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This study assessed the accuracy of an electronic hinge axis tracing device (Cadiax compact) in measuring the horizontal condylar inclination (HCI) and the Bennett angle. The hinge axis movements were simulated with an articulator to which the hinge axis tracer was attached. On the articulator the pre-set HCI values were 20 degrees, 40 degrees and 60 degrees, the pre-set Bennett angles were 0 degrees, 5 degrees, 10 degrees, 15 degrees, 20 degrees. The maximum measuring errors ranged from 0 to 3.4 degrees (in average 1.2 degrees ) and yielded statistically significant differences between articulator setting and Cadiax compact measurement (P < 0.05) except the HCI of 40 degrees and the Bennett angle of 0 degrees. Because of the small range of the maximum measuring error the Cadiax compact represented reasonable accuracy for clinical application in anterior guidance restorations.

The study investigated two mandibular positions based upon computerized axiography recordings of hinge axis movements of 262 subjects. Next to the well-known guided closure position RP (reference position by chin-point guidance), the position of final deglutition (FD) was quantified. FD represented the hinge axis position at the end of the swallowing movement. The results elicited average linear distances of 0.32 +/- 0.43 mm on the right and 0.33 +/- 0.40 mm on the left side between both positions in the sagittal plane. The average distance in the frontal plane was 0.02 mm (right) and 0.04 mm (left). Approximately 46 per cent of FD recordings were found anterior and inferior to RP, and showed significant difference to posterior and anterior-superior FD recordings. The replicability of both positions was tested on 53 subjects and averaged 0.04 mm (FD) and 0.09 mm (RP). Average deviations of repeated recordings within the subject ranged from 0.07 to 0.47 mm (FD) and 0.07 to 0.57 mm (RP) for each spatial direction. The results of this study showed a relative coincidence of an average FD and RP Variation of FD in anterior inferior direction questioned the clinical reliability of FD to reassure the guided closure position.

Computerized axiography was used as an objective instrumental method of evaluating the response of patients with temporomandibular joint (TMJ) symptomatology to occlusal splint therapy. Diagnosis was performed in a standardized manner by systematically analyzing TMJ path tracings obtained by computerized axiography. Thirty-six patients were axiographed before and after therapy with full-arch occlusal stabilizing appliances, followed by assessing the effect of therapy on various path curve parameters. The data obtained for the patient group treated with splints was compared to that of six patients also axiographed, but left untreated for a period of six weeks before a second TMJ tracing was obtained. The results show that splints have a certain effect on reciprocal TMJ clicking (response rate 67%). Retral stability and path characteristics are also substantially improved (response rates 44% and 40%). Less influence was noted on hypomobile joint paths (response rate 29%), the quality of movements (response rate 28%) and Bennett angle values (response rate 23%). Patients with disk displacements without reduction were not treated with splints, they underwent surgery. Their results will be reported later. By contrast, TMJ tracings in the control group remained essentially unchanged.

Unguided protrusive and retrusive mandibular movement was investigated in 76 asymptomatic volunteers and temporomandibular joint (TMJ) patients using computerized axiography. In 38 of these subjects, guided pro-/retrusion was also recorded. Measurements were performed in a three-dimensional Cartesian coordinate system (x = anteroposterior; y = transversal, toward the hinge axis; z = craniocaudal). Transversal shift (y) was measured and evaluated as well as the distance "s" and horizontal condylar inclination (HCl) at the point of maximum transversal deviation. The patterns of the tracings were analyzed with a view to diagnostic improvements. The objective of this study was to evaluate transversal shift and to examine the postulate of symmetrical behavior of the TMJs in pro-/retrusion. The mean mandibular shift was 0.15 mm to the left. This maximum deviation was seen in a mean distance "s" of 7.42 mm in relation to the Cartesian coordinate system in reference position. These results suggest a functional dominance of the right part of the mandible in protrusive and retrusive movement.

The objective of this series is to observe and analyze movements of the temporomandibular joint (TMJ). With the information from these studies, orthopedic standards for jaw movements will be established in further investigations according to the neutral-zero method used in general orthopedics. Any restricted range of motion can thus be defined as a deviation from these standards. Direct interpretation and objective evaluation of joint functions has major practical implications. With the aid of computerized axiography, mediotrusive movements of 48 asymptomatic volunteers and 66 jaw patients were evaluated. The movements performed were either free or guided. The mean curve lengths, as well as the Bennett angles at 3 mm and at the end point were recorded. An average group was defined, containing the values of 50% of all volunteers. The interquartile range was calculated for lengths of mediotrusive movements as well as for Bennett angles. The average range of free mediotrusive movement for female volunteers was 11.06-11.98 mm (mean 11.55 mm) on the right side and 10.47-11.75 mm (mean 11.24 mm) on the left side. Male volunteers showed an average range of 10.23-11.54 mm (mean 11.1 mm) on the right side and 10.24-11.73 mm (mean 11.12 mm) on the left side. The values for female patients amounted to 9.95-1.66 mm (mean 10.8 mm) on the right side and 9.75-11.28 mm (mean 10.55 mm) on the left side. The average range for male patients was 9.06-9.71 mm (mean 9.54 mm) on the right side and 9.17-10.23 mm (mean 9.73 mm) on the left side. The average range for Bennett angles at maximum excursion in free mediotrusive movement was between 0.41 and 5.89 degrees (mean 4.43 degrees) in the volunteers on the right side and between 2.45 and 10.07 degrees (mean 6.87 degrees), respectively, on the left side. The values for patients amounted to 0.19-12.65 degrees (mean 6.93 degrees), on the right side and 1.71-14.15 degrees (mean 6.73 degrees) on the left side.

This paper reviews earlier methods for the analysis of mandibular movement and gives a detailed account of state-of-the-art procedures. Special emphasis is given to computerized axiography and the application of this method to the diagnostics of the temporomandibular joint (TMJ). The article discusses the advantages of computerized axiography over the mechanical device and points out the limitations of the axiographic method. One major advantage of the computerized system is having the enlarged diagram of tracings on the computer screen. This means that small changes such as initial disk displacements can be diagnosed more readily than with the mechanical device.

The closing pathway of masticatory movement in the vicinity of the intercuspal position (ICP) is considered as a functional movement in reconstructing the occlusal guidance. The purpose of this study was to examine a correlation between elevator muscle activity and direction of the closing pathway in the vicinity of the ICP during mastication. Fifty subjects (18 male and 32 female subjects aged from 21 to 34 years) were selected randomly from the students of the Kanagawa Dental College. The measurements of jaw movement during mastication were recorded using a Sirognathograph instrument and surface electromyography (EMG) of the anterior temporalis and masseter muscles simultaneously. The muscle activity and the direction of the closing pathway were calculated on the working and non-working sides during unilateral chewing and analysed at the sections of ICP-2 mm and 2-4 mm in sagittal view. The direction of the closing pathway was expressed by the angle to a vertical reference axis. The direction of the closing pathway correlated significantly with the activity of the anterior temporalis muscles on the non-working side and the masseter muscles on the working side at ICP-2 mm. From the results of this study, it was suggested that the elevator muscle activity may be associated with the direction of the closing pathway during mastication.

This study compared the mandibular position at chin-point guided jaw closure, intercuspation and final deglutition (position at the end of swallowing) in 159 asymptomatic subjects and 142 subjects with symptoms in the craniomandibular system. The symptomatic subjects were assigned to four groups showing an adapted centric posture, pain, luxation with reduction of the temporomandibular joint and pain with luxation and reduction. Computer equipment aided recording of hinge axis movements in three dimensions. While the three positions differed significantly in anterior-posterior direction on both sides and in inferior-superior direction on the right, a significant difference between asymptomatic and symptomatic subjects existed only in final deglutition on the left side and in the anterior-posterior location of the guided closure. Final deglutition did not coincide with the guided closure or the intercuspation in approximately 89%. A proportionally large standard deviation gave evidence against a strict relationship of the three positions in asymptomatic and symptomatic subjects. Because of this variability, final deglutition was not recommended for verification of centric relation or the intercuspal position.

In order to evaluate the influence of interocclusal environment, condylar movement was investigated by computerized axiography. The sample consisted of 50 dentulous and 50 edentulous Caucasians. The mean length of translation at maximum opening in dentulous subjects was 16 mm, while edentulous subjects showed an average of 11 mm. The mean angle of hinge axis rotation at maximum opening was 30 degrees in dentulous subjects and 17 degrees in edentulous subjects. The mean length of translation and the rotation of hinge axis in opening and closing movements was smaller in edentulous subjects than in dentulous ones. In opening and closing movement of edentulous subjects, the length of translation and the rotation value revealed no significant correlation with age or duration of upper and lower prosthesis. No significant difference was shown between edentulous and dentulous subjects on translative quantity in protrusive movement.

An analysis and quantitation of protrusive and retrusive mandibular movement is provided. This report is one study along with four other parts analyzing the mandibular opening movement, the transversal shift during protrusion and retrusion, the mediotrusive movement and mastication. Protrusive movements of 225 individuals (180 patients, 45 volunteers) were analyzed using computerized axiography. Investigating both asymptomatic volunteers and patients with abnormal joint mobility helps to improve evaluation of these abnormalities. With the aid of diagnostic computer software, the length of the pathways was measured and the characteristics of the curves were analyzed. An average group was defined based on the values found in asymptomatic individuals, comprising 50% of our volunteers. The interquartile range for the male volunteers was 8.79-12.27 mm for the right joint and 9.43-12.93 mm for the left joint; for female volunteers it was 8.32-10.64 mm and 9.2-11.26 mm, respectively.