ABSTRACT
The masticatory system constitutes four closely interrelated components: Teeth, muscles, nerves, and temporomandibular joints (TMJ). The stable and physiologic rest position of the TMJ is based on the muscle guidance (mainly masticatory, and partially facial), neurally determined and controlled occlusion, integrated together with its peripheral proprioceptors and relax mechanism of the central nervous system. Oral rehabilitation procedures should emphasize on a holistic approach to establish a physiologic relationship of the lower jaw to the base of the cranium resulting in a neuromuscular rest position. This position then would support an occlusion for the stability of the TMJ, the masticatory muscles of the orofacial region and the teeth along with their supporting periodontium. Such a holistic approach becomes more important in cases where the patient not only requires oral rehabilitation but also presents with related TMJ problems. This is a case report where an attempt is made to rehabilitate a patient in a neuromuscular rest position by establishing a myocentric relation.
ABSTRACT
STATEMENT OF PROBLEM: The accuracy and reliability of the methods used for programming the semi-adjustable articulators determine the accuracy in occlusion. The current recommended average settings using the Hanau's formula commonly used by clinicians is questionable, and thus reassessment is needed. This study was carried out to evaluate and compare the lateral condylar guidance: (1) Using the Hanau's formula and the computerized jaw tracking device (Kinesiograph). (2) On the right and left sides using both these methods. MATERIALS AND METHODS: A total of 20 completely edentulous patients (14 male and 6 females) within 40-60 years of age were selected. Jaw relation was recorded followed by face bow transfer. Extraoral Gothic arch tracing was recorded; three protrusive records were obtained and condylar guidance was calculated. Lateral condylar guidance was then calculated using Hanau's formula, followed by the computerized jaw tracking device. A comparative evaluation was done of the obtained values. The same investigator worked with each of the study participants for the purpose of standardization. RESULTS: The lateral condylar guidance values obtained using the Hanau's formula ranged from 14 to 17° while those obtained using the computerized K7 jaw tracking device ranged from 8 to 40°. Bennett angle values, obtained using the jaw tracking device and Hanau's formula showed statistically significant differences (P < 0.05) using paired t-test (at 95% confidence interval). Bennett angle values of the right and left sides found using the Hanau's formula were almost similar. Difference in the Bennett angle values of the right and left sides were found using the jaw tracking device. However, this difference was not statistically significant (P > 0.05). CONCLUSION: Based on the results, dentist and dental technicians should consider reassessing the current recommended average settings and use of the Hanau's formula for programming the semi-adjustable articulators.
ABSTRACT
The loss of teeth and their replacement by artificial denture is associated with many problems. Pre-prosthetic surgical procedures are performed to provide a better anatomic environment and to create proper supporting structures for construction of dentures. Whenever inadequate vestibular depth is present in edentulous mouth, deepening of vestibule is considered to increase the retention and stability of denture. Deepening of vestibule without any addition of the bone is termed as vestibuloplasty. This article describes the ease and convenience of vestibuloplasty followed by the use of Bhawsar-Karandikar stent to maintain the soft tissue modifications. The study yielded promising results and patient acceptance.
