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Biomechanical study on the changes of stress in temporomandibular joints after the orthognathic surgery in patients with mandibular prognathism: a 3D finite element study

Shu Jingheng, Wang Quanyi, Ma Hedi, Teng Haidong, Zheng Tinghui, Liu Zhan

Acta of Bioengineering and Biomechanics

2020

Vol. 22, no. 2

155--163

Purpose: This study aimed to analyze the changes of the stress distributions in TMJs for the pre- and postoperative patients with mandibular prognathism under unilateral occlusions, a frequent occlusion in mastication. Methods: Pre- and six-mouth postoperative cone-beam computed tomography images of thirteen patients diagnosed with mandibular prognathism were scanned and used to construct complete maxillofacial models, assigned as the Pre and Post group, respectively. Another ten asymptomatic individuals were defined as the Control group. The inhomogeneous properties were assigned to the models. The muscle forces and boundary conditions corresponding to left and right unilateral occlusions were applied on the models. The analysis of variation (ANOVA) was chosen for the comparison among the groups. Results: The results showed that the Pre group had abnormal stress distributions ang higher stress level in TMJs, compared with those of the Post and Control groups. Moreover, from clinical cases, symptoms of temporomandibular disorders (TMDs) always followed with increased stresses. Conclusion: Generally, orthognathic surgeries could improve the stress distribution in TMJs of the patients with mandibular prognathism under the unilateral occlusions. However, the postoperative complications, especially symptoms of TMD, were closely related to changes of stress for patients with mandibular prognathism after orthognathic surgeries. Individual virtual surgery and finite element analysis should be conducted to prevent complications in TMJ.

Effects of magnetostimulation on muscle activity and pain in edentulous adults with temporomandibular disorders

Rój R., Chladek G., Wyszyńska M., Morawiec T., Kasperski J.

Acta of Bioengineering and Biomechanics

2018

Vol. 20, no. 2

89--99

Introduction: Multifactorial aetiologies of painful temporomandibular disorders (TMD) have an impact on correct diagnosis and consequently prevent proper treatment. Aim of the study: The aim of the study was to evaluate the effect of magnetic stimulation on electromyographic activity in temporal muscles and masseters in patients using occlusal splints. Materials and methods: The examined group consisted of 40 edentulous patients with TMD. The patients were examined based on Helkimo Index. Next, electromyographic activity of the temporal muscle and masseter were investigated using 8-channel surface electromyography. All patients received acrylic occlusal splints for 12 weeks. The group qualified for the study included 20 randomized patients, whose therapy was additionally carried out by extremely low-frequency magnetic fields for a period of 21 days. Following examinations were conducted after 3, 6 and 12 weeks with surface electromyography recording of the examined muscles. Patients received occlusal splint corrections using the T-Scan III system. The clinical evaluation of TMD was analysed using Helkimo index and VAS scale before and after the treatment. All the data were analysed using Statistica 12.5 PL. Results: Patients with combination therapy had lower asymmetry of temporal muscle activity. Conclusions: Combination therapy using magnetic stimulation reduced intensity of pain in patients with TMD and decreased values of the Helkimo indices.