Reestablishment Of Occlusion Research Articles

Success and Survival of Composite Resin Restorations for the Management of Localized Anterior Tooth Wear: A Systematic Review and Meta-Analysis.

To systematically review the literature and assess the success and survival rates of anterior composite restorations used in the management of anterior tooth surface loss, and to estimate complete posterior occlusion re-establishment when a Dahl approach is utilized. An electronic search was performed in the following databases: MEDLINE via Ovid and Scopus, for articles published from 1970 to November 2020. The systematic review was performed according to the PRISMA and Meta-analyses guidelines. Only randomized and non-randomized clinical trials, and Cohort studies that involved the exclusive use of direct/indirect anterior composite restorations for the management of localized anterior tooth wear were included. From the 724 studies identified through the initial search, six studies fulfilled the inclusion criteria and were included in the review; three prospective and three retrospective. In total, 141 patients received 1068 direct and indirect composite restorations. Follow-up periods ranged between 5 months and 10 years. The survival rate for anterior composite resin restorations reported in this review was 88% (95% CI: 70% to 98%) over a period of 2 and 10 years; however, high heterogeneity was observed amongst included studies; (I² = 97%). Sensitivity analysis reported survival rates of these restorations of 93% (95% CI: 85% to 98%) over a period of 2 and 7 years, (I² = 83%). Success rates were reported for these restorations of 68% (95% CI: 44% to 87%) over a period of 2 and 10 years, high heterogeneity; (I² = 98%). The success of composite Dahl in re-establishing posterior occlusion was 85% (CI: 73% to 94%). The result of this systematic review and meta-analysis support the use of anterior composite restorations as a short-medium term option for the management of tooth wear. In the long-term, patients should be informed that these restorations will require monitoring, repairs, or replacements.

Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis

BackgroundPrevious evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12–18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments.ResultsAt T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05).LimitationsThe small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials.ConclusionsSubjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion.

Utility of the LeFort I Osteotomy in the Acute Management of Midface Trauma

Purpose: Pure and isolated LeFort I, II, and III fractures are rare. Typically, they occur at different levels on each side and may be incomplete in nature, which complicates management. The LeFort I osteotomy is a well-described technique in elective management of midface deformities. However, there is minimal literature on its use in acute trauma. This study describes the use of the LeFort I osteotomy as a surgical maneuver to aid in the reduction of complex midface fractures and the re-establishment of premorbid occlusion. Methods: A retrospective review was performed of all consecutive midface fractures managed at our center from 2008 to 2020. The inclusion criteria were adult patients who had a LeFort I osteotomy in the setting of acute fracture management. Primary outcomes were the long-term stability of fracture fixation and the re-establishment of stable, reproducible occlusion at follow-up. Results: Twenty-two cases met the criteria for inclusion. The most common indication was contralateral LeFort I and ipsilateral incomplete or absent LeFort I (50%). Most remaining cases had a high LeFort (II or III) on the ipsilateral side and a high LeFort I on the contralateral side (41%). There was one case of nonunion requiring revision and bone grafting. In all remaining cases who presented for follow-up at an average of 1.5 years, stable, reproducible occlusion was achieved. Conclusions: In acute trauma, a LeFort I osteotomy is a safe and effective technique to re-establish premorbid occlusion when passive reduction of the maxilla cannot be achieved. This technique can be safely added to the armamentarium of any surgeon who manages acute craniofacial trauma.

REMOVAL SURGICAL OF MESIODENS IN THE PALATE FOR OCCLUSAL REESTABLISHMENT: A CASE REPORT

The purpose of this work is to report on the reestablishment of the patient's occlusion through the surgical removal of mesiodens in the palate. A 15-year-old male patient sought care at the dental clinic at Nilton Lins University accompanied by his guardian, carrying a panoramic radiograph and presenting aesthetic discomfort due to fracture of tooth 21 as the main complaint, the clinical evaluation verified the presence of a structure similar to a supernumerary tooth, this structure prevented a satisfactory occlusion of the patient, destabilizing the lower arch and acting on the intrusion effect of the lower incisors of the third quadrant. Based on the clinical characteristics presented along with the imaging exam, the person responsible for the removal of the mesiodens for occlusal reestablishment and subsequent fabrication of composite resin restoration with return of the disocclusion guide was chosen. The mesiodens was extracted and the occlusal normality was reestablished. Therefore, in view of the clinical resolution presented, the treatment was satisfactory, allowing the advancement to the restorative stages, and returning a normal pattern of the patient's occlusal profile.

Occlusal re-establishment of posterior teeth using stamp technique- A case report

According to Sturdevant, the main aim of restoration is to restore the form, function and occlusion of individual tooth which is mutilated by dental caries. To achieve all these factors many techniques and restorative materials have evolved in modern dentistry. Stamp technique is a new and decisive method for re-establishing the occlusal anatomy. In the present case report, a 15 year old male patient with occlusal caries on tooth number 37 is treated with composite restoration using stamp technique.

Detection of mandibular fractures on panoramic radiographs using deep learning

Mandibular fractures are among the most frequent facial traumas in oral and maxillofacial surgery, accounting for 57% of cases. An accurate diagnosis and appropriate treatment plan are vital in achieving optimal re-establishment of occlusion, function and facial aesthetics. This study aims to detect mandibular fractures on panoramic radiographs (PR) automatically. 1624 PR with fractures were manually annotated and labelled as a reference. A deep learning approach based on Faster R-CNN and Swin-Transformer was trained and validated on 1640 PR with and without fractures. Subsequently, the trained algorithm was applied to a test set consisting of 149 PR with and 171 PR without fractures. The detection accuracy and the area-under-the-curve (AUC) were calculated. The proposed method achieved an F1 score of 0.947 and an AUC of 0.977. Deep learning-based assistance of clinicians may reduce the misdiagnosis and hence the severe complications.

Adhesive Management of Anterior Tooth Wear in Combination with the Dahl Concept—A 27-Month Observational Case Series

Localized anterior maxillary tooth wear caused by erosion and attrition with loss of interocclusal space is difficult to manage. This observational case-series study reports six cases with worn anterior dentition treated with labial ceramic and palatal direct resin composite veneers at an increased vertical dimension of occlusion without restoration of unaffected posterior teeth. Thirty-six palatal direct veneers were made in six patients from a nanohybrid resin composite with the help of a wax-up-based template at an increased vertical dimension. After the complete re-establishment of posterior occlusion, 40 labial lithium-disilicate ceramic veneers were fabricated with a mock-up-guided method. The sandwich veneers were evaluated according to the United States Public Health Service (USPHS) criteria after a mean service time of 22.7 months. Re-establishment of posterior contacts as well as subjective patient satisfaction and function were evaluated. The overall success of the labial ceramic veneers was excellent. The quality of the palatal resin composite restorations was found to be good with predominantly "Alpha" scores. The marginal quality (11.1% and 33.3% of integrity and discoloration, respectively) and surface roughness (16.7%) showed small deteriorations indicated by "Beta" scores. The resin composite showed, in general, signs of wear facets which resulted in "Beta" scores in 44.4% of the cases. Posterior contacts re-established firmly within 4 weeks in all cases. Patient satisfaction with esthetics and function was high. The short-term outcome of this non-invasive treatment option is favorable and promising.

Measuring tooth movement with treatment using the Dahl principle: An observational study

Statement of problemResearch on the quantification of 3-dimensional tooth movements in patients undergoing treatment using the Dahl principle is lacking. PurposeThe purpose of this observational clinical study was to measure the magnitude, direction, duration, and rate of tooth movement occurring in patients to reestablish tooth contact and create restorative space. Material and methodsA total of 104 paired preoperative and postoperative physical and virtual casts from 26 patients were obtained. Commencement and completion dates were recorded to calculate movement duration to reestablish occlusion. Dental casts were digitized, and the 3-dimensional digital casts obtained were superimposed via a surface matching and analysis software program by using the global registration function. Color maps were used to visualize direction, and the annotation feature quantified magnitude of tooth movement in millimeters when specific reference points were selected. Teeth within the arch were categorized as per their location to evaluate their impact on occlusal reestablishment. The average rate of movement was determined by time taken for extrusive and intrusive movements over the treatment duration. Post hoc Tukey tests were applied if a significant difference was present in the magnitude of movement between different tooth categories. ResultsAll participants showed evidence of tooth movement during treatment. Duration of occlusal reestablishment ranged from 3.9 to 28.2 months, with more posterior tooth extrusive movements (56.9%) than anterior tooth intrusive (43.1%) movements occurring. A comparison of magnitude of extrusive or intrusive movement between categories (molar-anterior, premolar-anterior, and premolar-molar) showed that premolar and molar extrusive movements and anterior intrusive movements were significantly different (P<.001). The amount of buccal and lingual movement for molars and premolars was similar. Anterior teeth demonstrated more buccal than lingual movements. All teeth showed more mesial than distal movements. The extrusive and intrusive movement rate was 0.13 and 0.11 mm/mo, respectively. ConclusionsTooth movement occurred in patients regardless of age and sex. The results of this study indicated that tooth movements have a 3-dimensional nature. Occlusal reestablishment mainly occurred via a combination of extrusive and intrusive movements. The study further highlighted the advantages of digital technology such as surface scanners and 3-dimensional software programs that can be used to quantify change in patients undergoing treatment.

Improving the reconstruction of dental occlusion using a reconstructed-based identical matrix point technique

Digital dental models are widely used compared to dental impressions or plaster-dental models for occlusal analysis as well as fabrication of prosthodontic and orthodontic appliances. The digital dental model has been considered as one of the significant measures for the analysis of dental occlusion. However, the process requires more computation time with less accuracy during the re-establishment of dental occlusion. In this research, a modern method to re-establish dental occlusion has been designed using a Reconstructed-based Identical Matrix Point (RIMP) technique. The curvature of the dental regions has been reconstructed using distance mapping in order to minimize the computation time, and an iterative point matching approach is used for accurate re-establishment. Satisfactory restoration and occlusion tests have been analyzed using a dental experimental setup with high-quality digital camera images. Further, the high-quality camera images are converted to grayscale images for mathematical computation using MATLAB image processing toolbox. Besides, 70 images have been taken into consideration in which 30 planar view images has been utilized for experimental analysis. Indeed, based on the outcomes, the proposed RIMP outperforms overall accuracy of (91.50%) and efficiency of (87.50%) in comparison with conventional methods such as GLCM, PCR, Fuzzy C Means, OPOS, and OGS.

Occlusal force and occlusal contact reestablishment with resin-bonded fixed partial dental prostheses using the Dahl concept: A clinical study

Statement of problemSpace creation for a metal retainer of the resin-bonded fixed partial dental prostheses (RBFPDPs) with the Dahl concept remains controversial because of the lack of clinical studies. PurposeThe purpose of this clinical study was to investigate the occlusal force and occlusal contact reestablishment of RBFPDPs cemented at an increased occlusal vertical dimension (the Dahl concept) and to evaluate the factors affecting them. Material and methodsA prospective clinical study was carried out on 28 participants receiving cantilevered RBFPDPs at an increased occlusal vertical dimension at the Faculty of Dentistry, University Teknologi MARA. Maximum occlusal forces were recorded at precementation, postcementation, and 12-week review visit by using pressure indicating film, while occlusal contact reestablishment was assessed at the precementation stage and 12-week review visit by using shim stock foils. The Wilcoxon signed-rank and chi-squared tests were used for statistical analysis (α=.05). ResultsSignificant differences were found for maximum occlusal force between the precementation and the postcementation and between the postcementation and the 12-week review of RBFPDPs (P<.05 for both) in all 28 participants. However, no significant difference was found between the precementation and the 12-week review (P=.085). The occlusal force reestablishment concerning sex, age, location, and arch of the prosthesis was found to be similar. Most of the participants (89.3%) achieved complete occlusal contact reestablishment and 10.7% partial occlusal reestablishment. The demographic and prosthesis factors were not significantly related to the occlusal reestablishment (P>.05). ConclusionsOverall, occlusal force was reestablished after 12 weeks, and occlusal contact was completely reestablished in most participants after placement of RBFPDPs at an increased occlusal vertical dimension.

Occlusal re-establishment and clinical complications of resin-bonded fixed partial dental prostheses cemented at an increased occlusal vertical dimension: A retrospective study

Statement of problemResin-bonded fixed partial dental prostheses (RBFPDPs) cemented at an increased occlusal vertical dimension (OVD) (the Dahl concept) to create space for a metal retainer remain controversial because of the lack of reported clinical studies. This study evaluated RBFPDPs by applying the Dahl concept. PurposeThe purpose of this retrospective study was to investigate the clinical factors affecting the occlusal re-establishment and short-term complications of RBFPDPs cemented at an increased OVD. Material and methodsOcclusal re-establishment and clinical complications were reviewed in 109 participants (155 RBFPDPs) treated at the Faculty of Dentistry, Universiti Teknologi MARA from January 2013 to May 2018. Types of complications and risk factors were assessed from clinical data. Demographic factors, clinical factors, and prosthesis factors were distinguished and their association with occlusal re-establishment analyzed by using multiple regression analysis. ResultsA total of 155 RBFPDPs (42 anterior, 113 posterior) were placed in 109 participants. All achieved occlusal re-establishment, 89.9% complete occlusal re-establishment and 10.1% partial occlusal re-establishment, a minimum of 4 months after the RBFPDPs had been placed at an increased OVD. The design of the metal retainer coverage was found to be a significant factor affecting occlusal re-establishment and decementation (P<.05). Widening of the periodontal ligament space was the most common complication (29.2%). ConclusionsRBFPDPs cemented at an increased OVD can be clinically recommended. The design of the retainer coverage was a significant factor influencing occlusal re-establishment and clinical complications.

OSC11: Clinical Factors Affecting Occlusal Re-Establishment of Resin-Bonded Bridges using Dahl Concept.

OSC11: Clinical Factors Affecting Occlusal Re-Establishment of Resin-Bonded Bridges using Dahl Concept.

Reconstruction-Based Digital Dental Occlusion of the Partially Edentulous Dentition.

Partially edentulous dentition presents a challenging problem for the surgical planning of digital dental occlusion in the field of craniomaxillofacial surgery because of the incorrect maxillomandibular distance caused by missing teeth. We propose an innovative approach called Dental Reconstruction with Symmetrical Teeth (DRST) to achieve accurate dental occlusion for the partially edentulous cases. In this DRST approach, the rigid transformation between two symmetrical teeth existing on the left and right dental model is estimated through probabilistic point registration by matching the two shapes. With the estimated transformation, the partially edentulous space can be virtually filled with the teeth in its symmetrical position. Dental alignment is performed by digital dental occlusion reestablishment algorithm with the reconstructed complete dental model. Satisfactory reconstruction and occlusion results are demonstrated with the synthetic and real partially edentulous models.

Submental intubation: experience with 30 cases

IntroductionWhen a patient has multiple injuries, involving serious fractures in the maxillofacial region and base of skull, a tracheostomy is often performed to approach the different affected facial thirds simultaneously. Submental intubation offers an alternative to this type of airway management, involving a decreased risk for the patient due to its safety and versatility in treating nasal fractures and re-establishment of dental occlusion. MaterialsA total of 30 patients with different degrees of involvement of the facial thirds (superior, middle and inferior) were treated by our team, performing a submental intubation to maintain the airway. These fractures affected nasal bones and dental occlusion. ResultsIn all cases we accomplished an adequate reduction of nasal fractures and obtained an accurate dental occlusion, with no incidents during or after this intubation. ConclusionsSubmental intubation is a good alternative to treat multiple injury patients who have nasal and oral cavities involvement, avoiding the use of tracheostomy in cases that do not need it.

Intubación submental: experiencia con 30 casos

IntroductionWhen a patient has multiple injuries, involving serious fractures in the maxillofacial region and base of skull, a tracheostomy is often performed to approach the different affected facial thirds simultaneously. Submental intubation offers an alternative to this type of airway management, involving a decreased risk for the patient due to its safety and versatility in treating nasal fractures and re-establishment of dental occlusion. MaterialsA total of 30 patients with different degrees of involvement of the facial thirds (superior, middle and inferior) were treated by our team, performing a submental intubation to maintain the airway. These fractures affected nasal bones and dental occlusion. ResultsIn all cases we accomplished an adequate reduction of nasal fractures and obtained an accurate dental occlusion, with no incidents during or after this intubation. ConclusionsSubmental intubation is a good alternative to treat multiple injury patients who have nasal and oral cavities involvement, avoiding the use of tracheostomy in cases that do not need it.

Effect of Facial Massage on Static Balance in Individuals with Temporomandibular Disorder – a Pilot Study

The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD.

Periapical cemento-osseous dysplasia: case report

Periapical cemento-osseous dysplasia is a pathologic entity resulting from bone and cementum reactional process which affects the periapical region of the anterior mandible. Its etiology is not fully understood, but possibly it is related to an unusual bone and cementum response to some local factor. Objective: The aim of this study is to present a case of periapical cemento-osseous dysplasia. Case report: A 50 years-old female patient sought for dental care due to pain in the lower right premolar region. The panoramic radiography revealed the presence of an extensive radiolucent lesion with radiopaque areas located between the roots of the teeth #43 and #35. Teeth presented vitality and it was not observed any changes involving the periodontal ligament. Periapical cemento-osseous dysplasia diagnosis was established through clinical and radiographic features. Periapical cemento-osseous dysplasia does not require any treatment unless complications occur. Patient’s complaint of discomfort was related to occlusal imbalance and was solved after the occlusion reestablishment. The patient was radiographically followed-up for 12 months and the lesion exhibits satisfactory signs of healing. Conclusion: The dentists need to be aware of asymptomatic intra-osseous lesions affecting the anterior region of mandible not to misconduct the diagnosis that could compromise the patient’s oral health.

Reestablishment of occlusion through overlay removable partial dentures: a case report

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia's jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.

Re-establishment of occlusion after unilateral condylar fracture

Complications resulting from condylar fracture include occlusal disturbance due to loss of leverage from temporomandibular joint (TMJ). In general, closed reduction with active physical training has been performed, and under favorable circumstances, adaptation occurs in attempt to restore the articulation. The patient in this case report had unilateral condylar fracture accompanied with multiple teeth injuries, but he was left without any dental treatment for 1 mon which led to unrestorable occlusal collapse. Fortunately, delayed surgical repositioning of dislocated maxillary anterior teeth followed by consistent long-term physical training has been proved successful. Normal occlusion and satisfactory remodeling of condyle were obtained on 10 mon follow-up.

Reestablishment of Occlusion with Prosthesis and Composite Resin Restorations

Here, we present a case report on prosthetic reconstruction of posterior teeth and composite resin restoration of anterior teeth yielding considerable esthetic improvement, reestablishment of disocclusion guides and function.