Showing papers in "Cranio-the Journal of Craniomandibular Practice in 2018"
TL;DR: Significantly longer disclusion time, higher posterior frictional contacts, and more TMD symptoms were observed in the post-orthodontics group, suggesting that orthodontic treatment increases posterior tooth friction.
Abstract: Objective: Published studies indicate that orthodontically treated patients demonstrate increased posterior occlusal friction contributing to temporomandibular disorder (TMD) symptoms. This study investigated measured excursive movement occlusal contact parameters and their association with TMD symptoms between non- and post-orthodontic subjects.Methods: Twenty-five post-orthodontic and 25 non-orthodontic subjects underwent T-Scan® computerized occlusal analysis to determine their disclusion time (DT), the excursive frictional contacts, and occlusal scheme. Each subject answered a TMD questionnaire to determine the presence or absence of TMD symptoms. Statistical analysis compared the within group and between group differences (p < 0.05).Results: Statistically significant differences were observed in the disclusion time: DT = 2.69 s in the post-orthodontic and 1.36 s in the non-orthodontic group. In the non-orthodontic group, 72.7% working and 27.3% non-working side contacts were seen, while in th...
30 citations
TL;DR: TMJ arthrocentesis remains a procedure with a minimum number of important complications, and can be managed on an outpatient basis, if present.
Abstract: Objective: To evaluate intraoperative complications and postsurgical sequelae associated with arthrocentesis of the TMJ, including injection of Sodium Hyaluronate. Methods: This retrospective study...
27 citations
TL;DR: It can be concluded, therefore, that no relationship exists between cervical posture in the sagittal plane and TMD.
Abstract: Objective: To evaluate the relationship between temporomandibular disorders (TMD) and craniocervical posture in the sagittal plane measured from lateral radiographs of the head.Methods: The sample was comprised of 80 randomly selected students of dentistry at the Federal University of Rio Grande do Norte. Research Diagnostic Criteria for TMD (RDC/TMD) was used to evaluate the signs and symptoms of TMD. Lateral radiographs of each individual were used to measure the position of the hyoid bone, the craniocervical angle, and the occiput–atlas distance. A chi-square test was used to evaluate the relationships between craniocervical posture measures and TMD.Results: No relationship was found between TMD and the craniocervical posture measured by the positioning of the hyoid bone, head rotation, and the extension/flexion of the head (p > 0.05).Conclusion: It can be concluded, therefore, that no relationship exists between cervical posture in the sagittal plane and TMD.
23 citations
TL;DR: It is believed that sleep bruxism is closely related to SN as well as PSN activities and may control the AN system.
Abstract: Objectives: To confirm the relationship between sleep bruxism (SB) and autonomic nervous (AN) activities to elucidate SB physiology.Methods: Subjects included 11 healthy males (mean age, 24.7 ± 2.3...
20 citations
TL;DR: OGS enhanced masticatory function by improving occlusion in individuals with a dentofacial deformity by improving Occlusal splint application and electromyographic activity of the masseter and anterior temporal muscles.
Abstract: Objective: To evaluate the effect of double jaw orthognathic surgery (OGS) on masticatory performance and electromyographic activity of the masseter and anterior temporal muscles in skeletal Class III patients.Methods: Individuals were instructed to chew standardized round tablets of silicone impression material. The cumulative weight percentage was calculated using sieve analysis. The bilateral surface electromyographic activity of the muscles was evaluated. Following the orthodontic treatment, a stabilization splint was fabricated. Patients were instructed to wear it full-time until the surgical procedure occurred. Recordings were performed before the splint application (T0), after the splint application (T1), 1 month after the OGS (T2), and 6–8 months after the OGS (T3).Results: Median particle size of the chewed silicone material did not differ from T0 to T1 with the use of an occlusal splint (p > 0.05). However, it decreased from 9.46 to 6.92 cm from T2 to T3. From T0 to T3, a statistically s...
19 citations
TL;DR: A unilateral decrease in the vertical height of the dentition and the subsequent steeper occlusal plane inclinations correlated with mandibular rotational displacement and condylar lateral displacement and changes in temporal bone position.
Abstract: Objective: The purpose of this study was to evaluate the morphologic characteristics of MLD malocclusions using 3D imaging.Materials and methods: MLD characteristics were examined using CBCT data i...
18 citations
TL;DR: Arthrocentesis is an effective management method for symptomatic patients with ADDWOR at one-month post treatment, especially in the absence of parafunctional habits.
Abstract: Objective: Arthrocentesis is an effective procedure for management of symptomatic patients with temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDWOR), but its prognostic factors are still under investigation.Methods: Thirty-six patients with ADDWOR underwent arthrocentesis of the TMJ and hyaluronic acid injection. They were divided into groups based on three prognostic factors: Age, gender, and the presence of parafunctional habits. The procedure outcome (success or failure) was based on pre-set criteria for improvement in pain and maximum mouth opening (MMO) one month preoperatively.Results: Patients with parafunctional habits had a lower success rate than patients without these habits. Interesting trends were noted with age and gender as prognostic factors for arthrocentesis for patients with ADDWOR.Conclusion: Arthrocentesis is an effective management method for symptomatic patients with ADDWOR at one-month post treatment, especially in the absence of parafunctiona...
17 citations
TL;DR: Only extensive masticatory parafunctional oral activity is significantly related to myalgia in children living in Uganda, and when performed extensively, they were significantly associated with myalgia.
Abstract: Objectives: The aims of the current study were: (1) to assess the prevalence of oral habits, bruxism, and temporomandibular disorders (TMDs) among children living in Uganda; (2) to establish whether parafunctional activities are associated with TMDs; and (3) to examine the possible impact of gender and age on the prevalence of bruxism, oral habits, and TMDs Methods: This study included 153 children aged 6–17 years The study consisted of a questionnaire and a clinical examination Results: TMDs were moderately prevalent (35%) Parafunctional habits were performed by 93% of the participants When performed extensively, they were significantly related to myalgia No gender or age significant differences were found Conclusions: 1 Only extensive masticatory parafunctional oral activity is significantly related to myalgia 2 Gender and age had no impact on the prevalence of bruxism, oral habits, or TMDs 3 Sleep and awake bruxism were not related to anamnestic symptoms or clinical findings in TMD
16 citations
TL;DR: This review will focus on the Interleukin (IL) family of cytokines, which have been quantified in TMJ synovial fluids in a variety of studies, and compare IL-1 concentrations in TMD vs. control groups.
Abstract: Objective: Temporomandibular disorders (TMD) are a group of conditions affecting the temporomandibular joint (TMJ), leading to jaw dysfunction, joint and muscle pain, and a decrease in quality of life. A communication network of pro- and anti-inflammatory mediators called cytokines maintains the homeostasis of the TMJ. This review will focus on the Interleukin (IL) family of cytokines, which have been quantified in TMJ synovial fluids in a variety of studies. IL-1α and IL-1β have pro-inflammatory effects, while the endogenous receptor antagonist (IL-1RA) inhibits the pro-inflammatory effects of IL-1. Methods: A literature search (2006–2016) to identify eligible studies was completed using the PubMed database. Studies identified used saline irrigation to quantify cytokine profiles in synovial fluid of healthy and/or dysfunctional joints. Results: The initial search yielded 111 articles, 5 of which met the inclusion criteria after inter-reviewer discussion. Conclusions: Articles that compared IL-1 ...
15 citations
TL;DR: Distinct clinical patterns of cervical spine and masticatory function were found among subgroups of TMD, which has clinical implications for therapeutic management.
Abstract: Objectives: To identify clinical patterns of impairment affecting the cervical spine and masticatory systems in different subcategories of temporomandibular disorder (TMD) by an explorative data-driven approach.Methods: For this observational study, 144 subjects were subdivided according to Research Diagnostic Criteria for TMDs into: Healthy controls, temporomandibular joint (TMJ) signs without symptoms, TMJ affected, temporomandibular muscles affected, or TMJ and muscles affected. Factor analysis and linear regression were applied to cervical spine and masticatory data to identify and characterize clinical patterns in subgroups.Results: Factor analysis identified five clinical dimensions, which explained 59% of all variance: Mechanosensitivity, cervical movement, cervical and masticatory dysfunction, jaw movement, and upper cervical movement. Regression analysis identified different clinical dimensions in each TMD subgroup.Conclusion: Distinct clinical patterns of cervical spine and masticatory f...
14 citations
TL;DR: Condylar motion was reduced in skeletal Class III patients, in particular in the translational path.
Abstract: Objective: The aim of the study was to analyze the characteristics and changes in mandibular condylar motion in patients with skeletal Class III malocclusion.Methods: Using a 3D motion analyzer, mandibular movements were recorded in 9 patients with skeletal Class III malocclusion and 22 control subjects with Angle Class I jaw relationships.Results: Class III patients had a similar interincisor point displacement but a significantly reduced displacement of both condyles on the sagittal and frontal planes, with smaller translation paths than control subjects (right −9.4 mm; left −4.8 mm). The overall condylar rotation component was larger in Class III patients (right +8.8%; left +7.3%). The largest inter-group significant differences were observed in the first 10% of mouth opening, in which Class III patients had a larger rotating component than control subjects (+20%, p < 0.01).Conclusions: Condylar motion was reduced in skeletal Class III patients, in particular in the translational path.
TL;DR: MMP-13 is not significantly involved in collagen degradation in human TMJ disc displacement or osteoarthrosis, and there was no statistically significant difference for the area of M MP-13 immunostaining between the control group, ADDwR, and ADDwoR, nor between groups with and without osteoartrosis.
Abstract: Objective: MMP-13 performs digestion of collagen, which is a primary component of the temporomandibular joint (TMJ) articular disc. This study evaluated the expression of MMP-13 in patients with anterior disc displacement with (ADDwR) and without reduction (ADDwoR), and in the presence of TMJ osteoarthrosis.Methods: Thirty-nine human temporomandibular joint disc samples were collected and divided in two ways: ADDwR (21 samples), ADDwoR (10 samples), and a control group (8 samples); and with osteoarthrosis (10 samples) and without osteoarthrosis (29 samples). Immunostaining of the TMJ discs was statistically compared between the groups.Results: There was no statistically significant difference for the area of MMP-13 immunostaining between the control group, ADDwR, and ADDwoR, nor between groups with and without osteoarthrosis.Conclusion: This study suggests MMP-13 is not significantly involved in collagen degradation in human TMJ disc displacement or osteoarthrosis.
TL;DR: The assessment of the mandibular movement with a millimeter ruler is a reliable procedure irrespective of TMD and the patient should be asked beforehand to practice this movement.
Abstract: Objective: This study determines the effect of temporomandibular disorders (TMD) on the reliability of mandibular movement assessments.Methods: The vertical and horizontal jaw movements, as well as overjet and overbite, were measured twice in 56 consecutively recruited adult subjects with TMD according to the RDC/TMD and 29 controls without TMD diagnosis by experienced dentists utilizing a millimeter ruler. The reliability was determined by intraclass correlation coefficient (ICC).Results: Neither statistically nor clinically relevant differences in the repeatability between both subgroups could be detected (all p ≥ 0.077). The mouth opening and overjet proved an excellent reliability (ICC 0.85–0.92). Overbite and laterotrusion showed good to excellent reliable results (ICC 0.74–0.82). The second measurement of the vertical jaw movement resulted in systematically higher values (p < 0.003).Discussion: The assessment of the mandibular movement with a millimeter ruler is a reliable procedure irrespec...
TL;DR: Inter-arch occlusal measurements on digital models are accurate and reliable and are superior to manual measurements.
Abstract: Objectives: The purpose of this study was to evaluate the accuracy and reliability of inter-arch measurements using digital dental models and conventional dental casts. Methods: Thirty sets of dent...
TL;DR: The use of a single miniplate for the treatment of mandibular angle fractures is encouraged, however, postoperative MMF should be considered with the presence of little contact between bone segments, malocclusion, or extensive tooth loss.
Abstract: Objective: This retrospective study evaluated the use of a single miniplate for the treatment of mandibular angle fractures (MAF).Methods: Fifty patients with 53 MAF were treated by open reduction and internal fixation with the use of a single miniplate and were analyzed in this study.Results: Five patients with MAF had postoperative complications that required additional procedures. Three patients had postoperative infection, one patient complained of malocclusion in the first postoperative week, and one patient had miniplate exposure three months after surgery. Every additional procedure was performed in the office under local anesthesia without disruption of the initial fracture treatment. Postoperative maxillomandibular fixation (MMF) was performed in four patients. Treatment of MAF using a single miniplate was effective, with low morbidity and with low rates of postoperative complications. MAF can be treated without MMF, and stability is improved when long miniplates are used.Conclusions: The...
TL;DR: The results suggest that adaptive bone remodeling of the TMJ occurs during the correction of occlusion with labial inclination of the upper incisors by orthodontic treatment after premolar extraction in patients with Angle Class II malocclusion.
Abstract: Objective: The aim of this study was to examine the morphological temporomandibular joint (TMJ) changes that occur after orthodontic treatment in patients with Angle Class II malocclusion.Methods: ...
TL;DR: Chronic TMJ pain patients without MRI-detected TMJ effusion have a different personality profile than patients with TMj effusion and pain-free individuals, regarding high levels of concerns about physical health and physical symptoms.
Abstract: Objective: The study aimed at investigating personality traits in chronic temporomandibular joints (TMJ) pain patients with and without joint effusion.Methods: Two groups of chronic TMJ pain patients were recruited. The TMJ pain control group was composed of patients showing magnetic resonance imaging (MRI) signs of TMJ effusion, while the TMJ pain test group included patients with chronic TMJ pain seemingly not justified, due to the absence of MRI-detected disorders. A third set of pain free individuals was selected as a comparison group. All patients completed a personality assessment with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) instrument, and the between-group differences were assessed for significance by performing an analysis of variance test.Results: Patients of the TMJ pain test group had higher scores than subjects belonging to the TMJ pain and pain-free control groups in almost all of the MMPI-2 clinical scales. A significant difference was shown for the scales related...
TL;DR: The mandibular position seems to have no influence on the active cervical ROM in healthy subjects and the usefulness of the accelerometer in the cervical analysis of temporomandibular disorder subjects is assessed.
Abstract: Objective: The aim of this study is to analyze the influence of the mandibular positions (habitual rest position, habitual maximum intercuspation, habitual maximum intercuspation with clenching, and mandibular position with cotton rolls) on the active cervical range of motion (ROM) (flexion-extension, lateroflexions, rotations) using an accelerometer in a sample of healthy subjects.Methods: A total of 21 (14 M, 7 F) healthy volunteers aged from 18 to 27 years (mean age 23.88 ± 2.34 years; mean weight 67.86 ± 11.38 kg; mean height 172.52 ± 9.00 cm) underwent a cervical range of movement examination using a 9-axis accelerometer. A one-way ANOVA analysis was performed in order to statistically evaluate the effective influence of the mandibular position on the recorded parameters.Results: The analysis showed no statistically significant differences (all p-values > 0.1) with variations smaller than three degrees among the different mandibular positions.Discussion: The mandibular position seems to have ...
TL;DR: Patients with limited jaw function related to bilateral CPH can benefit by undergoing bilateral coronoidectomies and physiotherapy, relative to post surgery jaw function.
Abstract: Objective: Coronoid process hyperplasia (CPH) of the mandible is a rare condition that can be defined as an abnormal bony elongation of histologically normal bone with the symptoms of progressive, ...
TL;DR: Traumatic occlusal contact on posterior teeth may elicit protective mandibular repositioning affecting anterior teeth relationships and should be considered during comprehensive diagnosis, which can optimize the result of orthodontics, orthognathic surgery and comprehensive restoration.
Abstract: Background: Occlusal adjustment can optimize the result of orthodontics, orthognathic surgery, and comprehensive restoration, and resolve adverse forces to the dentition that affect the entire mast...
TL;DR: It is hypothesized that a separate series of events could have occurred in the central nervous system, which led to speech and OSA, and with the understanding of craniofacial evolution in humans, perhaps the authors can orthodontically or surgically modify the mandible, maxilla, palate, pharynx and/or tongue to maintain appropriate speech but reduce the severity of OSA.
Abstract: In 1859, Charles Darwin revealed his theory of evolution by natural selection in his famous book “On the Origin of Species.” According to the theory, natural selection is the process by which organisms evolve over time to allow for better adaption to its environment in order to survive and have more offspring [1]. In Homo sapiens (humans), the notion of natural selection is observed in the way we perform our activities of daily living. In 2003, Davidson et al. [2] presented data supporting the concept that craniofacial structural and anatomical changes took place for the development of speech and language (Figure 1). Unfortunately, the undesired consequence of this evolution facilitated obstructive sleep apnea (OSA) in modern humans [2]. Klinorynchy is the posterior migration of the splanchnocranium (facial skeleton) under the neurocranium [2]. This shift shortens the maxilla, palate, ethmoids, and mandible in order to provide speech and language. These changes are seen in the evolution from Pan Troglodyte, a common chimpanzee, to the modern Homo sapien [2]. According to Crelin et al. [3], the anterior migration of the foramen magnum with pharyngeal collapse is part of the evolutionary change to facilitate speech but diminishes olfaction. Lieberman et al. [4] proposed that the change from an obtuse to an acute cranial base angulation seen in the modern Homo sapiens furthered the development of speech, resonance, and voice. In regards to tongue position, Negus et al. [5] described that the posterior migration of the tongue into the pharynx decreased the oral cavity size to improve speech and deglutition. In the animal kingdom, the mechanism known as the epiglottic–soft palate lock-up, the overlapping of the epiglottis and soft palate, is prevalent [2]. Interestingly, the mechanism is present in infant Homo sapiens, but disappears as the soft palate shortens and the larynx descends, in order to promote buccal speech [2]. Although these adapted anatomical features facilitate speech and the development of language, they also predispose humans to OSA. Although the central reason for these anatomical changes were to develop voice, speech, and language, it is also recognized that these advances contributed to development of binocular vision and bipedalism [2]. We hypothesize that a separate series of events could have occurred in the central nervous system, which led to speech and OSA. With the understanding of craniofacial evolution in humans, perhaps we can orthodontically or surgically modify the mandible, maxilla, palate, pharynx and/or tongue to maintain appropriate speech but reduce the severity of OSA.
TL;DR: There is sexual differentiation in the pharyngeal airway morphology for Class III adults, as females present similar pharynx volume compared to a normal skeletal pattern, mandibular setback surgery should be carefully planned because of the risk of airway constriction.
Abstract: Objectives: To compare the pharyngeal airway dimensions in adults with skeletal Class III malocclusion and well-balanced faces, to ascertain whether sex can influence such measurements and ...
TL;DR: The Ehlers-Danlos syndromes (EDS) are a group of hereditary disorders that affect collagen and connective tissue structures throughout the body as discussed by the authors, and several subtypes have been identified.
Abstract: The Ehlers-Danlos syndromes (EDS) are a group of hereditary disorders that affect collagen and connective tissue structures throughout the body. Several subtypes have been identified [1], including...
TL;DR: The tooth contact area, anterior occlusal plane, and overbite are closely related, suggesting that tooth contact with the anterior teeth should be controlled with Occlusal therapy.
Abstract: Objective: Bruxism-induced mechanical load causes various dental problems, and its treatment is challenging. The present study analyzed upper and lower tooth contacts to determine actual occlusal contact during sleep bruxism.Methods: Tooth contact patterns were analyzed in 49 patients attending dental clinics, using a Bruxchecker®, cephalograms, and condylographs.Results: Approximately 80% of individuals demonstrated contact from the anterior teeth to the molar region (ICPM); about 96% had mediotrusive grinding and contact. The tooth contact area increased with the flatness of the anterior occlusal plane. The ratio of the contact area of the anterior teeth to the overall tooth contact area increased with overbite. Bilateral ICPM and mediotrusive contact patterns were associated with a high frequency of temporomandibular disorder symptoms, clicking, and/or pain.Discussion: The tooth contact area, anterior occlusal plane, and overbite are closely related, suggesting that tooth contact with the anter...
TL;DR: Cheeks appearance may be an instantly visible surrogate of tongue and pharyngeal fat deposition and of muscle function in OSA screening and may be useful for the identification of OSA risk.
Abstract: Objective: Obstructive sleep apnea (OSA) is a common, potentially life-threatening, but underdiagnosed condition. The study aimed to test the role of facial myofunctional alterations in OSA screeni...
TL;DR: This new physiological positioning strategy improves the position of the condyle compared with the preoperative position in patients with mandibular prognathism.
Abstract: Objective: The aim of this study was to elucidate the physiological position of the proximal segment for postoperative jaw movement in patients with mandibular prognathism.Methods: Twenty-two patie...
TL;DR: Children with CLP have longer muscle activation and increased cycle time during the chewing cycle, which might be a consequence of malocclusion, resulting in difficulty chewing.
Abstract: Objective: To investigate whether children with complete unilateral cleft lip and palate (CLP) have altered control of masticatory muscles Methods: The muscular activity of 66 children with CLP (n
TL;DR: This book was written to provide information for the dental/medical provider and the patient or concerned individual looking for answers to symptoms of progressive developmental pathology.
Abstract: This book was written to provide information for the dental/medical provider and the patient or concerned individual looking for answers to symptoms of progressive developmental pathology. The auth...
TL;DR: In this paper, a detailed chronology of developing consensus to the understanding of "bruxism" and its etiology is presented, and the authors provide the clinic with a detailed overview of the development of consensus.
Abstract: This book was written to provide the dental/medical professional with a detailed chronology of developing consensus to the understanding of “bruxism” and its etiology.The authors provide the clinic...
TL;DR: SEMG is a suitable tool for prosthodontists because it provides objective results on the stomatognathic system muscles function and can significantly increase muscle tension of the masticatory muscles and diminish muscle motor units recruitment during maximal contraction.
Abstract: Objective: Reinvestigation of clinical importance of surface electromyography recordings (sEMG) from the masticatory, neck and shoulder girdle muscles in patients with various clinically de...