Файловый архив студентов. Файловый архив студентов.
1327 вузов, 5482 предметов.
/ Регистрация
FAQ Обратная связь Вопросы и предложения
Добавил:
kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Ростовский Государственный Медицинский Университет
Предмет:
Медицина общая
Файл:

Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4496_Библиотеки_им_академика_М_И_Перельмана

.pdf
Скачиваний:
0
Добавлен:
31.08.2026
Размер:
36 Мб
Скачать
☆
352
https://t.me/medicina_free
W. Kater et al.
References
1. McCarthy JG, La Trenta GS, Breitbart AS, Grayson BH, Bookstein FL.The Le Fort III advancement oste­otomy in the child under 7 years of age. Plast Reconstr Surg. 1990;86(4):633–46.
2. Foley TF, Mamandras AH.Facial growth in females 14 to 20 years of age. Am J Orthod Dentofac Orthop. 1992;101(3):248–54.
3. Love RJ, Murray JM, Mamandras AH.Facial growth in males 16 to 20 years of age. Am J Orthod Dentofac Orthop. 1990;97(3):200–6.
4. Snow MD, Turvey TA, Walker D, Proft WR.Surgical mandibular advancement in adolescents: postsurgi­cal growth related to stability. Int J Adult Orthodon Orthognath Surg. 1991;6(3):143–51.
5. Stuzin JM, Baker TJ, Gordon HL. The relationship of the supercial and deep facial fascias: relevance to rhytidectomy and aging. Plast Reconstr Surg. 1992;89(3):441–9.
6. Epker BN, Fish LC, Paulus PJ. The surgical­orthodontic correction of maxillary deciency. Oral Surg Oral Med Oral Pathol. 1978;46(2):171–205.
7. Epker BN, Wolford LM.Middle-third facial osteoto­mies: their use in the correction of acquired and devel­opmental dentofacial and craniofacial deformities. J Oral Surg. 1975;33(7):491–514.
8. Freihofer HP Jr. Results of osteotomies of the facial skeleton in adolescence. J Maxillofac Surg. 1977;5(4):267–97.
9. Kriens O. Maxillary osteotomy in early child­hood. A preliminary report. J Maxillofac Surg. 1974;2(2–3):150–2.
10. Walker GF. A new approach to the analysis of cra­niofacial morphology and growth. Am J Orthod. 1972;61(3):221–30. 12.
11. Wolford LM, Schendel SA, Epker BN. Surgical­orthodontic correction of mandibular deciency in growing children (long term treatment results). J Maxillofac Surg. 1979;7(1):61–72.
12. Wolford LM, Walker G, Schendel S, Fish LC, Epker BN. Mandibular deciency syndrome. I. Clinical delineation and therapeutic signicance. Oral Surg Oral Med Oral Pathol. 1978;45(3):329–48.
13. Alwadei S. Early orthognathic surgery: a review. J Contemp Dent Pract. 2017;18(3):250–6.
14. Macgregor FC. Facial disgurement: problems and management of social interaction and implications for mental health. Aesthet Plast Surg. 1990;14(4):249–57.
15. Alley TR. Physiognomy and social perception. In: Alley TR, editor. Social and applied aspects of per­ceiving faces. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. p.167.
16. Phillips C, Proft WR.Psychosocial aspects of den­tofacial deformity and its treatment. In: Proft WR, White Jr RP, Sarver DM, editors. Contemporary treat­ment of dentofacial deformity. St. Louis, MO: Mosby;
2003. p.69–89.
17. Kiyak HA, McNeill RW, West RA. The emotional impact of orthognathic surgery and conventional orthodontics. Am Orthod. 1985;88(3):224–34.
18. Bishara SE, Ziaja RR.Functional appliances: a review. Am J Orthod Dentofac Orthop. 1989;95(3):250–8.
19. Nanda R, Topazian RG. Craniofacial growth fol­lowing LeFort I osteotomy in adolescent monkey. In: McNamara Jr JA, Carlson DS, Ribbens KA, edi­tors. Center for human growth and development. Ann Arbor: The University of Michigan; 1982. p.99–129.
20. Broadbent BH Sr, Broadbent BH Jr, Golden WH. Bolton standards of dentofacial developmental growth. St. Louis: Mosby; 1975.
21. van der Linden F.Facial growth and facial orthopae­dics. Surrey, UK: Quintessence Publishing; 1986.
22. Mehra P, Wolford L. Early orthognathic sur­gery: considerations for surgical management. Principles, planning and practice. 2016. https://doi.
org/10.1002/9781119004370.ch17.
23. Savara BS, Singh IJ.Norms of size and annual incre­ments of seven anatomical measures of maxillae in boys from three to sixteen years of age. Angle Orthod. 1968;38:104–20.
24. Sillman JH. Dimensional changes of the dental arches: longitudinal study from birth to twenty-ve years. Am J Orthod. 1964;50:824–42.
25. Bjork A.Facial growth in man studied with the aid of metallic implants. Acta Odont Scan. 1955;13:9–34.
26. Scott JH.The analysis of facial growth from fetal life to adulthood. Angle Orthod. 1963;33:110–3.
27. Singh IJ, Savara BS.Norms of size and annual incre­ments of seven anatomical measures of maxillae in girls from three to seventeen years of age. Angle Orthod. 1968:312–24.
28. Bjork A, Skieller V. Facial development and tooth eruptions: an implant study at the age of puberty. Am J Orthod. 1972;62:339–83.
29. O’Reilly MT. A longitudinal growth study: maxil­lary length at puberty in females. Angle Orthod. 1979;49:234–58.
30. Friehofer HP. Results of osteotomies of the facial skeleton in adolescence. J Maxillofac Surg. 1977;5:267–97.
31. Mogavero FJ, Buschang PH, Wolford LM. Orthognathic surgery effects on maxillary growth in patients with vertical maxillary excess. Am J Orthod Dentofac Orthop. 1997;111:288–96.
32. Wolford LM, Karras SC, Mehra P. Considerations for orthognathic surgery during growth. Part II: max­illary deformities. Am J Orthod Dentofac Orthop. 2001;119:102.
33. Epker BN, Schendel SA, Washburn M. Effects of early surgical superior repositioning of the maxilla on subsequent growth: III.Biomechanical consider­ations. In: The effect of surgical intervention on cra­niofacial growth. McNamara JA, Carlson DS, Ribbens KA (Eds). Ann Arbor: University of Michigan, 1982, pp.231–250.
26 Aspects ofDysgnathic (Distraction) Intervention inChildhood
https://t.me/medicina_free
353
34. Washburn MC, Schendel SA, Epker BN. Superior repositioning of the maxilla during growth. J Oral Maxillofac Surg. 1982;40:142–9.
35. Schröder S, Ebmeyer J. Diagnostik und Therapie von Funktionsstörungen der Tuba auditiva. HNO. 2018;66:155–66. https://doi.org/10.1007/
s00106- 017- 0465- 2.
36. Steinbach E, Pusalkar A, Heumann H. Cholesteatoma—pathology and treatment. Adv Otorhinolaryngol. 1988;39:94–106.
37. Maier S, Tisch M, Maier H.Balloon dilation of the eustachian tube in pediatric chronic obstructive eusta­chian tube dysfunction patients. HNO. 2015;63:686, 688, S690–684, S696–687.
Virtual TMJ Positioning Using
https://t.me/medicina_free
Digital Data Transfer forCAD/CAM Fabrication ofSplints
RöhrsAxel andUlrichMeyer
27
Introduction
The temporomandibular joint (TMJ) is formed by the right and left mandibular condyle inserting into the mandibular fossa of the temporal bone. Muscles of mastication are primarily responsible for movement of this joint (Fig.27.1). Form and position of TMJ structures are often altered towards the physiological situation, leading to clinical problems. In craniofacial malformations, TMJ anatomy often differs between the right and left sides. TMJ disorders can be categorized as intra-articular (within the joint) or extra-articular (involving the surrounding musculature) [1–5]. Within the intra-articular group, structural and functional disorders can be distinguished. Structural disorders can involve the bony, the car­tilaginous, or disc structure. Structural TMJ alter­ations are often seen in craniofacially malformed patients [6]. There is therefore also a high preva­lence of structurally based TMJ disorders in these patients. Various imaging modalities are used to determine TMJ diseases [7–10]. Computed
R. Axel KOFL, Specialised Orthodontic Dental Technician Laboratory, Everswinkel, Germany e-mail: axel@ko.de
U. Meyer (*) Center for Jaw-, Face- and Skull Surgery, Münster, Germany e-mail: praxis@mkg-muenster.de,
meyer@kieferklinik-muenster.de
tomography is superior to plain radiography for the evaluation of subtle bony morphology. Magnetic resonance imaging is the optimal modality for comprehensive joint evaluation in patients with signs and symptoms of TMJ.
Common symptoms of temporomandibular joint (TMJ) disorders are sounds/noises, pain, headaches, limited movement, masticatory dif­culties, and others [3, 4, 11]. Most of the patients with TMJ signs and symptoms can improve TMJ dysfunction, and pain levels can be reduced by a multimodal therapy. Multimodal therapies encompass patient education, self-care, cognitive behavior therapy, pharmacotherapy, physical therapy, and occlusal devices [12–15]. In TMJ therapy, as with most treatments, the patient’s improvement is closely connected to a proper diagnosis based on sound physiologic principles. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders in all patient groups [16–18]. Dental occlusal splinting and permanent occlusal adjust­ment have been the mainstays of TMJ disorder treatment for years. The aim of all splint thera­pies is to position the TMJ (condyle, disc) in a central and relaxed fossa position, mimicking the normal anatomy (Fig.27.1).
Patients having structural alterations (over­growth of condyle, deformation of condyle, dis­location of disc) are often in need for surgical therapies [19]. This is even more complex in cra­niofacially malformed patients, as occlusal dis-
© Springer Nature Switzerland AG 2023 U. Meyer (ed.), Fundamentals of Craniofacial Malformations,
https://doi.org/10.1007/978-3-031-28069-6_27
355
356
TMJ anatomy
condyle is located in the center of the fossa
https://t.me/medicina_free
Fig. 27.1 Skull and TMJ anatomy
R. Axel and U. Meyer
turbances like dysgnathia are present with structural TMJ alterations at the same time.
Recording the maxillomandibular relationship is the rst step in splint treatment. Facebow is the conventional instrument used to record the spatial relationship of the maxillary arch to some ana­tomic reference point or points and then transfer this relationship to an articulator; it orients the dental cast in the same relationship to the opening axis of the articulator [20–23]. Facebow is regarded as a convenient instrument to transfer maxillary cast to semi-adjustable articulators, also to support the casts while they are being attached to an articu­lator. Facebow can be congured to locate and transfer the mandibular transverse horizontal axis points to an articulator [24]. However, the axis of rotation belongs to the movable mandible, and many rotational centers are possible. Conventionally, facebow can be classied into two basic types: arbitrary or kinematic axis types. The kinematic center (KC)—dened by coinciding jaw opening/closing and protrusion- retrusion tra­jectories—has been proposed in the literature as a
reference point to represent TMJ movements [25]. The analysis of mandibular kinematics permits the detection and assessment of irregularities of TMJ function due to internal obstacles such as a dis­placed articular disc [26]. Splints are convention­ally fabricated in the articulator and the surface adjusted to the centric occlusion and the individual mandibular movement. A major advantage to date is therefore inclusion of kinematic data to the articulator.
In TMJ treatments, prosthodontics, and orthognathic surgery, virtual planning is gradu­ally taking over in clinical practice [27]. The elimination of facebow transfer and the mounting of dental casts, which are known as major sources of error in conventional splint or surgical thera­pies [28–30], provide further arguments for the use of virtual splint therapy or orthognathic sur­gery planning (VSP) [31]. A special problem of virtual planning is the transfer of jaw positions in an articulator, in order to optimize melt anatomi­cal data with dynamic masticatory movement data.
27 Virtual TMJ Positioning Using Digital Data Transfer forCAD/CAM Fabrication ofSplints
https://t.me/medicina_free
357
Planning, Execution, andControl ofTMJ Positioning
Special technical approaches allow nowadays the transfer of anatomical data (dental arch anatomy recorded by dental scans and bone anatomy recorded by CBCT) to the articulator. Such plan­ning of TMJ positioning and fabrication of splints can be done through a close collaboration between dental technicians and surgeons. The procedure is demonstrated in a case of a patient with a deep bite (Fig.27.2a, b) and resulting non­reversible anterior disc displacement.
1. Various data must be gained for the planning procedure:
(a) Dental data through scanning of plaster
models or intraoral scanners of both den­tal arches (Fig.27.2c, d)
(b) Denition of the patient’s occlusion by
an occlusal scan (Fig.27.2e)
(c) CBCT (or CT) data (Fig.27.3)
2. The CBCT data must be imported into the simulation system (Fig. 27.3). Technical components of the digital workow are pre-
sented in Table27.1. The dental scan is then important (maxillary scan, mandibular scan, dental and occlusion scan). Dental models of the mandible and maxilla are fabricated. The dental scan is then matched with the CBCT data.
3. The Frankfurt horizontal plane is dened, as this plane is the reference for the dental artic­ulator (Fig.27.4a).
4. The mandible is segmented and the rotation axis dened (Fig.27.4b).
5. The mandible is moved to an extent that both condyles are located in a central fossa posi­tion (Fig.27.4c), giving space for disc place­ment in a proper position.
6. A slight opening (rotation) of the mandible is necessary for splint denition and fabrication.
7. An individual positioning block is virtually created to allow the transfer of digital data into the dental articulator (Fig.27.4d).
8. The individual transfer block is CAD/CAM fabricated and used to place the mandibular model in relation to the joint axis in the artic­ulator (SAM system) (Fig.27.5a).
a
b
e
c
d
Fig. 27.2 Patient with a deep bite (a) based on mandibular retrognathia (b). Corresponding intraoral scans of the max- illary (c) and mandibular (d) arch as well as the occlusion scan (e)
358
https://t.me/medicina_free
R. Axel and U. Meyer
a
b
c
d
Fig. 27.3 CBCT scan of patient (Patient with deep bite and bilateral compression of both condyles), demonstrating the malpositioned condyle a) OPT view, b) right sided 3D view, c) left sided 3D view, d) sections of condyle postion
Table 27.1 Hard- and software components of the digital workow
Digital workow Hardware Program Work CBCT (KaVo) ExamVision Data acquisition
Intraoral scan
DIOS® 4.0 Dios Data acquisition
Scan
CADStar CADStar Model scan
Communicate 3Shape Ortho Analyser RealGUIDE PlastyCAD Fusion 360 PlastyCAD PreForm PrusaSlicer Exocad PlastyCAD
®
®
®
®
®
®
®
®
®
®
Transfer of scan data Processing of scan data CBCT processing, scan matching Data preparation Transposition of condyle, allocation to articulator (SAM®) Denition of arbitrary oriented nal (occlusion) Print planning (resin) Arbitrary positioning of mandible in articulator Splint planning Splint design creation
individual positioning block
27 Virtual TMJ Positioning Using Digital Data Transfer forCAD/CAM Fabrication ofSplints
https://t.me/medicina_free
359
a
c
b
d
Fig. 27.4 (a) Denition of Frankfurt horizontal plane. (b) Segmentation of mandible and denition of rotation axis. (c) Virtual positioning of condyle in the central fossa position. A slight decompression position was used to
9. The maxillary model is positioned in the patient’s occlusion (Fig.27.5b). At this point, dynamic data of the patients’ mandibular movement (gained through various devices that have been developed to record and ana­lyze the mandibular movement) can be inte­grated in the articulator.
10. The bite is opened and the splint designed and fabricated (Fig.27.5c).
allow the disc to replace in the physiological TMJ posi­tion. (d) Creation of a transfer block for the SAM articula­tor system
11. Patient with splint in situ (Fig.27.6a, b), cor­responding virtual model with splint (Fig.27.6c).
12. CBCT control of TMJ position with splint. 3D view (Fig.27.7a) as well as OPT image (Fig.27.7b) and TMJ sections (Fig.27.7c, d) demonstrate the central TMJ position.
360
https://t.me/medicina_free
R. Axel and U. Meyer
a
b
c
individual
positioning block
Fig. 27.5 (a) Positioning of the mandibular model through the CAD/CAM fabricated transfer block. (b) Positioning of the maxilla model in patients’ occlusion. (c) Opening of bite and fabrication of splint
a
b
c
Fig. 27.6 (a, b) Patient with splint in situ. (c) Scan of splint-related new occlusal relationship
27 Virtual TMJ Positioning Using Digital Data Transfer forCAD/CAM Fabrication ofSplints
https://t.me/medicina_free
a
361
c
d
b
Fig. 27.7 Control of condylar position with splint. (a) 3D view, (b) OPT view, and (c and d) section view of the cor- rected TMJ anatomy, displaying a central position of the condyle
Future Directions
Future directions are aimed to develop a system, which can directly combine and merge three­dimensional cone beam computed tomography (CBCT) and electronic jaw motion tracking (JMT) data [32]. Through such an approach, a complex virtual planning of splint therapies is possible [33]. Some systems are nowadays capa­ble of measuring and visualizing patient-specic jaw movement relative to the patient-specic anatomy of the jaw, coming close to an anatomi­cal and physiological correct virtual kinematic articulator.
References
1. Scrivani SJ, Keith DA, Kaban LB.Temporomandibular disorders. N Engl J Med. 2008;359(25):2693–705.
2. Okeson JP. Joint intracapsular disorders: diagnostic and nonsurgical management considerations. Dent Clin N Am. 2007;51(1):85–103.
3. Okeson JP, de Leeuw R. Differential diagnosis of temporomandibular disorders and other orofacial pain disorders. Dent Clin N Am. 2011;55(1):105–20.
4. Zakrzewska JM. Differential diagnosis of facial pain and guidelines for management. Br J Anaesth. 2013;111(1):95–104.
5. Hoffmann RG, Kotchen JM, Kotchen TA, et al. Temporomandibular disorders and associated clinical comorbidities. Clin J Pain. 2011;27(3):268–74.
6. Meyer U, editor. Fundamentals of craniofacial mal­formations. Springer; 2021.
7. Lamot U, Strojan P, Šurlan Popovič K. Magnetic resonance imaging of temporomandibular joint dysfunction- correlation with clinical symptoms, age, and gender. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(2):258–63.
8. Hunter A, Kalathingal S.Diagnostic imaging for tem­poromandibular disorders and orofacial pain. Dent Clin N Am. 2013;57(3):405–18.
9. Rawlani S, Rawlani S, Motwani M, et al. Imaging modality for temporomandibular joint disor­der—a review. J Datta Meghe Inst Med Sci Univ. 2010;5(2):126–33.
10. Lewis EL, Dolwick MF, Abramowicz S, et al. Contemporary imaging of the temporomandibular joint. Dent Clin N Am. 2008;52(4):875–90.
11. Cooper BC, Kleinberg I. Examination of a large patient population for the presence of symptoms and signs of temporomandibular disorders. Cranio. 2007;25(2):114–26.
12. Management of temporomandibular disor­ders. National Institutes of Health Technology Assessment Conference Statement. J Am Dent Assoc. 1996;127(11):1595–606.
362
https://t.me/medicina_free
R. Axel and U. Meyer
13. Dimitroulis G.Temporomandibular disorders: a clini­cal update. BMJ. 1998;317(7152):190–4.
14. List T, Axelsson S.Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010;37:430–51.
15. Gray RJ, Davies SJ. Occlusal splints and temporo­mandibular disorders: why, when, how? Dent Update. 2001;28:194–9.
16. Al-Ani MZ, Davies SJ, Gray RJ, Sloan P, Glenny AM. Stabilisation splint therapy for temporoman­dibular pain dysfunction syndrome. Cochrane Database Syst Rev. 2004;(1):CD002778. https://doi.
org/10.1002/14651858.CD002778.pub2.
17. Tsuga K, Akagawa Y, Sakaguchi R, Tsuru H. A short-term evaluation of the effectiveness of stabilisa­tion therapy for specic symptoms of temporoman­dibular joint dysfunction syndrome. J Prosthet Dent. 1989;61:610–3.
18. Davies SJ, Gray RJ. The pattern of splint usage in the management of two common temporomandibu­lar disorders. Part II: the stabilisation splint in the treatment of pain dysfunction syndrome. Br Dent J. 1997;183:247–51.
19. Miloro M, Peterson LJ. Peterson’s principles of oral and maxillofacial surgery. 3rd ed. Shelton, CN: People’s Medical Pub House; 2012.
20. Driscoll CF, Freilich MA, Guckes AD, Knoernschild KL, McGarry TJ. The glossary of prosthodontic terms, GPT-9. J Prosthet Dent. 2017;117:E1–105.
21. Farias-Neto A, Dias AH, de Miranda BF, de Oliveira AR. Face-bow transfer in prosthodontics: a sys­tematic review of the literature. J Oral Rehabil. 2013;40:686–92.
22. Thorp ER, Smith DE, NichollsJI. Evaluation of the use of a face-bow in complete denture occlusion. J Prosthet Dent. 1978;39:5–15.
23. Ahlers MO, Edelhoff D, Jakstat HA. Reproduction accuracy of articulator mounting with an arbitrary face-bow vs. average values-a controlled, random­ized, blinded patient simulator study. Clin Oral Investig. 2019;23:1007–14.
24. Preston JD. A reassessment of the mandibular transverse horizontal axis therory. J Prosthet Dent. 1979;41:605–13.
25. Suman V, Sonnahalli NK, Chowdhary R.Use of face­bow device in prosthodontics: a systematic review on randomized control trials. J Indian Prosthodont Soc. 2021;21:11–8.
26. Nagy WW, Goldstein GR. Facebow use in clinical prosthodontic practice. J Prosthodont. 2019;28:772–4.
27. Zinser MJ, Sailer HF, Ritter L, Braumann B, Maegele M, Zoller JE. A paradigm shift in orthognathic sur­gery? A comparison of navigation, computer-aided designed/computer-aided manufactured splints, and “classic” intermaxillary splints to surgical transfer of virtual orthognathic planning. J Oral Maxillofac Surg. 2013;71(2151):e1–21.
28. Ellis E.Accuracy of model surgery: evaluation of an old technique and introduction of a new one. J Oral Maxillofac Surg. 1990;48:1161–7.
29. Quast A, Santander P, Witt D, Damm A, Moser N, Schliephake H, MeyerMarcotty P. Traditional face­bow transfer versus three-dimensional virtual recon­struction in orthognathic surgery. Int J Oral Maxillofac Surg. 2019;48:347–54.
30. Walker F, Ayoub AF, Moos KF, Barbenel J.Face bow and articulator for planning orthognathic surgery: 1 face bow. Br J Oral Maxillofac Surg. 2008;46:567–72.
31. Quast A, Santander P, Kahlmeier T, Moser N, Schliephake H, Meyer-Marcotty P. Predictability of maxillary positioning: a 3D comparison of virtual and conventional orthognathic surgery planning. Head Face Med. 2021;17:27.
32. He S, Kau CH, Liao L, Kinderknecht K, Ow A, Saleh TA. The use of a dynamic real-time jaw tracking device and cone beam computed tomography simula­tion. Ann Maxillofac Surg. 2016;6:113–9.
33. Hanssen N, Ruge S, Kordass B.SICAT function: ana­tomical real-dynamic articulation by merging cone beam computed tomography and jaw motion tracking data. Int J Comput Dent. 2014;17:65–74.
Соседние файлы в папке Библиотека им академика М.И. Перельмана
Помощь Обратная связь Вопросы и предложения Пользовательское соглашение Политика конфиденциальности