Kim, Moon-Gyu;Han, Kyung-Soo;Kim, Jong-Young;Yang, Keun-Young
Journal of Oral Medicine and Pain
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v.26
no.1
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pp.59-73
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2001
This study was performed to investigate the effects of occlusal appliance on the mandibular position and the mandibular rotational torque movement during speech. For this study, 20 patients with temporomandibular disorders(TMDs) and 20 normal subjects without any signs and symptoms in the masticatory system were selected as the patient group and as the normal group, respectively. Biopak $system^{(R)}$(Bioresearch Inc., Milwaukee, USA) and a sentence of 'Sue is missing her house' were used for recording and for observing of speech pattern. There were five mandibular positions observed in this study, that is, mandibular rest position, 'ssi', 'her', 'ha', and 's' speech position. In each position, slant and A-P distance in sagittal plane, vertical distance and lateral distance in frontal plane were measured. Amount of the mandibular rotational torque movement were measured at 'her', 'ha' speech position and for all through speech movement. Centric relation splint(CRS) was placed in both groups, but anterior or posterior bite plane were placed in normal subjects only. Data collected were processed and analysed by SPSS windows program. The results of this study were as follows : 1. Mandibular positions in both groups were not different before adaptation, with CRS, and after removal, but total amount of the mandibular rotational torque movement was greater in patients. 2. Mandible was slightly placed anteriorly with CRS at 'her' and 'ha' speech position in patients, but was placed anteriorly at all the five positions in normal subjects. 3. Difference with type of occlusal appliance in normal subjects were noted only for vertical distance at 'ssi' and 'ha' speech position, and the distance with CRS were more than that with posterior bite plane. 4. Mandibular rotational torque movement at 'her' and 'ha' speech position was greater in patients, but the difference was disappeared after appliance removal. And the torque movement was greater at 'ha' speech position than that at 'her' speech position in frontal plane. It could be concluded that the adaptation of occlusal appliance showed a tendency to locate the mandible anteriorly during speech in both groups, but did not affect total mandibular rotational torque movement which was greater in patients.
This study was performed to investigate the location of the ideal bracket positioning plane in lingual orthodontics using the three-dimensional finite element method. Displacement of the anterior teeth were evaluated according to the vertical and the angular movements of the bracket positioning plane. To achieve the ideal movement of anterior teeth in the lingual central plane, the location of the force application point and the amount of the moment applied to the four incisors were evaluated. As the bracket positioning plane was moved parallel toward the incisal edge, uncontrolled tipping and extrusion of the maxillary and the mandibular incisors were increased. But lingual tipping of the crown was decreased in the maxillary and the mandibular canines. As the bracket positioning plane was inclined toward the incisal edge, lingual tipping was increased in the 6 anterior teeth and extrusion of incisors and intrusion of the canine was also increased. As the retraction hook of the canine bracket was elongated, lingual tipping and extrusion of the central incisor and mesial movement and extrusion of the lateral incisor were increased. In the canine, mesial and labial movements of the crown were increased. When the moment was applied to the 4 incisors of the maxillary and the mandibular arch in the lingual central plane, 280 gf-mm in the maxillary central incisor, 500 gf-mm in the maxillary lateral incisor, 170 gf-mm in the mandibular central incisor and 370 gf-mm in the mandibular lateral incisor produced bodily movement of the individual tooth.
This study was performed to investigate the reproductibility of eccentric mandibular movements according to preferred chewing side, range of mouth opening, type of lateral guidance and involvement of temporomandibular disorders. 50 patients with temporomandibular disorders and 65 dental students without any signs and symptoms were randomly selected for this study as the patients group and the control group, respectively. For recording and observation of eccentric mandibular movement trajectory, BioEGN$^\textregistered$ of Biopak$^\textregistered$ system (Bioresearch Inc., USA) was used. Each eccentric movement to anterior, right and left side was performed three times similar to the movement pattern for Pantronic Reproducibility Index. mandibular path was analyzed by three dimensional positional change and the three paths from one direction were compared with one another. From this, reproducibility index of one-directional lateral movement could be calculated, and total reproducibility index, named BioEGN reproducibility index(BERI), was also computed from three-directional eccentric movement likewise. BioEGN reproducibility Index could have four value of score by small or large scale, and by outgoing or incoming movement. The data were analyzed by SAS/stat program and the results obtained were as follows: 1. Right side chewing subjects showed more consistent pattern In reproducibility index in comparison between patients group and control group than left chewing subjects have done, and reproducibility was low in patients group. However, there was no difference between the two stoups in bilateral chewing subjects. 2. There were no difference in reproducibility index between preferred chewing side and contralateral side in unilateral chewing subjects whereas reproducibility index in left side on outgoing movement were higher than in right side in bilateral chewing subjects. 3. Difference in total reproducibility index(BERI) between canine guidance group and non-canine guidance group were not observed though difference in reproducibility index on lateral movement were observed in part. 4. There were no difference in reproducibility index between affected side and contralateral side in unilaterally affected patients, and between unilaterally affected patients and bilaterally affected patients in patients group. 5. Highly significant positive correlationship were shown among the four 쇼pes of total reproducibility index(BERI) in total subjects, and range of clinical mouth opening was negatively correlated with BEBI on outgoing movements and with index on outgoing movement to preferred side.
The purpose of this study was to identify the difference of vertical movement of mandible according to Angle's molar relationship and by skeletal factors affect to vertical movement of mandible. 172(age ranged from 20 to 30) subjects who go to college within territory of Kwangju city without any experience of temporomandibular disorder, extraction and orthodontic treatment. were selected for this study. The subjects were classified into class I(male:30, female:49), class II(male:18, female:24) and class III(male:18, female:33) according to Angle's molar relationship. The distance was measured between incisal edge of maxillary and mandibular central incisor and between bottom of central fossa of maxillary and mandibular 1st molar with ruler. The arch length and width were measured on the diagnostic cast. Cephalometrics were taken and then traced. Landmarks were identified and analyzed. 1. Maximal interincisal opening of male is larger than that of female in class I, class II and class III. Among each group maximal interincisal distance is the largest in class III. Maximal intermolar distance of male is superior to that of female in class I, class II, and class III, but there is no siginficant difference among them. 2. On maximal opening movement of Angle's classification class I and class II, total mandibular length, mandibular ramal length, madibular inferior border length and upper arch width were important variables and facial length, upper arch length and lower arch length had negative relationship to that. On maximal opening movement of Angle's class III, the upper arch length, the lower arch length and anterior facial length were important variables especially when compared with class I and II, and upper arch width had negative relationship. These results suggest that maximal opening movement is affected by facial morphology in all classes, but each group is affected by different facial skeletal variables. Accordingly, facioskeletal variables might be considered as diagnosis and treatment to improve the amount of mouth opening.
Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.
The purpose of this study was to investigate the mandibular opening and closing movements at mandibular incisor region and clinical rest position in normal subject using the newly developed electric mandibular movement analyzing device, (M.K.G.-K6 diagnostic system, Myo-tronics Inc. Seattle, WA, U.S.A.) The 58 normal subjects, who were students of the College of Dentistry, Chonbuk National University, were selected according to sampling criteria. The obtained results were as follows: 1. There was no significant difference of distribution of opening and closing movement patterns at mandibular incisor region between male and female. There was significant difference between habitual and maximum movement patterns both in sagittal and frontal plane. 2. Although the percentage of distribution of crossover pattern was highest in all cases, but there were significant differences between patterns only at habitual opening and closing movement in sagittal plane. 3. The mean of maximum opening was $47.29{\pm}4.68mm$ in male and $42.15{\pm}4.95mm$ in female. Therefore the mean of maximum opening was larger in male than in female. 4. The mean of maximum laterotrusion in frontal trajectory was larger to the left than to the right. Also the proportion of left deviation at maximum opening position was larger than that of other cases. 5. The mean of maximum opening and closing velocity was higher in male than in female and the mean of closing velocity was higher than that of opening velocity. Also the amount of separation from the centric occlusion was higher in maximum closing velocity than in maximum opening velocity. 6. Clinical rest position was $1.70{\pm}0.99mm$ inferior, $0.74{\pm}0.57mm$ anterior, $0.99{\pm}0.51mm$ right from centric occlusion and the A/V ratio was 1:2.7.
Alveolar distraction osteogenesis (ADO) has been regarded as an acceptable treatment for the alveolar bone deficiency. For ADO at anterior maxillary area, the vector should be oriented to forward and down-ward direction to get an adequate occlusion with mandibular teeth and to increase bone length and width for implant placement. However, the conventional commercial distraction devices for ADO are designed to allow mainly downward movement of alveolar segment, even though a forward movement can be obtained a little by controlling of inclination of device. To make ADO with controllable bidirectional vector possible, we used customized devices using self-manufactured ABDUL (Alveolar Bone Distractor Using Lag screw principle) and commercial orthodontic palatal expansion device ($Hyrex^{(R)}$). In all cases (n = 4), ADO could be performed successfully and dental implants were able to placed with adequate occlusion. We report the procedures, advantages and disadvantages of these methods.
In this study, 88 dental students were examined to evaluate the relationship between occlusal states and TM disorders for the epidemiologic study of TM disorders. The clinical evaluation were composed of mandibular movement, TMJ noise, occlusal states and muscle palpation. The following results were disclosed. 1. The frequencies of pain on mandibular movement were 3.4% on maximum opening, 1.13% on protrusion and no pain on laterotrusion. 2. The frequencies on TMJ sound were 21.6% in click, 1.13% in crepitus. 3. The frequency of tenderness on palpation was 12.5% on extra oral, intraoral and neck muscles, tenderness on palpation of TMJ capsule were reported 5 cases, and 4 of them were female. 4. The distribution of Angle's classification was found 79.5% in class I, 4.5% in clasII-div.1 and 15.9% in class III. There was no significant differences on TM disorders between Angles classifications. 5. There was no significant differences on TM disorders between the subjects of canine guided occlusion and group function occlusion, and also for the differences between the subjects of nonworking side interferences and no interferences on laterotrusion. 6. There was no significant differences on TM disorders between the subjects of anterior teeth trauma in C.C. and no anterior teeth trauma, but there were significant differences between the subjects of posterior protrusive contact and no posterior protrusive contact.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.2
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pp.172-178
/
2000
When we establish treatment planning of facial asymmetry, we must predict each asymmetrical element that will be changed upon coronal, axial, sagittal plane. At the visual point, prediction of the change of coronal plane is most important. It is important difference between Rt. and Lt. mandibular angle belonging to posterior coronal plane, as well as anterior coronal plane, such as upper and lower incisor, or midline of chin point. Several methods for control bulk of mandibular angle are additional angle shaving after osteotomy, grinding contact area between proximal and distal segment for decrease the volume, or bone graft for increase the volume. But, at the point of bimaxillary surgery, transverse position of posterior maxilla is an important factor for control it. So, we would report transverse movement of posterior maxilla for decrease asymmetry on the posterior coronal plane of face, that is, asymmetry of mandibular angular portion.
Recently the instantaneous centre concept has been used to understand the biomechanics by which a tissue derangement causes a mechanical derangement in temporomandibular joint. In this study, four male subjects without temporomandibular joint disorder and malocclusion were selected for the determination of the instantaneous centre of rotation (I.C.R) in the mandibular movement. The habitual opening and closing paths were recorded on the sagittal plate by two spring pencils attached on the lower anterior teeth which was designed for this study, and the I.C.R. was calculated by the computer program of Rouleaux's method. Also the computer graphic opening and closing movements of mandible were obtained according to the determined I.C.R. The results obtained from this study were as follows. 1. The instantaneous centres of rotation were not positioned within the condyle in the mandibular opening and closing movement. 2. There was some similarity between the anatomical curvature of the articular emience and the movement pattern of condyle. 3. The opening path and the closing path of the most superior pl)int of the condyle stowed a slight difference. 4. At the early stage of the habitual opening movement, the condyle was moved downward. 5. The opening and closing mandibular movements were simulated by the instantaneous centre of rotation which was determined by the computer program of Rouleaux's method.
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