Excursive Movements Research Articles

Comparative Evaluation of Functional Outcomes in High Condylar Fractures Treated with Closed Methods with and without Temporomandibular Joint Arthrocentesis: A Research Protocol for a Randomised Controlled Trial

Introduction: Temporomandibular Disorders (TMD) encompass a range of conditions affecting the joint and surrounding structures, often resulting in pain, restricted movement, and dysfunction. Arthrocentesis involves the insertion of a single needle into the joint space, allowing for irrigation, lavage, and aspiration of the joint. The present procedure aims to alleviate symptoms, improve joint function, and promote healing by removing inflammatory mediators, debris, and adhesions from the joint space. Need of the study: Arthrocentesis offers several advantages over traditional techniques, including reduced trauma, quicker recovery times, and a decreased risk of complications. It has emerged as a valuable tool in the multidisciplinary approach to managing TMDs, offering patients a minimally invasive option to relieve their symptoms and restore jaw function. Hence, the present study will present the utility of arthrocentesis as an adjunct procedure to closed reduction in high condylar fractures, improving the functionality of the condyle, providing pain relief, increasing mouth opening and bite force, stabilising bilateral occlusion, and normalising excursive movements. Aim: To compare and evaluate the efficacy of closed reduction with or without arthrocentesis in patients with high condylar fractures regarding functional outcomes. Materials and Methods: A randomised controlled trial will be conducted at Siddharth Gupta Memorial Cancer Hospital, Sawangi, Wardha, Maharashtra, India, from September 2024 to May 2026, involving 10 patients. The protocol includes examining patients with suspected high condylar fractures, taking detailed case histories, performing clinical examinations focusing on the Temporomandibular Joint (TMJ), and recording preoperative measurements of mouth opening and pain levels using a Visual Analogue Scale (VAS). Patients with suspected fractures will undergo radiographic examinations, and those meeting the inclusion criteria will be included in the study after providing informed consent. Arthrocentesis will be performed using a specialised needle with two lumens, inlet and outlet bevels, and a silicone stopper for maximal insertion depth. Statistical analysis will be conducted using descriptive and inferential statistics, specifically the Chi-square test and Student’s paired and Unpaired t-tests, with p-value<0.05 considered significant.

An investigation of machine learning algorithms for prediction of temporomandibular disorders by using clinical parameters.

This study aimed to predict temporomandibular disorder (TMD) using machine learning (ML) approaches based on measurement parameters that are practically acquired in clinical settings. 125 patients with TMD and 103 individuals without TMD were included in the study. Pain intensity (with visual analog scale), maximum mouth opening (MMO) and lateral excursion movements (with millimeter ruler), cervical range of motion (with goniometer), pressure pain threshold (PPT; with algometer), oral parafunctional behaviors (with Oral Behaviors Checklist), psychological status (with Hospital Anxiety and Depression Scale), and quality of life (with Oral Health Impact Profile) were evaluated. The measurements were analyzed via over 20 ML algorithms, taking into account an extensive parameter tuning and cross-validation process. Results of variable importance were also provided. Bagging algorithm using Multivariate Adaptive Regression Spline (MARS) algorithm (accuracy = 0.8966, area under receiver operating characteristic curve = 0.9387, F1-score = 0.9032) was the best performing model regarding the performance criteria. According to this model, the 5 most important variables for predicting TMD were pain intensity, MMO, lateral excursion and PPT values of masseter and temporalis anterior muscles, respectively. The Bagging algorithm using the MARS algorithm is a robust model that, in combination with clinical parameters, assists in the detection of patients with TMD in settings with limited capabilities. The clinical parameters and ML algorithm proposed in this study may assist clinicians inexperienced in TMD to make a preliminary detection of TMD in clinics where diagnostic imaging tools are limited.

Understanding the relationship between occlusal discrepancies and their role in temporomandibular disorder: A questionnaire-based research

Background: Temporomandibular disorder (TMD) presents as a multifaceted condition that impacts the temporomandibular joint (TMJ), the masticatory muscles, and other related structures. The role of occlusal factors in TMD etiology has been a subject of debate, necessitating further investigation. Aim: This questionnaire-based research aimed to explore the relationship between occlusal discrepancies and their role in TMD. Materials and Methods: The study involved 126 volunteers, comprising 69 females and 57 males, aged between 15 and 40 years, who had no previous history of systemic, musculoskeletal, or neurological disorders. To assess the degree of TMD, the researchers utilized the Fonseca questionnaire, and extra-oral and intra-oral examinations were done to check for occlusal discrepancy which was then classified according to the criteria of Angle’s classification in all three planes along with functional TMJ examination. Results: 55.5% of the population had some of the symptoms of TMJ disorders. Clinical examination showed that 45.2% of the population had tenderness on palpation. Variation of mouth opening was 37.72 ± 0.401 (±1.06%), the right lateral excursive movements were 6.88 ± 0.177 (±2.57%), and left lateral excursive movements were 6.6 ± 0.228 (±3.46%) respectively. The presence of “clicking” or “popping” was noted in 55 (43.6%) participants. Conclusion: The findings suggest that occlusal factors may significantly affect TMD development and symptomatology. Cases with occlusal discrepancies in multiple planes exhibited a significantly high prevalence of signs and symptoms related to TMD.

Implementing an optical jaw tracking system to locate centric occlusion: A dental technique

Optical jaw tracking systems are designed to record the static maxillomandibular relationship and the mandibular motion of a patient, including excursive movements and mastication pattern. This digital data acquisition technology can be integrated into diagnostic and treatment planning procedures, as well as into designing dental prostheses. A step-by-step protocol to record a patient’s digital data, including the repeatable reference position of the jaw or centric relation, by using an intraoral scanner, Kois deprogrammer, and optical jaw tracking system is described. The data are then processed in the software program of the jaw tracking system to locate centric occlusion.

TMJ anterior disc displacement anchorage surgery: a retrospective study based on a suture-free titanium screw strategy.

To evaluate the feasibility and effectiveness of using a suture-free titanium screw in repositioning anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ). A consecutive sample of twelve patients (fifteen joints) was included in this study. All patients were diagnosed with ADDwoR and showed limited mouth opening or temporomandibular joint pain symptoms. Suture-free titanium screw was placed in the condyle directly following the disc repositioning. Pre- and postoperative evaluation parameters include operation time, the visual analogue scale for pain (VAS), lateral excursion movements (LEM), maximum interincisal opening (MIO), and disc length and position on MRI. In addition, the mandibular condyle height was also measured. Statistical significance was considered when p < 0.05. The unilateral operation time was 58.54 ± 5.43min; during the 6-month period after the operation, the VAS values decreased from 87 ± 6.34 to 14.08 ± 6.65. The MIO increased from 30.07 ± 4.73 to 39.89 ± 1.69mm (p = 0.01). The TMJ disc length was prolonged from 8.23 ± 1.12 to 11.51 ± 1.29mm. The condyles showed significant remodeling, and the height of the condyle increased from 18.24 ± 4.12 increase to 19.6 ± 4.31mm. The LEM was increased from 5.27 ± 0.51 to 6.36 ± 0.62mm. The MRI images showed the stability of the disc in position during the opening and closing of the mouth. The TMJ disc position was stable during the follow-up period. Anteriorly displaced articular disc can be repositioned by a suture-free titanium screw strategy. This technique is an alternative method to address ADDwoR.

Factors that affect long-distance movements of small rodents and shrews in the Ural taiga: disentangling dispersal from excursion movements

Abstract Long-distance movements (LDMs) of small mammals (SMs) are complex phenomena that cover both dispersals and excursions occurring outside the home ranges of individuals. Owing to methodological difficulties, there are a lack of data on LDMs for SMs. In this study, we aimed to determine the factors that influence the LDMs of different mouse-sized rodents and shrews in the Ural taiga (Sverdlovsk region, Russia). We conducted a field experiment in a boreal forest using individual- (capture–marking–recapture [CMR]) and group- (biomarkers: tetracycline and rhodamine B) marking methods, in conjunction with additional feeding. The species, sex, maturity, plot ID, additional food supply, species abundance indices, individuals/100 trap-nights indices in the capture plot, and body weight of each animal were analyzed as predictors of LDMs. We identified 89 individuals from six species that moved at distances of 250, 350, and 500 m. LDMs varied with the particular species and its population abundance. Most of the observed movements were excursions and not dispersal events. Applying mathematical simulations to the obtained empirical data facilitated estimation of the intensity of the excursion activity for different species. We present the 1st excursion data on Sylvaemus uralensis (Pallas, 1811), Microtus arvalis (Pallas, 1778), and Sorex caecutiens (Laxmann, 1788). The detected excursion distance (250 m) for Myodes glareolus (Schreber, 1780) is the maximum excursion distance known for this species. We demonstrate that with comparable labor and time costs, the use of biomarkers makes it possible to detect many more LDMs than CMR allows.

Comparative Analysis of Sensory Responses from Dental Implants vs Natural Teeth: An In Vivo Study

Purpose: To compare subjects' sensory responses to horizontal and vertical forces on tooth- and implant-supported restorations. Materials and Methods: In this prospective study, three protocols simulating the horizontal or vertical forces that occur during mastication were used to obtain subjective responses from subjects. These protocols included the measurement of horizontal force intensity during excursive movements and the identification of initial contact during guided and free vertical closure. Responses were recorded using a 1- to 10-point visual analog scale (VAS) and/ or monitored with electromyography (EMG) and Tekscan. Results: The study included 30 patients with a single implant-supported restoration (ISR) with a contralateral tooth-supported restoration (TSR). For horizontal forces similar to those of mastication (0.6 N), subject VAS scores were similar for both ISRs and TSRs at 6.3 vs 6.1, respectively. At reduced forces (0.2 and 0.4 N), subject responses were greater for the TSR at 3.4 and 5.4, respectively, as opposed to 1.2 and 2.6 for ISR, respectively (P < .01). During vertical guided closure (Test 1) at 25% of maximum bite force (MBF), subjects were more successful at correctly identifying initial contact of TSRs at a rate of 12 out of 17, compared to ISRs, which achieved a rate of 4 out of 13 (P < .1). In vertical free closure (Test 2), subject responses for the correct identification of initial contact at 50% MBF were similar for both TSRs and ISRs at 13 out of 17 and 9 out of 13, respectively. However, comparing the correct responses for subjects whose initial contacts were ISR showed a significant improvement in correct answers from Test 1 to Test 2, from 4 out of 13 correct to 9 out of 13 correct (P < .05). Conclusion: While the mechanism is not clear, subjects' ability to discern the horizontal and vertical forces at levels comparable to mastication appear similar between TSRs and ISRs.

Influence of natal habitat preference on habitat selection during extra-home range movements in a large ungulate.

Natal habitat preference induction (NHPI) occurs when animals exhibit a preference for new habitat that is similar to that which they experienced in their natal environment, potentially leading to post-dispersal success. While the study of NHPI is typically focused on post-settlement home ranges, we investigated how this behavior may manifest during extra-home range movements (EHRMs), both to identify exploratory prospecting behavior and assess how natal habitat cues may influence path selection before settlement. We analyzed GPS collar relocation data collected during 79 EHRMs made by 34 juvenile and subadult white-tailed deer (Odocoileus virginianus) across an agricultural landscape with highly fragmented forests in Illinois, USA. We developed a workflow to measure multidimensional natal habitat dissimilarity for each EHRM relocation and fit step-selection functions to evaluate whether natal habitat similarity explained habitat selection along movement paths. Across seasons, selection for natal habitat similarity was generally weak during excursive movements, but strong during dispersals, indicating that NHPI is manifested in dispersal habitat selection in this study system and bolstering the hypothesis that excursive movements differ functionally from dispersal. Our approach for extending the NHPI hypothesis to behavior during EHRMs can be applied to a variety of taxa and can expand our understanding of how individual behavioral variation and early life experience may shape connectivity and resistance across landscapes.

Efficacy of arthrocentesis with intra-articular injection of hyaluronic acid and corticosteroid in the treatment of internal derangement of temporomandibular joint.

Various techniques have been used to treat internal temporomandibular joint derangements (TMJ ID), with arthrocentesis one of the most successful in reducing symptoms and promoting function. In cases of TMJ ID, this research study compares and evaluates the efficacy of arthrocentesis with injections of corticosteroids (CS) or hyaluronic acid (HA). This prospective randomized, non-blinded study involving 91 patients with symptoms of TMJ ID treated by arthrocentesis followed by intra articular injection of 1 ml of either corticosteroid (group A) or HA (group B) . Maximum mouth opening, lateral excursive movements, TMJ pain at rest and during function, masticatory efficiency, pre-treatment functional TMJ limitation and subjective judgment of efficacy of treatment were assessed with millimeter scale. All the parameters measured before the procedure and further followed at 1st week, 1st month, 3rd month and 6th month post-procedure. Maximum mouth opening post procedure improved significantly in Group B at follow up visits (P < 0.05). Subjects in group B showed significant reduction in pain at rest (P = 0.001) at 1 week and 1 month follow up & increased masticatory efficiency at 6 months (P = 0.042) as compared to that of group A subjects. Injection of HA post-TMJ arthrocentesis is found be comparatively more effective method of treating TMD IDs with resultant decrease in pain & improved functionality of the jaw. TMJ arthrocentesis along with injection of HA could serve as a possible alternative to treat chronic TMJ pain sufferers who are unresponsive to conservative medical therapies.

Open vs Closed Management of Condylar Fracture Our Experience of 100 Cases in a Suburban Tertiary Care Hospital.

Retrospective Observational Study. Mandibular condyle fractures are distinctive among maxillofacial injuries in which they disrupt mandibular function in a way that other traumatic injuries do not. Condylar fractures can be treated using either the conservative (closed reduction and immobilisation) or surgical (open reduction and internal fixation) approaches. Both of these modalities of treatment have advantages and disadvantages, as well as indications and contraindications. The purpose of this study is to compile and compare our experience in the management of condylar fractures through open and closed reduction. The present retrospective analysis included a total 100 patients of condylar fractures in patients > 18years of age who were randomly divided into nonsurgical and surgical group based on Edward Ellies criteria. In the present study, the outcomes of conservative vs surgical management of condylar fractures were discussed in terms of seven parameters, including the maximal inter-incisal mouth opening, protrusive and lateral excursive movements of the mandible, status of occlusion, deviation of mandible during mouth opening, temporo-mandibular disorders and facial nerve paralysis which were measured and evaluated pre- and post-operatively at different intervals of time. Follow-up period was for 6months. It was noted that the main cause of condylar fracture was trauma with a male predilection with an average age of 32.6 ± 1.2years. Subcondylar fracture was the commonest type of condylar fracture that we encountered. 33.3% of the patients had restricted mouth opening and 57% of the patients had deranged occlusion. 37% of the patients were treated surgically and 48.6% of these fractures were approached using peri-angular approach. More patients had an increased mouth opening and a stable occlusion at the 6months follow-up when compared to that of the 2month follow up. From the above study we can conclude that the treatment plan should be patient specific and follow the algorithm for a particular type of fracture. We endorse the same based on our experience in treating condylar fractures over the last 5years. The art of decision making solely depends on the surgeon's expertise in managing condylar fractures.

Evaluation of Disocclusion During Protrusive and Laterotrusive Movements.

Introduction The importance of disocclusion in maintaining the health of the stomatognathic system is well established. However, the quantification of the same is limited. This study aimed to determine the amount of posterior teeth disocclusion in protrusive and laterotrusive movements to establish the desired disocclusion in occlusal treatments. Materials and methods Twenty dentate subjects with Angles Class I occlusion, 18-30 years, were included in the study. Direct and indirect techniques measured disocclusion at the mesiobuccal cusp tip of the mandibular first molar. In the direct technique, the protrusive and working and nonworking records were made intraorally at the edge-to-edge position of maxillary and mandibular central incisors and canines, respectively. For the indirect technique, putty indices were made on a semi-adjustable articulator at 2 millimeters (mm) eccentric movements and the disocclusion records were then made intraorally using indices at the predetermined excursions. The records were trimmed, and the disocclusion was measured using an optical microscope (ZEISS Axio Imager 2; Carl Zeiss Microscopy Deutschland GmbH, Oberkochen, Germany). The comparison of disocclusion by both techniques was done by paired t-test. The Pearson correlation coefficient was used to analyze the statistical correlation between the disocclusion obtained during different excursive movements. Results The mean disocclusion obtained by direct technique was 1.72 ± .49 mm in protrusion, 1.19 ± .50 mm for the working side, and 2.54 ± .70 mm for the nonworking side. For the indirect technique, the disocclusion obtained was 1.22 ± .37 mm in protrusion, 8.57 ± .33 mm for the working side, and 1.71 ± .61 mm for the nonworking side. On comparison, there was a statistically significant difference (p<0.05) seen for the values between the groups for direct and indirect subgroups except for the left working subgroup (p>0.05) with higher values in the direct group. Conclusions The disocclusion obtained by the direct technique was higher than that obtained by the indirect technique. For both techniques, as the working side disocclusion increased, the nonworking side disocclusion also increased.

Yang’s keyhole plate versus conventional plate for treatment of mandibular sub-condylar fractures

Objectives: The use of a keyhole plate vs two miniplates in the treatment of mandibular subcondylar fractures. Materials and methods:Twenty patients were randomized into two equal groups. Ten patients with subcondylar fractures were treated with two Yang's keyhole plates in Group I. Ten patients with subcondylar fractures were treated with two conventional miniplates in Group II. Maximum mouth opening (MMO), Protrusive excursive movement, Lateral excursive movement, and Time for reduction and fixation were all used to evaluate patients clinically vertical height of ramus, and antero-posterior condylar angulation are all measured radiographically. Results: There was a statistically non-significant difference between the study and control groups at all intervals regarding MMO, Protrusive excursive movement, Lateral excursive movement, vertical height of the ramus, antero-posterior condylar angulation, but was significant at time for reduction and fixation. Conclusion: reducing a mandibular condylar fracture using a YK-plate, the results were similar and the operating time was quicker than when utilizing a traditional mini plate fixation.

Examination of chewing performance with extraction and non-extraction fixed orthodontic treatment – A prospective clinical 1-year study

Objectives: It shows that patients receiving orthodontic treatment may have a risk of developing temporomandibular disorder symptoms. The aim of this study is to examine the changes in the chewing system of occlusal contact parameters related to joint vibrations, chewing patterns, and measured excursive movements in fixed and non-extractive orthodontic treatments. Material and Methods: A total of 43 individuals with premolar extraction (n = 23) and without extraction (n = 20) who applied to the Department of Orthodontics, Dentistry Faculty of Istanbul Aydin University and needed orthodontic treatment were included in the study. In this study, 43 active fixed orthodontic treatment patients were conducted at the beginning (T0) and 6th month (T1) and 12th month (T2) on the parameter recorded during chewing. For occlusion analysis, T-Scan® computerized occlusion analysis recording and examination of the chewing pattern were used for JVA and JT temporomandibular joint parameters. Depending on whether the data showed normal distribution or not, differences between groups were evaluated using the Mann–Whitney or independent t-test, and intragroup differences were evaluated using the Wilcoxon sign test or paired t-test. Results: At the beginning, 6th month and 12th month of orthodontic treatment, it was observed that the opening, closing, and occlusion times and joint vibration frequencies in the chewing pattern in cases with and without tooth extraction, the integral value differences of total integral, and frequencies below 300 Hz and above 300 Hz were statistically significant (P &lt; 0.001). In digital occlusion analysis values, the right-left differences were not found statistically significant in the measurements made in cases with and without extraction (P &gt; 0.05), while there were statistically significant differences in disclusion values at the beginning, 6th and 12th months (P &lt; 0.05). Conclusion: At the beginning of the orthodontic treatments with or without extraction, it was observed that the values at the joint level changed significantly in the 6th month. However, the changes in the joints during the treatment, when they return to their ideal values at the end of the 12th month, are more than the change in occlusion.

An Evaluation of Jaw Tracking Movements in Patients with Total Joint Replacements versus a Control Group.

Background and Objectives: One form of treatment for degenerative temporomandibular joint diseases such as osteoarthritis, rheumatic arthritis, TMJ ankylosis, and condylar resorption is total joint replacement. The aim of this study was to examine the function of the temporomandibular joint after prosthetic joint replacement. Materials and methods: Fifteen patients with unilateral or bilateral TMJ total joint replacements and 15 healthy controls were evaluated via a SICAT JMT+ device. This non-invasive system measures 3D position and linear movements in all degrees of freedom and allows undisturbed functional mandibular movements to provide a quantitative evaluation. In addition, a TMJ questionnaire consisting of the subjective symptoms was also obtained. To date, no similar studies have been cited in the literature. Results: Mandibular movements after prosthetic joint replacement were recorded during opening, closing, protrusion, and lateral excursive movements and were all significantly decreased compared to those of controls. In the treatment group, the maximum incisal opening was 33.46 ± 5.47 mm, left lateral movement was 1.91 ± 2.7 mm, right lateral movement was 1.74 ± 1.74 mm, and protrusive movement was 2.83 ± 2.05 mm. The p-value comparison study and control group indicated significant difference (p < 0.0001) between the two groups. The study group stated a high level of satisfaction with the total joint replacement. Conclusion: Within the limitations of the study, the following conclusions can be drawn: (1) TMJ replacement patients showed significantly limited jaw movements compared to the control group; (2) a small percentage of TMJ replacement patients still present low levels of pain but improved chewing ability and quality of life.

Comparing open and closed treatment strategy in adult patients with condylar head fractures. What is associated with a better functional outcome?

IntroductionIntracapsular condylar fractures are an important component of craniofacial trauma. The indication for open repair has been historically controversial. A review of the literature was performed to compare functional outcomes of open vs closed treatment strategies of condylar head fractures, as well as to identify indications for operative management.Few systematic reviews have been conducted specifically addressing condylar fractures, however none to our awareness specifically address the condylar head fracture. MethodA literature review was designed and implemented to evaluate the functional outcomes and indications for open reduction of condylar head fractures versus closed treatment. A comprehensive electronic search of studies published between 2001 and 2021 of adult patients with condylar head fractures was conducted. ResultsThe literature review identified 18 articles that met the inclusion criteria. The majority of studies showed improved functional outcomes in the open reduction group with regards to maximal interincisal opening, excursive movements, deviation of midline, malocclusion, ankylosis, and chronic pain. Indications for operative management of condylar head fractures vary, however ramus shortening with loss of vertical height seems to be the prevalent indication. ConclusionThere is not yet one overriding consensus dictating management of condylar head fractures. It appears more and more studies are supporting the idea that better functional outcomes (and quicker return to function) are achievable using an open reduction strategy. However, closed treatment remains a valid option in some cases. Therefore, the most appropriate treatment must still be personalised to the individual patient.

A case report on an esthetic problem caused by jaw movement excursion treated with a dental implant

A case report on an esthetic problem caused by jaw movement excursion treated with a dental implant

Excursion of The Median, Ulnar and Radial Nerves During the Nerve Gliding Exercises Used in The Orthopedic Physiotherapy: A Cadaveric Study

Objective: The purpose of this study was to assess the measurement of nerve gliding, resulting from joint motion and changes of upper extremity position.&#x0D; Methods: The upper extremities of ten fresh human cadavers were dissected to delineate relationship between the positioning of upper extremity and gliding distance of nerves. Nerve mobilization – stretching therapy (SMG) techniques are mentioned in the literature for each of the radial, medial and ulnar nerves. Nerve excursion secondary to motion of shoulder, elbow, wrist, and fingers was evaluated at the elbow via SMG application. Initially extremities and the head were positioned with anatomic position. For the median nerve, extremity position was elbow extension, forearm supination, wrist and finger extension. For the ulnar nerve upper extremity position was elbow flexion, full forearm pronation, and wrist and finger dorsiflexion. Finally, the excursion of the radial nerve was observed with the position of elbow extension, forearm pronation, wrist and finger palmar flexion.&#x0D; Results: The ulnar, radial and median nerves excursion were 13.5, 29.75 and 11.37 mm respectively.&#x0D; Conclusion: In this study, longitudinal excursion movement of radial, median and ulnar nerves was observed with movements of shoulder, elbow, wrist and finger joints in different positions. SMG techniques can contribute to the mobilization of nerve tissue in orthopedic rehabilitation.

Motor slacking during resisted treadmill walking: Can visual feedback of kinematics reduce this behavior?

Functional resistance training is frequently applied to rehabilitate individuals with neuromusculoskeletal injuries. It is performed by applying resistance in conjunction with a task-specific training, such as walking. However, the benefits of this training may be limited by motor slacking, a phenomenon in which the human body attempts to reduce muscle activation levels or movement excursions to minimize metabolic- or movement-related costs. While kinematic feedback could reduce one's tendency to minimize effort during training, this has not been verified experimentally. Does functional resistance training during walking lead to motor slacking, and can techniques such as visual feedback be used to reduce these effects? Fourteen able-bodied individuals participated in this experiment. Participants were trained by walking on a treadmill while a bidirectional resistance was applied to the knee using a robotic knee exoskeleton. During training, participants were either instructed to walk in a manner that felt natural or were provided real-time visual feedback of their kinematics. Electromyography and knee kinematics were measured to determine if adding resistance to the limb induced slacking and if feedback could reduce slacking behavior. Kinematic aftereffects were measured after training bouts to gauge adaptation. Functional resistance training without feedback significantly reduced knee flexion when compared to baseline walking, indicating that participants were slacking. This reduction in knee flexion did not improve with continued training. Providing visual feedback of knee joint kinematics during training significantly increased knee muscle activation and kinematic aftereffects. The findings indicate that individuals are susceptible to motor slacking during functional resistance training, which could affect outcomes of this training. However, motor slacking can be reduced if training is provided in conjunction with a feedback paradigm. This finding underscores the importance of using additional methods that externally motivate motor adaptation when the body is not intrinsically motivated to do so.

Computerized occlusal analysis of two different removable retainers used during retention phase- A Randomized controlled trial

ABSTRACT Aim: To evaluate and compare occlusal contact force distribution, occlusion time and disclusion time following wear of Begg’s wrap around retainer and Vacuum formed retainer after completion of orthodontic treatment using a T-scan III. Materials and Methods: Twenty subjects after completion of active orthodontic treatment were randomly allocated into two groups, Group I – Begg’s wrap-around retainer (n-10) and Group II–vacuum formed retainer (n-10) one patient was lost to follow up in each group and the final sample size assessed at T1 in each group was 9. T-scan III was used at two-time intervals, T0 – first scan taken immediately after debonding and T1 – taken during retention any time between 10 and 12 months. Comparison of parameters within the groups was done using paired t-test and comparison between the groups was done using independent t-test. Results: No statistically significant difference in the distribution of occlusal contact forces was noted in both groups at T0 and T1 (p value<0.05). Disclusion time reduced in both groups at T1 but a statistically significant reduction in the disclusion time of left lateral excursive movement and protrusive movements (p value<0.05) was noted (T0-T1) in Group I. Statistically significant increase in the occlusion time was noted in Group II (T0-T1) at T1 between the two groups. Conclusion: No differences in occlusal contact force distribution was noted within and between the two groups. Disclusion time reduced in subjects on Begg’s wrap around retainers indicating favourable muscle activity and Occlusion time increased in subjects on vacuum formed retainers.

Accurate Treatment of Condylar Fracture Assisted by Three-Dimensional Prototype and Bioresorbable Plates

Although open treatments of condylar fracture have become the conventional treatment option, the accuracy is often not guaranteed. The purpose of this study was to improve the accuracy of fracture reduction assisted by three-dimensional (3D) prototype and bioresorbable plates in the treatment of condylar fractures.This was a prospective cohort study. Patients with condylar fractures were treated by surgery from October 2017 to November 2019 at School of Stomatology of China Medical University (Shenyang, China). The patients in the experimental group were treated with 3D-prototype and fixed with absorbable plates. Patients in the control group were treated routinely reduction and fixed with absorbable plates. Primary predictor variables were surgical treatment. Primary outcome was accurate reduction. Secondary outcomes were postoperative efficacy including maximum mouth opening, occlusal status, lateral excursion movements, and patient satisfaction. Other variables of interest included age, sex, type of patients. Continuous variables are reported as mean ± standard deviation. χ2 test and t test were used for analysis.The sample was composed of 48 patients (65 sides) who were treated surgically (25 men, 23 women; mean age, 39.50 year; range, 17 to 65 year) ; 27 patients (38 sides) were treated with the 3D-prototype approach and 21 patients (27 sides) were treated with the traditional approach. All 48 patients completed reduction and fixation of fractures. Preoperative and postoperative CT comparisons showed that 4 patients did not achieve accurate reduction, all in the control group, of which 3 patients had occlusal disorder. All patients in the experimental group achieved accurate reduction, of which 1 patient had occlusal disorder.Our results suggest that using 3D prototype for bending the bioresorbable plate is an effective method for accurate treatment of condylar fracture.