Search

Made available in DSpace on 2022-05-01T11:39:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives: The purposes of the present study were as follows: (1) to conduct a randomised crossover clinical trial to evaluate masticatory performance in wearers of conventional complete dentures in both arcs with conventional balanced occlusion (CBO) and lingualised balanced occlusion (LBO), using almonds as natural test food chewed for (a) 30 chewing cycles, (b) 40 chewing cycles and (c) until the subject felt ready to swallow and (2) to perform a randomised crossover clinical trial of oral health self-perception through the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. Background: During rehabilitation with full dentures, achieving stability and retention is essential for masticatory performance. A factor that can act is the appropriate occlusal scheme to be used, although the literature is full of discussions as to the most suitable occlusal scheme to be used, being CBO and LBO the most used in complete dentures. Materials and Methods: The clinical trial was conducted with 30 participants (14 males and 16 females; average age 65.8 years). A base of interchangeable posterior teeth in the lower dentures was used, thereby changing the occlusal schemes without needing to make another complete denture. The masticatory tests and GOHAI application were conducted in two sessions: first with each occlusal scheme, and second only after participants did not report discomfort with dentures. The analysis of variance for the mixed repeated-measures test (ANOVA) was used to verify the results (α = 0.05). Results: The results showed no difference in masticatory performance according to the occlusal scheme (P =.519). The masticatory performance increased with the number of cycles (P

Purpose The occlusal scheme required for an edentulous patient is controversial. The purpose of this Best Evidence Consensus Statement was to evaluate the existing complete denture literature related to occlusal schemes. Materials and methods A literature search was limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Studies (RCT) and Clinical Trials. Key Words were: Complete dentures, occlusion, harm; Complete dentures, occlusion alveolar bone loss; Complete dentures, occlusion, stability; Complete dentures, occlusion. Additional related articles were culled from the authors' library and reference lists in the articles found in the PubMed searches. Results Of the 165 articles that met the initial search criteria, 34 related to the focus questions and were evaluated and rated. Conclusions There is strong support that the average denture patient, with good residual ridges and no neuromuscular problems, will function adequately with a properly fabricated complete denture regardless of the occlusal scheme. There is neither strong support for or against bilateral balanced occlusal schemes as it relates to patient satisfaction, preference or chewing ability. There is some support for increased alveolar bone loss with complete dentures that have a non-balanced occlusion. There is a need for bilateral balanced occlusal schemes for patients presenting with loss of stability and retention as a result of their presenting conditions (PDI III and IV).

Occlusal scheme is a controversial topic that has been linked to patient satisfaction with conventional complete dentures (CCDs). This study aimed to compare the patient satisfaction with CCDs with four different occlusal schemes namely the lingualised occlusion (LO), buccalised occlusion (BO), fully bilateral balanced occlusion (FBBO) and partially group function occlusion (PGFO). In this clinical study, new CCDs were made for 121 patients; out of which, 97 patients (mean age of 57.87 ± 9.5 years) completed the 1-year follow-up. The CCD wearers were followed up at 1 month, 3 months and 1 year after CCD delivery. Data were collected via an interview and recorded in a checklist by a blinded examiner. The checklist included the demographic variables, the 19-item version of Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT), and seven 100-mm line visual analogue scales (VASs) to assess the items related to patient satisfaction. The Kruskal-Wallis and Friedman tests followed by post hoc tests were used to compare the variables among the 4 groups and between the 3 follow-ups. P-value ≤ .05 was considered statistically significant for all tests. The patients with BO presented higher satisfaction scores for comfort, stability and retention at the 1-year follow-up compared with PGFO. Both PGFO and FBBO groups had higher physical pain scores compared with BO and LO. The psychological discomfort scores of FBBO group were significantly higher than those in LO group. Pairwise comparisons revealed no significant differences in the general patient satisfaction and total OHIP-EDENT scores between the 4 groups. For most items, within-group analysis showed significant improvement of the satisfaction scores and reduction of domain scores over time.

To compare patient-reported outcomes among balanced, lingualized, and monoplane occlusal schemes in relation to edentulous jaw classifications.This randomized controlled trial was conducted in edentulous patients receiving new complete dentures using balanced, lingualized, or monoplane occlusal schemes. Demographic variables, bone ridge quantity, number of adjustments required after denture insertion, and satisfaction and quality of life (QoL) indices (ie, the Denture Satisfaction Questionnaire [DSQ] and General Oral Health Assessment Index [GOHAI], respectively) were assessed at 1, 2, 4, 8, 12, and 52 weeks. Within-group comparisons at different time points were carried out with Brunner-Langer nonparametric analysis. Furthermore, Kruskal-Wallis test was used to compare distributions of ordinal or continuous variables among the three occlusal scheme groups.A total of 60 subjects (mean age: 68.1 ± 11.1 years; 56.7% men and 43.3% women) were analyzed. All three groups presented significant improvements in DSQ and GOHAI scores between denture insertion and the 1-year follow-up appointment (P.001). There were no statistical differences in the distribution of demographic variables (eg, age, gender, years edentulous, and age of existing dentures) or of bone ridge classifications among the three groups. Similarly, there were no statistical differences in ridge classifications or in the DSQ and GOHAI values among the three groups for both the maxilla and mandible (P.05) over the 52-week follow-up. On the other hand, the number of cases requiring denture adjustments was significantly lower in the lingualized scheme group, as compared to the two other groups (P = .034).Within the limitations of this study, the present findings suggest that the occlusal scheme for posterior teeth did not influence patient-reported subjective outcomes. However, the lingualized occlusal scheme required significantly fewer adjustments.

Purpose Multiple clinical studies have been published comparing different philosophies of complete denture occlusion and different types of denture teeth. However, it is unclear whether comparable data are available for occlusal schemes used with removable partial dentures (RPDs). Therefore, this review investigated the dental literature related to occlusal schemes for RPDs. Materials and methods A PubMed search of English language articles was performed using the term "removable partial denture, occlusion" with 765 results. When the term "occlusion in removable partial prosthodontics" was used there were 784 results. Seventy-four articles were identified using the different search term of "RPD, occlusion" while use of the term "occlusal scheme, with removable partial dentures" listed 18 publications. The term "removable partial denture, occlusion, literature reviews" produced 38 potential publications related to the topic. Using the term "removable partial denture occlusion systematic review" resulted in 2 citations. Using the term "RPD occlusion literature review" resulted in one foreign language manuscript whereas using the term "RPD occlusion systematic review" resulted in one article unrelated to dentistry. The term "clinical studies of RPD occlusion" produced 5 results with none related to the topic. There were 23 results using the term "clinical studies of removable partial denture occlusion" with one potentially related to RPD occlusal schemes. Results A review of the titles and abstracts revealed 12 articles that appeared to contain specific information about the occlusal scheme used with RPDs. Following a detailed review of those publications, only 4 contained recommendations for RPD occlusion and were included in this review. The available information regarding the recommendations for occlusal schemes in these articles was based on expert opinion. A decision was made to include a hand search of 9 textbooks containing varying amounts of information related to occlusal schemes for RPDs, but no evidence-based references related to RPD occlusal schemes were found in the textbooks. Since this entire review is based on expert opinion, no attempt was made to critique the opinions expressed by these authors but rather to present their perspectives for evaluation by readers. Conclusions The occlusion developed with RPDs should be physiologically harmonious, allowing the supporting structures to remain in a good state of health with functional stress distributed among all the occluding teeth. Multiple authors indicate the occlusion in maximum intercuspation/centric occlusion should incorporate bilateral posterior contacts with no deflective occlusal contacts. When most occlusal contacts on natural teeth are missing, it has been proposed that extension base RPDs have their occlusal contacts developed in centric occlusion. Regarding eccentric occlusal relationships, a balanced occlusal scheme has been recommended by multiple authors with one author advocating use of a lingualized balanced. An anterior guided (canine-protected) occlusion has also been recommended when the canines are present and not periodontally compromised. When RPDs oppose a complete denture, several authors indicate a bilateral balanced occlusion should be used to help stabilize the complete denture.

BACKGROUND The suitability of mechanical thrombectomy (MT) for patients with acute mild ischemic stroke (AMIS) caused by large vessel occlusion (LVO) is controversial. This study evaluated MT in patients with AMIS and LVO. MATERIAL AND METHODS Forty-seven patients diagnosed as AMIS with LVO received MT or intravenous thrombolysis (IVT). Primary outcomes were National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale scores. Secondary outcomes were incidence of systemic complications and symptomatic intracranial hemorrhage. RESULTS There were no significant differences between IVT and MT groups for gender, age, risk factors of cerebrovascular disease, past history, NIHSS score at admission, blood pressure, and LVO sites. For all patients, the NIHSS scores at discharge were lower than those at admission. Patients with excellent outcomes were 66.6% (16/24) in the IVT group and 60.8% (14/23) in the MT group; favorable outcome rates were 75% (18/24) in the IVT group and 69.6% (16/23) in the MT group, with no significant differences between groups. Twelve patients (52.2%) in the MT group and 5 (20.8%) in the IVT group had systemic complications. Symptomatic intracranial hemorrhage was not detected in the IVT group, but manifested in 2 (8.7%) patients in the MT group. During 90-day follow-up, 1 patient died in each of the IVT and MT groups, with 4.2% and 4.4% mortality rates, respectively. CONCLUSIONS The efficacy of MT and IVT was comparable in AMIS patients with LVO. While MT had a higher incidence of systemic complications, its short- and long-term effects were equivalent to IVT.

OBJECTIVES To analyse occlusion time, occlusal balance and lateral occlusal scheme in subjects with various dental and skeletal characteristics. METHODS A total of 132 subjects (50 males and 82 females) seeking orthodontic treatment were included in this prospective study. Using the T-Scan III version 7.0 (Tekscan Inc, South Boston, MA, USA), the occlusion time, occlusal balance and lateral occlusal schemes were recorded and compared with gender, Angle's occlusal classification, overjet, overbite, space analysis, skeletal and transverse relations. ANOVA, t test and contingency tables analyses were performed. Statistical significance was set at P

Long-term posttreatment stability of anterior tooth alignment is of major interest to both patients and orthodontists. In the present study we examined the long-term outcome 10 years postretention and investigated the possible influence of treatment-related factors on posttreatment stability of maxillary and mandibular anterior tooth alignment. The sample comprised 51 patients treated with full fixed appliances in a university clinic. Average retention time was 1.8 years. All patients received a Hawley appliance in the maxilla and a bonded canine-to-canine retainer in the mandible. The Peer Assessment Rating (PAR) Index, Little’s Irregularity Index (LII) and dental cast variables were recorded at pretreatment, posttreatment and 10 years out of retention. Stability of occlusion was assessed with the PAR score percentage improvement method. For each jaw a multivariate regression analysis was performed to identify the influence of treatment-related factors on postretention tooth alignment. The PAR Index percentage improvement decreased from 73.1% posttreatment to 53.5% 10 years out of retention. For both jaws posttreatment increase in anterior irregularity was significantly correlated with the degree of treatment correction. The strongest association was found in the maxilla. Premolar extractions were associated with increased stability of mandibular alignment. The need for retention appears to increase with the degree of alignment correction, particularly in the maxilla. Extraction of premolars significantly improved long-term stability of mandibular incisor alignment.

Data sourcesMedline, Scopus and Cochrane Library databases supplemented by searches in the journals; American Journal of Dentistry, Clinical Oral Investigation, International Journal of Prosthodontics, Journal of Dental Research, Journal of Oral Rehabilitation, Journal of Prosthodontics, Journal of Prosthodontic Research, Journal of Advanced Prosthodontics and Journal of Prosthetic Dentistry.Study selectionRandomised controlled trials (RCTs) or prospective studies comparing bilateral balanced occlusion (BBO) with other schemes, eg lingual occlusion (LO) canine guidance (CG) and neutral-centric or zero-degree (ZD).Data extraction and synthesisOne reviewer extracted the data and two reviewers assessed risk of bias using the Newcastle-Ottawa scale for non-randomised studies and the Cochrane risk of bias tool for RCTs. A narrative summary of the findings was presented.ResultsSeventeen studies, 11 RCTs and six prospective studies involving a total of 492 were included. Average follow-up period was 2.96 months (range 1-6 months). Six RCTs were considered to be at low risk of bias, two at unclear risk and three at high risk. Studies compared BBO with LO, CG and ZD. Twelve out of 16 studies reported on quality of life and patients satisfaction.ConclusionsThe present systematic review indicated that BBO does not confer better quality of life/satisfaction or masticatory performance and muscle activity. Thus, lingualised occlusion can be considered a predictable occlusal scheme for complete dentures in terms of quality of life/satisfaction and masticatory performance, while canine guidance can be used to reduce muscular activity.

Objective: To evaluate mandibular kinematics in class I adults following class II therapy with removable functional appliances (RFAs) during the growth period in comparison with orthodontically untreated class I and II individuals.Methods: Condylar (CRoM) and incisal range of motion (InRoM), velocity during opening and closing, and the mandibular rotation angle were recorded using an ultrasound-based jaw-tracking system in 36 test patients (mean age = 28.03 ± 6.58 years).Results: Significant group effects were found for CRoM towards the posterior in the right joint (p = 0.002) and InRoM towards the anterior (p = 0.043). The post hoc Tukey test indicates a significantly longer CRoM (posterior) for the right condyle in class II (p = 0.003) and RFA individuals (p = 0.023).Discussion: The kinematic data imply greater dentoalveolar effects due to RFA therapy than adaptive remodeling of the temporomandibular joint. The class I relationship in the RFA group following treatment indicates stable long-term outcomes.

The purpose of this study was to assess and compare occlusal changes induced by Herbst treatment and the stability of these changes in patients with retrognathic and prognathic facial types.The sample comprised 11 retrognathic (SNA ≤76°, SNB ≤72°, ML/NSL ≥36°) and 10 prognathic (SNA ≥83°, SNB ≥80°, ML/NSL ≤32°) patients with Class II molar relationships of ≥0.5 cusp widths bilaterally or ≥1.0 cusp width unilaterally. Both groups involved similar distributions of skeletal maturity before treatment. Study parameters were assessed on casts reflecting the situations before treatment (T0), after Herbst treatment (T1), after multibracket treatment immediately following Herbst treatment (T2), and after a mean of 31.1 months of retention (T3).Sagittal molar relationships improved by 0.8 cusp widths in the retrognathic and by 0.7 cusp widths in the prognathic group during active treatment (T0-T2). Insignificant changes of ≤0,2 cusp widths were seen in both groups during retention (T2-T3). Overjet decreased by 8.6 mm in the retrognathic and by 5.5 mm in the prognathic group during T0-T2, and both groups showed clinically irrelevant amounts of relapse by 0.7 mm during T2-T3. Overbite improved by 1.2 mm in the retrognathic and by 2.5 mm in the prognathic group during T0-T2, reaching mean values of 1.0 mm or 1.4 mm by T2, which was followed by 0.2 mm or 1.1 mm of relapse during T2-T3.Treatment with a Herbst appliance seems to offer stable correction of the sagittal occlusal relationships in Class II patients with retrognathic or prognathic facial types, with the vertical changes being more pronounced in the prognathic cases.

The effectiveness of adhesives in enhancing several functional aspects of complete denture performance has been well established. The direct influence of adhesives on occlusal contact simultaneity has not yet been investigated.The purpose of this crossover clinical trial was to evaluate quantitatively the influence of adhesives on occlusal balance by recording timed occlusal contacts; namely occlusion time (OT) and disocclusion time during right (DT-right) and left (DT-left) excursions by using computerized occlusal analysis.A crossover clinical trial was adopted. Assessments were carried out while participants (n=49) wore their dentures first without then with adhesives. Computerized occlusal analysis using the T-Scan III system was conducted to perform baseline computer-guided occlusal adjustment for conventionally fabricated dentures. Retention and stability assessment using the modified Kapur index and recording of OT and DT-right and DT-left values using the T-Scan III were subsequently carried out for all dentures, first without adhesives and then after application of adhesive. All T-Scan procedures were carried out by the same clinician. Wilcoxon signed-rank test was used to analyze the Kapur index scores and occlusal parameters (α=.05).Stability and retention of conventional dentures ranged initially from good to very good. However, adhesive application resulted in significant improvement (P.001) in stability and retention and a significant decrease in duration of all occlusal parameters (OT [P=.003], DT-right [P=.003], and DT-left [P=.008]).Adhesives significantly decreased OT and DT durations in initially well-fitting complete dentures with fairly well balanced occlusion, and further enhanced denture stability and occlusal contact simultaneity.

Background: All disciplines of dentistry require that clinicians assess the articulation of the teeth/prosthesis with respect to simultaneous contacts, bite force and timing.Aims: This article intends to describe the advantages and limitations of the data acquired when using a computerized occlusal analysis as a dynamic occlusal indicator.Methodology: A search of the literature was completed (Medline, PubMed) using the keywords occlusion, occlusal registration, computerized occlusal analysis and T-Scan for dental.Results: According to the evidence available, the computerized occlusal analysis system is the only occlusal indicator that demonstrates the ability to provide quantifiable force and time variance in a real-time window from the initial tooth contact into maximum intercuspation.Conclusion: The reported advantages to accurately indicate occlusal contacts make the computerized occlusal analysis system a better occlusal indicator when compared with other non-digital convention indicator mater...

BACKGROUND Occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures. OBJECTIVES This study aimed to compare the patient satisfaction with 3 types of complete denture occlusion including fully bilateral balanced occlusion (FBBO), newly presented buccalised occlusion (BO) and lingualised occlusion (LO). METHODS In this parallel randomised clinical trial, new conventional complete dentures were fabricated for 86 volunteers. Participants were randomly allocated to 3 groups with 3 different occlusal schemes. All patients were recalled at 1 and 3 months after delivery for data collection. The 19-item version of Oral Health Impact Profile for Edentulous Patients questionnaire was used in this study. The visual analogue scale (VAS) was used for assessment of the prosthodontist's attitude towards denture quality, patient's attitude towards different occlusal schemes and evaluation of patient satisfaction. Data were analysed using the Wilcoxon signed rank test, the Kruskal-Wallis test and the post hoc Dunn test via SPSS version 18.0 (P ≤ .05). RESULTS Eighty-six patients completed the study, and their data were analysed (mean age ± standard deviation = 57.78 ± 9.98 years). The only significant difference when comparing the 3 groups was physical pain, which was significantly higher in FBBO group. No significant differences were found for the VAS scores of patient and prosthodontist satisfaction or the domain scores among the 3 occlusal schemes either at 1 or at 3 months post-delivery. The VAS score of patient satisfaction and prosthodontist satisfaction increased at third compared to first month after delivery. CONCLUSION The results of this randomised clinical trial provided evidence that BO is as effective as LO for the fabrication of complete dentures.

The present study aimed to find the proper distorotation of the upper first premolar to achieve the therapeutic ideal advocated for the stability of the human occlusion. Normal teeth were analyzed and occlusal photocopies of upper arch were made to perform the 2 measurements. The first parameter was the angle formed by the perpendicular to the wire through the buccal cusp and a line connecting the buccal and the lingual cusps of the upper first premolar. The second one was the angle from the buccal line and the sagittal plane of the model. The amount of distorotation was calculated and a method to bond the bracket was suggested.

This second part of a four-part series concerned with the development of nonanatomic denture occlusion follows nonanatomic tooth design from the time of Victor Sears' first nonanatomic tooth patent through the mid-1930s. Many of the designs featured in this series exhibit genius, while others are pure nonsense. Sears claimed that a new nonanatomic tooth design appeared every 9 months on average during the first 30 years of nonanatomic tooth production. Many current nonanatomic tooth patents are further refinements of those earlier designs. Part II reviews pioneering designs that appeared during the first dozen or so years of this paradigm shift in denture occlusion philosophy.

Edentulism presents an ongoing challenge for prosthodontic dentistry. Many aspects of complete denture construction lack contemporary evidence. One such aspect is denture occlusion. Balanced occlusion (BO) has become the prevailing occlusal scheme. It has been suggested that canine guidance (CG) is unsuitable for complete denture occlusion due to an increased risk for tipping of the prostheses. However it may be indicated in patients with minimal alveolus resorption. There has been limited evidence suggesting the superiority of either occlusal scheme over another. This article investigates the available literature assessing complete denture occlusion by means of clinical trials or reviews of evidence. We utilised PRISMA guidelines to investigate the effect of complete denture occlusal scheme (balance occlusion vs. canine guidance) on functional or quality of life. Seven studies were included for review. All studies were poor to moderate quality with the majority lacking randomisation, blinding and demographic data from the study sample. The available evidence suggests that the differences between occlusal schemes may be small, challenging the notion that BO may be the optimal occlusal scheme. There is a need for high-quality clinical research, investigating both chewing ability and quality of life in complete denture wearers in the long-term.

Part III of this four-part series about nonanatomic denture tooth development traces the evolution of this movement from the mid-1930s through the World War II era up to the early 1950s. By this time, the general preference for posterior denture occlusion had shifted from anatomic to nonanatomic teeth, and all the major denture tooth manufacturing companies listed at least one nonanatomic design in their inventories.

Statement of problem A valid system for assessing and classifying functional occlusion has not been established. The prevalence of anterior protected articulation is not known. Purpose The purpose of this study was to quantify the prevalence of various functional occlusal contact patterns, including anterior protected articulation, among dental students. Material and methods Occlusal contacts were examined during lateral excursions from the maximal intercuspal position to the canine-to-canine position in 100 young adults. A combination of 3 common clinical methods was used: a visual examination, articulating paper, and feedback from the participants. Results Data from 3 classification systems were analyzed: (1) Occlusal contacts on the working side only – canine protected articulation was present in 25% of laterotrusions; anterior protected articulation was present in 18.5% of laterotrusions. Group function was present in 56% of laterotrusions. Other schemes were present in 0.5% of laterotrusions. (2) Contacts on both the working and the nonworking side. (3) Contacts on the working and nonworking side during both right and left laterotrusion. Nonworking side contacts were present in 33% of the participants. Nonworking side interference was present in 1 participant. Conclusions The prevalence of anterior protected articulation found in this study was high enough to allow anterior protected articulation to be considered one of the fundamental working side occlusal contact patterns. More studies will be necessary to confirm this finding.

Statement of purpose Masticatory performance and maximum occlusal force may be different, depending on the occlusal schemes of the complete dentures used. Purpose The purpose of this study was to evaluate the effect of 2 complete denture occlusal schemes on masticatory performance and maximum occlusal force. Material and methods Two complete denture occlusal schemes, bilateral balanced occlusion and neutrocentric occlusion, were delivered to 10 participants who were completely edentulous (6 men and 4 women; mean age, 67.3 years). Masticatory performance was evaluated with the multiple sieve method and maximum occlusal force with pressure-sensitive films. The 2 occlusal schemes were interchanged on the participants' denture bases. Two-way repeated-measures ANOVA was used to examine the differences between the occlusal schemes and chewing strokes and their interactions. The paired t test was used to compare the maximum occlusal force of the 2 occlusal schemes (α=.05). Results No difference was found in masticatory performance ( P =.07) or maximum occlusal force ( P =.31) between the occlusal schemes. For both schemes, a significant difference was found in masticatory performance ( P Conclusions Complete dentures with bilateral balanced occlusion and neutrocentric occlusion found no significant differences in masticatory performance and maximum occlusal force. However, more chewing strokes resulted in better masticatory performance.

Article Title and Bibliographic Information Impact of lateral occlusion schemes: A systematic review. Abduo J, Tennant M. J Prosthet Dent 2015;114(2):193-204 Source of Funding Not reported Type of Study/Design Systematic review

The aim of this study was to investigate the accuracy and reliability of interpreting occlusal markings made by articulating paper on complete dentures intraorally. Clinical teachers at a training hospital interpreted occlusal markings intended for adjustment. Their scores were compared to a control score to determine accuracy. For reliability determination, the observations were repeated. Only between 20% and 30% of observations were found to be both accurate and reliable. Unless the procedure can be standardized, this technique shouldn't be considered appropriate prosthodontics protocol for balancing the occlusion of complete dentures.

Aims The aim of this study was to test subjective interpretation accuracy via digital polling of a large group of dentists to determine whether dentists can reliably interpret occlusal forces by visually assessing articulating paper markings. Methods One hundred fifty-two dentists selected the most forceful occlusal contact in five occlusal-view photographs of articulating paper marks that were compared against T-Scan® relative occlusal levels of the same tooth contacts. Results The mean correct response was a mere 13.13% correct (86.87% incorrect). Random chance was calculated at 16.7% correct. The cuspid contacts were the least often chosen as the most forceful contact. The Mann-Whitney U test found a significant difference between choosing the anterior teeth vs. posterior teeth. onclusions: Subjective interpretation is an inaccurate method for determining high force occlusal contacts. The reported low correct percentage fell below random chance, suggesting that dentists are unable to detect high occlusal force from looking at articulating paper marks.

The main goal of treatment of mandibular fractures is to restore normal dental occlusion and promote appropriate bone healing and a normal mouth opening. Recently, there has been a resurgent interest in the use of screws for intermaxillary fixation of mandibular fractures. This study was therefore designed to determine how the clinical outcomes of the use of screws for intermaxillary fixation compare with the use of miniplates in the treatment of mandibular fractures in Nigeria.The objectives of this study are as follows: 1. To compare the clinical outcomes of the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation with 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures in Lagos, Nigeria 2. To determine the clinical outcomes in the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation (IMF) and 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures 3. To compare the complications associated with the use of 2.0 mm × 9.0 mm screws for IMF and 2.0 mm noncompression miniplates in the treatment of mandibular fractures METHODOLOGY: This randomized controlled clinical study was carried out at the Department of Oral and Maxillofacial Surgery of the study institution. Subjects with simple unilateral mandibular fractures who met the inclusion criteria were randomly allocated into the study (intermaxillary fixation screw) and control (miniplate) groups through balloting. Factors assessed and compared during and after the procedures included intraoperative pain, postoperative nerve impairment, postoperative occlusion, limitation of mouth opening, incidence of hardware failure, incidence of infection and non-union. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 20.A total of 56 subjects participated in the study, with 28 subjects in each group. Majority (91%) of the subjects were male. Road traffic crash was the highest aetiological factor while sport was the least (3.6%). A higher proportion (25.0%) of subjects in the miniplate group had major complications compared with 14.3% in the IMF screw group. There was no statistically significant association between site of mandibular fracture, time elapsed before treatment and complications (p 0.05). All cases of mandibular fractures healed successfully at 6 weeks.The use of screws for IMF is as effective as 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures.

Cases in which teeth have only the cervical third remaining from orthodontically induced external root resorption, cast the following doubts: 1) What care should be taken to keep these teeth in mouth with the least risk possible? 2) What care should be taken with regards to reading of imaging exams, particularly in terms of accurately determining cervical root and bone loss? 3) Why is not endodontic treatment recommended in these cases? The present study aims at shedding light on the aforementioned topics so as to induce new insights into the theme. Nos casos em que os dentes têm apenas o terço cervical remanescente de uma reabsorção radicular externa induzida ortodonticamente: 1) Quais seriam os cuidados para que permaneçam na boca, com o menor risco possível de perda? 2) Quais seriam os cuidados na interpretação imaginológica desses casos, quanto à determinação precisa da perda radicular e óssea cervical? 3) Por que o tratamento endodôntico não estaria indicado? No presente trabalho, procura-se esclarecer esses pontos e respondendo os questionamentos, para induzir novos insights sobre o assunto.

Complete edentulism often limits patients' ability to masticate and perform other oral functions, resulting in a reduction of oral-health-related quality of life. Although the two-implant mandibular overdenture may be considered as a minimum standard of treatment of complete edentulism, patients often prefer conventional complete dentures due to cost and surgical procedures related to implant supported dentures. Many complete denture patients may have limited access to dental care due to socioeconomic or health issues, hence there is a need in simplification of complete denture fabrication. Researchers have proposed "simplified" techniques to fabricate complete dentures by eliminating two stage impression procedures facebow transfer, and articulator programming, with impressive initial results. However, long-term clinical data of these techniques is unavailable. A novel technique for fabricating simplified complete dentures in three visits, using patient's existing dentures is presented here. Unlike previously described techniques on "simplified" dentures, this technique does not eliminate vital steps such as border-molded impressions, facebow transfer, verification of centric relations during try-in, programming of the articulator, and balancing procedures.

Objectives To compare subjective and objective outcomes of complete dentures fabricated with standard clinical protocols, but omitted selected steps during the laboratory phase. Materials and methods Forty-three edentulous patients (mean age 58.1 years, SD 9.9, range 35–78), were consecutively recruited and randomly assigned to one of four groups according to selected variations of laboratory steps: Group 1 (n = 10), omission of secondary casts obtained from impressions in border moulded custom trays; Group 2 (n = 10), omission of secondary casts and face-bow articulator mounting; Group 3 (n = 10), omission of face-bow mounting; Group 4 (n = 13), no steps omitted (control). Clinical procedures for all groups were identical, and performed by senior dental students under supervision of prosthodontists, all of whom were blinded to the Group. At 1-, 4- and 12-weeks after delivery, patients rated their overall satisfaction, as well as a range of functional factors using visual analogue scales. An independent blinded prosthodontist similarly rated four domains of denture quality at the 1-week follow-up. Results No significant differences were noted among the groups in all aspects of patients’ assessments at all the time points (P > 0.1). There were no significant differences in prosthodontists’ ratings of denture quality in any of the domains examined (P > 0.1). Conclusion Selected omissions of steps (face-bow mounting and/or secondary casts) during the laboratory phase of complete denture fabrication has only a minor role, if any, in subjective and objective outcomes, contrasting with the common belief that such omissions will adversely affect outcomes. Clinical significance General practitioners provide most complete dentures. Many do not follow all the procedures they were taught at dental school. Our finding that omitting frequently advocated steps made no difference to patient satisfaction or to denture quality suggests that cost-effectiveness through simplifications be considered in practice and in education.

Purpose The aim of this study was to qualitatively review the literature regarding occlusal schemes for complete dentures. Materials and methods An electronic search was executed using PubMed (MEDLINE) with the aid of Boolean operators to combine the following terms: "complete denture," "occlusion," "balanced," "lingualized," "anatomic," "flat," "monoplane," and "canine." The search was limited to English peer-reviewed articles published up to January 2012. The literature search was supplemented by manual searching of relevant journals and the reference lists of selected articles. Results A total of 565 articles were retrieved; however, only 12 articles met the inclusion criteria. The included studies evaluated the effects of posterior tooth morphology/arrangement and lateral occlusal guidance. In relation to morphology, the posterior teeth were either anatomical or flat. The posterior tooth arrangements showed conventional bilaterally balanced occlusion (CBBO), lingualized bilaterally balanced occlusion (LBBO), or monoplane occlusion (MO). The lateral occlusal guidance involved either balanced occlusion or anterior tooth-guided occlusion (ATGO). Conclusions Within the limitations of this review, it can be concluded that anatomical teeth arranged in CBBO or LBBO are preferable to flat teeth arranged in MO. This is primarily related to patient acceptance. ATGO can also be considered for complete dentures.

Studies involving electrognathographic (EGN) recordings of chewing improvements obtained following occlusal adjustment therapy are rare, as most studies lack 'chewing' within the research. The objectives of this study were to determine if reducing long Disclusion Time to short Disclusion Time with the immediate complete anterior guidance development (ICAGD) coronoplasty in symptomatic subjects altered their average chewing pattern (ACP) and their muscle function.Twenty-nine muscularly symptomatic subjects underwent simultaneous EMG and EGN recordings of right and left gum chewing, before and after the ICAGD coronoplasty. Statistical differences in the mean Disclusion Time, the mean muscle contraction cycle, and the mean ACP resultant from ICAGD underwent the Student's paired t-test (α = 0.05).Disclusion Time reductions from ICAGD were significant (2.11-0.45 s. p = 0.0000). Post-ICAGD muscle changes were significant in the mean area (p = 0.000001), the peak amplitude (p = 0.00005), the time to peak contraction (p 0.000004), the time to 50% peak contraction (p 0.00001), and in the decreased number of silent periods per side (right p 0.0000002; left p 0.0000006). Post-ICAGD ACP changes were also significant; the terminal chewing position became closer to centric occlusion (p 0.002), the maximum and average chewing velocities increased (p 0.002; p 0.00005), the opening and closing times, the cycle time, and the occlusal contact time all decreased (p 0.004-0.0001).The average chewing pattern (ACP) shape, speed, consistency, muscular coordination, and vertical opening improvements can be significantly improved in muscularly dysfunctional TMD patients within one week's time of undergoing the ICAGD enameloplasty. Computer-measured and guided occlusal adjustments quickly and physiologically improved chewing, without requiring the patients to wear pre- or post-treatment appliances.

Removable dentures are always transient current. The epidemiology and causes of tooth gaps demonstrate the need to master the different prosthetic treatment. This made whether to propose treatment plans that take into account psychological, physiological and technical support for this patient. Different situations may arise. A gradual transition may be considered or immediate passage to the total edentulous according to general criteria, local and desiderata of patients. After tooth extraction, the transitional prosthesis can control bone lysis thereby it is part of a complete treatment before prosthesis. It also facilitates a good psychological and physiological integration before the prosthesis use.

Balanced occlusal force distribution is a critical factor for restorative, prosthetic or orthodontic treatment. It has been postulated that orthodontic treatment may lead to occlusal discrepancies in the arch due to changing the occlusal relationships. This study was conducted to compare the occlusal force parameters between natural dentition patients and a post-orthodontic treatment group.Fifty Thai subjects were divided into non-orthodontic and post-orthodontic groups comprised of 25 subjects each (mean age 24.8 years). The T-Scan® III computerized occlusal analysis system was used to record a multi-bite closure for each subject. The initial occlusal contact location, the bilateral percentage force distribution, the percentage force in the anterior and posterior quadrants, and the individual tooth force percentages were calculated for both groups. The Student's Paired t-Test compared the in-group differences, while a one-way ANOVA analyzed the differences between the two groups.The initial tooth contacts in both groups were found on the second molars and central incisors. Maximum force was most frequently observed on the left second molar tooth (15.9% non-orthodontic; 25.4% post-orthodontic). The bilateral right-to-left side force distribution (51.36% right-48.96% left) was not statistically different for all subjects, nor was it statistically different between the non-orthodontic (48.67% right-51.36% left) and the post-orthodontic groups (48.96% right-51.05% left). Statistically significant differences were found between the quadrants in both the groups (22.46% anterior-77.57% posterior in non-orthodontic subjects; 10.58% anterior-89.42% posterior in post-orthodontic subjects) (p 0.01).A significant occlusal force discrepancy was found in the post-orthodontic subjects, with higher force percentages observed posteriorly and much less percentage force anteriorly, when compared to the natural dentition subjects. T-Scan® III digital occlusal analysis may be recommended for orthodontic case finishing, to make visible to the clinician the severity of the orthodontically created occlusal force imbalance, such that it can be minimized during orthodontic case finishing.

Purpose A lingualized occlusion (LO) for complete dentures reduces lateral inferences and occlusal force contacts and direction; thus, LO is theorized to be more suitable for patients with compromised ridges than fully bilateral balanced articulation (FBBA). However, no studies have yet provided evidence to support LO in edentate patients with compromised alveolar ridges. The purpose of this study was to compare LO and FBBA in edentulous individuals with compromised ridges. Methods Sixty edentulous individuals were randomly allocated into groups and received dentures with either LO or FBBA. Following delivery, several denture-related satisfaction variables were measured using 100 mm visual analogue scales; oral health-related quality of life (OHRQoL) was also assessed using the Oral Health Impact Profile (OHIP). Sub-group analyses of the effect of moderate and severe mandibular bone loss were also carried out. Results No significant differences were detected between LO and FBBA with the primary outcome. At 6 months, participants with severely atrophied mandibles and FBBA rated their satisfaction with retention of mandibular dentures significantly lower than those with LO (median LO: 86, FBBA: 58.5, p = 0.03). They also had significantly lower OHRQoL for the domain of Pain (median LO: 4, FBBA: 5, p = 0.02). General satisfaction and total OHIP scores significantly improved between baseline and 6 months only for the LO subjects with severely atrophied mandibles (satisfaction: p = 0.003, OHIP total score: p = 0.0007). Conclusions The results indicate that the LO occlusal scheme with hard resin artificial teeth is more efficient for patients with severely resorbed mandibular ridges.

Introduction In this study, we compared the efficiency of Class II subdivision malocclusion treatment with symmetric and asymmetric extractions. Methods A sample of 71 patients with complete Class II subdivision malocclusion was selected: group 1 consisted of 40 patients treated with 4 premolar extractions with an initial mean age of 13.37 years, and group 2 had 31 patients treated with 3 premolar extractions (2 maxillary premolars and 1 mandibular premolar on the Class I side) with an initial mean age of 14.44 years. To compare the efficiency of each treatment protocol, the initial and final occlusal results were evaluated on dental casts with the Peer Assessment Rating occlusal index, and time spent in treatment was calculated from the clinical charts. The amounts of initial and final midline deviation and improvement of midline deviation correction were also evaluated. Efficiency was calculated as the rate between occlusal improvement by the treatment time. The groups were compared with t and Mann-Whitney tests. Results The results showed that group 2 had a significantly smaller final amount of midline deviation and a greater correction of midline deviation. Conclusions Treatment efficiency of type 1 Class II subdivision malocclusions with 3 or 4 premolar extractions is similar. However, treatment with 3 premolar extractions provides a better occlusal success rate.

The aim of this study was to evaluate whether a 6° counterclockwise change in occlusal plane inclination would produce significant modifications on the final result of a maxillary impaction and mandible advancement model surgery. Four groups were used in this study, with ten identical maxillary casts and one mandibular cast mounted on the same semi-adjustable articulator, with the same malocclusion. The occlusal plane of the two control and study groups had an inclination of 13° and 7°, respectively. Preoperative and postoperative measures were performed using the Erickson platform and impactions of 6 and 10 mm were tested. To control these movements during model surgery, two splints were fabricated using another two maxillary and mandibular casts mounted with occlusal plane of 13°, simulating the proposed movement. The results were compared using the t test. Only the antero-posterior movement of the upper incisor was statistically significant for both study groups (p

OBJECTIVE: To test the hypothesis that there is no difference in vertical alveolar bone loss and alveolar bone thickness around maxillary and mandibular central incisors in normal occlusion samples and skeletal Class III malocclusion patients. MATERIALS AND METHODS: The study sample comprised 20 Korean normal occlusion subjects (mean age, 22.1 years; group 1) and patients with skeletal Class III malocclusion with anterior open bite (mean age, 22.4 years; group 2). Three-dimensional (3D) cone beam computed tomography (CBCT) images were taken before orthodontic treatment, and sagittal slices chosen at the labio-lingually widest point of the maxillary and mandibular right central incisor were evaluated, respectively. The amount of vertical alveolar bone loss and/or alveolar bone thickness of the labial and lingual plate at the root apex were measured. RESULTS: Group 2 had statistically significant more vertical bone loss than group 1 (P < .05). Alveolar bone at the apex was significantly thinner in group 2 (P < .05), except for the maxillary incisors. Mandibular incisors showed greater alveolar bone loss than was seen in maxillary incisors in both groups, especially at the lingual side in group 2 (P < .05). Overall, alveolar bone thickness at the apex was wider than cementoenamel junction (CEJ) width, except for the mandibular incisors in group 2, for which the percentage was 81.33%. CONCLUSIONS: The hypothesis is rejected. Special care should be taken to avoid aggravating preexisting alveolar bone loss in the anterior teeth, especially in the mandible, in skeletal Class III patients, who may be more vulnerable to alveolar bone loss during orthodontic treatment.

The positive effects of wearing a mouthguard have been indicated in various epidemiological surveys and experiments, and their usage appears to be increasing in many sports. However, many preventable sports-related dental injuries still occur even with the use of a conventional mouthguard. We have developed a mouthguard (the HardSpace mouthguard) with sufficient injury prevention ability (more than 95% shock absorption ability against impact with a steel ball carrying 15.2 kg m(2) S(-2) potential energy) and ease of clinical application. This mouthguard consists of an outer and an inner EVA layer and a middle layer of acrylic resin (hard insert), with a space to prevent contact between the inner surface of the mouthguard and the buccal surfaces of the maxillary front teeth or teeth already weakened through prior damage or treatment. The purpose of this article is to describe the method by which the HardSpace mouthguard may easily be fabricated. We believe that this new type of mouthguard has the potential to reduce sports-related dental injuries.

For more than a hundred years, it has been supposed that canine guidance should be avoided in conventional complete dentures, since it would result in denture instability. Thus, bilateral balanced articulation has been held by many authors as fundamental for treatment success. However, randomized clinical trials have shown that balanced articulation is not as important as previously thought. The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant for both the dentist and dental technician. Therefore, the purpose of this study is to provide an evidence-based update on complete denture occlusion. Clinical Relevance: The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant.

It has long been claimed that presurgical orthodontics is crucial to the outcome of surgical-orthodontic treatment for dentofacial deformity. However, in the literature, the effect of presurgical orthodontics on the treatment outcome remains controversial. The purpose of the study was therefore to investigate the effect of presurgical orthodontics on the treatment outcome in terms of facial aesthetics, occlusion, stability, and efficiency.Thirty-three adult patients with skeletal class III open bite corrected by Le Fort I posterior impaction and bilateral sagittal split osteotomy were included. The patients were divided into two groups: 13 received presurgical orthodontics, and 20 did not. Cephalometric radiographs and study models were used to evaluate the treatment outcome.There were no between-group differences in facial aesthetics, overbite, or Peer Assessment Rating score. Overjet was larger in the no-presurgical orthodontics group than in the presurgical orthodontics group, but both were within normal limits. Both groups had similar maxillary and horizontal mandibular stability. Although the vertical mandibular stability was worse in the no-presurgical orthodontics group than in the presurgical orthodontics group, the direction of instability was favorable for open bite correction. Finally, longer treatment time was required in the presurgical orthodontics group compared with the no-presurgical orthodontics group (512±103 days versus 342±127 days; p0.001).The results suggest that in surgical-orthodontic correction of skeletal class III open bite, presurgical orthodontics has no clinically significant effects on facial aesthetics, occlusion, or stability. However, presurgical orthodontics has a significant adverse effect on efficiency. Patients receiving presurgical orthodontics undergo longer treatment time than those receiving no presurgical orthodontics.

金沢大学医薬保健研究域医学系, The purpose of this study was to evaluate changes in stress on the temporomandibular joint (TMJ) in 80 Japanese subjects (21 males and 59 females, mean age 23.7 years) with mandibular prognathism, with and without asymmetry after orthognathic surgery using the rigid bodies spring model (RBSM). The asymmetric group consisted of 40 subjects whose Mx-Md midline was more than 3 degrees. The remaining 40 subjects formed the symmetric group.The geometry of the stress analysis model was based on frontal cephalograms of the subjects. Menton (Me), the centre point of occlusal force on a line connecting the bilateral buccal cusps of the second molars, and the most lateral, superior, and medial points on the condyle were plotted on a computer display and stress on the condyle was calculated with the two-dimensional RBSM program, Fortran. The degree (force partition) of the resultant force, the direction (angulation), and the displacement (X, Y) of each condyle were calculated and the horizontal displacement (u), the vertical displacement (v), and rotation displacement (θ) of the mandibular body at Me were calculated pre- and post-operatively. The data was analysed using paired and unpaired t-tests.For the vertical (v) and rotational (θ) displacement, the post-operative value was smaller than the pre-operative value (v: P < 0.001, θ: P = 0.0063) in the asymmetric group. For angulation and the X-component, the post-operative value was smaller than that pre-operatively on the deviated (angulation: P = 0.0074, X-component: P = 0.0003) and non-deviated (angulation: P = 0.0024, X-component: P = 0.001) side in the asymmetric group. However, there was no significant difference between the pre- and post-operative value for any parameter in the symmetric group.These findings suggest that surgical correction of mandibular prognathism, with and without asymmetry, could induce an improvement in stress balance on the TMJ in the frontal aspect. © The Author 2010.

The provision of complete dentures is often perceived as a clinical 'black art' as it relies on a blend of clinical skill, scientific evidence and no little artistic interpretation. Coupled to this is a heavy reliance on patient ability to control their dentures in a muscular environment while, hopefully, coping with the various oral functions in addition to appearance. This article deals with the potential problem areas in the provision of complete dentures, reinforcing the importance of practitioners obtaining appropriate informed consent and of maintaining clinical knowledge and skills.

Purpose To assess the influence of mandibular residual ridge resorption (RRR) on objective masticatory measures of two occlusal schemes: lingualized occlusion (LO) and fully bilateral balanced articulation (FBBA). Methods The enrolled patients ( n =22) were randomly allocated one set of complete dentures with either LO or FBBA. Maximum occlusal force, masticatory performance (by the MPI), and mandibular movements were measured at 3- and 6-month follow-ups. Mandibular RRR was assessed as the sum of the mandibular bone height at the midline, first premolar region, and least vertical height region, and from the mental foramen to the alveolar crest, measured on panoramic radiographs; the treatment groups were subclassified into severe or moderate RRR subgroups by the value of the sum of individual measurements. Results Significant differences were observed in the between-subgroup comparisons (Kruskal–Wallis test) of the MPI (3 months, p =0.01; 6 months, p =0.04) and linear deviation from intercuspal position (anterior–posterior: 6 months, p =0.01; inferior–superior: 3 months, p =0.008; 6 months, p =0.02). The patients with severe RRR in the FBBA group showed a significant decrease in the MPI and increase in linear inferior deviation from intercuspal position at 3 months (post hoc comparison) as well as a significant increase in the linear posterior and inferior deviation from intercuspal position at 6 months. Conclusions LO is the preferable occlusal scheme for patients with severe RRR. (This trial has been registered at http://clinicaltrials.gov/ct2/show/NCT00959530.)