The author studied masticatory muscle activity and bite force in normal persons without Temporomandibular Disorders(TMD) signs and symptoms, The number of subjects was 15, and the age of them was from 22 to 25 years. Electromyography was used to record the muscle activity in tapping and clenching movement with or without occlusal splint. 3 splints were made from 3 different mandibular position, that if, centric occlusion position, Rocabado's mandibular rest position, Dawson's centric relation position. The thickness of splint was 3.0-3.5㎜ at molar region. The muscle examined were Masseter and Anterior Temporalis attached with surface electrodes and the device used to measure the EMG level was Bioelectric processor Model EM2. After recording the EMG, the author measured the bite force level in clenching movement with bite force meter Model MPM-3000 in the dame position used in the EMG experiment. The obtained results were as follow : 1. With occlusal splints insetion, the amount of decreased muscle activity in Anterior Temporalis was more than those in Masseter. 2. In the three maxillomandibular relationships with occlusal splints, Masseter showed slightly increased level of muscle in centric occlusion but Ant. Temporalis showed decreased level of muscle activity reversely in that position. 3. Muscle activities between Rocabado's rest position and Dawson's centric relation position were generally similar whatever the muscles or the movements the author examined. 4. Bite force in clenching movement increased with splints insertion, especially with the splint registered in centric occlusion position.
Purpose: The aim of this study was to evaluate the relationship between the mandibular canal and impacted mandibular third molars using cone-beam computed tomography (CBCT) and to compare the CBCT findings with signs on panoramic radiographs(PRs). Materials and Methods: This retrospective study consisted of 200 mandibular third molars from 200 patients who showed a close relationship between the mandibular canal and impacted third molars on PRs and were referred for a CBCT examination of the position of the mandibular canal. The sample consisted of 124 females and 76 males, with ages ranging from 18 to 47 years (mean, $25.75{\pm}6.15$ years). PRs were evaluated for interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. Correlations between the PR and CBCT findings were statistically analyzed. Results: In total, 146 cases(73%) showed an absence of canal cortication between the mandibular canal and impacted third molar on CBCT images. A statistically significant relationship was found between CBCT and PR findings (P<0.05). The absence of canal cortication on CBCT images was most frequently accompanied by the PR sign of diversion of the mandibular canal(96%) and least frequently by interruption of the mandibular canal wall(65%). Conclusion: CBCT examinations are highly recommended when diversion of the mandibular canal is observed on PR images to reduce the risk of mandibular nerve injury, and this sign appears to be more relevant than other PR signs.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.33
no.3
/
pp.204-210
/
2007
This study was intended to compare the cranial base morphology between the mandibular prognathism and maxillary retrognathism in skeletal class III patients. The subject of the present study was composed of 88 patients divided into two groups; Group 1 (Skeletal Class III with mandibular prognathism. SNA within normal range, SNB over normal range, n=54) and Group 2(Skeletal Class III with maxillary retrognathism. SNA below normal range, SNB within normal range, n=34). Lateral cephalogram were taken immediate before surgery and 18 landmarks were used to analyze the characteristics of cranial base and maxillomandibular skeleton. The result revealed that cranial base angle is significantly smaller in Group 1 than Group 2, which implies the influence of the cranial base angulation on the mandibular position. However the posterior cranial base length did not influence the mandibular horizontal position and anterior cranial base length did not influence the maxillary horizontal position. As the anterior cranial base length was closely related with ramal height, it is recommendable to investigate the regulatory mechanism of chondrogenesis of cranial base and condyle cartilage in the future research.
Purpose: This study was performed to examine distribution of accessory mandibular canal and its characteristics in mandibular third molars. Materials and methods: A total of 251 subjects (166 males and 85 females) having mandibular third molars bilaterally were included in the study. Cone-beam computed tomographic images were reviewed for bifid or trifid accessory mandibular canal. The prevalence of accessory mandibular canal was evaluated according to gender, side and its branching type. Proximity and crosssectional position of accessory mandibular canal to mandibular third molar was analyzed. Results: Accessory mandibular canals were found in 66 (26.3%) of 251 patients and 86 (17.1%) of 502 hemi-mandibles. Gender and sides showed no statistically significant differences in prevalence. Retromolar canal (46.1%) was the most common branching type. Proximity of accessory canal to mandibular third molars showed mean distance of 2.8 mm from third molar and a statistically significant difference was found among types of accessory canal. Dental canal was the closest to tooth among branching types and closer to tooth than main canal. On cross-sectional view, accessory canal was generally located on buccal side of mandibular third molar. Conclusion: Accessory mandibular canal was common and well detected with cone-beam computed tomography. Their localization is significant in all anesthetic and surgical procedures involving mandibular third molars.
Purpose: In general, the surgical treatment for mandibular retrognathism is represented by two methods, distraction osteogenesis (DO) and mandibular osteotomy surgery. The DO is mostly preferred when the degree of advancement of mandible is large. However, the postoperative stability of mandibular advancement using DO have not been actively investigated. Therefore, in the present study we have compared the postoperative stability between DO and bilateral sagittal split ramus osteotomy (BSSRO) in mandibular retrognathism. Methods: Seven patients who had been treated by DO and thirteen patients with BSSRO were included in this study. Serial lateral cephalograms were analyzed by manual tracing and the amount of the mandibular elongation was measured. To evaluate the postoperative stability, positional changes of the condylar position and B point were analyzed. Results: Mean amount of mandibular advancement was $6.51{\pm}3.57mm$ for BSSRO group and $12.43{\pm}4.35mm$ for DO group, respectively. There was no significant difference in age between the two groups (P>0.05). Mean follow up periods were 10.77 months for BSSRO group and 11.28 months for DO group, respectively. After mandibular advancement, mean positional changes in the condyle were $0.56{\pm}1.43mm$ horizontally and $0.72{\pm}1.61mm$ vertically for BSSRO group and $0.53{\pm}1.56mm$ horizontally and $0.56{\pm}1.75mm$ vertically for DO group, respectively. Mean change of distance from B point to Y-axis was $-1.76{\pm}0.83mm$ for BSSRO group and $-2.14{\pm}1.82mm$ for DO group, respectively. According to the condylar position and B point, there were no significant differences in postoperative stability between the two groups (P>0.05). Conclusion: There was no significant difference in postoperative stability between DO and BSSRO group according to condylar position and B point. Based on the results of the present study, it is hypothesized that DO would be a good treatment choice for severe mandibular retrognathism because DO could achieve more mandibular advancement and concurrent soft tissue elongation.
PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.
Evangelista, Karine;Cardoso, Lincoln;Toledo, Italo;Gasperini, Giovanni;Valladares-Neto, Jose;Cevidanes, Lucia Helena Soares;de Oliveira Ruellas, Antonio Carlos;Silva, Maria Alves Garcia
Imaging Science in Dentistry
/
v.51
no.1
/
pp.17-25
/
2021
Purpose: This study was performed to investigate mandibular canal displacement in patients with ameloblastoma using a 3-dimensional mirrored-model analysis. Materials and Methods: The sample consisted of computed tomographic scans of patients with ameloblastoma (n=10) and healthy controls (n=20). The amount of mandibular canal asymmetry was recorded as a continuous variable, while the buccolingual (yaw) and supero-inferior (pitch) directions of displacement were classified as categorical variables. The t-test for independent samples and the Fisher exact test were used to compare groups in terms of differences between sides and the presence of asymmetric inclinations, respectively (P<0.05). Results: The length of the mandibular canal was similar on both sides in both groups. The ameloblastoma group presented more lateral (2.40±4.16 mm) and inferior (-1.97±1.92 mm) positions of the mental foramen, and a more buccal (1.09±2.75 mm) position of the middle canal point on the lesion side. Displacement of the mandibular canal tended to be found in the anterior region in patients with ameloblastoma, occurring toward the buccal and inferior directions in 60% and 70% of ameloblastoma patients, respectively. Conclusion: Mandibular canal displacement due to ameloblastoma could be detected by this superimposed mirrored method, and displacement was more prevalent toward the inferior and buccal directions. This displacement affected the mental foramen position, but did not lead to a change in the length of the mandibular canal. The control group presented no mandibular canal displacement.
Kim, Jae-Won;Lee, Dong-Hyun;Lee, Su-Youn;Kim, Jae-Hyun;Lee, Sang-Han
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.35
no.4
/
pp.229-239
/
2009
The purpose of this study is to evaluate the change in condylar position, width, and angle before and after orthognathic surgery using 3-dimensional computed tomograph. Pre and posterative 3-D CT was taken on 38 patients and through axial, frontal, sagittal measurements and by 3-dimensional reconstruction, the changes in condylar postion, mandibular width and angle were analyzed and others such as the difference in gender, operation and fixation method, setback length and in relation with temporomandibular disorders were done together too. The results were as follows: The inward rotation of condyle in axial condylar angle, the forward movement of right condyle in sagittal anterior-posterior distance, the superior movement of both condyles in sagittal superior-inferior distance, the decrease in gonial angle, the increase in mandibular width, the decrease in distance between the axial coronoid process distance and the increase in the frontal intercondylar distance were statistically significant. There were no statistically significant changes in gender difference, however in the difference in operation method, change in the gonial angle was observed and there was more change in bilateral sagittal split osteotomy group compared to two-jaw surgery group. In the difference in fixation method, the decrease in axial coronoid process distance and the change in sagittal anterior-posterior distance were statistically significant. In the difference in setback, the increase in setback didn't relate directly with the increased change in condyle position. In the relation with temporomandibular disorder, changes in left axial condylar angle and axial coronoid process distance were statistically significant. Changes in condylar position could be observed after the orthognathic surgery but it doesn't seem to have much of a clinical importance. The orthognathic surgery is effective in decreasing the mandibular angle, and it is not related with the temporomandibular disorder.
Objective: To compare condylar position and morphology among different vertical skeletal patterns. Methods: Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. Results: The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. Conclusions: Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.
This study was performed to evaluate the hyoid bone position and airway in skeletal class III malocclusion and to prove the correlation between airway, hyoid bone position and mandibular position. The sample, considered of 47 class III malocclusion patients for experimmtal group and 52 class I malocclusion students for control group. Twenty three linear and angular measurements about hyoid bone position, airway size, mandibular position were taken from the lateral cephalograms. The differences between skeletal class III malocclusion group and normal occlusion group were compared and the correlation were evaluated statistically. The results obtained were as follows, 1. There were significant difference in S-APH, A-APH, N-APH, LAH-PBR, AA-PNS, PNS-ad between class I and class III malocclusion groups. 2. The hyoid bone was more anteriorly positioned in class III malocclusion group than class I malocclusion group and skeletal airway size in class III malocclusion group was smaller than class I malocclusion group. 3. There were significant difference in several measurements especially vertical and angular measurements of hyoid bone position and airway size between male and female. Usually the measurements in male were larger than female. 4. There were no significant correlation between hyoid bone position and airway size also airway size, and didn't showe significant correlation with mandibular position, 5. S-APH showed negative correlation with Wits appraisal and A-APH, N-APH showed positive correlation with Wits appraisal. On the contrary vertical measurements of hyoid bone position showed positive correlation with lower facial height.
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