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The Dental stick test - Useful to reveal intra-articular conditions in persons with temporomandibular disorder? Musculoskelet Sci Pract 2021; 56:102435. [PMID: 34403964 DOI: 10.1016/j.msksp.2021.102435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/28/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is a need for clinical tests that can reveal intra-articular conditions in the temporomandibular joint to be able to give proper treatment. The Dental stick test, where participants bite with their molars on a wooden stick, is a pain provocation test for the temporomandibular joint. OBJECTIVE The purpose of this study was to explore if the Dental stick test can be used to reveal intra-articular conditions in the temporomandibular joint in persons with long-lasting painful disorders. DESIGN Cross-sectional. MATERIALS AND METHODS Forty persons with pain in one or both temporomandibular areas were examined using the Dental stick test. The participants were between 18 and 70 years, and had 65 symptomatic joints. Sensitivity, specificity, false positive and false negative responses, and area under the curve were calculated for the Dental stick test with MRI and/or CT as reference standards. The phi-correlation coefficient (phi) was used to measure the correlation between the Dental stick test and intra-articular findings. RESULTS The sensitivity and specificity for the Dental stick test, revealing intra-articular findings, were 0.62 and1.0 respectively. False positive and false negative responses were 0 and 0.41 respectively, and the area under the curve 81% with p < 0.001. The correlation between a positive Dental stick test and intra-articular findings was not significant (phi = 0.60). CONCLUSIONS When the Dental stick test is positive, intra-articular findings will most probably be present on MRI/CT, but the test alone cannot reveal intra-articular conditions in persons with long-lasting painful temporomandibular disorder.
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A Randomized, Double-Blind, Placebo-Controlled Study of the Efficacy of Steroid Supplementation After Temporomandibular Joint Arthrocentesis. J Oral Maxillofac Surg 2020; 78:1088-1099. [DOI: 10.1016/j.joms.2020.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/15/2020] [Accepted: 02/13/2020] [Indexed: 11/20/2022]
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Lövgren A, Visscher CM, Alstergren P, Lobbezoo F, Häggman-Henrikson B, Wänman A. The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia. Clin Oral Investig 2019; 24:97-102. [DOI: 10.1007/s00784-019-02891-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/02/2019] [Indexed: 01/10/2023]
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Venezian GC, Antônio Moreira Rodrigues da Silva M, Mazzetto RG, Oliveira Mazzetto M. Low Level Laser Effects On Pain to Palpation and Electromyographic Activity in TMD Patients: A Double-Blind, Randomized, Placebo-Controlled Study. Cranio 2014; 28:84-91. [DOI: 10.1179/crn.2010.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Fernandes Pinheiro P, Andrade da Cunha D, Genuíno Dourado Filho M, Salvetti Cavalcanti Caldas A, Myriam Aragão Melo T, Justino da Silva H. The Use of Electrognathography in Jaw Movement Research: A Literature Review. Cranio 2014; 30:293-303. [DOI: 10.1179/crn.2012.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Learreta JA, Beas J, Bono AE, Durst A. Muscular Activity Disorders in Relation to Intentional Occlusal Interferences. Cranio 2014; 25:193-9. [PMID: 17696036 DOI: 10.1179/crn.2007.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The electromyographic activity (EMG) of the anterior temporal (AT), masseter (M), trapezius (T) muscles and anterior aspect of the digastric (D) was measured in 50 subjects, during six seconds of maximum contraction, bilaterally with and without unilateral premature contacts and individually for each tooth. Special occlusal interferences were designed to assess muscular activity. Muscular activity was measured simultaneously by placing premature contacts on each tooth, under T-Scan monitoring. Premature contacts reduced EMG activity during maximum contraction of the AT, D and M muscles, the highest disruption is in the AT muscle, at the level of upper right 2nd molar, with a 56% reduction in activity. Conversely, there was an increase of activity of the T muscle in all teeth when placing artificial occlusal premature contacts, with the highest difference in the upper right 1st bicuspid. Therefore, occlusal interferences can cause neuromuscular disruptions, thus inducing important muscular discrepancy. Both the EMG and T-Scan monitoring can be considered suitable methods to use in daily dental practice to identify premature contacts and to measure EMG activity.
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Cooper BC, Kleinberg I. Relationship of Temporomandibular Disorders to Muscle Tension-Type Headaches and a Neuromuscular Orthosis Approach to Treatment. Cranio 2014; 27:101-8. [DOI: 10.1179/crn.2009.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Law C, Bennani V, Lyons K, Swain M. Mandibular flexure and its significance on implant fixed prostheses: a review. J Prosthodont 2011; 21:219-24. [PMID: 22044758 DOI: 10.1111/j.1532-849x.2011.00798.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aims of this review are to determine the effect of mandibular flexure on the "implant-framework system," and analyze the existing literature on the topic. MATERIALS AND METHODS A MEDLINE and PubMed search was conducted to identify any articles in English related to the topic published up to May 2010 using the search words "mandible,""dental implants,""dental impression technique,""jaw movement,""dental stress analysis," and "mechanical stress." RESULTS The search identified 40 and 36 articles from MEDLINE and PubMed, respectively. Twenty articles met the inclusion criteria. CONCLUSIONS Mandibular flexure is a multifactorial phenomenon, and the effect of the implant-framework system in this is unclear. Studies have focused mainly on the fully edentulous mandible. These have found that mandibular flexure should be taken into consideration when designing a prosthesis and have suggested that dividing the prosthesis at the symphysis region, or into multiple implant fixed dental prostheses, may minimize the effect of mandibular flexure on the implant prosthesis. At this time, no studies have investigated the effect of mandibular flexure on long-span, unilateral, implant fixed prostheses. The clinical significance of mandibular flexure on the success of dental implant treatment is at this time unclear, and further research is needed.
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Affiliation(s)
- Constance Law
- Department of Oral Rehabilitation, University of Otago, Dunedin, New Zealand
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Akimoto T, Nakashima K, Matsumoto T, Muraoka K, Yokota M. Effect of occlusal interference on salivary stress markers. ACTA ACUST UNITED AC 2011. [DOI: 10.2329/perio.53.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Marklund S, Wänman A. Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders. Acta Odontol Scand 2010; 68:289-99. [PMID: 20528485 DOI: 10.3109/00016357.2010.494621] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period. MATERIAL AND METHODS The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses. RESULTS The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period. CONCLUSION This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.
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Clark GT, Tsukiyama Y, Baba K, Watanabe T. Sixty-eight years of experimental occlusal interference studies: what have we learned? J Prosthet Dent 1999; 82:704-13. [PMID: 10588807 DOI: 10.1016/s0022-3913(99)70012-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
STATEMENT OF PROBLEM Understanding is needed regarding the effect that occlusal interferences have on the teeth, periodontium, and especially on jaw function. PURPOSE This article summarizes research in which experimental occlusal interferences have been placed on the teeth of animals and human volunteers. MATERIAL AND METHODS Data from 18 human and 10 animals studies were reviewed. Experimental occlusal interferences were grouped into those that alter intercuspal position and those contacting on lateral jaw movement only. The outcome of these interferences were analyzed according to their local pulpal-periodontal, jaw function, or bruxism effects. RESULTS Experimental occlusal interferences in maximum intercuspation had a deleterious effect on periodontal and pulpal tissues of the affected tooth; sometimes this produces a disruption of smooth jaw function and occasionally jaw muscle pain and clicking. Experimental occlusal interferences that contact only in a lateral jaw movement are infrequently harmful to jaw function. Furthermore, no reliable evidence demonstrates that occlusal interferences can cause nocturnal bruxism, or stop it. CONCLUSION Transient local tooth pain, loosening of the tooth, a slight change in postural muscle tension levels, chewing stroke patterns, and sometimes a clicking joint can be induced by an experimental occlusal interference. Because such findings are present in relatively asymptomatic patients, these data do not prove that occlusal interferences are causally related to a chronic jaw muscle pain or temporomandibular joint dysfunction problems.
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Affiliation(s)
- G T Clark
- School of Dentistry, University of California, Los Angeles, CA 90095-1668, USA.
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Ferrario VF, Sforza C, Serrao G, Colombo A, Schmitz JH. The effects of a single intercuspal interference on electromyographic characteristics of human masticatory muscles during maximal voluntary teeth clenching. Cranio 1999; 17:184-8. [PMID: 10650405 DOI: 10.1080/08869634.1999.11746093] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In 13 healthy subjects (eight men and five women, mean age, 22 years), an aluminum intercuspal interference (height, 0.25 mm) was placed on the maxillary right first premolar to study its effect on the contractile symmetry of the right and left masseter and anterior temporalis muscles when measured through a Percentage Overlapping Coefficient (POC), derived from surface electromyographic recordings of maximum voluntary teeth clenching. Additionally, and to estimate the potential of the experimental intercuspal interference to induce lateral displacement of the mandible, a Torque Coefficient (TC) was derived from surface electromyographic recordings. The conclusion was that the experimental occlusal interference gave rise to asymmetric contractile activity in the studied mandibular elevator muscles as well as a potential to displace the mandible in a lateral direction.
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Affiliation(s)
- V F Ferrario
- Instituto di Anatomia Umana Normale, Milano, Italy.
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Peck CC, Murray GM, Johnson CW, Klineberg IJ, DeBoever JA. Trajectories of condylar points during working-side excursive movements of the mandible. J Prosthet Dent 1999; 81:444-52. [PMID: 10095215 DOI: 10.1016/s0022-3913(99)80012-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
STATEMENT OF PROBLEM Trajectories of different condylar points provide different interpretations of condylar movement during open-close jaw movements. Movement of the working-side condyle is often assessed clinically by recording the trajectory of a single arbitrary condylar point. PURPOSE This study examined the effect of the differences in condylar point location on condylar point movement trajectories during a working-side movement. METHODS Different points exhibited different trajectories during a single working-side movement in each of 44 subjects. RESULTS Up to 40% of a point's displacement could be attributed simply to the location of the point. CONCLUSIONS Interpretation of condylar movement on the working side within a subject depends on the point chosen.
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Affiliation(s)
- C C Peck
- Faculty of Dentistry, University of Sydney, Westmead, Australia
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Abstract
Several different mechanisms are potentially capable of generating sounds in the temporomandibular joint (TMJ). These include impact, sliding and stick-slip friction, fluid dynamic effects and the release of elastic strain energy. It is the aim of this paper to provide a framework with which to separate sounds resulting from the different underlying causes. Each mechanism is described and its relevance to TMJ sounds and clinical significance discussed. Since it is not possible to observe these mechanisms in vivo the arguments are based mainly on analogies which are used to make predictions of the characteristic acoustic signatures of the sounds produced by these different mechanisms. In particular the changes in the characteristics of the sounds as parameters such as mandibular speed and loading are stressed. It is suggested that single short duration sounds (clicks) are due to impact, multiple short duration sounds (creaks) to stick-slip friction and defects of form and long duration sounds (crepitus) to simple sliding friction. Several other mechanisms which have no obvious clinical significance but which are capable of producing similar sounds are also described and methods of distinguishing them from the sounds that do have clinical implications are discussed.
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Affiliation(s)
- J F Prinz
- Department of Anatomy, University of Hong Kong
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Christensen LV, McKay DC. Masticatory tooth contact patterns: predicted and observed cuspid and first molar contacts in cuspid and group function. Cranio 1997; 15:10-20. [PMID: 9586485 DOI: 10.1080/08869634.1997.11745989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Using the mouth as an "in vivo articulator," the bilateral nonmasticatory ("empty") contact patterns of opposing cuspid and first molar teeth were determined in two healthy subjects with well-defined cuspid function and two healthy subjects with well-defined group function. The electronically recorded "empty" contact patterns pertained to the static intercuspal position and dynamic laterotrusion to the right and the left. On the basis of the "empty" tooth contact patterns and the number of electronically recorded masticatory cycles of one masticatory sequence, we postulated two simple models that attempted to predict the masticatory ("functional") tooth contacts of one sequence of unilateral mastication of apple and banana. Statistical comparisons between the predictions of the two models and the actual ("functional") contacts of in vivo mastication showed that the models predicted fairly well the observed tooth contacts on the nonchewing-side of the mouth, but not the observed tooth contacts on the chewing-side of the mouth. In consequence, "empty" (nonmasticatory) tooth contact patterns should not be equated with "functional" (masticatory) tooth contact patterns.
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Clark GT, Tsukiyama Y, Baba K, Simmons M. The validity and utility of disease detection methods and of occlusal therapy for temporomandibular disorders. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 83:101-6. [PMID: 9007932 DOI: 10.1016/s1079-2104(97)90099-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Our evaluation of the clinical usefulness or devices for the diagnosis or treatment of temporomandibular disorders (TMD) led to the conclusion that the only current gold standard for TMD is a global clinical examination, because none of the instruments can be said to provide more than ancillary documentation and none have proven diagnostic validity or utility. Regarding the therapeutic efficacy of occlusal adjustment, we could find no comparative studies that test the efficacy of occlusal adjustment in preventing TMD. The studies we reviewed on the relationship of occlusion to TMD are not convincing, powerful, or practical enough to make any recommendations about a causal association.
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Affiliation(s)
- G T Clark
- Section of Diagnostic Sciences and Orofacial Pain, UCLA School of Dentistry, USA
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Mohamed SE, Harrison JD, Christensen LV. Masticatory tooth contact patterns: cuspid and first molar contacts during mastication of three types of food. Cranio 1996; 14:266-73. [PMID: 9110620 DOI: 10.1080/08869634.1996.11745977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In ten healthy subjects, bilateral contacts between opposing cuspid and first molar teeth were recorded during one sequence of unilateral chewing of apple, peanuts, and banana. Unknown magnitudes of mechanophysical (masticatory) forces were inferred to act directly on the chewing-side cuspid teeth in 71% of all masticatory cycles and on the nonchewing-side cuspid teeth in 68% of all masticatory cycles. In addition, unknown magnitudes of mechanophysical forces were inferred to act directly on the chewing-side first molar teeth in 74% of all masticatory cycles and on the nonchewing-side first molar teeth in 86% of all masticatory cycles. During the chewing of peanuts, the total number of chewing-side cuspid contacts exceeded significantly the total number of nonchewing-side cuspid contacts, suggesting more repetitive direct mechanophysical loading of the chewing-side cuspid teeth. During the chewing of apple, the total number of nonchewing-side first molar contacts exceeded significantly the total number of chewing-side first molar contacts, suggesting more repetitive direct mechanophysical loading of the nonchewing-side first molar teeth. The variable contact patterns were, to a large extent, explained by rotational movements of the entire mandible resulting in translational movements of the hemimandible.
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Affiliation(s)
- S E Mohamed
- LSU School of Dentistry, New Orleans 70119-2799, USA
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Abstract
To study possible associations between gum chewing and fatigue and pains in the jaw muscles, eight healthy adults performed prolonged idling, prolonged unilateral chewing of gum, and brief vigorous clenching of the teeth (MVC). Through surface electromyography (EMG), the authors monitored the cumulative (microV.s) as well as the average rates (microV.s-1) of contractile activities in the right and left masseter muscles. During 10 min of idling there was an absence of muscle fatigue and muscle pains when the EMG rates of the right and left masseter muscles were 2% and 3%, respectively, of those required to elicit isometric muscle pains through MVC. During 10 min of right-sided gum chewing at a rate of 1.2 Hz, the majority of subjects (75%) experienced weak jaw muscle fatigue-not jaw muscle pains-when the EMG rates of the right and left masseter muscles were 38% and 19%, respectively, of those required to elicit isometric pains through MVC. In comparison with 10 min of idling, the weak muscle fatigue of 10 min of unilateral gum chewing appeared when the total contractile activities of the right and left masseter muscles were increased by 1664% and 519%, respectively. It seemed as if prolonged unilateral gum chewing and previous pain-releasing MVC caused some sensitization of muscle nociceptors which, in turn, aggravated subsequent isometric jaw muscle pains elicited through MVC. Even though the right masseter muscle was the most frequent site of clinical fatigue and pains, the authors found no evidence supporting the theoretical foundation of the myofascial pain/dysfunction syndrome.
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Affiliation(s)
- L V Christensen
- Marquette University, School of Dentistry, Milwaukee, Wisconsin, USA
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Christensen LV, Rassouli NM. Experimental occlusal interferences. Part V. Mandibular rotations versus hemimandibular translations. J Oral Rehabil 1995; 22:865-76. [PMID: 9217298 DOI: 10.1111/j.1365-2842.1995.tb00235.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Frontal plane mandibular rotations and corresponding hemimandibular translations were studied in vitro by using direct observations of a human cadaver mandible and in vivo by using the indirect observations of rotational electrognathography. A comparison between the two methods showed that rotational electrognathography erred in measuring the clinically relevant hemimandibular translations resulting from mandibular rotations having a unilateral molar point (simulated occlusal interference) as the pivot of frontal plane torque. In vitro frontal plane rotations about a unilateral mandibular molar tooth (simulated occlusal interference) suggested that the resulting hemimandibular upward translations of the lateral portion of the mandibular condyle, contralateral to the molar tooth, would cause considerable compressive loading of the temporomandibular joint disc.
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Affiliation(s)
- L V Christensen
- Marquette University, School of Dentistry, Milwaukee, Wisconsin, USA
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Christensen LV, Rassouli NM. Experimental occlusal interferences. Part IV. Mandibular rotations induced by a pliable interference. J Oral Rehabil 1995; 22:835-44. [PMID: 8558357 DOI: 10.1111/j.1365-2842.1995.tb00231.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In 12 subjects, a pliable, yet unbreakable, intercuspal interference (aluminum shim onlay splint; uniform height of 0.25 mm) was placed between either the right or left maxillary and mandibular second premolars and first molars. During brief and forceful biting (dynamic chewing stroke of about 20 kg force) the interference emulated a semisoft food bolus, and at the end of biting (subsequent static clenching stroke of about 20 kg force) it emulated a rigid metal interference. During dynamic/static biting, rotational electrognathography measured maximum frontal and horizontal plane torque of the right and left mandibular condyles. Eleven subjects (92%) showed frontal plane upward rotation (mean of 1.0 degree) of the condyle contralateral to the interference, and one subject (8%) showed frontal plane upward rotation (0.4 degree) of the condyle ipsilateral to the interference. Two subjects (17%) showed no horizontal plane rotation; seven subjects (58%) showed backward rotation (mean of 0.4 degree) of the condyle contralateral to the interference; and three subjects (25%) showed backward rotation (mean of 0.3 degree) of the condyle ipsilateral to the interference. It is suggested that, in the presence of an occlusal interference, mastication may have both short- and long-term detrimental effects.
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Affiliation(s)
- L V Christensen
- Marquette University, School of Dentistry, Milwaukee, Wisconsin, USA
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