Kineziographic Research of Patients with Cross Bite

The paper describes the use of an objective method for the quantitative analysis of the relationship between the posterior cross-bite and the occurrence of occlusive interferences and damages to the mandible muscle elevator. Two groups of subjects were selected for the analysis: 10 patients with unilateral cross-bite and 10 students without any symptoms of temporomandibular disorders (TMD). By means of the Robert Jenkelson K5A kinesiograph we measured maximal – opening velocity of the mandible (mm/s), maximal- closing velocity (mm/s), first tooth contact velocity and displacement in the vertical plane at the maximal intercuspidation (mm). The following values were obtained: maximal-opening velocity in the first group was 349 mm/s and 380 mm/s in the control group. This difference was incidental. The maximal closing velocity in the study group was 204.9 and 345.2 in the control group (p < 0.05). The first tooth contact velocity in the study group was 75.93 and 325 in the control group (p < 0.01). Displacements in the vertical plane at the maximal intercuspidation in the investigated group was 0.240.01 mm, while in control group that value was 0120.012 mm

Prosthetic Therapy of a Seven Year Old Patient with Oligodontia

A seven year old male patient was referred by his dentist to a specialist in dental prothetics with a diagnosis of oligodontia. Examination of the orthopantomogram showed germs of only eight teeth. No teeth were present in the oral cavity. The first permanent molars had been esctracted because of caries. From the case history and a clinical examination, it was established that the boy had craniofacial dysmorphosis/ dysostosis and hypertelorizm with lower positioned and poorly formed ears. He had diagnosis of thickening of the right ventriculus. Kariotype normal. Also presented adactyly of digits II and III manus et pedis, clinodactyly of digit I, and syndactyly of digits IV and V was surgically treated. By examining the oral cavity, angulus infectiosus oris was diagnosed caused by lowered vertical dimension of occlusion and candidiasis lingue, and consequently the boy was referred to an oral pathologist for appropriate therapy. Special attention is required when fabricating a complete denture in a child\u27s mouth in orded not to comprome any prosthetic principle. Thus, we were faced with several problems including how to find impression trays of adequate size, and how to explain to the patient the procedure of functional movements, achievement of rest position, and the artificial teeth selection. Because of the small and narrow dental arches we decided for the smallest size of artificial teeth (D28) and reduced occlusion. The artificial teeth were modified and reduced. The second molar took the place of the first molar. With color and shape we tried to imitate deciduous teeth. After insertion of the complete dentures and control examination, the patient was given an appointment for making new dentures in six months, because of the growth and development of the maxilla and mandible

An Evaluation of the Quality of Tooth Preparation with Intraoral Parallometer-Axisgraph - Pilot Study

Measuring of the axial angle in practice shows an average angle of 20 degrees. The result of the high taper angles is a nonsatisfactory resistance form in 22.5% cases. The purpose was to examine the efficiency of the Jonjić oral parallelometer, known as the "AXISGRAPH", with respect to basic ergonomic rules, leading to savings in working energy and time and an increase in the quality of the preparation. METHODS: On the basis of clinical cases models were made of the upper and of the lower jaw of acrylic resin. The practitioner, who has 10 years experience, initially prepared each model set in a KAWO-EWL model, conventionally using freehand preparation, and then with an Axisgraph. Both models were in the same condition. Comparison was made between the time required for preparation, working energy used, and the quality of the preparation. The quality of the preparation was determined using the axial angle of the prepared tooth, measured by the method described in Jonjic\u27s dissertation. RESULTS: The freehand preparation took 80 minutes while preparation with the Axisgraph took 50 minutes. The average angle in freehand preparation was 15.03 degrees while, (the average angle of preparation was 10.4 degrees) using Axisgraph, and in 30 minutes less time than the freehand preparation. CONCLUSION: Preparation with the Axisgraph significantly saves time on preparation and allows better quality for the prepared tooth

Prosthetic Therapy of a Seven Year Old Patient with Oligodontia

A seven year old male patient was referred by his dentist to a specialist in dental prothetics with a diagnosis of oligodontia. Examination of the orthopantomogram showed germs of only eight teeth. No teeth were present in the oral cavity. The first permanent molars had been esctracted because of caries. From the case history and a clinical examination, it was established that the boy had craniofacial dysmorphosis/ dysostosis and hypertelorizm with lower positioned and poorly formed ears. He had diagnosis of thickening of the right ventriculus. Kariotype normal. Also presented adactyly of digits II and III manus et pedis, clinodactyly of digit I, and syndactyly of digits IV and V was surgically treated. By examining the oral cavity, angulus infectiosus oris was diagnosed caused by lowered vertical dimension of occlusion and candidiasis lingue, and consequently the boy was referred to an oral pathologist for appropriate therapy. Special attention is required when fabricating a complete denture in a child\u27s mouth in orded not to comprome any prosthetic principle. Thus, we were faced with several problems including how to find impression trays of adequate size, and how to explain to the patient the procedure of functional movements, achievement of rest position, and the artificial teeth selection. Because of the small and narrow dental arches we decided for the smallest size of artificial teeth (D28) and reduced occlusion. The artificial teeth were modified and reduced. The second molar took the place of the first molar. With color and shape we tried to imitate deciduous teeth. After insertion of the complete dentures and control examination, the patient was given an appointment for making new dentures in six months, because of the growth and development of the maxilla and mandible

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 Type of Occlusion and TMJ Sounds

Utjecaj okluzije na nastanak zvuka u temporomandibularnom zglobu nije potpuno potvrđen. Svrha je ovog istraživanja bila utvrditi utjecaj okluzijskih koncepcija na nastanak zvuka u temporomandibularnome zglobu. Ispitivana skupina sastojale se je od 96 ispitanika u dobi od 24 - 52 godine (x = 35,03 ± 6,92). Okluzijske koncepcije određene su kliničkim pregledom. U ovisnosti o kontaktima na laterotruzijskoj i meziotruzijskoj strani ispitanici su kategorizirani u tri skupine (okluzija vođena očnjakom, grupna funkcija, te bilateralno uravnotežena okluzija). Kliničkim pregledom te auskultacijom s pomoću stetoskopa registrirano je postojanje zvuka. 70,83 % ispitanika imalo je okluziju vođenu očnjakom, 16,66 % grupnu funkciju, a 12,5 % bilateralno uravnoteženu okluziju. Zvuk u temporomandibularnom zglobu postojao je u 41,6 % slučajeva. Rezultati statističke raščlambe (Pearson ?2) pokazuju da između skupina nema statistički znatne razlike (?2 = 2,09 p = 0,351). Rezultati ovog istraživanja upućuju na zaključak da okluzijske koncepcije nemaju utjecaja na nastanak zvuka u temporomandibularnom zglobu.The influence of occlusion on the occurrence of sound in the temporomandibular joint had not been complately proved. The objective of this investigation was to determine the effect of type of occlusion on the occurrence of sounds in the TMJ. A group of 96 subjects, aged from 24-52 years (x = 35.03 ± 6.92) was examined. The type of occlusion was dentermined by clinical examination. Depending on the contacts on the laterotrusal and mediotrusal side the subjects were categorized into three groups (canine guided occlusion, group function and balanced occlusion). The existence of sounds was registred by means of a clinical examination and auscultation by stethoscope. In the examined group 70.83% of examinees had canine guidance, 16.66 % group function and 12.5 % balanced occlusion. Temporomandibular joint sound was present in 41.6 % of subjects. The results of the statistical analysis (Pearson ?2) shows no statistically significant difference between these 3 groups (?2 = 2.09 p = 0.351). The results of this study suggest that the type of occlusion does not have an influence on the occurrence of sound in the TMJ

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

The Effect of Occlusal Relationships on the Occurrence of Sounds in the Temporomandibular Joint

The aim of this investigation was to determine the influence of occlusal relationships on the occurrence of sounds in the temporomandibular joint. A group of 100 male subjects aged 24–52 years (X = 35.03±6.92) was examined. Analysis of occlusion included determination of the number of existing teeth, number of teeth in occlusion, overbite and overjet, type of occlusion, mediotrusion interferences, relationship of the retruded contact position (RCP) to intercuspal position (ICP), and the amount and direction of sliding from RCP to ICP. Sound was registered by means of a stethoscope and classified according to its character in click or crepitation. Sound was present in 29% of subjects. In 28% of cases it was registered as click and in 2% of cases as crepitation. One subject had simultaneous click and crepitation. The results of the statistical analysis indicate that overbite, type of occlusion, existence of mediotrusion interferences, the relationship of RCP to ICP, and the amount and direction of sliding from RCP to ICP do not have an influence on the occurrence of sounds. The risk of the occurrence of crepitation is significantly increased in the case of the loss of more than 5 teeth, and in the case of horizontal overbite larger than 7.5 mm (p<0.05)

The Relation Between Occlusion and Temporomandibular Joint Sounds

The etiology of the occurrence of sounds and the role of occlusion, has not yet been entirely clarified. OBJECTIVE OF INVESTIGATION: The objective of this investigation was to determine the effect of occlusal relationships on the occurrence of sounds in the TMJ. METHODS: A group of 100 subjects, aged from 24 to 52 years (X=35.03) was examined. The existence of sounds was registered by means of a clinical examination and auscultation by stethoscope and classified according to character in click or crepitation. 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 chin-point technique, and fixing by Lucia-jig.The sliding from RCP to IKP position was determined in the anteroposterior, vertical and latero-lateral direction. A precise calliper was used to measure movement. RESULTS: 29% of the subjects had a clinically determined sound, in 27% it was click, and in 2% it was crepitation. The Pearson test analysis showed statistically significant difference (p<0.05) only for the occurence of crepitation in relation to the number of teeth, number ofteeth in occlusion and overjet. The same was confirmed by analysi s of variance (ANOVA). CONCLUSION: Overjet, difference in the position of RCP-ICP sliding from RCP into ICP, and type of occlusion, i.e. mediotrusion interference, do not have an influence on the occurrence of sound in the TMJ. A reduction in the number of teeth and the number of teeth in occlusion, have an influence on the occurrence