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Evaluation of median mandibular flexure values in dentulous and edentulous subjects by using an intraoral digital scanner

  • Gulsoy, Merve (Department of Prosthodontics, Faculty of Dentistry, Suleyman Demirel University) ;
  • Tuna, Suleyman Hakan (Department of Prosthodontics, Faculty of Dentistry, Suleyman Demirel University) ;
  • Pekkan, Gurel (Department of Prosthodontics, Faculty of Dentistry, Tekirdag Namik Kemal University)
  • Received : 2021.10.20
  • Accepted : 2022.01.25
  • Published : 2022.02.28

Abstract

PURPOSE. Mandibular flexure is a crucial phenomenon that may affect the success of rigid bilateral mandibular prosthetic treatment. The aim of this study was to determine the amount of median mandibular flexure (MMF) that occurs during mouth opening from anterior to posterior mandible in seven different regions, in different age and gender groups of both dentulous and edentulous subjects, using an intraoral digital scanner. MATERIALS AND METHODS. In this study, the mandibular arch of 56 dentulous and 35 edentulous individuals were scanned with an intraoral scanner at both the minimum mouth opening (MnMO) and the maximum mouth opening (MxMO). MMF values were calculated by subtracting the distance value at the MxMO from the distance between the reference points at the MnMO at seven different mandibular regions of dentulous and edentulous subjects. In addition, the left and right side MMF values were measured. All data were analyzed statistically (α = .05). RESULTS. MMF value increased linearly from anterior to posterior mandible in both dentulous and edentulous individuals. The differences in MMF values were not statistically significant according to side (left/right), age, or gender (P > .05). No significant differences were found between the mean MMF values of the same region in both dentulous and edentulous individuals (P > .05). CONCLUSION. MMF was seen in different regions of the mandibles of both edentulous and dentulous individuals measured at the MxMO. Mandibular flexure should be considered for the success and prognosis of the long-span and rigid prostheses.

Keywords

References

  1. Al-Sukhun J, Helenius M, Lindqvist C, Kelleway J. Biomechanics of the mandible part I: measurement of mandibular functional deformation using custom-fabricated displacement transducers. J Oral Maxillofac Surg 2006;64:1015-22. https://doi.org/10.1016/j.joms.2006.03.009
  2. Regli CP, Kelly EK. The phenomenon of decreased mandibular arch width in opening movements. J Prosthet Dent 1967;17:49-53. https://doi.org/10.1016/0022-3913(67)90050-9
  3. De Marco TJ, Paine S. Mandibular dimensional change. J Prosthet Dent 1974;31:482-5. https://doi.org/10.1016/0022-3913(74)90169-3
  4. Omar R, Wise MD. Mandibular flexure associated with muscle force applied in the retruded axis position. J Oral Rehabil 1981;8:209-21. https://doi.org/10.1111/j.1365-2842.1981.tb00495.x
  5. Goodkind RJ, Heringlake CB. Mandibular flexure in opening and closing movements. J Prosthet Dent 1973;30:134-8. https://doi.org/10.1016/0022-3913(73)90046-2
  6. Gates GN, Nicholls JI. Evaluation of mandibular arch width change. J Prosthet Dent 1981;46:385-92. https://doi.org/10.1016/0022-3913(81)90443-1
  7. Hobkirk JA, Schwab J. Mandibular deformation in subjects with osseointegrated implants. Int J Oral Maxillofac Implants 1991;6:319-28.
  8. Horiuchi M, Ichikawa T, Noda M, Matsumoto N. Use of interimplant displacement to measure mandibular distortion during jaw movements in humans. Arch Oral Biol 1997;42:185-8. https://doi.org/10.1016/S0003-9969(96)00101-X
  9. Paez CY, Barco T, Roushdy S, Andres C. Split-frame implant prosthesis designed to compensate for mandibular flexure: a clinical report. J Prosthet Dent 2003;89:341-3. https://doi.org/10.1067/mpr.2003.57
  10. Sivaraman K, Chopra A, Venkatesh SB. Clinical importance of median mandibular flexure in oral rehabilitation: a review. J Oral Rehabil 2016;43:215-25. https://doi.org/10.1111/joor.12361
  11. Shinkai RS, Canabarro Sde A, Schmidt CB, Sartori EA. Reliability of a digital image method for measuring medial mandibular flexure in dentate subjects. J Appl Oral Sci 2004;12:358-62. https://doi.org/10.1590/S1678-77572004000400020
  12. Hylander WL. Stress and strain in the mandibular symphysis of primates: a test of competing hypotheses. Am J Phys Anthropol 1984;64:1-46. https://doi.org/10.1002/ajpa.1330640102
  13. McDowell JA, Regli CP. A quantitative analysis of the decrease in width of the mandibular arch during forced movements of the mandible. J Dent Res 1961;40:1183-5. https://doi.org/10.1177/00220345610400061201
  14. Burch JG. Patterns of change in human mandibular arch width during jaw excursions. Arch Oral Biol 1972;17:623-31. https://doi.org/10.1016/0003-9969(72)90189-6
  15. Asadzadeh N, Madani AS, Mirmortazavi A, Sabooni MR, Shibani V. Mandibular width and length deformation during mouth opening in female dental students. J Appl Sci 2012;12:1865-8. https://doi.org/10.3923/jas.2012.1865.1868
  16. Madani AS, Asadzadeh N, Hosseini SH. Mandibular flexure in anterior-posterior and transverse plane on edentulous patients in mashhad faculty of dentistry. J Dent Mater Tech 2013;1:24-8.
  17. Chen DC, Lai YL, Chi LY, Lee SY. Contributing factors of mandibular deformation during mouth opening. J Dent 2000;28:583-8. https://doi.org/10.1016/S0300-5712(00)00041-5
  18. Ebadian B, Abolhasani M, Heidarpour A, Ziaei M, Jowkar M. Assessment of the relationship between maximum occlusal force and median mandibular flexure in adults: a clinical trial study. J Indian Prosthodont Soc 2020;20:76-82. https://doi.org/10.4103/jips.jips_282_19
  19. Wolf L, Bergauer B, Adler W, Wichmann M, Matta RE. Three-dimensional evaluation of mandibular deformation during mouth opening. Int J Comput Dent 2019;22:21-7.
  20. Choi AH, Conway RC, Taraschi V, Ben-Nissan B. Biomechanics and functional distortion of the human mandible. J Investig Clin Dent 2015;6:241-51. https://doi.org/10.1111/jicd.12112
  21. Clelland NL, Lee JK, Bimbenet OC, Brantley WA. A three-dimensional finite element stress analysis of angled abutments for an implant placed in the anterior maxilla. J Prosthodont 1995;4:95-100. https://doi.org/10.1111/j.1532-849x.1995.tb00323.x
  22. Brunski JB, Puleo DA, Nanci A. Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments. Int J Oral Maxillofac Implants 2000;15:15-46.
  23. Cochran DL. The scientific basis for and clinical experiences with Straumann implants including the ITI Dental Implant System: a consensus report. Clin Oral Implants Res 2000;11:33-58. https://doi.org/10.1034/j.1600-0501.2000.011S1033.x
  24. Prasad M, Hussain MZ, Shetty SK, Kumar TA, Khaur M, George SA, Dalwai S. Median mandibular flexure at different mouth opening and its relation to different facial types: a prospective clinical study. J Nat Sci Biol Med 2013;4:426-30. https://doi.org/10.4103/0976-9668.117028
  25. Canabarro Sde A, Shinkai RS. Medial mandibular flexure and maximum occlusal force in dentate adults. Int J Prosthodont 2006;19:177-82.
  26. Custodio W, Gomes SG, Faot F, Garcia RC, Del Bel Cury AA. Occlusal force, electromyographic activity of masticatory muscles and mandibular flexure of subjects with different facial types. J Appl Oral Sci 2011;19:343-9. https://doi.org/10.1590/S1678-77572011005000008
  27. Quaas S, Rudolph H, Luthardt RG. Direct mechanical data acquisition of dental impressions for the manufacturing of CAD/CAM restorations. J Dent 2007;35:903-8. https://doi.org/10.1016/j.jdent.2007.08.008
  28. Flugge TV, Schlager S, Nelson K, Nahles S, Metzger MC. Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner. Am J Orthod Dentofacial Orthop 2013;144:471-8. https://doi.org/10.1016/j.ajodo.2013.04.017
  29. Anh JW, Park JM, Chun YS, Kim M, Kim M. A comparison of the precision of three-dimensional images acquired by 2 digital intraoral scanners: effects of tooth irregularity and scanning direction. Korean J Orthod 2016;46:3-12. https://doi.org/10.4041/kjod.2016.46.1.3
  30. Jemt T, Hjalmarsson L. In vitro measurements of precision of fit of implant-supported frameworks. A comparison between "virtual" and "physical" assessments of fit using two different techniques of measurements. Clin Implant Dent Relat Res 2012;14:e175-82. https://doi.org/10.1111/j.1708-8208.2011.00416.x
  31. Schmidt A, Klussmann L, Schlenz MA, Wostmann B. Elastic deformation of the mandibular jaw revisited-a clinical comparison between digital and conventional impressions using a reference. Clin Oral Investig 2021;25:4635-42. https://doi.org/10.1007/s00784-021-03777-z
  32. Law C, Bennani V, Lyons K, Swain M. Mandibular flexure and its significance on implant fixed prostheses: a review. J Prosthodont 2012;21:219-24. https://doi.org/10.1111/j.1532-849X.2011.00798.x
  33. Choi AH. Finite element modeling of the mandible and ceramic dental implants. Dissertation. Sydney, Australia: University of Technology, 2004.
  34. Ben-Nissan B. Three-dimensional modelling and finite element distortion analysis of the mandible, Dissertation. Sydney, Australia: University of New South Wales, 1987.
  35. Balcioglu HA, Uyanikgil Y, Yuruker S, Tuna HS, Karacayli U. Volumetric assessment of lateral pterygoid muscle in unilateral chewing: a stereologic study. J Craniofac Surg 2009;20:1364-6. https://doi.org/10.1097/SCS.0b013e3181ae41e9
  36. Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J Prosthet Dent 1972;27:120-32. https://doi.org/10.1016/0022-3913(72)90188-6
  37. Burch JG, Borchers G. Method for study of mandibular arch width change. J Dent Res 1970;49:463. https://doi.org/10.1177/00220345700490025101
  38. Atkinson PJ, Woodhead C. Changes in human mandibular structure with age. Arch Oral Biol 1968;13:1453-64. https://doi.org/10.1016/0003-9969(68)90027-7
  39. Novak CA. Mandibular dimensional change in the various jaw positions and its effect upon prosthetic appliances. Dent Stud 1972;50:19-21.
  40. Gulsahi A, Yuzugullu B, Imirzalioglu P, Genc Y. Assessment of panoramic radiomorphometric indices in Turkish patients of different age groups, gender and dental status. Dentomaxillofac Radiol 2008;37:288-92. https://doi.org/10.1259/dmfr/19491030
  41. Zarone F, Apicella A, Nicolais L, Aversa R, Sorrentino R. Mandibular flexure and stress build-up in mandibular full-arch fixed prostheses supported by osseointegrated implants. Clin Oral Implants Res 2003;14:103-14. https://doi.org/10.1034/j.1600-0501.2003.140114.x
  42. Misch CE. Dental implant prosthetics. 3rd ed, Mosby Elsevier, 2008. p. 316-20.
  43. Flanagan D. Complete artificial dentition supported by endosseous implants: a case report of total in-office treatment. J Oral Implantol 2005;31:91-7. https://doi.org/10.1563/0-726.1