The dysgnathogenic distress syndrome.
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AIM: To present two clinical cases and demonstrate that occlusal trauma may affect healing of periapical pathoses. SUMMARY: Two teeth with periradicular disease did not respond successfully to conventional root canal treatment or endodontic surgery. Occlusal adjustment was finally performed on both cases. After occlusal adjustment, uncomplicated healing and periapical repair occurred in both cases. The findings in these two cases suggest that occlusal trauma may play a role in the healing of periapical pathoses. KEY LEARNING POINTS: Occlusal trauma is positively correlated with changes in periodontal tissues. Although experiments in animals have shown that application of forces to teeth will not induce further periodontal destruction, we believe that some failures of root canal treatment may be due to the presence of occlusal trauma modulating the responses of inflamed periapical tissues or apical pathoses with persistent infection.
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Much of the literature on craniomandibular joint (CMJ) dysfunction-pain (previously called temporomandibular joint (TMJ) dysfunction-pain) is focused on the etiology and treatment of symptoms, with little discussion of finalization procedures. Craniomandibular disorders encompass a broad range of patient complaints, and the therapies used for these symptoms include an entire spectrum of treatment modalities. Following successful therapy in Phase I, the problem facing the dentist is how to finalize treatment. This paper is a review of the literature on Phase II management including rationale, principals, and methods of stabilizing and rehabilitating the occlusion, emphasizing the prosthodontic perspective.
The relationship between the change of afferent information from occlusal contacts and its influence on the jaw muscles was investigated. For this purpose, the following questions were posed and experimental studies designed. If the subject was given habitual occlusal contacts in centric relations with a bite plane, were the habitual mandibular closing and opening movements influenced? Second, was it easier for the subjects to accomplish regular habitual mandibular opening and closing movements, when the bite plane was inserted and removed? From the results it could be concluded that the centric occlusal contacts in centric relation were more physiological for the jaw muscles. In addition, when the new occlusal position was coincident or close to the centric relation, it was easier for the subject to study and acquire the new habitual mandibular opening and closing movement.
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OBJECTIVE: The purpose of this study was to analyze the pre- and post surgical orthodontic treatment of mandibular asymmetry and prognathism in our hospital, and to summarize some helpful experiences for future clinical work. METHODS: The data were derived from 21 adults aged from 19 - 28 years who had severe mandibular asymmetry and prognathism. The ANB angle of all patients is from -3 degrees to -8 degrees. The value of wits of all patients is from -7 mm to -14 mm. The deviation of chin point of all patients is from 3 mm to 7 mm. RESULTS: The duration of pre- and post-surgical orthodontic treatment was 10-20 months (mean 18 months) and 5-10 months (mean 7.5 months), respectively. The keys in pre-surgical orthodontic treatment include (1) three dimensional dental decompensation; (2) arch form and transverse discrepancy correction; (3) model surgery and the splint making. The main objective of post surgical orthodontic treatment is to detail the occlusion. CONCLUSIONS: Pre- and post surgical orthodontic treatment is essential for the orthognathic treatment of patients with mandibular asymmetry and prognathism.
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The influence of a temporarily altered anterior guidance on mandibular movement patterns of tooth-guided and non-guided protrusion was examined in a clinical study on 20 patients, all with complete sets of teeth. Registration and recordings of movements were done with the computer-aided ultrasonic measuring system MT 1602. Based on an average measuring time of 40 min for each patient the main results were as follows: 1. The shape of the anterior guidance strongly influences the horizontal tracings of tooth-guided and non-guided protrusion. In most cases these tracings show a deviation from the mid-sagittal path due to neuromuscular coordination. 2. Insertion of an idealized, symmetrical anterior guidance or a horizontal plateau lessens the mandibular deviation and harmonizes the tooth-guided and non-guided paths. However, the old neuromuscular engrams are not completely erased. 3. Newly formed engrams can be erased much easier than old ones.
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