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Biomedical subjects

A G Forgione

Publications and source records attributed to A G Forgione.

15 recordsLinked to original sources
PubMed2000

Different effects of nocturnal parafunction on the masticatory system: the Weak Link Theory.

It is proposed that damage to the masticatory system from intense parafunction can be assessed more accurately by the Weak Link Theory. The theory predicts that the more intense and the more prolonged the forces, the more the tendency of damage to either. 1. the periodontal tissue; 2. the teeth; or 3. the orofacial structures. To test the theory, 22 subjects were selected based on reports of nocturnal bruxism. Each was assessed for masticatory system breakdown on the Russell Periodontal Index, the Helkimo Dysfunction Index, and a Tooth Wear Index. A Bruxcore (Forgione, A. 1974 J Dent Res 53:127) was used to obtain an objective score of bruxism. Five of eleven subjects with mild bruxism scored high on only one index. Significantly more subjects (ten of eleven) with moderate to severe bruxism scored high on one index only.

Female↗
PubMed1999

The effect of vertical dimension and mandibular position on isometric strength of the cervical flexors.

This study compared the peak isometric strength of the cervical flexors in deep bite temporomandibular dysfunction (TMD) patients while biting in four bite positions: habitual occlusion, edge-to-edge, lateral shift and retruded. These values were then compared to those of the same subjects' bite positions elevated to a functional criterion (maximum isometric strength of the deltoid muscles). The mean height increase was 2.4 mm with a range of 1.5-3.8 mm. Fifteen of eighteen deep bite subjects met an inclusionary criterion, at least 13.3 Newtons (N) stronger cervical muscle strength with mandible relaxed open than habitual bite. Peak strength biting edge-to-edge was significantly greater than biting in habitual occlusion. Strength was found to increase significantly when biting in each of four mandibular positions when the bite was elevated to the functional criterion. The greatest strength was obtained from elevated habitual and edge-to-edge positions. The findings are of clinical significance, suggesting that cervical muscle isometric strength is affected by bite position and vertical dimension of occlusion. The results suggest that when biting, individuals with deep bite may be functioning at about 60% of their potential cervical flexor, isometric strength. The interaction between occlusal position, vertical dimension and cervical muscle function suggests a craniomandibular-cervical masticatory system.

Adult↗
PubMed1998

Survey examines patients' fear of dental treatment.

From September through November 1996, 158 of 844 patients at the general dentistry clinic of Tufts University School of Dental Medicine completed surveys concerning their fear of dental treatment. High levels of dental fear affected 65 percent of the respondents, with patients under the age of 45 reporting higher levels of fear than patients ages 45 years and older. Results showed that the four most common causes of fear in patients occur when the dentist seems rushed (65 percent), when the patient feels uninformed (50 percent), when the patient worries if the local anesthetic will be effective (43 percent), and when the patient's feelings are neglected (40 percent).

Adult↗
PubMed1997

Effect of increased maxillo-mandibular relationship on isometric strength in TMD patients with loss of vertical dimension of occlusion.

The effect on isometric strength of the shoulders and limbs while biting in habitual occlusion, on a bite-elevating appliance and on a placebo appliance was analyzed. Twenty female volunteer patients, presenting with temporomandibular pain dysfunction syndrome and obvious loss of vertical dimension, served as subjects. All were weaker to the manual application of the isometric Deltoid Press (IDP) when biting, as opposed to maintaining the mandible in an unsupported rest position. Two intraoral appliances were fabricated for each subject: a bite-elevating appliance (BEA) set by a functional criterion of peak strength to the IDP and a placebo appliance which did not interfere with occlusion but was "set" with a mock IDP procedure. Testing was carried out by the Neuromuscular Research Testing Laboratory of the Neurology Department of Tufts New England Medical Center. Testing was independent of the dentist who fabricated and set the appliances. A standard neuromuscular test with the Maximal Voluntary Isometric Contraction apparatus was used to assess strength of right and left shoulder, elbow and knee flexion and extension as is routinely performed with all neuromuscular disease patients. Twelve strength tests were carried out for each of three conditions: 1. Baseline-biting in habitual occlusion; 2. Elevated-biting on the BEA; and 3. Placebo-biting with the placebo appliance inserted. The order of conditions 2 and 3 was counterbalanced without knowledge of the subjects. Twelve repeated measures ANOVAs (each subject as their own control) were conducted for each of the 12 strength measures. All F-tests indicated a significant main effect for treatment differences (p < 0.0001). Mean strength biting on the BEA was consistantly greater (p < 0.001) than Baseline or Placebo strength. Baseline and Placebo condition were equivalent. These findings confirmed previous observations at this TMD Center: individuals with loss of vertical dimension of occlusion respond to a bite raising appliance by increased isometric-strength.

Analysis of Variance↗
PubMed1996

The relationship between jaw posture and muscular strength in sports dentistry: a reappraisal.

From the late 1970s until the early 1990s, there have been several reports of improved appendage muscle strength and athletic performance. Much of the criticism of using a mouthguard alone or in conjunction with a splint, such as a mandibular orthopedic repositioning appliance (MORA), to enhance athletic performance has been aimed at study designs, controls, periods of time, double blindness, and the placebo effect. Although it would appear that designing a study which pleases both clinician and researcher would be a difficult task, studies have been performed that do meet the "gold standard." The results favor the premise that jaw repositioning can enhance appendage muscular strength and athletic performance. Studies performed during the mid-1980s, and to which the scientific community refers to continually, on closer examination are flawed.

Bite Force↗
PubMed1995

Relationship of muscular strength to jaw posture in sports dentistry.

From the late 1970s until the early 1990s there have been several reports of improved appendage muscle strength and athletic performance. Much of the criticism of using a mouthguard alone or in conjunction with a splint, such as a mandibular orthopedic repositioning appliance (MORA), to enhance athletic performance has been aimed at study designs, controls, periods of time, double blindness and the placebo effect. Although it would appear that designing a study that would please both clinician and researcher would be a difficult task, studies have been performed that do meet the "gold standard"; and the results favor the premise that jaw repositioning can enhance appendage muscular strength and athletic performance. Previous studies performed in the mid-1980s, and to which the scientific community refers to continually, on closer examination are flawed.

Dentistry↗
PubMed1992

Strength and bite, Part 2: Testing isometric strength using a MORA set to a functional criterion.

The effect on isometric strength of biting on three intraoral devices and habitual occlusion was analyzed. Only subjects who showed a relative weakness to the Isometric Deltoid Press (IDP) when biting as opposed to maintaining the mandible in an unsupported rest position were included in the study. Both in the original 35 subjects and the 23 subjects returning on the second day, performance wearing the appliance set by a functional criterion of peak strength (locking) to the IDP was significantly greater than wearing a placebo appliance and a bite raising appliance that deflected the mandible 1 mm to the left. Strength biting on the appliance set by a functional criterion was significantly greater than all these conditions. Strength biting in habitual trials that were matched with the deflection condition was found to be significantly greater than that biting in the placebo condition. It was concluded that a relationship does exist between bite and isometric strength. Previous speculation about the role of placebo effect was not substantiated by the data gathered in this experiment.

Adolescent↗
PubMed1991

Strength and bite, Part 1: An analytical review.

The original clinical observations and research in the area of bite and strength enhancement studied individuals with obvious malocclusion and a subject population with mixed occlusions. An increase in isometric strength was obtained when biting on a K-MORA, an intraoral device that supports a mandibular position determined by a functional criterion. The criterion is a locking response to the Isometric Deltoid Press, a muscle challenge used by kinesiologists. Rather than replication with improved design, subsequent research (1) employed different mandibular positions based on therapeutic, electrical impulse or structural criteria; (2) tested mainly isokinetic strength; (3) referred to "strength" without qualification, implying more generalization than the findings actually allowed; (4) criticized and rejected positive findings by attributing strength increase to the placebo effect even though in no instance has the placebo effect been demonstrated in this field. Considering published and unpublished research on isometric strength and the irrelevance of many studies that found no difference in isokinetic strength, it is concluded that it is most probable that isometric strength is increased by the K-MORA in mixed populations.

Bite Force↗
PubMed1988

Hypnosis in the treatment of dental fear and phobia.

The term hypnosis is currently used to define an area of research and treatment that employs suggestion. Within this area, suggestion refers to the induction of expectancies by implicit or explicit means, usually involving concentration and the expectancy that the suggested results are possible. This use of suggestion differs from the common use of the term suggestion, which is a logical offering for a change in behavior or thought. The long history of hypnosis is testimony to its effectiveness, although there has been controversy as to why it works. Patient selection is important. Further, fear must be distinguished from phobia. Combined with other treatment techniques, such as systematic desensitization, it is a powerful behavior modification method. To prevent accidental delivery of suggestions that may be counterproductive to treatment, the study of hypnosis is important even to those health care professionals who have no intention of employing it in their practice.

Adult↗
PubMed1970

The elimination of interfering response patterns in lever-press avoidance situations.

Lever holding into shock and short-latency responses to shock onset are two response patterns that interfere with avoidance acquisition in free-operant and discriminated avoidance situations. In an attempt to eliminate these patterns, an additional timer disabled the lever for a period slightly longer than shock duration. A free-operant avoidance schedule with a warning stimulus, but without the additional timer, constituted the control condition. The lever-disabling timer was turned on by different events in two experimental conditions: (a) release of the lever at the onset of shock, (b) shock onset. Interfering responses diminished most rapidly, and efficient avoidance behavior appeared earliest, when the lever-disabling timer was turned on by shock onset.

Journal Article↗
PubMedDate not supplied

An evaluation of bruxism control: massed negative practice and automated relaxation training.

Behavior modification techniques of massed negative practice and relaxation training were applied to separate groups of individuals who had been diagnosed as "bruxers" by multiple criteria. When assessed by an objective index of grinding, neither technique was found to have reduced bruxism significantly. Grinding and state of anxiety scores of bruxers were significantly higher than those of nonbruxing controls. Bruxers did not differ from nonbruxers on trait anxiety measures.

Adolescent↗