Search Results (7)

Objective: This cross-sectional study analyzed the relationship between maxillary incisor inclination and sagittal condylar guidance in patients with and without temporomandibular disorders (TMD) across different skeletal malocclusions, aiming to enhance orthodontic diagnosis and treatment. Materials and Methods: A total of 154 patients from a private clinic with various skeletal malocclusions were consecutively enrolled in this study. Mandibular kinematics were recorded using Modjaw^® and TMD signs and symptoms were evaluated using the DC-TMD questionnaire. Pearson’s correlation was applied to assess relationships between incisor inclination (U1–NA, U1–APog, U1–PP) and condylar guidance (right and left). Results: TMD signs or symptoms were present in 31.8% of patients. A weak negative correlation was observed between incisor inclination and sagittal condylar guidance for patients with positive overjet and overbite values. Retroclined maxillary incisors were weakly associated with a steeper condylar path (correlation values between R = −0.122 and R = 0.177). No significant relation was found between maxillary incisors’ inclination and the presence of TMD (p > 0.05). No significant association was found between TMD prevalence and skeletal or dental classifications (p > 0.05). Conclusions: Although some correlations reached statistical significance, their magnitude was below the accepted threshold for small effects (r ≥ 0.30), indicating negligible clinical impact. These findings suggest that maxillary incisor inclination does not meaningfully influence condylar guidance and should not be considered a primary determinant in treatment planning. Instead, it should be integrated only as a contextual variable within a multifactorial functional assessment. Full article

Background/Objectives: Lateral patellar dislocation (LPD) is a common pathology of the adolescent knee and a major predisposing factor for patellofemoral instability (PFI). The pathogenesis of PFI involves a combination of anatomical and biomechanical contributors, with increasing evidence pointing to sex-specific differences in knee morphology. Despite this, the developmental course of these parameters and their variation between sexes remain insufficiently characterized. This study aims to investigate sex-related differences in patellofemoral joint geometry among skeletally immature patients with a history of PFI, focusing on how these anatomical variations evolve with increasing knee size, as represented by femoral condylar width. Methods: A total of 315 knee MRIs from patients under 18 years with documented PFI were retrospectively analyzed. Trochlear morphology, patellar tilt, axial positioning, and sagittal alignment were assessed using established MRI-based parameters. All measurements were normalized to bicondylar width to account for individual knee size. Sex-specific comparisons were performed using independent t-tests and linear regression analysis. Results: Females exhibited significantly smaller femoral widths, shallower trochlear depth (TD), shorter tibial tubercle–posterior cruciate ligament (TTPCL) distances, and lower patellar trochlear index (PTI) values compared to males (p < 0.05). In males, increasing femoral width was associated with progressive normalization of patellar tilt and sagittal alignment parameters. In contrast, these alignment parameters in females remained largely unchanged or worsened across different femoral sizes. Additionally, patellar inclination angle and PTI were significantly influenced by knee size in males (p < 0.05), whereas no such relationship was identified in females. Conclusions: Sex-specific morphological differences in patellofemoral geometry are evident early in development and evolve distinctly with growth. These differences may contribute to the higher prevalence of PFI in females and underscore the importance of considering sex and knee size in anatomical assessments. Full article

Precision in diagnosis is essential for achieving optimal outcomes in prosthodontics, orthodontics, and orthognathic treatments. Virtual articulators provide a sophisticated digital alternative to conventional methods, integrating intraoral scans, facial scans, and cone beam computed tomography (CBCT) to enhance treatment predictability. This review examines advancements in virtual articulator technology, including digital workflows, virtual facebow transfer, and occlusal analysis, with a focus on Artificial Intelligence (AI)-driven methodologies such as machine learning and artificial neural networks. The clinical implications, particularly in condylar guidance and sagittal condylar inclination, are investigated. By streamlining the acquisition and articulation of digital dental models, virtual articulators minimize material handling errors and optimize workflow efficiency. Advanced imaging techniques enable precise alignment of digital maxillary models within computer-aided design and computer-aided manufacturing systems (CAD/CAM), facilitating accurate occlusal simulations. However, challenges include potential distortions during digital file integration and the necessity for robust algorithms to enhance data superimposition accuracy. The adoption of virtual articulators represents a transformative advancement in digital dentistry, with promising implications for diagnostic precision and treatment outcomes. Nevertheless, further clinical validation is essential to ensure the reliable transfer of maxillary casts and refine digital algorithms. Future developments should prioritize the integration of AI to enhance predictive modeling, positioning virtual articulators as a standard tool in routine dental practice, thereby revolutionizing treatment planning and interdisciplinary collaboration. This review explores advancements in virtual articulators, focusing on their role in enhancing diagnostic precision, occlusal analysis, and treatment predictability. It examines digital workflows, AI-driven methodologies, and clinical applications while addressing challenges in data integration and algorithm optimization. Full article

Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during functional and parafunctional movements in bruxers and non-bruxers and to assess a digital method for quantifying eccentric bruxism using an optical jaw tracking system (Modjaw^®). Methods: The study group included subjects diagnosed with eccentric bruxism according to validated clinical diagnostic criteria. A control group of non-bruxer subjects with demographic characteristics similar to the study group was considered. Each participant underwent Modjaw^® examination twice to assess the recordings’ repeatability. The anterior guidance, mastication, and simulated eccentric bruxism were recorded. The SCI and BA were computed. The trajectories of interincisal inferior point (IIP), left condyle (LC), and right condyle (RC) in the frontal (F), sagittal (S), and horizontal (H) planes were outlined in rectangles to calculate areas of mastication and areas of eccentric bruxism (mm²). Intraclass correlation coefficient (ICC) was used to assess the recordings’ repeatability. Comparisons between groups were performed using Student’s t- and Mann–Whitney tests. The receiver–operator characteristic (ROC) curve was used to assess the diagnostic quality of the digital method. Results: Twenty bruxers (10 F and 10 M) and 20 non-bruxers (10 F and 10 M) were included. The ICC had values higher than 0.85. SCI, BA, and area of mastication for IIP, LC, and RC were similar between the groups (p > 0.05). The area of eccentric bruxism was significantly wider in the bruxers (p < 0.001). According to the ROC curve, the following cut-off areas (mm²) for eccentric bruxism were found in F, S, and H planes: IIP (18.05, 13.43, 16.28); LC (3.74, 10.83, 3.35); and RC (4.21, 10.63, 2.9), corresponding to sensitivity > 0.8, specificity > 0.75 and area under the curve (AUC) > 0.85. Conclusions: Mandibular and condylar kinematics during functional movements were similar in bruxers and non-bruxers. A novel digital method for quantifying eccentric bruxism was found using Modjaw^®, which could serve as a tool for early detection of eccentric bruxism before the onset of clinical consequences. Full article

Background: The main aim of this research was to assess the reliability of two systems designed specifically for condylar movement recording using condylar slope and Bennett angle information. The objectives were to evaluate the validity of two subsequent null hypotheses: (1) there is no significant difference between the measurements of condylar slope and Bennett angle taken at T0 (initial) and T1 (after one week) using the same equipment; (2) there is no notable difference in the values of the condylar slope and Bennett angle measurements obtained using Modjaw and Cadiax 2. Methods: An observational, descriptive, and prospective study was conducted with a selected group of 25 individuals (13 females and 12 males) aged between 22 and 27. Results: The results of Cadiax 2 and Modjaw showed excellent measurement repeatability for both parameters, with intraclass correlation coefficients (ICC) above 0.90, indicating excellent reliability between T0 and T1, both at 3 mm and 5 mm of displacement. Modjaw had an overall average value relatively higher than Cadiax 2, even though Modjaw’s condylar slope at 5mm had a significantly lower average value (37.4 ± 6.31) with an interval of 24.5–48.1, which was lower than Cadiax 2 (48.4 ± 10.6) with an interval of 30.5–68.5. Regarding the primary aim, it can be stated that both Modjaw and Cadiax 2 demonstrated excellent repeatability on their own, demonstrating robust reliability since there was no discernible difference between the T0 and T1 measurements. On the contrary, analyses of the two devices’ measured values for the secondary aim showed a considerable difference. Conclusions: Even though each device is reliable on its own, the absolute values that are obtained are different. Technological differences between the systems may account for these variations. Full article

(1) Background: The temporomandibular joint (TMJ) is the most complex and one of the most important joints in the human body due to its essential roles in mastication, swallowing, breathing and speech. Several instruments have been used to track mandibular movements and register the characteristic parameters of the TMJ, among which condylography instruments are validated for the accurate clinical registration of the condylar path. Sagittal condylar inclination (SCI) is one of the most important parameters, together with the Bennett angle and the immediate side shift, used for articular settings in the process of oral rehabilitation. The aim of the present study was to evaluate the differences between the left and right SCI and to assess whether the differences were statistically significant for skeletal class, age, gender, dentate status, TMJ pathology or parafunctional habits. (2) Methods: One hundred and forty consecutive patients, fully dentate or partially edentulous, and with angle class I, II and II, were recruited. Their left and right SCIs were determined with an ultrasonic jaw tracking device. Each subject had to make three protrusive movements and three right and left laterotrusive movements. The software calculated the SCI from the mean of the protrusive movements. (3) Results: The mean values obtained for the right and left SCI were 34.68° (±12.44°) and 34.94° (±13.23°), respectively, with no statistically significant differences between the left and right values for gender, dentate status, TMJ disorders or parafunctional habits. Skeletal class III subjects registered lower SCI means, which were statistically significant for the left SCI. (4) Conclusions: For an optimal functionalization of prosthetic restorations and for an ideal treatment plan, the registration of both the left and right paths of the condyles and the articular disc should be taken into consideration. Full article

Background: During prosthodontic treatment, the averaged values of the transversal condylar inclination (TCI) and the sagittal condylar inclination (SCI) are used for articulator settings. This study evaluated different parameters of measurable mandibular movements according to skeletal classes. Methods: Seventy-five patients (mean age 30.8 ± 5.49) had a condylography using the Cadiax Compact device (Gamma Dental, Klosterneuburg, Austria) and cephalometric analysis performed. Statistical analysis was performed using R statistical software. Results: There was no statistical evidence to state that the value of SCI angle is different in I compared to II Skeletal Class. There were no statistically significant differences when comparing the I vs. III and II vs. III Skeletal Class. The lowest mean SCI angle values were found in subjects with Skeletal Class III. There were statistically significant differences in left-sided TCI between Class I and II. There was a statistically significant linear relationship between ANB angle value and SCI value. Conclusions: Due to the wide individual variation in SCI and TCI values, it is advisable to use individual measurable parameters of mandibular movements during prosthetic reconstructions. The statistically significant relationship between SCI and ANB angle can be used to individualize the articulating parameters, especially in significant skeletal disproportions. Full article