Background: Mandibular motion tracking system (ManMoS) has been developed for orthognathic surgery. This article aimed to introduce the ManMoS and to examine the accuracy of this system. Methods: Skeletal and dental models are reconstructed in a virtual space from the DICOM data of three-dimensional computed tomography (3D-CT) recording and the STL data of 3D scanning, respectively. The ManMoS uniquely integrates the virtual dento-skeletal model with the real motion of the dental cast mounted on the simulator, using the reference splint. Positional change of the dental cast is tracked by using the 3D motion tracking equipment and reflects on the jaw position of the virtual model in real time, generating the mixed-reality surgical simulation. ManMoS was applied for two clinical cases having a facial asymmetry. In order to assess the accuracy of the ManMoS, the positional change of the lower dental arch was compared between the virtual and real models. Results: With the measurement data of the real lower dental cast as a reference, measurement error for the whole simulation system was less than 0.32 mm. In ManMoS, the skeletal and dental asymmetries were adequately diagnosed in three dimensions. Jaw repositioning was simulated with priority given to the skeletal correction rather than the occlusal correction. In two cases, facial asymmetry was successfully improved while a normal occlusal relationship was reconstructed. Positional change measured in the virtual model did not differ significantly from that in the real model. Conclusions: It was suggested that the accuracy of the ManMoS was good enough for a clinical use. This surgical simulation system appears to meet clinical demands well and is an important facilitator of communication between orthodontists and surgeons.
Kim, Jin-Kwon;Park, Kwang-Ho;Kim, Hyung-Gon;Kim, Sang-Soo;Kim, Ki-Young;Huh, Jong-Ki
Maxillofacial Plastic and Reconstructive Surgery
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v.19
no.1
/
pp.1-13
/
1997
Preoperative and postoperative TMJ symptoms were observed in mandibular prognathism of 30 patients operated on by Le Fort I osteotomy and intraoral vertical ramus osteotomy. The alterations of TMJ symptoms were investigated and the relationship between changes of TMJ symptoms and some cephalometric values including occlusal plane angle, mandibular plane angle, posteior ramal height and a degree of deviation of mandibular incisor midline to facial midline were observed. The results are as follows. The incidence of patient with TMJ symptoms before orthognathic surgery was 40% and after orthognathic surgery was 20%. The most frequetly encountered symptoms in orthognathic TMJ dysfunction patients were TMJ pain and/or clicking. After surgery 66% of the preoperative symptomatic patients reported improvement TMJ symptoms. On the orther hand 2 patient (6%) of the preoperative asymptomatic patients developed TMJ symptoms after surgery. Preoperatively, 60% of the facial asymmetric patients with mandibular prognathism had TMJ symptomas. The more severe facial asymmetry was, the higher incidence of TMJ symptoms was. The alteration of occlusal plane angle and mandibular plane angle seems to be one of the contributing factors which make to change TMJ symptoms in orthognathic patients. But its amount seems to be low significance. Increase or decrease of posterior ramal height have influence on the change of TMJ symptoms.
Correlation between occlusal contact pattern and TMD have been hypothesized and partially investigated but results are controversial and not conclusive. The purposes of this study were to compare right-to-left difference of occlusal contact pattern, through contact points, contact force and occlusal balance, in the patients with unilateral TMD and also to evaluate its change related with TMD treatment. 36 patients with unilateral TMD from Department of Oral Medicine in Dankook University Dental Hospital were selected in this study (M:F=7:29, mean age of $29.2{\pm}14.8$ years). A computerized T-Scan II system (Tekscan, INC., USA) was employed for occlusal analysis and the simultaneity and occlusal balance through the number of tooth contact and magnitude of contact force were determined before and after TMD treatment. The number of contact points and contact force was more on the unaffected side than the affected side before treatment (p=0.056 and p=0.060, respectively) while significant difference between both sides was not found after treatment. The number of contact points and contact force on the affected sides significantly increased after treatment (p=0.038 and p=0.052), but the unaffected sides exhibited no significant difference between before and after treatment. In addition, sides difference in relative contact force decreased from about 27% to about 12% after TMD treatment (p=0.001). According to the results of this study, it is likely that unilateral TMD impairs right-to-left occlusal balance and that conservative TMD treatment alleviates the imbalance, subsequently leading to more symmetrical occlusal condition with increased contact points and force.
This study was investigated to assess the difference of facial height and occlusal plane inclination between pre- and post-treatment in Class I malocclusion group The subjects consisted of 35 extraction patients and 30 nonextraction patient,;, and was subdivided into Group I(overbite<0mm), Group II(04mm) in reference to overbite, and adolescent group and adult group in reference to age. Lateral cephalogram was taken with standard method, traced, and digitized for each subject. The computerized statistical analysis was carried out with SAS program The results wolf as follows. 1. In both groups of extraction and nonextraction group the anterior facial height increased after orthodontic treatment but there was no significant difference(p>0.05) between each goup. 2. There was no statstical significance in change of occlusal plane inclination in adolescent group, but significant difference(p<0.05) among three subgroup in adult group. 3. In adolescent-extraction and adolescent-nonextraction group there was significant increase of anterior facial height and posterior facial height, and was superior to adult groups in posterior facial height increment. 4 In all groups upper and lower molars were uprighted to occlusal plane. This had statistically significant effect.
Journal of Dental Rehabilitation and Applied Science
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v.19
no.2
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pp.57-67
/
2003
Suppose that dental occlusion is related to body posture. We want to find out that improving occlusal balance may affect vibration and distribution of C.O.P. in which way, by measuring change of posture and center of gravity (center of pressure, C.O.P.) which plays important role in measuring balance sensation. Total 11 students at Kyung Hee dental college students, 4 females and 9 males (age: 23-30) participated in this test, who have normal occlusion (Angle's classification I), no TMJ problems. All of the participants have no tooth loss except 3rd molar, no prosthesis over single tooth restoration, no orthopedic problems which affect balance sensation, and no otorhinolaryngological problems. First, we registrated bite by centric relation, and then fabricated stabilization splint that is increased 3.5mm vertical dimension around premolar region. By F-scan (Tekscan Inc., Boston, Mass), we measured discrepancy of average contact pressure of left and right foot. And we also measured discrepancy of vibration of C.O.P(center of pressure). before setting stabilization splint and after wearing stabilization splint at intervals of 1 week, 2 weeks, 3 weeks after. In normal human beings, improved occlusal balance by stabilization splint leads to decrease of vibration of C.O.P. (P<0.05). One week after wearing stabilization splint, vibration of C.O.P. decreased reliably (P<0.05), two weeks after wearing stabilization splint, vibration of C.O.P. decreased similarly comparing to before wearing and one week after wearing. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. (P>0.05) Difference between average contact pressure of right and left foot also decreased. (P<0.05) We could find decrease after one week of wearing stabilization splint (P<0.05) and two weeks after, the decrease was more reliable than one week after. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. Improvement of occlusal balance leads to decrease of vibration of C.O.P. and decrease of difference between right and left average contact pressure.
The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.
Gang Soo Park;Sunjai Kim;Se-Wook Pyo;Jae-Seung Chang
The Journal of Korean Academy of Prosthodontics
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v.62
no.2
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pp.157-164
/
2024
A variety of digital technologies are being used throughout the entire implant treatment process of diagnosis, surgery, impression, design, and fabrication of prostheses. In this case, using a digital surgical guide, sinus floor elevation was performed without complications, and the implants were placed in the planned position. After the healing period for osseointegration, CAD-CAM (Computer-aided design-Computer-aided manufacturing) customized abutments and provisional prostheses were delivered. While using the provisional prosthesis, occlusal change was observed. To transfer the intermaxillary relationship and abutment position that reflect occlusal change and axial displacement, double scanning and abutment-level digital impressions were taken. Abutment superimposition was used to capture the subgingival margin without gingival retraction. Then, the definitive prosthesis was designed and fabricated with digital system. We report a case applying digital system, to achieve the predictable result as well as the efficient treatment process from implant surgery to fabricating prosthesis in the posterior area.
The collapse of the posterior occlusion destroys the normal occlusal plane and causes excessive wear reducing the vertical dimension. Reduced vertical dimension of occlusion causes not only aesthetic and functional problems but also overloading on the temporomandibular joints and abnormalities of muscle nerve system. In order to improve the collapsed occlusal relationship, it is necessary to consider the change of the vertical dimension. It is necessary to make a precise diagnosis and analysis before the treatment and to evaluate the adaption of patient to the new vertical dimension of occlusion. A patient with excessive overbite often has occlusal problems of tooth wear and tooth eruption. Considering these considerations, overall prosthodontic restoration is required to solve the problem. A patient of 68 year old man in this case who suffered major tooth wear and maxillary posterior teeth loss was treated with elevation of vertical dimension of occlusion by maxillary removable dental prosthesis and mandibular fixed prosthesis.
A comparative study was conducted to evaluate the relationship of investing medium to the amount of vertical occlusal changes and to the differences of surface smoothness during denture construction. Three groups of 20 dentures, 30 sets of upper and lower were fabricated of conventional heatcuring acrylic denture base resin, using silicone-gypsum molding techniques, with or without covering the occlusal surfaces of the teeth by artificial stone and all-gypsum molding techniques. The distance between the two reference points indented by 1/2 round bur on the upper and lower frontal surfaces of each articulator were measured and recorded before processing and again after processing and remounting of each denture on the articulator. The differences between the two recordings indicated the amount of vertical opening during denture processing. The difference of surface smoothness were investigated and determined by 3 observers continual comparing of the two randomly selected dentures with each other, which were seperately selected as pairs from the different two groups of 20. The results obtained were as follows: 1. During resin processing no statistically significant differences of the amount of vertical occlusal changes were detected between any of the two groups of two silicone-gypsum and one allgypsum molding techniques, although the amount of vertical opening was somewhat increased when silicone-gypsum molding technique was used. 2. Surface smoothness of the processed denture was makedly by increased when silicone-gypsum molding technique was used.
This study was undertaken to investigate the effect of orthognathic surgery on occlusal force. The maximum bite force was measured in 26 dentofacial deformity patients, aged 14-26(mean age 20.3) years, before surgery and at IMF removal, 3, 6, and 12months postsurgery. To grope the correlation of bite force and skeletal change after orthognathic surgery, the cephalometric headplates were measured, tabulated and statistically analyzed. The results were as follows. 1. The presurgical maximum bite force was 13.7kg in upper first molar(rt. Side 12.7kg, it. Side 14.6kg). There was remarkable difference with that of normal occlusion. 2. The recovery of bite force was very significant in according to the operation method and the duration of IMF that was 7.6kg at IMF removal, 14.2kg at 3 months, 19.7kg at 6 months. 26.1kg at 12 months postsurgery. 3. To fasten the recovery and to increase the bite force after orthognathic surgery, the long IMF time and the injury to the masticatory muscle should be avoided by the internal rigid fixation and early physical exercise. 4. The bite force was positively correlated to the changes of mandibular plane angle, the angle between platatal plane and mandibular plan, the angle between occlusal plane and mandibular plane, and negatively correlated to the changes of mandibular body length in craniofacial structure. 5. There was no correlationship between bit force and mesial inclination of tooth long axis of first molar in this subject. 6. There was no correlation between the changes of bite force and the changes of mechanical advantage of the temporal and masseter muscle.
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