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Biomedical subjects

I Klineberg

Publications and source records attributed to I Klineberg.

At least 19 recordsLinked to original sources
PubMed2000

The involvement of the styloid process in head and neck pain--a preliminary study.

The styloid process and associated structures have been implicated in a variety of craniomandibular dysfunctions and pain complaints. There have been anecdotal reports that treatment directed at this area can result in a dramatic reduction in referred symptoms, somatic pain and autonomic signs as well as an increase in mandibular range of motion. In the past, an elongation of the styloid process was considered necessary for pain and dysfunction symptoms to arise from this area. The patients in this study did not have elongated styloid processes, yet had orofacial pain and dysfunction symptoms seemingly referred from this area. An injection of local anaesthetic and corticosteroid in the area of the styloid process significantly reduced lateral head pain and improved mandibular function in spite of an absence of any demonstrable pathology at the styloid process.

Adolescent↗
PubMed1999

Osseoperception: sensory function and proprioception.

Tooth loss and its replacement have significant functional and psychosocial consequences. The removal of intra-dental and periodontal mechanoreception accompanying tooth loss changes the fine proprioceptive control of jaw function and influences the precision of magnitude, direction, and rate of occlusal load application. With the loss of all teeth, complete denture restoration is a compromise replacement which only partially restores function. Implant-supported prostheses restore jaw function more appropriately, with improved psychophysiological discriminatory ability and oral stereognosis. Osseoperception is defined as depending on central influences from corollary discharge from cortico-motor commands to jaw muscles, and contributions from peripheral mechanoreceptors in orofacial and temporomandibular tissues. The processing of central influences is considered with the recognition of the plasticity of neuromotor mechanisms that occurs to accommodate the loss of dental and periodontal inputs.

Bite Force↗
PubMed1998

Chronic orofacial muscle pain: a new approach to diagnosis and management.

The initial data from this study indicate that there are clearly identifiable chronic muscle pain conditions in the form of localized pain; myofascial pain or regional pain conditions; and fibromyalgia or generalized pain conditions. A clear difference exists between the prevalence of these conditions in male and female patients, with a higher percentage of female patients suffering generalized pain problems and temporomandibular problems. Generalized or localized pain appears to be an individual variant of a similar problem and pain patients may have a genetically determined vulnerability associated with bacterial toxins, particularly within the genitourinary tract. It appears that in fibromyalgia there is an underlying genetic factor that causes abnormalities in the muscle metabolic cycle, and preliminary data suggest that lipid anomalies predispose to fibromyalgia and possibly chronic fatigue syndrome. Patients report infectious events at/or around onset in more than 60 percent of cases. Seventy percent of fibromyalgic cases report orofacial pain.

Chronic Disease↗
PubMed1995

A review of educational developments with Brånemark osseointegrated oral implants in Australia and New Zealand 1992-1994. Part I: Treatment data for Australia and New Zealand.

This review should be read in conjunction with the Teams Day Conference review of 1992. This data further emphasises the trend in implant restoration that was becoming apparent at that time. However, the degree to which single tooth implant restorations now dominate clinical implant treatment is unprecedented. There is clear evidence of a progressive increase also in segmental and full arch bridgework, but minimal increase in overdenture restorations. The data also indicates that for the first time the number of males treated was greatest and that the maxilla was more frequently restored. This latter feature is no doubt closely linked with the emphasis given to single tooth restorations. This data, fully supports the inclusion of implant restoration into general and specialist dental practice.

Australia↗
PubMed1995

A review of educational developments with Brånemark osseointegrated oral implants in Australia and New Zealand 1992-1994. Part II: Undergraduate, and postgraduate implant education in Australian and New Zealand dental schools.

A survey of Australian and New Zealand Dental Schools was carried out in 1993, aimed at assessing time allocation and curriculum content in relation to dental implants. Considerable variation was evident at both undergraduate and graduate levels. Continuing education courses in single-tooth implant surgery are available for general dental practitioners under carefully controlled circumstances. At the postgraduate level a formal University Diploma course in oral implants is now available at the University of Sydney. Dental educators must continue to react to the changing community scene in restorative dentistry, in terms of both need and demand. Educators must also be cognizant of the rapidity of change occurring in the area of implant dentistry. The provision of high-quality implant treatment and service is dependent on continual review of training and education at all levels of the dental profession.

Australia↗
PubMed1994

Investing procedures for immediate laboratory remounting of removable partial dentures.

Remounting removable partial dentures in the laboratory after deflasking and before clinical placement has several advantages. This modified investment procedure makes it easy to remount partial dentures after processing. Preliminary adjustments of laboratory errors and inaccuracies caused by dimensional changes in heart processing of acrylic resin may be made before the appointment with the patient.

Acrylic Resins↗
PubMed1994

Development of the Diploma in Clinical Dentistry (Conscious Sedation and Pain Control) Faculty of Dentistry, University of Sydney.

The Diploma in Clinical Dentistry (Conscious Sedation and Pain Control) of the Faculty of Dentistry, University of Sydney, is the first dedicated programme devoted to this field in Australia. Its development followed a decision by the Dental Board of New South Wales to require a formal qualification from the University of Sydney before dental practitioners could offer sedation and pain management in practice. The programme is conducted at Westmead Hospital in conjunction with the Department of Anaesthetics, and satisfies the guidelines developed by the Royal Australasian College of Dental Surgeons and the Royal Australasian College of Surgeons. The course is conducted either over one or two years, with block sessions requiring attendance at Westmead Hospital, together with assignments which are completed outside the block sessions. In this way, a dental practitioner enrolled in the programme is able to continue practice. The block sessions need not be completed over one year, but must be completed within two years.

Anesthesia, Dental↗
PubMed1993

The recording and analysis of EMG and jaw tracking. II. Reproducibility of jaw tracking.

In 10 male and 10 female adults jaw movements and muscle activity were monitored during chewing. Subjects had a Class I occlusion and fluent unrestricted jaw movements; non exhibited signs or symptoms of craniomandibular disorders. Recordings were made on two occasions separated by 2 weeks. Within each recording session the subjects carried out a number of tasks under direction, including eating nuts and gum. The jaw movements were monitored with a Sirognathograph which had been interfaced to a computer for data logging and analysis. A computer program identified each chewing stroke and after scrutiny a data base was constructed of measurements from a subset of 4447 suitable strokes. Mean values of 10 parameters selected to describe jaw movements during chewing were entered into an ANOVA. This indicated that the major contribution to variance was due to the subject from whom the data was recorded. This intersubject variability is well known, but can its separation from the other contributions to the variation within the data be assessed? To provide an estimate of the spread of data the variance for each parameter was calculated, transformed and these values entered into an analysis of variance. All subject differed significantly in their chewing movements from one another. But 15 of the 20 subjects showed a greater degree of consistency than the other five: they exhibited good inter- and intra-recording reproducibility. The food being eaten made a major contribution to the variability. The timing of the chewing strokes was also more consistent than the dimensions of the chewing envelope.

Adult↗
PubMed1993

An overview of Brånemark osseointegrated oral implants in Australia and New Zealand 1981-1992.

This report summarises the development of the use of Brånemark implants in Australia and New Zealand from 1981 to 1992. This decade of activity, although slow initially, has now gained momentum and there is increasing demand for this service. The single tooth implant is most frequently offered in dental practice although within Dental Hospital Clinics, the lower full arch bridge continues to provide the greatest rehabilitation need. Universities have now embraced Brånemark implants as an appropriate surgical-restorative procedure for predictable management of edentulism. The data summarised in this report confirms that the success rate in Australia and New Zealand is equal to that obtained internationally for Brånemark implants.

Australia↗
PubMed1992

The recording and analysis of EMG and jaw tracking. I. The recording procedure.

A computer-based system is described which records and analyses electromyographic (EMG) signals and tracking data for mandibular movements during function. EMG signals were obtained bilaterally from six muscles and a Sirognathograph monitored the position of the lower incisor teeth in three dimensions. Directed jaw movement tasks by subjects were monitored. These data were continuously sampled at a rate of 1 KHz per channel over an operator controlled period. Analysis of the data was performed off-line following the experiment. Individual chewing cycles associated with masticatory function were identified and the timing and dimensions of each chewing envelope established. Corresponding EMG values were also determined and displays of EMG and jaw movement were plotted on a common time base. An average chewing cycle and correlated EMG activity could also be displayed on a high resolution monitor and plotted for a hard copy to enable a comparison to be made between subjects with and without jaw dysfunction.

Analysis of Variance↗
PubMed1992

Prosthodontic procedures for implant reconstruction. 1. Diagnostic procedures.

The University of Sydney Dental School and more recently the Implant Centre have been treating patients with the Brånemark Osseointegration Implant System since 1981. Success depends on close cooperation between surgeon and prosthodontist. This paper describes specific prosthodontic treatment planning procedures based on a general knowledge of prosthodontics, and detailed methods for determining the position, length and alignments of the implants for a specific case by the use of radiographic and surgical templates.

Dental Articulators↗
PubMed1992

Prosthodontic procedures for implant reconstruction. 2. Post-surgical procedures.

There is essentially no flexibility in an osseo-integrated implant system, so that the final fit of the prosthesis must be absolutely precise. A simple approach to this problem is presented with details as to impression taking, confirmation of accuracy of the master cast, fitting of the cast metal framework and construction of the superstructure. The information presented describes a full arch fixed restoration attached to mandibular implants, but may easily be followed for the maxilla or modified for quadrant restorations.

Acrylic Resins↗
PubMed1991

The lateral pterygoid muscle: some anatomical, physiological and clinical considerations.

The lateral pterygoid muscles make a unique contribution to jaw movement control by virtue of their attachment to temporomandibular disc and condyle. Their highly specialized function is reflected in their extrafusal muscle fibre composition and the paucity of muscle spindles to provide proprioceptive feedback. It is likely (studies in progress) that their histochemical spindle intrafusal fibre composition is also unique. The superior and inferior portions of the muscle have defined functional roles. The superior portion primarily contributes to the apposition of disc, condyle and eminence in jaw closing, whilst the lateral portion primarily contributes to jaw opening. In this review, possible control mechanisms for this muscle are proposed. As well, the role of the superior head in influencing rotation and translation of disc and condyle and the relationship with internal derangement and temporomandibular dysfunction is considered.

Electromyography↗
PubMed1988

Occlusion as the cause of undiagnosed pain.

The teeth provide precise skeleto-motor influences for the stomatognathic system. This unique guidance mechanism characterizes each individual's chewing pattern. It controls the activity of jaw muscles to ensure that appropriate tooth contacts within the limits of existing tooth relationships occur at the end of each chewing cycle. This acts as a means of re-setting the neuromuscular system in anticipation of the next jaw opening movement. The absence of stable centric occlusion at the end point of each chewing cycle alters neuromuscular co-ordination and predisposes to muscle dysfunction. Tooth and jaw or craniomandibular relationships are associated with craniocervical relationships and especially tongue posture. This is also directly influenced by the need for airway maintenance as the predominant influence on tongue-muscle function. The susceptibility to pain and dysfunction is further influenced by individual stereognathic sensitivity or the variable awareness of tooth contour and tooth contacts. These special features are present within the framework of the psycho-physiological and psycho-social significance of the face and mouth, which directly bears on the individual response to and appreciation of pain and dysfunction. Tooth guidance also influences condyle-disc function. Anterior and posterior teeth provide primary and secondary lateral guidance in function, directing the jaw into centric occlusion. If this guidance tends to direct the jaw posteriorly along distal, rather than mesial tooth inclines, it restricts the antero-posterior 'function' of jaw movement at tooth contact. This predisposes to condyle-disc dysfunction and the development of internal derangements, by increasing the likelihood of the posterior thick band of the disc being displaced anteriorly and the condyle posteriorly.(ABSTRACT TRUNCATED AT 250 WORDS)

Facial Pain↗