• Title/Summary/Keyword: Protrusive movement

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Analysis of the Mandibular Movements in Patients with Internal Derangement of the Temporomandibular Joint According to Diagnostic Subgroups (측두하악관절내장 환자의 진단분류에 따른 하악운동 특성의 분석)

  • 김병연;기우천;최재갑
    • Journal of Oral Medicine and Pain
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    • v.23 no.1
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    • pp.21-36
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    • 1998
  • The purpose of this study was analyse the mandibular movements in patients with internal derangement of the temporomandibular joint according to diagnostic subgroups. The author classified patients with internal derangement of the temporomandibular joint into 4 diagnostic subgroups by means of the magnet resonance imagings, and evaluated the clinical signs and the mandibular movements with Mandibular Kinesiograph(MKG) in each subgroups. The mandibular movements, measured in this study, were the types of movement in frontal and sagittal plane, velocities in opening and closing movement, and the opening and closing movement, and the opening and closing velocity pattern. The data were compared between the 5 groups including the normal group. The results were as follows : 1. Pain was more frequently observed in the anterior disc displacement without reduction group than in the anterior disc displacement with reduction group. Sound of joint was more frequently observed in the anterior disc displacement with reduction group, and limitation of mandibular opening movement was more frequently observed in the anterior disc displacement without reduction group. Duration of the anterior disc displacement without reduction group was significantly short compared to that of the anterior disc displacement with reduction group, and duration of the unilateral anterior disc displacement without reduction group was shortest in the experimental group. The frequency of Angle's classifications had not significant correlations between the experimental groups. 2. Active and passive range of the opening movement, maximum protrusive movement, maximum lateral movement toward left side were significantly decreased in the experimental groups compared to the control group, but there was no significant difference in the range of the maximum lateral movement toward right side between the control and experiment groups. In unilateral anterior disc displacement without reduction group, the range of maximum lateral movement toward unaffected side was no significant difference in the range of the maximum lateral movement between toward affected side and toward unaffected side. 3. Maximum opening velocity, maximum closing velocity, average opening velocity, average closing velocity and maximum velocity of terminal tooth contact were significantly decreased in the experimental groups compared to control group. There was no significant difference in maximum opening velocity and maximum velocity of Terminal tooth contact between the subgroups of the experimental group each other, but there was significant difference in maximum closing velocity, average opening velocity and average closing velocity between the subgroups each other. 4. In the frontal plane of the MKG, the frequency of complex deviation type(F-2)pattern was significantly increased in the anterior disc displacement with out reduction group compared to the anterior disc displacement with reduction group and the control group. In the sagittal plane, the frequency of coincident type(S-1)was decreased in the same group. 5. In the maximum opening velocity pattern, the frequency of no-peak type (OV-3)in the unilateral anterior disc displacement with reduction group was significantly increased compared to the control group. The frequency of 1-peak type (OV-1) and 2-peak type (OV-2) was decreased in the anterior disc displacement with out reduction group, but the frequency of no-peak type (OV-3)was increased in the same group. In the maximum closing velocity pattern, the frequency of no-peak type (CV-3) was significantly increased in the anterior disc displacement without reduction group. Compared to the anterior disc displacement with reduction group and the control group. The frequency of 1-peak type (CV-1) and 2-peak type (CV-2) in the anterior disc displacement with reduction group was decreased than that in the control group.

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Comparison of the Strain on the Alveolar Ridge According to the Occlusal Scheme of Complete Dentures (총의치 교합양식에 따른 응력 분포 양상 비교연구)

  • Choi, Won-Jun;Lim, Young-Jun;Kim, Chang-Whe;Kim, Myung-Joo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.1
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    • pp.1-12
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    • 2010
  • The purpose of this study was to compare the strain on the alveolar ridge in the centric, eccentric and protrusive position according to the occlusal scheme (bilateral balanced occlusion with 33 degree anatomical teeth, group B; monoplane occlusion with non-anatomical teeth, group M; lingualized occlusion with 33 degree anatomical teeth and non-anatomical teeth, group L; of complete dentures. Experimental dentures were set bilateral balanced occlusion, lingualized occlusion and monoplane occlusion. They are analysed through T-Scan II(Tekscan, Boston, U.S.A) and 1.5mm thick layer was removed from the denture-supporting surface of resin model and then replaced with silicone to simulate resilient edentulous ridge mucosa. A $4{\times}6$ linear strain gauge is attached to the $1^{st}$ premolar and $1^{st}$ molar area. The strain values are recorded according to the occlusal scheme in the centric, eccentric and protrusive position after uniformly applying 50 N and 150 N force through a Universal Testing Machine(instron$^{(R)}$ 5567, Bluehill 2.0 software ,U.S.A.) with the models mounted in the articulator. When performing centric and protrusive occlusion, the three groups of occlusal scheme were compared in the anterior region and in the posterior region. The strains of each group were also compared in the working side and in the non-working side during eccentric excursion. It was observed that the strain in the bilateral balanced occlusion showed a higher value than the lingualized occlusion and monoplane occlusion in every position except the non-working side. However, during the eccentric movement the strain value in the non-working side showed the lowest value in the bilaterally balanced occlusion. The strain change amount from the working side or centric occlusion to non-working side and also the strain variation rate within the non-working side showed the highest value in bilateral balanced occlusion.

THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF MANDIBULAR STRESSES OF COMPLETE DENTURE OCCLUSION (하악 총의치 교합형태에 따른 하부조직에 미치는 교합력 양태의 3차원적 유합요소법 해석)

  • Lee Young-Soo;Yoo Kwang-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.30 no.2
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    • pp.286-318
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    • 1992
  • The objective of preventive dentistry is the maintenance of a healthy dentition for the life of a patient. Unfortunately, if an individual has not received the benefit of a comprehensive program of preventive dentistry and has finally reached the edentulous state, as a consequence, he receives a set of complete denture. Dentures are mechanical devices and subject to the principles of mechanics. In some cases, the general health and nutritional status of the patient are felt to be the causative factors. But, the most important thing in residual ridge resorption is felt to be caused by the unequal distribution of functional forces. This study was to analyze mandibular stresses of complete denture occlusion by three dimensional finite element method. The results were as follows ; 1. As deformation and stress distribution of the complete denture of the mandible were concentrated on the upper lingual side of the mandible, alveolar ridge resorption of the mandible occurred from lingual side to labio-buccal side. 2. Analyzing by three dimensional F. E. M., the mandible is a very effective form for tolerating stress and deformation biomechanically. 3. According to the concentration of stress distibution in the upper buccal side of the lower posteriors, buccal shelf area must be a primary stress bearing area in the lower complete denture. 4. Lower complete denture moved horizontally to the balancing side under lateral occlusal force. 5. Bilateral balanced occlusion should be constructed in the complete denture for denture stability, especially in the protrusive movement. 6. Physical property of the denture base material was as important for stress distribution in the denture base as or even more than that in the mandible. 7. Impression technique is very important because of most of stress was concentrated between them due to close contact of the mandible and the denture base.

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Faculty-supervised measurements of the face and of mandibular movements on young adults

  • Woelfel, Julian B.;Igarashi, Takayoshi;Dong, Jin-Keun
    • The Journal of Advanced Prosthodontics
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    • v.6 no.6
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    • pp.483-490
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    • 2014
  • PURPOSE. The purpose of this study was to determine the average facial proportions and mandibular movement capacity of 316 first-year dental students who carefully recorded them on each other. MATERIALS AND METHODS. This early exacting clinical experience was closely supervised by the authors in Columbus, Ohio during 1969-70. Five vertical and six horizontal distances were measured on each subject's face. An ala-tragus line and an occlusal line were drawn on the left side of the face to determine if these two lines were parallel. Measurements of mandibular movements involved maximum normal and hinge opening at the incisors and maximum amounts of right, left lateral and protrusive excursions of the mandible. RESULTS. The ala width and distance between the tips of upper right and left canine cusps averaged (35.2 mm and 34.8 mm) but with very large individual variations. The distance between ala to occlusal plane lines was 29.9 mm at the tragus and 31.3 mm near the ala. The angle between orbitale and ala-tragus averaged 13.6 degrees. CONCLUSION. The upper lip length was the most variable and the distance between the pupils was the most stable of the eleven facial measurements. The ala-tragus line and the occlusal plane lines were for all practical purposes parallel. Maximum jaw opening averaged 51.2 mm which was 3.0 times larger than maximal hinge opening of 17.2 mm. The maximum right plus left side jaw excursions (9.2 and 9.4 mm) totaled 18.6 mm, 2.3 times more than the 8.0 mm mean maximum forward protrusion.

A Study on Reproducibility of Mandibular Movements Using Pantographic Reproducibility Index (PRI) (Pantographic Reproducibility Index(PRI)를 이용한 하악운동의 재현성에 관한 연구)

  • Lee, Sang-Don;Park, Charn-Woon
    • The Journal of Korean Academy of Prosthodontics
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    • v.24 no.1
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    • pp.105-116
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    • 1986
  • In order to determine if a relationship exists between the clinical symptoms of TMJ dysfunction and the reproducibility of mandibular movements, twenty one subjects were chosen. The control group consisted of 5 subjects who were determined to be free from signs and symptoms of dysfunction . The sixteen experimental subjects were selected on the basis of their having dysfunctional symptoms. The author obtained two sets of pantographic tracings. Each set consisted of tracings from three both lateral and one protrusive movements. A second set of tracings were recorded immediately on the new recording papers using the same procedure as the first tracing. The tracings were scored by Pantographic reproducibility index (PRI). The obtained results were as follows. 1. Mean PRI scores of groups increased as the degree of dysfunction were increased. 2. For the groups of no or slight dysfunctional symptoms the PRI scores of the second tracing were smaller than the first one, wherea the scores of the second tracing from $D_2,\;D_3$ group were larger than the first tracing. 3. Differences between the mean PRI scores of control group and those of experimental group were statistically significant. 4. The second sets of tracings were more reliable statistically than those of first ones. 5. PRI can be used as a meaningful aid for the evaluation of the diagnostic and therapeutic results of treatment modalities for the TMJ dysfunction. 6. At 3east two sets of tracings should be recorded when the PRI is to be used to detect the incoordinated movements of TMJ dysfunction patient. 7. PRI scores of control group ($D_0$) was 137.7, thus, mandibular movement was reproducible, whereas PRI scores of experimental groups ($D_1,\;D_2,\;D_3$) were 22.5, 27.7, 30.45 respectively, thus were nonreproducible.

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A study on Pre-and Post-surgical Patterns of Mandibular Movement and EMG in Skeletal Class III Prognathic Patients who underwent Intraoral Vertical Ramus Osteotomy (하악 전돌증 환자의 구내 하악골 상행지 골절단술전후의 하악골 운동양상 및 저작근 근전도 변화에 관한 연구)

  • Park, Young-Chel;Hwang, Chung-Ju;Yu, Hyung-Seog;Han, Hee-Kyung
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.283-296
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    • 1997
  • Stomatognathic system is a complex one that is composed of TMJ, neuromuscular system, teeth and connective tissue, and all its components are doing their parts to maintain their physiological relationships. Mandible, in particular, performs various functions such as mastication, speech, and deglutition, the muscular activities that determine such functions are signalled by numerous types of proprioceptors that exist in periodontal membrane, TMJ, and muscles to be controlled by complicated pathways and mechanics of peripheral and central nervous system. Orthodontic treatment, especially when accompanied by orthognathic surgery, brings dramatic changes of stornatognat is system such as intraoral proprioceptors and muscle activities and thus, changes in patterns of mandibular function result The author tried to analyze changes in patterns of mandibular movement and physiologic activities of surrounding muscles in Skeletal Class III ortlrognathic surgery patients who presently show a great increase in numbers. The purpose of this study was to draw some objective guidelines in evaluating funclierual aspects of orthognathic surgery patients. Mandibular functional analysis using Biopak was performed for skeletal Class III prognathic patients who underwent IVRO(lntraoral Vertical Ramus Osteotmy), and the following results were obtained: 1. Resting EMG was greater in pre-surgical group than the control group, and it showed gradual decrease after the surgery. Clenching EMG of masseter and anterior temporalis of pre-surgical group was smaller than those of control group, they also increased post-surgically, and significant difference was found between pre-surgical and post-surgical(6 months) groups. 2. Resting EMG of anterior ternporalis was greater than that of all the other muscles, but there was no significant difference. Clenching EMG of anterior temporalis and masseter were greater than those of the other muscles with statistical difference. In swallowing, digastric muscle showed the highest EMG with statistical significance. 3. Limited range of mandibular movement was shown in pre-surgical group. Significant increase in maximum mouth opening was observed six months post-surgically, and significant increase in protrusive movement was observed three months post-surgically.

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MECHANO THERAPY OF PEDIATRIC CONDYLAR FRACTURES USING BENOIST'S APPLIANCCE : A CASE REPORT (Benoist씨 장치를 이용한 소아의 하악 과두 골절의 치험례)

  • Park, Sang-Wook;Cha, In-Ho;Kim, Seong-Oh;Choi, Byung-Jai;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.453-458
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    • 2004
  • Mandibular fracture is less common in children than in adults. However, children are more susceptible to ankylosis and developmental disorders, and don't respond as well to intermaxillary fixation compared to adults. On the other hand, bone fracture is healed more quickly in children and complications are scarce. Mandibular fracture in children is usually treated successfully with acrylic splint therapy with or without the use of eyelet wires and intermaxillary fixation. Severe complications that include ankylosis and developmental disorders may occur. The frequency and severity of such complications can be mitigated with a shorter duration of intermaxillary fixation and good post-operative care. Encouraging mandibular physical therapy by increasing patient motivation may be necessary in such cases where the patient's response is poor and the duration of intermaxillary fixation increases; when the patient is unable to undergo physical therapy, or when intermaxillary fixation is not necessary with the patient showing only minor symptoms such as trismus. In this case report, a 6 year-old girl with bilateral condylar fracture was treated with elastic in both the upper and lower jaws to allow mandibular physical therapy using a Benoist's appliance, which allows opening, lateral, and protrusive retrusive movements of the mandible. A 7-month follow-up showed beneficial therapeutic effects such as increased mandibular movement and prevention of condylar ankylosis.

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Open versus closed reduction of mandibular condyle fractures : A systematic review of comparative studies

  • Kim, Jong-Sik;Seo, Hyun-Soo;Kim, Ki-Young;Song, Yun-Jung;Kim, Seon-Ah;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.1
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    • pp.99-107
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    • 2008
  • Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.