Clinical importance of median mandibular flexure in oral rehabilitation: a review

Sivaraman, Karthik; Chopra, Aditi; Venkatesh, Shivanand

doi:10.1111/joor.12361

Cited by 31 publications

(56 citation statements)

References 46 publications

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“…The mandible has the ability to flex inwards around the mandibular symphysis with changes in shape and decreases in mandibular arch width during opening and protrusion of the mandible. This movement, which ranges from a few micrometres to more than 1 mm, occurs due to the contraction of lateral pterygoid muscles that pulls mandibular condyles medially and causes a sagittal movement of the posterior segments [12]. In addition, during biting and the power stroke of mastication, a combination of sagittal bending, corpus rotation, and transverse bending occurs.…”

Section: Discussionmentioning

confidence: 99%

A new way of evaluating the biomechanics of the mandible with freedom in three axes in space: Technical note

Meira

Landgraf

Shinohara

et al. 2018

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

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A biomechanical analysis of fixation devices to repair fractures or osteotomies of the mandible is carried out in hemi-mandibles fixed in the condylar process, the force is applied in the molar region and a single movement is allowed. This technical note presents a new setup for evaluating the biomechanics of the mandible with the following improvements: (1) providing freedom of mobility in three axes in the space; (2) applying forces in a way that closely replicates that of real cases; (3) capable of evaluating the fracture resistance and the stiffness and elastic recovery. Method: A rigid metal support mounted on bearings was developed that allowed the movement and deformation of the mandible during load application to mimic its freedom of movement when in function. Steadying was only in the mandibular fossae and free in all other regions. Ten fresh sheep mandibles were subjected to testing of their rigidity and capacity for elastic recovery after a displacement of 0.75 mm. Results: After three displacement cycles, the mean value of stiffness was 506 ± 64 N/mm, and the mandibles showed visco-elastic recovery. Conclusion: This new apparatus and approach is promising for use in the evaluation of mandibular fixations.

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Section: Discussionmentioning

confidence: 99%

A new way of evaluating the biomechanics of the mandible with freedom in three axes in space: Technical note

Meira

Landgraf

Shinohara

et al. 2018

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

View full text Add to dashboard Cite

show abstract

“…The mandible has the ability to flex inwards around the mandibular symphysis with changes in shape and decreases in mandibular arch width during opening and protrusion of the mandible. This movement, which ranges from a few micrometers to more than 1 mm, occurs due to the contraction of lateral pterygoid muscles that pulls the condyle of the mandible medially and causes a sagittal movement of the posterior segments (Sivaraman et al, 2016). In addition, during biting and the power stroke of mastication, a combination of sagittal bending, corpus rotation, and transverse bending occurs.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation of the Sheep Mandible as a Model for Studying Fixation Methods

Carvalho¹,

Saavedra²,

Ballester³

et al. 2018

Int. J. Morphol.

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Recently, there has been increased interest in the use of natural jaws for better results in bone fixation studies. Thus, the sheep mandible has been chosen for such studies. The aim of this study was to evaluate the length and resistance of the sheep mandible when submitted to a compression test with freedom in the three axes of space. Seventy fresh sheep (Ovis aries) mandibles were used in this study. Initially, the soft tissues were removed, and measurements of the mandible size were performed. Fifty mandibles were selected for mechanical testing based on the mean values from this assessment. The mandibles were joined by fixation in the symphyseal region and were tridimensionally deformed. A metallic support suitable for study of the mandible under efforts with freedom in the three axes in space was used. For this test, three displacement cycles were applied. Based on the mean stiffness, 35 mandibles were selected. The mean value of the sheep mandible mensuration was 13.6 cm ± 0.53 cm. The mean value of the sheep mandible stiffness was 153.5N ± 54.0 N. These data are useful for future studies on fixation systems for fractures and orthognathic surgery.

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“…In this case, the recovery from the pain and symptoms could be achieved only after splitting the prosthesis into three sections [ 26 ], possibly due to decreased stress on mandibular flexion with this prosthesis design. Therefore, for better longevity and outcomes of implant-related prosthesis, it is important to reduce the effect of mandibular flexure [ 15 , 16 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…In natural dentition, the stress generated by mandibular flexure can be compensated by adaptation of the periodontal ligament. However, this stress in a fixed implant-supported prosthesis is transmitted around the mandibular bone and could induce stress increases in the implant-related prosthesis and abutments and cause damage to the bone-implant interface [ 1 , 12 , 15 ], especially in posterior implants [ 17 ], bone loss around the implant, loss of implant fixation, material fracture, and/or loss of retention of restorations [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Split-Framework in Mandibular Implant-Supported Prosthesis

Marín

Dias

Paleari

et al. 2015

Case Reports in Dentistry

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During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient's discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities.

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Clinical importance of median mandibular flexure in oral rehabilitation: a review

Cited by 31 publications

References 46 publications

A new way of evaluating the biomechanics of the mandible with freedom in three axes in space: Technical note

A new way of evaluating the biomechanics of the mandible with freedom in three axes in space: Technical note

Biomechanical Evaluation of the Sheep Mandible as a Model for Studying Fixation Methods

Split-Framework in Mandibular Implant-Supported Prosthesis

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