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You S, Qin X, Zhao G, Feng Z. Personalized 3D Printed Tooth-Supported Template as a Novel Strategy for Radiofrequency Thermocoagulation for Trigeminal Neuralgia After the Failure of CT-Guided Puncture. J Pain Res 2024; 17:2347-2356. [PMID: 38983246 PMCID: PMC11232956 DOI: 10.2147/jpr.s449447] [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: 12/08/2023] [Accepted: 06/15/2024] [Indexed: 07/11/2024] Open
Abstract
Background Trigeminal neuralgia (TN) is a common form of craniofacial pain, and Radiofrequency thermocoagulation (RFT) has become a commonly utilized treatment modality for TN. However, the complex anatomical configuration of the maxillofacial region and the difficulties inherent in positioning the neck in a hyperextended manner can present challenges for CT-guided punctures. Aim The objective of this study is to assess the effectiveness and safety of 3D printed tooth-supported template(3D-PTST) guided RFT in patients who have previously undergone unsuccessful CT-guided puncture. Methods Patients with TN undergoing RFT at the Department of Pain Medicine, PLA General Hospital, from January 2018 to January 2023, were assessed. 3D-PTST guided RFT was employed as an alternative when percutaneous puncture failed. Clinical, demographic, and follow-up data were collected. The duration of the procedure was determined by subtracting the time of anesthesia administration from the time of surgical drape removal. Pain intensity was assessed using the Numerical Rating Scale-11 scale. Treatment effects were evaluated utilizing the Barrow Neurological Institute scale. Incidences of complications related to RFA were documented. Results Six TN patients underwent 3D-PTST guided RFT. With tooth-supported template guidance, five patients achieved therapeutic target puncture in one attempt with one CT scan. One patient required two attempts with two CT scans. Operation duration ranged from 18 to 46 mins (mean 30 mins). All completed 3D-PTST-guided RFT without difficulty, significantly improving pain symptoms. Four patients had no pain recurrence at 12, 18, 36 and 37 months follow-up, respectively. Recurrence occurred in two patients (at 1 and 13 months). No serious treatment-related complications were observed. Conclusion 3D-PTST guided RFT is an effective, repeatable, safe, and minimally invasive treatment method for patients with TN who have failed due to difficulty in puncture.
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Affiliation(s)
- Shaohua You
- Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Xiaoyan Qin
- Department of Clinical Laboratory, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, 100049, People's Republic of China
| | - Guoli Zhao
- Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Zeguo Feng
- Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People's Republic of China
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Oh SL, Hu J, Kwak KH, Chung MK. Survival analysis of teeth following clinical crown lengthening and crown insertion procedures up to 14 years: A retrospective cohort study. J Periodontol 2024. [PMID: 38874285 DOI: 10.1002/jper.24-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/21/2024] [Accepted: 04/28/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The purpose of this study was to conduct survival analysis of teeth following clinical crown lengthening procedures (CLPs) and crown insertions via a retrospective cohort study. METHODS Patient- and tooth-related data were collected from 268 participants who received CLPs from 2009 to 2015. The Kaplan-Meier curve and the log-rank tests were used to estimate the probability of survival and compare the survival probabilities among different variables. A Cox multivariate proportional hazard regression model was used to investigate the collective effects of root canal treatment (RCT) and the types of opposing dentition. RESULTS The rate of tooth loss was 21.6% during the observation period from 1 to 14 years, with 58 teeth extracted. The most attributable reason for tooth extraction was coronal tooth fracture, followed by endodontic failure such as root fracture. The survival probability was 0.87 at 5 years and 0.7 at 10 years. No significant differences in the survival probabilities were found among different providers and locations, the presence of a post, and the types of crowns. The hazard ratio for tooth loss was 6.3, 95% confidence interval (CI) [2.6 to 20.9] in the teeth with RCT (p < 0.001) and 2.4, 95% CI [1.1 to 4.8] in the teeth occluding implant-retained prostheses (p = 0.016). CONCLUSIONS Tooth loss following CLPs and crown insertions appeared least among the teeth without RCT when occluding natural teeth, while tooth loss was most among the teeth with RCT when occluding implants.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Jiaxin Hu
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Kee Hyun Kwak
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Yurchenko M, Hubálková H, Charvát J. Selected muscle tone and asymmetry of the occlusal plane in case of intracapsular temporomandibular joint disorder. Cranio 2024; 42:267-278. [PMID: 34355675 DOI: 10.1080/08869634.2021.1964052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: To discover the extent of the connection between occlusal plane asymmetry and the rest tone of the four muscle groups of the orofacial region with temporomandibular joint pathology.Methods: Eighty-seven subjects were divided into two groups. The following methods were applied: clinical examination, roentgenological examination, and electromyography. Data were evaluated and statistically analyzed.Results: The variability of occlusal plane inclination in relation to the porion plane was 0-4.6º.The tonus of masseter muscle was higher in the experimental group: 1.45 mV more than in the control group: 1.23 mV (p < 0.05).Conclusion: Asymmetry of the occlusal plane inclination was found for nearly all subjects in both groups. It can be compensated for by adaptation mechanisms and does not cause temporomandibular joint disorders. Undertaken research shows the existence of a proven correlation between TMJ disorders and the resting tonus of the masseter muscle.
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Affiliation(s)
- Maksim Yurchenko
- Charles University in Prague, 1st Faculty of Medicine, Department Of Stomatology, Prague 2, Czech Republic
| | - Hana Hubálková
- Charles University in Prague, 1st Faculty of Medicine, Department Of Stomatology, Prague 2, Czech Republic
| | - Jindřich Charvát
- Charles University in Prague, 1st Faculty of Medicine, Department Of Stomatology, Prague 2, Czech Republic
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Leandro LNR, Barra Grande MF, Pelegrine AA, Nishioka RS, Teixeira ML, Basting RT. Stress distribution on implant- supported zirconia crown of maxillary first molar: effect of oblique load on natural and antagonist tooth. Comput Methods Biomech Biomed Engin 2024; 27:599-608. [PMID: 37022099 DOI: 10.1080/10255842.2023.2195962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023]
Abstract
This study evaluated the stress distribution on an implant-supported zirconia crown of a mandibular first molar subjected to oblique loading by occlusal contact with the natural maxillary first molar by using the 3D finite element method. Two virtual models were made to simulate the following situations: (1) occlusion between maxillary and mandibular natural first molars; (2) occlusion between zirconia implant-supported ceramic crown on a mandibular first molar and maxillary natural first molar. The models were designed virtually in a modeling program or CAD (Computer Aided Design) (Rhinoceros). An oblique load of 100 N was uniformly applied to the zirconia framework of the crown. The results were obtained by the Von Mises criterion of stress distribution. Replacement of the mandibular tooth by an implant caused a slight increase in stress on portions of the maxillary tooth roots. The crown of the maxillary model in occlusion with natural antagonist tooth showed 12% less stress when compared with the maxillary (model in occlusion with the) implant-supported crown. The mandibular crown of the implant show 35% more stress when compared with the mandibular antagonist crown on the natural tooth. The presence of the implant to replace the mandibular tooth increased the stresses on the maxillary tooth, especially in the region of the mesial and distal buccal roots.
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Carneiro DE, Zander LRM, Ruppel C, De La Torre Canales G, Auccaise-Estrada R, Sánchez-Ayala A. Influence of the radius of Monson's sphere and excursive occlusal contacts on masticatory function of dentate subjects. Arch Oral Biol 2024; 159:105879. [PMID: 38211398 DOI: 10.1016/j.archoralbio.2023.105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/14/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To determine the influence of the radius of Monson's sphere, the number of posterior laterotrusive, mediotrusive, and protrusive contacts, and the chewing rate on food comminution. DESIGN Sixty healthy dentate subjects, aged 21.22 ± 2.30 years, were selected. The three-dimensional coordinates of the cusp tips of the lower canine, premolar, and molar teeth were identified from the subjects' digital models. Monson's sphere was designed using the simplex method for function minimisation by adjusting the coordinates on its surface. The contacts were verified using 12 µm metal strips in jaw excursions at 0.5, 1.0, 2.0, and 3.0 mm. The masticatory performance and efficiency, swallowing threshold, and chewing rate were assessed through particle size fractionation. Data were analysed with multiple linear regression (α = 0.05). RESULTS The sphere's radius, laterotrusive and protrusive contacts at 0.5 mm, and chewing rate were found to be negative predictor variables for masticatory performance until 20 chewing cycles (R2 = 0.429). For 40 cycles, the radius and total contacts (0.5 mm) were also explanatory factors (R2 = 0.223). Only the radius (R2 = 0.176) and the chewing rate (R2 = 0.082) were found to be significant for 60 cycles and swallowing threshold, respectively. Masticatory efficiency was influenced by masticatory performance until 40 and 60 cycles, as well as the radius and total contacts at 2.0 and 3.0 mm (R2 = 0.958). CONCLUSION A larger radius of Monson's sphere and a greater number of posterior excursive contacts were found to be related to better masticatory function.
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Affiliation(s)
| | | | - Carolina Ruppel
- Department of Dentistry, University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - 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; Department of Dentistry, Ingá University Center, Uningá, Maringá, Paraná, Brazil
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Ali Alkhalaf Z, Sghaireen MG, Ganji KK, Alam MK, Issrani R, Mohammed Alsaleh R, Almegren SZ, Gamal Salloum M. Unveiling the Influence of the Curve of Spee on Bite Force and Chewing Ability: A Comparative Study. Int J Clin Pract 2024; 2024:6533841. [PMID: 38420595 PMCID: PMC10901573 DOI: 10.1155/2024/6533841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 03/02/2024] Open
Abstract
Aim To investigate the impact of the curve of Spee (CS) accentuation on bite force, chewing ability, and additionally, other factors that influence chewing ability and bite force such as restorations, caries, gender, habits, and TMJ problems. Materials and Methods 231 participants (118 male and 113 female, mean age = ±27.96 years) were recruited for this cross-section study. Participants completed a data collection sheet in which age, gender, Angle's classification of malocclusion, overjet, overbite, TMJ problems, habits, restorations, and caries experience were recorded. Two examiners made a lower impression, chewing ability test and measured the bite force for each participant. Measurement of the CS was obtained digitally from the poured dental cast, and the categorization was as follows: flat (<1 mm), normal (1-2 mm), or deep (>2 mm). Results The mean maximum bite force (MBF) was 468.722 N for participants with flat CS, 389.822 N for normal CS, 647.08 N for deep CS, and 384.667 N for reverse CS. The average MBF was higher for participants with deep CS (p < 0.05). MBF force was higher in males. However, BMI was not significantly related to MBF values. Participants with normal and flat CS have comparable chewing capacity (p > 0.05). Also, a significant difference in bite force and chewing ability was found between the three categories of CS (p < 0.05). Conclusion Bite force variations across various CS types were linked to gender and habits. Chewing ability showed no differences concerning gender, habits, TMJ problems, caries, or restorations, emphasizing CS's significant impact on bite force while showcasing the unchanged nature of chewing ability amidst diverse factors.
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Affiliation(s)
- Zainab Ali Alkhalaf
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Aljouf, Saudi Arabia
| | - Mohammed Ghazi Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Aljouf, Saudi Arabia
| | - Kiran Kumar Ganji
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Aljouf, Saudi Arabia
- Department of Periodontology & Oral Implantology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi (Meghe), Wardha, India
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Aljouf, Saudi Arabia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil lnternational University, Dhaka, Bangladesh
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Aljouf, Saudi Arabia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Raghad Mohammed Alsaleh
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Aljouf, Saudi Arabia
| | - Sultana Zamil Almegren
- Department of Periodontology and Oral Implantology, Ministry of Health, Dental Clinics Complex West of Riyadh, Laban, Riyadh, Saudi Arabia
| | - Mahmoud Gamal Salloum
- Department of Substitutive Dental Sciences, College of Dentistry & Pharmacy, Buraydah Private Colleges, Buraydah, Saudi Arabia
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Arango-Piloneta EV, Plaza-Ruiz SP, Quiroga P, León-Lara DF. Simplifying two-vector mechanics calculations for challenging tooth movements. Comput Methods Biomech Biomed Engin 2024; 27:15-23. [PMID: 36625711 DOI: 10.1080/10255842.2023.2165392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023]
Abstract
The purpose of this article was to describe a simple graphical driven method for determining the necessary two-vector mechanics (TVM) as an alternative solution to the ideal or single force. In orthodontics, some tooth movements are difficult to achieve, mainly because of the impossibility of getting the point of application for the necessary force system. Given two points in biomechanically accessible areas, adding together two vectors applied to those points will result in an equivalent force system. The method was developed based on previous research, 3,880 hypothetical cases were analyzed to determine the trends between the resulting forces and their relative locations. A graphical driven TVM method (GTVM) for establishing the necessary TVM is presented in a manner that combine different procedures from the traditional method that simplify the analysis and may allow the user to perform more complex orthodontic cases making easier to compare systems of force equivalents.
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Affiliation(s)
- E V Arango-Piloneta
- Orthodontic Department, Fundación Universitaria CIEO-UniCIEO, Bogotá, Colombia
| | - S P Plaza-Ruiz
- Orthodontic Department, Fundación Universitaria CIEO-UniCIEO, Bogotá, Colombia
| | - P Quiroga
- Center for Studies in Structrures and Materials, Civil Engineering Department, Escuela Colombiana de Ingenieros Julio Garavito, Bogotá, Colombia
| | - D F León-Lara
- Escuela Colombiana de Ingenieros Julio Garavito, Bogotá, Colombia
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Wang M, Wang J, Jin X, Liu D, Bian H, Zhao Y, Li Y. Impact of occlusal contact pattern on dental stability and oromandibular system after orthodontic tooth movement in rats. Sci Rep 2023; 13:22276. [PMID: 38097596 PMCID: PMC10721791 DOI: 10.1038/s41598-023-46668-x] [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: 05/09/2023] [Accepted: 11/03/2023] [Indexed: 12/17/2023] Open
Abstract
How to ensure dental stability in new positions and reduce the likelihood of relapse is a major clinical concern in the orthodontic field. Occlusal contacts between arches may affect the transmission of masticatory forces, thereby influencing the biological response of the periodontal and the oromandibular system. Occlusion factors that may influence the stability after orthodontic tooth movement (OTM) remain largely unknown. Hence, this research was conducted in order to investigate the influence of different occlusal contact patterns on tooth stability and oromandibular system including the masseter muscle and the temporomandibular joint following OTM. By modifying the occlusal surfaces, in vivo animal study models with distinct occlusal patterns corresponding to clinical circumstances were established. The relapse distance of teeth and the level of inflammatory factors in the gingival cervical fluid were analyzed. We also closely observed the histological remodeling of periodontal tissue, masseter tissue, and joint tissue after one week of relapse. Moreover, genes expression in the alveolar bone was analyzed to illustrate the potential biological mechanisms of relapse under the influence of different occlusal contact patterns following OTM. Different occlusal contact patterns after OTM in rats were established. The intercuspation contact between cusp and fossa group exhibited the lowest level of relapse movement, inflammatory factors and osteoclast activity (P < 0.05). On the other hand, groups with interferences or inadequate contacts exhibited more relapse movement, and tend to promote inflammation of periodontal tissue and activate bone resorption (P < 0.05). Adequate occlusal contacts without interference may enhance tooth stability and reduce the likelihood of relapse. After active orthodontic treatment, necessary occlusal adjustment should be made to achieve the desired intercuspation contact relationship and ensure adequate contact between the arches. The elimination of occlusal interferences is crucial to achieving optimal stability and promoting overall healthy condition of the oromandibular system.
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Affiliation(s)
- Menglin Wang
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Department of Stomatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, China
| | - Jing Wang
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Xiang Jin
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Dedi Liu
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Huan Bian
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
| | - Yantao Zhao
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China.
- Beijing Engineering Research Center of Orthopedics Implants, Beijing, 100048, China.
- State Key Laboratory of Military Stomatology, Xi'an, 710032, China.
| | - Yanfeng Li
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
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Borges MHR, Miranda LFB, Dini C, Marañón-Vásquez GA, Magno MB, Maia LC, Barão VAR. Clinical performance of and patient satisfaction with conventional complete dentures with different occlusal schemes: A systematic review of systematic reviews. J Prosthet Dent 2023; 130:341-350. [PMID: 34991859 DOI: 10.1016/j.prosdent.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
STATEMENT OF PROBLEM The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for complete denture users is lacking. As a result, many dentists choose the scheme based on their preferences and clinical experience. PURPOSE The purpose of this review was to assess the methodological quality and summarize the scientific evidence from secondary studies about the influence of occlusal schemes on the clinical performance of and patient satisfaction with complete dentures. MATERIAL AND METHODS Ten sources were surveyed according to the patient, intervention, comparison, outcome (PICO) strategy. Systematic reviews that evaluated the clinical performance and patient satisfaction (O) of rehabilitated edentulous patients with conventional complete dentures (P) under different occlusal schemes (I/C) were included. Methodological quality was assessed by using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool by 2 authors independently. The effect of each occlusal scheme in comparison with others was summarized and classified as positive, neutral, negative, or inconclusive based on the conclusions of the systematic review concerning clinical performance and patient satisfaction outcomes. RESULTS The search led to the inclusion of 10 systematic reviews. Seven were classified as of critically low, 2 as low, and 1 as moderate methodological quality. The following occlusal designs were included and analyzed: bilateral balanced occlusion, lingualized occlusion, canine guidance, group function, and monoplane occlusion. Bilateral balanced occlusion and canine guidance obtained satisfactory results for both outcomes. Lingualized occlusion showed a trend toward better results than other occlusal schemes for normal and resorbed ridges. Group function presented mainly inconclusive results, and monoplane occlusion did not deliver satisfactory outcomes. CONCLUSIONS The present overview concluded that occlusal schemes might interfere with the clinical performance of and patient satisfaction with complete dentures. Lingualized, bilateral balanced, and canine guidance are preferred compared with monoplane occlusion, but lingualized occlusion tends to show better results in some reviews. However, the results should be carefully considered because of the low quality of the systematic reviews included.
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Affiliation(s)
- Maria Helena Rossy Borges
- Masters' degree student, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil
| | | | - Caroline Dini
- PhD Candidate, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil
| | | | - Marcela Baraúna Magno
- Postdoctoral Fellow, School of Dentistry, Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Professor, School of Dentistry, Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro, Brazil
| | - Valentim A R Barão
- Associate Professor, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil.
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Othman A, Sandmair M, Alevizakos V, von See C. The fracture resistance of 3D-printed versus milled provisional crowns: An in vitro study. PLoS One 2023; 18:e0285760. [PMID: 37656728 PMCID: PMC10473469 DOI: 10.1371/journal.pone.0285760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 04/29/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND CAD/CAM has considerably transformed the clinical practice of dentistry. In particular, advanced dental materials produced via digital technologies offer unquestionable benefits, such as ideal mechanical stability, outstanding aesthetics and reliable high precision. Additive manufacturing (AM) technology has promoted new innovations, especially in the field of biomedicine. AIMS The aim of this study is to analyze the fracture resistance of implant-supported 3D-printed temporary crowns relative to milled crowns by compression testing. METHODS The study sample included 32 specimens of temporary crowns, which were divided into 16 specimens per group. Each group consisted of eight maxillary central incisor crowns (tooth 11) and eight maxillary molar crowns (tooth 16). The first group (16 specimens) was 3D printed by a mask printer (Varseo, BEGO, Bremen, Germany) with a temporary material (VarseoSmile Temp A3, BEGO, Bremen, Germany). The second group was milled with a millable temporary material (VitaCAD Temp mono-color, Vita, Bad Säckingen, Germany). The two groups were compression tested until failure to estimate their fracture resistance. The loading forces and travel distance until failure were measured. The statistical analysis was performed using SPSS Version 24.0. We performed multiple t tests and considered a significance level of p <0.05. RESULTS The mean fracture force of the printed molars was 1189.50 N (±250.85) with a deformation of 1.75 mm (±0.25). The milled molars reached a mean fracture force of 1817.50 N (±258.22) with a deformation of 1.750 mm (±0.20). The printed incisors fractured at 321.63 N (±145.90) with a deformation of 1.94 mm (±0.40), while the milled incisors fractured at 443.38 N (±113.63) with a deformation of 2.26 mm (±0.40). The milled molar group revealed significantly higher mechanical fracture strength than the 3D-printed molar group (P<0.001). However, no significant differences between the 3D-printed incisors and the milled incisors were found (p = 0.084). There was no significant difference in the travel distance until fracture for both the molar group (p = 1.000) and the incisor group (p = 0.129). CONCLUSION Within the limits of this in vitro investigation, printed and milled temporary crowns withstood masticatory forces and were safe for clinical use.
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Affiliation(s)
- Ahmed Othman
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Maximillian Sandmair
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Vasilios Alevizakos
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Constantin von See
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
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Humm VL, Sailer I, Thoma DS, Hämmerle CHF, Jung RE, Zembic A. 13-year follow-up of a randomized controlled study on zirconia and titanium abutments. Clin Oral Implants Res 2023; 34:911-919. [PMID: 37340530 DOI: 10.1111/clr.14117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/22/2023] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES To assess survival rates and compare technical, biological, and esthetic outcomes of customized zirconia and titanium abutments at 13 years post loading. MATERIALS AND METHODS Initially, 22 patients with 40 implants in posterior regions were included. The sites were randomly assigned to 20 customized zirconia abutments with cemented all ceramic crowns (ACC) and 20 customized titanium abutments with cemented metal ceramic crowns (MCC). At a mean follow-up of 13.4 years, patients were examined and implants/restorations assessed for survival and technical complications, as well as biological and esthetic outcomes (pocket probing depth [PPD], bleeding on probing [BOP], plaque control record [PCR], bone level [BL], papilla index [PAP], mucosal thickness, and recession (distance of the margo mucosae [MM]/margo gingivae MG)). Descriptive analyses were performed for all outcome measures. RESULTS Fifteen patients with 21 abutments (13 zirconia, 8 titanium) were examined at 13 years. The drop-out rate was 25% (patient level). The technical survival rate of the abutments was 100%. The survival rate on the restorative level (crowns) was 100%. The assessed biological outcomes (PPD, PCR, BOP, BL) and esthetic outcomes (MG, PAP) were similar. CONCLUSIONS Zirconia and titanium abutments supporting single implant-borne restorations rendered a high survival rate and minimal differences in terms of technical, biological, and esthetic outcomes at 13 years of follow-up.
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Affiliation(s)
- Viviane Laura Humm
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
- Private practice, Winterthur, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Occlusion, University clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel Stefan Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | | | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
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12
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Londoño A, Assis M, Fornai C, Greven M. Premolar Extraction Affects Mandibular Kinematics. Eur J Dent 2023; 17:756-764. [PMID: 36167318 PMCID: PMC10569881 DOI: 10.1055/s-0042-1755629] [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] Open
Abstract
OBJECTIVES The practice of premolar extraction in orthodontics is controversial for its potential detrimental effects on the stomatognathic system. However, the ways in which premolar extraction affects mandibular function are still poorly understood. The purpose of this study was to assess the influence of premolar extraction on mandibular kinematics by evaluating axiographic tracings. MATERIALS AND METHODS Forty-five orthodontically treated patients with premolar teeth extraction were compared with 45 paired untreated controls, selected for the absence of malocclusions. Systematic three-dimensional axiographic recordings of the mandibular movements were performed for protrusive-retrusive movements and speech. The transversal deviations and length of the movements were recorded for both sides along with the rotation angle during speech. STATISTICAL ANALYSIS Differences between the axiographic variables were analyzed via the permutation test and Wilcoxon rank-sum test. Linear regression was performed to test whether axiographic parameters were predictive of group affiliation. Dot plots were used to explore the distribution of each of the axiographic outcomes, and isometric principal component analysis to assess the differences between the cumulative effects of premolar extraction on jaw motion. RESULTS The mandibular lateral translation in protrusion-retrusion and speech, the amount of rotation as well as the length of mandibular movements during speech were significantly higher in the treated subjects than in the controls, while retral stability did not differ. The linear regression yielded significant results for the mandibular lateral translation in protrusion-retrusion. The isometric principal component analysis showed higher values of the axiographic variables for 11 out of 45 individuals in the study sample compared with the control group. CONCLUSIONS Premolar extraction altered mandibular kinematics in at least 25% of the cases within our sample, and the transversal discrepancy between protrusive and retrusive tracings was even predictive of group affiliation. These results support the notion that the routine practice of premolar extraction as part of the orthodontic treatment should be discouraged. It is compelling to perform further studies to assess whether a disrupted kinematics of the mandible is associated to temporomandibular disorders.
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Affiliation(s)
- Alejandra Londoño
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
- Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
| | - Miguel Assis
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
- Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
| | - Cinzia Fornai
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Department of Evolutionary Anthropology & Human Evolution and Archaeological Sciences (HEAS), University of Vienna, Vienna, Austria
- Center of Clinical Research, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
| | - Markus Greven
- Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
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13
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Jauregi M, Amezua X, Manso AP, Solaberrieta E. Positional influence of center of masticatory forces on occlusal contact forces using a digital occlusal analyzer. J Prosthet Dent 2023:S0022-3913(23)00171-3. [PMID: 37003941 DOI: 10.1016/j.prosdent.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
STATEMENT OF PROBLEM Digital occlusal analyzers allow the recording of dental contact forces. Some authors assume a unique location for the center of contact forces at the position of maximum intercuspation, while others indicate variations in dental contact forces when recorded at different times of the day. Which approach is more appropriate is unclear. PURPOSE The purpose of this in vitro study was to analyze whether a change in the balance of masticatory forces influences the location of the center of contact forces and its magnitude. MATERIAL AND METHODS Three different dental casts, selected under dental criteria, were mounted in maximum intercuspation on a semiadjustable articulator equipped with a pattern indicating 9 different force application points (intersection point between 3 longitudinal rows and 3 transverse columns). A force of constant magnitude (169 N) was applied 10 times at each of the application points, and occlusal forces were recorded with a digital occlusal analyzer. Then, two variables were studied: the location of the center of contact forces and its magnitude. Each force application position (9 positions × 3 dental casts=27 in total) was repeated 10 times, and measured data were statistically analyzed with 2-way repeated measures ANOVA (α=.05) test. RESULTS The repeatability of the method indicated that the coefficient of variation mean was 0.37% in the location of the center of contact forces and that its magnitude was 3.70%. The 2-way repeated measures ANOVA test revealed statistically significant variations in the location of the center of contact forces and its magnitude, revealing that longitudinal changes of the application point of masticatory forces affected the magnitude of contact forces and that longitudinal and transverse changes of the application point of masticatory forces affected the location of the center of contact forces. CONCLUSIONS The location of the center of contact force and its magnitude provided by a digital occlusal analyzer at the position of maximum intercuspation are not necessarily unique to each articulated dental cast. Even if the intensity of the masticatory force remains unchanged, changes in its lateral or longitudinal balance also influence the result of the occlusion forces.
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Affiliation(s)
- Mikel Jauregi
- Associate Professor, Department of Mechanical Engineering, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Xabier Amezua
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Angel P Manso
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Eneko Solaberrieta
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain.
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14
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Ågren M, Nanchaipruek Y, Phumariyapong P, Apinuntham C, Rakchart S, Pettersson M, Wanitphakdeedecha R. Duration of bite force reduction following a single injection of botulinum toxin in the masseter muscle bilaterally: A one-year non-randomized trial. J Oral Rehabil 2023; 50:343-350. [PMID: 36810787 DOI: 10.1111/joor.13434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/07/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Previous studies concerning the effect of botulinum toxin in masseter muscle have mainly reported effects observed through inspection of facial features or differences in pain levels. One systematic review of studies utilizing objective measurements reported that long-term muscular effect of botulinum neurotoxin injections into masseter muscle was inconclusive. OBJECTIVE To evaluate the duration of reduced maximal voluntary bite force (MVBF) after botulinum toxin intervention. METHODS The intervention group was comprised of individuals seeking aesthetic treatment for masseter reduction (n = 20), the reference group (n = 12) comprised of individuals with no intervention. Intervention through 25 units of Xeomin® (Merz Pharma GmbH & Co KGaA, Frankfurt am Main, Germany) botulinum neurotoxin type A injected into the masseter muscles bilaterally (totalling 50 units). A reference group did not receive any intervention. MVBF was measured in Newtons using a strain gauge meter at the incisors and first molars. MVBF was measured at baseline, at 4 weeks, 3 months, 6 months, and after 1 year. RESULTS Both groups were similar in terms of bite force, sex and age at baseline. MVBF remained similar compared to baseline in the reference group. At 3 months, a significant reduction at all measurement points was observed in the intervention group; at 6 months, this reduction was no longer significant. CONCLUSION A single intervention of 50 units of botulinum neurotoxin results in a reversible MVBF reduction of at least 3 months, although a visually discernable reduction may be more long-lasting.
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Affiliation(s)
- Martin Ågren
- Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden.,Prosthodontic Specialist Clinic, Region Västerbotten, Umeå, Sweden
| | - Yanisorn Nanchaipruek
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phumithep Phumariyapong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chalermkwan Apinuntham
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Mattias Pettersson
- Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
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Nueesch R, Karlin S, Fischer J, Rohr N. In Vitro Investigation of Material Combinations for Meso- and Suprastructures in a Biomimetic Approach to Restore One-Piece Zirconia Implants. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1355. [PMID: 36836985 PMCID: PMC9960926 DOI: 10.3390/ma16041355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to find a suitable material combination to avoid cement excess in the marginal region of one-piece zirconia implant-supported restorations by means of a hybrid crown consisting of a meso- and a suprastructure. One-piece zirconia implants (n = 120) were embedded in epoxy resin. Microfilled resin composite mesostructures (n = 60), designed as caps, were bonded on the implant abutment with a primer only. A molar crown was constructed and cemented with a resin cement on top of the mesostructure as a suprastructure out of feldspar ceramic (n = 12), lithium-disilicate (n = 24), or zirconia (n = 24). Fracture load (n = 6) and retention force (n = 6) were measured immediately after storage in distilled water at 37 °C for 24 h, as well as after an additional exposure to artificial aging in a chewing simulator and simultaneous thermal cycling. For the measurement of the fracture load, monolithic crowns made of the employed restorative materials and identical in shape to the hybrid crowns served as controls (n = 6 each). Fracture load values for feldspar ceramic and lithium-disilicate hybrid crowns were slightly higher than those for the respective monolithic crowns at baseline and after aging, which was statistically significant only for feldspar crowns after aging. In contrast, fracture load values for zirconia monolithic crowns were higher than those for zirconia hybrid crowns, which was only statistically significant after aging. Artificial aging reduced the fracture load of feldspar and lithium-disilicate crowns both for hybrid and monolithic crowns. The effect was only statistically significant for lithium disilicate hybrid crowns. The fracture load for hybrid and monolithic zirconia crowns was increased by artificial aging without reaching statistical significance. The retention force of lithium-disilicate and zirconia hybrid crowns was not affected by artificial aging. Taking into account retention force and fracture load, lithium-disilicate hybrid crowns showed promising results.
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16
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Murakami K, Yoshimoto T, Hori K, Sato R, Sta. Maria MT, Marito P, Takano H, Khaing AMM, Nokubi T, Ono T. Masticatory Performance Test Using a Gummy Jelly for Older People with Low Masticatory Ability. J Clin Med 2023; 12:jcm12020593. [PMID: 36675521 PMCID: PMC9861735 DOI: 10.3390/jcm12020593] [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: 12/04/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Evaluation of masticatory ability has become more important in an aging society because decreased masticatory ability has the potential to affect the general health of older people. A new masticatory performance test, intended for older people with low masticatory ability, has been developed using gummy jelly half the size of that used in the conventional masticatory performance test. This study aimed to investigate the compatibility between the new and conventional tests and the adaptation of the new test. The new test using the 8-grade visual score with half-size gummy jelly was performed among 137 removable denture wearers (mean age 75.8 ± 9.0 years) with low masticatory performance (a score of ≤4 on a conventional test). The correlation between the scores of half-size gummy jelly (VS-H) in the new test and those of full-size gummy jelly (VS) in the conventional test was evaluated. VS-H among the groups divided by VS were also compared. A strong positive correlation was detected between VS-H and VS (rs = 0.70). In groups with VS of 0 and 1, VS-H values were widely distributed from 0 to 7. There were significant differences in VS-H between the groups with VS of 0-2 but no significant differences in VS-H between the groups with VS of 2-4. Therefore, the masticatory performance test using half-size gummy jelly is suitable for a detailed evaluation of masticatory ability in older people with low masticatory ability when their visual score of full-size gummy jelly in the conventional test is 2 or less.
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Affiliation(s)
- Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Tasuku Yoshimoto
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
- Correspondence: ; Tel.: +81-25-227-2891; Fax: +81-25-229-3454
| | - Rikako Sato
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Ma. Therese Sta. Maria
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
- Department of Prosthodontics, College of Dentistry, Manila Central University, Caloocan 1400, Philippines
| | - Pinta Marito
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
- Department of Prosthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Hinako Takano
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Aye Mya Mya Khaing
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | | | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka 540-0008, Japan
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17
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Zimmermann R, Seitz S. The Impact of Technological Innovation on Dentistry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:79-102. [PMID: 37016112 DOI: 10.1007/978-3-031-26462-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Technology has revolutionized the way dentists are able to treat their patients. These technological advances have paved the way for the creation of virtual patient models utilizing these 3-dimensional intra-oral patient models, cone bean computer tomography (CBCT) radiograph scans, extraoral 3-dimensional scans, and jaw motion tracings to create a patient-specific model. These models are advantageous in planning surgical treatments by providing 3-dimensional views of vital anatomical structures to accurately identify the location, size, and shape of a structure or defect in order to plan accordingly. Virtual augmentation of either hard tissue (bone) and/or soft tissue (i.e., gingiva) can also be accomplished.Technology has allowed the capture of the dynamic motions of the jaw and combined them with the virtual patient to develop permanent restorations in harmony with the patient's orofacial complex. With the introduction of new technology in the realm of digital dentistry, patient care is being brought to a new and higher level. This creates a level of more optimal care that a dentist can deliver to patients.
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Affiliation(s)
- Richard Zimmermann
- Department of Comprehensive Dentistry, UT Health San Antonio, San Antonio, TX, USA
| | - Stefanie Seitz
- Department of Comprehensive Dentistry, UT Health San Antonio, San Antonio, TX, USA.
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18
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Nakhaei M, Sterba M, Foletti JM, Badih L, Behr M. Experimental analysis and numerical fatigue life prediction of 3D-Printed osteosynthesis plates. Front Bioeng Biotechnol 2023; 11:1133869. [PMID: 37034247 PMCID: PMC10073497 DOI: 10.3389/fbioe.2023.1133869] [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: 12/29/2022] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
The trend towards patient-specific medical orthopedic prostheses has led to an increased use of 3D-printed surgical implants made of Ti6Al4V. However, uncertainties arise due to varying printing parameters, particularly with regards to the fatigue limit. This necessitates time-consuming and costly experimental validation before they can be safely used on patients. To address this issue, this study aimed to employ a stress-life fatigue analysis approach coupled with a finite element (FE) simulation to estimate numerically the fatigue limit and location of failure for 3D-printed surgical osteosynthesis plates and to validate the results experimentally. However, predicting the fatigue life of 3D components is not a new concept and has previously been implemented in the medical device field, though without experimental validation. Then, an experimental fatigue test was conducted using a proposed modification to the staircase method introduced in ISO 12107. Additionally, a FE model was developed to estimate the stress cycles on the plate. The stress versus number of cycles to failure curve (S-N) obtained from the minimum mechanical properties of 3D-printed Ti6AI4V alloy according to ASTM F3001-14 to predict the fatigue limit. The comparison between experimental results and fatigue numerical predictions showed very good agreement. It was found that a linear elastic FE model was sufficient to estimate the fatigue limit, while an elastic-plastic model led to an accurate prediction throughout the implant's cyclic life. The proposed method has great potential for enhancing patient-specific implant designs without the need for time-consuming and costly experimental regulatory testing.
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Affiliation(s)
- Mohsen Nakhaei
- Glad Medical SAS, Salon De Provence, France
- *Correspondence: Mohsen Nakhaei,
| | | | - Jean-Marc Foletti
- Aix Marseille Université, Université Gustave Eiffel, LBA, Marseille, France
- Assistance Publique, Hôpitaux de Marseille, Marseille, France
| | | | - Michel Behr
- Aix Marseille Université, Université Gustave Eiffel, LBA, Marseille, France
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19
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Erdil D, Bagis N, Eren H, Camgoz M, Orhan K. The Evaluation of the Relationship between Changes in Masseter Muscle Thickness and Tooth Clenching Habits of Bruxism Patients Treated with Botulinum Toxin A. J Med Ultrasound 2023; 31:22-28. [PMID: 37180633 PMCID: PMC10173841 DOI: 10.4103/jmu.jmu_51_22] [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: 05/20/2022] [Revised: 06/07/2022] [Accepted: 06/29/2022] [Indexed: 05/16/2023] Open
Abstract
Background Bruxism is defined as recurrent masticatory muscle activity. Although there is not an agreed treatment method for bruxism, the application of botulinum toxin A (BT-A) has become a reliable lately. This study aimed to evaluate the correlation between the changes in masseter muscle thickness and clenching habits in bruxism patients treated with BT-A. Methods Twenty-five patients, 23 females and 2 males, diagnosed with possible sleep bruxism were included in the study. The Fonseca Anamnestic Index was applied to the patients to determine their clenching habits and depression levels both before the treatment, and 6 months after it. The masseter muscle thickness was measured using ultrasonography before the treatment and 3 months and 6 months after the treatment. All the patients were injected with a total of 50 U of BT-A, 25 U to each masseter. Results A statistically significant decrease in masseter muscle thickness was observed in the ultrasonography 3 and 6 months after the BT-A treatment. There was a statistically significant decrease in the Fonseca scores, in which the teeth clenching habits of the patients were evaluated 6 months after the treatment. Although there was a decrease in the depression levels of the patients 6 months after the treatment, this difference was not statistically significant. Conclusion When the results of this study were evaluated, it was seen that the BT-A injections are an effective, safe, and side effect-free method in the treatment of bruxism and masseter hypertrophy.
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Affiliation(s)
- Deniz Erdil
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Nilsun Bagis
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hakan Eren
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Melike Camgoz
- Faculty of Dentistry, Gazi University, Ankara, Turkey
- Address for correspondence: Dr. Melike Camgoz, Gazi University Faculty of Dentistry, Ogretim Uyeleri (VIP) Klinigi Biskek Cd 1. Sk No.4, Emek/Cankaya, Ankara, Turkey. E-mail:
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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20
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Bernkopf E, Cristalli G, de Vincentiis GC, Bernkopf G, Capriotti V. Temporomandibular Joint and Otitis Media: A Narrative Review of Implications in Etiopathogenesis and Treatment. Medicina (B Aires) 2022; 58:medicina58121806. [PMID: 36557008 PMCID: PMC9786198 DOI: 10.3390/medicina58121806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a frequent clinical challenge. The middle ear, the mandible, and the temporomandibular joint (TMJ) share several embryological and anatomical connections. Despite that, the role of mandibular malposition and TMJ dysfunction is frequently overlooked in the management of otitis media. In this narrative review, we present current evidence supporting the etiopathogenetic role of a dysfunctional stomatognathic system in the onset of OM and the effectiveness of orthognathic treatment in preventing rAOM and OME. In particular, a focus on the influence of TMJ on Eustachian tube function is provided.
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Affiliation(s)
| | - Giovanni Cristalli
- Otolaryngology Unit, Bambino Gesù Children’s Hospital, IRCCS, Via della Torre di Palidoro, 00050 Rome, Italy
- Correspondence: (G.C.); (V.C.); Tel.: +39-066-859-4135 (G.C.); +39-351-768-6445 (V.C.)
| | | | | | - Vincenzo Capriotti
- Otorhinolaryngology and Head and Neck Surgery Unit, ASST Bergamo Ovest, Treviglio-Caravaggio Hospital, Piazzale Ospedale Luigi Meneguzzo 1, 20047 Treviglio, Italy
- Correspondence: (G.C.); (V.C.); Tel.: +39-066-859-4135 (G.C.); +39-351-768-6445 (V.C.)
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Assoratgoon I, Yoda N, Iwamoto M, Sato T, Kawata T, Egusa H, Sasaki K. In vivo measurement of three-dimensional load exerted on dental implants: a literature review. Int J Implant Dent 2022; 8:52. [DOI: 10.1186/s40729-022-00454-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
For biomechanical consideration of dental implants, an understanding of the three-dimensional (3D) load exerted on the implant is essential, but little information is available on the in vivo load, including the measuring devices.
Purpose
This review aimed to evaluate studies that used specific load-measuring devices that could be mounted on an implant to measure the functional load in vivo.
Materials and methods
An electronic search utilizing the internet research databases PubMed, Google Scholar, and Scopus was performed. The articles were chosen by two authors based on the inclusion and exclusion criteria.
Results
In all, 132 studies were selected from the database search, and 16 were selected from a manual search. Twenty-three studies were finally included in this review after a complete full-text evaluation. Eleven studies were related to the force measurements using the strain gauges, and 12 were related to the piezoelectric force transducer. The principles of the two types of devices were completely different, but the devices produced comparable outcomes. The dynamics of the load magnitude and direction on the implant during function were clarified, although the number of participants in each study was small.
Conclusions
The load exerted on the implant during function was precisely measured in vivo using specific measuring devices, such as strain gauges or piezoelectric force transducers. The in vivo load data enable us to determine the actual biomechanical status in more detail, which might be useful for optimization of the implant prosthetic design and development of related materials. Due to the limited data and difficulty of in vivo measurements, the development of a new, simpler force measurement device and method might be necessary.
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Dorado S, Arias A, Jimenez-Octavio JR. Biomechanical Modelling for Tooth Survival Studies: Mechanical Properties, Loads and Boundary Conditions-A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7852. [PMID: 36363451 PMCID: PMC9657341 DOI: 10.3390/ma15217852] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Recent biomechanical studies have focused on studying the response of teeth before and after different treatments under functional and parafunctional loads. These studies often involve experimental and/or finite element analysis (FEA). Current loading and boundary conditions may not entirely represent the real condition of the tooth in clinical situations. The importance of homogenizing both sample characterization and boundary conditions definition for future dental biomechanical studies is highlighted. The mechanical properties of dental structural tissues are presented, along with the effect of functional and parafunctional loads and other environmental and biological parameters that may influence tooth survival. A range of values for Young's modulus, Poisson ratio, compressive strength, threshold stress intensity factor and fracture toughness are provided for enamel and dentin; as well as Young's modulus and Poisson ratio for the PDL, trabecular and cortical bone. Angles, loading magnitude and frequency are provided for functional and parafunctional loads. The environmental and physiological conditions (age, gender, tooth, humidity, etc.), that may influence tooth survival are also discussed. Oversimplifications of biomechanical models could end up in results that divert from the natural behavior of teeth. Experimental validation models with close-to-reality boundary conditions should be developed to compare the validity of simplified models.
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Affiliation(s)
- Saúl Dorado
- Department of Mechanical Engineering, Escuela Técnica Superior de Ingeniería ICAI, Universidad Pontificia Comillas, 28015 Madrid, Spain
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Jesus R. Jimenez-Octavio
- Instituto de Investigación Tecnológica, Escuela Técnica Superior de Ingeniería ICAI, Universidad Pontificia Comillas, 28015 Madrid, Spain
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León Velastegui M, Montiel-Company JM, Agustín-Panadero R, Fons-Badal C, Solá-Ruíz MF. Enamel Wear of Antagonist Tooth Caused by Dental Ceramics: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:6547. [PMID: 36362777 PMCID: PMC9657667 DOI: 10.3390/jcm11216547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to evaluate the wear of the antagonist tooth in ceramic restorations. MATERIAL AND METHODS This study was carried out based on Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) recommendations; it was also registered in PROSPERO (register number: CRD42022316252). Three databases were consulted in the literature search, Embase, Scopus, and Web of Science. The citation searching was conducted by two researchers independently. The clinical studies that evaluated wear in antagonist teeth concerning ceramic restoration were included. Twelve articles were selected after eliminating duplicates ones and applying the inclusion criteria, and two were chosen through citation. Fourteen articles were considered for the qualitative and quantitative analysis (meta-regression and meta-analysis). RESULTS The mean linear wear of the antagonist tooth in relation to feldspathic was 8.914 μm, for lithium disilicate it was 0.018 μm, and for zirconia it was 0.257 μm. The mean volumetric wear of the antagonist tooth in relation to feldspathic was 0.273 mm3, for hybrid ceramic it was 0.030 mm3, for lithium disilicate it was 0.018 mm3, and for zirconia it was 0.014 mm3. The mean natural tooth wear was 0.7974 μm per month. Tooth wear caused by zirconia at six months was 31.755 μm, at 12 months it was 24.648 μm, and at 24 months it was 20.662 μm. CONCLUSIONS Feldspathic produces greater wear of the antagonist tooth from ceramic restorations linearly and volumetrically. In addition, zirconia generates the least wear that will decrease over time, and it will be equal to or less than the natural wear in the tooth.
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Affiliation(s)
- Manuel León Velastegui
- School of Dentistry, Faculty of Health Sciences, Universidad Nacional de Chimborazo, Riobamba 060103, Ecuador
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Carla Fons-Badal
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - María Fernanda Solá-Ruíz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
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Guastaldi FPS, Queiroz TP, Marques DO, Santos ABS, Molon RS, Margonar R, Guastaldi AC. Comparative Evaluation of Implants with Different Surface Treatments Placed in Human Edentulous Mandibles: A 1-Year Prospective Study. J Maxillofac Oral Surg 2022; 21:815-823. [PMID: 36274893 PMCID: PMC9474755 DOI: 10.1007/s12663-021-01600-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022] Open
Abstract
The aims of this study were to analyze prospectively and comparatively the peri-implant bone crest levels, bone density, stability and success rate of implants with different surface treatments in human edentulous mandibles. Twenty edentulous patients were selected. Four different implants were placed between the mental foramen. Four groups were evaluated: (1) laser-modified surface (LASER), (2) surface modified by laser with deposition of apatites (LASER + HA), (3) surface modified by double acid etching (ACID, Implacil De Bortoli) and (4) surface modified by sandblasting and acid etching (SLActive®, Straumann). Clinical, radiographic, resonance frequency and tomographic analyses were used. After 4 months, mandibular fixed implant prostheses were installed. Clinical and radiographic analyses were performed at times T0 (immediately after implant placement), T1 (15 days), T2 (30 days), T3 (60 days), T4 (90 days), T5 (120 days), T6 (180 days) and T7 (360 days), post-implant placement. The resonance frequency analysis (RFA) was measured at T0, T4, T6 and T7. The tomographic analysis was performed at T0, T4 and T7. In the radiographic bone density analysis, a statistical difference was found between the SLActive® and LASER + HA groups at T4 (p < 0.05). Statistical differences were observed in RFA at T4 (90 days), between the SLActive® and LASER groups (p < 0.05) and between the SLActive® and LASER + HA groups (p < 0.05). At T6 and T7, statistical differences were found between the SLActive® group and all other implant surfaces (p < 0.01). The experimental surfaces analyzed showed encouraging positive outcomes compared to those of the SLActive® surface. Long-term follow-up should be performed to confirm these results.
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Affiliation(s)
- Fernando P. S. Guastaldi
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara, SP Brazil
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Thier Research Building, 50 Blossom St, Boston, MA 513A USA
| | - Thallita P. Queiroz
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Daniela O. Marques
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Anne B. S. Santos
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Rafael S. Molon
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara, SP Brazil
| | - Rogerio Margonar
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Antonio C. Guastaldi
- Department of Physical Chemistry, Institute of Chemistry, São Paulo State University (Unesp), Araraquara, SP Brazil
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A Systematic Study of Restorative Crown-Materials Combinations for Dental Implants: Characterization of Mechanical Properties under Dynamic Loads. Int J Mol Sci 2022; 23:ijms23158769. [PMID: 35955903 PMCID: PMC9369216 DOI: 10.3390/ijms23158769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/28/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to find the optimum mechanical characteristics of the restorative materials for the manufacture of implant crowns subjected to impact loading when different combinations of materials are used for the inner and outer crown. Several combinations of external–internal crown restorative materials were analyzed. The dynamic stresses at eight different zones of a dental implant subjected to an impact load and the influence of several mechanical properties, such as the Young’s modulus, Poisson’s ratio, density, and initial velocity, were analyzed and compared. A detailed 3D model was created, including the crown, the retention screw, the implant, and a mandible section. The model was then built by importing the 3D geometries from CAD software. The whole 3D model was carefully created in order to guarantee a finite element mesh that produced results adjusted to physical reality. Then, we conducted a numerical simulation using the finite element method (FEM). The results of the FEM analysis allowed for evaluating the effect that different combinations of restorative materials and mechanical properties had on the stress distribution in various regions of the implant. The choice of restorative material is a factor to be considered in order to preserve the integrity of osseointegration. Restorative materials transfer more or less stress to the dental implant and surrounding bone, depending on their stiffness. Therefore, an inadequate Young’s modulus of the rehabilitation material can affect the survival of the implant over time. Eight interactive graphics were provided on a web-based surface platform to help clinical dentists, researchers, and manufacturers to select the best restorative materials combination for the crown.
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Barbosa DF, Bana LF, Berzin F, Júnior AJM. Combined Therapy for Associated Orofacial Disorders-A Challenging Case Report. Eur J Dent 2022; 16:947-949. [PMID: 35820439 DOI: 10.1055/s-0042-1749365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Health promotion and disease prevention link intricately with lifestyle habits such as a healthy diet, physical activity, and good sleep quality. Temporomandibular joint (TMJ) dysfunction and associated disorders can take away sleep and well-being depending on the form and intensity that affect the individual. A multidisciplinary effort has contributed to significant health advances, improving clinical outcomes concerning TMJ dysfunction. This report presents the case of a 37-year-old Caucasian female physical educator with a good healthy diet with complaints of tooth tightening, constant TMJ and neck pain, and tinnitus. The patient was treated with inferior occlusal splint placement and selective occlusal adjustments based on neuro-occlusal rehabilitation. The patient reported relief of pain symptoms with occlusal and body balance, discontinued analgesic medication, and maintained the occlusal splint to practice sports and sleep due to the perception of improved physical performance and sleep, and quality of life. Based on this report, it is necessary to analyze the causes and define the effects of different disorders to establish their diagnosis and treatment and changing patterns to reestablish functional balance.
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Affiliation(s)
- Denise Fernandes Barbosa
- Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, São Paulo, Brazil
| | - Laura Fernandes Bana
- Department of Morphology, Dentistry School of Piracicaba, Piracicaba, São Paulo, Brazil
| | - Fausto Berzin
- Department of Morphology, Dentistry School of Piracicaba, Piracicaba, São Paulo, Brazil
| | - Almiro José Machado Júnior
- Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, São Paulo, Brazil
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Chiba FY, Chiba EK, Moimaz SAS, Matsushita DH, Garbin AJÍ, Garbin CAS. Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders. Dental Press J Orthod 2022; 27:e2220305. [PMID: 35703616 PMCID: PMC9191855 DOI: 10.1590/2177-6709.27.2.e2220305.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/10/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence and severity of malocclusion and its impact on oral health-related quality of life (OHRQoL) and self-reported satisfaction of patients with anorexia and bulimia nervosa. METHODS The sample consisted of sixty women who attended a specialized mental health clinic of a Brazilian medical school. Participants were distributed into two groups: patients with anorexia and bulimia nervosa (ABN; n=30) and control patients without eating disorders (CN; n=30). The dental occlusion was evaluated by the Dental Aesthetic Index; the OHRQoL was assessed using the OHIP-14 questionnaire; and the self-reported satisfaction with the appearance of teeth, speech ability and chewing was obtained by interviews. RESULTS Severe and very severe malocclusion were observed in 26.67% and 46.67% of patients in the ABN group, respectively, while the CN group showed 80.00% of patients without abnormality/mild malocclusion. ABN group showed a higher proportion of patients (p < 0.05) with tooth loss, spacing in the region of incisors, maxillary misalignment, and mandibular misalignment in relation to CN group. ABN group presented lower (p< 0.05) OHRQoL and self-reported satisfaction with the appearance of teeth, speech ability and chewing, compared to the CN group. There was a significant positive correlation (p< 0.05) between the Dental Aesthetic Index and OHIP-14 scores in the ABN group. CONCLUSIONS The prevalence of severe malocclusion in ABN group was high, with a negative impact on OHRQoL and self-reported satisfaction with the chewing ability, speech ability and appearance of teeth.
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Affiliation(s)
- Fernando Yamamoto Chiba
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Erika Kiyoko Chiba
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Suzely Adas Saliba Moimaz
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Doris Hissako Matsushita
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Artênio José Ísper Garbin
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Cléa Adas Saliba Garbin
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
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Gomes RR, Zeola LF, Barbosa TAQ, Fernandes Neto AJ, de Araujo Almeida G, Soares PV. Prevalence of non-carious cervical lesions and orthodontic treatment: a retrospective study. Prog Orthod 2022; 23:17. [PMID: 35570252 PMCID: PMC9108122 DOI: 10.1186/s40510-022-00409-4] [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: 12/15/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to assess the distribution of non-carious cervical lesions (NCCLs) by tooth type, investigate the prevalence of NCCLs in patients undergoing orthodontic treatment, and identify the possible associated factors. Material and methods A total of 160 patients were enrolled in this retrospective study. Data on the following variables were collected from pre-and post-orthodontic treatment records: age, sex, Angle’s malocclusion, facial pattern, number of activation sessions, compensatory treatment, and retreatment. Frontal, right and left lateral intraoral photographs of each patient were evaluated to identify the presence or absence of NCCLs in each tooth and assess the distribution of NCCLs in the 3840 teeth from the enrolled patients. Furthermore, patients were classified as NCCLs present, irrespective of the number of NCCLs on the teeth or NCCL absent. Bivariate and multivariate Poisson regression analyses with robust variance were used to assess the association between the NCCLs and each independent variable. Prevalence ratio and 95% confidence intervals were calculated and p < 0.05 was considered statistically significant. Results The prevalence of NCCLs before and after orthodontic treatment was 22.71% and 30.91%, respectively. Premolars were the most affected teeth, followed by the first molars, canines, and incisors. After statistical analysis, age was found to be the variable factor that influenced the prevalence ratio, with NCCL being the most prevalent when orthodontic treatment was performed in adulthood. Conclusions Premolars were most commonly affected by NCCLs. Furthermore, age seemed to contribute to the increased prevalence of NCCLs in adults undergoing orthodontic treatment.
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Hinz S, Bensel T, Bömicke W, Henningsen A, Rudolph J, Boeckler AF. Impact of the Veneering Technique and Framework Material on the Failure Loads of All-Ceramic Computer-Aided Design/Computer-Aided Manufacturing Fixed Partial Dentures. MATERIALS 2022; 15:ma15030756. [PMID: 35160701 PMCID: PMC8836578 DOI: 10.3390/ma15030756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 02/04/2023]
Abstract
Objectives: Zirconia (Y-TZP) ceramics are considered as posterior fixed partial denture (FPD) materials; however, their applications are limited due to chipping. The use of monolithic lithium disilicate (LiDi) glass ceramics in posterior FPDs can be advantageous. This in vitro study aims to compare the loads until failure of posterior Y-TZP-FPDs and LiDi-FPDs before and after aging.
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Affiliation(s)
- Sebastian Hinz
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Tobias Bensel
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Judith Rudolph
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
| | - Arne F. Boeckler
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
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Greenbaum T, Pitance L, Kedem R, Emodi-Perlman A. The mouth-opening muscular performance in adults with and without temporomandibular disorders: A systematic review. J Oral Rehabil 2022; 49:476-494. [PMID: 35020217 PMCID: PMC9303535 DOI: 10.1111/joor.13303] [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: 08/14/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
Background The mouth‐opening muscular performance in patients with temporomandibular disorders (TMDs) is unclear. Understanding the impairments of this muscle group within specific TMDs is important to develop proper management strategies. Objective To characterise the mouth‐opening muscular performance in adults with and without TMDs. Methods PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane databases were searched from inception to 12 November 2020. Bibliographies were searched for additional articles, including grey literature. Case‐control, cross‐sectional and interventional studies reporting mouth‐opening muscular strength and/or endurance were included. Risk of bias was assessed by the SIGN checklist for case‐control studies and by the NIH quality assessment tool for cross‐sectional studies. Results were pooled with a random‐effects model. Confidence in cumulative evidence was determined by means of the GRADE guidelines. Results Fourteen studies were included; most were rated as having a moderate risk of bias. Only three studies assessed patients with TMDs and the other 11 assessed healthy adults. Significant sex differences in muscular performance were found for healthy adults in the review (strength deficit for females versus males). There was a significant reduction in maximal mouth opening performance (strength and endurance) in the three studies that assessed patients with temporomandibular disorders. Conclusion Sex plays a significant role in maximal mouth opening strength. There is a lack of reliable data on the normal mouth‐opening strength and endurance of healthy adults as well as for patients with TMDs. Implications Lack of reliable TMDs patient data and comparable healthy adult data highlight future direction for research.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Neuro-Musculo-Skeletal-Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Ron Kedem
- Academic Branch, Medical Corps, IDF, Tel Aviv, Israel
| | - Alona Emodi-Perlman
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Fu Y, Zhang L, Gao Y, Huang D. A comparison of volume of tissue removed and biomechanical analysis of different access cavity designs in two-rooted mandibular first molars: a multi-sample three-dimensional finite element analysis. J Endod 2021; 48:362-369. [PMID: 34953797 DOI: 10.1016/j.joen.2021.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/02/2021] [Accepted: 12/14/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The aim of this study was to compare the biomechanical properties and the amount of coronal tissue removed among the different access cavities with a multi-sample three-dimensional finite element analysis in mandibular first molar. The correlation between the amount of tissue removed and the fracture resistance of the teeth was also analysed. METHODS Micro-CT data from 20 two-rooted mandibular first molars were included in this study as three-dimensional modelling prototypes. The models of untreated molars and molars treated with the Traditional Access Cavity (TradAC), the Conservative Access Cavity (ConsAC) and the straight-line minimally invasive endodontic access cavities (SMIAC) were created. Each model was loaded in 3 ways to simulate the functional conditions of occlusion. The amount of tissue removed and the maximum stress in the cervical region were recorded and analysed, and the correlation between them was also analysed. RESULTS The amount of coronal tissue and peri-cervical dentin (PCD) removed in SMIAC and ConsAC was less than that of TradAC. The mean maximum stress in the cervical region was significantly smaller in SMIAC and ConsAC than in TradAC. The amount of hard tissue and PCD loss was positively correlated with the maximum stress in the cervical region of the tooth. CONCLUSIONS In mandibular first molars, it could be beneficial to improve the fracture resistance of the tooth after endodontic treatment by the minimally invasive access cavity to reduce the loss of coronal tooth tissue and PCD. The SMIAC may be an option balancing biomechanical properties and clinical convenience.
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Affiliation(s)
- Yujie Fu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Modeling the Contact Interaction of a Pair of Antagonist Teeth through Individual Protective Mouthguards of Different Geometric Configuration. MATERIALS 2021; 14:ma14237331. [PMID: 34885485 PMCID: PMC8658410 DOI: 10.3390/ma14237331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 12/03/2022]
Abstract
This study carried out modeling of the contact between a pair of antagonist teeth with/without individual mouthguards with different geometric configurations. Comparisons of the stress–strain state of teeth interacting through a multilayer mouthguard EVA and multilayer mouthguards with an A-silicon interlayer were performed. The influence of the intermediate layer geometry of A-silicone in a multilayer mouthguard with an A-silicon interlayer on the stress–strain state of the human dentition was considered. The teeth geometry was obtained by computed tomography data and patient dental impressions. The contact 2D problem had a constant thickness, frictional contact deformation, and large deformations in the mouthguard. The strain–stress analysis of the biomechanical model was performed by elastoplastic stress–strain theory. Four geometric configurations of the mouthguard were considered within a wide range of functional loads varied from 50 to 300 N. The stress–strain distributions in a teeth pair during contact interaction at different levels of the physiological loads were obtained. The dependences of the maximum level of stress intensity and the plastic deformation intensity were established, and the contact parameters near the occlusion zone were considered. It was found that when using a multilayer mouthguard with an A-silicone interlayer, there is a significant decrease in the stress intensity level in the hard tissues of the teeth, more than eight and four times for the teeth of the upper and lower teeth, respectively.
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Bone Stress Evaluation with and without Cortical Bone Using Several Dental Restorative Materials Subjected to Impact Load: A Fully 3D Transient Finite-Element Study. MATERIALS 2021; 14:ma14195801. [PMID: 34640200 PMCID: PMC8510134 DOI: 10.3390/ma14195801] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/18/2021] [Accepted: 10/01/2021] [Indexed: 12/14/2022]
Abstract
Statement of problem. Previous peri-implantitis, peri-implant bone regeneration, or immediate implant placement postextraction may be responsible for the absence of cortical bone. Single crown materials are then relevant when dynamic forces are transferred into bone tissue and, therefore, the presence (or absence) of cortical bone can affect the long-term survival of the implant. Purpose: the purpose of this study is to assess the biomechanical response of dental rehabilitation when selecting different crown materials in models with and without cortical bone. Methods: several crown materials were considered for modeling six types of crown rehabilitation: full metal (MET), metal-ceramic (MCER), metal-composite (MCOM), peek-composite (PKCOM), carbon fiber-composite (FCOM), and carbon fiber-ceramic (FCCER). An impact-load dynamic finite-element analysis was carried out on all the 3D models of crowns mentioned above to assess their mechanical behavior against dynamic excitation. Implant-crown rehabilitation models with and without cortical bone were analyzed to compare how the load-impact actions affect both type of models. Results: numerical simulation results showed important differences in bone tissue stresses. The results show that flexible restorative materials reduce the stress on the bone and would be especially recommendable in the absence of cortical bone. Conclusions: this study demonstrated that more stress is transferred to the bone when stiffer materials (metal and/or ceramic) are used in implant supported rehabilitations; conversely, more flexible materials transfer less stress to the implant connection. Also, in implant-supported rehabilitations, more stress is transferred to the bone by dynamic forces when cortical bone is absent.
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Duanmu Z, Liu L, Deng Q, Ren Y, Wang M. Development of a biomechanical model for dynamic occlusal stress analysis. Int J Oral Sci 2021; 13:29. [PMID: 34493701 PMCID: PMC8423745 DOI: 10.1038/s41368-021-00133-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/06/2021] [Indexed: 02/08/2023] Open
Abstract
The use of traditional finite element method (FEM) in occlusal stress analysis is limited due to the complexity of musculature simulation. The present purpose was to develop a displacement boundary condition (DBC)-FEM, which evaded the muscle factor, to predict the dynamic occlusal stress. The geometry of the DBC-FEM was developed based on the scanned plastic casts obtained from a volunteer. The electrognathographic and video recorded jaw positional messages were adopted to analyze the dynamic occlusal stress. The volunteer exhibited asymmetrical lateral movements, so that the occlusal stress was further analyzed by using the parameters obtained from the right-side eccentric movement, which was 6.9 mm long, in the stress task of the left-side eccentric movement, which was 4.1 mm long. Further, virtual occlusion modification was performed by using the carving tool software aiming to improve the occlusal morphology at the loading sites. T-Scan Occlusal System was used as a control of the in vivo detection for the location and strength of the occlusal contacts. Data obtained from the calculation using the present developed DBC-FEM indicated that the stress distribution on the dental surface changed dynamically with the occlusal contacts. Consistent with the T-Scan recordings, the right-side molars always showed contacts and higher levels of stress. Replacing the left-side eccentric movement trace by the right-side one enhanced the simulated stress on the right-side molars while modification of the right-side molars reduced the simulated stress. The present DBC-FEM offers a creative approach for pragmatic occlusion stress prediction.
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Affiliation(s)
- Zheng Duanmu
- grid.443248.d0000 0004 0467 2584Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
| | - Lu Liu
- grid.233520.50000 0004 1761 4404Department of Oral Anatomy and Physiology and TMD, School of Stomatology, Air Force Medical University, Xi’an, China
| | - Qi Deng
- grid.233520.50000 0004 1761 4404Department of Oral Anatomy and Physiology and TMD, School of Stomatology, Air Force Medical University, Xi’an, China
| | - Yuanyuan Ren
- grid.233520.50000 0004 1761 4404Department of Oral Anatomy and Physiology and TMD, School of Stomatology, Air Force Medical University, Xi’an, China
| | - Meiqing Wang
- grid.233520.50000 0004 1761 4404Department of Oral Anatomy and Physiology and TMD, School of Stomatology, Air Force Medical University, Xi’an, China
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Srinivasan R, Chander NG, Reddy JR, Balasubramanian M. Differences in quality of life and patient satisfaction between complete denture occlusion schemes: A parallel randomized control trial. J Prosthet Dent 2021; 129:748-753. [PMID: 34429196 DOI: 10.1016/j.prosdent.2021.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Bilateral balanced occlusion has been advocated over nonbalanced occlusion for improved removable complete denture stability and function. However, assessments of quality of life and patient satisfaction studies between the 2 occlusion schemes are lacking. PURPOSE The objective of this parallel randomized control trial was to determine the difference in quality of life and patient satisfaction between the nonbalanced and bilaterally balanced occlusal schemes. MATERIAL AND METHODS Sixty participants were included in the parallel randomized control trial of nonbalanced and bilaterally balanced complete dentures. Thirty were recruited into each group with definitive inclusion and exclusion criteria as per the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Quality of life was estimated from the oral health quality of life (Oral Health Impact profile) for edentulous patients questionnaire, and patient satisfaction was analyzed from a visual analog scale. The estimation was made at 0, 3, and 6 months after denture insertion. The data were statistically analyzed with the Friedman, Mann-Whitney, and t test (α=.05). RESULTS The mean ±standard deviation Oral Health Impact profile score was 60.81 ±8.87 for nonbalanced dentures and 64.12 ±8.98 for bilaterally balanced dentures. The mean ±standard deviation visual analog scale score was 2.84 ±0.28 for nonbalanced dentures and 2.90 ±0.31 for bilaterally balanced dentures. The Mann-Whitney and t test indicated nonsignificant differences between the 2 groups and at different time intervals for Oral Health Impact profile and visual analog scale scores (P>.05). CONCLUSIONS The study detected no significant differences between the 2 occlusal schemes in quality of life or patient satisfaction.
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Affiliation(s)
- Ramya Srinivasan
- Post Graduate student, Department of Prosthodontics, Sri Ramaswami Memorial Dental College, Chennai, India
| | - Naveen Gopi Chander
- Professor, Department of Prosthodontics, Sri Ramaswami Memorial Dental College, Chennai, India.
| | - Jetti Ramesh Reddy
- Reader, Department of Prosthodontics, Sri Ramaswami Memorial Dental College, Chennai, India
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Comparative Evaluation of Occlusion before and after Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126568. [PMID: 34207403 PMCID: PMC8296451 DOI: 10.3390/ijerph18126568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023]
Abstract
The aim of the study was to evaluate occlusal parameters in patients with myofascial pain with referral before and after soft tissue mobilization. The study group consisted of 50 people (37 females and 13 males, average age 23.36 ± 2.14 years) diagnosed with myofascial pain with referral. All patients underwent triplicate soft tissue mobilization. Occlusal parameters were evaluated six times, before and after each treatment, using T-scan III. A decreasing tendency of the occlusion time was observed after the first, second, and third therapy. After the third treatment, the mean occlusion time in the entire study group was 0.119 s. The 1st soft tissue mobilization shortened both right and left disclusion times to 0.181 s and 0.185 s, respectively. After the third treatment, these parameters amounted to 0.159 s and 0.165 s, respectively. The Friedman test for the entire study group indicated that soft tissue mobilization altered the occlusion time and both disclusion times (p < 0.05). In conclusion, soft tissue mobilization affects biotensegrity of the masticatory system, thus modifying occlusal parameters. The occlusion time and both disclusion times cannot be considered as cofactors of the existing temporomandibular disorders-myofascial pain with referral.
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Walton TR, Layton DM. Mediotrusive Occlusal Contacts: Best Evidence Consensus Statement. J Prosthodont 2021; 30:43-51. [PMID: 33783093 DOI: 10.1111/jopr.13328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The impact of mediotrusive (MT) occlusal contacts has been a topic of controversy and confusion in both clinical practice and in the dental literature. The purpose of this Best Evidence Consensus Statement was to explore whether MT interferences are harmful in the natural or therapeutic occlusion directed by 4 focus questions relating to prevalence, jaw function, jaw dysfunction and biomechanical models. MATERIALS AND METHODS An electronic search in October 2020 sought evidence in MEDLINE (Ovid) using (mediotrus* OR nonworking side OR nonworking contact OR balancing side OR interfer* side OR premature contact) in the multipurpose (.mp) search field; and in Google Scholar using permutations of the above. Supplementary articles were sourced from the associated reference lists. There was no language restriction. The search yield was reviewed in duplicate. RESULTS The electronic search identified 420 articles. Following screening, 164 were selected for eligibility assessments. Of these, 47 were included in the current paper. CONCLUSIONS Non-standardized nomenclature and methodology is used to identify MT interferences in patient populations, with resultant prevalence varying from 0% to 77%, (median = 16%). MT interferences may alter the biomechanics of mandibular function. Together with the presence of repeated high loads resultant strain can manifest as pathophysiology of the temporomandibular joint and associated muscle structures. MT interferences should be avoided in any therapeutic occlusal scheme to minimize pulpal, periodontal, structural and mechanical complications or exacerbation of temporomandibular disorders (TMDs). Naturally occurring molar MT interferences should be eliminated only if signs and symptoms of TMDs are present. Literature supports there being a biomechanical basis which can explain how MT interferences may affect temporomandibular joint morphology and jaw function.
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Affiliation(s)
- Terry R Walton
- School of Dentistry, Faculty of Medical Sciences, University of Sydney, & Specialist private practice, Sydney, New South Wales, Australia
| | - Danielle M Layton
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, & Specialist private practice, St Lucia, Queensland, Australia
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Bozyel D, Taşar Faruk S. Biomechanical Behavior of All-on-4 and M-4 Configurations in an Atrophic Maxilla: A 3D Finite Element Method. Med Sci Monit 2021; 27:e929908. [PMID: 33774647 PMCID: PMC8015646 DOI: 10.12659/msm.929908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In edentulous patients, the concept of 4 implants with early loading has been widely used in clinical settings. In the case of bone atrophy in the anterior maxilla, using short implants or an angulated implant may be a good choice for treatment. The occlusal scheme remains a key aspect of All-on-4. The aim of this study was to use the 3-dimensional (3D) finite element method (FEM) to evaluate how different All-on-4 designs for canine-guided and group function occlusion affected the distribution of stress in the atrophic premaxilla. MATERIAL AND METHODS A 3D edentulous maxilla model was created and in 3D FEM, 3 different configurations - M4, All-on-4, and short implant - were modeled by changing the anterior implants and using 2 different occlusal schemes. For each model, the occlusal load was applied to simulate lateral movements. For cortical bone, the maximum and minimum principal stress values were generated, and for ductile materials, von Mises stress values were obtained. RESULTS No significant differences were detected among the models; generally, however, the highest stress values were observed in the M-4 model and the models with short implants. Slightly higher stress values were observed in the group function occlusion group than in the canine-guided occlusion group. CONCLUSIONS To promote better primary stabilization, M-4 or short implant configurations with canine-guided occlusion appear to be preferable for patients who have severe atrophy in the anterior maxilla.
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Affiliation(s)
- Delal Bozyel
- Department of Prosthodontics, Near East University, Nicosia, Cyprus
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Kochi I, Takei E, Maeda R, Ito K, Magara J, Tsujimura T, Kulvanich S, Inoue M. Changes of bolus properties and the triggering of swallowing in healthy humans. J Oral Rehabil 2021; 48:592-600. [PMID: 33481324 DOI: 10.1111/joor.13151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
There is wide variation in chewing behaviours, even among healthy humans. Further, the way in which humans determine swallowing initiation when chewing solid foods remains unclear. The current study sought to investigate how the bolus properties change over time during chewing, and to clarify which factors affect chewing and swallowing behaviours, including swallowing initiation, in healthy humans. Twenty-four healthy volunteers were instructed to chew 8 g of steamed rice and spit it out at 50%, 100% and 150% of their own chewing duration, defined as the time of chewing from onset of the first chewing cycle to onset of the first swallow. Chewing and swallowing behaviours were monitored and determined by visual inspection of video recordings. The physical properties such as hardness, cohesiveness and adhesiveness as well as water content of the bolus were measured. In each subject, maximum bite force, tongue pressure and stimulated salivary flow rate were also measured. Hardness gradually decreased, and the cohesiveness and water content of the bolus did not change up to 50% of chewing duration, followed by a slight but significant increase. The adhesiveness of the bolus rapidly decreased at the beginning of chewing. Chewing duration was significantly related to stimulated salivary flow rate; greater salivary flow rate was associated with shorter chewing duration. Variation of chewing duration and swallowing initiation was not dependent on bolus properties during the chewing of steamed rice, but mainly depended on the surface lubrication of the bolus.
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Affiliation(s)
- Izumi Kochi
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Eri Takei
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Rumiko Maeda
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Rehabilitation, Faculty of Health Science, Kansai University of Welfare Sciences, Osaka, Japan
| | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sirima Kulvanich
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Mastrogianni A, Lioliou EA, Tortopidis D, Gogos C, Kontonasaki E, Koidis P. Fracture strength of endodontically treated premolars restored with different post systems and metal-ceramic or monolithic zirconia crowns. Dent Mater J 2021; 40:606-614. [PMID: 33456031 DOI: 10.4012/dmj.2020-223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to investigate the fracture strength of endodontically treated human maxillary premolars (ETP) restored with posts and metal ceramic (MC) or monolithic zirconia (MZ) crowns. Sixty ETP were randomly divided into 3 groups. Teeth in control group (C) received a resin filling. ETP in the MC group were restored with prefabricated metal posts, composite cores and MC crowns while in the MZ group with glass-fiber posts, composite cores and MZ crowns. Half of the specimens were loaded at a 135° angle and half under axial loading until fracture. The fracture modes were divided in repairable and irreparable using optical microscopy. Mean fracture strength was significantly higher for MC than for MZ crowns and control group only under axial loading. The distribution of repairable and irreparable failures presented no significant differences. Crown placement significantly improved the fracture strength of ETP irrespectively of post and crown type.
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Affiliation(s)
- Anna Mastrogianni
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Evdokia-Anna Lioliou
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Dimitrios Tortopidis
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Christos Gogos
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki
| | - Eleana Kontonasaki
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Petros Koidis
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
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Goodacre CJ, Roberts WE, Goldstein G, Wiens JP. Does the Stomatognathic System Adapt to Changes in Occlusion? Best Evidence Consensus Statement. J Prosthodont 2020; 30:5-11. [PMID: 33350537 DOI: 10.1111/jopr.13310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The purpose of this Best Evidence Consensus Statement was to evaluate the existing literature on the stomatognathic system's ability to adapt to occlusal changes. MATERIALS AND METHODS The search term stomatognathic system was not useful as it resulted in over 400,000 results nor was the search term temporomandibular joint adaptation with 738 results due to the large number of references not related to the topic. The terms stomatognathic system adaptation to occlusal changes (186 results), teeth flexion (139 results), muscle adaptation to dental occlusion (278 results), and occlusal changes and neuroplasticity (11 results) provided the best selection of articles related to the topic. Limiting the above searches to systematic reviews and randomized controlled clinical trials resulted in multiple publications that were related to the question.9-13 Other literature reviews, data-based publications, and expert opinion resources have been included due to their relationship to the question. RESULTS From the extensive list of search results, 242 articles were determined to be potentially related to the focus question and were evaluated with 56 being included in this paper. It was determined that the stomatognathic system adapts to occlusal changes through the temporomandibular joint, muscles, teeth and bone. The dynamically modified periosteum on the articulator surfaces of the condyle and fossa has a unique load-bearing morphology with 3 subarticular layers of fibrocartilage that absorb and dissipate both peak (impact) and sustained loads. Adaptability of the TMJs and muscles can be documented through studies where artificially produced occlusal interferences were placed in patients and those study participants with normal temporomandibular joints (TMJs) adapted fairly well whereas those with a previous history of temporomandibular disorders (TMD) did not adapt as well. CONCLUSIONS Available evidence indicates patients generally adapt to the occlusal change inherent in orthodontic treatment, mandibular advancement surgery, and the use of mandibular advancement devices. The head and neck muscles also adapt to occlusal changes in patients without a history of TMD. The dentition adapts to changes through the bone and periodontal ligaments as well as the ability of teeth to undergo slight flexion under masticatory loading. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Charles J Goodacre
- Distinguished Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
| | - W Eugene Roberts
- Professor Emeritus of Orthodontics, Adjunct Professor, Mechanical Engineering, Indiana University & Purdue University, Indianapolis, IN
| | | | - Jonathan P Wiens
- Adjunct Clinical Professor, Department of Restorative Dentistry, University of Detroit Mercy School of Dentistry, Detroit, Michigan
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Koper DC, Leung CAW, Smeets LCP, Laeven PFJ, Tuijthof GJM, Kessler PAWH. Topology optimization of a mandibular reconstruction plate and biomechanical validation. J Mech Behav Biomed Mater 2020; 113:104157. [PMID: 33187871 DOI: 10.1016/j.jmbbm.2020.104157] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Reconstruction plates, used to bridge segmental defects of the mandible after tumor resection or traumatic bone tissue loss, are subjected to repeated stresses of mastication. High stress concentrations in these plates can result in hardware failure. Topology optimization (TO) could reduce the peak stress by computing the most optimal material distribution in a patient-specific implant (PSI) used for mandibular reconstruction. The objective of this study was biomechanical validation of a TO-PSI. METHODS A computer-aided design (CAD) model with a segmental defect was created based on the geometry of a polyurethane mandible model. A standard-PSI was designed to bridge the defect. A TO-PSI was then designed with a maximum stress equal to the ultimate tensile stress of Ti6Al4V (930 MPa) during a loading condition of 378 N. Finite element analysis (FEA) was used to analyze stresses in both PSI designs during loading. The standard-PSI and TO-PSI designs were produced in triplicate by selective laser melting of Ti6Al4V, fixated to polyurethane mandible models with segmental defects identical to the CAD model, and subsequently subjected to continuous compression with a speed of 1 mm/min on a universal testing machine, while recording the load. Peak loads before failure in the TO-PSI group within a 30% range of the predicted peak load (378 N) were considered a successful biomechanical validation. RESULTS Fracture of the TO-PSI occurred at a median peak load of 334 N (range 304-336 N). These values are within the 30% range of the predicted peak load. Fracture of the mandible model in the standard-PSI group occurred at a median peak load of 1100 N (range 1010-1460 N). Failure locations during biomechanical testing of TO-PSI and standard-PSI samples corresponded to regions in the FEA where stresses exceeded the ultimate tensile strength of titanium and polyurethane, respectively. CONCLUSION This study demonstrates a successful preliminary biomechanical validation of TO in the design process for mandibular reconstruction plates. Further work is needed to refine the finite element model, which is necessary to ultimately design TO-PSIs for clinical use.
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Affiliation(s)
- David C Koper
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands; Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Carine A W Leung
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands
| | - Lars C P Smeets
- Department of Instrument Design, Engineering and Evaluation, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Paul F J Laeven
- Department of Instrument Design, Engineering and Evaluation, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Gabriëlle J M Tuijthof
- Department of Instrument Design, Engineering and Evaluation, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Peter A W H Kessler
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands
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Ågren M, Sahin C, Pettersson M. The effect of botulinum toxin injections on bruxism: A systematic review. J Oral Rehabil 2019; 47:395-402. [PMID: 31769044 DOI: 10.1111/joor.12914] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/31/2019] [Accepted: 11/20/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To systematize evidence on the efficacy of botulinum toxin type A (BTA) in the treatment of bruxism measured through bite force or electromyography (EMG) at the masseter muscle. METHOD Identification of relevant articles through databases PubMed, Web of Science, SCOPUS, Ovid and EBSCO and manual search were performed for sources from review articles. Studies scoring less than 3 on the Jadad Scale were excluded. RESULTS Four articles were included after an exclusion of 333 articles. 3 articles measured EMG and 1 bite force. 1 article did not record a significant drop of activity, 1 article recorded reduction midway and at final endpoint. 2 articles recorded initial reduction, but a non significant difference at later follow up. CONCLUSION The available research is inconclusive and does not show enough evidence that bruxism can be treated with BTA injections. However, promising results have been shown in individual studies and further research in this area is needed.
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Affiliation(s)
- Martin Ågren
- Prosthodontic specialist clinic, Region Västerbotten, Umeå, Sweden
| | - Christofer Sahin
- Department of Dermatology and Venerology, Linköping university hospital and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Mattias Pettersson
- Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
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Mandibular prognathism attenuates brain blood flow induced by chewing. Sci Rep 2019; 9:19104. [PMID: 31836754 PMCID: PMC6911081 DOI: 10.1038/s41598-019-55553-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 11/28/2019] [Indexed: 11/30/2022] Open
Abstract
Mastication is closely related to brain function. Animal experiments have revealed that tooth loss has a negative influence on brain function. Clinical studies also suggest that normal occlusion is an essential factor for favorable brain function. Mandibular prognathism (MP) usually results in occlusal dysfunction. However, the relationship between MP and brain function remains unclear. In the present study, we examined the relationship between MP and brain function by measuring brain blood flow (BBF). Seventeen subjects with normal occlusion (NORM) and 25 patients with MP participated in this study. The number of occlusal contacts were counted. Electromyography of the masseter muscles during clenching was also recorded. BBF was measured with non-invasive functional near-infrared spectroscopy during calculation task and chewing task. The number of the occlusal contacts and masseter muscle activity were lower in MP compared with NORM. The calculation task increased BBF in both groups. The chewing task also increased BBF in the inferior frontal gyrus in both groups, although the increase in MP was smaller than in NORM. We discovered that patients with MP exhibited a smaller increase in BBF at the inferior frontal gyrus during chewing as compared with NORM. As such, MP would negatively affect brain function.
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Rohr N, Balmer M, Müller JA, Märtin S, Fischer J. Chewing simulation of zirconia implant supported restorations. J Prosthodont Res 2019; 63:361-367. [DOI: 10.1016/j.jpor.2019.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/01/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022]
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Del Vecchio A, Floravanti M, Boccassini A, Gaimari G, Vestri A, Di Paolo C, Romeo U. Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related pain: A randomized, double-blind, placebo-controlled clinical trial. Cranio 2019; 39:141-150. [PMID: 30999823 DOI: 10.1080/08869634.2019.1599174] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: This study analyzed a home, low-level laser therapy (LLLT) protocol to manage temporomandibular joint disorders (TMJDs)-related pain.Methods: Ninety TMJD patients (12M, 78F) between 18 and 73 years were randomly subdivided into three groups. Study group (SG) received 1-week home protocol LLLT by B-cure Dental Pro: 808 nm, 5 J/min, 250 mW, 15 KHz for 8', 40 J each, over pain area, twice daily. Placebo group (PG) followed the same protocol using sham devices. Drugs group (DG) received conventional drugs. Pain was evaluated by visual analog scale (VAS) before and after therapy.Results: Statistical analysis showed that treatment was effective (F(2,83) = 4.882; p = .010). Bonferroni post-hoc analysis indicated a lower pain decrease in PG. SG registered a 34-point decrease per patient, while in PG and DG, the reduction was 25.6 and 35.3, respectively.Conclusion: The study supports the efficacy of home LLLT management of TMJD related pain.
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Affiliation(s)
- Alessandro Del Vecchio
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Miriam Floravanti
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Armando Boccassini
- Department of TMJ Dysfunction, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Gianfranco Gaimari
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Policlinic Umberto I Rome, Rome, Italy
| | - Carlo Di Paolo
- Department of TMJ Dysfunction, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Umberto Romeo
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
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Osiewicz MA, Werner A, Roeters FJM, Kleverlaan CJ. Wear of direct resin composites and teeth: considerations for oral rehabilitation. Eur J Oral Sci 2019; 127:156-161. [DOI: 10.1111/eos.12600] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Magdalena A. Osiewicz
- Department of Integrated Dentistry; Jagiellonian University; Krakow Poland
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
| | - Arie Werner
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
| | - Franciscus J. M. Roeters
- Department of Comprehensive Dentistry; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
| | - Cornelis J. Kleverlaan
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
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48
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Metallic crown-induced occlusal trauma as a protocol to evaluate inflammatory response in temporomandibular joint and periodontal tissues of rats. Clin Oral Investig 2018; 23:1905-1912. [DOI: 10.1007/s00784-018-2639-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/11/2018] [Indexed: 02/07/2023]
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49
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Moradpoor H, Salari F, Ebadian B, Raissi S, Shirani M. Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (Part II). J Oral Rehabil 2018; 45:702-709. [PMID: 29851120 DOI: 10.1111/joor.12660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 10/14/2022]
Abstract
The occlusion of choice is a controversial topic in conventional complete denture (CCD) treatment. This study aimed to compare patient satisfaction with CCD with partially group-function occlusion (PGFO), fully bilateral balanced occlusion (FBBO), buccalised occlusion (BO), lingualised occlusion (LO) and the entire balanced group. Participants received new CCDs with PGFO. All steps of patient enrolment, denture fabrication, assessments during the follow-up period and data collection were carried out exactly the same as part 1 of this research project. All patients were recalled at 1 and 3 months after delivery for data collection using the shortened version of oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire and 7 visual analog scales (VASs) for the quality of CCD based on general patient satisfaction, masticatory function, ability to speak, comfort, stability, retention and aesthetics. Data were analysed using the Wilcoxon signed-rank test, the Kruskal-Wallis test and Mann-Whitney test via SPSS version 18.0 (α = 0.05). Thirty participants completed the follow-up period for PGFO group. The mean age ± standard deviation of the new participants was 57.97 ± 6.93 years. Participants reported significantly less satisfaction in terms of comfort, stability and retention of denture with PGFO compared to balanced groups. Also, using OHIP-EDENT questionnaire, significantly higher physical pain score was noted for PGFO group compared to BO and LO. Higher physical disability score was noted in PGFO compared to LO. Participants receiving CCDs with PGFO reported lower satisfaction in terms of comfort, stability and retention of denture and higher physical pain and physical disability than the balanced occlusal schemes.
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Affiliation(s)
- H Moradpoor
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - F Salari
- Dental Students' Research Committee, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - B Ebadian
- Dental Implants Research Center, Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - S Raissi
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - M Shirani
- Prosthodontics, Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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50
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van de Rijt LJM, Weijenberg RAF, Feast AR, Vickerstaff V, Lobbezoo F, Sampson EL. Oral health and orofacial pain in people with dementia admitted to acute hospital wards: observational cohort study. BMC Geriatr 2018; 18:121. [PMID: 29792172 PMCID: PMC5966900 DOI: 10.1186/s12877-018-0810-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/07/2018] [Indexed: 11/14/2022] Open
Abstract
Background Orofacial pain in people with dementia is difficult to detect, and often under-treated. Our aim was to investigate the prevalence of orofacial pain in people with dementia in acute hospitals in the UK. Secondary aims were to examine oral health status and explore associations between orofacial pain and oral health factors. Methods This cross-sectional observational study was carried out in two UK hospitals. Using the Orofacial Pain Scale in Non-Verbal Individuals (OPS-NVI) to identify orofacial pain, 101 participants with dementia, admitted to acute medical wards, were observed for at least 3 min during rest and chewing. Verbal participants were then asked about presence of orofacial pain, using self-report pain scales. Finally, a brief oral assessment was performed. Results Orofacial pain, assessed with the OPS-NVI, was present in 11.9% (95% C.I. 5.9, 18.8) of participants at rest and 21.9% (95% C.I. 14.6, 31.3) whilst chewing. Participants who were no longer able to self-report pain were significantly more likely to experience orofacial pain. Oral health in both dentate and edentate participants was poor. Brush frequency, indication of chewing quality, consistency of the food, presence of extra-oral abnormalities, person who performed mouth care, and oral hygiene in dentate participants were significant predictors for the presence of orofacial pain. Conclusion Improving oral care in acute hospital patients with dementia, particularly those who cannot self-report pain, may significantly reduce pain and suffering in this population. Electronic supplementary material The online version of this article (10.1186/s12877-018-0810-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liza J M van de Rijt
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Roxane A F Weijenberg
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alexandra R Feast
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.,The Research Department of Primary Care and Population Health, University College London, London, UK
| | - Frank Lobbezoo
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.,Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
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