Evaluation of Stresses on Temporomandibular Joint in the Use of Class II and III Orthodontic Elastics: A Three-Dimensional Finite Element Study

Gurbanov, Vügar; Baş, Burcu; Öz, Abdullah Alper

doi:10.1016/j.joms.2019.11.022

Cited by 23 publications

(9 citation statements)

References 34 publications

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“…In contrast, the Class II component of the IMF elastic force showed fewer stress distributions in the mandible and fixation system than the Class III component. This was contrary to the results of a previous study, 38 which suggested that Class II elastics could cause more harmful stress to the TMJ than Class III elastics. This might be because the previous study was conducted focusing only on the TMJ, and so the results were interpreted differently than ours.…”

Section: Discussioncontrasting

confidence: 99%

A finite element analysis of stress distribution with various directions of intermaxillary fixation using orthodontic mini‐implants and elastics following mandibular advancement with a bilateral sagittal split ramus osteotomy

Lee

Park

et al. 2023

Orthod Craniofacial Res

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ObjectiveThis finite element analysis (FEA) aimed to assess the stress distribution in the mandible and fixation system with various directions of the intermaxillary fixation (IMF) using mini‐implants (MIs) and elastics following mandibular advancement with a bilateral sagittal split ramus osteotomy (BSSRO).Materials and MethodsA total of nine mandibular advancement models were set according to the position of the MIs (1.6 mm in diameter, 8 mm in length) and direction of the IMF elastics (1/4 inch, 5 oz). Major and minor principal stresses in the cortical and cancellous bones, von Mises stresses in the fixation system (miniplate and monocortical screws), and bending angles of the miniplate were analysed.ResultsCompressive and tensile stress distributions in the mandible and von Mises stress distributions in the fixation system were greater in models with a Class III IMF elastic direction and a higher IMF elastic force than in models with a Class II IMF elastic direction and a lower IMF elastic force. The bending angle of the miniplate was negligible.ConclusionsStress distributions in the bone and fixation system varied depending on the direction, amount of force, and position of IMF elastics and MIs. Conclusively, IMF elastics in the Class II direction with minimal load in the area close to the osteotomy site should be recommended.

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Section: Discussioncontrasting

confidence: 99%

A finite element analysis of stress distribution with various directions of intermaxillary fixation using orthodontic mini‐implants and elastics following mandibular advancement with a bilateral sagittal split ramus osteotomy

Lee

Park

et al. 2023

Orthod Craniofacial Res

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“…On the other hand, skin irritation can also occur secondary to TMJ pain. When the mandible is forced posteriorly, the condyle can press against the sensitive retrodiscal bilaminar zone, causing pain or discomfort 37 , 38 . For pain relief, the patient may develop a habit of mandibular thrusting, which increases the pressure on the chin area and the risk of skin irritation.…”

Section: Discussionmentioning

confidence: 99%

Skin irritation in children undergoing orthodontic facemask therapy

Kim

Kim²,

Kim³

et al. 2023

Sci Rep

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Orthodontic facemasks are extraoral orthodontic appliances that influence maxillary and mandibular development in children with skeletal Class III malocclusion. While a facemask is most effective in patients before the growth spurt, skin irritation is common during the treatment. Therefore, this retrospective study aimed to investigate the prevalence and pattern of such skin changes and identify their possible associated risk factors. We included 177 patients with skeletal Class III malocclusion who underwent facemask therapy. Patient age and sex, orthodontic parameters expressing the severity of malocclusion, the presence of complaints in the temporomandibular joint (TMJ) areas, and the level of patient cooperation were evaluated. Additionally, the severity and onset time of skin reactions were further analyzed. The results indicated that 43.5% of patients developed skin changes typical of irritant contact dermatitis. Skin irritation was significantly associated with the presence of TMJ complaints and female sex. Furthermore, skin irritation was more common in younger patients. Clinicians should pay special attention to the skin areas that come into contact with the appliance during each follow-up visit to detect potential problems. Moreover, patients and their parents should be given adequate information about the possibility, prevention, and management of skin problems during facemask therapy.

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“…Similar attention should be paid to the use of elastics during orthodontic treatment, especially for Class II patients, which increases the stress on the TMJ. It is still unclear whether this may predispose to signs and symptoms and TMD, but clinicians should be aware of that possibility [ 68 ]. Furthermore, significant differences are present in the occlusion when it is influenced by the teeth and when it is influenced by the condyles.…”

Section: Discussionmentioning

confidence: 99%

The Role of Maxillofacial Structure and Malocclusion on Condylar Displacement in Maximum Intercuspation and Centric Relation in Patients Seeking Orthodontic Treatment—A Scoping Review

Radej

Dargiewicz

Sawczuk-Siemieniuk

et al. 2023

JCM

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Background: Available knowledge about malocclusion and cephalometric variables and their connection with an increased risk of condylar displacement (CD) is scarce. This article aims to present current information on the relationship between centric relation-maximum intercuspal position discrepancies and maxillofacial morphology and malocclusion in patients seeking orthodontic treatment as well as to identify those who require expanded diagnostic evaluation for this disorder. Methods: This review analyzed the PubMed, Cochrane Library, Web of Science, and Scopus electronic databases up to February 2022. Keywords and additional manual searches were performed. Literature selection was based the PRISMA-ScR checklist. The JBI Critical Appraisal Tool assessed the methodological quality of included studies. Results: The databases search provided 2321 studies. A total of 10 studies were included in this review after eligibility criteria and JBI assessment. This review was separated into five parts that evaluated CD correlations depending on the following: maxillofacial structure in different vertical and sagittal skeletal patterns, vertical, horizontal, and transverse malocclusions. Conclusions: A hyperdivergent facial skeletal structure is a risk factor for increased CD, particularly in the vertical dimension. The condylar processes are usually displaced in a posteroinferior direction. Further studies are warranted to elucidate the relationship among remaining skeletal and dental malocclusions and the occurrence of CD.

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Evaluation of Stresses on Temporomandibular Joint in the Use of Class II and III Orthodontic Elastics: A Three-Dimensional Finite Element Study

Cited by 23 publications

References 34 publications

A finite element analysis of stress distribution with various directions of intermaxillary fixation using orthodontic mini‐implants and elastics following mandibular advancement with a bilateral sagittal split ramus osteotomy

A finite element analysis of stress distribution with various directions of intermaxillary fixation using orthodontic mini‐implants and elastics following mandibular advancement with a bilateral sagittal split ramus osteotomy

Skin irritation in children undergoing orthodontic facemask therapy

The Role of Maxillofacial Structure and Malocclusion on Condylar Displacement in Maximum Intercuspation and Centric Relation in Patients Seeking Orthodontic Treatment—A Scoping Review

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