The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.
The relationale for recording mandibular movement is to accurately adjust an articulator. Techniques to record mandibular movement include radiographic interpretation, extraoral tracing, and intraoral recording materials. This study was performed to compare the concylar guidance inclination and Bennett shift(immediate & progressive side shift)obtained by using an electronic pantograph, pantograph and wax interocclusal records in Korean. Ten adults who have normal occlusion and are free of TMJ dysfunction were selected and clutches were constructed. At first Pantronic survey was performed three times by using an kinematic hinge axis according to manufacturer's direction. Next pantographic survey was performed three times and the articulator was adjusted with each pantographic recording. And then maxillary cast was attached to the articulator with pantographic as a face-bow and the mandibular cast was mounted to the articulator with centric relation record. Three protrusive, three left lateral and three right lateral wax interocclusal records were taken on the subjects and the articulator was adjusted with each interocclusal record. Protrusive condylar inclination, lateral condylar inclination, immediate side shift and progressive side shift obtained by using electronic pantograph, pantograph and wax interocclusal record were compared and analized. The results were as follows; 1. The average left and right protrusive and orbiting condylar inclination($33.7^{\circ},\;37.1^{\circ},\;40.6^{\circ},\;43.5^{\circ}$) record with Pantronic was significantly greater than that recorded with other methods. 2. The average left and right protrusive and orbiting condylar inclination($24.8^{\circ},\;27.0^{\circ},\;31.4^{\circ},\;32.4^{\circ}$)recorded with wax interocclusal record was less than that of other methods. 3. The average left and right immediate side shift(0.57mm,0.44mm)recorded with wax interocclusal record was greater than that of other methods and the average left rigtht immmediate side shift(0.30mm,0.41mm)recorded with Pantronic was significantly greater than that recorded with pantograph(0.11mm,0.20mm). 4. The average variance of wax interocclusal was signivicantly higher than that of other methods.
The author studied on the effect of TMJ sounds to the patterns and ranges of mandibular border movements in horizontal plane with Pantograph (Denar Corp.). For study, 19 patients with TMJ sounds only and 16 students with no TM disorder were selected and classified as experimental group and control group, respectively. The subject performed right lateral movement, left lateral movement, and forward movement. Each movement were performed 3 times and the movement trajectory obtained with mechanical pantograph were observed for accordance of centric relation position, reproducibility and/or restriction of lateral movement paths, deviation of protrusive path in anterior table, restriction of protrusive condylar movement path in posterior horizontal table, presence of Fisher angle in posterior vertical table. And pantographic reproducibility Index (PRI) were obtained with pantronic by the same movement method as in the mechanical pantograph record. The obtained results were as follows : 1. In experimental group, PRI scores in those who show accordance of centric relation position were 14.4, and were 26.53 in those who did not show accordance of centric relation position. However, the PRI scores of the two subgroups show no statistically significant difference in control group. Therefore, in experimental group, the capability of accordance of centric relation position affected largely the PRI scores than in control group. 2. Deviation of protrusive path was opposite to the affected side in experimental group, and was left side in control group. 3. Restriction side of condylar movement in protrusion was ipsilateral to the deviation side in experimental group, but in control group, restriction side was not related to the deviation side. 4. PRI scores in experimental group were 23.2 (moderate dysfunction category), and in control group, were 17.8 (slight dysfunction category). The PRI scores in control group, however, implies that the evaluation of temporomandibular disorders by the PRI scores only may be unreasonable.
Electromyographic studies were performed on the action of the masseter muscles. Among the children aged from 6 to 8 years, ten children with normal occlusion and another ten with space maintainer were selected. The children were divided into 3 groups. They were: 1) A group: Children who removed space maintainer 2) B group: Children who inserted space maintainer 3) C group: Children with normal occlusion. The electromyogram was recorded with 4 channel polygraph. (Grass model VII) Electrodes which were cup-typed gold disks, 9 millimeters in the diameter, were located on the superficial layer of masseter muscles. The electromyogram was recorded in the physiologic rest position, molar occlusion, chewing movement, protraction, left lateral movement, and right lateral movement. The conclusions were as follows. 1. In the physiologic rest position, lateral movement, the electrical potentials of the masseter muscles were not changed clearly in each groups. 2. In molar occlusion, chewing movement, The electrical potentials of the masseter muscles of the B group were almost 10% higher than those of A group, and were almost 60-70% in comparision with C group. 3. In protraction, the electrical potentials of the masseter muscles of the B group were almost 40% higher than those of A group, and were almost equal to C group. 4. The electrical activities of the masseter muscles in the mandibular movements were in the following order: (1) Molar occlusion (2) Chewing movement (3) Protraction (4) Lateral movement.
In order to evaluate the influences of Myo-monitoring on masticatory muscles, Myo-monitoring on 31 normal persons and 30 persons with one more temporomandibular dysfunction symptoms during 45 minutes or above. The author observed velocities of mandibular opening and closing movement, variabilities of mandibular rest position and EMG activities of temporal and masseter muscles. The obtained results were as follows : 1. There were no significant differences on velocities of mandibular opening and closing movement between before and after Myo-monitoring. 2. There were significant differences on vertical dimension and total dimension form mandibular rest position to centric occlusion between before and after Myo-monitoring but no significant differences on anteroposterior and lateral dimension. 3. Activities of temporal and masseter muscles were decreased in Myo-Monitoring. 4. There were disappeared significant differences on EMG activity values between normal and symptom groups after myo-monitoring.
The movement range on the semi adjustable articulator and the movement range in an oral were measured. And then I studied to analyze the gap. I got wax records by the movement on the semi adjustable articulator, the movement in an oral. I measured the distance of the cusp tips that are close to the mesial direction and the distal direction, the buccal direction and the lingual direction then I compared gaps. As I saw results on data, I knew that the semi adjustable articulator represented the range of mandibular movement restrictively. I could find the decisive contradiction that the sliding movement finished on the semi adjustable articulator although it did not finish in an oral. When the sliding movement does not reappear exactly, it brings a fatal failure to the dental prosthesis. In addition it is impossible that the semi adjustable articulator restores the movement in an oral because the lateral condyle inclination and the horizontal condyle inclination are appeared to be straight. Therefore dental prosthesisses were made by the semi adjustable articulator, they will interfere with a mastication. I have obtained the following results; 1. The distance of sliding movement on the semi adjustable articulator showed shorter than the distance of sliding movement in oral. This means the increase of cusp inclination of the dental prosthesis that was made on the semi adjustable articulator. Therefore, when the lateral movement occurs in oral, there is a possibility to become the premature as the increase of cusp inclination. 2. The difference in the range of movement is considered as the gap that is made because the movement only can be occurred as straight in the semi adjustable articulator. 3. When the dental technician understand mandibular movement and articulator deficiencies, they can attain proficiency in use of the articulator and reduce the gap.
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.
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.
Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalometrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1. There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2. There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3. The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4. The upper lip length was increased and moved posterior direction after mandibular setback surgery 5. The lower lip was moved posterior direction by posterior movement of the mandibular structure 6. Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes
This study was performed to investigate the factors related to vibration of temporomandibular joint during mandibular opening movement. For this study, 144 patients with temporomandibular disorders were randomly selected. Angle's classification, lateral guidance pattern, range of maximal mouth opening, preferred chewing side, and affected side were investigated clinically. Mandibular torque rotational movement during opening was recorded with $BioEGN^{(R)}$ and vibration of temporomandibular joint during opening was recorded with $Sonopak^{(R)}$. After clinical diagnosis was made, visual analogue scale(VAS) was used for evaluation of clinical progress of the subject's chief complaints. The author calculated VAS treatment index(VAS Ti) from the record of VAS. The more VAS Ti was, the less remission of subjective symptom was, The data were analyzed with SAS/Stat program and the results of this study were as follows: 1. There were no significant difference in all the variables of joint vibration by age and sex. 2. Integral and peak amplitude in patients of Angle's class I were higher than those of class II or III patients. Integral in patients of group function was higher than that in patients of canine guidance or other types of lateral excursion. 3. As to Angle's classification or lateral guidance type, there were almost not significant difference between subgroup of same class or type and subgroup of different class or type on both sides. And there were also almost not difference between one side and the other side related to preferred chewing side or affected side. 4. Patients with disk displacement with reduction showed higher value of integral and peak amplitude than any other patients. 5. Joint vibration variables significantly correlated with VAS Ti of pain. with clinical range of mouth opening, and with ingredients of mandibular torque rotational movement.
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