The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.
Journal of Dental Rehabilitation and Applied Science
/
v.24
no.4
/
pp.351-359
/
2008
It is difficult to provide prosthodontic treatment to fully edentulous patients with severe alveolar bone resorption, because this makes patents hard to endure functional load, and to adapt to the dentures, which result in emotional stress to patients. Implant supported overdenture can be chosen to solve these problems. Among several types of them, the implant retained and tissue supported overdenture, is available to the patients of low masticatory force with the reduced cost. Attachments also can be used for increasing retention and esthetics in dentures. Especially, $Locator^{(R)}$ system needs a small vertical interarch space for restoration and is able to compensate the difference of angle between fixtures. In this study, we restored maxilla with conventional complete denture, and mandible with implant and tissue supported overdenture and $Locator^{(R)}$ system.
Many types of occlusal splints are used for treatment of craniomandibular disorders. Most widely used splint among them is flat-type centric relation splint. Insertion of splint into the mouth may cause increasing of vertical dimension, masticatory muscle realignment and rearrangement of maxillo-mandibular relationship, so as a result of splint treatment, occlusal relation may vary whether you like it or not. From this point of view, occlusal state of patient shold be frequently monitored to prevent undesired or harmful effect during occlusal splint therapy. The purpose of this study was to investigate the effect of occlusal splint, especially centric relation splint, on the occlusal contact state after 3 months treatment. 32 patients with craniomandibular disorders who had unilateral symptoms participated in this study. To observe and record occlusal contact state, the author used T-Scan system (Tekscan Co. U.S.A.) at both pretreatment and posttreatment. The recorded date were analyzed with regard to contact number, contact force and contact time, change of anterior tooth contact and coincidence of first contact point with affected side were observed, too. Aan last, the subjects were divided into 2 groups and compared, according to average value of VAS index, with respect to joint pain, sound and limitation of movement, respectively. The collected date were statistically processed with SPSS and the result as follows : 1. Total occlusal contact number and force were not changed by occlusal splint therapy but total occlusal contact time decreased slightly. 2. There was a tendency of increasing number of subjects with anterior tooth contact after treatment and change of first contact point side were observed in as many as 40.6% of subjects. 3. There were no difference between higher and lower group of VAS index, and between pretreatment and posttreatment in each group, either.
This study was performed to investigate the factor that might affect mandibualr body rotation. For the study, 115 patients with temporomandibular disorders and 35 dental students without angy signs and symptoms of temporomandibular disorders were randomly selected as the patient group and the contreol group, respectively. Preferred chewing side, Angle' classification, lateral guidance pattern, and affected side were clinically recorded, and the amount of Mandibular body rotational torque movement was measured in wide opening and closure, in right and left excursion with vertical and lateral distance in frontal plane, right and left rotational angel in horizontal and in frontal plane. Masticatory muscle activity of anteriorocclusal contact pattern on maximal hard biting were also observed synchronously with BioEMG and T-Scan , respectively. The observed items were muscle activity of anterior temporalis and superficial masseter, and tooth contact status related to contact number, force, duration, and occlusal unbalance between right and left arch. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Mean value of vertical distance in frontal plane in wide opening and closure was more in control subjects than in patients, but there was no difference for rotational angle. In right excursion, rotational angles were greater in patient group than in control group. 2. Comparison among the subjects by preferred chewing side did not reveal any significant difference, but comparison among patients by affected side showed more rotational amount in bilaterally affected patients than in unilaterally affected patients. 3. Comparison among the subjects by Angle's classification or lateral guidance pattern revealed no difference. There was also no difference between preferred chewing side and contralateral side, and between affected side and contralateral side. 4. Positive correlation in madibular rotational torque movements were observed among vertical distance, total horizontal rotation angle, electromyographic activity of anterior temporalis, tooth contact number, and tooth contact force but total frontal rotation angle almost did not show any correlation with other variables except vertical distance.
Kim, Ji-Young;Yang, Daum;Kim, Ha-Neui;Jung, Kyoung-Suk;Chang, Young-Il;Lee, Zang-Hee
International Journal of Oral Biology
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v.34
no.2
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pp.53-59
/
2009
Periodontal ligament (PDL) tissue is a connective tissue that is interposed between the roots of the teeth and the inner wall of the alveolar bone socket. PDL is always exposed to physiologic mechanical force such as masticatory force and PDL cells play important roles during orthodontic tooth movement by synthesizing and secreting different mediators involved in bone remodeling. The Wnt/${\beta}$-catenin signaling pathway was recently shown to play a significant role in the control of bone formation. In the present study, we applied cyclic tensile stress of 20% elongation to cultured human PDL cells and assessed its impact after six days upon components of the Wnt/${\beta}$-catenin signaling pathway. RTPCR analysis showed that Wnt1a, Wnt3a, Wnt10b and the Wnt receptor LRP5 were down-regulated, whereas the Wnt inhibitor DKK1 was up-regulated in response to these stress conditions. In contrast, little change was detected in the mRNA expression of Wnt5a, Wnt7b, Fz1, and LRP6. By western blotting we found decreased expression of the ${\beta}$-catenin and p-GSK-3${\beta}$ proteins. Our results thus show that mechanical stress suppresses the canonical Wnt/${\beta}$-catenin signaling pathway in PDL cells.
Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.
Kim, Jiwoong;Lee, Nanyoung;Jih, Myeongkwan;Lee, Sangho
Journal of the korean academy of Pediatric Dentistry
/
v.49
no.1
/
pp.45-56
/
2022
The purpose of this study is to evaluate changes of occlusion following the placement of preformed metal crown in the permanent first molar affected by severe caries or hypomineralization. The study was conducted on 24 patients who met the criteria among the patients with occlusion in the permanent first molar reaching the occlusal plane. Restorative treatment was performed on one first molar using preformed metal crown. Before treatment, immediately after treatment, after 4 weeks, and after 8 weeks, the T-scan III was used for measuring distribution of bite force at the maximum intercuspal position, and overbite was measured with digital vernier calipers and change of dental midline was surveyed. After 8 weeks, questionnaires survey was conducted. In most cases, immediately after treatment, the distribution of bite force between the restored side and non-restored side of arch was reversed compared to before treatment, and the overbite was decreased. However, after 4 weeks, bite force of the left and right side was balanced and the distribution of bite force on the restored and non-restored permanent first molars had similar values. Also, the changed overbite and midline were returned to pre-treatment status and there was no significant temporomandibular joint and masticatory discomfort after treatment. In this study, it was confirmed that spontaneous occlusal equilibrium was achieved one month after the placement of preformed metal crown.
Most patients suffering from TMD appear to have unsatisfactory masticatory function and compromised values of bite force. The purposes of this study were to investigate and compare bite force between affected and unaffected sides of patients with unilateral TMD and to evaluate its relation with duration of TMD. 42 patients with unilateral TMD, from Department of Oral Medicine, Dankook University Dental Hospital, were selected for this study. The ratio of men to women was 9:33 and their mean age of $27.2{\pm}10.4$ years. The bite forces were measured over both canines (for anterior bite force) and $1^{st}$ molars (for posterior bite force) using a bite force recorder while all the subjects were asked to clench successively for 3 seconds not until pain was felt. They were compared with those measured from bilateral TMD patients(N=6, M:F=1:5, mean age: $23.0{\pm}27.3$ years). The unilateral TMD patients were divided into time groups according to duration of TMD on the basis of 1 and 6 months, respectively. Paired and unpaired t-tests were used for statistical analysis. Unilateral TMD patients in this study showed that the affected sides had significantly lower bite force than the unaffected sides(force difference of about 7-8 kgf, p<0.05) while there was no significant sides difference in the bilateral patients. Nor did bite force on the affected sides reveal significant difference between unilateral and bilateral TMD patients. With regards to TMD duration, there was significant difference between the patients with TMD < 6 months and $\geq$ 6 months (p<0.05) while no significant difference existed between < 1 month and $\geq$ 1 month. The results of this study indicated that unilateral TMD patients can exhibit more reduced bite force on the affected sides compared with that on the unaffected sides and that bite force on the unaffected sides might be deteriorated more as longer did TMD last.
The purpose of this study was to evaluate the effects of oral habits on the muscles of mastication and facial expression by means of two parameters: muscle stiffness and elasticity. 10 healthy, fully-dentate male subjects in their twenties were selected for this study; all had normal Class I occlusal relationships. Muscle stiffness and elasticity were measured with a tactile sensor(Venustron, Axiom Co., JAPAN) while subjects were asked to relax and perform various parafunctional activities such unilateral clenching(biting the bite force recorder with a force of 50kg on each subject's preferred side), jaw thrusting and lip bracing. The following muscles were examined: temporalis anterior(Ta), masseter(Mm), frontalis(Fr), inferior orbicularis oculi(OOci), zygomaticus major(Zm), superior and inferior orbularis oris(OOrs and OOri) and mentalis(Mn). Paired t-test, Correlation Coefficients, ANOVA and Multiple Comparison t-tests were used for statistical analysis. Unilateral clenching was highly correlated with bilateral stiffness and elasticity of all the muscles tested. Mm was affected by all three oral habits; Ta was affected by unilateral clenching(p<0.05); Zm was affected by unilateral clenching and OOrs, OOri and Mn were most affected by lip bracing(p<0.05). This study indicates that not only the masticatory muscles but also the muscles of facial expression, mainly circumoral muscles, can be significantly influenced by parafunctional activities such as unilateral clenching and lip bracing.
This study was undertaken to investigate the distribution of the chewing side preference and variations in the maximum bite force and facial morphology according to chewing side preference since unilateral chewing may cause morphologic and functional anomalies. 50 dental students who had no signs or symptoms of masticatory system and Angle's Class I relationship in posterior segments were selected, and divided into two groups, that is, 25 in bilateral chewing group(19 male and 6 female) and 25 in unilateral chewing group(10 male and 15 female). Maximum bite force was estimated ana posteroanterior cephalogram were measured ana statistically analyzed. The results were as follows : 1. Their were more students with bilateral chewing side preference($68\%$) and unilateral chewing side group consisted of right side preference($68\%$) and left side preference($32\%$). 2. There was no significant difference in the strength of max. bite force between the right and left side in bilateral chewing group. The bite force of the chewing side nab greater in the unilateral chewing group but less in the non-chewing side compared to those of bilateral chewing group with Bo significant difference. Max. bite force of chewing side was greater than that of non-chewing side in the unilateral chewing group(Female p<0.05). Max. bite force of males was about twice in that of females in both groups(p<0.05). Max. bite force of chewing side of the unilateral chewing group was similar to that of the bilateral chewing group, but that of non-chewing side was less than that of the bilateral chewing group. 3. In comparison of the facial morphology, there was no statistically significant difference in the size between the right and left side of the bilateral chewing group and between chewing and non-chewing side of the unilateral chewing group.
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