The purpose of this study was to evaluate the mandibular movements of TMD patients comparing to normal persons. Sirognathograph was used to measure five parameters of mandibular movements of twenty normal persons and eight TMD patients. Five parameters were (1) Maximum opening during maximum opening and closing, (2) Mean velocity during maximum opening and closing, (3) Maximum opening during unilateral chewing, (4) Mean velocity during unilateral chewing, (5) Consistency of mandibular movement during unilateral chewing. Based on above results, new Mandibular Movement Index(M.M.I.) was formulated and compared to Helkimo's Clinical Dysfunction Index by measuring two indices before treatment and 2 weeks, 4 weeks, 6 weeks, 8 weeks after treatment. The conclusions were as follows: 1, The amounts of maximum opening and mean velocity during maximum opening and closing of TMD patients were less than those of normal persons(p<0.01). 2. The amounts of maximum opening and mean velocity during unilateral chewing of TMD patients were less than those of normal persons(p<0.05) (P<0.01). 3. Although TMD patients showed limited mandibular movements during unilateral chewing, the consistency of mandibular movements was better than that of normal persons(p<0.05). 4. Both mandibular movement index and Helkimo's Clinical Dysfunction Index, were useful in diagnosing TMD patients.
The author performed this study to investige the relationship between condylar movements recorded with Pantronicⓡ and mandibular rotational torque movements with BioEGNⓡ. For this study 56 patients with Temporomandibular disorders(TMD) and 30 dental students without any masticatory signs and symptoms were selected as patients group and control group, respectively. The items recorded with Pantronicⓡ(Denar Corp., USA) were immediate side-shift, progressive side-shift, angle of orbiting path, protrusive path and PRI. BioEGNⓡ(Bioelectric gnathography, Bioresearch Inc., USA) were used to measure the amounts of mandibular rotational torque movements in frontal and horizontal plane, and the distance of mandibular translation at incisal area. Amount of mandibular rotational torque movement depicted between the condyles was automatically analysed by angle and difference in frontal and horizontal plane. The obtained data were processed with SAS program and the conclusion of this study were as follows : 1. Mean values of items between patients group and control group in Pantronic measurements were not significantly different except in left protrusive path and in Pantronic Reproducibility Index(PRI). There were no significant difference of condylar paths by preferred chewing side and affected side between the two groups. 2. The amount of mandibular rotational torque movements were differed in frontal angle and difference on protrusion, and in frontal and in horizontal difference on left excursion between the two groups. But the amounts of translatory movements were actually same on all eccentric movements. 3. The amount of mandibular rotational torque movements with splint mere almost not changed from those without splint, with the exception of in horizontal measurements on protrusion. 4. The correlations of items between in Pantronic measurements and in BioEGN measurements wert not consistently, significant, however, generally the ISS related significantly with horizontal torque movement positively, and with frontal torque movement negatively on the contrary, the PSS showed positive correlation with frontal torque movement, and negative correlation with horizontal torque movement.
The purpose of this study is to investigate the correlationship between Pantographic Reproducibility Index(PRI) scores and patterns of mandibular movements by mandibular kinesiograph(MKG) that has been used to diagnose temporomandibular disorders. PRI scores have been measured in normal and symptom groups by tracing Denar mechanical pantograph. Maximum lateral deviation, opening & closing velocity, and clinical rest position of mandibular movements have been analyzed in the same group when the mandible is opened and closed. According to to Helkimo's Dysfunction Index, the students and graduates of College of Dentistry are classified as 6 normal groups and 42 symptom groups. The obtained reslts are as follows : 1. The mean of PRI scores was larger in symptom groups than in normal groups. 2. The mean of maximal laterotrusion in frontal trajectory was larger in symptom groups than in normal groups. 3. There was little significant correlationship observed between PRI scores and patterns of mandibular movements by MKG.
Ten subjects who were going to wear conventional complete dentures were selected for this study. Theree subjects were women and seven were men. The average age was 63.1 years(range : 44 to 76 years). With the Height tracer (extraoral tracing device) in place the subject was instructed to go through the entire range of mandibular movements. The extreme lateral pathway of the incisor point, the so-called Gothic arch, was thereby inscribed by the stylus on the tracing plate. The mandibular movements in this study were peformed voluntarily by the subject(self guided technique) and guided by the dentist(chin-point technique and bimanual technique). The Gothic arch tracings were analysed and the Gothic arch angles and eccentric movement distances were measured. The results were as follows : 1. The apex position of the Gothic arch tracings of mandibular movements in edentulous patients varied both anterioposteriorly and mediolaterally. 2. The Gothic arch tracing had some lateral deviation during protrusion. 3. The average Gothic arch tracing angle was $136.7{\pm}12.0^{\circ}$ by subjects self guided technique, $135.7{\pm}5.9^{\circ}$ by chin-point technique, $136.6{\pm}6.5^{\circ}$ by bimanual technique. But there were no statistical differences in the reliability among the three techniques. 4. The average mandibular eccentric movements were irregular and the mandibular eccentric movement distances varied with a wide range.
Park, Myungsoon;Na, Yonghyun;Park, Minbong;Ahn, Janghoon
대한치과교정학회지
/
제47권5호
/
pp.289-297
/
2017
Objective: The objective of this study was to analyze the patterns of tooth movements when distalization of mandibular molars using a mini-plate took place. A finite element analysis was applied to analyze patterns of tooth movements. Methods: The model of the mandible and teeth were used to build a finite element analysis model, and a mini-plate was inserted in the mandibular ramus. Two different orthodontic forces were established for displacement of mandibular molars. Orthodontic forces were applied at the level of the bracket and at the level of the cemento-enamel junction in the mandibular canine respectively. Results: Applying orthodontic forces at the level of the cemento-enamel junction resulted in a greater biomechanical bodily movement in distalization of the mandibular molars compared to when the orthodontic forces were applied at the level of the bracket. Applying orthodontic forces to the cemento-enamel junction also resulted in unwanted greater extrusive movements in distalization of the mandibular molars compared to the bracket level. Conclusions: With considering the mode of orthodontic teeth movement, applying different vertical orthodontic forces for distalization of mandibular molars can lead to more effective distalization of teeth.
An observation and evaluation of the reproducibility of the mandibular movements has been a integral part of a test for mandibular function and dysfunction. After Pantographic Reproducibility Index(PRI) was introduced in dentistry, many authors have used the index for investigation of mandibular movement function, especially in condylar compartment. Howerer, the difficult and time-consuming work of instrumentation for getting the PRI has been a major obstacle in using pantograph. This study was performed to try a new mandibular reproducibility index, so-called BioEGN reproducibility index(BERI), calculated from mandibular trajectory recorded with BioEGN. 26 dental students without any signs and symptoms of temporomandibular disorders and 22 patients with temporomandibular disorders took part in this study and classed to control group and patients group, respectively. Pantronic and BioEGN were used to record and calculate the indices, PRI and BERI. PRI had only one value, but BERI had two values of outgoing and incoming movement in each scale. With two scales of small and large, as a result, BERI had four values in this study. PRI corresponded to BERI in small scale on outgoing total movements. The data were calculated and analyzed with SAS/stat program and the conclusion of this study were as follows : 1. In every scales, in each movement, BERI on outgoing movement in control group was lower than that in patients group, respectively, but BERI on incoming movement was only different in one side movement, that was, left excursion. 2. The difference between BERI on outgoing movement and BERI on incoming movement was only shown in small scale on total movements, not in each movement, in control group. However, there was generally a positive correlationship between BERI on outgoing movement and BERI on incoming movement in each movement in both groups. 3. Simple statistics of PRI was similar to that of BERI on total movements in small scale, but there was a negative correlation between PRI and BERI on total movements in large sclae only in patients group.
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.
This study was accomplished to analyse and compare the occlusal contact patterns during eccentric mandibular movements in adult with normal occlusion. 50 subjects(male 27, female 23), who had natural occlusion and no symptom of temporomandibular disorder, were selected. Teeth contact patterns during mandibular eccentric movements were recorded and the distribution of tooth contacts in maximum intercuspation analysed by T-scan system. And then, tooth contact numbers recored by T-scan and silicone bite registration at centric occlusion were analysed and compared. The results obtained were as follows : 1. Antero-posteriorly, the qualitative center of occlusal contacts in centric occlusion were in the first molar areas, but there was a slight deviation in left-right directions. Thus, distribution of occlusal contacts were not bilaterally symmetric. 2. During the mandibular movements from centric occlusal position to right lateral and left lateral directions, the frequency that maxillary canine joined in lateral guidance was relatively high, but pure canine protected occlusion or pure group function occlusion had small frequency. 3. During mandibular protrusive movement, one or more maxillary central incisors frequently joined in protrusive guidance. 4. During mandibular eccentric movements, working and balancing side premature contact was observered in relatively high frequency. 5. In centric occlusal position, the numbers of occlusal contacts recorded on T-scan were relatively smaller than on silicone bite registration.
The aim of this study was to investigate the relationship between velocity and factors which could affect the velocity of mandibular movement. For this study, 30 dental students without any masticatory signs and symptoms and 90 patients with temporomandibular disorders(TMD) were selected as the control group and the patients group, respectively. After determining Angle's classification and lateral guidance pattern of occlusion, clinical examination for TMD was perfomed. Velocity and distance of mandibular movements were recorded with BioEGN, reproducibility index of lateral excursions was evaluated by Pantronic(PRI) and BioEGN (BERI) activity in masticatory and cervical muscles were measured with BioEMG, and occlusal contact time and cross-arch unbalance(Total left-right statistics, TLR) on clenching were recorded with T-scan, respectively. The results of this study were as follows : 1. Velocity in the patients was faster than that in the controls in most mandibular movements, but on wide opening and closing movement, result was reverse. 2. Velocity on closing movements were faster than that on opening movements in the control group and a similar tendency was also shown in the patients group. 3. Patients with muscle disorders showed a tendency to have the highest value of velocity of all diagnostic subgroups, while patients with degenerative joint diseases showed a tendency to have the lowest value. 4. Patients with canine guidance showed a tendency to have the highest value of velocity in three subgroups by lateral guidance pattern, while patients with group function showed a tendency to have the lowest value. 5. BERI had a positive correlation with opening velocity on lateral excursion, while TLR had a negative correlation with opening velocity on swallowing. 6. EMG activity on clenching in masticatory muscles had negative correlation with opening velocity on border movements, and on swollowing, while the activity in rest correlated positively with opening velocity on border movements. 7. There were positive correlation between the velocity and the distance in long components of mandibular trajectory.
Recently the instantaneous center concept has been to understand the biomechanics by which a tissue derangement causes a mechanical derangement in human joint. Therefore, to understand the biomechanics of temporomandibular joint (T.M.J.) as a part of human joint, it is necessary to clarify the instantaneous center of rotation (I.C.R.) in the mandibular movement. Twenty male subjects without T.M.J. disorder and mandibular deviation during the mandibular movement were selected for this study. The habitual opening and closing paths were recorded on the paper of the sagittal metal plate by two pencil markers connected to the resin open clutch attached on the lower teeth, which was designed for this study. The coordinates of the 33-target points and the 109-anatomical landmarks were obtained using a Summagraphic digitizer connected to a 18AT computer. The original raw data of the opening and closing paths were smoothed by B-spline curve fitting technique and then the I.C.R. pathways were determined mathematically by the computer using algorithm for finding the I.C.R. of a planer rigid body model. Also the opening and closing movements of the mandible were simulated according to the determined I.C.R. The results obtained from this study were as follows. 1. At the early opening and the last closing, I.C.R's were almost distributed around the mastoid process outside the mandibular body without the presence in the region of the mandibular condyle. 2. The I.C.R. pathway showed variable patterns to each subject at the opening and closing movements. 3. The K constant with uniform pattern was obtained by the rotation angle times the radius, which was assumed to the index of the mandibular movement. 4. The opening and closing movements of the mandible were simulated by the I.C.R. pathways at the habitual opening and closing movements. 5. The mandibular condyle was rotated or translated accordng to the relative rotation angle and radius of the determinant factors of K contant.
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