Journal of Clinical Medicine

Research

12 pages, 3822 KiB

Open AccessArticle

A New Mechanical Mouth Opener for Dynamic Magnetic Resonance Imaging of the Temporomandibular Joint

by Milica Jeremic Knezevic, Aleksandar Knezevic, Jasmina Boban, Aleksandra Maletin, Bojana Milekic, Daniela Djurovic Koprivica, Ivana Mijatov and Tatjana Puskar

J. Clin. Med. 2023, 12(15), 5035; https://doi.org/10.3390/jcm12155035 - 31 Jul 2023

Cited by 1 | Viewed by 1394

Abstract

(1) Background: During the magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ), it is necessary to scan the joints in the closed- and open-jaw position, as well as in the maximally open-jaw position. In order to examine both joints in these positions, [...] Read more.

(1) Background: During the magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ), it is necessary to scan the joints in the closed- and open-jaw position, as well as in the maximally open-jaw position. In order to examine both joints in these positions, an MRI compatible mouth opener is required, which allows the articular surfaces to maintain their position stably. (2) Methods: In this study, we included 200 patients aged 18 to 65, with various levels of clinical severity. The mouth opener is made of polymethyl methacrylate and used for dynamic imaging of TMJ. It is in the form of an arrow, with incisures on upper and lower surfaces 1 mm apart and these match possible variations in jaw opening. All the patients were scanned with mouth opener and, immediately after this scanning, with syringe (20 ccm) as a standard device used for mouth opening in clinical setting. (3) Results: A total of 200 MR examinations of TMJs were performed and the mechanical mouth opener was successfully applied without artifacts in all patients. The mouth opener device proved to be adequate in case of MRI of the TMJ for different ranges of mouth opening with the proper protocol for provoked imaging, because the incisures are located at a distance of 1 mm and no objective artifacts were observed in any examination that degraded the diagnostic quality of the examination. (4) Conclusions: The design of the acrylate mouth opener is precisely defined, and it has a purpose in the MRI diagnosis of TMJ disorders. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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21 pages, 9486 KiB

Open AccessArticle

Occlusal Changes with Clear Aligners and the Case Complexity Influence: A Longitudinal Cohort Clinical Study

by Vanessa Marcelino, Sofia Baptista, Sandra Marcelino, Maria Paço, Duarte Rocha, Maria dos Prazeres Gonçalves, Rui Azevedo, António Sérgio Guimarães, Gustavo Vicentis Oliveira Fernandes and Teresa Pinho

J. Clin. Med. 2023, 12(10), 3435; https://doi.org/10.3390/jcm12103435 - 12 May 2023

Cited by 8 | Viewed by 2647

Abstract

Background: Clear aligners (CA) are used 22 h daily, creating a bite-block effect. This work aims to (i) analyze occlusal changes before the beginning of treatment, after the first set of CA and after the use of additional aligners; (ii) compare planned occlusal [...] Read more.

Background: Clear aligners (CA) are used 22 h daily, creating a bite-block effect. This work aims to (i) analyze occlusal changes before the beginning of treatment, after the first set of CA and after the use of additional aligners; (ii) compare planned occlusal contacts with the ones obtained after the first set of CA; (iii) analyze the occlusal changes occurred after reaching the orthodontic goals after 3 months of using CA only at night; (iv) evaluate and characterize which tooth movements did not allow the treatment to be completed at the end of the first set of aligners, and finally (v) verify the possible relation between the changes in occlusal contact and areas and parameters such as case complexity and facial biotype. Materials and Methods: A quantitative, comparative, and observational longitudinal cohort study design was implemented to evaluate the clinical data and the complexity levels of cases receiving CA. A non-probabilistic and convenience sample of 82 individuals was recruited. The orthodontic malocclusion traits were classified as simple, moderate, or complex corrections based on the basis of the Align^® recommendations with the Invisalign^® evaluation tool. According to the Invisalign^® criteria, patients need only one complex problem for their case to be classified as complex. Meshlab^® v. 2022.02, ClinCheck^® version Pro 6.0, My-Itero^® version 2.7.9.601 5d plus, and IBM^® SPSS Statistics software (Statistical Program for Social Sciences), version 27.0 for Windows were the software^® used. Results: A statistically significant decrease in area and occlusal contacts number were observed from before the start of orthodontic treatment (T0) to the end of treatment (T1). The changes in the occlusal area (from T0 to T1) were statistically different between hyperdivergent (28.24 [15.51–40.91]) and hypodivergent (16.23 [8.11–24.97]) biotypes (p = 0.031). A significant difference between the hyperdivergent (4.0 [2.0–5.0]) and normodivergent (5.5 [4.0–8.0]) group was found in T1 for the anterior contacts (p = 0.044). Anterior contacts obtained were significantly higher than the planned (p = 0.037) Between T1 and T2 statistically significant increases of occlusal areas, posterior and total contacts were observed. Conclusions: Occlusal contact and area were decreased, either at the end of the first set or after the use of additional aligners. Anterior occlusal contacts obtained were higher than planned as opposed to posterior occlusal contacts obtained. The hardest tooth movements to achieve to complete the treatment were distalization, rotation, and posterior extrusion. After completing orthodontic treatment (T1) to 3 months after (T2) using additional aligners only at night, posterior occlusal contacts were significantly increased, which could be due to the natural settling of the teeth in this period. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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15 pages, 2833 KiB

Open AccessArticle

A Comparative Study of Temporomandibular Joints in Adults with Definite Sleep Bruxism on Magnetic Resonance Imaging and Cone-Beam Computer Tomography Images

by Juan Zhang, Wenjuan Yu, Jianghong Wang, Sijia Wang, Yifan Li, Huimin Jing, Zekui Li, Xin Li, Meng Liang and Yonglan Wang

J. Clin. Med. 2023, 12(7), 2570; https://doi.org/10.3390/jcm12072570 - 29 Mar 2023

Cited by 4 | Viewed by 1857

Abstract

Objective: The aim was to study the imaging characteristics of the temporomandibular joint (TMJ) of definite sleep bruxers through magnetic resonance imaging (MRI) and cone-beam computer tomography (CBCT). Methods: Nineteen definite sleep bruxers diagnosed by polysomnography and twenty asymptomatic non-bruxers matched by age, [...] Read more.

Objective: The aim was to study the imaging characteristics of the temporomandibular joint (TMJ) of definite sleep bruxers through magnetic resonance imaging (MRI) and cone-beam computer tomography (CBCT). Methods: Nineteen definite sleep bruxers diagnosed by polysomnography and twenty asymptomatic non-bruxers matched by age, gender, and education level participated in this study. After obtaining MRI and CBCT images of all TMJs of the subjects, evaluation and measurement were conducted, respectively. The analyzed parameters included disc position, disc configuration, joint effusion (JE), joint space or condyle position, and condylar bony changes. Results: Of the 38 joints in the study group, disc deformity and disc displacement of TMJs were both 57.9% when the mouth was closed, and 76.3% showed condylar bony changes, while when the mouth was open, 82% of all TMJs showed physiological biconcave discs. Comparison of joint space revealed that the anterior space was larger in the study group. There was no significant difference between the mild and the moderate to severe sleep bruxism subgroups in the changes of TMJ. Conclusion: The results demonstrated that a higher prevalence of disc deformity, disc displacement, JE, and condylar bony changes occurred in temporomandibular joints of sleep bruxers. These changes were not related to the severity of sleep bruxism. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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10 pages, 718 KiB

Open AccessArticle

Impact of Acrylic and Silicone-Based Soft-Liner Materials on Biting Force and Quality of Life of the Complete Denture Wearers: A Randomized Clinical Trial

by Ahmed Yaseen Alqutaibi, Ahmad A. Alnazzawi, Ahmed E. Farghal, Ramy M. Bakr and Ihab Ismail Mahmoud

J. Clin. Med. 2023, 12(5), 2073; https://doi.org/10.3390/jcm12052073 - 6 Mar 2023

Cited by 5 | Viewed by 2226

Abstract

This rerandomized clinical trial evaluated the influence of soft liners (SL) on biting force, pain perception, and the oral health-related quality of life (OHRQoL) of complete denture wearers. Twenty-eight completely edentulous patients complaining of ill-fitting lower complete dentures were selected to participate in [...] Read more.

This rerandomized clinical trial evaluated the influence of soft liners (SL) on biting force, pain perception, and the oral health-related quality of life (OHRQoL) of complete denture wearers. Twenty-eight completely edentulous patients complaining of ill-fitting lower complete dentures were selected to participate in the study from the Dental Hospital, College of Dentistry, Taibah University. All patients received new complete maxillary and mandibular dentures; then they were randomly divided into two groups (14 patients in each group): the acrylic-based SL group, in which the mandibular denture was lined with an acrylic-based soft liner, and the silicone-based SL group, in which the mandibular denture was lined with a silicone-based soft liner. OHRQoL and maximum bite force (MBF) were assessed in this study before denture relining (baseline), then at one month and three months after relining. The finding showed that both treatment modalities significantly improved the OHRQoL of included patients at one-month and three-month periods compared to baseline records (i.e., dentures before relining) with a statistically significant difference (p < 0.05). However, there is no statistical difference between groups at the baseline, one-, and three-month follow-up periods. Regarding maximum biting force, when acrylic-based SL is compared to silicone-based SL, there is no statistical difference between groups at baseline (75 ± 31 and 83 ± 32 N) and one-month follow-up periods (145 ± 53 and 156 ± 49 N); however, after three months of function, the silicone-based group recorded 166 ± 57 N statistically significant high biting force compared to the acrylic-based group that recorded 116 ± 47 N (p < 0.05). Permanent soft denture liners positively affect maximum biting force, pain perception, and OHRQoL more than conventional dentures. After three months, silicone-based SL outperformed acrylic-based soft liners in maximum biting force, which may indicate better long-term results. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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12 pages, 1400 KiB

Open AccessArticle

A CBCT Investigation of the Sella Turcica Dimension and Sella Turcica Bridging in Different Vertical Growth Patterns

by Shiyi Yan, Sheng Huang, Zuping Wu, Ying Liu, Yanling Men, Xiuping Nie and Jie Guo

J. Clin. Med. 2023, 12(5), 1890; https://doi.org/10.3390/jcm12051890 - 27 Feb 2023

Cited by 4 | Viewed by 2146

Abstract

This study aimed to compare the sella turcica dimensions and sella turcica bridging (STB) via cone-beam computed tomography in different vertical patterns and then analyze the link between the sella turcica and vertical growth patterns. The CBCT images of 120 skeletal Class I [...] Read more.

This study aimed to compare the sella turcica dimensions and sella turcica bridging (STB) via cone-beam computed tomography in different vertical patterns and then analyze the link between the sella turcica and vertical growth patterns. The CBCT images of 120 skeletal Class I subjects (an equal proportion of females and males; mean age of 21.46 years) were divided into three vertical growth skeletal groups. Student’s t tests and Mann–Whitney U tests were used to assess the possible diversity in genders. The link between sella turcica dimensions and different vertical patterns was explored by one-way analysis of variance, as well as Pearson and Spearman correlation tests. The prevalence of STB was compared using the chi-square test. Sella turcica shapes were not linked to gender, but statistical differences were observed among different vertical patterns. In the low-angle group, a larger posterior clinoid distance and smaller posterior clinoid height, tuberculum sellae height, and dorsum sellae height were determined, and the incidence of STB was higher (p < 0.01). Sella turcica shapes were linked to vertical growth patterns, mainly involving the posterior clinoid process and STB, which could be used as an index to assess vertical growth trends. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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10 pages, 2601 KiB

Open AccessArticle

Analysis of the Curative Effect of Temporomandibular Joint Disc Release and Fixation Combined with Chitosan Injection in the Treatment of Temporomandibular Joint Osteoarthrosis

by Chuan-Bin Wu, Hai-Jiang Sun, Ning-Ning Sun and Qing Zhou

J. Clin. Med. 2023, 12(4), 1657; https://doi.org/10.3390/jcm12041657 - 19 Feb 2023

Cited by 3 | Viewed by 1852

Abstract

Objective: Temporomandibular joint osteoarthritis (TMJ-OA) is common in clinic. The purpose of this study was to evaluate the efficacy of disc release, fixation and chitosan injection in the treatment of TMJ-OA. Methods: From March 2021 to March 2022, 32 patients who underwent the [...] Read more.

Objective: Temporomandibular joint osteoarthritis (TMJ-OA) is common in clinic. The purpose of this study was to evaluate the efficacy of disc release, fixation and chitosan injection in the treatment of TMJ-OA. Methods: From March 2021 to March 2022, 32 patients who underwent the unilateral reduction and fixation of temporomandibular joint disc release were retrospectively studied. All patients were diagnosed with TMJ-OA and were treated with chitosan injection. This group of patients was analyzed by the visual analog scale (VAS) for pain and improvement of maximum comfortable mouth opening before treatment and 6 months after treatment. A paired t-test was used to evaluate the treatment effect, and p < 0.05 indicated that the difference was statistically significant. Results: All 32 patients were successfully treated by surgery and chitosan injection in the second week after operation. The duration of disease in this group ranged from 1 to 10 months, with an average of 5.7 months. After 6 months of follow up, 30 patients were satisfied with the treatment and two were unsatisfied. The difference in the treatment effect was found to be statistically significant (p < 0.05). Conclusions: Temporomandibular joint disc release and fixation combined with chitosan injection is effective in the treatment of TMJ-OA. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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11 pages, 261 KiB

Open AccessArticle

Orofacial Pain, Musical Performance and Associated Coping Behaviors, Psychological Distress and Disability among Asian Young Adults

by Rahul Nair, Chihiro Tanikawa and Joao N. Ferreira

J. Clin. Med. 2023, 12(4), 1271; https://doi.org/10.3390/jcm12041271 - 6 Feb 2023

Cited by 5 | Viewed by 1647

Abstract

Musicians often report orofacial pain (OFP) and performance-related psychological distress related to occupational neuromuscular overuse, but to date, no study has been performed in Asian musicians to assess these factors. This study evaluated OFP, psychological distress, coping behaviors, and disability among Asian musical [...] Read more.

Musicians often report orofacial pain (OFP) and performance-related psychological distress related to occupational neuromuscular overuse, but to date, no study has been performed in Asian musicians to assess these factors. This study evaluated OFP, psychological distress, coping behaviors, and disability among Asian musical performers. A total of 201 participants in Singaporean music ensembles were surveyed from which 159 met the inclusion criteria for vocalists or instrumentalist musicians (mean age 20.26 ± 2.20 years). Self-administered questionnaires assessed musical practices, jaw/neck pre-conditioning exercises, pain-related temporomandibular disorders (TMD), OFP descriptors, pain chronicity and disability, coping behaviors and psychological distress. Univariate and multi-variate analyses were carried out. OFP, while performing, was more than two-fold higher in instrumentalists when compared to vocalists (41.4–48% vs. 17.2%, p = 0.002). A similar trend occurred for OFP that progresses while playing (p = 0.035) and for persistent OFP that reduces playing (p = 0.001). There were no differences in psychological distress, pain coping and disability between groups. Vocalists were found to practice jaw/neck pre-conditioning exercises more frequently (75% vs. 4–12.9% in instrumentalists, p < 0.0001). While performing, Asian vocalists reported less OFP when compared to instrumentalists. Future prospective studies are needed to confirm if pre-conditioning exercises play a protective role against OFP in vocalists. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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14 pages, 2877 KiB

Open AccessArticle

Craniofacial Morphology of Temporomandibular Disorder Patients with Different Disc Positions: Stratifying Features Based on Sex and Sagittal Skeletal Pattern

by Chengxinyue Ye, Peidi Fan, Jie Zhang, Qiaoyu Cheng, Xin Xiong and Jun Wang

J. Clin. Med. 2023, 12(2), 652; https://doi.org/10.3390/jcm12020652 - 13 Jan 2023

Cited by 5 | Viewed by 2204

Abstract

Disc displacement (DD) appears in the majority of temporomandibular disorder (TMD) patients. The correlation between craniofacial morphology and different disc positions has been underlined, while the craniofacial morphological differences based on sex and sagittal skeletal pattern stratification have been insufficiently studied. In this [...] Read more.

Disc displacement (DD) appears in the majority of temporomandibular disorder (TMD) patients. The correlation between craniofacial morphology and different disc positions has been underlined, while the craniofacial morphological differences based on sex and sagittal skeletal pattern stratification have been insufficiently studied. In this study, 304 patients with TMD complaints were included and classified into normal position, disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR) groups according to magnetic resonance imaging. A total of 24 cephalometric measurements, covering the cranial base, vertical relationship, sagittal relationship, mandible position and morphology, and dental relationship, were assessed using lateral cephalograms. A stratified analysis was performed based on the sex and sagittal skeletal pattern. Overall, DD patients had distinctive craniofacial morphological features. The posterior cranial base length and mandibular arc angle were statistically different only in females, while the Y-axis angle, occlusal plane angle and sella nasion point A angle (SNA) might be unique features in males. Skeletal class II had the most statistically different measurements compared to the others. Differences in the Frankfort mandibular incisor angle (FMIA) and saddle angle were especially displayed in skeletal class III patients. The sex and skeletal sagittal pattern could affect the morphological differences in TMD patients with different disc positions. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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11 pages, 781 KiB

Open AccessArticle

Association between Psychological Status and Condylar Bony Changes in Adults: A Retrospective Survey-Based Study

by Chenghao Zhang, Ling Ji, Zhihe Zhao and Wen Liao

J. Clin. Med. 2022, 11(24), 7497; https://doi.org/10.3390/jcm11247497 - 17 Dec 2022

Viewed by 1417

Abstract

Background: This article studies the association between psychological status and condylar bony changes in adults and assesses psychological questionnaires as an indicator of potential condylar bony changes. It is meaningful because condylar bony changes, a severe subtype of TMD and big concern in [...] Read more.

Background: This article studies the association between psychological status and condylar bony changes in adults and assesses psychological questionnaires as an indicator of potential condylar bony changes. It is meaningful because condylar bony changes, a severe subtype of TMD and big concern in orthodontic treatment, would likely be ignored in patients with few TMD symptoms, in which case, even with potential psychological problems (depression, somatization and anxiety) being noticed, orthodontists may underestimate the possibility or severity of condylar bony changes and thus may not perform relevant examinations. Methods: A total of 195 adults (145 female and 50 male) who consulted orthodontists and had clinical records were included in this study. Initial CBCT images taken before orthodontic treatment were used for observing their condylar bony changes, and a comprehensive questionnaire conducted by each adult to evaluate psychological status was collected. Age, sex, TMD symptom history, scores on Patient Health Questionnaire-9 (PHQ-9), PHQ-15 and Generalized Anxiety Disorder-7 (GAD-7), and condylar bony changes of these adults were recorded. Odds ratios (OR) and 95% confidence intervals (CIs) for identifying the independent risk factors associated with condylar bony changes were calculated with univariate and multivariate logistic regression analysis. The kappa statistic was used to assess intraobserver reliability of CBCT analysis. Results: The scores of PHQ-15 (OR: 2.088, 95% CI: 1.061–4.108, p < 0.05) and GAD-7 (OR: 2.133, 95% CI: 1.082–4.204, p < 0.05) were correlated with the condylar bony changes on CBCT. Besides, the probability of having condylar bony changes was positively correlated with the number of psychological problems concomitantly present in an adult (OR: 1.440, 95% CI: 1.10–1.867, p < 0.01). The intraobserver agreement value for CBCT analysis was substantial (κ = 0.732). Conclusions: This study found that positive PHQ-15 (somatization) and GAD-7 (anxiety) scores were associated with condylar bony changes in adults. Moreover, the number of psychological problems concomitantly present in an adult was positively associated with the probability of having condylar bony changes. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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12 pages, 3151 KiB

Open AccessArticle

Effect of Scanning Origin Location on Data Accuracy of Abutment Teeth Region in Digital Impression Acquired Using Intraoral Scanner for Removable Partial Denture: A Preliminary In Vitro Study

by Eung-Yeol Kim, Junichiro Wada, Kazuki Sakamoto, Yurika Ishioka, Yuki Arai, Natsuko Murakami, Toshiki Yamazaki, Hironari Hayama, Miona Utsumi, Shusuke Inukai and Noriyuki Wakabayashi

J. Clin. Med. 2022, 11(24), 7392; https://doi.org/10.3390/jcm11247392 - 13 Dec 2022

Cited by 3 | Viewed by 2186

Abstract

The aim of this study was to investigate the effect of scanning origin location on the data accuracy of removable partial denture (RPD) abutment teeth region in digital impressions acquired by an intraoral scanner. A mandibular partially edentulous model including the following target [...] Read more.

The aim of this study was to investigate the effect of scanning origin location on the data accuracy of removable partial denture (RPD) abutment teeth region in digital impressions acquired by an intraoral scanner. A mandibular partially edentulous model including the following target abutment teeth was used: the left second molar (#37); left first premolar (#34); and right second premolar (#45). The following scanning strategies were tested: the strategy starting from #37 to mesial direction (37M); strategies starting from #34 to mesial (34M) and distal directions (34D), and strategies starting from #45 to mesial (45M) and distal directions (45D). The evaluated measures were trueness, precision, and linear accuracy. One-way and two-way ANOVA were performed for the comparison of trueness and linear accuracy, while Kruskal–Wallis test was performed for the precision comparison (α = 0.05). 45M and 45D showed significantly superior trueness of #34 to 37M and 34D. 45M also showed significantly superior trueness of #45 to 34. 45D showed significantly inferior linear accuracy of #34 and superior linear accuracy of #45 compared to other strategies. It was concluded that scanning origin location would have an impact on data accuracy of RPD abutment teeth region in digital impressions acquired by intraoral scanner. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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14 pages, 2366 KiB

Open AccessArticle

Nonlinear Relationship between Temporomandibular Joint Disc Displacement Distance and Disc Length: A Magnetic Resonance Imaging Analysis

by Qinlanhui Zhang, Zheng Ye, Yange Wu, Yufan Zhu, Jiaqi Liu, Wenke Yang, Chengxinyue Ye, Sophie Lau Rui Han, Jun Wang and Xin Xiong

J. Clin. Med. 2022, 11(23), 7160; https://doi.org/10.3390/jcm11237160 - 1 Dec 2022

Cited by 4 | Viewed by 1945

Abstract

Objective: to explore the association between the distance of disc displacement and disc morphology in patients with temporomandibular disorders (TMDs). Methods: a total of 717 joints in 473 subjects were enrolled in this cross-sectional study. The magnetic resonance imaging (MRI) of each patient [...] Read more.

Objective: to explore the association between the distance of disc displacement and disc morphology in patients with temporomandibular disorders (TMDs). Methods: a total of 717 joints in 473 subjects were enrolled in this cross-sectional study. The magnetic resonance imaging (MRI) of each patient was evaluated for temporomandibular joint (TMJ) disc morphology classification and position. The distance of the disc displacement and disc length were measured for smoothing spline prediction. A stratified analysis was performed based on the types of disc positions. The disc width and length-width ratio (L/W) were also measured. Descriptive statistics, one-way analysis of variance, smoothing spline analysis, threshold analysis, and two piecewise linear regression were performed to investigate the association between the displacement distance and length of discs. Results: the differences in displacement distance among morphological categories and among different disc positions were statistically significant. Nonlinear relationships were found between distance and length in all subjects. Two turning points of distance (−1.8 mm and 1.7 mm) were found, dividing the curve into three segments. Disc width and L/W were significantly different among discs in the three segments of the curve. The correlation coefficient (β) for the three segments were as follows: −0.6 [95% confidence interval (CI) = −0.9 to −0.3, p < 0.001], 0.0 (95% CI = −0.1 to 0.0, p = 0.027), and −0.7 (95% CI = −0.8 to −0.7, p < 0.001). Nonlinear relationships were also found between the distance and length in cases with anterior disc displacement (ADD), anterior disc displacement with reduction (ADDWR), and without reduction (ADDWoR). Conclusion: the turning points of the disc displacement distance may be considered as a potential reference value for high-risk disc deformation and ADD. Disc length decreases sharply with anterior disc displacement when the disc displacement distance is over 1.7 mm. Prospective and long-term studies are required to clarify the natural course of the disc at different stages of the regression curve. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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13 pages, 2194 KiB

Open AccessArticle

Retrospective 1- to 8-Year Follow-Up Study of Complete Oral Rehabilitation Using Monolithic Zirconia Restorations with Increased Vertical Dimension of Occlusion in Patients with Bruxism

by Shlomo Matalon, Hadas Heller, Ilan Beitlitum, Evgeny Weinberg, Alona Emodi-Perlman and Shifra Levartovsky

J. Clin. Med. 2022, 11(18), 5314; https://doi.org/10.3390/jcm11185314 - 9 Sep 2022

Cited by 2 | Viewed by 2176

Abstract

Aim: The aim of this paper is to perform a retrospective assessment of the clinical performance of the complete oral rehabilitation of patients with bruxism treated with implants and teeth-supported veneered and non-veneered monolithic zirconia restorations with increased occlusal vertical dimension. Methods: In [...] Read more.

Aim: The aim of this paper is to perform a retrospective assessment of the clinical performance of the complete oral rehabilitation of patients with bruxism treated with implants and teeth-supported veneered and non-veneered monolithic zirconia restorations with increased occlusal vertical dimension. Methods: In this retrospective follow-up study, 16 bruxer patients, mean age 59.5 ± 14.9 years, were treated with 152 veneered and 229 non-veneered monolithic zirconia and followed for a mean of 58.8 ± 18.8 months (range 1–8 years). The patients were examined clinically and radiographically, annually. Clinical data were extracted from the medical records. In the recall appointments, modified California Dental Association (CDA) criteria were used to evaluate the restorations. Implant and restoration survival and success rates were recorded and analyzed. Results: The cumulative survival rates of implants and restorations were 97.7% and 97.6%, respectively. Nine restorations were replaced: three due to horizontal tooth fractures, two because of implant failure and four had secondary caries. A total of 43 biologic and technical complications were recorded. In the veneered group, the predominant complication was minor veneer chipping (16.4%), which required polishing only (grade 1). In the non-veneered group, the main complication was open proximal contacts between the implant restorations and adjacent teeth (14.5%). Conclusions: The survival rates of restorations and implants in patients with bruxism are excellent, even though veneered zirconia restoration exhibited a high rate of minor veneer chipping, which required polishing only. The biologic complication of fractured single-tooth abutment may occur. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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Review

Jump to: Research, Other

11 pages, 610 KiB

Open AccessReview

Pain Relief in Dental Local Anaesthesia with Vibrational Devices: Much Ado about Nothing? A Scoping Review

by Alessandra Putrino, Maria Rosaria Abed, Enrico Marinelli and Simona Zaami

J. Clin. Med. 2023, 12(4), 1448; https://doi.org/10.3390/jcm12041448 - 11 Feb 2023

Cited by 1 | Viewed by 1810

Abstract

In recent years, vibrational devices have been introduced in order to reduce patient discomfort in some situations such as orofacial pain, orthodontic therapy, and injection of local anaesthetics. This article aims to review the clinical experience given by the use of these devices [...] Read more.

In recent years, vibrational devices have been introduced in order to reduce patient discomfort in some situations such as orofacial pain, orthodontic therapy, and injection of local anaesthetics. This article aims to review the clinical experience given by the use of these devices in local anaesthesia. The literature search was carried out on the main scientific databases for articles up to November 2022. Eligibility criteria were established, and pertinent articles selected. The results were classified by author, year, type of study, sample size and characteristics, purpose of use, type of vibrational device used, protocol used, and outcomes. Nine relevant articles were found. These are split mouth randomized clinical trials which evaluate the reduction in pain perception with different devices and different protocols of use in children, during procedures which require local analgesia by injection, compared with traditional local anaesthesia with premedication based on anaesthetic gels. Different objective and subjective scales of pain and discomfort perception were used. Although results are promising, some data, such as those relating to vibrational intensity and frequency, are not clear. Evaluations on samples varying by age and context of use are necessary to fully define the indications for this type of aid during oral rehabilitation procedures. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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Other

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19 pages, 8360 KiB

Open AccessCase Report

Invisalign Treatment of a Three-Year-Old Child with Bilateral Posterior Scissor Bite and Multisite Upper Airway Obstruction: A Case Report

by Yilin Xin, Hongling Zhou, Yifan Zhao and Lixing Zhao

J. Clin. Med. 2023, 12(1), 333; https://doi.org/10.3390/jcm12010333 - 1 Jan 2023

Cited by 1 | Viewed by 4519

Abstract

Background: Scissor bites have been reported in relatively few epidemiological studies because of their extremely low prevalence rate (below 1%). The etiology of scissor bites remains obscure, but its impact on growth and function should not be ignored. Methods: In this case report, [...] Read more.

Background: Scissor bites have been reported in relatively few epidemiological studies because of their extremely low prevalence rate (below 1%). The etiology of scissor bites remains obscure, but its impact on growth and function should not be ignored. Methods: In this case report, a novel treatment that utilizes Invisalign aligners was performed on a 3-year-old child who presented with a bilateral posterior scissor bite and anterior crossbite, accompanied by multisite obstruction in the upper airway. The aligners functioned as occlusion pads to unlock the scissor bite relationship and combined with cross-traction to narrow the maxillary arch and enlarge the mandibular arch simultaneously. Results: The duration of orthodontic therapy was 28 weeks. A multidisciplinary consultation (orthodontics department, ENT department, and spinal surgery) was conducted and a stable result was achieved. A healthy occlusal relationship, improved dental esthetics and a better lateral profile were eventually obtained. Conclusions: Positive treatment outcomes rely on patients’ good compliance in this case. In addition, we hope that clinicians will consider our situation in terms of alternative treatments and interprofessional experience. Full article

(This article belongs to the Special Issue Clinical Updates in Oral Rehabilitation)

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