Evaluation of different kinds of asymmetry in the masticatory system based on clinical and instrumental examinations
Journal Title: Prosthodontics - Year 2011, Vol 61, Issue 1
Abstract
Introduction. Acquired disorders in the asymmetry due to tooth loss or maltreatment of the individual elements of the stomatognathic system may contribute to establishing a deviated chewing pattern of and imbalanced asymmetrical strain on temporo-mandibular joints (TMJs).Aims of the study. (1) To evaluate the incidence of clinical symptoms and signs of temporo-mandibular dysfunction (TMD), as well as unilateral chewing pattern in the study group; (2) to analyse whether the asymmetrically missing teeth and the type of occlusal model are related to the severity of clinical symptoms and signs of TMD as expressed by the Helkimo Di; and (3) to evaluate the asymmetry of measurable parameters for both TMJs obtained with Arcus®digma appliance in the examined group and in persons showing Di>0.Material and methods. The study comprised 84 persons, aged 19–27 years, with full dentition preserved (59 persons) or with single molar teeth missing (25 persons). The study was performed using the Helkimo Anamnetic Index (Ai) and Clinical Index (Di) and the ultrasound KaVo Arcus®digma appliance.Results. In the examined group, 61 persons experienced subjective symptoms Ai=I, and in 20 persons Clinical Helkimo Index was Di=II. These were statistically significant differences. Unilateral mastication was practiced by 15 persons. The presence of single missing molar teeth and the type of bite model on the left and right sides showed statistically significant asymmetry. Statistically significant differences and asymmetry in the left and right TMJ results of measurable parameters, such as Bennett Angle, Shift Angle and retrusion, were found.Conclusions. (1) Severity of clinical symptoms may depend on asymmetry in missing teeth and the occlusal model; (2) in the TMD diagnostics the effect of asymmetry on the whole stomatognathic system should be considered; and (3) TMD symptoms affect the values of some measurable parameters (Bennett Angle, Shift Angle and retrusion) obtained from the instrumental examination.
Authors and Affiliations
Anna Sójka, Wiesław Hędzelek
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