Radiographic signs of excessive occlusal forces are associated with marginal bone loss: a retrospective clinical study.

OBJECTIVES: Work in animal models has implicated excessive occlusal forces and occlusal trauma as co-destructive factors for periodontitis. The main aim of the present study was to make a radiographic assessment of the effects of excessive occlusal forces, ie occlusal/incisal tooth wear, widening of the periodontal space, and the presence of a mandibular torus, on interproximal marginal bone loss in a large series of patients. A secondary aim was to evaluate the statistical correlation between the parameters in two specific teeth and those of 12 teeth for marginal bone loss and six teeth for occlusal/incisal tooth wear within the same individual. METHOD AND MATERIALS: A total of 1,950 full-mouth radiographic surveys were analyzed retrospectively. Interproximal marginal bone loss was quantified relative to the root length (Schei ruler technique). In addition, occlusal/incisal tooth wear and periodontal ligament space widening of the periodontal space were assessed, as well as the presence of a mandibular torus. Odds ratio and logistic regression analysis were used to determine the association between occlusal trauma and marginal bone loss. RESULTS: The correlation of the measured parameters between the values for specific teeth and the whole dentition was evaluated from data from the first 400 radiographs. Teeth 41 and 33 showed the best correlation to the whole dentition: 0.85 for interproximal marginal bone loss, 0.83 for widening of the periodontal space, and 0.97 for occlusal/incisal tooth wear. The results of a logistic regression analysis with age as an independent variable, revealed a significant association between bone loss and both tooth wear (odds ratio = 2.767) and bone loss and widening of the periodontal space (odds ratio = 2.585). CONCLUSION: Tooth wear was positively correlated to both widening of the periodontal space and marginal bone loss. No correlation was found between the presence of a mandibular torus and marginal bone loss.

Mandibular Torus as a New Index of Success for Mandibular Advancement Devices.

BACKGROUND: In obstructive sleep apnoea (OSA), treatment with mandibular advancement devices (MADs) reduces patients' Apnoea-Hypopnoea index (AHI) scores and improves their sleepiness and quality of life. MADs are non-invasive alternatives for patients who cannot tolerate traditional continuous positive airway pressure (CPAP) therapy. The variability of responses to these devices makes it necessary to search for predictors of success. The aim of our study was to evaluate the presence of mandibular torus as a predictor of MAD efficacy in OSA and to identify other potential cephalometric factors that could influence the response to treatment. METHODS: This was a retrospective cohort study. The study included 103 patients diagnosed of OSA who met the criteria for initiation of treatment with MAD. Structural variables were collected (cephalometric and the presence or absence of mandibular torus). Statistical analysis was performed to evaluate the existence of predictive factors for the efficacy of MADs. RESULTS: A total of 103 patients who were consecutively referred for treatment with MAD were included (89.3% men); the mean age of the participants was 46.3 years, and the mean AHI before MAD was 31.4 (SD 16.2) and post- MAD 11.3 (SD 9.2). Thirty-three percent of patients had mandibular torus. Torus was associated with a better response (odds ratio (OR) = 2.854 (p = 0.035)) after adjustment for sex, age, body mass index (BMI; kg/m2), the angle formed by the occlusal plane to the sella-nasion plane (OCC plane to SN), overinjection, and smoking. No cephalometric predictors of efficacy were found that were predictive of MAD treatment success. CONCLUSIONS: The presence of a mandibular torus practically triples the probability of MAD success. This is the simplest examination with the greatest benefits in terms of the efficacy of MAD treatment for OSA.

Association between masticatory muscle activity and oral conditions in young female college students.

The purpose of this study was to determine the characteristics of masticatory muscle activity and various oral condition factors, and to analyze their associations in order to improve the prevention and diagnosis of masticatory muscle-related diseases. This study included 30 Korean females (mean age of 20 years, age range of 19-21 years). Participants were instructed to complete a self-written questionnaire on factors that may affect their muscle activity. Surface electromyography was used to measure the activity of the masseter and temporalis muscles. We also observed the buccal mucosa ridge, tongue indentation, tooth cracks and fractures, and mandibular tori in the oral cavity. Spearman correlation analysis and the nonparametric Mann-Whitney U test were applied to the data. When subjects had temporomandibular disorder, the right temporalis muscle exhibited significantly lower activity (P<0.05). Those who had received orthodontic treatment within the previous 2 years showed significantly lower activity of the left masseter muscle (P<0.05). Those who had a left buccal mucosa ridge exhibited lower activity of the left masseter muscle and higher activity of the right temporalis muscle compared with those without such a ridge (P<0.05). Participants with no tongue indentation showed significantly higher activity in the left masseter muscle (P<0.05). These results indicate that there are relationships between masticatory muscle activity and various factors related to the oral condition.

Associations between mandibular torus and types of temporomandibular disorders, and the clinical usefulness of temporary splint for checking bruxism.

BACKGROUND: Occlusal stress from oral parafunctional habits is one of the causes of temporomandibular disorders (TMD) and mandibular torus (MT). Although some studies have investigated the correlation between TMD and MT, understanding of the relationships between types of TMD and MT is insufficient. Therefore, we conducted this study to investigate the associations between presence of MT and TMD types. METHODS: This study included 77 patients diagnosed with TMD who first visited our clinic for TMD between March 2019 and July 2020. Among them, 30 (38.9%) had MT, and 54 (70.1%) had oral parafunction. Parafunctional activity during sleep was confirmed using a temporary splint for checking bruxism (TSCB). RESULTS: The relationship between prevalence of MT and oral parafunction in TMD patients was not statistically significant (P = 0.131), but the odds ratio was relatively high at 2.267. An analysis of TMD type revealed that Type I, which is classified as myalgia of the masticatory muscles, and MT had a significant association (P = 0.011). We fabricated a TSCB for 27 patients to wear during sleep and confirmed that 23 (85.2%) had nocturnal bruxism. The TSCB results and presence of MT showed a significant relationship (P = 0.047). CONCLUSION: Through the results of this study, clinicians may consider the hyperactivity of masticatory muscles in the presence of MT when treating TMD patients. In addition, TSCB has a great diagnostic value as it can be easily manufactured and be useful for discovering pre-existing oral parafunctions that patients are not aware of.

Osteonecrosis of Bilateral Mandibular Tori After Direct Laryngoscopy.

A 36-year-old man underwent direct laryngoscopy with routine general anesthesia for a knee procedure. Several days later, he experienced pain involving an ulceration along the medial aspect of the right mandible in the floor of the mouth. This evolved to a painful bony mass, and subsequently, a bony sequestrum was spontaneously shed. The initially misdiagnosed pathologic process occurred several more times on both sides of the mouth. A computed tomography scan eventually revealed large bilateral mandibular tori, a feature that likely predisposed the patient to this course of events. Pain in the floor of the mouth after airway manipulation should be carefully evaluated and the possibility of osteonecrosis considered.

Oral and dental considerations of combat-induced PTSD: a descriptive study.

OBJECTIVE: Stress experienced as an intense and traumatic event can increase the odds of orofacial morbidities that may affect oral, periodontal, or masticatory system health. The aim of this study was to evaluate the dental, periodontal, oral, and bruxism situation among Israeli posttraumatic stress disorder (PTSD) war veterans. METHOD AND MATERIALS: This retrospective cohort pilot study aimed to examine the oral and facial manifestations in 71 Israeli veterans with combat PTSD. All patients underwent full dental, oral, and periodontal examination. Signs of parafunctional activity were also evaluated, accompanied by a full set of periapical and/or panoramic radiographs. RESULTS: The patients were 37 to 77 (mean 60.7 ± 10.15) years of age and presented a poor overall oral hygiene status (Plaque Index 0.75 ± 0.26). All patients (100.0%) suffered from periodontal disease, and most of them (66.0%) were severely affected. A significant correlation was found between signs of parafunctional activity and severe periodontal disease (P = .035). The patients had a high decayed, missing, and filled teeth (DMFT) score (20.06 ± 8.86), which was mainly attributed to the large number of "filled" (F) teeth (11.95 out of 20.06). The DMFT score was significantly lower among light smokers than among heavy, former, or nonsmokers (P = .012). Most patients (90%) had signs and symptoms of parafunctional activities. A significant positive and dose-dependent correlation was found between smoking and periodontal disease (P = .012). CONCLUSIONS: An association was found between combat PTSD and oral, dental, and periodontal morbidity.

Mandibular Torus Harvesting for Sinus Augmentation: Two-Year Follow-Up.

Maxillary sinus grafting is a commonly used treatment alternative in cases with insufficient bone height to enable insertion of implants in the posterior maxilla. It is commonly carried out with autogenous grafts, biomaterials or both. Autogenous bone grafts are considered gold standard for this procedure; however, due to donor site morbidity, it is not as commonly used as other biomaterials. Mandibular tori are hyperostoses on the lingual side of the mandible in the premolar region. This a case in which mandibular tori were used for a sinus augmentation procedure. The patient was then followed up for 2 years with no complaints, or objective symptoms.

Mandibular torus variation of Chinese ancient population / 解剖学报

Objective To present the performance of mandibular torus of Chinese in the Holocene, to analyze the age variation and the intercrowd variation of the mandibular torus and to explore related reasons. Methods Image comparison and combination description of the mandibular torus with seeds of the specified size, such as peanuts, soybeans, pumpkin seeds, etc,and compare them in different eras,genders,and locations. Results The result showed that the male's mandibular torus was distinctively stronger than that of the female. It was larger in the Neolithic Age than in the Bronze and Iron Age and the size decreased further as human beings moved into the modern era. Iri comparison of mandibular torus in different locations, Jiangjialiang was the largest, Xinjiang was the second, and Tuchengzi and Lamadong were the smallest. Conclusion During the Holocene period, the degree of bulging of the mandibular torus is reduced from time to time, and the difference in the performance of the mandibular torus may be closely related to the difference in mastication pressure caused by food differences.

Use of a mandibular torus for autogenous grafting: a case report.

Conventional treatment for the management of 2- to 3-walled intrabony defects is the use of allograft or alloplasts. Autogenous grafts are the gold standard because of their osteogenic potential. Mandibular tori are an ideal site for harvesting bone because their excision causes no structural, esthetic, or functional compromise to the patient. This case report describes the use of an autogenous graft obtained from a mandibular torus. The graft was utilized, in particulate form, to fill an intrabony defect at the mandibular right central incisor. The mandibular torus provided sufficient graft material and eliminated the need for a second surgical site. A follow-up at 1 year revealed reduction in clinical attachment loss and complete resolution of tooth mobility.

Identification of a stable reference area for superimposing mandibular digital models.

PURPOSE: The purpose of this retrospective study was to assess the stability of buccal and lingual alveolar bone surfaces for superimposing three-dimensional (3D) digital models of dental casts. MATERIALS AND METHODS: The pre- and posttreatment dental casts and lateral cephalometric radiographs were obtained from 10 adult patients who had undergone orthodontic treatment entailing the extraction of four premolars. Five of them had bilateral mandibular tori and the other 5 patients had no torus. Dental casts were scanned with a three-dimensional (3D) surface scanning system and 3D digital models were reconstructed using 3D reverse modeling software. The pre- and posttreatment digital models were superimposed on the following reference areas by the best-fit method: Area 1, bilateral lingual surfaces of the alveolar process of the posterior teeth; Area 2, the lingual alveolar surface of the anterior and posterior teeth; Area 3, bilateral surfaces of the posterior teeth's buccal and lingual alveolar surfaces; Area 4, bilateral mandibular tori. The horizontal and vertical movements of the mandibular central incisors and first molars were measured on cephalometric radiographs and on the 3D digital models. RESULTS: In the 5 patients without a mandibular torus, the median differences between cephalograms and 3D digital models ranged from 0.8-1.9 mm and the maximum differences from 1.5-10.0 mm. The median and maximum differences between cephalograms and 3D digital models superimposed on Area 2 were greater than those superimposed on Areas 1 and 3. In the patients with mandibular tori, the median differences between cephalograms and 3D digital models were under 1.0 mm, the maximum difference being 0.7 mm. CONCLUSION: The buccal and lingual alveolar surface near the dentition seems to be inappropriate as a reference area for superimposing 3D mandibular digital models of patients without a mandibular torus. Mandibular tori in adult patients are stable structures which can be used as reference areas for the superimposition of 3D mandibular digital models.

Modified incision for surgical removal of mandibular tori in geriatric immunocompromised patients : report of cases