Articulated dental cast analysis of asymptomatic and symptomatic populations

Abstract

Analysis of dental casts indicates patients with painful jaw symptoms exhibit significant displacement of the lower jaw bone at the joint. Misalignment of teeth when the jaws are closed is called dental arch displacement (DAD), and can cause headaches and jaw pain. The 3D nature of DAD, particularly the resulting displacement of bone at the jaw joint, has not been fully explored. Frank Cordray at Ohio State University College of Dentistry, USA, investigated DAD using 1192 articulated dental casts taken from patients with and without symptoms. Cordray took casts from each patient when they were relaxed, then measured the 3D displacement that occurred when he manipulated each cast until there was maximum contact between teeth. In symptomatic patients, Cordray found significant downwards and sideways displacement of the lower jaw bone, alongside increased overall DAD displacement.

Keywords

dental arch displacement / condylar displacement / seated condylar position / intercuspal position / musculo-skeletal dysfunction / temporo-mandibular dysfunction / common muscle contraction headache

References

[1] Hoffman PJ, Silverman SI, Garfinkel L. Comparison of condylar position in centric relation and in centric occlusion in dentulous subjects. J Prosthet Dent, 1973, 30(4 Pt 2): 582-588.

[2] Cordray FE. Three-dimensional analysis of models articulated in the seated condylar position from a deprogrammed asymptomatic population: a prospective study. Part 1. Am J Orthod Dentofacial Orthop, 2006, 129(1): 619-630.

[3] Williamson EH, Evans DL, Barton WA. The effect of bite plane use on terminal hinge axis location. Angle Orthod, 1977, 47(1): 25-33.

[4] Huffman RW, Regenos JW. Principles of occlusion, 1978 Columbus: Hand R Press

[5] Rosner D. Hinge axis translation from retruded contact position to intercuspal position in dentulous subjects in treatment. J Prosthet Dent, 1982, 48(6): 713-718.

[6] Rosner D, Goldberg GF. Condylar retruded contact position and intercuspal position correlation in dentulous patients. Part I: three-dimensional analysis of condylar registrations. J Prosthet Dent, 1986, 56(2): 230-239.

[7] Rosner D, Goldberg GF. Condylar retruded contact position and intercuspal position in dentulous patients. Part II: patients classified by anamnestic questionnaire. J Prosthet Dent, 1986, 56(3): 359-368.

[8] Cacchiotti DA, Bianchi P, McNeill C. Use of the mandibular position indicator in TMJ disorder diagnosis. J Dental Res, 1989, 68(Special Issue): 391.

[9] Wood DP, Korne PH. Estimated and true hinge axis: a comparison of condylar displacements. Angle Orthod, 1992, 62(3): 167-175.

[10] Alexander SR, Moore RN, DuBois LM. Mandibular condyle position: comparison of articulator mountings and magnetic resonance imaging. Am J Orthod Dentofacial Orthop, 1993, 104(3): 230-239.

[11] Shildkraut M, Wood DP, Hunter WS. The CR-CO discrepancy and its effect on cephalometric measurements. Angle Orthod, 1994, 64(5): 333-342.

[12] Utt TW, Meyers Jr CE, Wierzba TF. A three-dimensional comparison of condylar position changes between centric relation and centric occlusion using the mandibular position indicator. Am J Orthod Dentofacial Orthop, 1995, 107(3): 298-308.

[13] Roth RH. Occlusion and condylar position. Am J Orthod Dentofacial Orthop, 1995, 107(3): 315-318.

[14] Crawford SD. Condylar axis position, as determined by the occlusion and measured by the CPI instrument, and signs and symptoms of temporomandibular dysfunction. Angle Orthod, 1999, 69(2): 103-115.

[15] Girardot RA Jr. Comparison of condylar position in hyperdivergent and hypodivergent facial skeletal types. Angle Orthod, 2001, 71(4): 240-246.

[16] Hidaka O, Adachi S, Takada K. The difference in condylar position between centric relation and centric occlusion in pretreatment Japanese orthodontic patients. Angle Orthod, 2002, 72(4): 295-301.

[17] Shafagh I, Amirloo R. Replicability of chinpoint-guidance and anterior programmer for recording centric relation. J Prosthet Dent, 1979, 42(4): 402-404.

[18] Wood DP, Elliott RW. Reproducibility of the centric relation bite registration technique. Angle Orthod, 1994, 64(3): 211-220.

[19] Karl PJ, Foley TF. The use of a deprogramming appliance to obtain centric relation records. Angle Orthod, 1999, 69(2): 117-124.

[20] Williamson EH, Steinke RM, Morse PK. Centric relation: a comparison of muscle-determined position and operator guidance. Am J Orthod, 1980, 77(1): 133-145.

[21] Wood DP, Floreani KJ, Galil KA. The effect of incisal bite force on condylar seating. Angle Orthod, 1994, 64(6): 53-61.

[22] de Laat A, van Steenberghe D. Occlusal relationships and temporomandibular joint dysfunction. Part I: epidemiologic findings. J Prosthet Dent, 1985, 54(6): 835-842.

[23] Hicks ST, Wood DP. Recording condylar movement with two facebow systems. Angle Orthod, 1996, 66(4): 293-300.

[24] Ramfjord SP, Ash MM. Occlusion, 1983 Philadelphia: WB Saunders

[25] Beard CC, Clayton JA. Effects of occlusal splint therapy on TMJ dysfunction. J Prosthet Dent, 1980, 44(3): 324-335.

[26] Howat AP, Capp NJ, Barrett NVJ. A coloraAtlas of occlusion and malocclusion, 1991 St Louis: CV Mosby

[27] Ingervall B. Tooth contacts on the functional and nonfunctional side in children and young adults. Arch Oral Biol, 1972, 17(1): 191-200.

[28] Agerberg G, Sandström R. Frequency of occlusal interferences: a clinical study in teenagers and young adults. J Prosthet Dent, 1988, 59(2): 212-217.

[29] Okeson JP. Management of TM disorders and occlusion, 1993 St Louis: CV Mosby 113.

[30] Roth RH. Temporomandibular pain-dysfunction and occlusal relationships. Angle Orthod, 1973, 43(2): 136-153.

[31] Dawson PE. Functional occlusion: from TMJ to smile design, 2007 St Louis: CV Mosby

[32] Thilander B, Rubio G, Pena L. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod, 2002, 72(2): 146-154.

[33] Droukas B, Lindee C, Carlsson GE. Occlusion and mandibular dysfunction: a clinical study of patients referred for functional disturbances of the masticatory system. J Prosthet Dent, 1985, 53(3): 402-406.

[34] Weffort SY, de Fantini SM. Condylar displacement between centric relation and maximum intercuspation in symptomatic and asymptomatic individuals. Angle Orthod, 2010, 80(5): 835-842.

[35] He SS, Deng X, Wamalwa P. Correlation between centric relation–maximum intercuspation discrepancy and temporomandibular joint dysfunction. Acta Odontol Scand, 2010, 68(6): 368-376.

[36] Padala S, Padmanabhan S, Chithranjan AB. Comparative evaluation of condylar position in symptomatic (TMJ dysfunction) and asymptomatic individuals. Indian J Dent Res, 2012, 23(1): 122.