Freeway Space Research Articles

The Effect of Changing Vertical Dimension of Complete Denture Within its Normal Range on Sound Production With The Presence or Absence of Palatal Rugae.

Purpose: To investigate the effect of changing vertical dimension of complete denture within its normal range on phonation with the presence or absence of palatal rugae, using Computerized speech lab (CSL). Material and Methods: Ten completely edentulous patients (aged 50-60 years) were selected for reading some sentences. Each patient had two maxillary and two mandibular dentures with an adaptation period between each denture. The patients’ speech records were divided into four groups,Group I: Maxillary acrylic denture had polished anterior palatal surface without rugae reproduction and a free-way space of 2 mm.Group II: Maxillary acrylic denture with rugae reproduction on its polished surface and a free-way space of 2 mm.Group III: Maxillary acrylic denture had polished anterior palatal surface without rugae reproduction and a free-way space of 4 mm.Group IV: Maxillary acrylic denture with rugae reproduction on its polished surface and a free-way space of 4 mm, the samples selected were s/sh/t sounds . Results: There is no significant difference was recorded in mean value of first formant frequency in dentures with and without Ruge using freeway of 4 and 2 mm for S and Sh sounds and in the voice onset time (VOT) of T sound. Conclusion: Any change in the normal cross section of the oral cavity by a removable prosthesis will affect the properties of normal human voice, so it is not recommended to construct thick areas in the anterior region of denture even if it contains palatal rugae so that it will not affect palatolingual sounds.

Research on the influence of freeway space environment on the driver’s visual behavior

In order to understand the driver’s visual behavior in different space, the Smart Eye Pro5.7 non-intrusive eye tracking instrument was used in this study to record the driver’s eye movement data in three types of space environment. The main visual behavior indicator included pupil diameter, visual angle X and visual angle Y. The results showed that the driver was relaxed under open space. Through the significance statistical analysis, the space environment has significant influence on the driver’s pupil diameter and visual angle. The driver’s gaze positon in closed space was diffuse and lower, while in open space was more uniform.

Factors associated with the non-wear of mandibular dentures in the Brazilian public primary health care.

This study investigated factors that affect the use of complete conventional mandibular dentures (CCMD) by patients of the Brazilian Public Health Service. For this, two hundred and thirty one subjects who received CCMD in the Primary Health Care of the Public Health Service in Belo Horizonte - Brazil were evaluated and divided in Group 1 - irregular/non-wear; Group 2 - regular wear. Multivariate logistic regression analysis was used to create predictive models for CCMD non-wear and included socio-demographic and biological variables, technical quality of CCMD, and user satisfaction. The prevalence of CCMD non-wear was 41.10%. The mean score of CCMD quality was 54.97 (0-100). Not wearing the CCMD was significantly associated with user satisfaction and technical quality (p < 0.05). The lack of retention of the CCMD was the most important factor in the evaluation of satisfaction and quality. The final predictive model (specificity = 92.65%; AROC = 0.8759) for not wearing the CCMD retained the variables CCMD stability (OR = 0.888; 95%CI = 0.827-0.954), freeway space (OR = 0.916; 95%CI = 0.860-0.976), satisfaction with speech (OR = 0.694; 95%CI = 0.612-0.786), and irregular CCMD edges (OR = 3.185; 95%CI = 1.478-6.864). Socio-demographic and biological variables were not associated with patients not wearing the CCMD, whereas technical quality and user satisfaction were strongly associated.

Highly producible method for determination of occlusal vertical dimension: relationship between measurement of lip contact position with the closed mouth and area of upper prolabium

PurposeA new method inducing the physiologic rest position of the mandible using the lip contact position with the closed mouth have compared with those obtained using conventional methods of placing the mandible in the physiologic rest position. MethodsThe lip contact position with the closed mouth as a method was investigated whether the technique was useful for determining the occlusal vertical dimension. The relationship between the space between the maxillary and mandibular front teeth in the lip contact position with the closed mouth and the areas of the prolabia was also investigated. ResultsMedian space between the maxillary and mandibular front teeth in the lip contact position with the closed mouth was 1.53mm, a value intermediate between the value of 2.16mm in the resting mandibular position obtained by the conventional technique and that of 1.33mm in the swallowing position. The coefficient of variation of the space in the lip contact position with the closed mouth was significantly lower than those in the resting mandibular position and in the swallowing position. A significant positive correlation was recognized between the space in the lip contact position with the closed mouth and the area of the prolabium of the upper lip. ConclusionsThese results clarified that the lip contact position with the closed mouth obtained the excellent reproducibility comparing to the conventional methods. These findings suggested that the area of the prolabium of the upper lip might offer an effective index for individual determination of the correct free-way space.

Case Report: Management of Class II Division 2 Case with Cetlin Intrusion Arch

Deep bite is one of the frequently seen malocclusion, that occurs along with other associated malocclusions. It is said to be one of the most perpetuating and damaging malocclusions. It may jeopardize the periodontal support, occlusion itself or TMJ. Intrusion mechanics are considered if there is an inadequate or normal freeway space. Deep overbite correction by intrusion of anterior teeth affords a number of advantages including simplifying control of the vertical dimension and allowing forward rotation of the mandible to aid in Class II correction. This article highlights the treatment of deep bite with Cetlins intrusion arch.

The potential etiologic factors influencing tinnitus intensity in patients with temporomandibular disorders

Objectives: To investigate the potential relationships between the intensity of tinnitus associated with temporomandibular disorders (TMD) and potential etiologic factors, including age, gender, freeway space, sleep bruxism (SB), joint clicking, and headache.Methods: The sample was comprised of 90 patients without any hearing loss, as confirmed by otorhinolaryngology, who self-reported subjective tinnitus and simultaneous TMD, based on the Research Diagnostic Criteria for TMD (RDC/TMD).Results: The results showed a positive, weak correlation between the intensity of tinnitus and age (r = 0.225, p = 0.033). The presence of SB and headache were seen in higher proportions in the present sample, at 75.5% (n = 68) and 66.6% (n = 60), respectively.Conclusions: In a population of patients with subjective tinnitus and TMD, no significant associations were found between tinnitus intensity and age, freeway space, SB, clicking presence, and headache, though gender did show a weak correlation with tinnitus intensity.

Usefulness of an occlusal device in the treatment of medication overuse headache and persistent idiopathic facial pain: preliminary results.

There is a debate in literature about the therapeutic usefulness of oral devices in patients suffering from Medication Overuse Headache (MOH) or in patients suffering from Persistent Idiopathic Facial Pain (PIFP). From the case histories of 3356 patients, referred to us with a diagnosis of chronic craniofacial pain for assessment of the eventual application of an occlusal device to correct an impaired neuromuscular relationship between the mandible and the maxilla, we selected, following the criteria of the International Classification of Headache Disorders (ICHD-3beta), two groups of patients suffering from MOH and PIFP. All patients of the two groups underwent a Kinesiographic exam and an EMG to evaluate the freeway space (FWS). Patients presenting an impaired FWS were placed in treatment with the application of an occlusal device. At the follow-up after 6months and after 1year, we found a significant decrease in pain with regard to the intensity resulting in the reduction of clinical disability. The preliminary data collected using the VAS scale and the MIDAS questionnaire confirm that the neuromuscular cranio-mandibular system can have an important role in the diagnostic process of the MOH and the PIFP, suggesting the usefulness of treatment with an occlusal device, where there is adequate FWS.

Integrated Microfluidic Flow-Through Microbial Fuel Cells

This paper reports on a miniaturized microbial fuel cell with a microfluidic flow-through configuration: a porous anolyte chamber is formed by filling a microfluidic chamber with three-dimensional graphene foam as anode, allowing nutritional medium to flow through the chamber to intimately interact with the colonized microbes on the scaffolds of the anode. No nutritional media flow over the anode. This allows sustaining high levels of nutrient utilization, minimizing consumption of nutritional substrates, and reducing response time of electricity generation owing to fast mass transport through pressure-driven flow and rapid diffusion of nutrients within the anode. The device provides a volume power density of 745 μW/cm3 and a surface power density of 89.4 μW/cm2 using Shewanella oneidensis as a model biocatalyst without any optimization of bacterial culture. The medium consumption and the response time of the flow-through device are reduced by 16.4 times and 4.2 times, respectively, compared to the non-flow-through counterpart with its freeway space volume six times the volume of graphene foam anode. The graphene foam enabled microfluidic flow-through approach will allow efficient microbial conversion of carbon-containing bioconvertible substrates to electricity with smaller space, less medium consumption, and shorter start-up time.

Re-evaluation of interarch space determination in fully dentate adults with different facial forms: A clinical study.

The aim is to determine the average inter-arch space of fully dentate subjects at rest and at occlusion with different facial forms. Fifty subjects each of three groups of facial form, square, taper, and oval facial with a complete set of maxillary and mandibular arch teeth with average age from 25 to 40 years were included in this study. An equal number of male and females were included in all the groups. Vertical height at rest and at occlusion was recorded in every subject of the all the three groups using a prescribed procedure, and freeway space (FWS) was measured. The collected data were statistically evaluated, and it showed the mean and median for each facial form subjects, square facial form (3, 2.32), taper facial form (2.62, 2), and ovoid facial form (2.68, 2), respectively. No significant difference between any of the readings (P < 0.05). However, 9% of the individuals showed the FWS range of 5-6 mm. The lowest and highest FWS measurements were 1 and 7 mm, respectively. One more significant factor is that majority (56%) of the square facial form subjects showed FWS range of 3-4 mm. The conclusions were drawn, to understand the average inter-arch space in various facial forms, which was more than 3-4 mm.

Freeway space determination using lateral profile photographs: A pilot study.

Statement of Problem:Many methods are reported in literature to determine freeway space (FWS), but they yield dissimilar measurements.Purpose:Recording FWS of patients during prosthetic rehabilitation is one of the important steps in dentistry. The purpose of this study is to evaluate the ability to predict FWS using lateral profile photographs (LPPs) in edentulous participants.Materials and Methods:Fifty-three participants in the age range of 20–27 years who met the inclusion criteria were recruited. LPP were taken for all participants using standard protocol and duplicate copy obtained; on which three soft tissue reference points, porion (Stp), gnathion (Stgn), and gonion (Stg) (Stg prenoted on the face) were marked and joined to form an angle Stp-Stg-Stgn. This angle was correlated with the mean FWS obtained using 3 methods, swallowing, phonetics, and no command. Simple linear regression model was used to develop a prediction formula for FWS using Stp-Stg-Stgn angle as the independent variable.Results:The angle Stp-Stg-Stgn had a significant negative correlation with FWS (r = −0.76, P < 0.001). Using simple linear regression analysis, the following formula was obtained: FWS (in millimeters) = 11.405 − 0.072 × (Stp-Stg-Stgn angle in degrees).Conclusion:Within the limitations of this study, considering the usage of LPP as a method to determine the FWS can be recommended.

Full-mouth rehabilitation of a patient with severely worn dentition for function and esthetics

Management of patients with worn dentition is complex and difficult. The management of tooth wear, especially attrition, is becoming a subject of increasing interest in the prosthodontic literature. The specific objectives of this treatment were to restore the masticatory functions by prosthetic rehabilitation of missing teeth, and then treating the periodontally and endodontically involved teeth. This case report presents a 65-year-old woman who was referred for restoration of her worn and missing teeth. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was done and also the collapse bite was regained by raising the vertical dimension of occlusion by 2 mm within the limit of free-way space. In this case report, the vertical dimension was regain, missing teeth were replaced which enhance esthetics. With better treatment planning and patient’s psychological counseling, dentists can improve patient’s quality of life.

Cisti radicolo-dentale in paziente con malocclusione di Classe II scheletrica. Caso clinico

Objectives.The study shows how a skeletal second class malocclusion, combined with an overbite and muscular hypertonicity, can be a contributing factor to the development of an inflammatory radicular dental cyst. Materials and methods.The case of a female patient is reported, with a radicular cyst caused by necrotic 4.1 e 3.1, which extended from 3.1 to 4.5. The first orthopantomograph showed an area of bone rarefaction at 3.4 and 3.5. At the physical examination, the patient presented with second class malocclusion, pronounced overbite and muscular hypertonia. Endodontic therapy of 3.1 and 4.1 was performed, followed by cystic enucleation. Electromyographic and kinesiographic examinations were subsequently carried out to assess the muscles status and a therapy with orthosis was implemented for 8 months. Several orthopantomographic examinations were performed to assess the prognosis: in the pre-surgery phase (T0), in the post-operative phase at one month (T1), after neuromuscular therapy at 8 months (T2). Finally, a follow-up at 10 years was carried out to assess the stability of results (T3). Results.At T1 and at T2, bone regeneration in both lesions was observed. At T3 the patient was in a stable condition. Conclusions.Malocclusion is responsible for necrosis and loss of periodontal bone support in the more affected teeth by occlusal trauma. In addition to surgical therapy, a correction of the freeway space and of the neuromuscular trajectory is necessary, in order to achieve bone regeneration in the traumatized sites.

The difference in the measurement of freeway space in an upright sitting position with and without electromyograph

Introduction: Measurement of vertical dimension is very important because improper measurement of vertical dimension may create stomatognatic problem. Electromyography is a tool for recording electrical signals generated from the mechanism of muscle contraction.This study aims to determine the accuracy of measurements of FWS with and without electromyograph. Methods: This research was a descriptive comparative study using purposive sampling methods. Measurements of FWS in an upright sitting position with and without electromyograph were done on 10 students of class 2008 from Faculty of Dentistry, UNPAD who met the criteria. Data were analyzed by t test statistics, showed that there were significant differences in the measurements with and without electromyography in upright sitting position. Results: The mean of FWS measured with electromyography was 2.38 mm with standard deviation of 0.44 mm, whereas the mean of FWS measured without electromyography was 1.69 mm with a standard deviation of 0.46 mm. Average FWS in men measured with electromyography was 2.51 mm with a standard deviation of 0.15 mm, whereas the mean without electromyography was 1.68 mm with a standard deviation of 0.43 mm. Average FWS in women measured with electromyography was 2.35 mm with a standard deviation of 0.49 mm, whereas the mean without electromyography was 1.69 mm with a standard deviation of 0.50 mm. Conclusion: The measurements of FWS with electromyograph in an upright seating position was greater than without electromyography.

Validity of cephalometric approach to determine freeway space in edentulous cases

Aims and Objectives: The aim was to determine freeway space in edentulous individuals by correlating clinical findings of freeway space clinically with the gonial angle cephalometrically. Materials and Methods: The study was conducted on 100 dentulous individuals in the age-group of 20-30 years. Freeway space was determined by the difference between the readings of vertical dimension of rest and vertical dimension of occlusion in dentulous individuals. Gonial angle was calculated with the help of cephalometric radiographs, and the two were co-related. Results: Gonial angle (X) varied from 103° to 104° with an average of 122.45°. Freeway space (Y) ranged from 0.9 mm to 2.9 mm with an average of 1.77 mm. Co-relation of 51.21% existed between the gonial angle and freeway space. Conclusion: The study establishes a co-relation between gonial angle and freeway space with a value of 51.215%. In this way, the value of freeway space can be obtained.

A Case Report of Multidisciplinary Treatment of an Adult Patient with Bilateral Cleft Lip and Palate

This is a case report about the successful orthodontic treatment of a bilateral cleft lip and palate patient by using a combination of bone grafting and subsequent prosthodontic rehabilitation. An adult patient with a bilateral cleft lip and palate presented with a concave profile, anterior and lateral crossbite, a markedly deep overbite, and residual bilateral alveolar clefts. His jaw movement patterns were unstable and irregular due to his collapsed bite. Orthodontic treatment with bilateral bone grafting improved his concave profile by downward and backward rotation of the mandible within the freeway space, and optimum occlusion and functionally stable and smooth jaw movements were obtained. After a 6-year retention period, no skeletal relapse could be detected, and his occlusal stability was satisfactory.

Orofacial Myofunctional Disorders and Otolaryngologists

Objective: The purpose of this editorial is to alert otolaryngologists to Orofacial Myofunctional Disorders (OMDs) and their primary causes of airway interferences and allergies. An understanding of the variety of OMDs should facilitate improved communications between otolaryngologists and orofacial myologists. Method: OMDs are identified, and the dental alignment and other consequences of OMDs are detailed. Otolaryngologists are a primary resource for evaluating and treating airway interferences in patients with OMDs. Orofacial myofunctional therapy will not be successful without the resolution of airway issues. Results: Tongue thrusting and oral rest posture differences and interactions are discussed. The importance of the dental freeway space in contributing to dental misalignments is detailed. Conclusions: Following referrals from orofacial myologists, otolaryngologists can play an important role in identifying and treating airway interferences that serve to characterize most patients with orofacial myofunctional disorders (OMDs). Knowledge of the characteristics of patients with OMDs regarding rest posture of the jaws and teeth, and abnormal functional activities of the tongue, should facilitate improvements in interdisciplinary communications between otolaryngologists and orofacial myologists.

Complex chromosomal rearrangements in a patient with oligozoospermia and Charcot–Marie–Tooth disease

Complex chromosomal rearrangements in a patient with oligozoospermia and Charcot–Marie–Tooth disease

Positive outcome of occlusal freeway space reestablishment in patients with medication overuse due to chronic migraine

Considering the great chapter of migraines, it is important to note the signs and symptoms caused by an alteration of the relationship of the facial musculature and the occlusal freeway space (FWS) that is the distance from maximal intercuspation to the habitual rest position (measurable in 1.4-2.5 mm). To any mandible position changing (detected by periodontal, muscle and joint proprioceptors), there is an influence on the neuromuscular system and then an alteration of the FWS. A group of 60 patients with chronic migraine (CM) underwent a withdrawal of overused medication and were subjected to electromyographic and kinesiographic evaluation. All those who presented an alteration of the FWS at rest position have been subjected to treatment with orthosis device for about 12 months. The aim of our work is to obtain and define a correct mandibular position, physiological, in agreement with the neuromuscular structures of the patient. Clinical results obtained on this pool of patients, in terms of reduction of the VAS, let us understand the importance of the inviolability of the FWS and to eliminate any type of mandibular deviation with respect to the closure trajectory induced by TENS in patients suffering from CM.

An assessment of interocclusal space in a dentate Nigerian population

To determine the average interocclusal space values in a dentate Nigerian population,and to examine the effect of gender, age and different molar relationships on the values obtained. Three hundred and fifty one subjects mainly of Yoruba extraction with ages ranging from 16 to 78 years were involved in the study. They included 165 males and 186 females. Inclusion criteria in the study included the presence of a stable posterior occlusion with all first molars present and the absence of moderate to deep wear facets suggestive of parafunction. Subject's occlusal dimensions were measured with a calliper at rest and in occlusion. Interocclusal distances were determined by subtracting the occlusal vertical dimension from the rest vertical dimension. The Angles molar relationship was then recorded for each subject. The average freeway space was 2.93 mm with a standard deviation of 1.38; with the females having marginally higher values. The mean values according to age groups were 15-25 years: 3.15 mm, 26-35 years: 2.68 mm, 36-45 years: 2.66 mm, 46-55 years: 3.2 2mm, 56-65 years: 2.74 mm and 66 years and over: 3.10mm.Class Imolar relationship predominated in the sample with 312 patients (88.9%).Nineteen patients (5.4%) had Class II and 20 patients (5.7%) had Class III.Mean freeway space values for Class I, Class II and Class III were: 2.84 mm, 3.88 mm and 3.37 mm respectively. The difference in values was statistically significant. The average interocclusal space amongst the population assessed was 2.93 mm; a value which is similar to that previously reported for Nigerians. Marginally higher values were observed in females while the 26-35 and 36-45 year old groups had lower values than the other age groups. Angle's Class II and III subjects had higher values when compared to class I subjects and was statistically significant. A multi-centre study is recommended to assess possible ethnic variations in these values.

3-Dimensional Physiologic Postural Range of the Mandible: A Computerized-Assisted Technique—A Case Study

Previous studies demonstrated that while the mandible assumes its resting position in space, antagonistic muscles should assume minimal muscle activity within a spatial range. This zone of mandibular rest has been mapped using physiologic parameters of muscle activity and incisal spatial kinematics. This case study expands on previous research by monitoring incisal and posterior jaw position and includes lateral pterygoid muscle activity, thus allowing for determining the spatial range including additional relevant coordinates and muscle activity. Four positions were evaluated: a maximum physiologic open position, a maximum physiologic closed position, physiologic rest position, and maximum physiologic protrusion position. Within the physiologic zone of rest formed by these 4 positions, the vertical and anterior borders of the envelope of function may be documented for the incisal and posterior mandible in true 3-dimensional fashion to assist the clinician in determining a physiologic interocclusal freeway space and vertical dimension of occlusion. Advantages and limitations are discussed.