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2.
Stomatologiia (Mosk) ; 101(2): 47-51, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35362703

RESUMO

THE AIM OF THE STUDY: Was to assess the adaptation of patients to obturator at different periods of adaptation using objective digital methods of analysis: axiography, cone-beam computer tomography, digital facial scans, and intraoral scanning. MATERIAL AND METHODS: The study comprised 17 patients with postoperative defects of the upper jaw at different periods of removable obturators usage. RESULTS: In 88.2% of the subjects limited mouth opening and displacement of the mandible to the healthy side was detected. Contracture as a complication can develop in the later stages of rehabilitation. CONCLUSION: A long-term rehabilitation of patients is recommended using simulators and special gymnastic exercises in order to prevent extra-articular contracture.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Mandíbula , Computadores , Eletrônica , Humanos , Registro da Relação Maxilomandibular/métodos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia
3.
Int J Comput Dent ; 25(1): 47-56, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35322652

RESUMO

Sufficient occlusion is a basic prerequisite for the functional efficiency of the occlusal surfaces. Exactly where and in what number the occlusal contacts in the posterior region should be present for this purpose is controversial. The present study investigated the number and location of occlusal contacts on posterior teeth without dental findings, ie, without caries or restorative restorations such as fillings, crowns, etc. Such natural posterior teeth were present in 709 subjects (males (m) = 446: 48.9 ± 13.04 years, females (f) = 283: 52.4 ± 14.23 years) of a subject collective of 1223 subjects (m = 648, f = 575) of the regional baseline study 'Study of Health in Pomerania 1' (SHIP-1). Silicone bite registrations in habitual intercuspation (IP) were evaluated, whereby the test persons were asked to fix the bite block with biting force without biting firmly. The registrations were scanned with a document scanner in incident and transmitted light; a calibration strip was used to determine the transparency threshold of a layer thickness of 20 µm, below and equal to which the transparent zone was considered as a contact or contact area. The Greifswald Digital Analyzing System 2 (GEDAS 2) software was used to determine the number and location of occlusal contact areas tooth by tooth. To define the localization of the contacts, a cross with two concentric circles symmetric to the longitudinal fissure was superimposed on the occlusal surface; this resulted in four inner and four outer quadrants. Thus, the number of pixels in occlusal contact areas per inner and outer quadrant could be determined. The image resolution was 300 dpi. On average (median), the premolars had two occlusal contacts each, the posterior teeth had four to five, and tooth 46 had six contacts. The right and left teeth did not differ in the frequency of occlusal contacts in the Mann-Whitney U test for independent samples. In the maxillary premolars, frequent contact areas were primarily located mesially on the inner and outer slopes of the palatal cusp. In the maxillary molars, the palatal slope of the distopalatal cusp and the inner slopes of the mesiopalatal and distopalatal cusps were frequently affected. On the mandibular premolars, the inner slopes of the buccal cusps and the buccal slope of the distobuccal cusp were particularly frequently addressed; in teeth 35 and 45, the buccal slope of the mesiobuccal cusp was also somewhat more frequently addressed. Teeth 36 and 46 frequently had contact areas on the buccal slope of the distobuccal cusp as well as on the inner slopes of the distal cusps (distobuccal and distolingual), whereas teeth 37 and 47 tended to behave similarly. Epidemiologically, the focus of the frequent contact areas on the respective supporting cusps of the maxillary and mandibular posterior teeth and a distribution of contacts stabilizing the tooth in its position in the dental arch through the interlocking were confirmed. It makes sense to take this into account when designing occlusal surfaces in the posterior region.


Assuntos
Força de Mordida , Oclusão Dentária , Registro da Relação Maxilomandibular , Dente Pré-Molar , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino
4.
Biomed Res Int ; 2022: 1439203, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35097107

RESUMO

PURPOSE: This study is aimed at evaluating the impact of the craniofacial structure and occlusal conditions on the position of the articular heads of the mandibular condyles in the maximum intercuspal position (MIP) and comparing the centric relation (CR) and MIP of the mandibular condyles prior to orthodontic treatment. METHODS: The studied group consisted of 33 women and 15 men (median age of 17.75 years). Contact points of opposing teeth in the MIP were assessed by hand-held casts. Condylar displacement (CD) in three spatial planes on both sides was measured on models mounted in an articulator using a mandibular position indicator (MPI). Patients were divided into groups according to craniofacial structures (vertical and horizontal growth directions). The Mann-Whitney, Kruskal-Wallis, post hoc Dwass-Steel-Critchlow-Fligner, and Pearson's χ 2 independence tests as well as Spearman's nonparametric correlations were used in the statistical analyses. RESULTS: Within the limitations of this study, no statistically significant correlation of CD with certain cephalometric measurements from a lateral cephalometric radiograph (ANB, SN-ML, and SGo/NMe) was observed. Correlation, however, was found between condylar displacement in the transverse axis and the mandibular plane angle SN-ML (p = 0.033) and also between condylar displacement in the anteroposterior axis and a midline shift of the mandible (p = 0.041). The results revealed a relationship between Angle's classification of molar position on the right side and anteroposterior CD values (p = 0.006). CONCLUSIONS: Cephalometric measurements cannot be used to predict CD at the level of the condyles. Analysis of occlusal conditions of models mounted in an articulator is desirable for patients with Angle's class I and lower jaw asymmetry.


Assuntos
Mandíbula , Côndilo Mandibular , Adolescente , Relação Central , Cefalometria , Articuladores Dentários , Feminino , Humanos , Registro da Relação Maxilomandibular/métodos , Masculino , Mandíbula/diagnóstico por imagem , Côndilo Mandibular/diagnóstico por imagem
5.
J Prosthodont ; 31(4): 326-332, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34196456

RESUMO

PURPOSE: To analyze the accuracy of transferring casts in maximal intercuspal position to a virtual articulator by using transfer plates in the laboratory scanner before and after occlusal optimization. MATERIAL AND METHODS: Five sets of standard dental casts were mounted on a mechanical articulator in maximal intercuspal position. The number and position of occlusal contacts were determined with 12-µm articulating foil. After a calibration process according to the manufacturer's instructions, the mountings were transferred to a virtual articulator using the transfer plates in a laboratory scanner. The occlusion of the digital casts was determined before and after the occlusal optimization process. Then, the sensitivity and positive predictive value were determined by comparing the occlusal contact points in the virtual articulator with those in the mechanical articulator. To evaluate trueness, the occlusal surface of the maxillary teeth in the mechanical articulator was recorded by polyvinyl siloxane occlusal record in maximal intercuspal position and retained on the mandibular arch. The trueness was calculated as the deviation between the occlusal surface of the maxillary teeth in the mechanical articulator and the virtual articulator. To evaluate precision, one set of the casts was scanned 10 times. And the deviation of the interarch position of the maxillary arches when superimposing the mandibular arches of every 2 different scans was calculated. RESULTS: The sensitivity before occlusal optimization (0.14 ± 0.15) was significantly lower than that after occlusal optimization (0.82 ± 0.10) (p = 0.003). However, there was no significant difference between the positive predictive value before (0.80 ± 0.45) and after (0.81 ± 0.09) occlusal optimization (p = 0.952). The trueness before (91.0 ± 10.7 µm) and after (75.4 ± 25.2 µm) occlusal optimization had no significant difference (p = 0.249). The precision before occlusal optimization (11.6 ± 3.8 µm) was significantly superior to that after occlusal optimization (75.6 ± 39.2 µm ) (p < 0.001). CONCLUSIONS: The accuracy of transferring casts in maximal intercuspal position to a virtual articulator using transfer plates in the laboratory scanner could be improved after occlusal optimization and can meet the clinical needs for occlusal design and analysis of prostheses.


Assuntos
Articuladores Dentários , Dente , Oclusão Dentária , Registro da Relação Maxilomandibular , Maxila
6.
J Prosthodont ; 31(1): 79-84, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34170604

RESUMO

Customized cast orientations and parameter settings of the virtual articulator according to the patient's condyles are indispensable parts of today's digital workflows in prosthodontics. This article describes a digital technique to align the intraoral scans to a virtual articulator by using a facial scanner to locate the patient's cutaneous landmarks of the arbitrary hinge axis and the reference plane, and to customize the sagittal condylar inclination of the virtual articulator through a digital protrusive interocclusal record and a dental computer-aided design software program. It enables individual cast orientations and virtual articulator parameter settings without conventional facebow transferring and bite registration procedures and can be easily integrated with most virtual articulator systems on the market to allow clinicians and technicians to work in a complete digital workflow and facilitate customized treatment planning and dental prosthesis fabrication.


Assuntos
Desenho Assistido por Computador , Articuladores Dentários , Osso e Ossos , Face , Humanos , Registro da Relação Maxilomandibular , Prostodontia
7.
J Prosthodont ; 31(S1): 13-22, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34605582

RESUMO

Although the evolution of digital technology continues to improve patient data acquisition, the ability to both standardize the recording of the maxillary occlusal plane and capture the necessary dynamic data for dento-facial analysis remains elusive. This article describes step-by-step techniques to position the maxilla on an articulator using the natural head position and a facial reference system (Kois Facial Reference Glasses) for both analog and digital workflows. A photographic technique will be presented that captures the natural head position and allows the clinician to align a 2D reference photograph with the maxillary intraoral digital scan and the virtual articulator. Using this reference photograph, the clinician can record and communicate to the technician the maxillary arch position in relationship with the facial references, as well as transfer the additively manufactured casts in the same facial orientation for mounting and analysis either virtually or on an analog articulator.


Assuntos
Articuladores Dentários , Oclusão Dentária , Face , Humanos , Registro da Relação Maxilomandibular , Maxila
8.
J Indian Prosthodont Soc ; 21(4): 397-404, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34810368

RESUMO

Aim: The Aim of the study was to evaluate the reproducibility of condylar inclination values obtained using three different interocclusal recording materials in Hanau Wide-Vue semi-adjustable articulator and to compare those values of condylar inclination with panoramic radiographic images. Settings and Design: In Vivo Comparative study. Materials and Methods: The clinical trial was carried out in the Department of Prosthodontics, M. R Ambedkar Dental College and Hospital, Bengaluru. A total of 30 dentulous subjects aged between 20 and 40 years were selected, without any signs and symptoms of temporomandibular joint disorders. With the help of a custom-made protrusive guide, protrusive records for three materials were made. These records were used for programming the articulator and the respective horizontal condylar inclination (HCI) value, and panoramic radiographs were made. The values obtained were statistically analyzed. Statistical Analysis Used: Independent t-test, multiple comparisons using Bonferroni method followed by Analysis of variances (ANOVA) were used. Results: Among each pair of groups there exists a significant difference, i.e., the mean condylar inclination (degree) was found to be statistically significant between wax and polyvinyl siloxane (P < 0.01) as well as between wax and polyether (P < 0.01). No significant difference was observed between polyvinyl siloxane and polyether (P > 0.05). Conclusion: HCI values differed depending on the type of material employed. The study concluded that the protrusive condylar guidance angles obtained by panoramic radiograph can be used in programming the semi-adjustable articulator and among the materials polyether gave the highest Condylar Guidance values with less variability and wax gave lowest values with greater variation.


Assuntos
Articuladores Dentários , Côndilo Mandibular , Adulto , Humanos , Registro da Relação Maxilomandibular , Côndilo Mandibular/diagnóstico por imagem , Radiografia Dentária Digital , Radiografia Panorâmica , Reprodutibilidade dos Testes , Adulto Jovem
9.
Biomed Res Int ; 2021: 2177385, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34778449

RESUMO

INTRODUCTION: The function of the masticatory apparatus is complete when the dentition is intact with contact between the individual teeth and proper occlusion with the antagonists. For years, occlusal contacts have been studied to determine their exact location and describing various materials and methods for their registration such as paper foil, silk, and Shimstock foil. For years, occlusal contacts have been studied to determine their exact location and describe various materials and methods for their registration such as paper foil, silk, shim stock foil, the T-Scan system, and more recently the OccluSense system. The primary aim of the study was at evaluating which of the occlusal indicators is the most commonly used in practice, and the secondary aim was whether dentists are willing to use digital methods to examine occlusion. MATERIALS AND METHODS: The main primary information of the survey was collected by sending electronically anonymous questionnaires to 2014 dentists, randomly selected from all regions of the country. 228 questionnaires were filled in and returned. To achieve the goal of the study, the self-developed questionnaire was created and tested to survey the opinion about the use of occlusal indicators in dental practice. Each questionnaire contains questions about the sociodemographic and professional status of the people in the group and their opinion about the positives and negatives and the effectiveness of occlusal indicators. RESULTS: The obtained results confirm the statement that the most frequently used occlusal indicator in dental practice is the articulation paper. Articulation foil and silk are used less frequently than articulation paper. Of the listed quality indicators, Shimstock foil is rarely used in practice. Of the indicated quantitative indicators, the T-Scan system is more used than the OccluSense system. In the era of rapid technology development, the opinion and desire of dentists to increasingly want to introduce in their clinical practice quantitative methods are the digital diagnosis of occlusion. CONCLUSION: In any dental practice, if technically possible, digital methods would be used, giving more accurate and reliable data on the registered occlusal contacts.


Assuntos
Oclusão Dentária , Odontologia/tendências , Ajuste Oclusal/métodos , Adulto , Idoso , Atitude , Bulgária/epidemiologia , Odontólogos/psicologia , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Indicadores e Reagentes/farmacologia , Indicadores e Reagentes/normas , Registro da Relação Maxilomandibular/métodos , Masculino , Má Oclusão/diagnóstico , Pessoa de Meia-Idade , Motivação , Inquéritos e Questionários
10.
Niger J Clin Pract ; 24(10): 1457-1462, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34657010

RESUMO

AIM: The study aimed to evaluate the effect on condylar guidance values with casts mounted by facebow transfer (Guichet's point as the third point of reference), Bonwill's, and radiographic method. MATERIALS AND METHODS: The dentulous subject's casts were mounted to a semi-adjustable articulator (Artex Type AR) after facebow transfer with Guichet's point as the third point of reference and also by Bonwill's method. Protrusive records made earlier were utilized to program the right and left side condylar guidance value. Two digital lateral cephalograms were made, one in centric relation, and one in protrusion and the condyles were traced and overlapped. The condylar guidance readings obtained by Bonwill's method, facebow transfer, and lateral cephalometric tracings were compared in this study using the SPSS (Version 17.0 Illinois, Chicago, USA) software. RESULTS: The condylar guidance values obtained from Bonwill's and the facebow transfer method (p < 0.001) was lesser than the radiographic method. The values obtained by casts mounted to the Bonwill's method differed significantly (p < 0.001) from the other two methods. CONCLUSION: The values obtained by facebow transfer were closer to the radiographic values whereas the values obtained by Bonwill's method mounting differed markedly.


Assuntos
Articuladores Dentários , Côndilo Mandibular , Cefalometria , Aparelhos de Tração Extrabucal , Humanos , Registro da Relação Maxilomandibular , Côndilo Mandibular/diagnóstico por imagem
11.
J Dent ; 114: 103798, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34517071

RESUMO

INTRODUCTION: In fixed prosthetic rehabilitations, the restorations must be designed and fabricated in a proper maxillomandibular relationship, with correct vertical dimensions of occlusion (VDO) and centric relation (CR). This short communication introduces a novel digital technique that allows to obtain the maxillomandibular record and transfer it throughout the treatment procedure. METHODS: The protocol consisted of the following steps: 1. scan-jig planning and production; 2. maxillomandibular record prior to tooth preparation; 3. sequential tooth preparation and post-operative data recording through a cut-out and re-scan protocol; 4. control of the pre- and post-operative alignment of the scans in the correct VDO and CR, design and delivery of the definitive restorations. RESULTS: There was no clinical difference in the spatial positions of the virtual models and the relationships between the arches throughout every step of the treatment. CONCLUSION: The main advantages of this technique are that it allows to maintain the therapeutic maxillomandibular relationship after its clinical evaluation, to reduce chair time and to avoid inaccuracies determined by multiple bite registrations.


Assuntos
Testes Diagnósticos de Rotina , Registro da Relação Maxilomandibular , Dimensão Vertical
12.
Int J Comput Dent ; 24(3): 275-282, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34553892

RESUMO

AIM: The present prospective clinical study aimed to validate the Greifswald Digital Analyzing System (GEDAS) as a method for digital assessment of the occlusion in primary and mixed dentition. MATERIALS AND METHODS: The reproducibility of GEDAS in primary and mixed dentition was assessed using the intraclass correlation coefficient (ICC). In addition, the acceptability of the method to the dentist, the child, and the parent/caregiver was assessed using a modified visual analog scale of faces, the Frankl behavior scale, and the 10-point Likert scale. In total, 20 participants aged between 3 and 9 years (mean age: 6; standard deviation: ± 1.74) with primary (n = 10) and mixed (n = 10) dentition were recruited. RESULTS: The ICC for the number of contact points in all teeth was 0.94 and for the area of contact points was 0.97, indicating good to excellent reproducibility. The average total number of contacts per bite registration per arch in the primary and mixed dentition was 36.5 (17 to 66) and 37.9 (9 to 74), respectively. The average of the total area of interocclusal contact area in the primary and mixed dentition was 25.55 mm2 (5.39 to 70.20) and 29.59 mm2 (2.80 to 78.53), respectively. During the procedure, the majority of dentists reported the child's behavior to be positive (85%) and found the procedure easy to perform (80%), short (6.0 min), and tolerable (80%). CONCLUSION: GEDAS is an occlusal analysis tool with good acceptability and reproducibility in children and could be considered for the planning and assessment of restorative and orthodontic treatment in the intermediate stages.


Assuntos
Oclusão Dentária , Dentição Mista , Criança , Pré-Escolar , Humanos , Registro da Relação Maxilomandibular , Estudos Prospectivos , Reprodutibilidade dos Testes
13.
J Contemp Dent Pract ; 22(6): 624-629, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34393118

RESUMO

AIM AND OBJECTIVE: The purpose of the investigation was to determine the reliability of intraoral records for the programming of the condylar inclination of the semiadjustable articulator (SAA), performed by dentistry students at the Central University of Ecuador (UCE). MATERIALS AND METHODS: The concordance study was of an observational type and was carried out in sixth- and seventh-semester students of the Faculty of Dentistry of the UCE in the period 2019 to 2020. It was applied to a sample made up of 60 students: divided into G1 (n = 30), sixth-semester students and G2 (n = 30), seventh-semester students. The students were given articulated plaster models in an SAA in order to program the condylar inclination based on intraoral records, comparing it with the condylar inclination obtained from a computed tomography (CT) scan by an expert, determining inter-rater reliability. A Fleiss' Kappa test was performed for this study, with a 95% confidence level. RESULTS: The average condylar inclination of the left side measured by the groups of students was 28.68° ± 10.16° and for the right side it was 27.85° ± 10.59°, while in CT, it was 45° on the left side and 35° on the right side. The range of discrepancy of the groups with the CT values is 4.30° to 19.11°, with a significant difference between the programmed condylar inclination of the SAA between the study groups (p <0.05), with greater amount of success in G1 (40% of students programmed the condylar inclination perfectly) compared to G2 (31.67% of students did it perfectly). CONCLUSION: When performing the Fleiss' Kappa test, the concordance of the condylar inclination in an SAA programmed by the students gave a result with a negative sign, which suggests that there is no concordance of the articulator data compared to the CT, verifying that the students are not trained in this practice. CLINICAL SIGNIFICANCE: The clinical significance of this study lies in the fact that students must learn to better program the condylar inclination so that the treatments they carry out in the future are jointly and preserving all the normal anatomical factors related to the mouth and the TMJ, in order to do so. achieve more personalized treatments for each patient.


Assuntos
Articuladores Dentários , Côndilo Mandibular , Humanos , Registro da Relação Maxilomandibular , Côndilo Mandibular/diagnóstico por imagem , Boca , Reprodutibilidade dos Testes
14.
Quintessence Int ; 53(1): 78-88, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34235911

RESUMO

OBJECTIVES: The literature review aimed to compile and summarize the results of research relating to the recordings of condylar displacements obtained with extraoral devices, to guide clinicians to set dental (virtual) articulator parameters. The meta-analysis was undertaken to assess the sagittal condylar inclination (SCI) and transversal condylar inclination (TCI, also known as Bennett angle) values according to horizontal reference planes, movement studied, and patient characteristics: dental status, interocclusal relationship, skeletal pattern, and signs and symptoms of temporomandibular disorders (TMD). DATA SOURCES: A bibliographic search was conducted in the three following electronic databases: MEDLINE, EMBASE, and Cochrane Library and Best Evidence. The review was restricted to trials involving participants meeting the following criteria: (1) adult, (2) no previous surgery in the temporomandibular region, and (3) no serious comorbidity conditions. Descriptive statistics were calculated for all study groups and were compared by applying a one-way ANOVA. CONCLUSION: All 20 articles selected corresponded to a total of 933 subjects evaluated. The recording devices and horizontal reference planes had a significant impact on the SCI values. Age, dental status, and the presence of symptoms and signs of TMD in subjects had no influence on SCI values, unlike Angle class II, division 2, the class II sagittal pattern, or the increased vertical skeletal pattern SCI parameters (P < .05). The mean TCI value was 8 degrees and was independent of individual patient characteristics and the extraoral recording device used. For accurate kinematic simulation, the patient's personal plane of reference must be transferred to the system.


Assuntos
Articuladores Dentários , Má Oclusão Classe II de Angle , Adulto , Humanos , Registro da Relação Maxilomandibular , Côndilo Mandibular , Articulação Temporomandibular
15.
Eur J Prosthodont Restor Dent ; 29(4): 223-229, 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34218536

RESUMO

Correctly articulated dental casts are essential for certain dental treatment. Articulation can be traditional: using a physical articulator; digital: using a physical articulator followed by 3D scanning, or virtual: using 3D scanning and software to articulate scans without initial physical articulation. This study compared the precision of traditional articulation, using physical centric relation records and an articulator and virtually, by digitally aligning scans of the casts and record. Articulated casts and centric relation records were obtained. 12 record pairs were recorded from the articulated casts. Virtual method: all records were scanned, unclamped, in a custom laboratory scanner. The casts were aligned to each scanned record to create virtual articulations. Traditional method: each record was used to physically articulate the casts. Each articulation was recorded using an intraoral scanner. The mean inter-arch separation between three key-points on each cast-pair were used to determine differences in occlusal separation in three anatomical directions, and precision of methods. Traditional articulations: standard deviations in key-point distance never exceeded 0.102mm. The virtual equivalent was 0.059mm. Statistically significant differences (p⟨0.05) between all anteroposterior separation distances were found between the methods, and in three of six lateral/vertical separations. Virtual articulation was significantly more precise than traditional articulation.


Assuntos
Articuladores Dentários , Relação Central , Imageamento Tridimensional , Registro da Relação Maxilomandibular , Fluxo de Trabalho
16.
Head Face Med ; 17(1): 31, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34301272

RESUMO

AIM: The aim of this work is to present a digital methodology of a conventional articulator based planning protocol. METHODS: The digital counterpart consists of intra-oral scans (3Shape) and a free available 3D mesh software (Meshmixer, Autodesk). The maxillary position in relation to the reference plane used and the arbitrary hinge axis were determined mathematically from landmarks on cephalometric x-rays and frontal photographs. Distances and angles were calculated to virtually mount the digital jaws in Meshmixer's wold frame. Virtual planning is done by cloning and moving the jaws according to the preliminary surgery plan. The spatial movements of the jaws are measured by attached reference points. RESULTS: This digital approach eliminate the need for articulator hardware and laboratory plaster work. It enables all planning scenarios as they are also possible with conventional plaster-based procedures. The method is time-saving, practical and cost-effective. Standard dimensions of articulators and face-bows have been incorporated in the implementation. This reduction of individual patient values puts the accuracy of the presented method within the range of conventional model surgery. CONCLUSION: Arbitrary planning will continue to have its place in orthognathic surgery, especially when digital methods can improve the overall process. The method presented can be seen as a cost-effective alternative for patients who do not require technically complex planning.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Humanos , Imageamento Tridimensional , Registro da Relação Maxilomandibular , Planejamento de Assistência ao Paciente , Universidades
17.
Acta Odontol Latinoam ; 34(1): 35-42, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34137776

RESUMO

The aim of this study was to compare jaw relation record in the completely edentulous patient using acrylic rim trays with curved or flat registration plates or using the manual guidance technique. The study included 17 patients - 11 female and 6 male, average age 70 years. Three jaw relation records were taken during one session, in the same vertical dimension, using acrylic rim trays: (1) with manual guidance (IM), (2) with self-guided recording system with acrylic rim tray and central support using a curved plate (BYC) and (3) with self-guided recording system with acrylic rim tray and central support using a flat plate (BYR). The models were mounted on a Whip Mix 2240 articulator to which a condyle position device (Orthodent) was added to register, at the level of the condyle box and incisal table, the differences among the positions recorded with the different setups (IM, BYC and BYR). The distances were measured on millimeter paper provided by the recording system manufacturer. For statistical analysis, confidence intervals (95%) were calculated for the mean differences and Student's t-test for paired data (significance level: alpha<0.05). On both the mesiodistal plane and the vertical plane at the level of each condyle box and the incisal table, there were statistically significant differences among the three systems (p<0.001). At the level of incisal table, BYC and BYR provided more retrusive records than IM [arithmetic means (standard deviations) in millimeters: 3.82 (2.10) and 4.53 (2.18), respectively). The records obtained with BYR were significantly more retrusive with BYC [arithmetic mean (standard deviation) in millimeters: 1.41 (1.00)]. We reject the null hypothesis that proposes that all three registration systems described are clinically equivalent for establishing a jaw relation record in completely edentulous patients.


El objetivo de este estudio fue comparar el registro de la posición intermaxilar en el paciente desdentado total obtenido con el uso de cubetas rodete de acrílico y platinas de registro curva o recta y con la técnica de inducción manual. Se incluyeron en el estudio 17 pacientes, 11 mujeres y 6 varones con edad promedio de 70 años. En cada uno de ellos se obtuvieron en la misma sesión y en la misma dimensión vertical tres registros intermaxilares con cubetas rodete de acrílico: uno con inducción manual (IM), otro autoinducido con el sistema de cubeta rodete de acrílico y apoyo central único utilizando una superficie palatina de registro curva (BYC) y un tercero con este mismo sistema pero con la superficie palatina recta (BYR). Los modelos correspondientes fueron montados en un articulador Whip Mix modelo 2240 al que se le adicionó un dispositivo de posición condilar (Orthodent) para registrar, a nivel de la caja condílea y la platina incisiva, las diferencias existentes entre las posiciones obtenidas con cada una de las variantes de las platinas en las cubetas rodete acrílicas y la posición registrada con inducción manual. Las distancias fueron medidas sobre papel milimetrado provisto por el fabricante del sistema de registro. El análisis estadístico se llevó a cabo mediante el cálculo de intervalos de confianza (95%) para las diferencias medias y prueba de t de student para datos apareados (nivel de significancia: alfa<0,05). Tanto en el plano mesiodistal como en el vertical a nivel de cada caja condilea como en la platina incisiva, se encontró diferencia estadísticamente significativa entre las tres variables de registro (p<0,001). A nivel de las platinas incisivas tanto BYC como BYR proporcionaron registros más retrusivos que IM [medias aritméticas (desviaciones estándar) en milímetros: 3,82 (2,1º) y 4,53 (2,18), respectivamente). Los obtenidos con BYR fueron significativamente más retrusivos que en el grupo BYC [media aritmética (desviación estándar) en milímetros: 1,41 (1,00)]. Rechazamos la hipótesis nula que propone que los tres sistemas de registro expuestos son clínicamente equivalentes para establecer una posición de registro intermaxilar en desdentados totales.


Assuntos
Boca Edêntula , Idoso , Relação Central , Feminino , Humanos , Registro da Relação Maxilomandibular , Masculino , Dimensão Vertical
18.
J Oral Rehabil ; 48(9): 1050-1055, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34164832

RESUMO

PURPOSE OF THE ARTICLE: Centric relation is a dental term that has undergone many alterations over the years, which in turn have led to significant clinical controversies. These continuing changes in the meaning of the term CR have not only led to confusion, but they also have resulted in a variety of unnecessary diagnostic and therapeutic procedures. Analysis of the dental literature reveals ongoing misunderstanding and disagreement regarding that term among both clinicians and academic dentists. MATERIALS AND METHODS: A search of the PubMed database was performed with the following search terms: "centric relation", "masticatory muscles", "maxillomandibular relationship" and "condylar position." Relevant literature from the past 70 years until the present day was meticulously scrutinised. RESULTS: As expected, the literature review on the topic of CR revealed a problematic pattern of changing definitions and clinical disagreements, all of which have had a significant impact on the practice of dentistry. CONCLUSION: There are semantic, conceptual and practical reasons for concluding that the term 'centric relation' is flawed. Those flaws have a significant impact on dental practice. Based on our analysis, argumentation is provided to conclude that the term 'centric relation' should be abandoned. Instead, it appears that every individual has a unique temporomandibular joint relationship which cannot be described by any singular term. In healthy dentate patients, this relationship is determined by the maximum intercuspation of the teeth and should therefore be considered as biologically acceptable.


Assuntos
Articulação Temporomandibular , Dente , Relação Central , Oclusão Dentária Central , Humanos , Registro da Relação Maxilomandibular , Côndilo Mandibular , Músculos da Mastigação
19.
J Contemp Dent Pract ; 22(1): 47-50, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34028362

RESUMO

BACKGROUND: Condylar guidance can be determined using the clinical and radiographic methods. The present study was conducted to determine condylar guidance using the protrusive interocclusal wax method, panoramic radiographs, and lateral cephalogram. AIMS: The aim of the study was to compare the correlation between sagittal condylar guidance with protrusive interocclusal method, panoramic radiographs, and lateral cephalogram. MATERIALS AND METHODS: The present study was conducted on 82 dentulous subjects (males 41, females 41). In all subjects, interocclusal registration values and condylar guidance values were measured using panoramic radiographs and lateral cephalograms. RESULTS: The mean ± SD protrusive interocclusal registration value on the left side was 34.01 ± 1.2 mm and 34.08 ± 1.4 mm on the right side. The panoramic radiographs showed 35.12 ± 1.6 mm on the left side and 35.16 ± 1.7 mm on the right side. The mean ± SD protrusive interocclusal registration values on the left side was 34.01 ± 1.2 mm on the left side and 34.08 ± 1.4 mm on the right side. Lateral cephalogram showed 34.35 ± 1.3 mm on the left side and 34.67 ± 1.6 mm on the right side. There was a significant difference between the methods (p < 0.05). CONCLUSION: Sagittal condylar guidance can be evaluated using protrusive interocclusal method. Along with it, other methods such as panoramic radiographs and lateral cephalogram may also be used for recording condylar guidance. CLINICAL SIGNIFICANCE: Lateral cephalogram and panoramic radiographs may be reliable in determining condylar guidance, which can be used in orthodontic treatment planning.


Assuntos
Articuladores Dentários , Côndilo Mandibular , Feminino , Humanos , Registro da Relação Maxilomandibular , Masculino , Côndilo Mandibular/diagnóstico por imagem , Radiografia Panorâmica
20.
Chin J Dent Res ; 24(1): 61-66, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33890457

RESUMO

OBJECTIVE: To verify horizontal jaw relations using anatomical marks on a cast and evaluate the efficiency and accuracy of the test on checking the horizontal relation. METHODS: A total of 200 patients with a loss of posterior occlusion were recruited. After casts were made and the horizontal jaw relation was recorded, the pterygomaxillary notch and retromolar pad were identified bilaterally on the maxillary and mandibular casts. On each cast, a vertical line was drawn to bisect the anatomical landmarks and the distance between the two vertical lines was measured. Using the result of the wax try-in appointment and the corresponding measurements, a diagnostic test was conducted. A receiver operating curve was created and the maximum horizontal distance between bisecting points that still obtained correct jaw relations was determined to be a criterion. The accuracy of the test to verify horizontal jaw relations was evaluated. RESULTS: The area under the curve of the receiver operating curve was 0.833 (P < 0.05). With a maximum Youden index, the d value threshold was 1.0 mm. Using 1.0 mm as a criterion to check the horizontal relation, the sensitivity of the test was 0.76 and the specificity was 0.93. The kappa value for different researchers was calculated to be 0.79 (P < 0.05). The intraexaminer 1 reliability gave a kappa value of 0.76 (P < 0.05), and intraexaminer 2 gave a value of 0.81 (P < 0.05). CONCLUSION: The test for verifying the accuracy of horizontal jaw relations is reliable. If horizontal distance is measured as greater than 1.0 mm at the jaw relation record appointment, the recorded horizontal jaw relationship may be wrong and need to be reexamined.


Assuntos
Testes Diagnósticos de Rotina , Humanos , Registro da Relação Maxilomandibular , Mandíbula , Reprodutibilidade dos Testes
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