Jaw biodynamic data for 24 patients with chronic unilateral temporomandibular disorder.

This study assessed 24 adult patients, suffering from severe chronic unilateral pain diagnosed as temporomandibular joint (TMJ) disorder (TMD). The full dentate patients had normal occlusion and had never received an occlusal therapy, i.e., were with natural dental evolution/maturation. The following functional and dynamic factors were assessed: (1) chewing function; (2) TMJ remodeling or the condylar path (CP); and (3) lateral jaw motion or lateral guidance (LG). CPs were assessed using conventional axiography, and LG was assessed by K7 jaw tracking. Seventeen (71%) of the 24 (100%) patients consistently showed a habitual chewing side. The mean (standard deviation [SD]) of the CP angles was 47.90 (9.24) degrees. The mean (SD) of the LG angles was 42.95 (11.78) degrees. Data collection emerged from the conception of a new TMD paradigm where the affected side could be the habitual chewing side, the side with flatter lateral jaw motion or the side with an increased CP angle. These data may lead to improved diagnosis, therapy plans and evolution in TMD patients.

A prosthetic alternative for severely angled implants beneath a maxillary overdenture: a clinical report.

Implant-retained overdentures have been shown to be a predictable, accepted option and represent a viable and cost-effective treatment; however, patients with severe lack of bone volume and anatomical limitations are often a contraindication to the placement of osseointegrated implants without prior surgical procedures. In these situations, the placement of angled implants may offer a simple solution. This clinical report describes a case of dental rehabilitation using angled implants for a patient with a severely resorbed edentulous maxilla. The inclination has been solved by making a bar on the right side and individual pillars on the left side so as to obtain a functional and esthetic prosthetic result.

Maxillary changes and occlusal traits in crania with artificial fronto-occipital deformation.

Artificial fronto-occipital deformation of the cranial vault was typical of pre-Columbian cultures in the central Andean coastal regions. We have studied the influence of this deformation on maxillary and mandibular morphology. Measurements were performed on 86 adult Ancon skulls with anteroposterior deformation. Undeformed skulls from the area of Makatampu (n = 52) were used as the control group. To explore the influence of the deformity on occlusion, the skulls were categorized using the Angle classification and the alignment of the interincisor midline. In the group of deformed skulls, there was an increase in lateral growth of the vault and of the base of the skull (P < 0.001), giving rise to a greater interpterygoid width of the maxilla (P < 0.001), and an increase in the transverse diameter of the palatal vault. The mandible presented an increase in the length of the rami (P < 0.001) and in the intercondylar width, with no alteration of mandibular length. The deformed skulls had normal (class I) occlusion, with no displacement of the midline. The difference in the asymmetry index between the two groups was not statistically significant. Artificial fronto-occipital deformation of the cranial vault provoked compensatory lateral expansion of the base that was correlated with the transverse development of the maxilla and mandible. Occlusion and sagittal intermaxillary position were not affected by the cranial deformity. These results provide evidence of the integration between the neurocranium and the viscerocranium in craniofacial development, and support the hypothesis of a compensatory effect of function.

Guidelines for occlusion strategy in implant-borne prostheses. A review.

Medium- or long-term failure of endosseous dental implants after osseointegration, when it has occurred, has been associated in the great majority of cases with occlusal overload. Overload depends ultimately on the number and location of occlusal contacts, which to a great extent are under the clinician's control. Much of our current understanding of occlusal contacts in this context is based on concepts derived from non-implant-borne prosthetics and has not been rigorously tested. The present article reviews occlussal contact designs and offers occlusion strategy guidelines for the main types of implant-borne prostheses.

Midline shift and lateral guidance angle in adults with unilateral posterior crossbite.

INTRODUCTION: Unilateral posterior crossbite is a malocclusion that, if not corrected during infancy, typically causes permanent asymmetry. Our aims in this study were to evaluate various occlusal parameters in a group of adults with uncorrected unilateral posterior crossbite and to compare findings with those obtained in a group of normal subjects. METHODS: Midline shift at maximum intercuspation, midline shift at maximum aperture, and lateral guidance angle in the frontal plane were assessed in 25 adults (ages, 17-26 years; mean, 19.6 years) with crossbites. RESULTS: Midline shift at maximum intercuspation was zero (ie, centric midline) in 36% of the crossbite subjects; the remaining subjects had a shift toward the crossbite side. Midline shift at maximum aperture had no association with crossbite side. Lateral guidance angle was lower on the crossbite side than on the noncrossbite side. No parameter studied showed significant differences with respect to the normal subjects. CONCLUSIONS: Adults with unilateral posterior crossbite have adaptations that compensate for the crossbite and maintain normal function.

Unilateral posterior crossbite and mastication.

OBJECTIVE: This study was designed to characterize masticatory-cycle morphology, and distance of the contact glide in the closing masticatory stroke, in adult subjects with uncorrected unilateral posterior crossbite (UPXB), comparing the results obtained with those obtained in a parallel group of normal subjects. STUDY DESIGN: Mandibular movements (masticatory movements and laterality movements with dental contact) were registered using a gnathograph (MK-6I Diagnostic System) during unilateral chewing of a piece of gum. Traces were recorded on the crossbite and non-crossbite sides in the crossbite group, and likewise on both sides in the non-crossbite group. RESULTS: Mean contact glide distance on the crossbite side in the UPXB group was significantly lower than in the control group (p<0.001), and mean contact glide distance on the non-crossbite side in the UPXB group was significantly lower than in the control group (p=0.042). Cycle morphology was abnormal during chewing on the crossbite side, with the frequency distribution of cycle types differing significantly from that for the noncrossbite side and that for the control group (p<0.001). CONCLUSIONS: Patients with crossbite showed alterations in both contact glide distances and masticatory cycle morphology. These alterations are probably adaptive responses allowing maintenance of adequate masticatory function despite the crossbite.

A titanium and visible light-polymerized resin obturator.

Obturator prostheses are typically large, and their weight and size are often important design factors. This article describes the fabrication of an obturator prosthesis with a titanium framework and visible light-polymerized denture base resin. It is speculated that these low-density materials may produce prostheses lighter than similar ones made with conventional materials. An added advantage is that visible light-polymerizing resins facilitate relining.