Kim, Taek-Kyun;Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
Archives of Craniofacial Surgery
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v.9
no.2
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pp.105-109
/
2008
Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.
In the past the jaw and occlusal relationship in centric occlusion were merely considered in case of orthodontic diagnosis and treatment planning. As the fact that functional disturbance of the temporomandibular joint may be caused by occlusal interference was recognized, the importance of functional occlusion and centric relation is emphasized today. Known the importance of centric relation, there are various opinions about definition of centric relation and its taking methods. The purpose of this study was to investigate the relative centric condyle position and to compare the reproducibility of the recordings utilizing different centric relation records obtained by different taking methods. The 15 adults with normal occlusion were participated in this study. Every four centric relation records were taken in each of three methods - leaf gauge, Dawson and myomonitor method. Then the relative centric condyle position, the distance between the condylar position in centric occlusion and the position in centric relation and the reproducibility were studied using SAM 2 articulator and mandibular position indicator. The results were as follows ; 1. The trend of condyle position was different depending on centric relation taking methods. 2. The position of condyle in centric relation by leaf gauge and Dawson methods was superior to that by myomonitor method, and the position by myomonitor method was relatively antero-inferior. 3. The distance between the condylar positions in centric occlusion and the position in centric relation was longest in myomonitor method. 4. The reproducibility had little differences in transverse direction among three methods, while leaf gauge method showed the highest reproducibility and myomonitor method did the lowest reproducibility in antero-posterior and supero-inferior direction.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.28
no.6
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pp.440-455
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2002
The final goal for an orthognathic surgery is a functional and esthetic achievement based on occlusion theory. All the dental treatment should be done with the occlusion in mind, though, they tend to be ignored with no good reason. We cannot think of occlusion without temporomandibular joint because it is the first clue to define an occlusion. As normal occlusion comes from the central tendency of distribution of population, we can get it by examining the population that closely meet the criteria of ideal occlusion. To perform proper occlusal function and to maintain the stability after treatment, the case must be finished in normal occlusion closer to ideal one. Our aim is to achieve the ideal occlusal scheme like the mutually protected occlusion with the best masticatory efficiency and the stability. The facial esthetics are influened by culture, race and the time in which human live. While the occlusal function rarely changes as time goes by, esthetics tend to do from one country to another. Orthodontists and maxillofacial surgeons should have solid sets of treatment goals to achieve the best facial esthetics and the ideal occlusion dictated by the joint. Doing orthognathic surgery, two factors aforementioned should be taken into account to establish the Surgical Treatment Objectives(STO). The doctors who are planning orthognathic surgery need to have a very logical and systematic thought process to make STO. The author examined 28 selected beautiful Korean female adults with normal skeleton with normal occlusion and analyzed the hard and the soft tissue relationship into five parts : dentomaxillary relationship, intermaxillary relationship, posture to hard tissue relationship, facial balance, and posture to soft tissue relationship. This study presents a sequential flow of diagnosis and treatment planning especially for surgical patients and it also can be applied to the nonsurgical patients.
Jaeyeon, Kim;Yiseul, Choi;Yool Bin, Song;Wonse, Park;Seong Taek, Kim
Journal of Dental Rehabilitation and Applied Science
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v.38
no.4
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pp.204-212
/
2022
Purpose: The aim of this study was to compare changes of bite force, occlusal contact area, and dynamic functional occlusion analysis after occlusal stabilization splint therapy during sleep for one month in a patient with bruxism. Materials and Methods: From October 2021 to July 2022, sleep bruxism of 30 patients who visited the Department of Oral Medicine at Yonsei University College of Dentistry Hospital were recruited. The participants were divided into two groups: using an occlusal stabilization splint during sleep (treatment; n = 15) and not using an occlusal stabilization splint (control; n = 15). Before using the occlusal stabilization splint and one month after, bite force, occlusal contact area and dynamic functional occlusion analysis (ratio of left/right bite forces, average bite forces, maximum bite forces, and maximum contact areas during lateral and anterior and posterior mandibular movements) were performed. Results: There was no difference in bite force and occlusal contact area between the treatment group using the occlusal stabilization splint and the control group not using the occlusal stabilization splint during sleep for one month. However, there were significant differences in the average bite force and maximum bite force in the lateral and anterior and posterior mandibular movements and the maximum contact areas in the anterior and posterior mandibular movements. Conclusion: The occlusal stabilization splint is helpful for sleep bruxism patients who lateral and anterior and posterior mandibular movements. In addition, further studies are needed a double-blind study with a large population.
As in all other parts in the body, oral tissue also undergoes dramatic changes with increasing age. Since these changes occasionally go beyond physiological scope, which may result in pathological changes, it is essential for dentist to understand changes caused by normal aging process. With increasing age, tooth morphology and occlusion also varies, especially loss of hard tissue, which is taking place in lifelong time, occurs as a result of tooth wear. When this loss of hard tissue is presented rapidly or excessively, functional and esthetical problems are raised, resulting in lowering quality of life of patient as well as making dental treatment for oral rehabilitation even more complex. Therefore, based on understanding of change in occlusion with increasing age, strategic approaches for maintenance of oral health in both functional and esthetic aspect are required as appropriate restoration and maintenance for progressive tooth wear enables desirable occlusal relationship. Carefully planned-restorative treatment in accordance with changed occlusal relationship is also required in the same context. Instead of taking changes in oral tissue as only a consequence of ageing, it is vital to educate patient and his or her guardian, assuring maintenance of oral hygiene and regular dental check-up are of utmost importance for improved oral health.
In the process of arranging artificial teeth the simple atracing technique was shown to be more precise and convenient for general use in dental clinic than gothic arch tracing. The simple tracing technique had some advantages over other ones in that they were very useful to check protrusive, lateral and central occlusion of mandible movement, and it was very easy to transfer the oral condition and mandible movements precisely onto the articulator. Also the technique was more effective than when using wax bite in that the functional movement range has shifted to 0.2 - 0.4mm form central occlusion.
Journal of the Korean Academy of Esthetic Dentistry
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v.23
no.2
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pp.80-85
/
2014
Orthodontic treatment is obviously the first choice to get aligned teeth cause of conservative treatment. But it is impossible to get highly esthetic result only orthodontic treatment in case of peg lateralis, discrepancy tooth size, discolored teeth or fractured teeth. As all treatment does, especially in esthetic treatment it is always required interdisciplinary diagnosis and treatment plan; orthodontics, periodontology, prothetics, implant therapy. As also, the treatment should be maintained long-term treatment with stable and harmonious state by esthetic satisfaction and functional occlusion those who needs various dental care as interdisciplinary treatment. This case is the laminate treatment with the orthodontic treatment on 37 ages/ Female patient who has cross bite at anteriors and premolar area and abrasion on centralis at right maxilla. By orthodontic treatment aligned teeth positions, it makes functional occlusion. As laminate treatment with minimum teeth preparation is able to release anterior esthetics. Follow up check for 2 years has been performed since the final prosthetics delivery to the patient. No sign of relapse, fracture of laminate were detected.
Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.
There is a little scientific documentation reporting the stress, distribution to the edentulous mandible by different concepts of occlusal scheme. So, this study was to investigate the hypothesis that the magnitude and distribution of the occlusal stresses, transmitted through a mandibular complete denture base to the edentulous mandible, would be influenced by the lingualized occlusion. This investigation was performed to analyze the stresses induced in a three-dimensional photoelastic edentulous mandible, when a load is applied to the denture arranged into lingualized occlusion in centric relation, lateral and protrusive functional position. The mounted denture on a Dentatus Type ARO articulator was loaded in a pure vertical direction with 15kgs on the center of articulator in each case and the stresses were frozen into epoxy edentulous model at $127^{\circ}C$ in the stress freezing furnace. The stress-frozen epoxy models were sliced with diamond disc saw into 4mm thick. The slices were examined with a circular polariscope. The results were as follows: 1. In centric relation, the stresses were low at anteriors, and gradually increase to the premolar, molar area and highest at the first molar and gradually decrease from the second molar and lowest at the retromolar pad region. The lingual side showed higher stresses than labiobuccal side. 2. In lateral functional position, the working side showed higher stresses than the balancing side. In working side, the lingual side showed higher stresses than the buccal side and in balancing side, the buccal side showed higher stresses than the lingual side. 3. In protrusive position, stress distribution was symmetrical on the posteriors and the stresses were concentrated at the labial side of the anteriors.
Park, Jong Hyuk;Han, Young Min;Jang, Kyeong Sool;Yoon, Wan Soo;Jang, Dong Kyu;Park, Sang Kyu
Journal of Korean Neurosurgical Society
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v.58
no.3
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pp.192-196
/
2015
Objective : The aim of this study is to investigate good prognostic factors for an acute occlusion of a major cerebral artery using mechanical thrombectomy. Methods : Between January 2013 to December 2014, 37 consecutive patients with acute occlusion of a major cerebral artery treated by mechanical thrombectomy with stent retrievers were conducted. We analyzed clinical and angiographic factors retrospectively. The collateral flow and the result of recanalization were sorted by grading systems. Outcome was assessed by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at 90 days. We compared the various parameters between good and poor angiographic and clinical results. Results : Twenty seven patients demonstrated good recanalization [Thrombolysis in Cerebral Infarction (TICI) 2b or 3] after thrombectomy. At the 90-day follow up, 19 patients had good (mRS, 0-2), 14 had moderate (3-4) and four had poor outcomes (5-6). The mRS of older patients (${\geq}75years$) were poor than younger patients. Early recanalization, high Thrombolysis in Myocardial Infarction risk score, and low baseline NIHSS were closely related to 90-day mRS, whereas high TICI was related to both mRS and the decrease in the NIHSS. Conclusion : NIHSS decreased markedly only when recanalization was successful. A good mRS was related to low initial NIHSS, good collateral, and early successful recanalization.
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