Temporomandibular disorders in relation to craniofacial dimensions, head posture and bite force in children selected for orthodontic treatment.
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The present study examined the associations between craniofacial dimensions, head posture, bite force, and symptoms and signs of temporomandibular disorders (TMD). The sample comprised 96 children (51F, 45M) aged 7-13 years, sequentially admitted for orthodontic treatment of malocclusions entailing health risks. Symptoms and signs of TMD were assessed by 37 variables describing the occurrence of headache and facial pain, clicking, jaw mobility, tenderness of muscles and joints, and the Helkimo Anamnestic and Dysfunction indices. Craniofacial dimensions (33 variables), and head and cervical posture (nine variables) were recorded from lateral cephalometric radiographs taken with the subject standing with the head in a standardized posture (mirror position). Dental arch widths were measured on plaster casts and bite force was measured at the first molars on each side by means of a pressure transducer. Associations were assessed by Spearman correlations and multiple stepwise logistic regression analyses. The magnitudes of the significant associations were generally low to moderate. On average, temporomandibular joint (TMJ) dysfunction was seen in connection with a marked forward inclination of the upper cervical spine and an increased craniocervical angulation, but no firm conclusion could be made regarding any particular craniofacial morphology in children with symptoms and signs of TMJ dysfunction. Muscle tenderness was associated with a 'long face' type of craniofacial morphology and a lower bite force. Headache was associated with a larger maxillary length and increased maxillary prognathism. A high score on Helkimo's Clinical Dysfunction Index was associated with smaller values of a number of vertical, horizontal, and transversal linear craniofacial dimensions and a lower bite force. (+info)
Tooth movement and changes in periodontal tissue in response to orthodontic force in rats vary depending on the time of day the force is applied.
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The purpose of this study was to investigate whether there are any differences in tooth movement or in the response of periodontal tissue to orthodontic force when the force is applied at different times of the day. One hundred 6-week-old male Wistar rats were divided into one control group without force application and three experimental groups based on the time of day the force was applied to the upper first molars. Animals in the whole-day group received force continuously throughout the experimental period, while animals in the light- and dark-period groups received force only during the light (07:00-19:00) or dark period (19:00-07:00), respectively. Tooth movement was measured using the occlusal view of a precise plaster model with a profile projector. Periodontal tissues were evaluated histologically. The time course of tooth movement varied among the groups. Tooth movement over 21 days in the whole-day and light-period groups was about twice that as in the dark-period group. The formation of new bone on the tension side in the whole-day and light-period groups was more than twice that as in the dark-period group. On the pressure side, more osteoclasts appeared on the alveolar bone in the whole-day and light-period groups than in the dark-period group. The light-period group showed less extensive hyalinization of the periodontal ligament (PDL) than the whole-day group. The area of root resorption on day 21 also varied among the groups. Interference by masticatory forces did not seem to be a principal cause of the decreased tooth movement in the dark-period group. These results indicate that there are considerable variations in tooth movement and in the response of periodontal tissue to orthodontic force when the force is applied at different times of the day in rats. The results suggest that diurnal rhythms in bone metabolism have important implications in orthodontic treatment. (+info)
What is occlusion?
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The aim of this series of papers is to explore the role of occlusion in dental practice. The range of opinion in the dental profession as to the importance of occlusion is enormous. It is very important that the profession in general and practising dentists in particular have a balanced view of occlusion. This is more important than every patient having a balanced occlusion. The fact that the study of occlusion is characterised by extremes makes it confusing and possibly difficult for individual dentists to find a philosophy which is in line with contemporary good practice supported by evidence from practice-based research. (+info)
Occlusal stability in implant prosthodontics -- clinical factors to consider before implant placement.
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The success of any prosthetic design depends on proper management of the occlusion. The clinical variables influencing occlusal stability must be determined and considered in the design of the final prosthesis. This paper outlines some of these variables. (+info)
Bite force in pre-orthodontic children with unilateral crossbite.
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In the present study bite force was examined in pre-orthodontic children with unilateral posterior crossbite and compared with an age- and sex-matched control group. The sample comprised 52 children aged 7-13 years, 26 pre-orthodontic children with unilateral posterior crossbite (crossbite group), and 26 children with neutral occlusion (control group). Unilateral bite force was measured at the first molar by means of a pressure transducer. Furthermore, symptoms and signs of temporomandibular disorders (TMD) and number of teeth in contact in the intercuspal position (ICP) were recorded. In both groups, the maximum bite force increased significantly with age and with increasing stages of dental eruption, but the bite force in both sexes did not differ significantly. There were no significant differences in bite force between sides, but this was significantly smaller in the crossbite group than in the controls (P < 0.001). Regression analysis showed that stage of dental eruption (P < 0.001), number of teeth in occlusal contact (P < 0.01), and unilateral crossbite (P < 0.001) were the only variables significantly correlated with bite force. The number of teeth in contact was significantly smaller in the crossbite group than in the controls (P < 0.05) and the frequency of muscle tenderness was significantly higher in the crossbite group than in the controls (P < 0.05). These results suggest that differences in the muscle function associated with unilateral crossbite lead to a significantly smaller bite force in the crossbite group compared with controls and this difference did not diminish with age and development. These findings indicate that early treatment of unilateral posterior crossbite is advisable to optimize conditions for function. (+info)
Dynamics of the human masticatory system.
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In this review, the movement characteristics of the human masticatory system are discussed from a biomechanical perspective. The discussion is based upon the three fundamental laws of mechanics applied to the various anatomical structures that are part of the masticatory system. An analysis of the forces and torques applied to the mandible by muscles, joints, articular capsules, and teeth is used to assess the determinants of jaw movement. The principle of relating the interplay of forces to the center of gravity of the lower jaw, in contrast to a hinge axis near its joints, is introduced. It is evident that the muscles are the dominant determinants of jaw movement. The contributions of the individual muscles to jaw movements can be derived from the orientation of their lines of action with respect to the center of gravity of the lower jaw. They cause the jaw to accelerate with six degrees of freedom. The ratio between linear and angular accelerations is subtly dependent on the mass and moments of inertia of the jaw, and the structures that are more or less rigidly attached to it. The effects of articular forces must be taken into account, especially if the joints are loaded asymmetrically. The muscles not only move the jaw but also maintain articular stability during midline movements. Passive structures, such as the ligaments, become dominant only when the jaw reaches its movement boundaries. These ligaments are assumed to prevent joint dislocation during non-midline movements. (+info)
Ontogeny of feeding function in the gray short-tailed opossum Monodelphis domestica: empirical support for the constrained model of jaw biomechanics.
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The constrained model of masticatory function enables specific predictions of bite force potentials in skulls of differing craniodental configurations. In this study, empirical support for the constrained model is provided using maximum voluntary bite force data along Region I and II of the jaws of gray short-tailed opossums Monodelphis domestica. Then, growth series of M. domestica are used to assess how bite force potential changes with growth by evaluating craniodental changes using longitudinal sets of dorsoventral radiographs and by assessing maximal bite force potential at the Region I-II boundary of the jaw in juveniles (aged 70-80 days) and adults. Our findings show that, while juveniles and adults alike enclose at least three molariform teeth within Region II (the area of highest bite force potential along the jaw), age-dependent elongation of the masticatory muscle resultant lever arm and narrowing of the palate relative to jaw length especially enhance the mechanical advantage of the adductor muscle resultant in adults. While maximal bite forces at the Region I-II boundary are absolutely greater in adults, these bite forces scale isometrically with body mass, which suggests that mass-specific forces exerted by jaw adductor muscles of larger (adult) opossums are disproportionately smaller than those exerted by smaller (juvenile) opossums. (+info)
Response of human jaw muscles to axial stimulation of the incisor.
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The role of periodontal mechanoreceptors (PMRs) in the reflex control of the jaw muscles has thus far been mainly derived from animal studies. To date, the work that has been done on humans has been limited and confined to orthogonal stimulation of the labial surface of the tooth. The purpose of this study was to investigate the response of the masseter and digastric muscles in humans to controlled axial stimulation of the upper left central incisor, both before and during a local anaesthetic block of the PMRs. Ten neurologically normal young adult females were tested, each on two separate occasions to confirm the reproducibility of the results. It was found that the reflex response in the masseter was modulated by the rate of rise of the stimulus used and, to a lesser degree, the level of background muscle activity. There was little detectable change in the activity of the digastric muscle under the tested conditions and what was found could be attributed to cross-talk with the masseter. The reflex responses obtained were significantly different between subjects; however retesting the same subject on a different occasion yielded similar results. The results indicate that the most common response of the masseter muscle to brisk axial stimulation of the incisor is a reflex inhibition at 20 ms, followed by a late excitation at 44 ms. However, it is possible that this late excitation could be due to delayed action potentials and hence be artefactual. As the application of a local anaesthetic block removed or significantly reduced both of these responses, it was concluded that they originated from the PMRs. Unlike during orthogonal stimulation, slowly rising stimuli did not produce any excitatory reflex activity. This indicated a difference in jaw reflexes to forces applied in different directions, possibly due to the activation of different receptor types when stimulating the tooth in either the orthogonal or axial directions. (+info)