A Three-Dimensional Assessment of a Type I Shallow Palatogingival Groove by Cone Beam Computed Tomography: A Case Report.

The palatogingival groove is a developmental anomaly on the palatal surface of the maxillary anterior teeth. The shallow groove, often less than 1 mm, is challenging to diagnose, particularly in radiographic examinations. Such grooves are mistaken for root fractures. In this case study, we explore the prevalence, types, radiological appearances, and treatment options of type I shallow palatogingival grooves encountered in cone beam computed tomography.

In silico approach towards neuro-occlusal rehabilitation for the early correction of asymmetrical development in a unilateral crossbite patient.

Neuro-occlusal rehabilitation (N.O.R.) is a discipline of the stomatognathic medicine that defends early treatments of functional malocclusions, such as unilateral crossbite, for the correction of craniofacial development, avoiding surgical procedures later in life. Nevertheless, N.O.R.'s advances have not been proved analytically yet due to the difficulties of evaluate the mechanical response after the treatment. This study aims to evaluate computationally the effect of N.O.R.'s treatments during childhood. Therefore, bilateral chewing and maximum intercuspation occlusion were modelled through a detailed finite element model of a paediatric craniofacial complex, before and after different selective grinding-alternatives. This model was subjected to the muscular forces derived from a musculoskeletal model and was validated by the occlusal contacts recorded experimentally. This approach yielded errors below 2% and reproduced successfully the occlusal, muscular, functional and mechanical imbalance before the therapies. Treatment strategies balanced the occlusal plane and reduced the periodontal overpressure (>4.7 kPa) and the mandibular over deformation (>0.002 ε) on the crossed side. Based on the principles of the mechanostat theory of bone remodelling and the pressure-tension theory of tooth movement, these findings could also demonstrate how N.O.R.'s treatments correct the malocclusion and the asymmetrical development of the craniofacial complex. Besides, N.O.R.'s treatments slightly modified the stress state and functions of the temporomandibular joints, facilitating the chewing by the unaccustomed side. These findings provide important biomechanical insights into the use of N.O.R.'s treatments for the correction of unilateral crossbite, but also encourage the application of computing methods in biomedical research and clinical practise.

[Comparison of the accuracy of three methods for determining maxillomandibular horizontal relationship of the complete denture].

OBJECTIVE: To observe the changes of forward displacement of maxillary complete denture during centric occlusion, three different methods were used to record the changes of vertical overlap and the comfort level of patients before and after the selective grinding of the three dentures made according to maxillo-mandibular horizontal relationship record. METHODS: Twelve edentulous patients with normal stomatognathic system were recruited in this study. Three types of complete dentures for these 12 edentulous patients were made according to their different maxilla-mandibular horizontal relationship record methods. The amount of displacement of the maxillary complete denture, the vertical overlap of the anterior teeth as well as patient comfort level were recorded before and after selective grinding. Statistical analysis was performed using the SPSS 17.0 software package. RESULTS: Before selective grinding, the amount of displacement of denture A was significantly larger than those of dentures B and C (P<0.05). After selective grinding, there was no statistical difference among the three dentures (P>0.05). During selective grinding, the vertical overlap variation of denture A was significantly greater than those of dentures B and C (P<0.05). Before selective grinding, the comfort level of the denture A was the lowest (P<0.05), and no statistical difference was found between dentures B and C (P>0.05). After selective grinding, no statistical difference was found among the three dentures (P>0.05). CONCLUSIONS: Among the complete dentures with anatomical teeth, the dentures whose horizontal relationship was recorded at 1 mm before the apex of the Gothic arch apex and with checkbite are more in line with clinical repair requirements. Complete dentures whose horizontal relationship was recorded at the apex of Gothic arch need to be adjusted with selective grinding to meet the clinical restoration requirements.

Comparison of the accuracy of three methods for determining maxillomandibular horizontal relationship of the complete denture / 华西口腔医学杂志

OBJECTIVE@#To observe the changes of forward displacement of maxillary complete denture during centric occlusion, three different methods were used to record the changes of vertical overlap and the comfort level of patients before and after the selective grinding of the three dentures made according to maxillo-mandibular horizontal relationship record.@*METHODS@#Twelve edentulous patients with normal stomatognathic system were recruited in this study. Three types of complete dentures for these 12 edentulous patients were made according to their different maxilla-mandibular horizontal relationship record methods. The amount of displacement of the maxillary complete denture, the vertical overlap of the anterior teeth as well as patient comfort level were recorded before and after selective grinding. Statistical analysis was performed using the SPSS 17.0 software package.@*RESULTS@#Before selective grinding, the amount of displacement of denture A was significantly larger than those of dentures B and C (P0.05). During selective grinding, the vertical overlap variation of denture A was significantly greater than those of dentures B and C (P0.05). After selective grinding, no statistical difference was found among the three dentures (P>0.05).@*CONCLUSIONS@#Among the complete dentures with anatomical teeth, the dentures whose horizontal relationship was recorded at 1 mm before the apex of the Gothic arch apex and with checkbite are more in line with clinical repair requirements. Complete dentures whose horizontal relationship was recorded at the apex of Gothic arch need to be adjusted with selective grinding to meet the clinical restoration requirements.

Preventive orthodontic approach for functional mandibular shift in early mixed dentition: A case report.

The case reported here highlights the importance of examination of functional occlusion along with static occlusion. Any undetected malocclusion during early mixed dentition has potency to alter the growth and function of stomatognathic system. Premature contacts in primary canine region is the most prevalent cause of functional mandibular shift and can lead to TMJ problems for the prevalence of self correction of such malocclusion is very low if not intervened. A case of functional mandibular shift due to faulty canine guidance because of premature contacts is discussed here. Selective grinding of premature contacts and myofunctional exercise resulted in well balanced centric occlusion coinciding with centric relation.

Efficacy of Selective Grinding Guided by an Occlusal Splint in Management of Myofascial Pain: A Prospective Clinical Trial.

BACKGROUND: For patients whose centric relation (CR) has not been considered at the start and during treatment, the task of achieving an occlusal scheme that works together with the temporomandibular joint, the muscles, and the structures of the stomatognathic apparatus becomes a major concern. OBJECTIVE: This study aims to describe a reproducible, predictable and to date unreported procedure of selective grinding guided by an occlusal splint and to analyze condylar position (CP) based on the skeletal pattern. METHODS: A total of 72 symptomatic patients (38 females and 34 males) were classified into three groups: hyperdivergent, intermediate and hypodivergent. CP was quantified by mounted casts on a measures condyle displacement (MCD) device. Helkimo index was also performed in order to assess the severity of the temporomandibular joint (TMJ) disorders attending to clinical dysfunction, occlusal state and anamnestic dysfunction. Once the stability had been obtained, the splint was progressively reduced until the maximum intercuspation (MIC) was achieved. RESULTS: The vertical displacement was found to be significantly different between the hyperdivergent and other two groups (p<0.01). Comparisons of MCD analysis before and after the selective grinding procedure identified a statistically significant difference in the horizontal and vertical CP (p<0.01) between the different groups whereas the Helkimo Index showed a clear improvement of TMJ disorders. CONCLUSION: All facial types, specially the hyperdivergent face type, showed a reduction in condylar displacement (CD) and less craniomandibular symptoms using this procedure, making it an excellent technique for clinicians.

The Value of Occlusion in Dentistry: A Clinical Report Showing the Correction of an Anterior Reverse Articulation with Selective Occlusal Adjustment.

The subject of occlusion has been deemphasized by academia over the last 30 years. This marginalization in turn has negatively impacted recent graduates who are largely unfamiliar with the use of occlusal adjustment by selective reshaping as a treatment modality. Use of proper occlusal therapy enables clinicians to more effectively help patients recover from parafunctional wear of the anterior and posterior teeth. In addition, familiarity with this field enhances the correction of progressive posterior and anterior reverse articulations. This article aims to highlight the importance of occlusal principles in treatment planning. In addition, we illustrate the benefits of occlusal adjustment by using a conservative technique, selective reshaping, as an option to correct anterior reverse articulation in a 20-year-old patient. The knowledge of occlusal principles enhances diagnosis of malocclusion in the development of a treatment plan. When properly employed, the technique of occlusal adjustment by selective reshaping may be used to correct an adaptive anterior reverse articulation with a high degree of predictability for select patients.

Efectos del tratamiento temprano en variables morfológicas, cinco años después de su aplicación / Effects of early treatment on morphological variables five years after application

Introducción: las pautas del tratamiento temprano propician una respuesta de desarrollo del sistema estomatognático. Objetivo: evaluar los efectos del tratamiento temprano en variables morfológicas, con técnicas de la rehabilitación neuro oclusal, cinco años después de ser aplicado durante la dentición temporal. Métodos: investigación de desarrollo, longitudinal y descriptiva, entre los años 2001 y 2010, en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara. Universo: 2 215 niños de cinco años de edad perteneciente a instituciones infantiles de la ciudad de Santa Clara (2001-2002). Se utilizó un método estratificado por etapas. Las variables de estudio se analizaron en tres etapas evolutivas: inicial, intermedia y final. La muestra fue de 59 niños con interferencias oclusales durante la dentición temporal que fueron tratados con terapias funcionales, durante el año 2002 y evaluados un año después (primera etapa). La segunda etapa se desarrollo durante los años 2007-2010; la muestra fue de 46 niños con diez años de edad. Se diseñó un modelo de consentimiento informado que estableció el compromiso de colaboración de los niños seleccionados. Se realizaron pruebas estadísticas: test de Friedman, Wilcoxon, Fisher y medida clásica de chi cuadrado. Resultados: se observó un aumento del resalte en 33 de los casos y predominó el escalón mesial (87 por ciento) al final del estudio. Se mantuvo la tendencia al aumento en la anchura intermolar temporal. Los valores medios a nivel de los primeros molares permanentes se comportaron similares a la norma descrita por Mayoral (47 mm). Conclusiones: los cambios favorables observados en las variables morfológicas objeto de estudio, cinco años después de ser aplicado el tratamiento temprano con técnicas de la rehabilitación neuro oclusal, corroboran que los cinco primeros años de la vida del niño constituye la etapa ideal para comenzar a tratar las alteraciones del sistema estomatognático(AU)

Introduction: early treatment typically obtains an adequate developmental response from the stomatognathic system. Objective: evaluate the effects of early treatment on morphological variables using neuro-occlusal rehabilitation techniques five years after application during primary dentition. Methods: adevelopmental longitudinal descriptive study was conducted from 2001 to 2010 at the School of Dentistry of the University of Medical Sciences of Villa Clara. The study universe was 2 215 five-year-old children from educational institutions of the city of Santa Clara (2001-2002). A staged stratified method was applied. Study variables were analyzed along three evolution stages: initial, intermediate and final. The study sample was composed of 59 children with occlusal interferences during primary dentition, which were treated with functional therapies in 2002 and evaluated one year later (first stage). The second stage extended from 2007 to 2010. The sample consisted of 46 ten-year-old children. An informed consent form was developed to record the commitment of the children selected with the study. The statistical tests performed were Friedman's, Wilcoxon's, Fisher's and classical chi-square measure. Results: increased overjet was found in 33 of the cases, with a predominance of the mesial step (87 percent) at the end of the study. A tendency to increased temporary intermolar width was observed throughout the study. Mean values for the first permanent molars were similar to the standard described by Mayoral (47 mm). Conclusions: the favorable changes found in the morphological variables under study five years after application of early treatment with neuro-occlusal rehabilitation confirm that the first five years in the life of a child are the ideal stage to start treating alterations of the stomatognathic system(AU)

Facial talon cusp: A rarity, report of a case with one year follow up and flashback on reported cases.

Talon cusp is a relatively uncommon developmental anomaly characterized by cusp-like projections, usually presenting on palatal/lingual surface of the anterior teeth. This cusp resembles an eagle's talon, and hence the name. Normal enamel and dentin covers the cusp, which may or may not contain an extension of pulp. Presence of this anomalous cusp on the facial surface of an anterior tooth is a rare finding and very few cases have been reported in the literature. In most instances, such cusps are associated with clinical problems such as poor esthetics and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This case report presents a facial talon cusp on the maxillary left central incisor of a 10 year old boy, which was conservatively treated. Vitality of the affected tooth was maintained and followed up for a period of 1 year.

Ajuste oclusal na Ortodontia: por que, quando e como? / Occlusal adjustment in Orthodontics: why, when and how?

INTRODUÇÃO: o conhecimento sobre oclusão dentária deve ser considerado condição fundamental para a prática de uma Ortodontia de qualidade. O diagnóstico feito sem a manipulação do paciente em Relação Cêntrica pode levar à surpresa desagradável de se planejar o tratamento de uma má oclusão e se deparar com outra, depois dos primeiros arcos de nivelamento. Ao usar arcos retangulares, é importante a checagem dos contatos oclusais para se definir o tipo de movimento dentário necessário para o alcance do equilíbrio oclusal e, principalmente, verificar se este movimento é exeqüível. Durante o tratamento ortodôntico, devido à complexidade das superfícies oclusais, o ajuste oclusal por desgaste deve ser realizado para viabilizar movimentos dentários verticais, reduzindo o tempo de tratamento. Interferências oclusais são responsáveis tanto por efeitos adversos na biomecânica, quanto por aplicação de forças excessivas, que podem causar reabsorções radiculares. Após a Ortodontia, o ajuste oclusal é um dos determinantes da estabilização dentária, devendo-se obter, para cada dente posterior, contatos oclusais "A" e "B", ou "B" e "C" no sentido vestibulolingual, além dos contatos de "parada" e "equilíbrio" no sentido mesiodistal. Os dentes anteriores passam a funcionar em movimentos mandibulares, desocluindo de imediato os dentes posteriores, o que é denominado de guia anterior, visando equilíbrio muscular e proteção do sistema estomatognático. O desgaste seletivo não deve ser utilizado como substituto da movimentação ortodôntica. OBJETIVO: apresentar os princípios relacionados ao ajuste oclusal em Ortodontia.

INTRODUCTION: The knowledge of dental occlusion should be considered the basic foundation to an excellent orthodontic practice. The patient's diagnose without the centric relation assessment can take the orthodontist to an unpleasant surprises. The use of rectangular archwires requires occlusal contacts been checked to decide what kind of the dental movement will be necessary to achieve the dental equilibrium and mainly to investigate if the movement will be possible. Considering the occlusal surfaces complexity, the occlusal adjustment by selective grinding should be performed during the orthodontic treatment to allow vertical dental movements reducing treatment's time. Occlusal interferences are responsible not only for biomechanics adverse effects, producing undesirable dental movements, but also for potential side effects such as excessive forces (occlusal trauma), leading to roots reabsorption. The occlusal adjustment is a determinant point on dental balance after the end of orthodontics treatments, where each posterior occlusal tooth contacts "A" and "B", or "B" and "C" on buccolingual aspect, as well as the stoppers and equalizers contacts on mesiodistal direction must be achieved and well established. The appropriate role of anterior teeth in mandibular movements must be determined, allowing immediate disclusion of posterior teeth, known as anterior guide, and promoting protecting muscle forces to the stomatognathic system. Selective grinding should not be used in place of well planned and executed orthodontic movement. AIM: The aim of this article is to present the rationale use of occlusal adjustment in Orthodontics.