Reliability of a Trapezium Miniplate with Endoscope-Assisted Internal Fixation in Mandibular Subcondylar Fractures: A Three-Dimensional Analysis

This study aimed to evaluate the reliability of a trapezium plate for open reduction and internal fixation (ORIF) of mandibular subcondylar fractures with the simultaneous use of an endoscope. We selected and retrospectively studied 18 patients (12 males and 6 females) with unilateral mandibular subcondylar fractures who visited the Wonju Severance Christian Hospital. The mean age of the patients was 43.43 ± 15.76 years. Patients underwent ORIF with trapezium miniplate application through an intraoral incision under general anesthesia. The clinical and radiographic findings of the fractured side were compared with those of the non-operated side at 6 months follow-up. All occlusions became stable, and transient functional disturbances disappeared within 6 months of periodic follow-up. Functional mandibular movement recovered within the normal range, with an average mouth opening of 41.5 mm, protrusion of 7.5 mm, and lateral excursion of 7 mm at 6 months. Radiographic controls and statistical analysis confirmed a decent anatomical reduction in all 18 cases. In conclusion, the use of a trapezium miniplate with endoscope-assisted ORIF in mandibular subcondylar fractures can be useful for fixation and functional recovery.

MANDIBULAR DEVIATION IN UNILATERAL CHEWING HABITS

ntroduction: The mandibular movement pattern was used to evaluate the presence of a dysfunction. Impaired TMJ function is called temporomandibular disorder (TMD). One of the causes that are often associated with TMD is a bad habit of chewing one side. This habit is often done without realizing it, causing an imbalance in the distribution of the chewing load and can result in deviation or displacement. The occurrence of TMD can be characterized by limited mouth opening of less than 40 mm. Objective: This study aims to determine the presence of abnormalities in the pattern of mandibular movement in the bad habit of chewing on one side. Methods: The research method used is descriptive observational research with saturated sampling technique with a sample of 25 students of the Faculty of Dentistry, Mahasaraswati University Denpasar, class of 2017. Data collection was carried out by observing through videos of mandibular movement patterns. Results and conclusions: The results showed the pattern of mandibular movement with the habit of chewing on one side, in men who deviated 28%, in women 32%, while in men who did not deviate 12% and in women as much as 28%

Physiology of dying

This chapter discusses the physiological changes that occur in the last weeks and days of life, and how this understanding can help in providing better care for patients and families. Starting in the last months of life with an accelerating course in the last several weeks, patients with advanced illnesses typically develop a characteristic decline in their physical function, nutritional status, respiratory function, and cognition as a result of progressive cancer and acute symptomatic complications. These changes correspond with worsening performance status, anorexia-cachexia, breathlessness, and delirium, which are prognostic factors in patients with advanced illnesses. In the last days of life, other physiological changes involving the neurological, neuromuscular, cardiovascular, and respiratory systems become apparent. The presence of telltale signs such as non-reactive pupils, Cheyne–Stokes breathing, inability to close eyelids, grunting of vocal cords, respiration with mandibular movement, death rattle, drooping of nasolabial fold, pulselessness of radial artery, hyperextension of neck, and decreased urine output significantly increase the likelihood of impending death within 3 days, although the absence of these signs cannot rule out impending death. Physiological monitoring such as vital signs, phase angle, cardiac electrophysiology, and bispectral index may provide further insights into the dying process.

Using Autoplasma in Treatment of Secondary Arthrosis, Developed from Dislocation of TMJ Disc

22 patients diseased with secondary arthrosis, developed from dislocation of TMJ disc, were observed by the authors of the article. Between these patients were 17 females and 5 males. The age of patients was from 21 to 60 years. In the clinical case, the leading symptom was constant or periodical pain, located at the injured joint, limitation of mandibular movement, aggravation of pain while moving jaw and was attached with clicking in joint. In the complex treatment of this problematical disease, successfully and for the first time was used autoplasmolifting. Authors injected autoplasma once in 5-6 days, 6 injections on one course of treatment. After noted treatment, 18 patients all the symptoms were released, 4 patients condition got better there was slight pain left, while moving jaw. In 1 patient's case, the neuralgia of III branch of the trigeminal nerve was diagnosed and he received suitable treatment. In 3 cases there was necessary to include orthopedic/orthodontic treatment.

Alteration of the Occlusal Vertical Dimension for Prosthetic Restoration Using a Target Tracking System

Clinicians and researchers have used various methods to reproduce the maxillomandibular relationship and mandibular movement of individual patients using an articulator, with efforts being made to reduce errors associated with the conventional technique. When a change to a vertical dimension is required during the conventional prosthesis construction process, the maxillary and mandibular casts are mounted on the mechanical articulator using a facebow and bite registration and the elevation of the anterior guide pin of the articulator is used. However, this can inevitably cause errors due to differences between the articulator hinge movement and the actual trajectory of the patient. There has recently been increasing interest in tracking the trajectory of jaw motion of a patient, and this paper presents a new technique for altering the vertical dimension based on the measured trajectory. Target materials for performing tracking are attached to the maxillary and mandibular anterior teeth to record opening and closing movements of the patient’s mouth in real time and align the patient’s scanned intraoral data or cast data. The movements of the targets are replaced with the movement of the patient’s oral scan data. Additionally, then the occlusal vertical dimension is set to a new position based on the obtained trajectory. After determining the optimal vertical dimension with consideration of the space required for restoration, maxillary and mandibular STL files are exported and the designed cast is created using a 3D printer. The printed cast is mounted on an articulator for subsequent procedures. This approach maintains the patient’s actual maxillomandibular relationship at various vertical heights and can also reduce the chair time required when adjusting for errors.

Comparison of the diagnostic accuracy of Ultrasonography and CBCT for detection of mandibular condyle erosion (an in-vitro study)

Temporomandibular joint (TMJ) is one of the most important, unique and structurally has the highest complex synovial system in the body (1, 2). TMJ, encompassing the temporal bone, mandibular condyle and articular disc, is a diarthrodial joint. As a collective form, Temporomandibular Joint Disorders (TMD) is often with multifactorial etiologies, and these diseases can more commonly affect the soft-tissue components of the TMJ including the articular disc and posterior attachment, the osseous components of the TMJ and also the related muscles (3, 4). The most common cause of the regional orofacial pain of non-dental origin is a result of TMD. Additional symptoms may include TMJ sounds such as clicking, pumping, limited or asymmetric mandibular movement (5). As TMJ is covered by a layer of fibrocartilage, unlike other joints in the human body, the mandibular condyles can be damaged due to cartilage degeneration. In addition, arthritis can also be initiated because of the particular dynamics in the maxillofacial area (6). TMD's are frequently associated with degenerative bone changes which can involve the bone structures of the TMJ such as erosion, flattening, osteophytes, subchondral bone sclerosis and pseudocysts (7). To correctly diagnose the dysfunctions associated with the disease and for adequate treatment planning Knowledge about these bone changes is fundamental (8).

Associations of Electromyographic Activity of Anterior T aphic Activity of Anterior Temporalis Muscles, Sex, and Occlusal Classes in Asymptomatic Young Adults

Symmetry evaluation of the craniofacial complex generally involves models of mandibular movement and masticatory muscle activity, especially during the growth of the craniofacial complex. Objectives: The aim of the study was to determine what, if any, associations exist between the activity of the masticatory muscles, sex, and occlusal classes in asymptomatic young adults. Methods:18-year-old volunteers, showing no symptoms of TMD based on an RDC/TMD examination, were included in the study.Surface electromyography (sEMG) recording was used to quantify the activity of masticatory muscles. The occlusal contact points were analyzed using a T-scan III Evolution 7.01 device. Occlusal classes were graded, employing an approach based on plaster study models. Results: In Class I–II subjects, we found significant differences only in the voltage of LTA in correlation with the gender and occlusal Class. Conclusions: Our findings show that the electromyography voltage of LTA significantly differs according to sex and occlusal Class. The voltage is higher in the female occlusal class II group, while the voltage is less in the male Class I and II group. This may be responsible for the symmetry index, which shows the predominance of the right-side muscles in all gender and occlusal groups.