To answer a clinical research question: 'is there any association between features of dental occlusion and temporomandibular disorders (TMD)?' A systematic literature review was performed. Inclusion was based on: (i) the type of study, viz., clinical studies on adults assessing the association between TMD (e.g., signs, symptoms, specific diagnoses) and features of dental occlusion by means of single or multiple variable analysis, and (ii) their internal validity, viz., use of clinical assessment approaches to TMD diagnosis. The search accounted for 25 papers included in the review, 10 of which with multiple variable analysis. Quality assessment showed some possible shortcomings, mainly related with the unspecified representativeness of study populations. Seventeen (N = 17) articles compared TMD patients with non-TMD individuals, whilst eight papers compared the features of dental occlusion in individuals with TMD signs/symptoms and healthy subjects in non-patient populations. Findings are quite consistent towards a lack of clinically relevant association between TMD and dental occlusion. Only two (i.e., centric relation [CR]-maximum intercuspation [MI] slide and mediotrusive interferences) of the almost forty occlusion features evaluated in the various studies were associated with TMD in the majority (e.g., at least 50%) of single variable analyses in patient populations. Only mediotrusive interferences are associated with TMD in the majority of multiple variable analyses. Such association does not imply a causal relationship and may even have opposite implications than commonly believed (i.e., interferences being the result, and not the cause, of TMD). Findings support the absence of a disease-specific association. Based on that, there seems to lack ground to further hypothesise a role for dental occlusion in the pathophysiology of TMD. Clinicians are encouraged to abandon the old gnathological paradigm in TMD practice.

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Objective: To investigate the stress release properties of four thermoplastic materials used to make orthodontic aligners when subjected to 24 consecutive hours of deflection. Materials and Methods: Four types of aligner materials (two single and two double layered) were selected. After initial yield strength testing to characterize the materials, each sample was subjected to a constant load for 24 hours in a moist, temperature-regulated environment, and the stress release over time was measured. The test was performed three times on each type of material.

BackgroundThe aim of this study was to evaluate the predictability of F22 aligners (Sweden & Martina, Due Carrare, Italy) in guiding teeth into the positions planned using digital orthodontic setup.MethodsSixteen adult patients (6 males and 10 females, mean age 28 years 7 months) were selected, and a total of 345 teeth were analysed. Pre-treatment, ideal post-treatment—as planned on digital setup—and real post-treatment models were analysed using VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA). Prescribed and real rotation, mesiodistal tip and vestibulolingual tip were calculated for each tooth and, subsequently, analysed by tooth type (right and left upper and lower incisors, canines, premolars and molars) to identify the mean error and accuracy of each type of movement achieved with the aligner with respect to those planned using the setup.ResultsThe mean predictability of movements achieved using F22 aligners was 73.6%. Mesiodistal tipping showed the most predictability, at 82.5% with respect to the ideal; this was followed by vestibulolingual tipping (72.9%) and finally rotation (66.8%). In particular, mesiodistal tip on the upper molars and lower premolars were achieved with the most predictability (93.4 and 96.7%, respectively), while rotation on the lower canines was the least efficaciously achieved (54.2%).ConclusionsWithout the use of auxiliaries, orthodontic aligners are unable to achieve programmed movement with 100% predictability. In particular, although tipping movements were efficaciously achieved, especially at the molars and premolars, rotation of the lower canines was an extremely unpredictable movement.

Objectives: To investigate and compare the characteristics of commonly used types of traditional and heat-activated initial archwire by plotting their load/deflection graphs and quantifying three suitable parameters describing the discharge plateau phase. Materials and Methods: Forty-eight archwires (22 nickel titanium [NiTi] and 26 heat-activated) of cross-sectional diameter ranging from 0.010 to 0.016 inch were obtained from seven different manufacturers. A modified three-point wire-bending test was performed on three analogous samples of each type of archwire at a constant temperature (37.0uC). For each resulting load/ deflection curve, the plateau section was isolated, along with the mean value of the average plateau force, the plateau length, and the plateau slope for each type of wire obtained. Results: Statistically significant differences were found between almost all wires for the three parameters considered. Statistically significant differences were also found between traditional and heat-activated archwires, the latter of which generated longer plateaus and lighter average forces. The increase in average force seen with increasing diameter tended to be rather stable, although some differences were noted between traditional and heat-activated wires. Conclusions: Although great variation was seen in the plateau behavior, heat-activated versions appear to generate lighter forces over greater deflection plateaus. On average, the increase in plateau force was roughly 50% when the diameter was increased by 0.002 inch (from 0.012 to 0.014 and from 0.014 to 0.016 inch) and about 150% when the diameter was increased by 0.004 inch (from 0.012 to 0.016), with differences between traditional and heat-activated wires noted in this case. (Angle Orthod. 2012;82:507-521.)

Objective A smartphone-based ecological momentary assessment (EMA) strategy to collect real time data on awake bruxism (AB) has been recently introduced. The aim of this study was to assess the compliance with its use over 1 week in a sample of healthy young adults. Method Sixty (N = 60) healthy young adults (mean age 24.2 ± 4.1 years) used a dedicated smartphone application that sent 20 alerts at random times throughout the day. Upon alert receipt, the subjects had to report in real time their condition among five possible options: relaxed jaw muscles, teeth contact, teeth clenching, teeth grinding, and mandible bracing. Compliance rate with the app was assessed at the individual and group level in terms of percentage of answered alerts as well as number of days that were needed to reach the targeted observation period of 7 days with a compliance of at least 60%. ResultsThe mean compliance recorded with the smartphone application was 67.8% of the total alerts. On average, 9.8 ± 3.2 days (range 7-19) have been necessary to achieve the targeted goal of 7 days with a minimum of 60% alerts/day. No gender differences were detected in any compliance data. Response rate was not different during weekdays or weekends. Conclusions This investigation is the first attempt to assess individual compliance with EMA for reporting awake bruxism. Results suggest that a smartphone-based strategy can have interesting potential. The compliance rate reported in this study will serve as a comparison standpoint for future investigations. Clinical significance Based on the recent multidisciplinary focus on the study of awake bruxism, EMA has emerged as a potential approach for use in the clinical and research settings. This investigation suggests that compliance with such strategy is good, thus making it worthy of adoption for the assessment of AB and its clinical implications.

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Objective: To test the null hypothesis that there are no correlations between the morphology of the upper jaw, the position of the upper incisors, and facial type. Materials and Methods: From a sample of 191 patients, the FMA angle was used to select 20 short face type, 20 norm face type, and 20 long face type patients, aged 12 to 40 years. Using cone-beam computed tomography (CBCT), tomography was carried out on sagittal sections corresponding to the four upper incisors. Some parameters defining the dentoskeletal relationships, the alveolar thickness, the alveolar height, and the dental movement were measured. The measurements were processed using analysis of variance and Tukey's test. Results: At the upper central incisors, short face type patients presented a greater alveolar bone thickness than long face type patients. In short face type and norm face type subjects the root apex of the upper incisors was farther away from the lingual cortex than in the long face type patients. At the central incisors the alveolar thickness was greater and the lingual cortex was higher with respect to the lateral incisors in all three facial types. Conclusion: At the upper incisors, facial type is statistically significantly correlated with both alveolar bone thickness and distance between the root apex and lingual cortex. (Angle Orthod. 2009;79:692-702.)