The effect of disocclusion time-reduction therapy to treat chronic myofascial pain: A single group interventional study with 3 year follow-up of 100 cases

An observational analysis to evaluate the influence of occlusion on body posture and plantar pressure - An in vivo study

AIM

The aim of this study is to evaluate the influence of occlusion on body posture and plantar arch pressure.

SETTINGS AND DESIGN

An Observational analysis to Analyze the Influence of Occlusion on Plantar Pressure and Body Posture.

MATERIALS AND METHODS

A total of 30 asymptomatic subjects were selected for the study including 18 females and 12 males from age group 22 years to 28 years with a mean age of 24.83 years. Each subject underwent evaluation of occlusion at MIP using a Digital Occlusal analyzer (T-Scan III). At this point, the subjects were made to stand on a mat scan which consisted of a large postural platform sensor and a computer that displayed the plantar pressure data. The computer connected to the T Scan displayed the occlusal pressure analysis. This was followed by an evaluation of body posture using a posture grid where the photographs were taken and an evaluation of the frontal and lateral photos was done using the APECS - posture analysis app.

STATISTICAL ANALYSIS USED

Statistical package for social sciences (SPSS) for windows version 22.0 Released 2013, Armonk, N Y: IBM Corp., was used to perform Statistical Analysis. A chi-square test was applied for qualitative variables to find the association. Paired t-test was applied to compare the changes in the quantitative parameters in eye-open and eye-closed conditions. The level of significance was set at 5%.

RESULTS

As observed from the results, occlusion for 40% of the subjects, where n = 12, was dominant on the right side. Occlusion for 23.3% of subjects, where n = 7, was dominant on the left side. Whereas, for 36.7% of subjects, where n = 11, the pressure distribution was almost equal on both sides. The inclination of body posture for 23.3% of subjects, where n = 7, was towards the right side. The inclination of body posture for 50% of subjects, where n = 11, was towards the left side. And, the inclination of body posture for 26.7% of subjects, where n = 8, was neutral i.e., balanced on the right and left side. Plantar pressure for 6.7% of subjects, where n = 2, was dominant on the right side. Plantar pressure for 36.7% of subjects, where n = 11, was dominant on the left side. Whereas, for 56.7% of subjects, where n = 17, the plantar pressure distribution was almost equal on both sides.

CONCLUSION

On correlating the three parameters, it was found that occlusion for most of the subjects dominated on the right side, while body posture and plantar pressure dominated on the contralateral i.e., left side.

Influence of disclusion time reduction on changes in posterior implant prosthesis occlusion and its association with crestal bone loss: A clinical study

STATEMENT OF PROBLEM

A prolonged period of high magnitude occlusal contact can be associated with rapid changes of the occlusal surfaces and, in turn, may lead to overloading of an implant-supported prosthesis. Crestal bone loss may be one of the repercussions of overloading, but the influence of disclusion time (DT) reduction (DTR) is unclear.

PURPOSE

The purpose of this clinical study was to evaluate the role of DTR in preventing the occlusal changes and crestal bone loss at progressive time intervals of 1 week, 3 months, and 6 months in posterior implant-supported prostheses.

MATERIAL AND METHODS

Twelve participants with posterior implant-supported prostheses and opposing natural teeth were enrolled in the study. Occlusion time (OT) and DT were evaluated with the T-scan Novus (version 9.1). By performing immediate complete anterior guidance development (ICAGD) coronoplasty, prolonged contacts were selectively ground to achieve OT ≤0.2 seconds and DT ≤0.4 seconds in maximum intercuspal position and laterotrusion after cementation and during follow-up visits after 1 week, 3 months, and 6 months. Crestal bone levels were evaluated after cementation and at the 6-month follow-up. Repeated measures ANOVA and Bonferroni post hoc analysis were done for OT and DT. Student paired t test was done for crestal bone level evaluation (α=.05 for all tests).

RESULTS

A significant decrease in OT from 0.59 ±0.24 seconds to 0.21 ±0.06 seconds (P<.001) and in DT from 1.51 ±0.6 seconds to 0.37 ±0.06 seconds (P<.001) were detected in posterior implant-supported occlusion immediately after attaining ICAGD and at the 6-month follow-up period. The mean crestal bone levels at the mesial and distal sides of the implant from day 1 (0.4 ±0.13 mm, 0.36 ±0.20 mm) to 6 months (0.40 ±0.13 mm, 0.37 ±0.19 mm) showed no significant changes (P>.05).

CONCLUSIONS

Minimal occlusal changes in implant prosthesis and negligible crestal bone loss were observed up to 6 months by achieving DTR according to the ICAGD protocol.

A Multi-Center Disclusion Time Reduction (DTR) Randomized Controlled Occlusal Adjustment Study Using Occlusal Force and Timing Sensors Synchronized with Muscle Physiology Sensors

Objective—To perform a Randomized Controlled Trial (RCT) Disclusion Time Reduction (DTR) study at five Dental Colleges, using intraoral sensors and muscular electrodes. Methods and Materials—One hundred students were randomly assigned to a treatment group to receive the ICAGD coronoplasty, or a control group that received tooth polishing. All subjects answered symptom questionnaires: Beck Depression Inventory-II, Functional Restrictions, and Chronic Pain Symptom and Frequency. Subjects self-reported after ICAGD or placebo at 1 week, 1 month, 3 months, and 6 months. The Student’s t-Test analyzed the measured data. The Mann–Whitney U Test analyzed the subjective data (Alpha = 0.05). Results—The Disclusion Times, BDI-II scores, and Symptom Scales were similar between groups prior to treatment (p > 0.05). At 1 week, all three measures reduced in the treatment group, continuing to decline over 6 months (p < 0.05), but not for the controls (p > 0.05). Symptom Frequency, Functional Restrictions, and Pain Frequencies were higher in the treated group (p < 0.05), but declined after ICAGD compared to the control group (p < 0.05). Conclusions—ICAGD reduced Pain, Functional Restrictions, Symptom Frequency, and Emotional Depression within 1 week, which continued for 6 months. The tooth polishing did not initiate a placebo response.

Evaluation of Disclusion Time in Various Angle's Malocclusions by T-Scan III System

Objective  The main purpose of this article is to evaluate the disclusion time (DT) in the lateral excursions and protrusion among subjects with Angle’s malocclusions using a T-Scan III system.

Materials and Methods  One hundred subjects with malocclusions were divided into Class I, Class II division 1, Class II division 2, and Class III ( n = 25 per group). All groups’ DT of each excursion was evaluated by a T-Scan III system.

Statistical Analysis  One-way analysis of variance, followed by a post hoc test, was used to analyze the numerical data at p < 0.05.

Results  In the respective malocclusions, means ± standard deviations in second(s) of the DT were 2.08 ± 0.65, 2.13 ± 0.74, 2.12 ± 0.72, and 3.19 ± 1.34 during left excursion; 2.15 ± 0.94, 2.58 ± 1.16, 2.37 ± 1.07, and 3.28 ± 1.25 during right excursion; and 1.88 ± 0.99, 2.08 ± 1.11, 2.07 ± 0.68, and 3.01 ± 1.53 during protrusion. When compared to Class I and Class II malocclusions, Class III showed a significantly higher mean DT of each excursion ( p < 0.05).

Conclusion  Class III had the significantly highest mean DT of each excursion and the significantly longest DT in all excursions.