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Gong Y, Liu F, Zhu Y, Zhang Q, Zhu J, Liu Y, Yin D. A proposed novel digital condylar position adjustment technique to help restore a normal disc-condyle relationship. Heliyon 2024; 10:e32037. [PMID: 38961908 PMCID: PMC11219320 DOI: 10.1016/j.heliyon.2024.e32037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/05/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Objectives To demonstrate a novel digital technique that enables real-time visualisation of occlusal transfer and adjustment of condyle position, to (1) improve the repeatability of occlusal transfer and the accuracy of condyle position adjustment and (2) be clinically effective in helping to restore the disc-condyle relationship. Materials and methods Three participants were included in the study and underwent facebow transfers using two different methods. The digital method used patient-related three-dimensional imaging data matched with digital dental casts for occlusal transfer. The conventional method used anatomical facebows. The condylar position was adjusted based on occlusal transfer results. The results were evaluated and compared in three dimensions. In addition, clinical application data from 36 patients were analysed before and after condylar position adjustment. Statistical significance was set at p < 0.05. Results Differences in the spatial positions of the three anatomical structures reproduced by both methods were statistically significant (p = 0.000). After adjusting the rotation of the condylar position, the positional deviation of the condylar point along the X- and Z-axes was significantly lower in the digital group (p < 0.05). After adjustment for translation (X and Z), the positional deviation showed no difference along the X- and Z-axes (p > 0.05) but a significant difference along the Y-axis (p < 0.001). Conclusion A novel digital technique for occlusal transfer and condylar position adjustment was presented. This technique simplifies clinical practice, improves the accuracy of results, and can help restore a normal disc-condyle relationship.
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Affiliation(s)
- Yanji Gong
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Fang Liu
- College of Medicine, Xi'an International University, Xi'an, 710077, China
| | - Yunfan Zhu
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Qinlanhui Zhang
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jinyi Zhu
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yang Liu
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Deqiang Yin
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
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Da Silva FP, Dos Santos IM, Carneiro DE, De La Torre Canales G, Sánchez-Ayala A. Effect of artificial eccentric occlusal interferences on masticatory performance: A randomised double-blind clinical trial. J Oral Rehabil 2024; 51:536-545. [PMID: 37964439 DOI: 10.1111/joor.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/20/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Occlusal interferences lead to changes in mandibular kinematics to compensate and improve function. However, the effects of different types of eccentric disturbance on the comminution capacity are not known. OBJECTIVE To determine the immediate effect of eccentric occlusal interferences on masticatory performance. METHODS This crossover clinical trial included 12 healthy dentate subjects aged 25.2 ± 3.3 years who were randomly submitted to seven types of occlusal interference: unilateral and bilateral laterotrusive and mediotrusive, protrusive, dummy and control (no interference). The interference forms were planned in a semi-adjustable articulator, fabricated with composite resin and adhered to the mandibular first molars such that subjects' maximum intercuspation was maintained. Masticatory performance and the chewing rate during 20 cycles were evaluated during subjects' comminution of silicone test food under one interference condition per test day; the multiple sieve method was applied to the comminuted particles. The interference was removed upon test completion, and a 1-week washout period was applied between tests. RESULTS Comminuted median particle sizes were larger under unilateral (4.94 ± 0.41 mm) and bilateral (4.81 ± 0.49 mm) laterotrusive, bilateral mediotrusive (4.65 ± 0.50 mm) and protrusive (4.83 ± 0.54 mm) interferences (p < .05) than under the control (4.01 ± 0.52 mm) and dummy (4.18 ± 0.58 mm) conditions (p < .05). Only unilateral and bilateral laterotrusive interferences narrowed the comminuted particle size dispersion (p < .05). The chewing rate did not differ among conditions (p = .1944). CONCLUSION Artificial eccentric interferences had an immediate adverse effect on masticatory performance by resulting in larger comminuted particles. CLINICAL TRIAL REGISTRATION Brazilian Registry of Clinical Trials (RBR-8g5zfg8).
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Affiliation(s)
| | | | | | - Giancarlo De La Torre Canales
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neurosciences (SCON), Flemingsberg, Huddinge, Sweden
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Scolaro A, Khijmatgar S, Rai PM, Falsarone F, Alicchio F, Mosca A, Greco C, Del Fabbro M, Tartaglia GM. Efficacy of Kinematic Parameters for Assessment of Temporomandibular Joint Function and Disfunction: A Systematic Review and Meta-Analysis. Bioengineering (Basel) 2022; 9:bioengineering9070269. [PMID: 35877320 PMCID: PMC9311583 DOI: 10.3390/bioengineering9070269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this review was to answer the following PICO question: “Do TMJ kinematic parameters (intervention and comparison) show efficacy for assessment of mandibular function (Outcome) both in asymptomatic and TMD subjects? (Population)”. PubMed, Scopus, Web of Science, Embase, Central databases were searched. The inclusion criteria were (1) performed on human, (2) English only, (3) on healthy, symptomatic or surgically altered TMJ, (4) measured dynamic kinematics of mandible or TMJ (5) with six degrees of freedom. To assess the Risk of Bias, the Joanna Briggs Institute tool for non-randomised clinical studies was employed. A pairwise meta-analysis was carried out using STATA v.17.0 (Stata). The heterogeneity was estimated using the Q value and the inconsistency index. Ninety-two articles were included in qualitative synthesis, nine studies in quantitative synthesis. The condylar inclination was significantly increased in female (effect size 0.03°, 95% CI: −0.06, 0.12, p = 0.00). Maximum mouth opening (MMO) was increased significantly in female population in comparison with males (effect size 0.65 millimetres (0.36, 1.66). Incisor displacement at MMO showed higher values for control groups compared with TMD subjects (overall effect size 0.16 millimetres (−0.37, 0.69). Evidence is still needed, considering the great variety of devices and parameters used for arthrokinematics. The present study suggests standardising outcomes, design, and population of the future studies in order to obtain more reliable and repeatable values.
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Affiliation(s)
- Alessandra Scolaro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Pooja Mali Rai
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Francesca Falsarone
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Francesca Alicchio
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Arianna Mosca
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Christian Greco
- Azienda Sanitaria dell’Alto Adige, Merano Hospital, 39100 Bolzano, Italy;
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- IRCC Orthopaedic Institute Galeazzi, 20161 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
- Correspondence:
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Woodford SC, Robinson DL, Mehl A, Lee PVS, Ackland DC. Measurement of normal and pathological mandibular and temporomandibular joint kinematics: A systematic review. J Biomech 2020; 111:109994. [PMID: 32971491 DOI: 10.1016/j.jbiomech.2020.109994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/27/2020] [Accepted: 08/08/2020] [Indexed: 01/08/2023]
Abstract
Motion of the mandible and temporomandibular joint (TMJ) plays a pivotal role in the function of the dentition and associated hard and soft tissue structures, and facilitates mastication, oral communication and access to respiratory and digestive systems. Quantification of TMJ kinematics is clinically relevant in cases of prosthetic rehabilitations, TMJ disorders, osteoarthritis, trauma, tumour resection and congenital abnormalities, which are known to directly influence mandibular motion and loading. The objective of this systematic review was to critically investigate published literature on historic and contemporary measurement modalities used to quantify in vivo mandibular and TMJ kinematics in six degrees of freedom. The electronic databases of Scopus, Web of Science, Medline, Embase and Central were searched and 109 relevant articles identified. Publication quality was documented using a modified Downs and Black checklist. Axiography and ultrasonic tracking are commonly employed in the clinical setting due to their simplicity and capacity to rapidly acquire low-fidelity mandibular motion data. Magnetic and optoelectronic tracking have been used in combination with dental splints to produce higher accuracy measurements while minimising skin motion artefact, but at the expense of setup time and cost. Four-dimensional computed tomography provides direct 3D measurement of mandibular and TMJ motion while circumventing skin motion artefact entirely, but employs ionising radiation, is restricted to low sampling frequencies, and requires time-consuming image processing. Recent advances in magnetic tracking using miniature sensors adhered to the teeth in combination with intraoral scanning may facilitate rapid and high precision mandibular kinematics measurement in the clinical setting. The findings of this review will guide selection and application of mandibular and TMJ kinematic measurement for both clinical and research applications.
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Affiliation(s)
- Sarah C Woodford
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Dale L Robinson
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Albert Mehl
- Centre of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Peter V S Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia.
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