INTERRELATED FACTORS IN COMPLETE DENTURE CONSTRUCTION.
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Dental Occlusion↗
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Results for “DENTAL OCCLUSION, BALANCED”
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Traumatic malposition of the mandible: the essence of balanced occlusion.
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Dental Occlusion, Balanced↗
[Imbalance of the temporomandibular articulation and balancing of articular occlusion].
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Dental Occlusion, Balanced↗
Occlusal adjustment for a physiologically balanced occlusion.
An investigation of the neuromuscular effects of dental contact at the physiologic median occlusal position was conducted before and after occlusal adjustments. Eighteen patients with histories of functional disturbances of the masticatory system, but whose painful symptoms had subsided, were analyzed before and after occlusal adjustments. Nine of the patients with missing teeth received fixed partial dentures and occlusal adjustments. Another group of nine subjects with normal occlusions were used as controls. Electromyographic recordings of the bilateral temporal and masseter muscles enabled quantification of two reflex parameters, the EMG silent period duration, and the mechanical latency of the jaw-opening reflex. Phase-plane traces of jaw-closing velocity as a function of position displayed the repeatability of the median occlusal position. The statistical analysis disclosed that the mean duration of EMG silent periods and latency of the jaw-opening reflex were significantly reduced following the treatment procedures. Within the limits of this study it was concluded that the described occlusal adjustments will reduce the masticatory reflexes evoked at median occlusal position to within the range of normal subjects. Furthermore these changes can be monitored by electrophysical methods.
Adolescent↗
Pathophysiology of occlusal balance.
Functional disturbances of the masticatory system reflect a failure in the adaptive capacity of the individual to excessive structural and functional demands. Formerly, a particular type of articulation, balanced occlusion, was thought necessary for maintaining the health of the dental apparatus. Over the years the concept of stability of occlusion has evolved, however controversy still exists as to where stable tooth contact is made, centric occlusion of centric jaw relation. In order to express biological adaptability within the normal masticatory system, harmony at the anatomical median occlusal position is suggested as the prerequisite of a physiologically balanced occlusion.
Adult↗
[Functional balancing by selective casting].
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Dental Casting Technique↗
Articulator-generated amalgam stops for complete dentures.
Balanced occlusion in eccentric positions for complete denture occlusion is an acceptable and widely practiced concept. Many methods have been described for achieving balanced occlusion. The technique outlined in this article uses amalgam stops generated on a programmed Hanau Model H2 articulator. The posterior occlusal scheme used to facilitate this technique is also described.
Dental Amalgam↗
Arrangement of anatomic-type artificial teeth into balanced occlusion.
The mechanical factors which are involved in the arrangement of anatomic type artificial teeth into balanced occlusion have been described. Many of the mechanical problems encountered during artificial tooth arrangement have been listed, together with suggestions for their solution. Hanau's Laws of Articulation have been utilized in a practical manner in formulating some of the solutions to tooth arrangement problems when establishing balanced occlusion. Trial dentures which present ideal occlusions in the articulator may not always do so when examined in the patient's mouth. Possible reasons for these differences are listed, and methods for making the necessary corrections are described.
Dental Articulators↗
Maxillomandibular relationship in TMD patients before and after short-term flat plane bite plate therapy.
This study assessed the maxillomandibular relationship in temporomandibular disorders (TMD) patients, before and after short-term, flat plane bite plate therapy. It was of interest to determine the incidence and degree of mandibular deviation in a group of TMD patients and whether the mandible would shift to the midline and consequently affect reported symptoms. Seventeen female and three male subjects (age range 19-60) were included in the study. Thirteen subjects were diagnosed with myofascial pain while seven were diagnosed as exhibiting disk displacement with reduction (Research Diagnostic Criteria). After taking impressions for these subjects, casts were fabricated and mounted. Maxillomandibular relationship was evaluated by the Denar Centric Check system (Anaheim, CA). The maxillary and mandibular labial frena were used as a reference to evaluate mandibular shift. Symptom questionnaires were used to assess temporomandibular joint pain and clicking. All subjects exhibited deviation (12 subjects to the right and 8 subjects to the left) prior to bite plate therapy. After flat plane bite plate therapy, the mandibular position of all subjects shifted toward the labial frenum midline position. Based on the Binomial test, the shift was significant (p < 0.001). Measurements on the Centric Check system showed a significant movement of both condyles in the anterio-posterior plane as well as the vertical plane. There was also significant reduction in TMJ pain and clicking (p < 0.01). The results support the hypothesis that the balanced position of the mandible is with frena aligned. When occlusal obstructions are eliminated, the mandible will drift to this position.
Adult↗
A century of controversy regarding the benefit or detriment of occlusal contacts on the mediotrusive side.
Many opinions have been presented in the literature during the past century regarding so-called mediotrusive/balancing/non-working side contacts. During the first half of this century, most authors advocated the advantage of these contacts (it was more or less the state of the art in prosthetic treatments), while during the last 50 years mediotrusive side contacts/interferences have mostly been regarded as a disturbing factor in the functioning of the mandible. Recently, it has been proposed that mediotrusive side contacts have a protective effect on the temporomandibular joint (TMJ). The aim of this study was to review opinions advocated during the twentieth century regarding the advantages and disadvantages of having contacts on the mediotrusive side during lateral excursions of the mandible. We conclude that, at present, there is no uniform body of scientific evidence supporting a balanced occlusion in favour of a mutually protective occlusion or vice versa. Longitudinal studies based on cohorts with different types of occlusal contacts, estimating the risk among these of developing signs and symptoms of temporomandibular disorders, are generally lacking and could provide valuable knowledge in this field.
Bruxism↗
An in vitro study of the influence of occlusal scheme on the pressure distribution of complete denture supporting tissues.
This study compared lingualized occlusion and completely balanced occlusion using a simulation device. Sixteen pressure transducers were placed in the simulated residual ridge area supporting the test dentures. Lingualized occlusion was found to transfer stresses from the occluding side to the opposite, nonworking side to stabilize the mandibular denture.
Dental Articulators↗
Vectorial analysis of the static equilibrium of forces generated in the mandible in centric occlusion, group function, and balanced occlusion relationships.
Mechanical analyses supporting various and prevailing stomatognathic concepts of occlusal function are sparse. This study, using a mechanical model, simulates a system in function and provides a vectorial analysis based on a static equilibrium of forces generated in a mandible at 10 different positions. The positions analyzed were one in centric occlusion and nine in eccentric positions. Four eccentric positions were in a balanced occlusal relationship and five were in group function. Among other conclusions that were drawn, the most relevant seems to be the finding that cusp inclines and condylar path inclination have a profound influence on the forces acting within the joints and dentition.
Bite Force↗
The investigation of occlusal contacts during the retention period.
Removable retention appliances were applied to 20 treated orthodontic patients, and their occlusal contact points were determined from occlusal registrations taken at the beginning and the end of retention. Furthermore, to determine the results at the end of retention, the occlusion of 20 treated patients was compared with a control group of another 20 subjects who had an ideal occlusion. During the retention phase the number of contacts in centric occlusion increased significantly. No significant difference was observed with regard to the location of contacts. Whereas the number of ideally located contacts was similar to that in the control group, differences were observed in actual and canine contacts between the groups. At the end of retention, the balancing side contacts in lateral movements and the posterior contacts in protrusive movements were generally determined as near contacts and showed a similarity to the control group. In order to maintain the occlusal stability that is needed for the success of orthodontic treatments, ideal occlusal contacts and localization of contacts in centric and eccentric occlusion should be considered.
Adolescent↗
Temporomandibular disorders and functional occlusion after orthodontic treatment: results of two long-term studies.
The prevalence of temporomandibular (TM) disorders and the status of the functional occlusion in former orthodontic patients many years after treatment were evaluated in two independent clinical studies. In each study, the former orthodontic patients were compared to similar groups of adults with untreated Class I and Class II malocclusions. Both studies reported similar findings with regard to TM disorders; there was no statistically significant difference (p greater than 0.05) between the orthodontic and control groups in either study. The illinois study found a high prevalence of nonfunctional (balancing) contacts in both groups, while the Eastman study found a somewhat lower prevalence. Differences for most of the occlusal parameters between the orthodontic and control groups were not statistically significant in either study. The findings for these two studies are similar and suggest that orthodontic treatment performed during adolescence does not generally increase or decrease the risk of developing TM disorders in later life.
Adult↗
[Clinical results of functional bite analysis. III. The effect of objectifiable factors upon the therapeutic results].
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.
Bruxism↗
Electromyographic analysis of the masticatory muscles of patients after complete rehabilitation of occlusion with protection by non-working side contacts.
Surface electromyography was used to study the function of the anterior temporal, surface masseter, deep masseter and anterior digastric muscles of 14 patients after complete rehabilitation of occlusion with fixed prostheses and/or removable partial prostheses. All patients had a balanced occlusion with protection by non-working side contacts during lateral excursion. Mean resting myoelectric activity was 2.5-3.8 microV, showing no hypertonia or muscular spasm. When patients clenched their teeth (i.e. exerted maximum voluntary occlusal force in centric occlusion), the anterior temporal muscles were the most active, followed by the surface masseters; the digastrics were significantly less active. During lateral displacements, the muscles exhibiting significantly higher potentials than the other muscles monitored were the working side anterior temporal muscle and the contralateral surface masseter. During mastication, the muscle that was most active in relation to its contralateral homologue was the working side surface masseter, the difference between the two being statistically significant.
Adult↗
Masticatory muscle activity before and after elimination of balancing side occlusal interference.
The activity of the masseter and anterior and posterior temporal muscles was studied by electromyography (EMG) in the thirteen subjects with unilateral balancing side interferences and in twelve control subjects without such interferences. In both groups the EMG recordings were made during postural activity and various functions of the masticatory system and in the interference group they were repeated on two occasions following occlusal adjustment. The postural muscle activity was significantly lower in the interference than in the control group while there was no difference during maximal bite. The number of chewing cycles was somewhat longer in the interference than in the control group. During swallowing of water the maximal mean voltage amplitude was smaller in the interference than in the control group. The findings are discussed in relation to previous results and the conflicting ideas concerning occlusal factors in the aetiology of mandibular dysfunction.
Adult↗
Patient response to variations in denture technique. Part III: Five-year subjective evaluation.
Dentures were constructed for 64 patients by two different techniques. One technique, designated as "complex," involved more complicated procedures such as a true hinge axis location, balanced occlusion, dentures remounted on an articulator after processing with new interocclusal records, and occlusal corrections made on the articulator. The "standard" technique involved an arbitrary mounting of the maxillary cast on the articulator, arranging the occlusion with centric relation coincident with centric occlusion but without a balanced occlusion, and making occlusal corrections in the mouth. Subjective evaluations were made for each of the 64 patients at initial placement of the dentures and for all active patients at five yearly recall visits following placement. The evaluation method was designed to determine clinical differences between the dentures made by the two techniques. At the end of 5 years, the data obtained at five yearly recall visits were subjected to statistical testing. These tests were performed to determine if the technique by which the dentures were made had any effect on the performance of the dentures that could be detected clinically. The results of the test showed that there was no significant difference between dentures made using two denture techniques that could be detected by subjective means.
Alveolar Process↗