Search Results (194)

Background/Objectives: Occlusal disturbances occurring during central occlusion, mandibular movements and mastication may contribute to the development of temporomandibular disorders (TMDs). To reduce the disclusion time (DT) in all mandibular contacts, a procedure known as enameloplasty can be applied. The aim of this study was to evaluate the effect of occlusion-correcting treatments on disclusion time reduction, determination of the center of force, and the distribution of masticatory forces on the right and left side, through digital occlusal analysis in patients with TMD. Methods: The single-centered, prospective study including 106 patients with TMD after 6 months of prosthetic treatment. Digital occlusal analysis was performed before and after the enameloplasty to assess occlusion time, disclusion time and symmetry of occlusal contacts. Results: Selective enameloplasty significantly reduced disclusion time in the whole study population (0.8 vs. 0.4 s; p < 0.001), with greater improvement observed in patients with inappropriate Center of Force (COF) and premature occlusal contacts. Conclusions: Digital occlusal analysis-guided selective enameloplasty effectively reduces disclusion time and can improve occlusal parameters in TMD patients. Full article

Successful health management in older adults requires adequate nutrition, which is often compromised by oral health issues like edentulism. Tooth loss can reduce masticatory function, especially when rehabilitation treatments fail. The present study aims to generate initial information on the potential effects of the placement of mandibular mini-implants in patients with complete maxillary and mandibular dentures on mandibular kinetics, electromyographic activity, and quality of life. Participants with complete dentures, adequate mandibular bone height, and good general health were recruited. All underwent cone beam computed tomography for diagnosis and planning to place two mandibular mini-implants. Mandibular movements were analyzed using electromagnetic articulography and electromyography before treatment and five months after implant placement. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-7sp at baseline and six months post-treatment. Five subjects were included (mean age 69.7 ± 10.8 years). All mini-implants demonstrated a 100% initial success rate. At five months, significant improvements were observed in the vertical range of maximum opening, as well as in the area, trajectory, and range of frontal and sagittal movement envelopes (p < 0.05)—along with increased movement symmetry. OHRQoL also improved, with greater esthetic satisfaction, communication, and social engagement. Mandibular mini-implants improved mandibular movements and prosthetic stability, enhancing patients’ oral health-related quality of life without altering muscle activity. Full article

Background: Class II malocclusion is one of the most common and challenging orthodontic problems, often requiring complex, lengthy treatment and sometimes involving extractions or surgery. While conventional fixed appliances have been the gold standard, the increasing demand for aesthetic and comfortable treatment alternatives has made clear aligners a prevalent choice. Understanding the specific biomechanics, limitations, and successful clinical strategies for using aligners—especially in managing vertical dimension and achieving skeletal correction (mandibular advancement)—is crucial for expanding non-invasive treatment options and improving outcomes for a broad range of Class II patients. Objective: The objective of this review is to examine the effectiveness and clinical approaches of clear aligners in Class II correction across different age groups, with particular attention to vertical control, mandibular advancement methods, and the predictability of tooth movements in both growing and fully mature patients. Materials and Methods: This review narratively discusses the most relevant clinical findings and practical strategies for managing Class II malocclusions with clear aligners. Particular attention is given to the integration of auxiliary devices, such as elastics, attachments, and temporary anchorage devices (TADs), which can enhance biomechanical control. Results: The combination of aligners with mini-implants and attachments resulted in a consequent decrease in excessive overjet, improvement in facial profile, and long-term stability supported by fixed retention. In growing patients, correction benefited from mandibular advancement protocols and control of molar extrusion, allowing for preservation of the mandibular plane angle. Movement predictability showed higher reliability in anterior torque movements, whereas maxillary incisor intrusion remained less predictable. Conclusions: Clear aligners, especially when supported by auxiliary device, such as mini-implants and attachments, offer a reliable and aesthetic alternative to conventional orthodontic treatment for Class II malocclusions. However, certain tooth movements may still be less predictable, highlighting the need for careful planning, individualized biomechanics, and ongoing technological improvements. Full article

Mandibular second molar (MM2) impaction presents a relatively rare but complex orthodontic challenge, with potential consequences for occlusal function, periodontal health, and adjacent teeth. The aim of the article is to share data on the design and protocols of working with digitally designed systems for Printed Dento-alveolar Anchorage (PDaA) used in orthodontic traction of MM2. Accuracy in design comes from incorporating intraoral scans with CBCT files when planning the support system. The customized PDaA has an extension in the retention area of MM2 and allows multiple points of force application and vector control for precise tooth movement. The clinical flow includes surgical exposure and button placement on MM2, orthodontic traction using elastic elements attached to the PDaA, periodic activation every 3–4 weeks until the introduction of MM2 into the dental arch, and continuing with complete treatment of the entire orthodontic malocclusion. The clinical results demonstrated successful eruption and vertical leveling of MM2, stable anchorage, and absence of adverse effects on supporting teeth. Therapy with PDaA was well tolerated by patients, and did not disrupt aesthetics. This study highlights the potential of digital orthodontics to deliver personalized, biomechanically efficient solutions for molar impaction cases. Full article

Bit-related trauma is a welfare issue in equestrian sports; therefore, a proper understanding of how the bit behaves inside the mouth is of importance. The objective of this study is to investigate the influence of bit design (snaffle bits/single/double-jointed; ring/eggbutt and curb bits), size, rein tension, and rein angle on the intra-oral movement of the bit in ex vivo specimens. The lateral and posterior movement of different bits was measured on cadaver heads under different circumstances. This ex vivo model, while not fully replicating natural conditions, provided insight into potential bit-related movements. Lateral displacement of the snaffle bit was significantly greater with higher unilateral rein tension. Bits that were too wide exhibited significantly more lateral and posterior displacement under unilateral rein tension. Posterior displacement increased with both unilateral and bilateral rein tensions. Using a bit that is too wide, using reins at a 20° angle, and applying 4 kg of rein tension were identified as risk factors for contact with the mesial gingival tissues of the mandibular 06s. Similar patterns were observed with curb bits, although bit movement was more restricted, and no contact with the mesial gingival tissues of the mandibular 06s was noted. This study demonstrated that bit design, bit size, rein angle, and rein tension all influence bit movement in the horse’s mouth. Full article

Background/Objectives: This systematic review aimed to evaluate the effectiveness and predictability of lower incisor intrusion with clear aligners in permanent dentition, addressing one of the most challenging aspects of vertical tooth movement control in the mandibular anterior region. Methods: A comprehensive literature search was conducted across five databases (PubMed, Scopus, Embase, and Cochrane) according to PRISMA guidelines. Eight clinical studies fulfilled the eligibility criteria. Risk of bias was assessed using ROBINS-I, and certainty of evidence was graded with GRADE. Key outcomes included the amount of achieved versus planned intrusion, predictability, treatment protocols, use of auxiliaries, and patient-related factors such as age and compliance. Results: Reported mean intrusion values ranged from 0.4 to 1.5 mm, with predictability between 35% and 65%. The effectiveness of intrusion was influenced by the magnitude of planned movement, auxiliaries (e.g., attachments, elastics), refinement strategies, and patient-specific factors. Substantial heterogeneity was present in measurement methods (CBCT, cephalometry, digital models) and clinical protocols (aligner change intervals, refinement frequency), preventing meta-analysis. Seven of the eight studies were rated as having a serious risk of bias, and the overall certainty of evidence was moderate to low. Long-term outcomes and patient-centered measures were not adequately assessed. Conclusions: Within the limitations of the available evidence, lower incisor intrusion with clear aligners may be considered a feasible orthodontic option when supported by biomechanically informed clinical management. However, conclusions should be interpreted with caution due to heterogeneity, high risk of bias, and lack of long-term data. Further standardized studies with longer follow-up are required to strengthen reliability and clinical applicability. Full article

Temporomandibular joint disorders (TMDs), particularly disc displacement with reduction (DDwR), are prevalent musculoskeletal conditions characterized by symptoms such as joint clicking, pain, and sometimes limited jaw movements. Accurate diagnosis requires a multidisciplinary approach, including clinical examination, imaging (MRI), and functional analysis. Among conservative treatment modalities, anterior repositioning splints (ARSs) are widely used to recapture the displaced discs and reposition the mandibular condyles. Determining the optimal therapeutic position (Th.P) for anterior repositioning splint fabrication remains challenging due to individual anatomical variability and a lack of standardized guidelines. This study introduces the controlled mandibular repositioning (CMR) method, which integrates clinical examination, imaging (MRI), computerized cephalometry, computerized condylography, neuromuscular palpation, and the Condylar Position Variator (CPV) to define an individualized Th.P. After treatment with CMR stabilizers (splints), the control MRI confirmed that in 36 out of 37 joints, the discs were repositioned to their normal position. There was a reduction in pain, as shown by VAS scores at the 6-month follow-up. This study demonstrated the effectiveness of the CMR method to find a precise therapeutic position, resulting in a 97.3% joint luxation reduction in DDwR. This study underscores the importance of precise, individualized Th.P determination for effective anterior repositioning. Full article

Background/Objectives: The Motor Speech Hierarchy (MSH) Probe Words (PWs) have yet to be validated as effective in discriminating between children with impaired and children with typically developing speech motor control. This preliminary study first examined the effectiveness of the mandibular control subtest of the MSH-PWs in distinguishing between typically developing (TD) and speech sound-disordered (SSD) children aged between 3 years 0 months and 3 years 6 months. Secondly, we compared automatically derived kinematic measures of jaw range and control with MSH-PW consensus scoring to assist in identifying deficits in mandibular control. Methods: Forty-one children with TD speech and 13 with SSD produced the 10 words of the mandibular stage of the MSH-PWs. A consensus team of speech pathologists observed video recordings of the words to score motor speech control and phonetic accuracy, as detailed in the MSH-PW scoring criteria. Specific measures of jaw and lip movements during speech were also extracted to derive the objective measurements, with agreement between the perceptual and objective measures of jaw range and jaw control evaluated. Results: A significant difference between TD and SSD groups was found for jaw range (p = 0.006), voicing transitions (p = 0.004) and total mandibular scores (p = 0.015). SSD and TD group discrimination was significant (at alpha = 0.01) with a balanced classification accuracy of 0.79. Initial analysis indicates objective kinematic measures using facial tracking show good agreement with perceptual judgements of jaw range and jaw control. Conclusions: The preliminary data indicate the MSH-PWs can discriminate TD speech from SSD at the level of mandibular control and can be used by clinicians to assess motor speech control. Further investigation of objective measures to support perceptual scoring is indicated. Full article

Aim: To evaluate whether maximum occlusal loading and periodontal status are different between teeth presenting deflective occlusal contacts and those without such contacts, specifically adjacent and homologous teeth. Method: A cross-sectional study was conducted using OccluSense to detect deflective contacts and quantify occlusal load per tooth. For group comparisons, the Kruskal–Wallis, Friedman, Cochran’s Q, and chi-squared tests were used. Results: A total of 493 teeth with deflective contacts were compared to 473 adjacent (first control group) and 457 homologous teeth (second control group). Teeth with deflective contacts showed significantly higher occlusal loading (mean value: 208) than adjacent (72) and homologous teeth (97) (p < 0.05). They also exhibited more advanced periodontal damage, including deeper probing depths, greater gingival recession, alveolar bone loss, and a wider periodontal ligament space. Deflective contacts in centric relation were more strongly linked to periodontal deterioration than those in protrusive or lateral mandibular movements, despite similar occlusal forces. Conclusions: Within this study’s limitations, deflective occlusal contacts are associated with increased occlusal forces and more severe periodontal damage, suggesting a biomechanical factor in periodontal disease progression. Full article

Electromagnetic articulography is a technique developed for recording three-dimensional movements. It is based on magnetic induction, where small currents are induced in miniature receiver coils acting as motion sensors by means of electromagnetic fields generated by transmitter coils. This technology has been applied in dental research to record mandibular movements during mastication, Posselt’s envelope of motion, and micromovements of dental prostheses. The AG501 electromagnetic articulograph (Carstens Medizinelektronik GmbH, Bovenden, Germany) provides a Head Correction (HC) procedure to eliminate head movement, which requires the reference sensors to be firmly attached to the subject’s head. If the sensors shift during the recordings, it becomes necessary to reposition them and repeat the head correction procedure. The aim of this study was to develop a 3D-printed helmet to securely fix the reference sensors to the head of a subject in the context of performing a series of recordings involving the mastication of 36 foods and the execution of Posselt’s envelope of motion. The number of HCs required was recorded for a group using the helmet and for a control group in which the sensors were attached to the subject’s head using tissue adhesive. A total of 29 recordings were conducted with and without the helmet. Without the helmet 44 HCs were required; on the other hand, with the helmet 36 HCs were required. On average, 1.5 HCs were required per session without the helmet and 1.2 HCs with the helmet, showing a non-significant difference (p < 0.05). A reduction in the number of HCs required per session was observed. However, more than one HC was still needed to complete a session. This could be addressed in future research by designing a series of helmets that adapt to different head sizes. Full article

Background: Distalization is a fundamental orthodontic strategy for correcting Class II and Class III malocclusions, particularly in cases where specific dental or skeletal conditions favor its application. Recent technological advances have enabled complex dental movements to be performed using clear aligners, aided by digital planning platforms such as ClinCheck^®. Methods: This retrospective study aimed to evaluate the accuracy of ClinCheck^® in predicting molar and canine distalization outcomes with the Invisalign^® system and to identify clinical factors influencing treatment predictability. Thirty patients with complete permanent dentition and at least 2 mm of programmed distalization were selected. Planned movements were extracted from the Invisalign^® Doctor Site and compared to achieved outcomes using Geomagic^® Control X™ software. Occlusal improvements were assessed using the Peer Assessment Rating (PAR) index. Results: The results revealed significant discrepancies between the programmed and achieved distalization, with mean deviations greater than 1 mm in both arches. Skeletal anchorage with mini-screws significantly improved distalization outcomes in the maxillary arch; however, no significant effect was observed in the mandibular arch. Additionally, no significant associations were found between distalization outcomes and skeletal pattern (ANB angle) or facial biotype. Conclusions: Clear aligners are effective in achieving substantial occlusal improvements, particularly when combined with personalized digital planning and supplementary strategies such as skeletal anchorage. Mandibular cases demonstrated greater reductions in PAR scores, emphasizing the potential of aligners in complex distalization treatments. Full article

Study design: The advent of the Matrix Wave^TM System (Depuy-Synthes)—a bone-anchored Mandibulo-Maxillary Fixation (MMF) System—merits closer consideration because of its peculiarities. Objective: This study alludes to two preliminary stages in the evolution of the Matrix Wave^TM MMF System and details its technical and functional features. Results: The Matrix Wave^TM System (MWS) is characterized by a smoothed square-shaped Titanium rod profile with a flexible undulating geometry distinct from the flat plate framework in Erich arch bars. Single MWS segments are Omega-shaped and carry a tie-up cleat for interarch linkage to the opposite jaw. The ends at the throughs of each MWS segment are equipped with threaded screw holes to receive locking screws for attachment to underlying mandibular or maxillary bone. An MWS can be partitioned into segments of various length from single Omega-shaped elements over incremental chains of interconnected units up to a horseshoe-shaped bracing of the dental arches. The sinus wave design of each segment allows for stretch, compression and torque movements. So, the entire MWS device can conform to distinctive spatial anatomic relationships. Displaced fragments can be reduced by in-situ-bending of the screw-fixated MWS/Omega segments to obtain accurate realignment of the jaw fragments for the best possible occlusion. Conclusion: The Matrix Wave^TM MMF System is an easy-to-apply modular MMF system that can be assembled according to individual demands. Its versatility allows to address most facial fracture scenarios in adults. The option of “omnidirectional” in-situ-bending provides a distinctive feature not found in alternate MMF solutions. Full article

Background/Objectives: Mandibular coronoid process hypertrophy (MCPH) is a rare condition characterized by an abnormal enlargement of the mandibular coronoid process, resulting in restricted mouth opening and reduced lateral mandibular movements due to interference with the zygomatic bone. The objective of this paper is to evaluate the functional outcomes of intraoral coronoidectomy followed by physiotherapy in five consecutive patients with MCPH. Methods: Five male patients (mean age 38 ± 18.7 years) with radiologically confirmed bilateral MCPH underwent intraoral coronoidectomy between May 2020 and December 2022. Maximal inter-incisal opening (MIO) was measured pre-operatively, on postoperative day 1, and at 6-month follow-up. A standardized 5-10-60 mouth-opening exercise protocol using a Heister mouth gag was administered from postoperative day 1. Results: The hyperplastic mandibular coronoid processes were removed intraorally without any long-lasting complications. All patients demonstrated a postoperative increase in mouth opening. Notably, patients with more severe mouth-opening limitations showed greater improvement compared with those with milder initial restrictions. Conclusions: Intraoral coronoidectomy, combined with early and intensive physiotherapy, represents a safe and effective treatment for MCPH. Early diagnosis and timely surgical intervention are crucial to prevent ineffective non-surgical management. Additionally, a modest initial postoperative increase in mouth opening should not be considered the final outcome, as these patients often achieve substantial long-term functional improvement. Full article

Background and Clinical Significance: Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in achieving long-term success in complex rehabilitations of periodontally compromised patients. Case Presentation: This case report describes the digital minimally invasive rehabilitation of a 39-year-old male patient with Stage III periodontitis, occlusal discrepancies, tooth mobility, and an interincisal diastema. A fully digital workflow—including intraoral scanning, aesthetic previewing, and mandibular motion analysis—was employed to guide diagnosis, treatment planning, and prosthetic execution. Conservative tooth preparations using a biologically oriented approach (BOPT) were combined with customised provisional restorations to support soft tissue conditioning and functional control throughout the provisional phases. Mandibular motion tracking facilitated the design of a personalised anterior guidance to improve occlusion and correct the deep bite. The interincisal diastema was initially maintained then closed during the advanced phase of treatment based on aesthetic simulations and patient preference. One unplanned endodontic treatment was required during the provisional phase, but no other complications occurred. Conclusions: At the four-year follow-up, the patient demonstrated stable periodontal and occlusal conditions, improved clinical indices, and high satisfaction with the aesthetic outcome. Full article

Background/Objectives: Previous studies on clear aligner therapy (CAT) in mixed dentition primarily focused on the predictability of maxillary arch expansion. However, limited evidence is available regarding mandibular arch changes, particularly in relation to inter-arch coordination. This study aims to evaluate the effectiveness and predictability of dental expansion in both the upper and lower arches using Invisalign First^® aligners. Methods: A retrospective analysis was conducted with 15 participants. Dental expansions were assessed before and after treatment using iTero intraoral scans processed with 3D analysis software. Measurements were compared to the predicted movements planned in ClinCheck^®. Data normality was verified (Shapiro–Wilk test), descriptive statistics were calculated, and paired t-tests were performed to compare clinical and predicted expansions, with significance set at 0.05. Results: Clear aligners achieved effective dento-alveolar expansion in both arches. Predictability was higher at the cusp level than at the gingival level, indicating a tendency toward tipping movements rather than bodily expansion. The study also highlighted mandibular expansion outcomes and gingival-level discrepancies, providing new insights compared to the previous literature. Minor differences between predicted and achieved movements were observed, partly attributable to natural growth and deciduous tooth exfoliation. Conclusions: Clear aligners are effective in achieving maxillary and mandibular arch expansion in mixed dentition, with good predictability at the coronal level. Overengineering buccal root torque may help promote bodily expansion and reduce cuspal–gingival discrepancies. Further studies with larger sample sizes are needed to optimize treatment planning and predictability. Full article