Articulating paper mark size has been widely accepted in the dental community to be descriptive of occlusal load. The objective of this study is to determine if any direct relationship exists between articulating paper mark area and applied occlusal load. A uniaxial testing machine repeatedly applied a compressive load, beginning at 25N and incrementally continuing up to 450N, to a pair of epoxy dental casts with articulating paper interposed. The resultant paper markings (n = 600) were photographed, and analyzed the mark area using a photographic image analysis and sketching program. A two-tailed Student's t-test for unequal variances compared the measured size of the mark area between twelve different teeth (p < 0.05). Graphical interpretation of the data indicated that the mark area increased non-linearly with increasing load. When the data was grouped to compare consistency of the mark area between teeth, a high variability of mark area was observed between different teeth at the same applied load. The Student's t-test found significant differences in the size of the mark area approximately 80% of the time. No direct relationship between paper mark area and applied load could be found, although the trend showed increasing mark area with elevating load. When selecting teeth to adjust, an operator should not assume the size of paper markings, accurately describing the markings' occlusal contact force content.
The purpose of this study was to determine if a statistically significant reduction in muscle activity (p<0.05) occurs when prolonged disclusion time (>0.4 sec/excursion) is shortened to <0.4 sec/excursion with the Immediate Complete Anterior Guidance Development (ICAGD) enameloplasty. Forty-five symptomatic, fully informed subjects (29 female, 16 male) had their right and left disclusion times recorded with T-Scan III, while simultaneously, the bilateral masseter and anterior temporalis muscle activity was recorded electromyographically with BioEMG III (n=180 muscles). This recording was done twice, once pretreatment and again posttreatment (same day) after undergoing the ICAGD enameloplasty on the same day without changing electrodes. The Student's paired t-test was utilized to detect any significant change in the muscle activity levels between the pre- and posttreatment lateral excursive muscle contractions. Highly significant reductions were found in all four muscles' activities after shortening the pretreatment prolonged disclusion time to less than 0.4 seconds (p<0.0014); after Bonferroni correction (p<0.006). When properly performed, such that the posttreatment disclusion time is <0.4 sec/excursion, the ICAGD enameloplasty predictably reduces excursive muscle activity levels in the bilateral anterior temporalis and masseter muscles. Excursive muscle hyperactivity can be a source of lactic acid accumulation, muscular ischemia, and chronic myalgic temporomandibular joint dysfunction (TMD) symptoms. The ICAGD enameloplasty significantly reduces excursive muscle contractions after completion of the first ICAGD treatment session.
The purpose of this study was to measure the performance of a new design of occlusal sensor, the high definition (HD) sensor, and directly compare this sensor to the previous design. This new HD sensor design has increased active recording area by 33%, and decreased inactive recording area by 50% as compared to the previous design (G3). This was accomplished by determining the force reproduction variability for repeated occlusal closures on the same sensor for a sampling of sensors from both designs. Thirty (30) G3 and 30 HD sensors were consistently positioned and loaded 24 times between articulated epoxy casts by a Pneumatic Occlusal Force Simulator. Their force reproduction consistency was measured as an electronic voltage drop across six occlusal contacts that were consistently located on all sensors. The force variability of the two sensor designs was determined by comparing the consistency of the voltage drops across the six occlusal contacts. An analysis of variance was employed to determine the variability of force reproduction over multiple closures across six occlusal contact regions. For five of the six contacts, the G3 sensor mean variances, were significantly larger (p < 0.05) than those of the HD sensor. The within sensor variability of the HD sensor was significantly less than that of the G3 sensor. Within the limitations of this study, the HD sensor exhibited less variable force reproduction than the G3 sensor for at least 20 in-laboratory loading cycles.
Simultaneous recording of excursive function and muscle activity on 62 MPDS patients demonstrated that reducing prolonged disclusion time (1.4 seconds per excursion) to short disclusion time (0.41 seconds per excursion) created a therapeutic effect such that within one month's time following treatment, there was an observed increase in the maximal clenching capacity of the masseter and temporalis muscles. This clinical treatment effect appears to be the result of decreased ischemia in these same muscles resultant from minimizing the time posterior teeth compress their periodontal ligament mechanoreceptors as these teeth are engaged and disengaged during excursive function.
Subjective Interpretation is an ineffective clinical method for determining the relative occlusal force content of tooth contacts. The reported low scores obtained from a large group of participant dentists suggest clinicians are unable to reliably differentiate high and low occlusal force from looking at articulating paper marks. This longstanding method of visually observing articulating paper marks for occlusal contact force content should be replaced with a measurement-based, objective method.
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