Mandibular Movements In Patients Research Articles

Natural History of Mandibular Function in Spinal Muscular Atrophy Types 2 and 3.

Hereditary proximal spinal muscular atrophy (SMA) is characterized by abnormal alpha motor neuron function in brainstem and spinal cord. Bulbar dysfunction, including limited mouth opening, is present in the majority of patients with SMA but it is unknown if and how these problems change during disease course. In this prospective, observational, longitudinal natural history study we aimed to study bulbar dysfunction in patients with SMA types 2 and 3. We included 44 patients with SMA types 2 and 3 (mean age was 33.6 (95% CI 28.4;38.9) and re-examined them after on average 4 years. None were treated with SMN-modulating treatments before or during the course of this study. Longitudinal assessments included a questionnaire on mandibular and bulbar function, the Mandibular Function Impairment Questionnaire (MFIQ), and a clinical examination of masticatory performance, maximum voluntary bite force, and mandibular movements including the active maximal mouth opening. We found significant higher MFIQ scores and a significant decrease of all mandibular movements in patients with SMA type 2 (p < 0.001), but not in SMA type 3. Masticatory performance and maximum voluntary bite force did not change significantly. Mean reduction of active maximal mouth opening at follow-up was 3.5 mm in SMA type 2 (95% CI: 2.3; 4.7, p < 0.001). SMA type 2 was an independent predictor for a more severe reduction of the mouth opening (β= -2.0 mm (95% CI: -3.8; -0.1, p = 0.043)). Bulbar functions such as mandibular mobility and active maximum mouth opening decrease significantly over the course of four years in patients with SMA type 2.

Analysis of Mandibular Movement after insertion of Fixed Partial Dentures using Cadiax Compact II®

The aim of this clinical study was to analysis the mandibular movement in patients after insertion of fixed partial dentures using Cadiax Compact II and compares the Horizontal condylar angles and Bennette angles before and after insertion of posterior fixed partial denture.Material and methods: Mandibular movement of thirty two patients, sixteen males and sixteen female planed for posterior fixed partial dentures), had been recorded using Cadiax Compact II® for Horizontal Condylar Inclination and Bennette Angle. Three records had been obtained R1 before the abutments teeth preparations of the Fixed Partial Dentures, R2 after the cementation of the Fixed Partial Dentures and R3 after one month of the Fixed Partial Dentures cementation.Results: Statistical highly significant difference was found between R1&amp;R2 for Bennette angles in both males and females, and significant difference in group R1&amp;R3 for Horizontal condylar Inclination in females only. The other groups show no statistical significant difference.Conclusion: Within the limit of this clinical study, the insertion of fixed partial denture have no changing effect on the Horizontal Condylar inclination in males but in females have mild change. For Bennette angle there is highly significant change in both males and females immediately after the fixed partial denture cementation, but after one month this change disappeared.

Evaluation of Mandibular Movements in Patients with Bell's Palsy Using Kinematic Variables.

Since the function of muscles, and subsequently the mandibular joint, is affected in patients with Bell's palsy, therefore, the evaluation of facial muscles and mandibular function in these patients can be effective in diagnosis, prevention, and treatment planning. The present study aimed to evaluate the degree of displacement and range of motion (ROM) of the mandible and the ability of the facial symmetrical muscles of patients with Bell's palsy. This was a quasi-experimental comparative study. The variables evaluated were mandibular movement in a vertical direction and side-to-side displacement. Ten patients with Bell's palsy and 10 healthy eligible volunteers participated in the present study. Three mobile video cameras (to record jaw movements), 9 color markers, Kinovea software, House-Brackmann index, Toledo protocol, and a specialized patient questionnaire were used. Descriptive and inferential statistics were used for data analysis, the Kolmogorov-Smirnov test was used to investigate the normality of data distribution, and independent samples the t test and paired samples t test were used to compare means. The maximum lateral on the sound side was 12.40 and 4.49 mm during lateral movements of the patients' mandible, while this value was between 12.30 and 3 mm on the involved side. There is a difference between the affected side and the nonaffected side in terms of the mean lateral movements of the patients' mandible. However, this difference in the mean ROM on both sides is not statistically significant. The maximum mouth opening in healthy individuals during mandibular movements was between 40 and 60 mm, while this value was between 25 and 50 mm in the patients with Bell's palsy. This study shows a significant difference (P = 0.007) between patients and healthy individuals in terms of the mean of maximum mouth opening ( P < 0.05). The results of this study showed that the ROM of temporomandibular joint (TMJ) of the patient is the same as that of normal subjects, but the side-to-side motion is more than normal which should be considered in rehabilitation treatments. The present study emphasizes the need to implement a mandibular kinematic evaluation protocol in patients with bell's palsy to prevent damage to the TMJ in the long term.

Evaluation of the effect of low level LASER therapy versus printed occlusal splint on mandibular movements in patients with TMJ muscular disorders by using ARCUS digma

Evaluation of the effect of low level LASER therapy versus printed occlusal splint on mandibular movements in patients with TMJ muscular disorders by using ARCUS digma

Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry

BackgroundSoft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors.MethodsPositional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery.ResultsMaxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values.ConclusionThe horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy.

The efficacy of a combination treatment of arthrocentesis and stabilisation splint for patients with bilateral anterior disc displacement without reduction (ADDWoR) and erosive change of the TMJ remains controversial. To evaluate clinical outcomes of patients with ADDWoR and erosive change of the TMJ after performance of unilateral arthrocentesis and stabilisation splint therapy. A retrospective study of 44 patients (37 females, 7 males, mean age of 34years) with bilateral ADDWoR and erosive change of the TMJ were included in this study. Their clinical outcomes before and after arthrocentesis and stabilisation splint therapy were compared. Evaluation criteria were as follows: (a) Maximal mouth opening (MMO); (b) Right and left maximal lateral movement (RLM, LLM) and maximal protrusive movement (PM); (c) Visual analog scale (VAS) pain score during MMO, RLM, LLM and PM; and (d) VAS pain score during palpation of masticatory muscles. Wilcoxon signed-rank test, Mc Nemar test and paired t test were used for statistical analysis. Differences in VAS pain score between arthrocentesis and non-arthrocentesis sites were not statistically significant except MMO and LLM (P<.05) after 6months. Differences in mean VAS pain scores for all variables between before arthrocentesis and 6months follow-up in the arthrocentesis site were statistically significant. (P<.01). Unilateral arthrocentesis on more symptomatic TMJ and subsequent stabilisation splint therapy was highly successful for pain and achievement of normal range of mandibular movements in patients with both ADDWoR and bony change.

Efficiency of arthrocentesis treatment for different temporomandibular joint disorders

This study was performed to determine whether arthrocentesis therapy has different outcomes in three groups of patients with different temporomandibular disorders (TMDs). A clinical trial was conducted including 45 patients with 45 unilaterally affected joints divided into three groups (n=15): osteoarthritis (OA), disc displacement with reduction (DDWR), and disc displacement without reduction (DDWoR). All patients underwent the same arthrocentesis treatment protocol. The outcome variables, including visual analogue scale evaluations and measurements of mandibular motion (in millimetres), were recorded at baseline and at 1 and 6 months postoperative. Inter-group assessments showed significant short-term differences in joint sounds (P=0.016) and significant long-term differences in masticatory efficiency (P=0.046) and protrusive movement (P=0.048). The estimation of mean changes between baseline and long-term follow-up revealed significant differences in joint sounds (P<0.001), disruption in daily activities (P=0.002), maximum mouth opening (P=0.008), and protrusive movement (P=0.002) between the groups. Arthrocentesis therapy may be useful to improve clinical symptoms and range of mandibular movement in patients with all three types of TMD. However, the benefit of arthrocentesis may be greater for patients with DDWoR than for those in the other groups.

Trial does not show any benefits of low-level laser therapy in pain, swelling, and mandibular movements in patients undergoing orthognathic surgery

D'ávila RP, Espinola LVP, de Freitas PM, Silva AC, Landes C, Luz JGC. Longitudinal evaluation of the effects of low-power laser phototherapy on mandibular movements, pain, and edema after orthognathic surgery [published online ahead of print February 1, 2019]. J Craniomaxillofac Surg. https://doi.org/10.1016/j.jcms.2019.01.038.

Effects of short-term acupuncture treatment on occlusal force and mandibular movement in patients with deep-bite malocclusion

Background/purposeAcupuncture is well known to be effective for pain relief and muscle relaxation, and hence it is feasible that acupuncture treatment could change the occlusal forces and mandibular movements in subjects with deep-bite malocclusion. The purpose of this research was to determine the distribution of occlusal force and the border movement of the mandible in patients with deep-bite malocclusion before and after acupuncture treatment. Materials and methodsThis study involved 17 volunteers with deep-bite malocclusion and aged 20–30 years. Before and after acupuncture treatment, the distribution of the occlusal-force percentage at each tooth was measured and the percentage biting force in the first molar area during maximal clenching was recorded. Additionally, the mandibular movements including the maximum mouth opening and maximum lateral border movement were also evaluated. All of the data were analyzed statistically using the Wilcoxon signed-rank test. ResultsThe percentage biting force at the first molar differed significantly between before and after the acupuncture treatments (P = 0.017). However, no treatment effects were seen for the maximum mouth opening and the maximum lateral border movement. Conclusion: Although the mandibular border movements did not change significantly, this study has confirmed that acupuncture treatment may become an alternative choice on improving the occlusal force of deep-bite patients.

Characteristics of opening movement in patients with unilateral mastication

To analyze characteristics of mandibular movement in patients with unilateral mastication. Undergraduate students in oral medicine from Grade 2011 and 2012 in Wannan Medical College were enrolled for this study by cluster sampling method, which include 30 people with unilateral mastication and 30 people with bilateral mastication. The surface electromyogram (sEMG) of masseter muscle and anterovent of digastric muscle were recorded and the trajectory of mandibular incisor point was recorded simultaneously in the maximum opening and closing movement. The results were analyzed by SPSS 19.0 software. Average electrical peak of left anterior digastric muscle and right anterior digastric muscle in the unilateral chewing group was lower than that in the bilateral chewing group (P<0.05). The jaw tangent point trajectory was separate in the unilateral chewing group. There were significant differences at the opening type between the 2 groups. The vertical displacement and the sagittal displacement in the unilateral chewing group were significantly lower than those in the bilateral chewing group (P<0.01). There was significant positive correlation between the average peak potential of masseter muscle and displacement on the right side. Average electrical peak of left masseter muscle, left anterior digastric muscle, and right anterior digastric muscle decreases in the unilateral chewing group. Jaw tracking in most people deflects to the working side. Opening and closing jaw tracking is separate in 50% unilateral chewing individuals with the decreased opening degree. Unilateral chewing leads to changes in muscle performance accompanied by trajectory anomalies.

Мandibular range of motion and its relation to temporomandibular disorders

Introduction. One of the most important signs and symptoms of temporomandibular disorders (TMD) is deviation or restriction in the mandibular range of motion. Limited or increased movement is considered as a sign of dysfunction, so measurement and evaluation of mandibular movement ranges are considered important parameters within the clinical examination and a significant component in the treatment and follow up of the temporomandibular disorders. Material and methods . A total of 34 articles are included in this comprehensive review of the relevant studies on mandibular range of motion related to temporomandibular disorders. This review provides summarized clinical and cephalometric analyses focused on the three planes of the mandibular range of motion used in all classifications and diagnostic criteria for temporomandibular disorders. Results and conclusion. The majority of the studies show variations in the degree of mandibular movements in patients with TM pathology. This review of the literature presents a synthesized version of the basic parameters of the mandibular movements that can be considered in the diagnosis of temporomandibular disorders in accordance with the postulates of the relevant research and diagnostic criteria.

Longitudinal Observation of Mandibular Motion Pattern in Patients With Skeletal Class III Malocclusion Subsequent to Orthognathic Surgery

The aims of the present study were to delineate the characteristic patterns of 3-dimensional (3D) mandibular movement in patients with skeletal Class III malocclusion compared with normal individuals and to investigate the longitudinal changes in mandible and condylar motion after orthognathic surgery (OGS). The subjects in the present prospective study consisted of 2 groups. The OGS group included 24 patients with skeletal Class III who underwent OGS. The control group consisted of 25 patients who underwent orthodontic treatment only. The patient records included demographic data, lateral and posteroanterior cephalometric radiographs before treatment, and serial mandibular motion data. In the OGS group, the mandibular motion data were obtained before OGS (T1), 1 month after OGS (T2), and at least 6 months after OGS (T3). The differences in cephalometric measurements and mandibular movements between the 2 groups were compared. The Pearson correlation test was performed to assess the relationship between the cephalometric measurements and the mandibular movements. Serial changes in mandibular movement in the OGS group were also compared. The skeletal pattern in the OGS group demonstrated retrusive maxilla and a protrusive mandible, with a larger mandibular plane angle. For the incisal range of motion, the OGS group's maximal mouth opening was larger than the control group's by 6.9 mm. In the OGS group, the condylar range of motion in retrusion and the Bennett angle were asymmetric. Skeletal Class III patients tended to have a smaller range of condylar retrusion. At 1 month after OGS, the maximal incisal range of motion decreased from 57.23 to 25.61 mm. Other variables, including laterotrusion, movement velocity, and angle and distance of condylar movement in protrusion, reduced significantly. The Bennett angle demonstrated increased symmetry on both sides. Six months after OGS, the condylar motion in opening demonstrated improvements, but to a lesser extent than at T1. The condylar motion in retrusion recovered totally. The maximum incisal range of motion reduced slightly, but remained similar in value to that of the control group. The variables, including laterotrusion, movement velocity, and angle and distance of condylar movement in protrusion, demonstrated total recovery. The mandibular movement variables at T3 were not significantly different from those of the control group. Skeletal Class III patients demonstrated a larger maximal mouth opening than did the controls, along with similar laterotrusion, but with a smaller retrusive condylar range of movement. The range of incisor motion and condylar movement did not correlate. The deterioration in mandibular motion after OGS can recover totally within 6 months. At T3, the mandibular movement remained consistent with the amount in normal subjects.

The effects of orthognathic surgery on mandibular movements in patients with mandibular prognathism

Mandibular prognathism, one of the most severe dentofacial deformities, affects the person's appearance, psychological health and the quality of life in the most sensitive age period. The aim of this study was to evaluate the effects of sagittal split ramus osteotomy on the range of mandibular border movements in the early postoperative period. The study was conducted on 20 patients, of mean age 20.8 years, with mandibular prognathism. All patients included in this study were operated on by bilateral sagittal spliting ramus osteotomy according to Obwegeser and Dal Pont followed by mandibular immobilization during eight weeks. In all patients mandibular border movements were recorded before and six months after surgery using the computerized pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany). The analysis of the chosen kinematic parameters revealed that sagittal split ramus osteotomy followed by eight weeks of mandibular immobilization had severe effects on the mouth opening. Six months after surgery the range of maximal mouth opening decreased for approximately 13.9 mm in relation to the preoperative stage. On the contrary, the ranges of maximal protrusion and the border of laterotrusive excursions increased significantly after surgery. In patients with mandibular prognathism where enormous mandibular growth was the main causal factor of the deformity, the sagittal split ramus osteotomy yielded good results. The rigid fixation of bone fragments and reduced period of mandibular immobilization followed by appropriate physical therapy could considerably contribute to a more rapid recovery of mandibular kinematics in the postoperative period.

Evaluation of soft-tissue artifacts when using anatomical and technical markers to measure mandibular motion

Background/purpose Skin marker-based systems are used to accurately measure the three-dimensional motion of the temporomandibular joint. Since skin markers move relative to the underlying bone during jaw movements, the measured temporomandibular joint kinematics is subject to soft-tissue artifacts. A complete evaluation of soft-tissue artifacts for markers on the facial anatomical landmarks and on an optical frame during jaw opening/closing movements is not available. The purpose of this study was to further our knowledge using a commercial opto-electronic movement tracking system to measure marker movements, that were then compared to true values defined by a transoral rigid device attached to the incisors. Materials and methods Twenty healthy subjects performed jaw opening/closing movements at a self-selected pace while the 3D trajectories of 17 facial skin markers, three markers on an optical frame, and 4 markers on a transoral device were measured using a six-camera opto-electronic motion tracking system. Movements of the skin and optical frame markers relative to the head coordinate system defined by the transoral device (gold standard) were calculated. The movements of the head coordinate systems defined using different groups of skin markers relative to the gold standard were also analyzed. Results The results showed that nose-bridge markers had minimal displacements but the middle- and side-face markers had large displacements. Conclusions It appears that markers on the frontal nose bridge are good alternatives to transoral rigid devices for measuring mandibular motion, compared to optical frame markers and other skin markers on the face. The results of the current study will be helpful for establishing guidelines for marker placement when measuring mandibular movements in patients with potential temporomandibular disorders.

Characteristics of mandibular movements in patients with square mandible

The aim was to report the kinetics of masticatory muscles using a 4-dimensional muscle model and kinetically investigate the etiology of square mandible (SQM) in vivo. To ascertain the mandibular movements in patients with SQM, we compared a group of 11 SQM patients with painless limited mouth opening to a matched group of 11 healthy volunteers who acted as control subjects. Mandibular movements were recorded using a 6-degrees-of-freedom jaw-tracking device, with the incisal and kinematic condylar as analytic points. For the control group, mean tracking distance for the incisal point was 50.1 +/- 6.8 mm, whereas for the SQM group mean tracking distance was 27.1 +/- 2.8 mm. With lateral excursions, the control group's mean tracking distance of the incisal point was 9.9 +/- 2.01 mm, and the SQM group's was 8.1 +/- 1.64 mm. Despite a sufficient lateral excursion, motion of the mandible was limited by some factors at opening and suggests that the mode of lateral movements in SQM patients may differ slightly from those in healthy individuals.

Analysis of mandibular movement in patients with internal derangement of temporomandibular joint

Analysis of mandibular movement in patients with internal derangement of temporomandibular joint

Lateral capsular ligament reconstruction in temporomandibular joint surgery

Surgery of the temporomandibular joint can result postoperatively in compromised mobility of the mandible. This article presents a surgical approach to enhance postoperative mandibular movements in patients undergoing surgical correction of temporomandibular joints disorders.