[A novel tray for recording maxillomandibular relationship of edentulous patients based on dimensional surveying of complete dentures].

OBJECTIVE: To measure the dimensional data of complete dentures and to design a novel tray for recording maxillomandibular relationship of edentulous patients. METHODS: For the measurement, 100 pairs of complete dentures from the clinic were surveyed for the following parameters: a1, the distance between the middle fossa of the upper left and right first molars; a2, the anterior-posterior distance between the middle fossa of the upper first molars and the incisal edge; a3, the width of the upper denture; a4, the anterior-posterior length of the upper denture; a51, the height from the mesio-lingual cusp of the right upper first molar to the saddle surface; a52, the height from the central fossa of the right lower first molar to the saddle surface; a6, the height from the notch of the upper lip frenulum to the upper central incisor edge; a7, the least thickness of the labial saddle base in the upper central incisor region. Based on the data, the trays with different sizes were designed and fabricated, and the key parameters were: b1, the distance between the foramina of screw posts, b2, the anterior-posterior distance between the foramina of the screw posts and the incisal edge; b3, the width of the tray; b4, the anterior-posterior length of the tray; b51, the height of the posterior platform with the screw nut; b52, the height of the screw post; b6, the height of the anterior tray handle; b7, the thickness of the anterior tray handle. RESULTS: The minimum, average and maximum data for each parameter were (in millimeter): a1: 37.1, 44.5, and 59.6; a2: 22.6, 29.0, and 38.1; a3: 48.5, 58.2, and 76.6; a4: 37.4, 50.8, and 61.0; a51: 5.6, 9.5, and 14.7; a52: 3.8, 9.9, and 18.8; a6: 8.9, 16.6, and 24.7; a7: 1.2, 2.8, and 5.9. Based on the data, the trays in small, medium and large sizes were designed and fabricated. In clinical application, the putty silicone rubber impression material was used to reline the tray, meanwhile the posterior platform and anterior tray handle were set as the occlusal plane, then the screw posts were added and adjusted till the proper vertical dimension, after that, the putty silicone rubber impression material was added around the screw posts to record the horizontal maxillomandibular relationship, finally, the anterior surface of the tray handle was used to record the midline of the face and lower edge of the upper lip at rest and with smile. CONCLUSION: The dimensional data offered reference for the analysis of restoration space in edentulous patients. The tray designed and fabricated in this study may serve as a new tool for recording the maxillomandibular relationship.

Neurological symptoms in Hypophosphatasia.

Hypophosphatasia (HPP) typically manifests with fractures, tooth loss, and muscle pain. Although mental health diagnoses and neurological symptoms have not been previously well documented in HPP, they occur commonly. The recognition of non-traditional symptoms may improve patient satisfaction, preempt costly evaluation and misdiagnosis, and lead to further treatment options. INTRODUCTION: Hypophosphatasia (HPP) is an inborn error of metabolism due to deficiency of tissue non-specific alkaline phosphatase (TNSALP). It is traditionally characterized by rickets in children and osteomalacia in adults, along with fractures, tooth loss, and muscle pain. Neurological symptoms and mental health diagnoses have not been widely reported, and we therefore report their prevalence in a cohort of patients with HPP. METHODS: A retrospective chart review was performed on a series of 82 HPP patients. Patient charts were reviewed to identify the possible presence and onset of 13 common neurological symptoms. RESULTS: Median age was 36 years (2 to 79). Seventeen had adult onset HPP (> 18 years) and 65 had pediatric onset HPP (< 18 years). Median time from symptom onset to HPP diagnosis was 8 years (0 to 67). Seventy-four percent had a family history of bone disease, while 17% had a family history of neurologic disease. Bone problems occurred in 89%, dental problems in 77%, and muscle problems in 66%. Fatigue occurred in 66%, headache in 61%, sleep disturbance in 51%, gait change in 44%, vertigo in 43%, depression in 39%, anxiety in 35%, neuropathy in 35%, and hearing loss in 33%. CONCLUSIONS: The extra-skeletal manifestations of HPP, specifically neurological symptoms, have not been previously well documented. However, mental health diagnoses and neurological symptoms such as headache and sleep disturbance occur commonly in patients with HPP. The recognition of non-traditional symptoms in HPP may improve patient satisfaction, preempt costly evaluation and misdiagnosis, and may lead to further treatment options.

Potential application of shape memory plastic as elastic material in clinical orthodontics.

Polynorbornen, a shape memory plastic developed in Japan, has a glass transitional point of 35 degrees C. Once the environmental temperature exceeds the critical point, this plastic will begin to display an elastic property, then return to its original shape, if deformed. We examined whether the force generated during the elastic phase of polynorbornen could be used to displace human teeth. We found that the shape memory plastic wire of 1 mm in diameter stretched to two to three times of its original length at a temperature of 50 degrees C and a speed of 0.5 mm/sec would exert a relatively stable continuous light force of 119-156 g to move the teeth. This new material, compared with conventional elastic modules used in orthodontic therapy, exhibited a lesser degree of force degradation at a body temperature of 37 degrees C for a long period, and can be manufactured to near the tooth colour required. These advantages make feasible clinical application of the shape memory plastic in orthodontics.

Heritability of dental arch dimensions in humans.

The purposes of this study were to estimate the heritabilities of several human dental arch dimensions and compare the hereditary differences among kinships and among variables. The sample consisted of 102 Japanese families, each including both parents and one of their offspring, and on average all subjects had relatively well-aligned permanent dentitions. The heritabilities of all variables were estimated from the regression of offspring on parent and on midparent. Results showed that genetics played a role regarding dental arch dimensions, and arch perimeter (sum of tooth width) was a more definite genetic-related factor than other arch dimensions, such as width, length, or size. There were few significant hereditary differences between sons and daughters, and between upper and lower arches for each variable. Sex chromosomal involvement was not confirmed, but maternal effects were found to be more evident in daughters than in sons, for both arches. Comparisons among the heritabilities of overall and of anterior arch dimensions indicated that size of the anterior part of the dental arch might be less resistant to environmental factors, especially in case of the lower arch.

Familial similarity in dental arch form and tooth position.

This study was done to quantify and compare similarities in dental arch form and tooth position among individuals of various degrees of biological kinship. The sample consisted of 360 dental casts selected from 102 Japanese families, each including both parents and one of their offspring. Most of the subjects had well-aligned permanent dentitions. Coefficients of dissimilarity were obtained by orienting two standard-sized dental arch diagrams plotted from occlusal photographs to the position of best fit. Dissimilarity between adults and children from different families was computed and served as the control data. With few exceptions, the mean dissimilarity between parents and offspring was smaller than that of the nonfamilial pairings; however, statistical differences were not always significant. Among all the teeth observed, the position of both upper and lower central incisors was found to exhibit the least familial similarity. Analysis of variance among pairings of different sources of variation suggested the existence of significant additive genetic effect, both autosomal and sex-linked. Relative contribution of the additive genetic effect in the total variability of this sample was estimated for dental arch form and tooth position to be in the range of 55-60% and 39-77%, respectively. Autosomal additive genetic effects appear to strongly account for the variation in position of the second premolar and of the first molar.