The Thermal Influence of Oral Rehabilitation on the Cranio-Cervico-Mandibular Complex: A Thermographic Analysis.

André Moreira,Joaquim Mendes,Maria Helena Figueiral,Susana Oliveira,Ricardo Batista,Margarida Sampaio-Fernandes

doi:10.3390/ijerph181910441

Abstract

Purpose: Assess the thermal effect of prosthodontic treatment on the cranio-cervico-mandibular complex using infrared thermography. Methods: The treatment group was composed of adults of both sexes who underwent a prosthodontic treatment in which at least posterior occlusal contacts were added and/or the vertical dimension of occlusion was reestablished. The control group (CG) was constituted of adult subjects of both sexes, with no more than a single missing posterior tooth, excluding third molars. Thermograms were taken of the treatment group with a Flir i7 IR camera both before oral rehabilitation (TGB; n = 33) and two months after treatment was concluded (TGA; n = 19). CG (n = 33) had only one occasion for data acquisition. Results: Statistically significant differences were found when the thermal difference (ΔT) and the health status of the orbicularis oris muscle were compared between the TGB and the TGA groups (p = 0.020 and p = 0.003, respectively). By comparing the health status of the masseter muscle between the CG and TGB, statistically significant differences were also observed (p = 0.030). Conclusion: A prosthodontic treatment appears to have a minimum or null effect on the ΔT and/or on the health status of the TMJ and the temporal muscle. In contrast, orbicularis oris muscles exhibited significant thermal variations.

Highlights

The cranio-cervico-mandibular complex (CCMC) is composed of multiple structures, as diverse as bones, ligaments, and muscles
Based on the evidence described above, this study aims to assess the thermal effect of a prosthodontic treatment on the CCMC components (anterior part of the temporal, masseter, and orbicularis oris (Oo) muscles, and temporomandibular joints (TMJ)) of edentulous subjects
The results of the present study suggest that the Oo muscles are structures of the CCMC, susceptible to thermal variations elicited by prosthodontic treatments

Summary

Introduction

The cranio-cervico-mandibular complex (CCMC) is composed of multiple structures, as diverse as bones, ligaments, and muscles. There are two temporomandibular joints (TMJ)—the right and the left—where an intra-articular disc articulates with the condylar process of the mandible below, and the mandibular fossa of the temporal bone above. Contraction of the jaw elevator muscles allows intercuspation, creating a third supporting point between the cranium and the mandible. Besides their importance for the mandibular cinematic (incisal and lateral guidance, Spee and Wilson curves, and vertical dimension of occlusion (VDO)), teeth are crucial for mastication, phonetics, and aesthetics [3,4]. A lack of tooth contacts and an incorrect relationship between the cranium and the mandible may have a negative impact on other structures of the CCMC [5,6]

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