Sonja Kraljević Šimunković

Measurements of the sagittal condylar inclination: intraindividual variations

Abstract Aims: Sagittal condylar inclination is an important parameter during fabrication of prosthetic restorations. Existing data about intraindividual variations of sagittal condylar inclination are scarce. The purpose of this study was to investigate intra- and interindividual variations of the sagittal condylar inclination, depending on the position of the condyle in the temporomandibular joint. Methodology: The study included 51 subjects with Angle’s Class I occlusion (21–32 years of age, mean 25·1). Measurements were done using an electronic axiograph. After a paraocclusal tray was fixed in the mouth, every subject had to make three protrusive movements, from which the device’s software calculated the mean left and mean right sagittal condylar path. The mean left and right condylar path of each subject was divided into three equal sequences, based on whole condylar path length. Condylar inclination values for the first, second and third movement sequences were calculated. Results: Results showed significant differences between movement sequences (P<0·05). For the left joint, condylar inclination values in the first condylar movement sequence demonstrated, on the average, 14·4% higher values compared to the second movement sequence, and 39·2% higher values than in the third movement sequence. For the right joint, the first condylar movement sequence demonstrated, on the average, 15·8% higher values compared to the second movement sequence, and 41·5% higher values than the third movement sequence. Conclusions: Results suggest that condylar movement in the sagittal direction is not uniform. Mean left and mean right condylar inclination values do not necessarily describe the actual condylar path, nor do they give adequate information for articulator setup. Left–right side condylar inclination differences greater than 10° can be considered as normal.

Reproducibility of the obtained centric relation records in patients with disc displacement with reduction

Objective The aim of this study was to investigate reproducibility of the position of centric relation in patients with disc displacement with reduction. Materials and methods The test group included 30 subjects, diagnosed with disc displacement with reduction in right, left or both joints. The control group included 12 individuals with no signs and symptoms of temporomandibular disorders. Using chin point guidance with a jig, centric relation record was made three times by every participant, in a single session. Left and right condylar position for each centric relation record was determined and recorded using the electronic ultrasonic measuring device. The data were transferred to the computer, processed and analyzed. Condylar distances between centric relation records were measured (anteroposterior, vertical, transversal and linear values), and the data were statistically analyzed using the t and the F tests. Results No statically significant difference was found between the test and the control groups. Two thirds of study participants demonstrated condylar position of the repeated centric relation recording within the area of 0.3 mm in diameter. For more than 90% of participants that area was within 0.4 mm. Conclusions There is no difference in reproducibility of the centric relation between patients with disc displacement with reduction and healthy temporomandibular joint individuals (p>0.05). When doing centric relation record on a patient with disc displacement with reduction there is no need for previous splint therapy and standard precautions are acceptable. The obtained results must be interpreted within the experimental group, and not projected on the other groups of temporomandibular disorders.

Centric slide in different Angle's classes of occlusion

The purpose of this study was to test the possible differences in centric slide values between different Angles classes of occlusion. The study included 98 participants divided into four groups: Angles class I, Angles class II, subdivision 1, Angles class II, subdivision 2 and Angles class III. All recordings were obtained using an ultrasound jaw tracking device with six degrees of freedom. The distance between the maximum intercuspation (reference position) and the centric occlusion was recorded at the condylar level. Anteroposterior, superoinferior and transversal distance of the centric slide were calculated for each participant, and the data were statistically analyzed (analysis of variance and Newman-Keuls post hoc test). No statistically significant difference was found in the anteroposterior and transversal distance of the centric slide between tested groups, while Angles class II, subdivision 2 showed smaller vertical amount of the centric slide compared to Angles class I and class II, subdivision 1. None of the 98 participants showed coincidence of centric occlusion and maximum intercuspation. Our results suggest that coincidence of the maximum intercuspation with the centric occlusion should not be expected. Smaller extent of the vertical distance of the centric slide could be morphological and a functional expression characteristic of the Angles class II, subdivision 2.