The effect of occlusal alteration and masticatory imbalance on the cervical spine.

The characteristics of mandibular lateral displacement include lateral inclination of the occlusal plane and the differences between the right and left masticatory muscles. The aims of this investigation were to compare the mandibular stress distribution and displacement of the cervical spine using three-dimensional finite element models (3D FEM) to simulate masticatory movements and to clarify the association between morphological and functional characteristics and head posture. A symmetrical standard model was produced (model-A). Model-B had higher masticatory muscle strength on the left side, model-C had symmetrical masticatory muscle strength but the occlusal plane was inclined upwards towards the right and model-D had the occlusal plane inclined upwards towards the right with higher masticatory muscle strength on the left side. Model-A showed a completely symmetrical stress distribution pattern, while in model-B there was an uneven distribution in the mandible with higher stress on the left side. In addition, the stress distribution in the cervical spine was asymmetrical, showing displacement to the right. Model-C showed a similar mandibular tendency to model-B but the opposite tendency in the cervical spine. In model-D, the mandibular stress distribution was markedly asymmetrical, but almost symmetrical in the cervical spine with markedly decreased lateral displacement. These results suggest that lateral inclination of the occlusal plane and imbalance between the right and left masticatory muscles antagonistically act on displacement of the cervical spine, i.e. the morphological and functional characteristics in patients with mandibular lateral displacement may play a compensatory role in posture control.

Stresses on the cervical column associated with vertical occlusal alteration.

The biomechanical effects on cervical vertebral columns (C1-C7) during mastication were calculated using a three-dimensional (3D) finite element method. To verify the biomechanical influences of vertical occlusal alteration to the cervical column, three finite element models (FEM) showing a normal (model A), a steep (model B), and a flat occlusal plane (model C) were constructed. The occlusal stress distribution showed various patterns for the three models; the stress extended to the anterior area as the occlusal plane became steeper. The plots of the stresses on the mid sagittal section of the cervical columns showed different patterns for the three models; the stress converged at the odontoid process in models A and B, whereas the stresses at C7 in model B tended to decrease compared with model A. Concentrated stress was observed at C5 in model C, supporting the hypothesis that vertical occlusal alteration could influence stress distribution in the cervical columns.

Tongue pressure on loop of transpalatal arch during deglutition.

The purpose of this study was to measure tongue pressure exerted on the loop of the transpalatal arch (TPA) during deglutition and to consider the influence of the distance of the loop of the TPA from the palatal mucosa and the anteroposterior position of the loop. Tongue pressures of 4 subjects with normal occlusion were measured with subminiature pressure sensors fixed on the TPA. The distances from the palatal mucosa to the surface of the pressure sensor were set at 2, 4, and 6 mm. The loop of the TPA was placed at the level of the middle of the maxillary second premolars (P), first molars (M1), or second molars (M2). Nine types of TPA devices were measured for each subject. The maximum recorded tongue pressure was taken from each act of deglutition. The minimum pressure value was exerted at position P when the distance from the palatal mucosa to the surface of the pressure sensor was 2 mm. The maximum value was obtained at position M2 and a distance of 6 mm from the palatal mucosa. When distances of 2, 4, and 6 mm were compared, significant differences between 2 and 4 mm, and between 2 and 6 mm were found. Significant differences were observed in comparisons between the positions P and M1, M1 and M2, and P and M2.

Biomechanical influences of head posture on occlusion: an experimental study using finite element analysis.

The biomechanical influences of head posture on the cervical column and craniofacial complex during masticatory simulation were quantified using three-dimensional (3D) finite element analysis (FEA). Three types of finite element model (FEM) were designed to examine relationships between the position of the head and malocclusion. Model A was constructed to have a standardized cervical column curve, model B a forward inclined posture, and model C a backward inclined posture. The results of the spinal displacements revealed that model B moved in a forward direction and model C in a backward direction during masticatory simulation. The stress distributions on the cervical column (C1-C7) for models A, B, and C showed differences; stress converged at the atlas in model A, high-level stresses were observed at the spinous processes of C6 and C7 in model C, and the stress converged at the anterior edge in the vertebral body of C4 of model B. Stress distribution on the occlusal plane and maxillofacial structure did not show absolute differences among the three models. Alteration of head posture was directly related to stress distribution on the cervical column, but may not always directly influence the occlusal state.

Stresses in mandibular cortical bone during mastication: biomechanical considerations using a three-dimensional finite element method.

This study investigated biomechanical aspects of the action of the biting force during mastication upon the mandibular bone in the lower first molar area. A three-dimensional (3D) finite element model (FEM) consisting of the tooth, periodontal ligament (PDL), alveolar bone, and cortical bone corresponding to the lower first molar area based on computed tomogram (CT) images was constructed. The model was then analyzed while applying a biting force during mastication, which was transmitted from the tooth to the cortical bone, through the PDL and cancellous bone. A compressive stress of 0.3-7.9 MPa acted on the cortical bone during mastication. In the model, the stress in the cortical bone was distributed from the linguo-superior margin to the basal area, and was also observed in the bucco-medial area. These areas completely agreed with the areas that were significantly thicker in the morphological study described by Masumoto et al. (10). It is suggested that there may be a relationship between masticatory force and cortical bone hypertrophy. Further study of the effects of various factors is required.

An experimental study on mandibular expansion: increases in arch width and perimeter.

The purpose of this study was to estimate the increase in arch perimeter associated with mandibular lateral expansion. The mandibular expansion was simulated using a three-dimensional (3D) finite element method (FEM) and a computer graphics technique (3D simulation). The centre of rotation of molars during movement accompanied by lateral expansion was calculated using 3D FEM. The geometry of the model was determined using the mandibular bone of an East Indian skeletal specimen and 1 mm computer tomogram (CT) slices. The 3D set-up simulation was then conducted using 3D computer graphics instead of performing a manual set-up. Rotational movement was induced in the buccal segment, from the first premolar to second molar, in the 3D set-up model around the location of the centre of rotation (4.5 mm below the root apex of the first molar) derived from the FEM. According to 3D simulation, the model showed an opening space of 1.43 mm between the canine and first premolar, and thus a change in arch perimeter of 2.86 mm. The tip of the mesio-lingual cusp of the first molar moved 3.88 mm laterally, resulting in a change in inter-molar width of 7.76 mm. These values mean that a 1 mm increase in arch width resulted in an increase in arch perimeter of 0.37 mm. This result would be of value clinically for prediction of the effects of mandibular expansion.