A Multi-Center Disclusion Time Reduction (DTR) Randomized Controlled Occlusal Adjustment Study Using Occlusal Force and Timing Sensors Synchronized with Muscle Physiology Sensors (original) (raw)
Related papers
Disclusion time reduction therapy in treating occluso-muscular pains
The Journal of Indian Prosthodontic Society, 2016
Disclusion time reduction (DTR) is an objective treatment protocol using T-Scan III (digital analysis of occlusion) and electromyography for treating occlusally activated orofacial pains. Chronic occluso-muscle disorder is a myogenous subset of temporomandibular disorder symptoms. These muscular symptoms are induced within hyperactive masticatory muscles due to prolonged disclusion time, occlusal interferences, and occlusal surface friction that occur during mandibular excursive movements. This case report describes a patient treated by DTR therapy, whereby measured pretreatment prolonged disclusion time was reduced to short disclusion time using the immediate complete anterior guidance development enameloplasty, guided by T-Scan occlusal contact time and force analysis synchronized with electromyographic recordings of four masticatory muscles.
2020
Background: This study was done to compare and analyse the effect of occlusal adjustment on postoperative pain after endodontic treatment in patients diagnosed with symptomatic irreversible pulpitis. Methods: Eighty-four participants were included in this study, patients were divided into two groups, Group 1: patients receiving occlusal adjustment (intervention group) and Group 2: patient not receiving occlusal adjustment (control group). endodontic treatment was performed and pain score was evaluated using Verbal rating scale (VRS). Pain assessment was done at 6, 24 and 72 hours. Statistical analysis: Data was analysed using chi square and T test, Wilcoxon Rank Sum rank test was used to test if pain score is likely to derive from the same population. Results: No statistical significance was observed between the group when compared at 6,24 and 72 hours (p>0.001). While at 6-24-time interval group 1 showed a significant reduction (P<0.001) in postoperative pain as compared to group 2. Conclusion: Occlusal adjustment did not affect the occurrence of post-endodontic pain over a 72-hour period.
Scientific Reports, 2021
The purpose of this systematic review was to analyze the influence of occlusal reduction on the postoperative pain levels after endodontic treatment (instrumentation and obturation of the root canal system). This review followed the PRISMA statement and was registered at PROSPERO (CRD42018107918). Two independent reviewers searched the Lilacs, Cochrane Library, PubMed (Medline), Web of Science, Scopus, Scielo, and ScienceDirect for articles published until April 2021. The research question was, "Does occlusal reduction decrease postoperative pain in endodontically treated teeth?". Only randomized clinical trials were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (presence or absence of pain). The search strategies retrieved 4114 studies. Twelve studies were included for qualitative analysis and nine for quantitative analysis. The meta-analysis results did not reveal ...
2020
**Abstract** A clinical concern is when is the best time to evaluate and revise occlusal contacts. A review of the literature suggests a time factor could significantly affect recording a patient’s bite. **Objectives** A pilot study was undertaken utilizing T-Scan (Tekscan, Inc. South Boston, MA USA) to measure first tooth contacts in 32 patients as they self-guided into Maximum Intercuspation (MIP). **Methods** 32 subjects were recorded at 8am and again at 5pm on the same day following a strict protocol. AM T-Scan data were compared to PM data to see if there were differences in first tooth contacts between morning and evening closures. **Results** 26 patients (81%) showed no changes in first tooth contact, the remaining 6 (19%) did show a slight variation in first tooth contact from morning to evening scans. Occlusion Time (OT) and Disclusion Time (DT) were also recorded from these same subjects. The mean OT changed significantly, increasing by 50 milliseconds (p < 0.05) in the PM. The mean DT decreased by up to 70 milliseconds in the PM, but with greater variability and only the third opening reached significance (p < 0.05). An incidental finding in this study was 56% (18) of the participants had at least one contact within the arch that received 30% or more of the total bite force on a single tooth. These were all iatrogenic conditions because the overloaded tooth was either a crown or onlay. **Conclusions** Statistically significant but very small differences were found between the AM and PM mean occlusion times and mean disclusion times for this group. Although it is questionable whether such small differences are clinically relevant, the data support a high level of consistency in the measurements. Additional research will be needed to determine whether a 30 - 50 millisecond increase in occlusion time or 56 - 69 millisecond reduction in disclusion time is clinically relevant.
Egyptian Dental Journal, 2018
Background: Occlusal balance in complete dentures is usually achieved by eliminating occlusal discrepancies through selective grinding. The main challenge lies in the accurate detection of the premature contacts to be able to achieve true and proper occlusal balance. There are several ways to detect occlusal errors and premature contacts including the intra-oral clinical assessment methods and remounting procedures. Purpose: Dental literature lacks studies that objectively investigated the accuracy of occlusal adjustment after clinical remounting procedures as compared with that done only by intra-oral assessment using articulating paper. The aim of this study was to quantitatively and objectively assess the influence of clinical remounting on occlusion (OT) and disocclusion (DT) times, as objective indicators of occlusal balance, using computerized occlusal analysis. Methods: This clinical study included 20 completely edentulous patients, 11 males and 9 females (aged 51 to 64, with an average of 57.6 years). Two sets of conventional complete dentures were constructed for each patient with a total of 40 dentures. Occlusal adjustment of 20 denture sets was done based on intra-oral assessment using articulating paper (control group) while occlusal adjustment of the other 20 denture sets was done based on clinical remounting procedures (experimental group). Occlusal parameters including OT, DT during right excursion (DT-Right) and DT during left excursion (DT-Left) were recorded for each set of dentures. Paired t-test was used to statistically analyze and compare the OT, DT-Right and DT-Left values between the two denture groups. A probability value of less than 0.05 was considered statistically significant. Results: The mean recorded OT was 0.48 seconds in the intra-oral method (articulating paper) group and decreased to 0.32 seconds in the clinical remounting group. This decrease was statistically significant. The mean recorded DT was 0.6 and 0.62 seconds for DT-Right and DT-Left respectively in the intra-oral method group. However they decreased to 0.36 and 0.37 seconds in the clinical remounting group. Again this decrease was statistically significant for both right and left lateral excursions. Conclusion: Occlusal adjustment based on clinical remounting procedures is more accurate and achieves more occlusal balance, as represented by shorter occlusion and disocclusion times, when compared to the intra-oral adjustment method using an articulating paper.
Objective: This literature review summarizes the properties, advantages, limitations, and clinical implications of employing static occlusal indicators compared to quantifi-able digital occlusal indicators during occlusal adjustments. Method: An electronic database search of dental literature was carried out in PubMed/MEDLINE using the key words Occlusal Indicators, Occlusal Assessment, Static, Reliability, Dynamic, Repeata-bility, Validity and Clinical Accuracy. A total of 231 papers were isolated, with 129 papers considered for review. Results: The included papers were grouped by Static and Dynamic Occlusal indicators. The numbers of papers in the Static Group was extremely low (only 20 papers) compared to The Dynamic group (T-Scan: 89; Dental Prescale: 28; Intraoral Scanners:17). Conclusion: Little evidence supports the use of static occlusal indicators due to their high degree of subjectivity required during implementation. However, much scientific evidence supports the use of T-Scan, as it measures relative occlusal forces and timing objectively, accurately, and repeatedly. For the improvement of Occlusal Practice, Subjective Interpretation using Static occlusal indicators should be replaced with digital ones for objective measurements. Clinical Relevance: The computerized occlusal analysis system is well studied and has the capacity to provide precise time and force sequencing information to objectively evaluate occlusal contacts for improved treatment outcome.
Diş Tedavisindeki Hareketlerin Ergonomik Analizi: Rahatsızlık Sebeplerinin Tespiti ve Vücut Bölgelerine Etkisi Öz Diş hekimliği mesleği, uzun süreli statik kas yüklemesi, yüksek oranda tekrarlanan ve monoton çalışma, dokuların kuvvetle zorlanması veya mekanik olarak sıkıştırılması ve titreşimli araçların kullanılmasını içerir. Bu nedenle diş hekimlerinin, maruz kaldıkları mesleki kas-iskelet rahatsızlıkları (MKİSR) yüzünden maliyetli sağlık sorunları yaşayarak erken emekli olmaları söz konusudur. Bu çalışmanın amacı dişhekimlerinin yaşamakta olduğu kas iskelet sistemi rahatsızlıklarının risk faktörlerini tanımlamak ve bölgesel olarak tespit edip, etki derecelerini incelemektir. Bu çalışma kapsamında bir anket hazırlanmış olup, çeşitli üniversitelerin, hastahanelerin ve diş kliniklerinde görev yapan 67 dişhekimi tarafından doldurulmuştur. Diş hekimlerinin altı vücut bölgesine en yaygın tedavi yöntemleri esnasında EMG ölçümleri yapılmıştır. İstatistiksel olarak anlamlı ve MKİSR'nın oluşmasına sebep olan faktörleri belirlemek amacıyla Diskriminant Analiz yöntemi kullanılmıştır. EMG deneyinden elde edilen sonuçları ise ANOVA kullanılarak belirlenen MKİSR faktörleri teyit edilmiştir. Diş hekimlerinin tedavi esnasında en sık rastlanan pozisyon statik ve uzun süreli oturma / durma pozisyonda oldukları tespit edilmiştir. Son 12 ayda yaşanan kas iskelet sistemi rahatsızlıklarının en çok görülmekte olduğu bölgeler boyun, el/bilek, üst sırt, ve omuzlar olarak saptanmıştır. Son 7 günde ise en çok dirsek, ayaklar, kalça, ve bilek/el bölgelerinde rahatsızlık yaşandığı tespit edilmiştir. Diş hekimlerinin uygulamakta olduğu endodonti, dolgu, diş çekimi, muayene, ve çıkarılabilir protez tedavilerinin, vücut bölgeleriyle etkileşerek kas-iskelet sistemi rahatsızlıklarına yol açtığı ortaya çıkmıştır. Ancak, vücut bölgesi diş çekimi, endodonti ve diş muayenesi esneasında oluşabilecek tek anlamlı risk faktörü olarak bulunmuştur. Abstract Dentistry profession involves in prolonged static muscle loads, highly repetitive and monotonous work, high force exertion or mechanical compression of tissues, and using vibrated tools. Therefore dentists are exposed to work-related musculoskeletal disorders (WRMSDs), which results in costly health problems and early retirements. This research aims to determine the risk factors of musculoskeletal discomforts among dentists, and to identify the impact of the dental tasks on the body regions during particular treatments. A questionnaire is created and fulfilled by 67 dentists from universities, hospitals, and dental offices. Electromyography studies were applied on six body regions of randomly selected three dentists during most common dental treatments. Discriminant Analysis was applied to determine whether a set of variables is effective in predicting category membership, and to identify statistically significant factor(s) which contribute(s) formation of the WRMSDs. ANOVA was utilized to analyze the results which were obtained from sEMG experiment and to determine the risk factors of work related musculoskeletal disorders. The most common position of the dentists while performing their profession was static and prolonged sitting / standing position. Musculoskeletal discomforts were experienced during the past 12 months in neck, hand / wrist, upper back, and shoulder regions; and during the past 7 days in elbows, feet, hip, and wrist / hand regions. There is no significant factor on dental filling therapy, tooth cleaning, fixed prosthodontics, and removable prosthodontics treatments. However, body region is the only significant factor on tooth extraction, endodontic and dental examination treatments.
Tooth Positioner Effects on Occlusal Contacts and Treatment Outcomes
The Angle Orthodontist, 2008
Objective: To determine if an increase in tooth contacts is the principal effect of tooth positioner wear. Materials and Methods: Patient charts from a consecutive series were reviewed until a sample of 100 cases that used a tooth positioner was obtained. One hundred control cases were randomly selected from patients treated at the same period. Malocclusion severity and finished occlusion were assessed with the American Board of Orthodontics (ABO) Discrepancy Index (DI) and Objective Grading System (OGS) score, respectively. Finish casts for each patient were mounted on a Galleti articulator. Occlusal registrations were obtained with silicone-based impression material from casts fabricated from impressions taken at the time of fixed appliance removal (control) or at the end of the tooth positioner treatment (experimental). The number of the perforations and transparent areas on the occlusal registrations were quantified. Results: There was no significant difference (P ϭ .20) in the number of total occlusal contacts between the two groups. However, the OGS score of the tooth positioner group (16.7) was significantly (P ϭ .0009) better than for the control group (19.9). Conclusions: Tooth positioners were effective in improving the occlusal finish, but the effects were independent of an increase in occlusal contacts. Positioners primarily improved first order alignment by tipping teeth into an improved intercuspation.
European journal of orthodontics, 2015
To assess the effects of a follow-up text message and a telephone call after bonding on participants' self-reported level of pain. Eighty-four participants were randomly assigned to one of three trial arms. Randomization was performed by the Department of Epidemiology and Biostatistics of IRCCS G.Gaslini. Participants were enrolled from patients with a permanent dentition who were beginning fixed no extraction treatment at the Orthodontic Department, Gaslini Hospital. Participants completed baseline questionnaires to assess their levels of pain prior to treatment. After the initial appointment, participants were completed a pain questionnaire at the same time, daily, for 7 days. The first group, served as control, did not receive any post-procedure communication; the second group received a structured text message; and the third group received a structured telephone call. Participants were blinded to group assignment. A larger sample size should have been considered in order to ...