Urbano Santana

Comparison of the fracture resistances of pulpless teeth restored with a cast post and core or carbon-fiber post with a composite core

STATEMENT OF PROBLEM The survival of pulpless teeth restored with a post and core system is a controversial issue. PURPOSE This study compared the fracture resistance of 2 types of restorations: teeth restored with prefabricated carbon-fiber posts and composite cores to cast dowel-core restored teeth. MATERIAL AND METHODS A total of 44 recently extracted sound premolars were randomly distributed into 2 equal groups: group I, restored with prefabricated carbon-fiber post and a composite core; and group II, with custom-cast type III gold alloy post and cores. The size and shape of the posts were identical in the 2 groups. All teeth were fully covered with a nonprecious cast crown. Fracture resistance was measured by applying a point force at 45 degrees to the long angle of the tooth. RESULTS Mean fracture threshold was 103.7 +/- 53.1 kg for group I versus 202.7 +/- 125.0 kg for group II (differences significant with P = .003). In group II, however, fracture nearly always affected the tooth itself, whereas in group I, the post-core nearly always failed first. CONCLUSIONS Significantly higher fracture thresholds were recorded for the cast post and core group. Teeth restored with cast posts typically showed fracture of the tooth, although at loads rarely occurring clinically.

Distance of the contact glide in the closing masticatory stroke during mastication of three types of food

This study was designed to characterize the distance of the contact glide in the closing masticatory stroke in healthy adult subjects, during chewing of three types of food (crustless bread, chewing gum and peanuts). Mandibular movements (masticatory movements and laterality movements with dental contact) were registered using a gnathograph (MK-6I Diagnostic System) on the right and left side during unilateral chewing of the three food types. Length of dental contact was measured in masticatory cycle, which is defined as where the terminal part of the chewing cycles could be superimposed on the pathways taken by the mandible during lateral excursions with occlusal contacts. The length of dental contact during mastication of chewing gum is 1.46 +/- 1 mm, during chewing of soft bread is 1.38 +/- 0.7 mm and during chewing of peanuts is 1.45 +/- 0.9 mm. There is no significant difference in the lengths of dental contact during mastication of three types of foods that enable direct tooth gliding.

Myoelectric activity during unilateral chewing in healthy subjects: Cycle duration and order of muscle activation

STATEMENT OF PROBLEM Craniomandibular disorders, unilateral mastication, and asymmetry of masticatory muscles appear to be related to each other. Thus, it is of interest to investigate masticatory muscle activity during unilateral mastication in healthy subjects. PURPOSE This study monitored contractile activity of the right and left masticatory muscles during right- and left-side gum chewing. MATERIAL AND METHODS Electromyographic techniques were used to determine chewing cycle duration and duration of contractile activity of the masticatory muscles (right and left masseter and anterior temporalis muscles) during unilateral chewing in 40 subjects without orofacial pain. The time-course of activation of the 4 muscles was also investigated. RESULTS Electromyographic traces showed extensive interindividual variation. In both right- and left-side chewing tests, and regardless of whether the masseter or the temporalis muscles were considered, mean duration of the contraction phase did not differ significantly between the working and nonworking sides. The working side temporalis contracted first, whether alone or at the same time as the other muscles. CONCLUSIONS In healthy subjects, no significant differences in masticatory muscle activity should be expected between either the right and left or the working and nonworking sides.

Maxillary changes and occlusal traits in crania with artificial fronto‐occipital deformation

Artificial fronto-occipital deformation of the cranial vault was typical of pre-Columbian cultures in the central Andean coastal regions. We have studied the influence of this deformation on maxillary and mandibular morphology. Measurements were performed on 86 adult Ancon skulls with anteroposterior deformation. Undeformed skulls from the area of Makatampu (n = 52) were used as the control group. To explore the influence of the deformity on occlusion, the skulls were categorized using the Angle classification and the alignment of the interincisor midline. In the group of deformed skulls, there was an increase in lateral growth of the vault and of the base of the skull (P < 0.001), giving rise to a greater interpterygoid width of the maxilla (P < 0.001), and an increase in the transverse diameter of the palatal vault. The mandible presented an increase in the length of the rami (P < 0.001) and in the intercondylar width, with no alteration of mandibular length. The deformed skulls had normal (class I) occlusion, with no displacement of the midline. The difference in the asymmetry index between the two groups was not statistically significant. Artificial fronto-occipital deformation of the cranial vault provoked compensatory lateral expansion of the base that was correlated with the transverse development of the maxilla and mandible. Occlusion and sagittal intermaxillary position were not affected by the cranial deformity. These results provide evidence of the integration between the neurocranium and the viscerocranium in craniofacial development, and support the hypothesis of a compensatory effect of function.

Midline shift and lateral guidance angle in adults with unilateral posterior crossbite

INTRODUCTION Unilateral posterior crossbite is a malocclusion that, if not corrected during infancy, typically causes permanent asymmetry. Our aims in this study were to evaluate various occlusal parameters in a group of adults with uncorrected unilateral posterior crossbite and to compare findings with those obtained in a group of normal subjects. METHODS Midline shift at maximum intercuspation, midline shift at maximum aperture, and lateral guidance angle in the frontal plane were assessed in 25 adults (ages, 17-26 years; mean, 19.6 years) with crossbites. RESULTS Midline shift at maximum intercuspation was zero (ie, centric midline) in 36% of the crossbite subjects; the remaining subjects had a shift toward the crossbite side. Midline shift at maximum aperture had no association with crossbite side. Lateral guidance angle was lower on the crossbite side than on the noncrossbite side. No parameter studied showed significant differences with respect to the normal subjects. CONCLUSIONS Adults with unilateral posterior crossbite have adaptations that compensate for the crossbite and maintain normal function.

A Prosthetic Alternative for Severely Angled Implants Beneath a Maxillary Overdenture: A Clinical Report

Implant-retained overdentures have been shown to be a predictable, accepted option and represent a viable and cost-effective treatment; however, patients with severe lack of bone volume and anatomical limitations are often a contraindication to the placement of osseointegrated implants without prior surgical procedures. In these situations, the placement of angled implants may offer a simple solution. This clinical report describes a case of dental rehabilitation using angled implants for a patient with a severely resorbed edentulous maxilla. The inclination has been solved by making a bar on the right side and individual pillars on the left side so as to obtain a functional and esthetic prosthetic result.

Jaw biodynamic data for 24 patients with chronic unilateral temporomandibular disorder

This study assessed 24 adult patients, suffering from severe chronic unilateral pain diagnosed as temporomandibular joint (TMJ) disorder (TMD). The full dentate patients had normal occlusion and had never received an occlusal therapy, i.e., were with natural dental evolution/maturation. The following functional and dynamic factors were assessed: (1) chewing function; (2) TMJ remodeling or the condylar path (CP); and (3) lateral jaw motion or lateral guidance (LG). CPs were assessed using conventional axiography, and LG was assessed by K7 jaw tracking. Seventeen (71%) of the 24 (100%) patients consistently showed a habitual chewing side. The mean (standard deviation [SD]) of the CP angles was 47.90 (9.24) degrees. The mean (SD) of the LG angles was 42.95 (11.78) degrees. Data collection emerged from the conception of a new TMD paradigm where the affected side could be the habitual chewing side, the side with flatter lateral jaw motion or the side with an increased CP angle. These data may lead to improved diagnosis, therapy plans and evolution in TMD patients.