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At least 271 records · Page 15Linked to original sources
PubMed2002

Proximal segment displacement in mandibular distraction osteogenesis.

Distraction osteogenesis has been advocated for treatment of the mandibular deformity in patients with hemifacial microsomia (HFM). During the active phase, the force of distraction pushes the distal segment of the mandible down, creating a distraction gap. Because of the abnormal temporomandibular joint anatomy in HFM patients, the proximal segment may not seat in the glenoid fossa and thus may be displaced with distraction. The purpose of this study was to determine the vector(s) of proximal segment movement during mandibular distraction using a semiburied device. Two investigators traced the immediate pre-and postdistraction panoramic radiographs of 12 HFM patients (mean age at operation = 8.4 years, mean distraction = 28 mm) who had mandibular distraction with a semiburied device. Radiographic analysis, based on a vertical maxillary reference line, measured change in condylar position with angular and linear measurements. Inter-rater reliability for the tracing and analysis was shown with a correlation coefficient between 0.89 and 0.99 for all measures. Based on the angular and linear measurements, 10 of the 12 patients had superior movement of the proximal segment with distraction. Sagittal movement of the proximal segment could not be judged adequately. This study was based on measurements made on panoramic radiographs. Direct measurements could not be made; thus, it was not possible to estimate proximal segment movement in millimeters or as a percentage of total movement. Further studies to document proximal segment movement using computed tomography scans may provide more quantitative data.

Child↗
PubMed1999

Custom-made titanium mandibular reconstruction tray.

Reconstruction of the mandible after ablative surgery can be achieved by using preformed trays or trays formed from models produced by computer-assisted modelling systems. The former presents difficulty in matching the required facial contour, jaw relationship and condylar position; while the latter is expensive. This paper presents a simple and inexpensive method of fabricating a custom-made titanium bone grafting tray. The dimensions of the patient's mandible are obtained by clinical measurement. Such measurements are used to construct a mandibular replica. The region to be reconstructed is carved to produce the ideal shape and dimensions of an edentulous segment. The tray is made either by casting or by swaging. Twenty-one custom-made titanium bone grafting trays have been fitted in patients with encouraging results. This method of bone grafting tray construction is a simple, inexpensive technique for achieving excellent facial contour and functional reconstruction after mandibulectomy.

Bone Transplantation↗
PubMed1998

Considerations when planning occlusal rehabilitation: a review of the literature.

As one of the most demanding tasks facing the restorative dentist, planning and executing an occlusal rehabilitation should not be undertaken lightly. The stakes are high and failure is costly. Treatment planning decisions should be undertaken on the basis of scientific evidence, where this is available, or on the basis of documented experience where it is not. This review article identifies the major biological and clinical considerations used when planning an occlusal rehabilitation. These include the indications for reorganising the occlusion, the choice of condylar position and occlusal scheme, the implications of and indications for increasing the vertical dimension, replacing missing teeth and the choice of materials. Finally, the literature surrounding the controversial issue of occlusal rehabilitation as a means to treat temporo-mandibular disorders is also reviewed.

Decision Making↗
PubMed1984

Radiography of the temporomandibular joint in female patients with TMJ pain or dysfunction. A seven year follow-up.

One hundred and twenty-four patients with temporomandibular joint (TMJ) pain/dysfunction were examined radiographically and 54 of these patients were reexamined at a follow-up approximately after 7 years. The radiographic examination included submentovertical, oblique lateral transcranial and transmaxillary projections. Abnormalities of structure and shape of the bony components were found in 50% of the joints; cortical/subcortical erosion was recorded in 15%, sclerosis in 33% and deviation in shape in 48%. Abnormal condylar position was observed in 46% of the joints. The 20 patients examined only at the follow-up demonstrated a frequency of these findings similar to those observed in patients selected for examination during the treatment period. At the 7-year follow-up, a slight increase in number of all types of abnormalities was found as well as a slight progression of abnormalities present at the first examination.

Adolescent↗
PubMed1993

Reliability and validity of diagnostic modalities for temporomandibular disorders.

Temporomandibular disorders (TMD) encompass a group of musculoskeletal conditions that involve the temporomandibular joint (TMJ) or joints, the masticatory musculature, or both. These conditions are typically characterized by pain in the pre-auricular area that is usually aggravated by chewing or other jaw function and is often accompanied, either singly or in combination, by limitation of jaw movement, joint sounds, palpable muscle tenderness, or joint soreness. As with most other musculoskeletal conditions, the diagnostic "gold standard" for TMD is based upon an evaluation of the patient's history and clinical examination, supplemented, when appropriate, by TM joint imaging. It is against this "gold standard" that the reliability and validity of diagnostic modalities must be compared. With regard to electronic devices, several reviews of the scientific literature have concluded that the diagnostic reliability, validity, sensitivity, and specificity of such devices in the diagnosis of TMD have not been established. In addition, although clinical examination of the dentition may provide useful diagnostic information for some conditions, specific occlusal relationships have poor sensitivity and specificity when related to the presence or absence of TMD. TMJ imaging, when indicated, is useful in the detection of pathology within the joint, provided that validated criteria are applied to an analysis of the image. However, the assessment of condylar position as a diagnostic criterion for TMD has very poor reliability and validity.

Diagnostic Imaging↗
PubMed1999

[Stomatologic and maxillofacial pathology in a medieval population (10th-12th centuries) of southwestern France].

We present an assessment of the dental and maxillofacial pathology in a medieval population in southwestern France. One hundred and ninety eight mandibles and 29 craniofacial complexes were analysed. Dental and periodontal infectious pathology predominated. Third molar agenesia was quite frequent, concerning 25% of the mandibles. Third molar eruption was almost constant and in a normal position. Condylar process degeneration concerned 6% of the population. Three cases of traumatic pathology were observed, one case of long mandible was noted, and two cases of hypertrophic inferior alveolar process. Dento-mandibular maladjustment was uncommon. No unwedging of the maxillo-mandibular bone basis was observed.

Adult↗
PubMedDate not supplied

Techniques in recording centric relation.

1. Muscle seated centric registration is a reproducible method of obtaining centric relation (Wood, 1994). 2. The muscle-seated CR record provides a consistent, accurate, less technique-sensitive CR record of condylar position.

Centric Relation↗
PubMed2000

Occlusion: an orthodontic perspective.

In recent years, orthodontists have examined their concepts of occlusion. In current literature, at professional meetings, and in continuing education courses, one hears an ongoing discussion of condylar position and mandibular border movements in relation to occlusion. There is a wide variation in opinion as to whether dental occlusion and TMJ function are interdependent. The authors have adopted a dynamic concept of dental function to replace the traditional static view of molar relationship and incisor overlap. This article discusses how occlusion has evolved in orthodontics and reviews Andrews' six keys to ideal static occlusion, the goals of ideal dynamic occlusion, and the six signs of developing malocclusions. The authors also review the literature on the relationship between orthodontics, occlusion, and TMD.

Child↗
PubMedDate not supplied

[Posterior vertical dimension and condylo-discal non-coordination of the temporomandibular joint. Hypothesis on correlation].

BACKGROUND: On the basis of clinical evidence, an analytic study has been carried out to verify the hypothetic correlation between reduction of the posterior vertical overlap and internal derangements. METHODS: 58 patients with temporomandibular disorders have been observed; they presented clinically a reduction of the posterior vertical dimension (RPVD) due either to the loss of molar teeth or to the molar occlusal surface abrasion or to a wrong prosthetic rehabilitation. A cephalometric exam showed a significative correspondence between the RPVD and the retruded condylar position in the glenoidae fossa with a reduction of posterior joint space in comparison with the standard values purposed by Farrar. RESULTS: The results obtained showed a possible relation between occlusal alterations and the TMJ pathology. CONCLUSIONS: The conclusion is drawn that the clinical evaluation brings to consider occlusal factors, and in particular the reduction of posterior vertical dimension may be considered as possible etiologic factors of TMJ disorders.

Female↗
PubMed2000

[Comparison of effect of the mandible setbacked by SSRO and IVRO on gnathostomatic system].

OBJECTIVE: To compare the effect of the mandible setbacked by sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) on gnathostomatic system. METHODS: 27 cases with mandibular prognathism were treated, 16 received SSRO and 11 IVRO. Their occlusal force and masticatory efficiency were measured preoperatively and at 3 and 6 months after operation. The condylar positions were assessed by radiography before surgery and at 6 months postoperatively. RESULTS: In three months postoperatively, the occlusal force and masticatory efficiency of IVRO group was decreased more than that of SSRO group. At six months postoperatively, the occlusal force and masticatory efficiency of SSRO group recovered quicker than IVRO group and better than that of before operation. In IVRO group, the occlusal force approached the preoperative level, the masticatory efficiency was better than preoperative value. 26/32 (81.2%) condyles were relatively retropositioned in SSRO group, 14/22 (63.6%) condyles were relatively forward positioned in IVRO group. CONCLUSIONS: The function recovery time after surgery was shorter in SSRO group. The masticator muscles were detached in varying degree and the bone segments healed slowly, the effect on gnathostomatic system was greater and recovery time after surgery was longer in the IVRO group.

Adult↗
PubMed1991

Surgical orthodontics.

This was an interesting year for the surgical orthodontic literature. Excellent large long-term studies addressed the stability of rigid versus wire fixation, lag screws versus bicortical screws, and osteotomy site selection. The effect of orthognathic procedures on speech and hearing deficits, condylar position, and the patient's psyche were reported in detail. Possible solutions to financial difficulties and the concern about blood transfusions were presented. Treatment failures and prediction shortcomings were candidly discussed.

Humans↗
PubMedDate not supplied

[Relationship between malocclusion and TMJ dysfunction. Literature review].

The purpose of this paper is to discuss some current concepts of maloclusion and TMJ Syndrome by reviewing the most significative literature. This analysis the great differences between well-knowing authors about very important subjects in occlusion, as the condylar position in centric relation and in TMJ Syndrome, or what kind of malocclusion (morphologic and functional, skeletal or dental) was the cause of TMJ Syndrome. The theory of emotional stress would be useful to explain some of the discrepancies, by reducing the occlusal disharmony to predisposal factors depending on the personal adaptation to stress.

Dental Occlusion, Centric↗
PubMedDate not supplied

[New directions in cranio-cervico-mandibular cephalometry].

A pilot survey has been conducted on a sample of 22 adolescents in order to correlate the cranio-facial morphology and the condylar position with the mandibular posture, cranio-cervical posture and airway adequacy. Cephalograms extended to the cervical column and oblique lateral trans-cranial X-Rays with the standard projection has been adopted. The use of specific cephalometrics parameters allowed to separate the sample in sub-groups with similar variables and to obtain diagnostic indications. The utility of an analysis not only cranio-basal but extended to the cranio-cervical, intercervical, cervico-mandibular and hyoid parameters has been demonstrated.

Adolescent↗
PubMed1989

[A case report: occlusal guidance of Angle Class II malocclusion with dysfunction of the masticatory system].

The purpose of this study was to evaluate the condylar changes induced by Bionator therapy. The pre and post treatment Cephalometric, tomographic, and dental cast record were evaluated. An 11-Year, 8 month-old boy with malocclusion class II div. 1 was referred to the Pedodontic clinic of the Nippon Dental University Hospital with a chief complaint of Brxism and Protrusion. The medical history was non-contributory. The period of the observation was 3 years 2 months. Normal permanent occlusion was obtained after treatment. The cephalometric findings showed a favorable relationship between the results of the skeletal and dental changes. Also the results showed an effect on the maxilla and mandible stimulation, class II skeletal correction. Favorable changes in the mandibular condylar position using the Bionator were observed in tomographic records before and after treatment.

Activator Appliances↗
PubMed1989

Early relapse following bilateral sagittal split advancement.

Early relapse following bilateral sagittal split advancement (BSSA) was assessed by evaluating the cephalograms of 47 patients. The records were assigned to either screw fixation (SF: n = 25) or wire osteosynthesis (WF: n = 22) groups and subdivided if additional Le Fort I osteotomy was performed. 9 skeletal parameters were evaluated. The results showed that there were relatively minor differences between the screw and wire osteosynthesis groups in the first 6 weeks following surgery. Relapse of 11 percent and 22 percent was recorded respectively but this difference was not statistically significant. Relapse was not correlated with the preoperative mandibular plane, altered posterior facial height, gonial angle or changes in gonial arc radius in either group. A clear association between condylar displacement and relapse tendency was not expressed. This suggests that whilst condylar position remains important, early postsurgical relapse is due to multifactorial influences.

Analysis of Variance↗
PubMed1978

[The condymeter].

The condymeter serves for the technical measurement of condylar displacement where the usual condylar position (habitual intercuspidation) is used as a relative constant. Technical fitting and calibration of the machine with the commercially available SAM-Articulator System ensures its time-saving use in diagnosis and and therapy of diseases of the temporo-mandibular joint and the neuromuscular system.

Dental Articulators↗
PubMed1993

[Biomechanics of the knee joint].

The capsular and ligamentous structures as control system of a healthy knee-joint supported by the muscular system are responsible for the rolling and gliding motion of the femoral condyles on the tibial plateau. Both the condyles and the tibial plateau have individually developed but to each other adjusted shapes and fine structures thereby. These structures consist of hyaline cartilage at their three-dimensional surfaces and of closely packed fibrils (lamina splendens) as the final gliding zone for tensile load. The orientation of the collagenous fibres can be made visible by split lines. The chondral surfaces are indirectly in contact to each other and orthogonally stressed at the particular point of contact. The indirect contact of the cartilaginous surfaces happens under interposition of the menisci. The meniscus serves to reduce and equalize the surface pressure by its own projected surface on the one hand and by maintaining of a hydraulic pressure of the synovial fluid on the other hand. Deviations of the condylar position as a result on ligamentous instabilities or ruptures with a following occurring loss of congruence, meniscal lesions or traumatic ruptures lead to a rapid discharge of the synovial fluid under load. The result is a hydraulic head loss with direct contact of the chondral surfaces under stress leading to arthrotic deformations. Severe arthrotic deformations or very much every meniscectomy produce intraarticular lumped loads resulting in a hyper-physiologic chondral pressure and malnutrition thereby. Further on there develop subchondral stress concentrations (caused by the lumped loads) leading to osseous damages, too. MR-pictures can make visible these damages. Chondromalacia, fissure or even chondrolysis are arthroscopically detectable sometimes. As after-effects of deficient knee ligaments occur pathological deviations of the femoral condyles and resulting destructions of the articular surfaces under stress enormously intensified by strongly dynamic stress after ruptures of the cruciate ligaments with a too late muscular compensation. The reconstruction of cruciate ligaments is consequently required from biomechanical view to preserve the physiological position of the articular surfaces.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomechanical Phenomena↗