Biomedical subjects

E Piehslinger

Publications and source records attributed to E Piehslinger.

At least 19 recordsLinked to original sources

PubMed2000

Mandibular position at chin-point guided closure, intercuspation and final deglutition in asymptomatic and temporomandibular dysfunction subjects.

This study compared the mandibular position at chin-point guided jaw closure, intercuspation and final deglutition (position at the end of swallowing) in 159 asymptomatic subjects and 142 subjects with symptoms in the craniomandibular system. The symptomatic subjects were assigned to four groups showing an adapted centric posture, pain, luxation with reduction of the temporomandibular joint and pain with luxation and reduction. Computer equipment aided recording of hinge axis movements in three dimensions. While the three positions differed significantly in anterior-posterior direction on both sides and in inferior-superior direction on the right, a significant difference between asymptomatic and symptomatic subjects existed only in final deglutition on the left side and in the anterior-posterior location of the guided closure. Final deglutition did not coincide with the guided closure or the intercuspation in approximately 89%. A proportionally large standard deviation gave evidence against a strict relationship of the three positions in asymptomatic and symptomatic subjects. Because of this variability, final deglutition was not recommended for verification of centric relation or the intercuspal position.

Adolescent↗

PubMed1998

Lengths of condylar pathways measured with computerized axiography (CADIAX) and occlusal index in patients and volunteers.

The lengths of the condylar pathways during protrusive and opening movements were investigated with computerized axiography in 100 individuals. Forty-two patients suffering from anterior disk displacement with reduction (ADD) in one or both temporomandibular joints (TMJ) and 28 patients with anterior overrotation clicking (AOC) of the TMJ were compared with 30 asymptomatic volunteers. Patients suffering from ADD showed significantly shorter tracings than did the two other groups. A significant difference of length of TMJ movement between men and women was found only in one group. The occlusal indices (OI) of the three groups were assessed and compared with each other. Here, a significant difference was found between volunteers and patients suffering ADD and between volunteers and patients with AOC. Between men and women a significant difference of the OI was found in the group with AOC, women presenting higher scores than men. Except for the group of patients with ADD, who showed shorter average lengths, volunteers as well as patients with AOC, were within the normal limits given in the literature for TMJ movement lengths recorded with axiography. The results of this examination therefore indicate that when considering movement length alone no discrimination between healthy and diseased TMJ can be made.

Adult↗

PubMed1997

Treatment of recurrent mandibular dislocation, Part I: Leclerc blocking procedure.

Nine patients with recurrent mandibular dislocation, who underwent the blocking procedure of Leclerc and Girard, as modified by Gosserez and Dautrey, are presented. The follow-up period range from 2.5 to 5 years. An axiographic study revealed significant postoperative limitation of translation of the condyle when opening, while maximal mouth opening as measured between the incisors, as well as translation of the condyle in protrusion and mediotrusion, showed no significant limitation. Long-term evaluation showed a high incidence of clicking and pain, not evident prior to surgery. The causes for recurrence in three cases were analysed.

Adolescent↗

PubMed1996

Mandibular reference position: chin-point guided closure vs. final deglutition.

The study investigated two mandibular positions based upon computerized axiography recordings of hinge axis movements of 262 subjects. Next to the well-known guided closure position RP (reference position by chin-point guidance), the position of final deglutition (FD) was quantified. FD represented the hinge axis position at the end of the swallowing movement. The results elicited average linear distances of 0.32 +/- 0.43 mm on the right and 0.33 +/- 0.40 mm on the left side between both positions in the sagittal plane. The average distance in the frontal plane was 0.02 mm (right) and 0.04 mm (left). Approximately 46 per cent of FD recordings were found anterior and inferior to RP, and showed significant difference to posterior and anterior-superior FD recordings. The replicability of both positions was tested on 53 subjects and averaged 0.04 mm (FD) and 0.09 mm (RP). Average deviations of repeated recordings within the subject ranged from 0.07 to 0.47 mm (FD) and 0.07 to 0.57 mm (RP) for each spatial direction. The results of this study showed a relative coincidence of an average FD and RP Variation of FD in anterior inferior direction questioned the clinical reliability of FD to reassure the guided closure position.

Adolescent↗

PubMed1995

Computer simulation of occlusal discrepancies resulting from different mounting techniques.

The effect of arbitrary mounting of maxillary casts on occlusal relationships was investigated in this study. Maxillary casts of 31 volunteers were mounted on an articulator by use of two split cast bases. This mounting was done first with the arbitrary face bow and second with a hinge bow. Three reference points were defined and measured on each maxillary cast with a three-dimensional digitizer. The measurements were taken from the arbitrarily mounted cast and from the cast mounted according to the hinge axis. Opening and closing movements that were transferred according to the hinge axis. Opening and closing movements that were transferred from the articulator to the mouth of the patient were simulated by a computer based on measurements of the reference points. The results revealed that the use of an arbitrary face bow causes a deviation of the hinge-axis points from the precise axis of more than 5 mm in 77% of the cases. Resulting occlusal errors depended on the angles between the arbitrary and precise axes and the direction of the axis shifts. The occlusal error is roughly proportional to the shift or tilting of the hinge axis in millimeters or degrees. For a given deviation of the arbitrary and precise axes, the occlusal error is proportional to the record height. For a record height of 2 mm or more, an occlusal error of more than 0.1 mm will occur. An average occlusal error of more than 0.1 mm would most likely lead to the necessity of extensive selective grinding of occlusal discrepancies in the patient's mouth.

Adult↗

PubMed1995

Comparison of magnetic resonance tomography with computerized axiography in diagnosis of temporomandibular joint disorders.

This study compared the accuracy of two noninvasive methods, computerized axiography and magnetic resonance tomography (MRT), in diagnosing temporomandibular joint (TMJ) disorders. Forty-seven subjects underwent axiography and subsequent assessment of the TMJ by MRT. The statistical analysis referred to the correlations of the most relevant clinical diagnoses, i.e., no appreciable disease, disk displacement with reposition, disk displacement without reposition, morphologic alterations, and hypermobility of the condyle. In 70% of the disk-displacement-with-reposition and disk-displacement-without-reposition patient groups, axiography and MRT gave the same information. In other patient groups, the axiography findings agreed with the MRT findings in 45% of the cases. It was concluded that although a large percentage of morphologic alterations could be detected by MRT, axiography determined the dysfunctional dynamics more clearly.

Adolescent↗

PubMed1995

The effect of occlusal splint therapy on different curve parameters of axiographic TMJ tracings.

Computerized axiography was used as an objective instrumental method of evaluating the response of patients with temporomandibular joint (TMJ) symptomatology to occlusal splint therapy. Diagnosis was performed in a standardized manner by systematically analyzing TMJ path tracings obtained by computerized axiography. Thirty-six patients were axiographed before and after therapy with full-arch occlusal stabilizing appliances, followed by assessing the effect of therapy on various path curve parameters. The data obtained for the patient group treated with splints was compared to that of six patients also axiographed, but left untreated for a period of six weeks before a second TMJ tracing was obtained. The results show that splints have a certain effect on reciprocal TMJ clicking (response rate 67%). Retral stability and path characteristics are also substantially improved (response rates 44% and 40%). Less influence was noted on hypomobile joint paths (response rate 29%), the quality of movements (response rate 28%) and Bennett angle values (response rate 23%). Patients with disk displacements without reduction were not treated with splints, they underwent surgery. Their results will be reported later. By contrast, TMJ tracings in the control group remained essentially unchanged.

Adolescent↗

PubMed1995

Computerized axiography for standardized evaluation of TMJ function and dysfunction.

Computerized axiography permits the recording of mandibular movement and offers analytic systems for evaluation. Data of both temporo-mandibular joints can be compared simultaneously in relation to changes in space and time [1]. The experienced dentist is able to detect early symptoms of disturbances in the stomatognathic system.

Cephalometry↗

PubMed1994

Orthopedic jaw movement observations. Part III: The quantitation of mediotrusion.

The objective of this series is to observe and analyze movements of the temporomandibular joint (TMJ). With the information from these studies, orthopedic standards for jaw movements will be established in further investigations according to the neutral-zero method used in general orthopedics. Any restricted range of motion can thus be defined as a deviation from these standards. Direct interpretation and objective evaluation of joint functions has major practical implications. With the aid of computerized axiography, mediotrusive movements of 48 asymptomatic volunteers and 66 jaw patients were evaluated. The movements performed were either free or guided. The mean curve lengths, as well as the Bennett angles at 3 mm and at the end point were recorded. An average group was defined, containing the values of 50% of all volunteers. The interquartile range was calculated for lengths of mediotrusive movements as well as for Bennett angles. The average range of free mediotrusive movement for female volunteers was 11.06-11.98 mm (mean 11.55 mm) on the right side and 10.47-11.75 mm (mean 11.24 mm) on the left side. Male volunteers showed an average range of 10.23-11.54 mm (mean 11.1 mm) on the right side and 10.24-11.73 mm (mean 11.12 mm) on the left side. The values for female patients amounted to 9.95-1.66 mm (mean 10.8 mm) on the right side and 9.75-11.28 mm (mean 10.55 mm) on the left side. The average range for male patients was 9.06-9.71 mm (mean 9.54 mm) on the right side and 9.17-10.23 mm (mean 9.73 mm) on the left side. The average range for Bennett angles at maximum excursion in free mediotrusive movement was between 0.41 and 5.89 degrees (mean 4.43 degrees) in the volunteers on the right side and between 2.45 and 10.07 degrees (mean 6.87 degrees), respectively, on the left side. The values for patients amounted to 0.19-12.65 degrees (mean 6.93 degrees), on the right side and 1.71-14.15 degrees (mean 6.73 degrees) on the left side.

Adolescent↗

PubMed1994

Recording orthopedic jaw movements. Part IV: The rotational component during mastication.

The recording and analysis of mastication provides information on neuromuscular engrams, and hence avoidance mechanisms. Avoidance mechanisms are pathologic movement patterns which are developed to avoid occlusal interferences during functional movements. Evaluation of hinge-axis rotation permits selective quantitative analysis of a complex movement pattern. The objective of this study was to determine the amount of hinge axis rotation in mastication using computerized axiography. Furthermore, the distance of the condyles from reference position (RP) at maximum rotation was evaluated and the chronological sequence of translation and rotation was investigated. The mean value for the rotational angle of the mandible (gamma) during mastication was 14.1 degrees in the volunteers and 13.44 degrees in the patients. The linear spatial distance from RP amounted to a mean of 6.57 mm on the right side and 6.21 mm on the left in the volunteers. In the patients, the measurements were 6.33 mm on the right side and 6.7 mm on the left. In most cases, maximum rotation did not correspond with maximum translation. The chronological sequence of maximum excursion was not constant.

Adolescent↗

PubMed1994

Orthopedic jaw movement observations. Part V: Transversal condylar shift in protrusive and retrusive movement.

Unguided protrusive and retrusive mandibular movement was investigated in 76 asymptomatic volunteers and temporomandibular joint (TMJ) patients using computerized axiography. In 38 of these subjects, guided pro-/retrusion was also recorded. Measurements were performed in a three-dimensional Cartesian coordinate system (x = anteroposterior; y = transversal, toward the hinge axis; z = craniocaudal). Transversal shift (y) was measured and evaluated as well as the distance "s" and horizontal condylar inclination (HCl) at the point of maximum transversal deviation. The patterns of the tracings were analyzed with a view to diagnostic improvements. The objective of this study was to evaluate transversal shift and to examine the postulate of symmetrical behavior of the TMJs in pro-/retrusion. The mean mandibular shift was 0.15 mm to the left. This maximum deviation was seen in a mean distance "s" of 7.42 mm in relation to the Cartesian coordinate system in reference position. These results suggest a functional dominance of the right part of the mandible in protrusive and retrusive movement.

Adolescent↗

PubMed1994

The reproducibility of condylar hinge axis positions in patients, by different operators, using the electronic mandibular position indicator.

Three operators each made five recordings from 15 symptomatic patients using the electronic mandibular position indicator. The method consisted of measuring bilateral spatial changes of the hinge axis recalculated by the computer to an intercondylar distance of 110 mm and a third position, calculated from the rotation of the hinge axis, at the incisal guidance table. All individual patient recordings were related to the origin of the same coordinate system. This origin is designated and defined as the reference position, with purposeful elimination of any stated joint position for this definition. The measurements were in all planes of space at 10-millimicron increments, including the rotation of the transverse hinge axis in hundredths of degrees. These data showed that the reproducibility of hinge axis positions, ie, reference positions, to hinge axis condylar positions dictated by the maximum intercuspation of teeth was in average less than 0.2 mm for each record from all operators and patients.

Analysis of Variance↗

PubMed1993

[MRI of the temporomandibular joint. Demonstrability and significance of the retro-articular vascular plexus].

The retro-articular vascular plexus of the temporomandibular joint (TMJ) is of great importance for the function of this joint. Aim of this study was to determine the amount of increase of signal intensity in the retro-articular vascular plexus after intravenous injection of contrast medium and to figure out potential advantages of this procedure. The posterior band of the articular disc--a landmark in the diagnosis of disc dislocations--becomes prominent after injection of contrast medium. Forty-five temporomandibular joints were studied before, and after intravenous injection of contrast medium with magnetic resonance imaging (MRI) using T1-weighted images in parasagittal plane. In all cases a measurable increase of signal intensity was demonstrable in healthy volunteers as well as in patients with normal or pathological TMJ findings. In 53.3% of cases the posterior band was better differentiable after administration of contrast medium. In patients with suspicion of pathological features in series without contrast medium, in 27.3% of those cases administration of contrast medium led to a more precise--"diagnostic"--evaluation of disc location. The study emphasizes the use of contrasts medium for evaluations of disc dislocation with MRI in cases of pathological or unclear findings in precontrast MRI series.

Adolescent↗

PubMed1993

Orthopedic jaw movement observations. Part I: Determination and analysis of the length of protrusion.

An analysis and quantitation of protrusive and retrusive mandibular movement is provided. This report is one study along with four other parts analyzing the mandibular opening movement, the transversal shift during protrusion and retrusion, the mediotrusive movement and mastication. Protrusive movements of 225 individuals (180 patients, 45 volunteers) were analyzed using computerized axiography. Investigating both asymptomatic volunteers and patients with abnormal joint mobility helps to improve evaluation of these abnormalities. With the aid of diagnostic computer software, the length of the pathways was measured and the characteristics of the curves were analyzed. An average group was defined based on the values found in asymptomatic individuals, comprising 50% of our volunteers. The interquartile range for the male volunteers was 8.79-12.27 mm for the right joint and 9.43-12.93 mm for the left joint; for female volunteers it was 8.32-10.64 mm and 9.2-11.26 mm, respectively.

Diagnosis, Computer-Assisted↗

PubMed1993

Orthopedic jaw movement observations. Part II: The rotational capacity of the mandible.

Using computerized axiography, particularly the electronic mandibular position indicator (EMPI), the mandibular opening movement was measured in 86 asymptomatic volunteers and temporomandibular joint (TMJ) patients. Terminal hinge-axis movement and hinge-axis rotation at maximum-guided mouth opening were recorded. The angle of hinge-axis rotation was used as a parameter for both movements, in accordance with the neutral-zero method. This is a well-established technique in orthopedics and is the standard tool for quantitative functional analysis of joints. An average group was defined, 50% being volunteers. The interquartile range for terminal hinge-axis movement in this study was 5.42 degrees-7.41 degrees in the volunteers and 4.73 degrees-7.25 degrees in the patients. The interquartile range for hinge-axis rotation at maximum opening was from 29.09 degrees-34.87 degrees in the volunteers and from 26.7 degrees-35 degrees in the patients. Computerized axiography is a refined tool for analyzing rotational and translational capacities of the mandible. It is a valid and practical method for orthopedic-diagnostic evaluation of mandibular movements and gives objective criteria for diagnosis in accident victims.

Adolescent↗

PubMed1993

Reproducibility of the condylar reference position.

The reproducibility of the condylar reference position was examined at the pont of unstrained hinging movement of the mandible in subjects with TMJ symptoms and in asymptomatic subjects. Three different operators performed the procedure to detect interoperator variability. Each operator made five registrations using computerized axiography in the electronic mandibular position indicator mode. Data were evaluated by an analysis of variance using three factors: (1) repetitions of the single operator, (2) data from symptomatic versus asymptomatic patients, and (3) values of different operators. The results showed that none of these factors had a significant influence on reproducibility of the condylar reference position. High reproducibility was obtained in both symptomatic and asymptomatic groups. Measured values remained within +/- 0.1 mm in 58.6% and within +/- 0.2 mm in 24.3% of the registrations.

Adolescent↗

PubMed1992

Sonography of nonneoplastic disorders of the salivary glands.

We examined 637 patients with salivary gland disorders by real-time sonography. In 270 patients, the possibility of neoplasia of the salivary glands could not be excluded by ultrasound. In the remaining 367 patients, the following disorders were diagnosed sonographically: acute inflammation (72 patients), Sjögren's syndrome or chronic inflammation (81 patients), abscess (9 patients), sialolithiasis (192 patients), and cysts (13 patients). The present study discusses the ultrasound appearances of a variety of diseases and the indications and limits of sonography in the evaluation of salivary gland pathology.

Abscess↗

PubMed1991

Computerized axiography: principles and methods.

This paper reviews earlier methods for the analysis of mandibular movement and gives a detailed account of state-of-the-art procedures. Special emphasis is given to computerized axiography and the application of this method to the diagnostics of the temporomandibular joint (TMJ). The article discusses the advantages of computerized axiography over the mechanical device and points out the limitations of the axiographic method. One major advantage of the computerized system is having the enlarged diagram of tracings on the computer screen. This means that small changes such as initial disk displacements can be diagnosed more readily than with the mechanical device.

Dental Articulators↗