Loss Of Posterior Support Research Articles

Periodontitis: orthodontic implications and management

Orthodontics is increasingly ingrained in the overall management of patients with periodontitis. Advanced periodontitis is often characterised by pathological tooth migration, loss of posterior support and incisal proclination. Orthodontics may therefore offer both aesthetic and therapeutic benefit. A tailored approach to treatment, however, is necessary given the myriad of presentations and associated risk. The nuances underpinning effective treatment planning, space creation, treatment mechanics, and retention in the periodontal patient are described.

Systematic Management of Severe Anterior Tooth Surface Loss using Provisional Onlay and Permanent Overlay Removable Prostheses: A Case Report

Background: Management of severe tooth surface loss presents a growing difficulty that is encountered increasingly in everyday practice. Loss of posterior support has been identified as the causative factor in severe anterior tooth surface loss, leading to a reduction in the occlusal vertical dimension and complex tooth wear, which can affect the quality of life. Objective: The purpose of this report is to show the systematic approach utilized in the management of severe anterior tooth surface loss in a partially edentulous old patient. Case Report: This report describes the management of a 59-year-old gentleman with a complaint of short anterior teeth as well as inefficient function. Clinical examination revealed short anterior teeth and multiple missing teeth posteriorly, which resulted in the loss of posterior tooth support. The management of this case involved reorganizing the occlusion to create the restorative space, which was achieved by a combination of fixed and removable restorations. The short- and medium-term management consisted of an occlusal splint, endodontic treatment, composite build-ups, provisional onlay acrylic dentures, and metal copings. Single crowns and removable cobalt chrome partial dentures were the definitive treatment for the maxillary arch, while a modified overlay cobalt chrome partial denture with cast facings and custom-made porcelain teeth was fabricated for the mandibular arch. Results: The patient was able to function well with the provisional onlay denture, and at the same time, the increased vertical dimension and the patient’s tolerance and compliance to partial denture treatment were evaluated. The permeant overlay partial denture restored the patient’s aesthetics and function, with minor adjustments needed. At the 2-year review appointment, the patient denied experiencing any muscular or temporomandibular joint soreness or dental complaints except for minor sensitivity. The patient was compliant and satisfied with the overall performance of the dentures. Conclusion: A systematic approach to the management of a patient with a complex presentation can lead to a predictable and favourable prognosis. Onlay and overlay removable partial dentures are regarded as treatment alternatives that are non-invasive, reversible, and conservative.

Updating The General Practitioner on The Association Between Teeth Loss and Temporomandibular Disorders: A Systematic Review.

The belief about a possible association between the absence of one or more teeth and the presence of temporomandibular disorders (TMD), although old, is still present among the dental class. Although evidence points to a lack of association between loss of posterior support and the presence of TMD, we do not have critical studies on the extent, quantity, or location of these losses. In this sense, this systematic review aims to investigate the association between tooth loss and the presence of TMD signs or diagnostic subgroups. Search strategies using a combination of keywords tooth loss and TMDs were performed in six databases (PubMed, Embase, Web of Science, Livivo, Lilacs, and Scopus) and gray literature from August to September 2020. Observational studies that investigated the association between tooth loss in TMD were considered. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Assessment Checklist for cross-sectional analytical studies, case-control, and cohort studies. Finally, the level of certainty measured by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was assessed. Six articles were included in the review according to the eligibility criteria. Of these, five had a high risk of bias and one had a moderate risk. Only one study showed an association between the loss of posterior teeth and the presence of joint sounds and joint pain, the others found no significant association with sign or TMD subgroups diagnostic.There is no scientific evidence to support the association between one or more tooth loss and the presence of TMD signs and symptoms or diagnostic subgroups.

Full-mouth rehabilitation of a patient with loss of posterior support and collapsed occlusion utilizing dental CAD-CAM system

Full-mouth rehabilitation of a patient with loss of posterior support and collapsed occlusion utilizing dental CAD-CAM system

Optimization of Diagnosis and Surgical Treatment of Involutional Entropion of the Lower Eyelid

Background: Rolling inwards of the lid margin is called entropion, and is produced by a disparity in length and tone between the anterior skin muscle, and posterior tarso-conjunctival laminae of the eyelid. Involutional, cicatricial, spastic, or congenital are some of the classifications involutional entropion there is general instability of the lid structures with age .A weakness of the posterior retractors of the lid occurs, together with a laxity of the medial and lateral canthal ligaments, accompanied by a loss of posterior support ,as atrophy of the orbital fat leads to enophthalmos. The current treatment modalities for this condition are surgical in nature, although non-surgical temporary medical treatment are also used. It's a commonest types of eyelid asymmetry. Corneal and conjunctival damage may lead to abrasions, scarring, corneal thinning, or corneal neovascularization due to this misalignment. Unilateral or bilateral entropion is possible. Involutional entropion of lower eyelids are common, but cicatricial upper eyelids are common. Entropion of lower eyelid is a much more prevalent than entropion of the upper eyelid.
 Objective: The purpose is to review the scientific literature on diagnosis and surgical management of involutional entropion of the lower eyelid.
 Methodology: The data were collected from the various electronic data bases like google scholar, PubMed and various books.
 Conclusion: After reviewing the articles, we come to the conclusion that the signs and symptoms of involutional entropion are easily manageable by given treatment.

Dental Occlusion: Proposal for a Classification to Guide Occlusal Analysis and Optimize Research Protocols

Dental occlusion often rhymes with confusion, discrediting many research protocols. The profession seems to be in "major chaos about occlusion." This may be due to the lack of a precise classification of occlusal dysfunctions. We suggest using a classification based on the separation of three occlusal functions, with the identification of precise, objective clinical diagnostic criteria. This article aims to define a precise classification of occlusal functions, in order to be able to establish a positive diagnosis of occlusal disorders. This occlusal analysis method could then be used in the daily practice of dentists and orthodontists, with a view to align epidemiological studies that focus on occlusion, in order to obtain results capable of comparison in different studies. A analysis of the literature in PubMed database published between the early 1970s and the present day identified many confusing definitions of occlusal disorders. In this paper, we propose the separation of occlusal functions into three subcategories: Stabilizing, centering, and guiding functions, defining three different subcategories of occlusal disorder. Occlusal function allows the definition of three kinds of malocclusion: Stabilizing dysfunction, centering dysfunction, and guiding dysfunction. The individualization of clear subcategories could allow the study of the more pertinent impacts of pathogenic malocclusion. This classification of occlusal functions or dysfunctions allows lines to be drawn between different occlusal situations that are frequently confused, such as a loss of posterior occlusal support and loss of occlusal vertical dimension, infra-occlusion and loss of posterior support, short or reduced dental arch, reversed and scissor occlusion, sagittally and transversely deflected mandible, posterior occlusal interference and balancing contact, as well as natural and iatrogenic malocclusion. An occlusal analysis that makes use of the three occlusal functions, "stabilizing, centering, guiding," could offer diagnostic standardization. It may also allow the avoidance of incorrect interpretations. Therefore, this occlusal function classification may be relevant to many fields, for instance, for epidemiological studies of occlusion and the periodontium, TMD and occlusion, or TMD and orthodontic treatment.

Restoration of patient accelerating anterior teeth wear by loss of posterior support: Case report

Restoration of patient accelerating anterior teeth wear by loss of posterior support: Case report

Full mouth rehabilitation of a patient with worn dentition and loss of posterior support by vertical dimension reestablishment: a clinical report

Full mouth rehabilitation of a patient with worn dentition and loss of posterior support by vertical dimension reestablishment: a clinical report

Vertikal Boyut Yükseltilerek Yapılan Protetik Rehabilitasyon

Tooth wear can be classified according to its cause; attrition, abrasion and erosion. Tooth wear is considered pathologic when an intervention is necessary for cosmetic or functional purposes. It is important to determine the factors of tooth wear for treatment protocols. A differential diagnosis is not always possible because there may be a combination of these processes occuring. Lost of vertical dimension can cause loss of posterior support, reduce of interocclusal distance and change of fasial appearance. Loss of tooth structure does not necessarily mean loss of vertical dimension of occlusion. Loss of vertical dimension of occlusion caused by physiologic tooth wear is usually compensated by continuous tooth eruption and alveoler bone growth. In this case report, a treatment to recover lost of masticatoring function and vertical dimension has been described that a patient who has excessive wear of the teeth.

Treatment of second molar impaction

Although the prevalence of second molar impaction is not very high, retention can be a real functional problem within the oral cavity, leading to a loss of posterior support and decreased masticatory potential. Prevention and treatment may alleviate these problems. This article outlines the various treatment options and their implementation characteristics, to facilitate communication and the relationship between dental surgeon and orthodontist in implementing the chosen treatment plan.

Full-mouth rehabilitation of a patient with reduced occlusal vertical dimension due to severe wear: a clinical report

The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects. (J Korean Acad Prosthodont 2013;51:39-46)

The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations

The relationship between the dental occlusion and temporomandibular disorders (TMDs) has been one of the most controversial topics in the dental community. In a large epidemiological cross-sectional survey - the Study of Health in Pomerania (Germany) - associations between 15 occlusion-related variables and TMD signs or symptoms were found. In other investigations, additional occlusal variables were identified. However, statistical associations do not prove causality. By using Hill's nine criteria of causation, it becomes apparent that the evidence of a causal relationship is weak. Only bruxism, loss of posterior support and unilateral posterior crossbite show some consistency across studies. On the other hand, several reported occlusal features appear to be the consequence of TMDs, not their cause. Above all, however, biological plausibility for an occlusal aetiology is often difficult to establish, because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either, because the amelioration may be due to the change of the appliance-induced intermaxillary relationship. In addition, symptoms often abate even in the absence of therapy. Although patients with a TMD history might have a specific risk for developing TMD signs, it appears more rewarding to focus on non-occlusal features that are known to have a potential for the predisposition, initiation or perpetuation of TMDs.

Temporomandibular disorders. A case-control study

Objective: To compare the risk factors and clinical manifestations of patients with temporomandibular disorders (TMDs) diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (axis I) versus an age and gender matched control group. Study Design: A total of 162 patients explored according to the RDC/TMD (mean age 40.6±18.8 years, range 7-90; 11.1% males and 88.9% females) were compared with 119 controls, measuring differences in TMD risk factors (sleep disturbances, stress, psychoactive medication, parafunctions, loss of posterior support, ligament hyperlaxity) and clinical variables (joint sounds, painful muscle and joint palpation, maximum aperture). Results: Myofascial pain (MFP) (single or multiple diagnoses) was the most frequent diagnosis (42%). The most common diagnostic combination was MFP plus arthralgia (16.0%). Statistically significant differences were observed in clenching (OR 2.3; 95%CI: 1.4-3.8) and in maximum active aperture (MAA) on comparing the two groups both globally (TMD vs. controls) (patients 36.7±8.6 mm, controls 43.1±5.8 mm; F=45.41, p = 0.000) and on comparing according to diagnostic categories. MFP explained most of the observed differences in the risk factors: stress perception (OR=1.98;I.C.:1.01-3.89), psychoactive medication (OR=2.21; I.C.:1.12-4.37), parafunctions (OR=2.14;I.C.:1.12-4.11), and ligament laxity (OR=2.6;I.C.:1.01-6.68). Joint sounds were more frequent in patients with MFP (39.7% vs. 24.0%; χ2=4.66; p=0.03), and painful joint palpation was more common in patients with disc displacement with reduction (DDWR)(15.9% vs. 5.0%; χ2 = 5.2; p = 0.02) and osteoarthrosis (20.8% vs. 5.0%; χ2 = 7.0; p = 0.008). Conclusions: There is a high prevalence of signs and symptoms of TMDs in the general population. Significant differences are observed in clenching and MAA between patients and controls considered both globally and for each diagnostic category individually. The analyzed risk factors (except loss of posterior support) show a statistically significant OR for the diagnosis of MFP. Key words:Disorder, dysfunction, temporomandibular, myofascial, osteoarthrosis, TMJ, disc displacement.