On the Comparison of Temporomandibular Joint Angle Measures, Between Angle Class I and ...

71 Pages·2007·7.04 MB·English

On the Comparison of
Temporomandibular Joint Angle
Measures, Between Angle Class I and
Angle Class II
Ricardo Batista
DDs in Dental Sciences,
Egas Moniz - Instituto Superior de CiŒncias da Saœde, 2001
THESIS
Submitted in Partial Ful(cid:133)llment of the Requirements for the Degree of
MSc in Dental Sciences
Donau University Krems
Advisor: Professor Rudolf Slavicek
Co-Advisor: Dr. Miguel de Carvalho
November, 2007
c 2007, Ricardo Batista
(cid:13)
iii
Dedication
To my lovely wife, and to her unbounded patience and support.
To my daughter Carolina, for her strength.
"Knowledge is a process of piling up facts; wisdom lies in their simpli(cid:133)cation."
- Martin H. Fischer
"I am the proudest monkey..."
- Dave Mathews Band
iv
Acknowledgments
Iwouldliketorecordmyindebtednesstomyadvisors, ProfessorRudolf Slavicek
1 andDr. MigueldeCarvalho2, fortheircontinuousassistanceandentirededication.
I am also grateful to Dr. MÆrcia Machado, Dr. AndrØ Baptista and Dr. Tiago
Balseiro, who have kindly read this work in draft and suggested a set of helpful
comments and valuable improvements.
All errors are, of course, my entire responsibility.
1Donau-Universit(cid:228)t Krems, Department f(cid:252)r Interdisziplin(cid:228)re Zahnmedizin und Tech-
nologie; e-mail: [email protected].
2Universidade Nova de Lisboa, Faculdade de CiŒncias e Tecnologia - Centro de
MatemÆtica e Aplica(cid:231)ıes (CMA); email: [email protected].
v
On the Comparison of
Temporomandibular Joint Angle
Measures, Between Angle Class I and
Angle Class II
by
Ricardo Batista
ABSTRACT OF THESIS
Submitted in Partial Ful(cid:133)llment of the Requirements for the Degree of
MSc in Dental Sciences
Donau University Krems
Advisor: Professor Rudolf Slavicek
Co-Advisor: Dr. Miguel de Carvalho
November, 2007
On the Comparison of
Temporomandibular Joint Angle
Measures, Between Angle Class I and
Angle Class II
by
Ricardo Batista
MSc Candidate in Dental Sciences, Donau University Krems, 2007
Abstract
The maturation of the temporomandibular joint occurs predominantly in the func-
tional phases of mixed dentition,and all angle classes generally di⁄er from each other
in the mature functional phase of dentition. One problem of considerable interest
is to assess where such a di⁄erence begins. In this work we study whether there
are signi(cid:133)cant di⁄erences over angle class I and class II for some relevant temporo-
mandibular joint angle measures, namely the Sagittal Condylar Inclination (SCI),
the transversal condylar inclination. In this context, it was collected a sample of
said measures from individuals in the (cid:133)rst and second functional phases of mixed
dentition through a computerized axiography (CADIAX), the use of an articulator,
and a cephalometric analysis. This work provides evidence supporting that there is
no statistical evidence to reject the null hypothesis of mean value equality of such
measures between angle classes I and II.
KEYWORDS: angle class I, angle class II, axiography, Bennett movement, sagit-
tal condylar inclination, transversal condylar inclination.
vii
Contents
List of Figures x
List of Tables xi
Glossary xiii
1 Introduction 1
2 Literature Background 5
2.1 Historical Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.2 Recent Developments . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.3 Extraction vs non extraction . . . . . . . . . . . . . . . . . . . . . . . 15
2.4 Anatomy Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2.4.1 Bony structures . . . . . . . . . . . . . . . . . . . . . . . . . . 17
2.4.2 Ligamentary Structures of the TMJ . . . . . . . . . . . . . . . 18
2.4.3 Articular disk . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
viii
Contents
2.4.4 Retro-articular structures . . . . . . . . . . . . . . . . . . . . 19
2.4.5 The muscle system for the TMJ . . . . . . . . . . . . . . . . . 19
2.4.6 The sinovial-capsule apparatus . . . . . . . . . . . . . . . . . 22
2.4.7 Extended ligamentary attachments . . . . . . . . . . . . . . . 22
3 Design of the Study 25
3.1 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
3.2 Equipment Used for Collecting the Data . . . . . . . . . . . . . . . . 28
3.2.1 CADIAX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
3.2.2 Cephalometry . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
4 Data Analysis 39
4.1 Comparison of SCI over Angle Class I and Angle Class II . . . . . . . 40
4.2 Comparison of TCI over Angle Class I and Angle Class II . . . . . . . 45
4.3 Comparison of s over Angle Class I and Angle Class II . . . . . . . . 48
5 Concluding Remarks 50
A Appendix 51
References 56
ix
List of Figures
2.1 Three dimensional orientation of the skull . . . . . . . . . . . . . . . 10
3.1 Silicon clay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
3.2 Determination of s. . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
3.3 Articulator face bow, side view. . . . . . . . . . . . . . . . . . . . . 29
3.4 Articulator face bow, front view. . . . . . . . . . . . . . . . . . . . . 30
3.5 Lateral rx cephalometric points . . . . . . . . . . . . . . . . . . . . . 36
4.1 Sagittal Condylar Inclination with/without premolars: Class I vs
Class II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
4.2 Right/Left Side Average Sagittal Condylar Inclination with/without
premolars: Class I vs Class II . . . . . . . . . . . . . . . . . . . . . . 44
4.3 Transversal Condylar Inclinations with/without premolars: Class I
vs Class II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
4.4 s values with/without premolars: Class I vs Class II . . . . . . . . . 49
x
List of Tables
2.1 Source: The Functional Determinants of the Chewing Organ, Slavicek. 11
3.1 Biotype/Race Relationship . . . . . . . . . . . . . . . . . . . . . . . 26
3.2 Determination of Skull Type (Slavicek) from CADIAS . . . . . . . . 37
4.1 Observations on SCI, for right side, without premolars . . . . . . . . 41
4.2 Observations on SCI, for right side with premolars . . . . . . . . . . 41
4.3 Observations on SCI, for left side, with premolars . . . . . . . . . . 42
4.4 Observations on SCI, for left side, with no premolars . . . . . . . . . 43
4.5 Observations on SCI, for average value, without premolars . . . . . . 43
4.6 Observations on SCI, for average value, with premolars . . . . . . . 45
4.7 Observations on TCI, for right side, without premolars . . . . . . . . 45
4.8 Observations on TCI, for right side, without premolars . . . . . . . . 46
4.9 Observations on TCI, for left side, without premolars . . . . . . . . 47
4.10 Observations on TCI, for left side, with premolars . . . . . . . . . . 47
4.11 Observations on s, with premolars . . . . . . . . . . . . . . . . . . . 48
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