Mandibular Movement Research Articles

Effectiveness of mobilization on cranio– –mandibular index in temporomandibular joint dysfunction among collegiates

Background: Temporomandibular disorder (TMD), according to the American Academy of Orofacial Pain (AAOP), is a collection of painful and/or dysfunctional diseases affecting the masticatory muscles, temporomandibular joints (TMJs), and associated tissues. This can be treated effectively by the manual mobilization. Objective: To find out the effectiveness of mobilization on craniomandibular index in Temporomandibular Joint Dysfunction among college students. Methods: It is a quasi-experimental pre and post type study performed among 40 college students, both boys and girls, with Temporomandibular Joint Dysfunction, selected through convenient sampling of the age group 18–25 years, with a Craniomandibular index score of more than 0.50. The selected group is treated with a 4 week mobilization to see the effectiveness of the treatment. Outcome measure: Cranio Mandibular Index which encloses of the mandibular movement, range of motion, joint palpation ,muscle palpation, TMJ noise. Results: The results show that there was a significant improvement in the mean values of the craniomandibular index score after mobilization, with a mean difference of 0.32 ± 0.05. Conclusion: The study concluded that mobilization is an effective treatment approach for temporomandibular joint dysfunction among college students.

Treatment to an edentulous patient with unstable muscular position and unilateral limited mandibular movement: a case report

Treatment to an edentulous patient with unstable muscular position and unilateral limited mandibular movement: a case report

The Effect of Postural Rehabilitation on Pain, Balance, Mandibular Movement, and Posture in Temporomandibular Disorder Patients: A Comparison Between Posterior Edentulous and Dentate Groups.

Objective: Posterior edentulism reduces occlusal support, thus increasing the risk and symptoms of temporomandibular disorder. No previous study has explored its effect on the treatment of temporomandibular disorders. This study aimed to examine the relationship between neck posture, balance, and posterior edentulism in patients with temporomandibular disorder and compare the effectiveness of physical therapy. Methods: In a quasi-experimental controlled trial, 26 patients with temporomandibular disorder were divided into 13 in the partly edentulous group and 13 in the dentate group. Both groups received manual therapy, postural exercises, deep neck flexor stabilization, and Kinesio tapping for 6 weeks. Each participant completed 12 physiotherapy sessions, administered twice weekly, with a minimum interval of 48 hours between sessions. Outcomes were assessed at baseline and after the 6-week program, including pain, mandibular movement, posture, and balance. Results: The physical therapy program significantly improved all measured outcomes (P < .05). Furthermore, the partially edentulous group showed more remarkable improvement in pain and balance compared to the dentate group (P < .05). Conclusions: Postural exercises effectively alleviate symptoms in patients with temporomandibular disorder, with more significant improvements observed in the partially edentulous group than in the dentate group.

Comparative analysis of myoelectric activity and mandibular movement in healthy and nonpainful articular temporomandibular disorder subjects.

Temporomandibular disorders (TMDs) are one of the leading causes of craniofacial pain, and a high incidence of TMDs in young adults has been reported. Previous studies have used surface electromyography (sEMG) and mandibular kinematic analysis for TMDs diagnosis. This study aimed to provide normal reference values of sEMG and mandibular kinematics in Han Chinese adults, compare the sex differences and assess their diagnosis value on pain-free articular TMDs. This observational study recruited healthy young adults with individual normal occlusion and nonpainful articular TMDs patients with disc displacement. The sEMG signals of the anterior temporalis (TA), masseter (MM), and sternocleidomastoid and digastric were recorded in the mandibular postural positions (MPP) and during maximal voluntary clenching (MVC) with K7 electromyograph. Mandibular kinematics, including maximum opening and opening/closing velocities, were assessed by K7 kinesiograph. The sEMG reference values ranged from 3.0 to 4.3 µV in the MPP (n = 90) in healthy subjects. The sEMG values during MVC, maximum opening, and opening velocity were significantly higher in males than in females. Also, these indices showed good diagnostic efficiency for pain-free articular TMDs (n = 26). Reference values and sex differences in sEMG and mandibular kinematics in healthy subjects were determined. Compared with them, articular TMDs patients showed significantly lower myoelectric activity during maximal biting and restricted mouth opening range and velocity, which may assist in TMDs diagnosis. By analyzing sEMG of masticatory muscle and mandibular kinematics data from healthy Han Chinese young adults and TMDs patients with disc displacement, this study evaluated the sex difference and their diagnosis value on nonpainful TMDs with disc displacement. NCT06372769.

Open surgical approach to fractures of the mandibular condyle: surgical technique and associated complications.

This study evaluates anatomical reduction and rigid internal fixation of mandibular condyle fractures using the preauricular retroparotid approach. It also discusses advantages, deficiencies, and associated complications of the technique. This retrospective study reviewed the medical records of a total of 52 mandibular condyle fractures from 42 patients who were treated with open surgery using the preauricular retroparotid approach between January 2019 and January 2024. Preoperative and postoperative assessments included measurements of mouth opening (maximum interincisal distance), vertical mandibular movement, and facial paralysis. Moreover, the Vancouver Scar Scale (VSS) was used to evaluate scar quality at the surgical site. Descriptive statistics were used to summarize patient demographics, preoperative findings, and postoperative outcomes. Anterior open bite was the most common finding, detected in 83% of the patients before surgery. The mean mouth opening of the patients increased significantly from 29 ± 4.94 mm to 37.76 ± 2.12 mm. Vertical mandibular movement exceeding 4 cm was a finding in more than half (52.3%) of the patients. The mean VSS score, indicating scar quality, was 1.64 ± 0.70, suggesting overall good cosmetic outcomes. Plate breakage in two patients was noted as a complication during follow-up. Several surgical techniques have been described for mandibular condyle fractures, each with its own benefits and limitations.

An automatic tracking method to measure the mandibula movement during real time MRI

Mandibular movement is complex and individual due to variations in the temporomandibular joint (TMJ). Consequently, patient-centered dentistry should incorporate patients’ specific anatomy and condylar function in treatment planning. Real-time magnetic resonance imaging (rt-MRI) visualizes relevant structures and tracks mandibular movement. However, current assessments rely on qualitative observations or time-consuming manual tracking, lacking reliability. This study developed an automatic tracking algorithm for mandibular movement in rt-MRI using least mean square registration (LMS) and compared it to manual tracking (MT) during mouth opening. Ten participants with skeletal class I underwent rt-MRI (10 frames/s). The same operator tracked the condylar pathway for the two methods, setting 2000 landmarks (2 landmarks x100 frames x10 participants) for MT and 210 landmarks (3 landmarks x7 frames x10 participants) for LMS. Time required, superimposition error, and the distance between tracked condylar pathways were compared between methods. LMS tracking was 76% faster and showed significantly better superimposition (0.0289 ± 0.0058) than MT (0.059 ± 0.0145) (p = 0.002). During one-third of the movement, the pathways tracked by both methods were more than 1 mm and 1° apart. These findings highlight the benefits of automatic condylar movement tracking in rt-MRI, laying the groundwork for more objective and quantitative observation of TMJ function.

Angled Screws With Locking Plates-An Alternative Fixation for Minimally Invasive Mandibular Orthognathic Surgery.

The purpose of this study was to evaluate the short-term behavior of angled screws with locking plates after bilateral sagittal split osteotomy using the anterior oblique technique within the concept of minimally invasive orthognathic surgery (MIOS). Twenty patients who underwent bimaxillary surgery with mandibular advancement were included in this preliminary and retrospective study. All patients underwent computed tomography preoperatively and 1 day postoperatively. The incidence of neurosensory dysfunction, clinical evaluation of the occlusion and temporomandibular joint, and overall complications were recorded during a minimum follow-up of 4 months. The mean extent of sagittal mandibular advancement movements was 7.2mm (2.5-13.2mm). All patients had stable occlusion without evidence of temporomandibular joint dysfunction. None of the patients presented with dysaesthesia, hyperaesthesia, or anesthesia after four months of follow-up. The overall results of this study are very satisfactory with no major or minor complications. The new design of mandibular plates with locking screws can be an alternative in all orthognathic surgeries, but especially interesting for minimally invasive approaches where stronger fixation is needed. Long-term studies are needed to draw further conclusions.

Comparative evaulation of condylar guidance obtained by digital panoramic radiographic images with that of obtained during jaw relation and try-in using two different interocclusal record material in completely edentulous patients: an in vivo study

Background In completely edentulous patients, maintaining the patient’s temporomandibular joint (TMJ) health and intraoral components is very essential, which can be achieved by an accurate interocclusal record, which can be taken by various materials and also at various stages. Simulation of the temporomandibular joint anatomy and mandibular movements is possible on a semi-adjustable articulator, which is widely used in prosthodontics. Transferring the record on articulator is a critical step in the fabrication of complete dentures, so it should be done precisely to reduce chair side time and also to avoid complications for patients. This study examines which material is more accurate and records which stage gives more precision by comparing the Condylar guidance on radiographs. This is because it is a relatively consistent bony landmark and can be used to correlate with clinical methods in terms of verification. The objective is to determine the inter occlusal records created during the Jaw Relation stage and Try-in using reinforced wax and Polyvinyl siloxane and compare these values to the condylar guidance obtained by orthopantomogram (OPG). Methods Recording the Condylar Guidance value on OPG by tracing the Glenoid fossa, Articular eminence, and the Frankfurt Horizontal Plane. Followed by conventional steps in making complete dentures at jaw relation and try-in stage. We will record values of condylar guidance with the two different Interocclusal record materials. Expected result It will help the clinicians to gain knowledge about obtaining precise condylar inclination angle by using suitable interocclusal record materials. Conclusions This study will help us to obtain condylar inclination, which in turn helps the patient’s satisfaction as it preserves the intraoral components and health of TMJ.

Multi-material 3D printing of functionally graded soft-hard interfaces for enhancing mandibular kinematics of temporomandibular joint replacement prostheses

Temporomandibular joint (TMJ) replacement prostheses often face limitations in accommodating translational movements, leading to unnatural kinematics and loading conditions, which affect functionality and longevity. Here, we investigate the potential of functionally graded materials (FGMs) in TMJ prostheses to enhance mandibular kinematics and reduce joint reaction forces. We develop a functionally graded artificial cartilage for the TMJ implant and evaluate five FGM designs: hard, hard-soft, and three FGM gradients with gradual transitions from 90% hard material to 0%, 10%, and 20%. These designs are 3D printed, mechanically tested under quasi-static compression, and simulated under physiological conditions. Results from computational modeling and experiments are compared to an intact mandible during incisal clenching and left group biting. The FGM design with a transition from 90% to 0% hard material improves kinematics by 19% and decreases perfomance by 3%, reduces joint reaction forces by 8% and 10%, and increases mandibular movement by 20% and 88% during incisal clenching and left group biting, respectively. These findings provide valuable insights for next-generation TMJ implants.

Effect of Cognitive Decline on Mandibular Movement during Mastication in Nursing Home Residents.

Background: Many studies have reported on the relationship between cognitive and masticatory functions. However, it remains unclear how the mandibular movements change during chewing in facility residents as dementia progresses. This study aimed to investigate the relationship between a kinematic analysis of mandibular movement during mastication and cognitive function in facility residents. Methods: Sixty-three participants were included from two long-term care facilities. The primary outcome variable was the kinematic data of mandibular movement during mastication. The participants chewed rice crackers, and their faces were recorded during this motion. The partial correlation coefficient between kinematic data and cognitive function was calculated. Furthermore, group comparisons were performed after dividing the participants into three groups based on their cognitive function. Results: Circular motion frequency was significantly correlated with the ABC dementia scale, even after adjusting for the appendicular skeletal muscle index, Eichner index, and short-form mini-nutritional assessment. The cycle and circular motion frequencies were markedly lower in the severe dementia group than in the mild dementia group. Conclusions: With declining cognitive function, mandibular movements during mastication decrease in circular motion and increase in linear motion. Additionally, our results suggested that residents with severe cognitive impairment had more linear mandibular motions during mastication than those with mild cognitive impairment. This may make it more difficult for residents with cognitive decline to ingest normal solid foods.

Botulinum toxin for the management of bruxism: an overview of reviews protocol

IntroductionBruxism is characterised by a repetitive activity in the masticatory muscles that involves teeth clenching or grinding and/or forceful mandibular movements. Its management is typically initiated when individuals start experiencing...

The activity of suprahyoid muscles during sevoflurane-induced gasping in mice

Sevoflurane-induced gasping in mice involves an enormous increase in inspiratory effort, mandibular movement, and a marked decrease in respiratory frequency (fR). We examined differences in breathing patterns and electromyogram activity (EMGSH) of the suprahyoid muscles (SHMs) during eupnea under 3.2 % (1 MAC: minimum alveolar concentration) sevoflurane inhalation and sevoflurane-induced gasping under 6.5 % (2 MAC) sevoflurane inhalation in eight spontaneously breathing, tracheally intubated, adult mice. We found that the phasic EMGSH is obtained only during inspiration in eupnea and gasping and that integrated EMGSH increases more, as a percent of baseline (% baseline) than tidal volume (VT) during gasping (median [interquartile range]; integrated EMGSH: 720 [425–1965] vs. VT: 300 [238–373], P < 0.05). We also found that the onset of EMGSH precedes the start of airflow while maintaining a bell-shaped EMGSH contour, which characterizes the EMG of upper airway dilator (UAD) muscles during eupnea and gasping. Vigorous respiratory-related mandibular movements were never observed during eupnea but were observed in seven of 8 mice during sevoflurane-induced gasping. Our observations indicate that SHMs act as a preferentially activating UAD muscle, contributing to the development of mandibular respiratory movements.

The Stress Effects of Mandibular Movements on the Temporomandibular Joint With Sagittal Split Ramus Osteotomy.

The aim of this study was to evaluate the stress changes in the temporomandibular joint (TMJ) after sagittal split ramus osteotomy (SSRO) with finite element analysis (FEA). 5 and 10mm mandibular setback and advancement were applied to models by using SSRO and a control model without osteotomy evaluated. The articular disc was modeled as superelastic, and the stresses on the articular fossa, disc, and condyle were evaluated. The stresses on the cartilage were 1.150 MPa on the 5mm advancement model and 1.506 MPa on the 10mm advancement model. The stresses on the disc were 11.56 MPa on the 5mm advancement model, 7.94 MPa on the 10mm advancement model and the amount were significantly higher than other models. The stress, especially in the cartilage, increased with the amount of advancement. In the setback models, the stresses on the condylar cartilage and the disc were higher than in the control model, and the stress in the condylar cartilage increased with the amount of setback. SSRO increases the stresses in the TMJ components and stresses increase depending on the amount of advancement and setback and may cause the development of joint problems.

Effects of Attachment Design and Aligner Material on Mandibular Canine Distal Bodily Movement in Aligner Treatment

Abstract Purpose Dental crowding is a result of a mismatch between tooth size and arch dimensions, which leads to malocclusion; treatment often involves premolar extraction before orthodontic alignment. Clear aligners are limited in their ability to achieve canine distal bodily movement, a common orthodontic maneuver. This study investigated the impacts of attachment design and aligner material on the efficacy of canine distal bodily movement. Methods A finite element analysis was conducted to examine the impact of various attachment designs and two aligner materials, thermoplastic polyurethanes/polycarbonate (TPU/PC) and polyethylene terephthalate glycol-modified (PETG), on mandibular canine distal bodily movement. The investigation focused on the biomechanical responses in the periodontal ligament (PDL) and surrounding alveolar bone. Results Attachment configuration exerted a strong influence on mandibular canine movement. Vertically oriented attachment pairs positioned mesially (mesial occlusal–mesial cervical) resulted in the most effective canine distal bodily movement, followed by a rectangular attachment. TPU/PC aligners induced slightly higher principal stresses in the PDL and von Mises stress and strain in the surrounding alveolar bone compared with PETG aligners; however, the difference was negligible, amounting to less than 6%. Conclusion Attachment design, specifically vertically oriented pairs positioned mesially (mesial occlusal–mesial cervical), was determined to be the crucial factor influencing the efficacy of canine distal bodily movement. The choice of aligner material (TPU/PC or PETG) has minimal impact on this orthodontic procedure.

Is minimally invasive approach to genioplasty predictable for mentolabial soft tissue? A retrospective cohort study

IntroductionThe aim of this study was to conduct a three-dimensional analysis of the effects on mentolabial soft tissues of three different orthognathic surgery protocols: bimaxillary surgery without genioplasty, bimaxillary surgery with conventional or minimally invasive genioplasty (MIS). Materials and methodsPre-operative and post-operative CBCT were superimposed to quantify and ascertain the direction of mandibular movements, and soft tissue were analyzed to evaluate the hard to soft tissue ratio. Data from 97 consecutive patients were evaluated: 30 conventional genioplasty, 36 MIS and 31 no genioplasty. ResultsThe impact of the surgical movements on the overlying soft tissues can be consider with stronger correlation in the group No Genioplasty in the whole mentolabial region, stronger correlation in labial and pogonion region in the MIS group and no stronger correlation in the conventional group. ConclusionsSutures in the mentolabial region directly interfere with the postoperative impact of orthognathic surgery on soft tissues in mentolabial area, in both the vertical and horizontal directions. A smaller incision – consequently involving less detachment of soft tissues in the region – may promote a lower risk of chin ptosis, in addition to greater suspension of the musculature.

MANUAL OROFACIAL STIMULATION AND ITS IMPACT ON CHILDREN WITH CEREBRAL PALSY

Orofacial education of children with cerebral palsy is a long-lasting process that requires perseverance especially from their families. The main methods based on active orofacial exercises and those from speech therapy continue to question the effectiveness of oral motor treatment, leaving a gap in the literature concerning the feeding skills improvements of the children diagnosed with cerebral palsy. Based on this concern, we ask ourselves the question: are there other better methods of oral motor rehabilitation for these children with special needs? In this study we aimed to investigate, within the complex rehabilitation programme for CP, the impact of manual orofacial stimulation in order to reduce sialorrhea and improve mandibular movements, which play an important role in the feeding process. The study included 10 participants (5 girls and 5 boys), aged 8-10 years, diagnosed with cerebral palsy, spastic tetraplegia form with severe orofacial impairment and the intervention protocol consisted of a manual orofacial stimulation programme 4 times a week. Statistical results revealed that the application of the proposed orofacial stimulation programme was highly effective for the 10 research participants, whose scores improved significantly at the final assessment compared to those achieved at the beginning of the study, reaching almost normal values even in the case of mandibular parameters.

基于弓背蚁上颚切-锯运动机理的农业仿生刀开发研究

Aiming at issues such as low instantaneous grasping ability, unsatisfactory cutting quality, and proneness to damage of the blades for existing harvesters, by observing the physiological structure and movement characteristics of the ant's mandible and by bionic design theory, a bionic blade was designed to optimize its performance. In this paper, Camponotus was selected as the research object to observe the movement of the right mandibular teeth. It was concluded that the movement of the ant's mandibular teeth was a cutting-sawing motion. A comparative analysis was carried out using the flat blade and the mandibular teeth blade, uncovering that the mandibular teeth movement formed a sliding cut with a variable sliding cutting angle. The mandibular teeth were beneficial for clamping the target and boosting the instantaneous grasping force. The fourth tooth of the mandible was selected as the bionic prototype. from which the contour curve was extracted and analyzed, followed by the design of the bionic blade. Through the finite element method, the influence laws of parameters such as the tooth pitch, structural angle, and blade inclination angle on the stress field and deformation of the bionic blade were analyzed under two force application circumstances: along the inclination direction of the tooth edge and the blade face direction. The results showed that when the applied force was along the tooth edge inclination, the total deformation of the bionic blade initially decreased and then increased with the tooth pitch increase. The maximum equivalent stress of the bionic blade rose gradually with the tooth pitch increase, and the total deformation decreased with the increase of the inclination angle of the tooth. The equivalent stress diminished with the rise in the inclination angle. With the increase of the structural edge angle, the total deformation of the bionic blade rose gradually. When the force was applied along the blade face direction, the deformation and stress values of the blade were significantly lower than those when the force was along the tooth edge inclination. The research findings can offer theoretical references for the design of bionic blades for harvesters.

Comparative analysis of three jaw motion tracking systems: A study on precision and trueness.

The purpose of this study was to assess the precision and trueness of three jaw motion tracking systems, the KaVo ARCUSdigma system, SDiMatriX system, and Modjaw system, in recording mandibular movements based on optical and ultrasonic principles. Twenty-five healthy subjects were selected for the present study to measure protrosive movement and left and right lateral movements using the three jaw motion tracking systems. Each subject's mandibular movement was recorded twice with a 1-week interval. Five parameters-sagittal condylar inclination (SCI) angle, incisal guide angle, Bennett angle, lateral condylar inclination angle, and Fischer's angle-were acquired for further analysis. The precision of the jaw motion tracking systems was evaluated by comparing the results of two measurements of the same parameter. Simultaneously, cone beam computed tomography (CBCT) was utilized during the initial data acquisition and was aligned with intercuspal position (ICP) and edge-to-edge occlusion intraoral scan data. Bone landmarks were used to calculate bilateral SCI as a reference for comparison with the SCI values from each jaw motion tracking system. An independent-sample t-test was conducted to compare parameter differences, with statistical significance set at a p-value below 0.05. There were no significant differences among the three jaw motion tracking systems regarding the corrected values of SCI, incisal guide angle, Bennett angle, lateral condylar inclination angle, and Fischer's angle during the 1-week interval (p>0.05). The values of bilateral SCI obtained by CBCT were 48.57±6.74 (L) and 48.35±5.28 (R), respectively. No significant differences were found between the reference SCI and those parameters measured by the KaVo ARCUSdigma system and the Modjaw system (p>0.05), while the results obtained from the SDiMatriX system indicated a significant difference compared to the reference SCI (p<0.05). The three jaw motion tracking systems exhibited favorable results in terms of precision. Regarding trueness, both the KaVo ARCUSdigma system and the Modjaw system demonstrated a satisfactory levels suitable for applications in digital prosthodontics within clinical settings. However, further refinement is needed to enhance the trueness of the SDiMatriX system.

The preliminary study of the effects of individual musculoskeletally stable position in the treatment of temporomandibular disorders

BackgroundTemporomandibular Disorders (TMD) is the dysfunction of group of muscles and bones in the joint area, the main symptoms of TMD are the pain of the chewing muscles and (or) the temporomandibular joints, mandibular movement disorders and joint noise. This study was designed to explore the therapeutic effects following Individual Musculoskeletally Stable (IMS) position stabilization splint therapy for TMD patients using Fricton index, cone beam computed tomography (CBCT) and surface-Electromyogram (sEMG).MethodsIn this study, we enrolled 31 TMD patients (ranging from 18 to 26 years old, including 7 males and 24 females), first Fricton index was used to evaluate the clinical curative effect of TMD with the treatment of IMS stabilization splint; then CBCT was used to observe the TMJ condylar position changes of TMD before and after the treatment of IMS stabilization splint; finally sEMG was used to observe the changes of electromyography of anterior temporalis (AT) and masseter muscles (MM) of TMD before and after the treatment of IMS stabilization splint.ResultsThe course of treatment was 6–8 months, with an average of 7.6 months. After the IMS stabilization splint treatment, TMD symptoms relieved, especially in pain, mandibular movement disorder, but still slightly inferior in the treatment of joint noise. And there was a statistically significant difference in the anterior and inner joint space, the condyle had the tendency of moving forward and outward. AT presented reduction significantly of EMG value at rest position after treatment.ConclusionsIMS stabilization splint is a therapeutic reversible treatment for TMD, especially for pain and mandibular movement disorder; it produces effects of forward and outward condylar movement and elimination of the masticatory muscles antagonism.

A study on the precision of voxel- and surface-based mandibular superimposition.

To apply the more accurate technique for mandibular superimposition and provide a valuable reference for the assessment of mandibular tooth movement and condylar remodeling before and after orthodontic treatment. This retrospective study involved 38 adult patients who underwent two cone beam computer tomography (CBCT) scans at different stages of treatment at Fujian Provincial People's Hospital between September, 2020 and December, 2022. The software Dolphin was used for mandible segmentation, enabling voxel-based mandibular superimposition with the mandibular ramus as the reference region. The Geomagic Wrap software was employed to process surface-based mandibular superimposition with the mandibular ramus as a reference. Additionally, the voxel and surface-based methods were compared for precision, with the mandibular ramus being the reference. After voxel-based mandibular superimposition using the mandibular ramus as a reference, with all measurement errors (< 0.20 mm). In contrast, the results of surface-based mandibular superimposition with the same reference, and the measurement errors were all less than 0.10 mm. The Wilcoxon signed-rank test revealed statistically significant differences between AS1 and BS1, AS2 and BS2, AS3 and BS3, and AS4 and BS4 (all r< 0.05). Moreover, the absolute mean distances of AS1-AS4 were all greater than those of BS1-BS4. All mandibular superimposition procedures, including the voxel- and surface-based ones using the mandibular ramus as a reference, have acceptable surface errors (< 0.20 mm), indicating the good reliability of these techniques. Under the specified conditions, surface-based mandibular superimposition appears to yield a higher degree of precision compared with the voxel-based technique.