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Reduction in Orthopedic Conditions through Teledontic Treatment of Pharyngorofacial Disorders
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Joseph Yousefian, Michael N. Brown
The most orthopedically stable position of the POF complex is in natural head posture with mandible in centric occlusion and teeth in maximum intercuspation. The orthopedic instability may result from conditions that are related to the occlusion, the TM joints, the cervical region influenced by head and neck posture or combination. Other factors of instability include the genetic or epigenetic factors including developmental, or iatrogenic causes, arthritic condition, alterations in the normal anatomy of the TM joints, and disharmony between a stable intercuspal position (ICP) of the teeth and the musculoskeletal stable position of TM joints and cervical region. Spontaneous posturing of the head and neck or mandible including wear of unfitting oral appliances may also alter orthopedic stability of POF complex and cause dysfunction, symptoms, or in the long term, contribute to the development of POFD (Table 10.1).
Dental Anatomy and Occlusion
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Pedro E. Santiago, Lindsay A. Schuster
As our knowledge of dental occlusion has matured, two important concepts have developed: centric occlusion and centric relation. Centric occlusion is a person’s habitual bite. It is the position determined by dentition, when the maxillary and mandibular teeth are in maximum intercuspation. It is dentally determined and is independent of condylar position. Centric relation is the relation of the mandible to the maxilla when the condyles are in a physiologically stable position, independent of tooth contact. This relation has been described as the most superoanterior position of the condyles in the articular fossae with the discs correctly interposed (Fig. 4-12).4
Effects of occlusal splints on shoulder strength and activation
Published in Annals of Medicine, 2019
Amândio Dias, Luís Redinha, João R. Vaz, Nuno Cordeiro, Luís Silva, Pedro Pezarat–Correia
Fourteen male subjects were recruited (age = 21.67 ± 0.86 years; body mass = 76.33 ± 7 kg; height = 1.76 ± 0.61 m) for this experiment. A dental examination confirmed that none of the participants had any type of temporomandibular joint (TMJ) disorders. An occlusal splint (OS) that repositioned the TMJ in centric relation (CR) was fabricated for each of the subjects. The CR is considered the most stable position for the mandible, and it is achieved when the TMJ condyles are in their most anterior-superior position in the articular fossae. This position encourages the condyles to seat stably in a congruent skeletal arrangement [31]. The OS were custom-made, using a vacuum former machine (Easy Vac, Baekseokdong, South Korea). A thermoforming foil (Erkodent, Pfalzgrafenweiler, Germany) was adapted over the maxillary casts, trimmed and adjusted in the articulator to the requisites of a stabilization splint in CR position. The thermoforming foil had a thickness of 1 mm and lost about 20%–30% in the manufacturing process. Hence, the interocclusal distance was ∼7 mm. A placebo splint was also fabricated for each subject, using the same manufacturing process, adapted over maxillary casts and trimmed down on the occlusal surface to ensure that they would not interfere with the subjects normal maximum intercuspation This research was approved by the ethics committee of the Faculdade de Motricidade Humana for use of human research (6/2016) and all subjects signed an informed consent.
Temporomandibular disorders in growing patients after treatment of class II and III malocclusion with orthopaedic appliances: a systematic review
Published in Acta Odontologica Scandinavica, 2018
Antonio Jiménez-Silva, Romano Carnevali-Arellano, Matías Venegas-Aguilera, Julio Tobar-Reyes, Hernán Palomino-Montenegro
The relationship between occlusion and TMD is still considered as a controversial topic in dentistry. For years, some professionals were based on the evaluation and correction of occlusal anomalies to treat patients with TMD [7]. In the past, the evidence suggested that malocclusion was considered as the main factor for predisposition, initiation and perpetuation of TMD [8–10]. In 1990s some studies showed that some occlusal and skeletal characteristics as anterior open bite, unilateral posterior crossbite, overjet greater than 6 to 7mm and centric relation (CR) to maximum intercuspation (MI) discrepancy >2 mm could be considered occlusal risk factors for TMD [2,11,12]. Current evidence based on Systematic Reviews of observational studies would not support an association for dental occlusion in the pathophysiology of TMD [13,14]. Therefore, malocclusion would not be present, but the rapid change and stress applied in the system that would exceed the physiological tolerance threshold are being unfavourable for the TMJ [15–19]. In addition to the psychological factors, some studies indicate the importance of the role that would have stress, anxiety and depression in children along with TMD [20–23].
Relevant research from orthodontic journals: sleep apnoea
Published in Journal of Orthodontics, 2018
Twelve participants were selected out of 26 patients who had been referred to the King Abdul-Aziz University between 2010 and 2014, for treatment of obstructive sleep apnoea (OSA). The inclusion criteria were mild to moderate OSA, an adequate dentition for retention of the mandibular advancement appliance (MAA), adequate nasal breathing, a minimum of 7 mm of protrusive jaw movement from the position of maximum intercuspation and a 30–40 mm distance between the incisal edges of the maxillary and mandibular incisors during opening. Exclusion criteria included the presence of any periodontal disease, TMJ dysfunction, serious nasal passage obstructions, medical contraindications of previous experience with an oral appliance. There was no sample size calculation reported in the paper; the 12 patients who were selected made a convenience sample. The participants consisted of 2 men and 10 women.