Biomedical subjects
Publications and source records attributed to H T Schrems.
Inhibiting factors to patient motivation for oral hygiene are found both with the patient and the dentist. These factors were considered in terms of the daily practice. The concept of oral hygiene motivation, described used primarily with children was.
The reproducibility of occlusal contacts of 30 subjects was tested in the Dentatus and Stuart articulators. Primary contacts in the terminal hinge axis position were reliably reproducible in both articulators. Contacts in habitual intercuspidation were reproduced only approximately by both devices. Contacts in eccentric occlusion were satisfactorily reproduced in the Stuart articulator only. The findings show that doubts are indicated about the simulating capacity of semi-adjustable articulators which is frequently rated too high.
Orthodontic measures can create improved functional conditions for optimum rehabilitation of the masticatory system. Prerestorative orthodontics involve relatively great efforts, but the results of consistent treatment justify them. The range of indication of such treatment should, therefore, be very restricted and the patient must be instructed in detail and thoroughly motivated.
The temporo-mandibular joint situation was pantographically examined in class 1, class II and class III cases who had or had not been submitted to functional orthodontic therapy. The adaptation of the temporomandibular joint appears to be less complete in treated class II cases than in treated class III cases. The present investigation in 115 subjects also showed that pantography is a suitable means of analyzing the temporo-mandibular development in adolescents and the temporo-mandibular reaction to orthodontic measures.
In patients treated with an activator the individual axial hinge points lie on the average 4.5 mm more ventral than in untreated patients. In those treated, the analytically calculated gliding movement of the condyles from the posterior position of contact to habitual intercuspidation on the average was 0.88 mm compared to 0.36 mm in the untreated. Movement of the teeth amounted to 1.18 mm in group 1, and 0.46 in group 11.
The influence exerted by objectifiable factors on the therapeutic result of temporo-mandibular joint disorders was analyzed in follow-ups carried out in 73 patients. As the most frequent cause of still existing complaints occlusal interferences, especially balance contact, were found. The majority of these balance contacts had developed after termination of our therapy, as a result of occlusal surfaces having an unfavorable shape with regard to masticatory function or as a result of spaces in the dentition that had not been treated prosthetically. It was possible to demonstrate that lasting therapeutic success is mainly due to the consistent securing of an interference-free centric and eccentric occlusion. Function controls should also be carried out as a routine measure in people with healthy temporo-mandibular joints, in order to guarantee improved prophylaxis of disorders in the stomatognathic system.
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In the present study the influences of type and duration of complaints, findings, therapeutic method, duration of therapy and patient cooperation on the prognosis of temporo-mandibular joint disorders were analyzed. The elimination of occlusal interferences may be regarded as causal therapy in the large majority of temporo-mandibular joint disorders. In these cases a very good and long-term rate of success may be achieved by the method of selectively grinding-in the teeth according to A. Lauritzen.
Two methods are recommended as diagnostic-therapeutic means for controlling frontal interlocking: 1. Composite materials for temporary onlays on canines, 2. incorporation of a miniplast splint with individually shaped occlusal surfaces made of cold curing acrylics in cases of isolated interferences in protrusion as well as interferences in both protrusion and lateral movement of the front teeth.