An observational analysis to evaluate the influence of occlusion on body posture and plantar pressure - An in vivo study.

AIM: The aim of this study is to evaluate the influence of occlusion on body posture and plantar arch pressure. SETTINGS AND DESIGN: An Observational analysis to Analyze the Influence of Occlusion on Plantar Pressure and Body Posture. MATERIALS AND METHODS: A total of 30 asymptomatic subjects were selected for the study including 18 females and 12 males from age group 22 years to 28 years with a mean age of 24.83 years. Each subject underwent evaluation of occlusion at MIP using a Digital Occlusal analyzer (T-Scan III). At this point, the subjects were made to stand on a mat scan which consisted of a large postural platform sensor and a computer that displayed the plantar pressure data. The computer connected to the T Scan displayed the occlusal pressure analysis. This was followed by an evaluation of body posture using a posture grid where the photographs were taken and an evaluation of the frontal and lateral photos was done using the APECS - posture analysis app. STATISTICAL ANALYSIS USED: Statistical package for social sciences (SPSS) for windows version 22.0 Released 2013, Armonk, N Y: IBM Corp., was used to perform Statistical Analysis. A chi-square test was applied for qualitative variables to find the association. Paired t-test was applied to compare the changes in the quantitative parameters in eye-open and eye-closed conditions. The level of significance was set at 5%. RESULTS: As observed from the results, occlusion for 40% of the subjects, where n = 12, was dominant on the right side. Occlusion for 23.3% of subjects, where n = 7, was dominant on the left side. Whereas, for 36.7% of subjects, where n = 11, the pressure distribution was almost equal on both sides. The inclination of body posture for 23.3% of subjects, where n = 7, was towards the right side. The inclination of body posture for 50% of subjects, where n = 11, was towards the left side. And, the inclination of body posture for 26.7% of subjects, where n = 8, was neutral i.e., balanced on the right and left side. Plantar pressure for 6.7% of subjects, where n = 2, was dominant on the right side. Plantar pressure for 36.7% of subjects, where n = 11, was dominant on the left side. Whereas, for 56.7% of subjects, where n = 17, the plantar pressure distribution was almost equal on both sides. CONCLUSION: On correlating the three parameters, it was found that occlusion for most of the subjects dominated on the right side, while body posture and plantar pressure dominated on the contralateral i.e., left side.

Evaluation of the Effect of Occlusal Calibration in Periodontitis Patients with Occlusal Trauma Using T-Scan.

BACKGROUND: High occlusal forces in patients with untreated periodontitis may reflect occlusal trauma-associated periodontal conditions. Occlusal analysis using T-scan might provide the distribution of occlusal loading forces in periodontitis patients. The study aimed to evaluate the effect of occlusal trauma in periodontitis patients and occlusal calibration using a T-scan. MATERIALS AND METHODS: A total of 30 periodontitis patients were recruited for the study. Patients were categorized into two groups: Group I: scaling and root planing followed by T-scan recording and no occlusal calibration; Group II: scaling and root planing followed by occlusal calibration using T-scan. Clinical parameters, orthopantomogram (OPG) and T-scan evaluation were evaluated at baseline, 3-month and 6-month intervals. RESULTS: Significant improvements in clinical parameters were noted at different time intervals after occlusal calibration using T-scan. At 3-month intervals, mean pocket depth showed statistically significant difference among the test group in the right (upper and lower) and left lower quadrant at P = 0.01, 0.002 and 0.005, respectively. Mean clinical attachment level (CAL) showed statistically significant difference among the test group in the right upper, right lower and left lower quadrants at P = 0.02, 0.001 and 0.009, respectively, at 3 months. The comparison of the mean gingival index (GI) at 6 months showed statistically significant difference among test and control groups at 6 months in different study quadrants (P = 1 in right upper, 0.009 in right lower, <0.001 in left upper and <0.001 in left lower). Mean pocket depth at the 6-month follow-up showed statistically significant difference among the test group in all the study quadrants (P = <0.001 in right upper, <0.001 in right lower, 0.003 in left upper and 0.005 in left lower). Mean CAL showed statistically significant difference among the test group in all the study quadrants at 6-month intervals (P = 0.02 in right upper, <0.001 in right lower, 0.01 in left upper and 0.04 in left lower). The bone defect height showed a statistically significant difference only in the right upper quadrant among both the test groups at the 6-month follow-up (P = 0.02). Comparing the mean percentage of force on both sides of the jaw showed a statistically significant difference among the test group at 6 months (P = 0.001 on the left side and 0.001 on the right side). CONCLUSION: The occlusal correction using T-scan showed a positive association between probing pocket depth (PPD) and CAL at different time intervals from baseline to 6 months when these parameters were compared after occlusal adjustments.

A retrospective five-year survey on the treatment outcome of disclusion time reduction (DTR) therapy in treating temporomandibular dysfunction patients.

OBJECTIVE: To assess the five-year long-term quality of life of patients who were treated with Disclusion Time Reduction Therapy (DTR). METHODS: Thirty occluso-muscular disorder patients responded to two questionnaires about their symptom intensities, frequencies, and pain levels that were given to the patients before DTR therapy and five years after. Both surveys were subjected to the Wilcoxon signed-rank test to compare differences in the reported intensities, frequencies, and pain levels. RESULTS: A statistically significant reduction was found between the pre- and five-year post-DTR treatment intensities, frequencies, and pain scores (p < 0.05). CONCLUSION: The chronic pain intensity and frequency observed in patients with occluso-muscular disorders can be markedly reduced by Immediate Complete Anterior Guidance Development (ICAGD)/DTR therapy, while improving the patient's overall long-term quality of life. Many pre-ICAGD/DTR daily chronic and painful, occluso-muscular symptoms were no longer present years after undergoing ICAGD/DTR treatment.

A Multi-Center Disclusion Time Reduction (DTR) Randomized Controlled Occlusal Adjustment Study Using Occlusal Force and Timing Sensors Synchronized with Muscle Physiology Sensors.

Objective-To perform a Randomized Controlled Trial (RCT) Disclusion Time Reduction (DTR) study at five Dental Colleges, using intraoral sensors and muscular electrodes. Methods and Materials-One hundred students were randomly assigned to a treatment group to receive the ICAGD coronoplasty, or a control group that received tooth polishing. All subjects answered symptom questionnaires: Beck Depression Inventory-II, Functional Restrictions, and Chronic Pain Symptom and Frequency. Subjects self-reported after ICAGD or placebo at 1 week, 1 month, 3 months, and 6 months. The Student's t-Test analyzed the measured data. The Mann-Whitney U Test analyzed the subjective data (Alpha = 0.05). Results-The Disclusion Times, BDI-II scores, and Symptom Scales were similar between groups prior to treatment (p > 0.05). At 1 week, all three measures reduced in the treatment group, continuing to decline over 6 months (p < 0.05), but not for the controls (p > 0.05). Symptom Frequency, Functional Restrictions, and Pain Frequencies were higher in the treated group (p < 0.05), but declined after ICAGD compared to the control group (p < 0.05). Conclusions-ICAGD reduced Pain, Functional Restrictions, Symptom Frequency, and Emotional Depression within 1 week, which continued for 6 months. The tooth polishing did not initiate a placebo response.

Comparison of Bite Force and the Influencing Factors Pre- and Post-cementation of Stainless Steel Crown in Children Using T-Scan.

BACKGROUND: In children, stainless steel crowns (SSCs) have become an invaluable restorative option for grossly decayed primary teeth. The crowns are manufactured in different sizes with preformed anatomy which requires trimming or contouring as a necessary step to fit an individual tooth. Initially, this may produce variation in the occlusal contact points yet may not result in pain or discomfort. Little research exists regarding bite force equilibration measurements in children after placing SSC, and its influencing factors such as age and gender. AIM AND OBJECTIVE: To evaluate and compare the measurements of bite force pre- and post-cementation of SSC using the conventional technique at maximal intercuspal position (MIP) on primary molars at different time intervals and whether age and gender influence bite force measurements. DESIGN: Bite force and occlusal contacts during occlusion were made using T-Scan III. Twenty children scheduled for treatment who needed SSCs were included. T-Scan measurements of the bite force and occlusal contacts of the maxilla and mandibular teeth were recorded and analyzed before and immediately after cementation of SSC later 4 weeks during the follow-up period. These measurements were correlated with age and gender influence. RESULTS: There was no significant result in the percentage of bite force on the crowned tooth (placement of SSC) at different time intervals. Prematurities were present in all the groups but a significant reduction was seen on the crowned tooth from baseline to 1-month follow-up (p = 0.03). Also, a statistically significant increase in the bite force was seen in >7 years of age (p = 0.006) and no statistical significance among the gender. CONCLUSION: Following the standard tooth preparation, the SSC will continue to appear clinically acceptable for many years. Our study children showed an adaptable masticatory system irrespective of age and gender during growth and development. HOW TO CITE THIS ARTICLE: Aishwarya N, Nagarathna C, Poovani S, et al. Comparison of Bite Force and the Influencing Factors Pre- and Post-cementation of Stainless Steel Crown in Children Using T-Scan. Int J Clin Pediatr Dent 2021;14(1):46-50.

Digital occlusal analysis of vertical dimension and maximum intercuspal position after placement of stainless steel crown using hall technique in children.

BACKGROUND: The stainless steel crowns (SSCs) placed using the Hall technique disrupt the occlusion, but stabilization appears to occur within a short period post-placement. Negligible understanding and comprehension is presently handy about the changes in overbite and bite force after placement of stainless steel crown using the Hall technique in children. AIM/HYPOTHESIS: To evaluate the digital occlusal analysis of vertical dimension and maximum intercuspal position to understand the changes in overbite and bite force after placement of stainless steel crown using the Hall technique. DESIGN: Twenty children who needed treatment for the carious tooth with decay extending to enamel and dentin and multisurface caries were managed using the Hall technique. Following that, overbite measurement for vertical dimension was carried out clinically using digital vernier calipers. Later, the T-Scan III was used for measuring occlusal load at the maximum intercuspal position. The bite force and occlusal premature contacts were digitally analysed and recorded pre-operatively, immediately after placement of SSC and after 1 month follow-up period. RESULTS: A significant result in the vertical dimension, bite force on crowned tooth, and significant reduction in the prematurities were seen from baseline to one-month follow-up. CONCLUSION: There was an occlusal re-equilibration attained after 1 month.

Disclusion time reduction therapy in treating occluso-muscular pains.

Disclusion time reduction (DTR) is an objective treatment protocol using T-Scan III (digital analysis of occlusion) and electromyography for treating occlusally activated orofacial pains. Chronic occluso-muscle disorder is a myogenous subset of temporomandibular disorder symptoms. These muscular symptoms are induced within hyperactive masticatory muscles due to prolonged disclusion time, occlusal interferences, and occlusal surface friction that occur during mandibular excursive movements. This case report describes a patient treated by DTR therapy, whereby measured pretreatment prolonged disclusion time was reduced to short disclusion time using the immediate complete anterior guidance development enameloplasty, guided by T-Scan occlusal contact time and force analysis synchronized with electromyographic recordings of four masticatory muscles.

The effect of disocclusion time-reduction therapy to treat chronic myofascial pain: A single group interventional study with 3 year follow-up of 100 cases.

PURPOSE: The purpose of this study is to evaluate the longevity of reduced disclusion time in treating and removing myofascial pain dysfunction symptoms following the T-Scan-based, immediate complete anterior guidance development (ICAGD) coronoplasty. This measured occlusal adjustment has been shown to reduce the muscle hyperactivity of myofascial pain. METHODS: Myofascial pain symptomatic patients were recruited as per the diagnostic criteria for temporomandibular disorders (TMDs), including the clinical protocol and assessment instruments outlined by the international RDC/TMD consortium network (version: January 20, 2014) to assess the efficacy of reduced disclusion time in left and right lateral excursions to resolve the myofascial pain symptoms. As per the inclusion and exclusion criteria, 100 cases were treated with ICAGD in three visits, each 1 week apart. Recall disclusion time measurements were recorded every 3 months over 3 years. The RDC/TMD questionnaire was used for symptom assessment at every recall visit. ICAGD brought pretreatment prolonged disclusion time down to <0.4 s, as quantified from T-Scan force and time data records, while the subjects were assessed for symptom relief. The Wilcoxon signed-rank test was used for statistical analysis (P < 0.05). RESULTS: Changes in the intensity of many symptoms from reducing the disclusion time to <0.4 s were statistically significant from treatment day 1, and onward through the 3-year period of observation (P < 0.05). CONCLUSION: The results indicate that ICAGD reduces the musculoskeletal symptoms of myofascial pain, such that this methodology increases clinical therapeutic success.

Temporomandibular joint vibrations from totally asymptomatic subjects.

OBJECTIVE: Precisely characterize the TMJ vibrations of a youthful, adult and completely asymptomatic population. METHODS: TMJ vibrations were recorded from 237 asymptomatic subjects (163 f, 74 m) at Dayananda Sagar Institute in India. The subjects were selected, examined and informed (WMA Helsinki Declaration). TMJ vibrations were recorded bilaterally during maximal open - close. 6 parameters of the vibrations were analyzed between the left and right sides, between genders and with respect to age. RESULTS: Mean vibration intensity was greater for females (p < 0.01) than males. A portion of the frequency spectrum < 300 Hz was also more intense for females (p < 0.022). Females 18 - 20 years old exhibited higher Peak Amplitude than 27 - 30 year olds (p < 0.025) and lower Median Frequency (p < 0.005). CONCLUSIONS: A significant difference in TMJ vibrations was present between males and females, increased with age in females but not in males.

The influence of immediate complete anterior guidance development technique on subjective symptoms in Myofascial pain patients: Verified using digital analysis of occlusion (Tek-scan) for analysing occlusion: A 3 years clinical observation.

OBJECTIVES: The purpose of this study is to evaluate the effect of occlusal equilibration using immediate complete anterior guidance development (ICAGD) technique by Kerstein and Farrell on the subjective symptoms of myofascial pain. This technique is the most advanced verifiable and measurable way of digitally analyzing the occlusion using T-scan technology. The primary objective is to reduce the anterior disclusion time to <0.4 s and the secondary objective is to reduce the signs and symptoms of myofascial pain. MATERIALS AND METHODS: This study is to assess the reducing effects of subjective symptoms of 100 patients diagnosed as myofascial pain patients treated by ICAGD technique as described by Kerstein and Farrell. The common complaints of the patients were a pain in the masseter and temporal muscles, jaw tiredness in the mornings, night bruxing and difficulty in chewing. In this technique occlusal equilibration involves removal of posterior interferences and establish anterior guidance. The patients were treated over three visits 1-week apart and followed for 3 years with an interval of 3 months for the subsequent visits. A visual analog ordinal scale is used to rate the symptoms. The symptoms reduction occurred for all the patients after the first correction in about 5-10 days. In about a period of 3 years review, no recurrence was seen of the chronic myofascial symptoms. RESULTS: In spite of the chronic nature of the patient's symptoms, symptom reduction occurred in a week's time. This was assessed by the results of the ordinal scale values. This agrees with the studies of Kerstein and Farrell. CONCLUSION: Equilibration of occlusion using digital analysis by T-scan in which force is quantified against time, should be done to establish free functional movements without any interference; otherwise the disturbances in the excursive movements may lead to muscle dysfunction at later years.

The effect of reduced disclusion time in the treatment of myofascial pain dysfunction syndrome using immediate complete anterior guidance development protocol monitored by digital analysis of occlusion.

STATEMENT OF PROBLEM: Chronic myofascial pain dysfunction syndrome (MPDS) has been a nightmare for patients suffering from it, who have been treated with various treatment options with varied outcomes. This population of patients has been neglected, due to nagging revisits to a clinician and decreased percentage of success. OBJECTIVE: T-Scan-based immediate complete anterior guidance development (ICAGD) has been shown by a researcher to reduce the muscle hyperactivity consistent with MPDS. The purpose of this study is to evaluate the effect of reduced disclusion time in lateral excursions in treating the MPDS symptoms. MATERIALS AND METHODS: Fifty-one myofascial pain patients with symptoms in the area of the head and neck region were treated with ICAGD. The quantified force and time data from T-Scan records were used to correct the prolonged disclusion time, and the subjects were assessed for the symptom relief. The Wilcoxon Signed Ranks Test was used for statistical analysis (P<0·05 denotes significant changes). RESULTS: The changes in disclusion time and intensity of various symptoms were found to be statistically significant (P<0·05) from Day 1 onwards, and patients were relieved of their symptoms after reduction of disclusion time of less than 0·5 seconds. CONCLUSION: The results clearly indicated that ICAGD protocol reduces musculoskeletal-based symptoms of MPDS patients, and this protocol can prove beneficial for the clinical treatment success.

Full Mouth Rehabilitation by Minimally Invasive Cosmetic Dentistry Coupled with Computer Guided Occlusal Analysis: A Case Report.

Evidence of dentistry dates back to 7000 B.C. and since then has come, indeed a long sophisticated way in treatment management of our dental patients. There have been admirable advances in the field of prosthodontics by the way of techniques and materials; enabling production of artificial teeth that feel, function and appear nothing but natural. The following case report describes the management of maxillary edentulousness with removable complete denture and mandibular attrition and missing teeth with onlays and FPD by the concept of minimally invasive cosmetic dentistry. Computer guided occlusal analysis was used to guide sequential occlusal adjustments to obtain measurable bilateral occlusal contacts simultaneously.

Force Finishing and Centering to Balance a Removable Complete Denture Prosthesis Using the T-Scan III Computerized Occlusal Analysis System.

Obtaining bilateral balance of removable complete denture prostheses is the occlusal goal of the restorative dentist or prosthodontist. Despite our best clinical efforts, and the using of advanced mechanical devices like semi-adjustable articulators and face bow transfer mounting of dental casts, it is a struggle to provide accurate occlusal force balance. Some of the advocated reasons for the clinical difficulty of obtaining reliable occlusal balance are that stone casts lack soft tissue resiliency, and articulators only approximate human occlusal functional movements. However, modern technology offers clinicians a digital answer to this clinical force balance problem. It is known as computerized occlusal analysis. The T-Scan III system can be employed with complete removable denture prostheses to perform computer-guided occlusal force-finishing corrective adjustments that measurably improve the installed prosthetic occlusal balance.