Search Results (11)

This observational cross-sectional study evaluated the differences in condylar guidance angles during mandibular protrusion and mouth opening using digital axiography and CBCT. A total of 30 healthy subjects (60 TMJs) aged 20–24 years were examined. Mandibular movements were recorded using the Modjaw system, and fossa height was assessed from CBCT images. A statistically significant correlation was observed between condylar angles measured during protrusion and opening (r = 0.57, p < 0.001). Protrusive measurements were more consistent, while opening exhibited greater variability. The results suggest that protrusive movements are more reliable for articulator programming. Digital tools such as Modjaw can enhance precision and workflow efficiency in TMJ diagnostics. Full article

Objective: To evaluate mandibular kinematics in an orthodontic population using the Modjaw^® optical jaw tracking system. Materials and methods: A total of 154 orthodontic patients underwent mandibular kinematic analysis using the Modjaw^® system. ANB values determined skeletal classification, while dental classification was assessed on digital casts. The Modjaw^® records were taken as instructed by the manufacturer, and data collected from the readings included the discrepancy between centric occlusion and maximum intercuspation, maximum opening, Bennett angles, and sagittal condylar guidance. The presence or absence of temporomandibular disorders was determined by the DC-TMD questionnaires. Non-parametric tests and Spearman correlations were applied for the statistical analysis. Results: Significant differences in mandibular kinematics were observed between skeletal classes, particularly in CO-MI discrepancies, Bennett angles, and maximum opening (p < 0.05). TMD symptoms were associated with higher absolute CO-MI discrepancies but did not significantly alter other kinematic parameters. Weak correlations were found between sagittal condylar guidance and anterior guidance variables. Conclusions: Mandibular kinematics differ by skeletal classification, with Class III patients demonstrating distinct patterns. While TMD symptoms impact CO-MI discrepancies, overall mandibular dynamics remain consistent. Full article

Precision in diagnosis is essential for achieving optimal outcomes in prosthodontics, orthodontics, and orthognathic treatments. Virtual articulators provide a sophisticated digital alternative to conventional methods, integrating intraoral scans, facial scans, and cone beam computed tomography (CBCT) to enhance treatment predictability. This review examines advancements in virtual articulator technology, including digital workflows, virtual facebow transfer, and occlusal analysis, with a focus on Artificial Intelligence (AI)-driven methodologies such as machine learning and artificial neural networks. The clinical implications, particularly in condylar guidance and sagittal condylar inclination, are investigated. By streamlining the acquisition and articulation of digital dental models, virtual articulators minimize material handling errors and optimize workflow efficiency. Advanced imaging techniques enable precise alignment of digital maxillary models within computer-aided design and computer-aided manufacturing systems (CAD/CAM), facilitating accurate occlusal simulations. However, challenges include potential distortions during digital file integration and the necessity for robust algorithms to enhance data superimposition accuracy. The adoption of virtual articulators represents a transformative advancement in digital dentistry, with promising implications for diagnostic precision and treatment outcomes. Nevertheless, further clinical validation is essential to ensure the reliable transfer of maxillary casts and refine digital algorithms. Future developments should prioritize the integration of AI to enhance predictive modeling, positioning virtual articulators as a standard tool in routine dental practice, thereby revolutionizing treatment planning and interdisciplinary collaboration. This review explores advancements in virtual articulators, focusing on their role in enhancing diagnostic precision, occlusal analysis, and treatment predictability. It examines digital workflows, AI-driven methodologies, and clinical applications while addressing challenges in data integration and algorithm optimization. Full article

Introduction: Facial asymmetry can be attributed to a multitude of underlying causes. Multiple reference points can be utilized for guidance in surgery planning. The scope of mandibular overgrowth and asymmetry should always be measured on CBCT radiographs (cone-beam computed tomography). The assessment of the mental foramen, and the supra and infraorbital foramina is crucial in surgical procedures. Their potential as reference points for predicting specific conditions has never been studied before. The authors explored if the mentioned foramina can be used for diagnostic purposes to distinguish the type of asymmetry or perhaps could improve any surgery planning in those skeletal asymmetry cases. Material and methods: Evaluation of 30 CBCT radiographs in the present preliminary study based on three study groups consisting of patients with normal skeletal features without any skeletal malocclusion (n = 10), and those compared with hemimandibular elongation (HE = 10) and hyperplasia (CH/HH = 10). For the evaluation of asymmetry, fluctuating asymmetry indices were calculated. Results: The fluctuating asymmetry indices did not differ between both sexes; however, they were remarkably higher in the CH groups than in HE or control. Some of the indices showing the highest differences show some potential as promising predictors for early detection of CH. Conclusions: The condylar hyperplasia shows the highest facial asymmetry among study groups and metric traits. The supraorbital-mental foramina measurement may be used for initial screening for the occurrence of condylar hyperplasia Additional measurements could increase the predictive value of this indicator. Further study on improved samples could confirm the hypothesis of facial foramina displacement influence on jaw osteotomy planning. Full article

Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during functional and parafunctional movements in bruxers and non-bruxers and to assess a digital method for quantifying eccentric bruxism using an optical jaw tracking system (Modjaw^®). Methods: The study group included subjects diagnosed with eccentric bruxism according to validated clinical diagnostic criteria. A control group of non-bruxer subjects with demographic characteristics similar to the study group was considered. Each participant underwent Modjaw^® examination twice to assess the recordings’ repeatability. The anterior guidance, mastication, and simulated eccentric bruxism were recorded. The SCI and BA were computed. The trajectories of interincisal inferior point (IIP), left condyle (LC), and right condyle (RC) in the frontal (F), sagittal (S), and horizontal (H) planes were outlined in rectangles to calculate areas of mastication and areas of eccentric bruxism (mm²). Intraclass correlation coefficient (ICC) was used to assess the recordings’ repeatability. Comparisons between groups were performed using Student’s t- and Mann–Whitney tests. The receiver–operator characteristic (ROC) curve was used to assess the diagnostic quality of the digital method. Results: Twenty bruxers (10 F and 10 M) and 20 non-bruxers (10 F and 10 M) were included. The ICC had values higher than 0.85. SCI, BA, and area of mastication for IIP, LC, and RC were similar between the groups (p > 0.05). The area of eccentric bruxism was significantly wider in the bruxers (p < 0.001). According to the ROC curve, the following cut-off areas (mm²) for eccentric bruxism were found in F, S, and H planes: IIP (18.05, 13.43, 16.28); LC (3.74, 10.83, 3.35); and RC (4.21, 10.63, 2.9), corresponding to sensitivity > 0.8, specificity > 0.75 and area under the curve (AUC) > 0.85. Conclusions: Mandibular and condylar kinematics during functional movements were similar in bruxers and non-bruxers. A novel digital method for quantifying eccentric bruxism was found using Modjaw^®, which could serve as a tool for early detection of eccentric bruxism before the onset of clinical consequences. Full article

The purpose of this retrospective study was to analyze changes in the position of the condyles following mandibular setback surgery with manual guidance. The study included 28 patients with mandibular prognathism who underwent mandibular setback surgery using manual guidance with a bioabsorbable mesh for mandibular fixation, and changes in the position of the center of the condylar head were compared at three time points: before surgery (T0), within 1 week after surgery (T1), and 6 months after surgery (T2). The results showed significant lateral, anterior, and inferior movements of the condyle at T1 compared to T0, with an average movement of 0.66 ± 0.84 mm along the x-axis, −1.27 ± 0.82 mm along the y-axis, and −0.20 ± 0.69 mm along the z-axis, with a 1.77 ± 0.87 mm linear distance (p < 0.05). At T2, the condylar position had mainly changed inferiorly along the y-axis (−0.17 ± 0.48 mm) (p < 0.05) compared to that at T0. The change in the position along the x-axis (−0.14 ± 0.57 mm), z-axis (−0.05 ± 0.68 mm), and linear distance (0.85 ± 0.57 mm) at T2 was not significantly different from that in the condylar position at T0 (p > 0.05). The study suggests that significant anterior–lateral–inferior condylar movement occurs within 1 week after mandibular setback surgery using manual guidance, but the condyle returns to its original position over time, which is clinically acceptable. Full article

The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types of CGV measurement protocols—articulators (both arcon and non-arcon) and panoramic radiographs. Additionally, it attempts to determine which of the mentioned methods performs better across several parameters. Several important web databases were searched using search terms derived from medical subject headings (MeSH), using keywords linked to “Arcon articulator”, “Condylar guidance angle”, “non-arcon articulator”, “Panoramic x-ray” and “Radiographic examination”, which constituted the first step in the study selection strategy. After completion, the search strategy which initially turned up to 831 papers, eventually ended up with 13 studies. The review and subsequent meta-analysis revealed that panoramic radiographs had noticeably greater efficacy in terms of the CGVs as compared to the articulators in the majority of the studies. Within the articulators, the arcon types recorded slightly higher CGVs than the non-arcon variety owing to the precision of jaw movement simulation in the former. However, further studies are required to validate these findings and establish more precise guidelines for the use of CGV measurement protocols in prosthodontic practice. Full article

Objective. To investigate the influence of endogenous and exogenous neuroendocrine analogues on the range and motion of jaw movement, mandibular growth, and factors affecting condylar guidance in patients with temporomandibular joint disorders using clinical assessment and radiographic imaging. Material and Methods. Eligible articles were extracted from eleven databases in early 2023 and screened following PRISMA protocols. Certainty of evidence and potential biases were assessed using the GRADE approach. Results. Nineteen articles were screened, with four deemed to be of high quality, eight of moderate quality, and the remaining seven of low to very low quality. Corticosteroids improve maximal incisal opening but not TMJ disorder symptoms. Higher doses worsen jaw movement and cause osseous deformity. Growth hormone affects occlusal development, and delayed treatment affects arch width. Sex hormone correlation with TMJ disorder is complex, with some studies showing a correlation between menstrual cycle phases and pain/limited mobility. Conclusions. The evaluation of neuroendocrine influencers in relation to jaw movement in patients with temporomandibular joint disorders involves the complex interplay of potentially confounding factors that each require careful consideration to ensure accurate diagnoses and evaluations. Full article

A complex prosthodontic treatment is believed to be more successful when the condylar path is replicated using the articulator. However, there is an ongoing major disagreement between the researchers as the exact relationship between the posterior and anterior determinants has not been clear. The purpose of this study was to investigate whether the protrusive movement of the mandible does correlate with the temporomandibular joint (TMJ) anatomy or with incised features. Subjects (15 males and 15 females) were qualified for this study based on an initial interview including the following criteria: age 21–23 (+/−1), no history of trauma, orthodontic treatment, or temporomandibular disorders (TMD). For each patient, the angle of the condylar path, incisal guidance angle (IGA), interincisal angle, as well as overbite and overjet were measured on cone beam computed tomography (CBCT). This was followed by the examination with the Modjaw^® electronic axiograph recording and calculating the functional sagittal condylar guidance angle (SCGA) for the right and left TMJ during the protrusion. The results show that the mean functional axiographic measurement of SCGA in protrusion significantly correlates with the TMJ anatomy presented on CBCT. Moreover, a significant correlation was found between the values of SCGA in the functional and anatomical measurements in all its variants. It turned out that, statistically, the AB measurement was the most accurate. Finally, results showed that incisal relationships of permanent teeth such as overbite, overjet, incisal guidance angle and interincisal angle do not correlate with TMJ anatomy, and therefore, regarding an analyzed study group, do not affect the TMJ formation in young adults. Full article

This case report describes a 70 year-old man with IVA lung cancer who required oral function rehabilitation by fabricating dentures with a simplified clinical remount technique. A pair of dentures were fabricated for a 70-year-old man with stage IVA lung cancer. Due to severe bimaxillary exostoses, the dentures could not properly extend and achieve a peripheral seal. The treatment philosophy was to stabilize the dentures and achieve proper function with optimized occlusion. The simplified Lauritzen clinical remount technique was performed at the time of denture delivery and 3 months later. After the second clinical remount procedure, the patient was able to eat meals with the dentures and maintained in a stable condition. Compared with the original technique, the simplified Lauritzen clinical remount omits the facebow transfer and keeps the condylar guidance setting and the Bennett angle unchanged during the adjustment. The prostheses are mounted to a type 3, non-arcon type articulator with anterior stop screws attached to the bilateral condylar parts. With the aid of anterior stop screws, the eccentric movement of dentures can be differentiated on a millimeter scale and balanced easily. It is effective to use occlusal-optimized dentures and the clinical remount technique, especially in difficult cases. Full article

Endoscope-assisted treatment of mandibular condylar fractures is an evolving surgical technique of this controversial subject. The approach is performed through an intraoral and additional submandibular incision. This study presents a technique for minimizing the length of the optional submandibular incision. Ten patients with displaced subcondylar fractures andmalocclusion underwent endoscope-assisted open reduction and internal fixation (ORIF). A limited (<1 cm) submandibular incision (dissected under endoscopic guidance from within) was needed in eight patients to complement the intraoral incision and facilitate the reduction in the fractures. Satisfactory small scar could be obtained in all patients with neither wound complications nor facial nerve injuries. Our technique depends on dissection first then incision. Performing the external incision after complete intraoral dissection is safe for the facial nerve and minimizes scarring markedly. This very limited submandibular incision facilitates reduction in relatively difficult cases and enables clear visualization of posterior border of the mandible to confirm adequate fracture reduction. Full article