The Influence of Bruxism on Mandibular Movement

Etiologija temporomandibularnih poremećaja (TMD) još je uvijek nerazješnjena. Mogući utjecaj bruksizma predmet je mnogih rasprava. Svrha ovog istraživanja bila je odrediti učinak bruksizma na funkciju stomatognatoga sustava. Ispitivana se skupina sastojala od 46 bruksista u dobi od 24-52 godine (x = 35,03 ± 6,92). Kontrolnu skupinu tvorilo je 50 nebruksista u dobi od 25-51 (x = 37,24 ± 6,37). Dijagnoza bruksizma postavljena je anamnestičkim upitnikom i kliničkim pregledom. Za mjerenje kretnje čeljusti uporabljena je precizna klizna mjerka. Mjereno je maksimalno otvaranje, desna i lijeva maksimalna laterotruzijska kretnja, te maksimalna protruzijska kretnja. U skupini bruksista srednja vrijednost maksimalnog otvaranja bila je 48,51 ± 5,01 mm, a u skupini nebruksista 49,76 ± 6,92 mm. Srednja vrijednost maksimalne desne laterotruzijske kretnje u skupini bruksista iznosila je 10,04 ± 2,51 mm, a kontrolna skupina imala je srednju vrijednost 10,31 ± 2,47 mm. Maksimalna lijeva aterotruzijska kretnja u bruksista iznosila je 9,74 ± 2,50 mm, a vrijednost kontrolne skupine bila je 10,33 ± 2,30 mm. Maksimalna protruzijska kretnja kod bruksista iznosila je 9,53 ± 1,97 mm, a u kontrolnoj skupini 10,81 ± 2,29 mm. Pearson ?2 test pokazao je statistički znatnu razliku između ispitivanih skupina (p < 0,05) jedino u varijabli maksimalne protruzijske kretnje (t = 2,93, p = 0,0004). Rezultati ovog istraživanja upućuju na zaključak da bruksizam može imati samo ograničeni utjecaj na pokretljivost čeljusti.The aetiology of temporomandibular disorders (TMD) remains controversial. The role of bruxism is still under discussion. The objective of this investigation was to determine the effect of bruxism on the function of the stomatognatic system. A group of 46 bruxers, aged from 24-52 years (x = 35.03 ± 6.92) was examined. The control group consisted of 50 nonbruxers aged from 25-51 years (x = 37.24 ± 6.37) bruxism was assessed by a questionaire and clinical examination. A precise calliper was used to measure jaw movement. Maximal opening, right and left aterotrusion, and maximal protrusion were measured. The mean value of maximal opening in the bruxers group was 48.51 ± 5.01 mm, and in the nonbruxers group 49.76 ± 6.92 mm. Ther mean value of maximal right laterotrusion in the bruxers group was 10.04 ± 2.51 mm, and of left laterotrusion 9.74 ± 2.50 mm compared to the nonbruxers group where the mean value of right laterotrusion was 10.31 ± 2.47 mm, and left laterotrusion 10.33 ± 2.30 mm. The mean value of maximal protrusion in the bruxers group was 9.53 ± 1.97 mm, while in the nonbruxers group it was 10.81 ± 2.29 mm. Pearson ?2 test analysis shows statisticaly significant difference (p < 0.05) between the groups only in relation to the maximal protrusion (t = 2.93, p = 0.0004). The results of this study suggest that bruxism may only have a limited influence on mandibular mobility

The Relationship Between Occlusion and Temporomadibular Disorders

Etiologija temporomandibularnih poremećaja i može bitini utjecaj nisu potpuno razjašnjeni. Svrha istraživanja bila je utvrditi utjecaj okluzijskih odnosa na funkciju stomatognatoga sustava. Ispitivana skupina sastojala se je od 96 ispitanika u dobi od 24-52 godine (x = 35,03 ± 6,92). Kliničkim pregledom utvrđen je broj zuba, broj zuba u okluziji, okluzijska koncepcija (okluzija vođena očnjakom, grupna funkcija i bilateralno uravnotežena okluzija). Izjereni su iznosi okomitog preklopa i vodoravnog pregriza. RKP položaj određen je chin-point tehnikom i fiksiran Luciajigom. Klizanje iz RKP u IKP položaj izmjereno je u anteroposteriornom, okomitom i postraničnome smjeru. Mjerenja maksimalnih kretnji izvršena su s pomoću precizne pomične mjerke. Registrirana je možebitna pojava zvuka i boli. Izvršena je palpacija temporomandibularnih zglobova, žvačnih i vratnih mišića. Izračunani su Helkimov okuzijski, anamnestiči i klinički disfunkcijski indeks (indeks mandibularne pokretljivosti, indeks funkcije temporomandibularnoga zgloba, indeks bolnosti mandibularnih kretnji te indeks mišićne i zglobne boli). 3,21% ispitanika bilo je bez okluzijskih poremećaja (Oi0), 52,32% imalo je umjerene okluzijske poremećaje (OiI), a 38,56% imalo je ozbiljne okluzijske poremećaje (OiII). U usporedbi s anamnestičkim i kliničkim disfunkcijskim indeksom Pearson ?2 test pokazuje da ozbiljni okluzijski poremećaji nisu povezani sa ozbiljnim disfunkcijskim poremećajima. Razlika među skupinama nije statistički znatna (p > 0,05). Rezultati ovoga istraživanja upućuju na zaključak da okluzija nema utjecaja na nastanak i tijek TMD-a.The etiology of temporomandibular disorders and the role of occlusion, has still not been entirely clarified. The objective of this investigation was to determine the effect of occlusal relationship on the function of the stomatognathic system. A group of subjects, aged from 24-52 years (x = 35.03 ± 6.92) was examined. The number of teeth, the number of teeth in occlusion, type of occlusion (canine guided occlusion, group function and balanced occlusion) was determined by clinical examination. Overbite and overjet were measured. RCP position was determined by chinpoint technique and fixing by Lucia-jig. The sliding from RCP to IKP position was determined in the anteroposterior, vertical and lateral direction. A precise calliper was used to measure maximal jaw movement. Pain and sounds were registred. Temporomandibular joints, masticatory and neck muscles were palpated. Helkimo Occlusal, Anamnestic and Clinical Dysfunction Indexes (Index of mandibular movement, index of TMJ function, Index of painful mandibular movements, index of muscular and TMJ pain) were calculated. 3.21% of the subjects were without occlusal disorders (Oi0), 58.32% had moderate occlusal problems (OiI) and 38.56% had severe occlusal problems (OiII). When compared to Anamnestic and Clinical Dysfunction Index the Pearson ?2 test analysis shows that severe occlusal problems are not correlated to severe dysfunction. The difference between the groups is not statistically significant (p > 0.05). The results of this study suggest that occlusion does not have an influence on the occurrence of TMD

Prevalence of Self-Reported Symptoms of TMD in a Population of Rijeka, Croatia

Svrha ovog istraživanja bila je ispitati prevalenciju simptoma TMD u stanovništvu Rijeke. Istraživanje je provedeno na uzorku 408 odraslih osoba starih od 18-84 godine, podijeljenih po dobi i spolu. Postojanje TMD simptoma dobili smo upotrebom kliničko- anamnestičkih upitnika koji se sastojao od 11 pitanja tipičnih za TMD simptomatologiju. Okluzalne parametre dobili smo raščlambom RCP, ICP prednjega vođenja i lateralnih kretnji. Kliničke znakove TMD dobili smo palpacijom mišića žvakača i TMJ. Anamnezom smo došli do podatka da je 16 % ispitanika izjavilo kako ima noćni bruksizam, a 33 % dnevni. 26 % ispitanika osjetilo je škljocanje u zglobu. 37 % pacijenata ima uz bruksizam i glavobolju, 35 % ima bolan vrat i ramena, a 33 % ima škljocanje u TMZ. U skupini pacijenata bez bruksizma 41 % ima glavobolju, 29 % bolni vrat i 24 % ima škljocanje. Možemo zaključiti da postoji veza između pojave noćnog bruksizma i bolnosti mišića vrata i ramena te škljocanje TMZ.The aim of this study was to evaluate the prevalence of temporomandibular disorder (TMD) symptoms in a population of Rijeka, Croatia. The study was performed on a sample of 408 adult subjects, aged 18-84 years divided into three groups by age and gender. The presence and severity of TMD was determined by using a self reported anamnestic questionnaire comprised of 11 questions regarding common TMD symptoms. Occlusal evaluation included analyses of RCP, ICP, anterolateral guidance, and nonworking side contacts during mandibular movements. Palpation of the muscles and TMJ was performed to detect clinical signs of TMD. A total of 16 % of the examinees had self-reported nocturnal bruxism and 33 % had daily bruxism. 26 % of the examinees experienced TMJ clicking. 28 % of the examinees experienced tension type headache, more than once a month. 37 % of the patients with bruxism had headaches, 35 % had painful necks and shoulders, and 33 % experienced TMJ clicking. Of those who did not suffer from bruxism, 41 % had headaches, 29 % had painful neck and sholders and 24% had TMJ clicking. It appears that sleep bruxism is related with the presence of painful neck and sholders and TMJ clicking

Evaluation of Craniometric Methods for Determination of Vertical Dimension of Occlusion

In clinical practice, fully precise method for exact determination of vertical relation of occlusion still does not exist. This study examines the relationship between different craniofacial distances and the distance subnasale– gnathion (Sn–Gn), which represents the lower third of the face in vertical relation determination. The highest coefficient of correlation was (r = 0.8678, p < 0.05) between the distance eye–ear (E–E = lateral border of the ocular orbit–medial opening of the meatus of the external auditory canal) and Sn–Gn. The prediction of the distance Sn–Gn could be determined through the formula: Sn–Gn = E–E / 1.08 or through the regression analysis: Sn–Gn = 1.9197 + 0.6449 x E–E. None of the calculated coefficients of correlation was 1, but was < 1, so that the prediction of the distance Sn–Gn by craniometric distances is not absolutely reliable, although it is considerably helpful. Our results point at the variations of craniofacial distances in the Croatian population. Yet, craniometry could still be recommended in everyday clinical practice for prediction of vertical relation of occlusion, as it is a simple, economic and non-invasive method, however in combination with some other methods, which have proved to be helpful