Stomatognathic Research Articles

Full mouth prosthetic rehabilitation using hobo’s philosophy: A case report

The face, which is the part of the body that is most exposed, has the mouth as a prominent feature. The allure of the teeth draws all eyes. Some patients with collapsed bites were required to have all of their teeth extracted and replaced with traditional complete dentures because rehabilitation techniques' efficacy was questioned in the 20th century. The occlusal surfaces of a patient's teeth will gradually deteriorate over the course of their lifetime. But excessive occlusal wear can result in pulpal injury, occlusal discord, functional impairment, and aesthetic deformity. Thanks to improvements in dental technology, equipment, and materials over the last millennium, the task of restoring and rehabilitating the damaged dentition has gotten simpler. This has given restorative dentists the ability to maintain teeth and associated structures. Establishing optimal oral health should be the main objective of all rehabilitation procedures because maintaining oral health and safeguarding the stomatognathic system will always be the end goal. The report's case study serves as an illustration of Hobos' full mouth rehabilitation technique.

Creating patients: how technology and measurement approaches are misused in diagnosis and convert healthy individuals into TMD patients

The advances made in recent years regarding technological approaches to medical and dental diagnosis are impressive. However, while those tools, procedures, and instruments may produce an improved clinical diagnosis or discover a new disorder, they also can be misused and misinterpreted in various ways. In the field of temporomandibular disorders (TMDs), the very nature of those conditions is similar to common orthopedic problems elsewhere in the body. Yet, beyond imaging of the affected areas, there have been few important new technological approaches to augment the traditional history and examination for a sufficient diagnosis of such problems. The traditional approach is exemplified by the Diagnostic Criteria for Temporomandibular Disorders, which has high inter-examiner reliability and diagnostic validity; translations into over 20 languages allow for widespread use. In contrast and unfortunately, the TMD field is replete with a variety of so-called diagnostic instruments and procedures, which have not been tested for diagnostic validity; these instruments and procedures, through misuse, are capable of complicating a true diagnosis of patients who present with symptoms, while also creating new patients by finding so-called abnormalities in healthy subjects. This paper discusses those technological approaches and their misuse with respect to TMD diagnosis from a critical viewpoint, and the authors argue that there are significant risks for patients if their uncritical implementation becomes accepted and widespread. Therefore, dentists are encouraged to reject the proposed application of such technological approaches to diagnosis of the stomatognathic system.

Implant restoration and stomatognathic system rehabilitation

Stomatognathic system rehabilitation (SSR) is an important component of dental implant therapy, involving multiple disciplines and factors. This article focuses on the importance of clinical issues, such as mandibular position, vertical distance, occlusion and temporomandibular joint in SSR, in order to provide reference for dentists in clinical diagnosis and treatment.

Orofacial Myofunctional Aspects of Nursing Infants and Preschoolers.

Introduction Clinical assessment in orofacial motricity is required for the speech therapist to diagnose and treat disorders involving the stomatognathic system. Validated tools can help establish a prognosis and outline intervention methods connected to human development. Objective The goal of the present study was to examine the domains of the oromyofunctional assessment of nursing infants and preschoolers according to sex and age group, as well as the application of the MMBGR Protocol - Nursing Infants and Preschool Children. Methods A quantitative technique was used to conduct an analytical and cross-sectional investigation. The present study included a total of 214 healthy breastfeeding infants and preschoolers of both sexes. The Mann-Whitney test was used to compare the medians. The Spearman correlation of each test domain was determined. R Core Team 2021 (R Foundation, Vienna, Austria) was used, and the significance threshold was set at 5%. Results In intraoral and extraoral examinations, there was a difference between sexes for tongue scores in nursing infants (d = - 0.428; p = 0.045), worse in males. When the orofacial functions were considered in nursing infants, there were differences between the sexes for the liquid/solid/semisolid deglutition scores (d = 0.479; p = 0.031), with females performing worse. There were sex differences in solid/semisolid deglutition (d = - 0.335; p = 0.043), and speech in preschoolers (d = - 0.478; p = 0.034), including the production of phones/phonemes (d = - 0.599; p = 0.007), which were always worse in males. Conclusion The research revealed sex disparities and related the domains of oromyofunctional assessment, according to scores, of the domains of myofunctional assessment, as recorded in a standardized oromyofunctional assessment protocol by age group.

Relationship between occlusion and posture

The stomatognathic system includes the relationship between teeth, masticatory muscles and temporomandibular joints with its relation with body and head posture. Aim of the study: This Systematic review is to research the relationship between occlusion and body posture. Materials and methods-Study design: This is a literature systematic review which is done after collecting more than 10 previous papers. Inclusion criteria: Papers explaining dental occlusion in details and its correlation with body and head posture. Exclusion criteria: Papers about occlusion focusing on occlusal splints and lab work. Conclusion: There is a strong relation between dental occlusion class, head, and body posture through PDL and the trigeminal nerve in the brain. Accordingly, the occlusion affects the posture and, more importantly, the position of the condyle in the temporal fossa. It was always believed that condyle position comes first then the occlusion, but it is the other way around.

Knowledge and Awareness of Temporomandibular Disorders (TMDs) among Post-graduate residents

INTRODUCTION: Malocclusion and TMD were believed to have a correlation when it is associated that the alteration of form might cause alteration in the stomatognathic system function. A multidisciplinary approach is particularly important for the successful treatment of chronic TMD cases. Management of TMD involves the work of dentists from various specialities. It is multifactorial in nature and requires proper examination and treatment planning. Thus, the primary purpose of this study is to find out the awareness of TMDs among postgraduate students. MATERIALS AND METHODOLOGY: The present study was retrospective in nature. A questionnaire involving TMDs was sent to all postgraduates involved in patient treatment through google forms. All participants were asked to anonymously answer the structured questionnaire containing multiple-choice and open-text questions in google forms. The questionnaire was specially developed for students and was organized into three sections. RESULTS: 204 participants responded and returned the completed questionnaires. Results showed that 98 % of the respondent’s occlusal disturbance causes TMD and TMJ problems are associated with malocclusion. The majority of the participants were aware of the aetiology and diagnosis but only 53% of them were aware of the treatment protocols. CONCLUSION: The causes and diagnosis domains of the questionnaire yielded a high degree of agreement while the treatment modalities were not known. Most of them were not aware of the treatment modalities reason being a lack of knowledge during the course of their undergraduate and postgraduate study.

Change in the clinical status of a patient with dysfunction of the temporomandibular joint after osteopathic correction of somatic dysfunctions

The described clinical case shows positive results of osteopathic correction in the complex treatment of syndrome of pain dysfunction of the temporomandibular joint (DTMDJ). Diagnosis and treatment of this syndrome attract attention because of the ambiguity of the etiology, pathogenesis and lack of effectiveness the treatment algorithm to achieve a stable result. In order to increase the adaptive capabilities of the body to the changes occurring in the stomatognathic system in the treatment of DTMDJ, we have developed and put into practice an interdisciplinary principle of diagnosis and treatment, which consists in an objective assessment of the clinical manifestations of somatic dysfunctions and their elimination before the start of dental intervention, which is carried out with adequate osteopathic support, leveling the increased load on the adaptation mechanisms. The dental intervention itself is carried out with adequate osteopathic support, leveling the increased load on the adaptation mechanisms. Interdisciplinary interaction allows you to optimize the approach to dental treatment.

Roughness and Wear Resistance in the Process of Selecting Composite Resins

"Due to the the multitude of composite materials available, choosing the most adequate ones is a difficult task. Apart from most relevant characteristics such as aesthetics and mechanical strength, it is just as important to obtain smooth restorations, given the negative effects of bacterial plaque retention on the stomatognathic system. We have considered four of the composite resins most frequently used by dentists in Romania and we used laboratory tests to analyse the wear resistance and surface roughness after applying 3 finishing systems. We show that finishing systems have a powerful impact on composite materials roughness, and the best results are obtained with a microhybrid composite. As for wear resistance, nanohybrid composites proved to be superior to microhybrid ones. The results of the study suggest that the structure of the composite material counter-balances its roughness. From a clinical perspective, the quality of the surface of dental restorations is important not only functionally, preventing their wear and bacterial plaque retention, but also from an aesthetical point of view. "

Periodontal Inflammation and Its Relationship with the Risk of Cardiovascular Diseases: Literature Review

For dental practice today, it has become important to emphasize the relevance of periodontal inflammation and oral microorganisms in the development and progression of atherosclerosis and cardiovascular diseases. Generally, the focus on PI as a causal factor of CVD is due to the great complexity and interaction that present the Gram-negative bacteria characteristic of chronic periodontal disease with the vast vascularization of the stomatognathic system. In many recent studies, researchers examined the association at the cellular and molecular level between periodontal and cardiovascular diseases. Although the specific causal correlation as a determining risk factor has not been established, it seems that periodontal disease is associated with several systemic diseases. In this connection, atherosclerosis is important in recent years. There is a possibility of an association documented in several field investigations, and this one refers to a systemic bacteremia caused by poor oral hygiene, which in turn can cause bacterial growth on the atherosclerotic plaques located in the coronary arteries, which possibly.

Dry Needling for Treatment of Temporomandibular Disorder of Muscular Origin: A Functional Approach to the Stomatognathic System

Dry Needling for Treatment of Temporomandibular Disorder of Muscular Origin: A Functional Approach to the Stomatognathic System

The role of the lateral pterygoid muscle in temporomandibular disorders

Introduction. The clinical concept that would argue that the activity of the lateral pterygoid muscle, being disturbed, would play an important role as an etiological factor in temporomandibular joint dysfunctions is still widely accepted, being also a decisive factor in the correct choice of the treatment plan. However, because of the fact that very few research and clear evidence were conducted and presented to support completely that concept, it continues to remain a very controversial one. Material and methods. For this literature review were considered and studied scientific articles published between 2000 and 2023, in the following electronic databases: PubMed, MEDLINE, Google Scholar, BIR Publications, ScienceDirect. Research methods – analysis, synthesis, systematization, and description. Results. Patients presenting temporomandibular joint dysfunction complain about pain in the temporomandibular joint or/and in masticatory muscles, limitation and sounds during mandibular activity. Temporomandibular dysfunction is a non-specific collective term, used to describe a heterogeneous group of pathological conditions located in the territory of the stomatognathic system. These are considered musculoskeletal conditions that cause pain while performing the function (mastication, speech, swallowing), with increased sensitivity in the masticatory muscles and/or the temporomandibular joint, with possible limitations of the range of motion, the appearance of joint noises and otological symptoms. One of the theories claims that in temporomandibular dysfunction, the lateral pterygoid muscle becomes hyperactive, hypoactive or that there is a lack of coordination between the superior and inferior branches of the muscle, or that there is a disturbance during the performance of the role of the muscle to control and stabilize the temporomandibular joint. However, the in-depth study of the specialized literature indicates that no scientific evidence is yet available that the function of the lateral pterygoid muscles in temporomandibular dysfunction is somehow disturbed. Moreover, the muscle’s role during the execution of its normal function has also been questioned and remains a matter of controversy. Conclusions. The lateral pterygoid muscle obviously plays an important role in the development of temporomandibular dysfunction through the prism of its anatomical and functional particularities, referring to the superior fascicle responsible for the correct anatomical maintenance of the articular disc during function.

Association of Anterior and Posterior occlusal planes with skeletal class I, class II and class III malocclusion

Introduction: The occlusal plane is a very vital in stomatognathic system and the association between anterior occlusal planes and posterior occlusal plane plays an important role during orthodontic treatments. Methods: Lateral cephalometric radiographs of 270 adult patients of the different classes of malocclusion were used. Several angular measurements were measured and compared among all study groups to evaluate the existence of relationship between AOP and POP with skeletal and vertical patterns. Results: The skeletal patterns showed a significant difference in anterior occlusal plane angle relative to both SN plane and FH plane among all classes of malocclusion (p-value =0.001**) having a steeper inclined plane in Class II and flat inclined plane in Class III. POP in relation to FH plane and SN plane showed lowest angle in skeletal Class III and highest in Skeletal Class I patients. Conclusion: The occlusal planes were found to have an impact on the jaw base where the variation in its angulation of different occlusal planes had affected both sagittal and vertical facial patterns. AOP relative to SN and FH were steeper in Class II and flat in Class III, while the POP relative to FH showed the same value in Classes II and III. Keywords: Anterior occlusal plane, Posterior occlusal plane, Malocclusion, Skeletal patterns, Vertical pattern, Lateral cephalometric radiograph.

Muscle activity between dentate and edentulous patients rehabilitated with dental prostheses: A systematic review.

Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food. To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses. This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches. Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND. Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.

Down syndrome-Trisomy 21: Oral and systemic considerations for the dental approach

Objective: The physical, systemic and stomatological characteristics of patients with Down Syndrome (DS) were verified, for a better integration with the dentist and other health professionals. Methodology: A search was carried out in the main databases and articles that were read in full and according to the objective, published as original research, case reports and literature review articles, 56 were included. Individuals with DS have unmistakable characteristics such as short stature and low-set ears, in addition to systemic impairments. On the stomatognathic system, they have injuries mainly in relation to malocclusion, dental caries and periodontics. Discussion: The search for an oral health professional is late and the quality of life is negatively affected by changes that are often already aggravated. Dental surgeons should be more prepared to manage the care of these patients, and public policies focused on prevention should be addressed and are suggested. Conclusion: According to the literature found, the physical and systemic characteristics of patients with Down Syndrome are easily identifiable by the dentist through a clinical look and anamnesis. In addition, oral health is more affected by dental caries, periodontal disease and malocclusion and professionals should be better trained to provide care with a focus on prevention.

Mutual influence of posters and kinematics of the temporomandibular joint

Achievements in integrative areas of medicine can significantly supplement the traditional ideas about the etiopathogenesis of temporomandibular joint dysfunction, based on the positions of occlusal and neuromuscular theories and mainly limited to consideration of the elements of the stomatognathic system. The article presents the results of a study of data on the influence of the state of the spine on the pathogenesis of diseases of the temporomandibular joint and data on the effectiveness of the treatment of combined pathology of the joint and posture according to publications in domestic and foreign literature over the past 15 years. Expanding the view on the structure and function of the maxillofacial region and the role of craniopostural and craniovisceral relationships requires the development of a unified methodological approach to the diagnosis of patients with dysfunction of the temporomandibular joint, which will help reduce the number of diagnostic errors and the risk of chronic pain phenomena.

Robert M. Ricketts and Rudolf Slavicek: dentistry by the rules of nature.

The stomatognathic structures act as a complex and integrated system, thereby accomplishing several essential functions of the body. Aside from participating in food digestion, they are key for respiration and swallowing and play a central role in social interaction and stress management. The lifeworks of Robert M. Ricketts (1920-2003), an American orthodontist, and Rudolf Slavicek (1928-2022), an Austrian prosthodontist, were centered on this understanding. Both were educated in the time of gnathology, functional dentistry, and cephalometry and were ready to challenge conventional knowledge and traditions, leading toward innovation. As untiring clinicians, researchers, and mentors, they were fully invested in the study of the stomatognathic system, considering its morphology, dynamics, growth patterns, evolution, and interactions with the body and mind. Based on their extensive knowledge of the masticatory system, they advanced dentistry both with theoretical notions and by implementing new diagnostic and therapeutic concepts, thus reinforcing the idea of dentistry as a medical discipline requiring interdisciplinary effort. Their heritage is represented by numerous publications, discoveries, and inventions that inspire the dental community to follow their exemplary approach to the individualized care of patients. Their knowledge and passion are further passed on through their students. As part of their legacy, they prepared the ground for new research aimed at fostering advancements in occlusion medicine, hence supporting education in oral health.

The Anatomy of the Stomatognathic System in Different Skull Types in Dogs.

The anatomy of the stomatognathic system is important for both clinical evaluations and surgical approaches in all animal species. The aim of this study was to describe the innervation and vascularization of the stomatognathic system of the dog. Twelve dogs without a history of disease or cranial malformation were used: 4 brachycephalic, 4 mesocephalic, and 4 dolichocephalic. The dogs were dissected, and arteries, veins, and nerves related to the masticatory and swallowing components were identified. The distribution pattern of these structures in the 3 different skull types were observed. The entire blood supply of the stomatognathic system is derived from the external carotid artery, which originates from the common carotid artery, and terminates as it branches into the superficial temporal and maxillary arteries. The other main branches of the common carotid artery are the occipital, cranial laryngeal, ascending pharyngeal, lingual, facial, caudal auricular, and parotid arteries. Blood drainage was achieved via the external jugular vein, which originates from the union of the linguofacial and maxillary veins. Brachycephalic dogs had blood vessels with greater sinuosity (more deviations) when compared to dolichocephalic and mesocephalic dogs. The stomatognathic system innervation of brachycephalic skull dogs showed differences in the distribution of the facial nerve in the labial commissure and maxillary and mandibular regions. The cranial conformation of dogs demonstrated anatomical variations of the vascular and neural structures of the stomatognathic system. This data may be useful to improve clinical practice, surgical planning, and interpretation of clinical dysfunctions.

Light and Affordable Vision System for Mouth Opening–Closing Movement Deviation Assessment in Women with Mild Temporomandibular Joint Disorder

(1) Background: This paper aims to demonstrate a novel and, in terms of application, universal method of the qualitative and quantitative assessment of mandibular movement. (2) Methods: Mandibular movements are recorded by a mono-vision system where a digital camera is fixed on a special extension arm attached to the patient’s head. The described method was used to check lateral deviations in 25 women with mild temporomandibular joint disorder (TMD) and in 25 women from the control group. The maximum deviation (MAX) and mean deviation (MSE) parameters were examined. In addition, the occurrence of parafunctions and joint clicking in the temporomandibular joints was checked in the examined individuals. (3) Results: Among the women with mild TMD, a significantly higher MSE parameter was found compared to the control group. Joint clicking also occurred significantly more frequently. The parameter of MAX did not differ significantly between the examined groups. (4) Conclusions: In women with mild TMD, a lack of movement coordination between the right and left joints can be observed. The method’s high availability combined with simple use makes it a valuable tool for experts in different fields who diagnose and treat stomatognathic system disorders.

Changes in Dento-Facial Morphology Induced by Wind Instruments, in Professional Musicians and Physical Exercises That Can Prevent or Improve Them-A Systematic Review.

The aim of this study is to highlight the changes that occur regarding dento-facial morphology, facial, and masticatory muscles in musicians who play wind instruments. Anatomical and functional changes may occur after the long-term use of each type of wind instrument. We considered studies of the impact of playing the wind instrument on the masticatory muscle activity and the resulting modifications. Both children and adults can be affected by playing wind instruments in regard to tooth positioning and facial morphology. These changes relate to the type of wind instruments, the type of vowels and tones used by instrumentalists. There most valuable breathing techniques have been identified that improve the redistribution of pressure, with a minimizing effect on the morphological changes in the oral cavity and cephalic extremity, implicitly on the masticatory functional disorders. In addition to these beneficial effects on the stomatognathic system, these breathing techniques favorably increase lung capacity. Furthermore, a series of toning exercises for neck muscles-which are actively involved and overworked by wind instrument-playing artists-was identified. The study concludes that less experienced instrumentalists demonstrate increased facial muscle engagement, possibly leading to excessive strain, while experienced instrumentalists exhibit more optimized patterns of muscle activity. The novelty of this research lies in its interdisciplinary approach to understanding the influence of wind instruments on dento-facial morphology, addressing preventive and corrective measures to mitigate undesirable outcomes.

A suggested universal protocol for dental examination in sports.

The athletes of any sport and level submit their bodies to constant exercise. Any given pathology can increase the risk of injury, illness, or even reduced performance. The medical examination is valuable in diagnosing existing health problems and preventing medical issues that might compromise the athlete's overall health when exercising. The stomatognathic system is not an exemption, as oral pathologies, including dental caries and periodontal diseases, are found in high incidence in sports. The need for accurate and detailed dental examination in sports leaded dentists from the European Association for Sports Dentistry and the Academy for Sports Dentistry to elaborate a universal dental examination in sports protocol that can record the overall oral health of the athlete, including the teeth, periodontium, and musculoskeletal screening, for all athletes. The outcome of this stomatognathic examination allows sports physicians and professionals other than dentists to have a complete image of the individual oral health condition of any given athlete, and it allows the dentists to efficiently screen and prevent pathologies, as well as to advise on the eligibility to practice sports from the oral health perspective.