: 23260543 DOI: 10.1016/j.pio.2012.03.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 03/02/2012] [Accepted: 03/06/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To date, there is no evidence-based method of quantification for malocclusion. Consequently, how deviant occlusal traits should be scored and weighted relative to one another is a matter of serious debate. Orthodontic Treatment Need Indices (OTNI) use the subjective opinion of the experts, as their foundation, to define the pathological boundaries (cut-offs) of occlusal traits. This paper reviews the evidence relating malocclusions or deviated occlusal traits to oral health problems, and investigates if this evidence supports the cut-off points and the rationale used for OTNI. MATERIALS AND METHODS The relevant cited studies and reviews from the MEDLINE, Web of Science, Scopus, Cochrane databases, and scientific textbooks were used. The citation rate was confirmed by using the Google Scholar. RESULTS So far, the evidence for harmful effects of deviated occlusal traits on oral health is either lacking or exists as cross-sectional (mostly) and longitudinal (a few and primarily short-term) studies. When an association was reported between a deviated occlusal trait and an oral health problem, either the strength of that association was weak, or due to methodological issues, findings were not conclusive. Consequently, establishing a cause and effect relationship is difficult. Further, commonly used OTNI do not record a full spectrum of occlusal traits, and relating their ranking or scoring systems to the available evidence is difficult. Therefore, there is little evidence to suggest that individuals with a high need (high score), as measured by OTNI, will necessarily put at risk their oral health if they turn down orthodontic therapy. CONCLUSION OTNI have a role in the epidemiology and can be used for resource planning, but their predictive value to detect the future objective functional deficits or oral health problems is questionable. OTNI will need revalidation over time with emerging research findings.
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Hara ES, Matsuka Y, Minakuchi H, Clark GT, Kuboki T. Occlusal dysesthesia: a qualitative systematic review of the epidemiology, aetiology and management. J Oral Rehabil 2012; 39:630-8. [PMID: 22506934 DOI: 10.1111/j.1365-2842.2012.02300.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Occlusal dysesthesia refers to a persistent complaint of uncomfortable bite sensation with no obvious occlusal discrepancy. This systematic review aimed to draw a picture of such patients, to present an agreement of previously reported diagnostic criteria and to analyse the evidence level of the recommended management approaches. An electronic search for all relevant reports on occlusal dysesthesia was thoroughly performed based on previous nomenclatures (e.g. phantom bite, occlusal hyperawareness) in PubMed and The Cochrane Library in July, 2011. A total of 84 reports were matched, among which only 11 studies were included after a two-step (abstract and detailed full-text revision) screening process. Additionally, a thorough manual review of reference lists of the included reports enabled the inclusion of two additional studies. Data analysis revealed that 37 occlusal dysesthesia patients presented a mean age of 51.7 ± 10.6 years and were predominantly women (male/female: 1/5.1) with symptom duration of more than 6 years (average: 6.3 ± 7.5 years) and with concomitant psychological disturbances (e.g. mood disorders, somatoform disorders, personality disorders). Only four authors presented diagnostic criteria for occlusal dysesthesia, which served as the basis for an agreement in the diagnostic criteria. Treatment approaches included psychotherapy, cognitive/behaviour therapy, splint therapy and prescription of anti-depressants or anti-anxiety drugs. Classification of evidence level of management approaches, however, revealed that most of them were expert opinions with single- or multiple-case report(s). Future studies are necessary for a deeper understanding of the mechanisms behind the occlusal dysesthesia symptoms, and consequently, for improvements in evidence-based management approaches.
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Affiliation(s)
- E S Hara
- Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Andersen MK, Sonnesen L. Risk factors for low molar bite force in adult orthodontic patients. Eur J Orthod 2012; 35:421-6. [PMID: 22291432 DOI: 10.1093/ejo/cjs003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Benoliel R, Svensson P, Heir GM, Sirois D, Zakrzewska J, Oke-Nwosu J, Torres SR, Greenberg MS, Klasser GD, Katz J, Eliav E. Persistent orofacial muscle pain. Oral Dis 2011; 17 Suppl 1:23-41. [PMID: 21382137 DOI: 10.1111/j.1601-0825.2011.01790.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The pathophysiology of persistent orofacial myalgia has been the centre of much controversy. In this article we suggest a novel descriptive term; 'persistent orofacial muscle pain' (POMP) and review current evidence that supports the hypothesis that the induction of POMP involves the interplay between a peripheral nociceptive source in muscle, a faulty central nervous system component and decreased coping ability. In this context it is widely accepted that a complex interaction of variable intrinsic and extrinsic factors act to induce POMP and dysfunction.
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Affiliation(s)
- R Benoliel
- Department of Oral Medicine, The Faculty of Dentistry, Hebrew University-Hadassah, Jerusalem, Israel.
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Naser-Ud-Din S, Sowman PF, Sampson WJ, Dreyer CW, Türker KS. Masseter length determines muscle spindle reflex excitability during jaw-closing movements. Am J Orthod Dentofacial Orthop 2011; 139:e305-13. [PMID: 21457836 DOI: 10.1016/j.ajodo.2009.12.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2009] [Revised: 12/01/2009] [Accepted: 12/01/2009] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The masticatory muscles are considered to be important determinants of facial form, but little is known of the muscle spindle reflex characteristics and their relationship, if any, to face height. The aim of this study was to determine whether spindle reflexes, evoked by mechanical stimulation of an incisor and recorded on the masseter muscle, correlated with different facial patterns. METHODS Twenty-eight adult volunteers (16 women; ages, 19-38 years) underwent 2-N tap stimuli to their maxillary left central incisor during simulated mastication. Reflexes were recorded during local anesthesia of the stimulated tooth to eliminate the contribution from periodontal mechanoreceptors. Surface electromyograms of the reflex responses of the jaw muscles to these taps were recorded via bipolar electrodes on the masseter muscle and interpreted by using spike-triggered averaging of the surface electromyograms. Lateral cephalometric analysis was carried out with software (version 10.5, Dolphin, Los Angeles, Calif; and Mona Lisa, Canberra, Australia). RESULTS Two-newton tooth taps produced principally excitatory reflex responses beginning at 17 ms poststimulus. Correlation analysis showed a significant relationship between these muscle spindle reflexes and facial heights: specifically, shorter face heights were associated with stronger spindle reflexes. This correlation was strongest between the derived measure of masseter length and the spindle reflex strength during jaw closure (r = -0.49, P = 0.008). CONCLUSIONS These results suggest that a similar muscle spindle stimulus will generate a stronger reflex activation in the jaw muscles of patients with shorter faces compared with those with longer faces. This finding might help to explain the higher incidence of clenching or bruxism in those with short faces and also might, in the future, influence the design of orthodontic appliances and dental prostheses.
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Lisboa MV, Lopes CB, Rocha R, Ramos TA, de Abreu IDN, Cangussu MCT, Pinheiro ALB, dos Santos JN. Assessment of the effect of the use of laser light or dantrolene on facial muscle under occlusal wear: a Raman spectroscopic study in a rodent model. Photomed Laser Surg 2010; 28 Suppl 1:S135-41. [PMID: 20666575 DOI: 10.1089/pho.2009.2614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of the present study was to use Raman spectroscopy to measure levels of CaPi in muscles under occlusal wear and treated with laser phototherapy (LPT) or muscle-relaxant therapy or both on rodents. BACKGROUND The etiology of temporomandibular disorders is multifactorial. Malocclusion may influence the masticatory muscles, causing fatigue. A major type of fatigue is the metabolic, caused by the increased accumulation of metabolites such as inorganic phosphate. Raman spectroscopy allows nondestructive analysis of the biochemical composition of tissues. METHODS The 30 male Wistar rats were randomly divided into three groups: occlusal wear (G-1), occlusal wear + LPT (G-2), and occlusal wear + muscle relaxant (G-3). Ten untreated animals were used for baseline data. Under intraperitoneal general anesthesia, animals of groups 1, 2, and 3 had unilateral amputation of molar cusps to simulate an occlusal-wear situation. The masseter muscle of G-2 received LPT (lambda830 nm, 4 J/cm(2), 40 mW, phi approximately 2 mm) after the procedure and repeated every other day for 14-30 days. Animals of G-3 were treated with a daily injection of dantrolene (2.5 mg/kg in 0.5 ml of H(2)O) beginning 24 h after cusp removal. Animals were killed with an overdose of general anesthetics at days 14 and 30 after cusps removal, and the ipsilateral masseter muscle was excised and divided into two parts. One part was routinely processed and underwent histologic analysis; the other was kept in liquid nitrogen for Raman spectroscopy. The mean value of the intensity of the peak 958 per centimeter was determined. RESULTS No morphologic changes were seen. Raman analysis showed significantly less Raman intensity in the laser group at 30 days (p < 0.01). CONCLUSION Occlusal wear did not caused morphologic alterations in the masseter muscle but resulted in changes of the levels of CaP(i) that were less compromising when the laser light was used.
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Affiliation(s)
- Márcio V Lisboa
- Center of Biophotonics, School of Dentistry, Federal University of Bahia, Salvador, Brazil
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Abstract
BACKGROUND Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual's life with phases of symptoms affecting the quality of life. In an attempt to treat this complex group of disorders many treatment modalities have been identified some of which are also considered in other Cochrane reviews. The disorder also has a normal cycle of events appearing to spontaneously improve without treatment. OBJECTIVES To establish the effectiveness of orthodontic intervention in reducing symptoms in patients with TMD (compared with any control group receiving no treatment, placebo treatment or reassurance) and to establish if active orthodontic intervention leads to TMD. SEARCH STRATEGY The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching of orthodontic journals and other related journals was undertaken in keeping with the Cochrane Collaboration handsearching programme. No language restrictions were applied. Authors of any studies were identified, as were experts offering legal advice, and contacted to identify unpublished trials. Most recent search: 13th April 2010. SELECTION CRITERIA All randomised controlled trials (RCTs) including quasi-randomised trials assessing orthodontic treatment for TMD were included. Studies with adults aged equal to or above 18 years old with clinically diagnosed TMD were included. There were no age restrictions for prevention trials provided the follow-up period extended into adulthood. The inclusion criteria required reports to state their diagnostic criteria for TMD at the start of treatment and for participants to exhibit two or more of the signs and/or symptoms. The treatment group included treatment with appliances that could induce stable orthodontic tooth movement. Patients receiving splints for 8 to 12 weeks and studies involving surgical intervention (direct exploration/surgery of the joint and/or orthognathic surgery to correct an abnormality of the underlying skeletal pattern) were excluded. The outcomes were: how well were the symptoms reduced, adverse effects on oral health and quality of life. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in triplicate and independently by three review authors. As no two studies compared the same treatment strategies (interventions) it was not possible to combine the results of any studies. MAIN RESULTS The searches identified 284 records from all databases. Initial screening of the abstracts and titles by all review authors identified 55 articles which related to orthodontic treatment and TMD. The full articles were then retrieved and of these articles only four demonstrated any data that might be of value with respect to TMD and orthodontics. After further analysis of the full texts of the four studies identified, none of the retrieved studies met the inclusion criteria and all were excluded from this review. AUTHORS' CONCLUSIONS There are insufficient research data on which to base our clinical practice on the relationship of active orthodontic intervention and TMD. There is an urgent need for high quality randomised controlled trials in this area of orthodontic practice.When considering consent for patients it is essential to reflect the seemingly random development/alleviation of TMD signs and symptoms.
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Affiliation(s)
- Friedy Luther
- Department of Orthodontics, Division of Child Dental Health, Leeds Dental Institute, Clarendon Way, Leeds, UK, LS2 9LU
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