Korean J Orthod.  2011 Apr;41(2):127-137. 10.4041/kjod.2011.41.2.127.

Differences in opening and protrusive mandibular movements between Class I and II malocclusions in healthy adolescents

• Tuncer BB
• Ozogul B
• Akkaya S

• KMID: 2274249
• DOI: http://doi.org/10.4041/kjod.2011.41.2.127

Abstract

OBJECTIVE
The aim of the study was to compare the opening and protrusive mandibular movements between Class I and Class II malocclusions in healthy adolescents by clinical and axiographic evaluations.
METHODS
Mechanical axiography was performed on non-orthodontically treated, temporomandibular disorder (TMD)-free adolescents (12 - 16 years) with Class I (n = 38, 16 boys, 22 girls) or Class II (n = 40, 19 boys, 21 girls) malocclusion. Opening and protrusive movements were measured clinically and axiographically. Intergroup comparisons were evaluated by t-tests.
RESULTS
In opening movement, the maximum clinical opening capacity was significantly different (p < or = 0.05) between the groups. In protrusive movement, the Class II group had significantly greater maximum clinical protrusion (p < 0.001) and maximum axiographic protrusive length (p < 0.01) than the Class I group. No significant difference in the other opening and protrusive axiographic measurements was observed.
CONCLUSIONS
TMD-free adolescents with Class II malocclusion have increased protrusive capacity compared with TMD-free adolescents with Class I malocclusion; however, the detected differences could be normal variations during adolescence.

Keyword

Condylar path; TMJ; Mandibular movements; Class II adolescents

MeSH Terms

Adolescent
Humans
Jaw Relation Record
Malocclusion
Temporomandibular Joint
Temporomandibular Joint Disorders

Figure

• 

  Fig. 1 Cephalometric landmarks used in the cephalometric analysis. S, Sella turcica; N, nasion; A, most anterior point on prosthion; B, most anterosuperior point on the symphysis; C, most posterosuperior point on the condyle; Go, lowest and most lateral point of the mandibular angle; Gn, most inferior point of the mandible on the midline; SNA, angle representing the anteroposterior relationship of the maxillary basal arch with the anterior cranial base; SNB, angle representing the anterior limit of the mandibular basal arch in relation to the anterior cranial base; ANB, anteroposterior relation of the maxilla with the mandible; CGn, effective mandibular length measured between C and Gn; GoGn, mandibular corpus length; CGo, ramus length; SNGoGn, angle representing the inclination of the mandibular plane in relation to the anterior cranial base; CGoGn, gonial angle; PP, palatal plane; U1-NA, perpendicular distance from the most anterior point of the upper central incisor to the NA plane; U1-PP, angle between the palatal plane and the long axis of the upper central incisor; L1-NB, perpendicular distance from the most anterior point of the lower central incisor to the NB plane; IMPA, angle between the mandibular plane and the long axis of the most anterior lower incisor.

• 

  Fig. 2 Individual clutch prepared on the lower dental cast.

• 

  Fig. 3 Adjustment and recording with the axiographic device. A, Upper and posterior frames supporting the head of the recording device; B, recording center of the terminal hinge axis point; C, Drawing system during opening movement of the lower recording frame.

• 

  Fig. 4 Representative axiographic tracings. A, Determination of opening and protrusive movements (left drawing, Class I group; right drawing, Class II group); B, angular (a) and linear (b) axiographic measurements.

Reference

1. al-Hadi LA. Prevalence of temporomandibular disorders in relation to some occlusal parameters. J Prosthet Dent. 1993. 70:345–350.

2. McLaughlin RP. Malocclusion and the temporomandibular joint - an historical perspective. Angle Orthod. 1988. 58:185–191.

3. Pahkala RH, Laine-Alava MT. Do early signs of orofacial dysfunctions and occlusal variables predict development of TMD in adolescence. J Oral Rehabil. 2002. 29:737–743.

4. Ozkan H, Kucukkeles N. Condylar pathway changes following different treatment modalities. Eur J Orthod. 2003. 25:477–484.

5. Theusner J, Plesh O, Curtis DA, Hutton JE. Axiographic tracings of temporomandibular joint movements. J Prosthet Dent. 1993. 69:209–215.

6. Zimmer B, Jäger A, Kubein-Meesenburg D. Comparison of 'normal' TMJ-function in Class I, II, and III individuals. Eur J Orthod. 1991. 13:27–34.

7. Thilander B, Rubio G, Pena L, de Mayorga C. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod. 2002. 72:146–154.

8. Thilander B. Graber LW, editor. Temporomandibular joint dysfunction in children. Orthodontics, State of the Art, Essence of the Science. 1986. St. Louis: Mosby;342–351.

9. Harper RP. Analysis of temporomandibular joint function after orthognathic surgery using condylar path tracings. Am J Orthod Dentofacial Orthop. 1990. 97:480–488.

10. Riolo ML, Brandt D, TenHave TR. Associations between occlusal characteristics and signs and symptoms of TMJ dysfunction in children and young adults. Am J Orthod Dentofacial Orthop. 1987. 92:467–477.

11. Turasi B, Ari-Demirkaya A, Biren S. Comparison of increased overjet cases and controls: normative data for condylar positions. J Oral Rehabil. 2007. 34:129–135.

12. Piehslinger E, Celar RM, Horejs T, Slavicek R. Orthopedic jaw movement observations. Part II: The rotational capacity of the mandible. Cranio. 1993. 11:206–210.

13. Arat M, Üner O, Gazilerli Ü. Distribution of Angle Class I, Class II, Class III anomalies. Ankara Univ Hekim Fak Derg. 1975. 2:1–12. Turkish.

14. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wris. 1966. 2nd ed. Stanford, California: Stanford University Press;95–110. 159–172.

15. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud. 2010. 47:931–936.

16. Solberg WK, Bibb CA, Nordstrm BB, Hansson TL. Malocclusion associated with temporomandibular joint changes in young adults at autopsy. Am J Orthod. 1986. 89:326–330.

17. Katsavrias EG. Changes in articular eminence inclination during the craniofacial growth period. Angle Orthod. 2002. 72:258–264.

18. Katsavrias EG, Halazonetis DJ. Condyle and fossa shape in Class II and Class III skeletal patterns: a morphometric tomographic study. Am J Orthod Dentofacial Orthop. 2005. 128:337–346.

19. da Silva CM, Ramos MM, Carrara CF, Dalben Gda S. Oral characteristics of newborns. J Dent Child (Chic). 2008. 75:4–6.

20. Egermark-Eriksson I. Mandibular dysfunction in children and in individuals with dual bite. Swed Dent J Suppl. 1982. 10:1–45.

21. Stamm T, Vehring A, Ehmer U, Bollmann F. Computer-aided axiography of asymptomatic individuals with Class II/2. J Orofac Orthop. 1998. 59:237–245.

22. Ingervall B. Variation of the range of movement of the mandible in relation to facial morphology in young adults. Scand J Dent Res. 1971. 79:133–140.

23. Gsellmann B, Schmid-Schwap M, Piehslinger E, Slavicek R. Lengths of condylar pathways measured with computerized axiography (CADIAX) and occlusal index in patients and volunteers. J Oral Rehabil. 1998. 25:146–152.

24. Baqaien MA, Barra J, Muessig D. Computerized axiographic evaluation of the changes in sagittal condylar path inclination with dental and physical development. Am J Orthod Dentofacial Orthop. 2009. 135:88–94.

25. Reicheneder C, Gedrange T, Baumert U, Faltermeier A, Proff P. Variations in the inclination of the condylar path in children and adults. Angle Orthod. 2009. 79:958–963.

26. Bolt KJ, Orchardson R. Relationship between mouth-opening force and facial skeletal dimensions in human females. Arch Oral Biol. 1986. 31:789–793.

27. Dijkstra PU, Hof AL, Stegenga B, de Bont LG. Influence of mandibular length on mouth opening. J Oral Rehabil. 1999. 26:117–122.

28. Pullinger AG, Liu SP, Low G, Tay D. Differences between sexes in maximum jaw opening when corrected to body size. J Oral Rehabil. 1987. 14:291–299.

29. Kubein-Meesenburg D, Nägerl H, Klamt B. The biomechanical relation between incisal and condylar guidance in man. J Biomech. 1988. 21:997–1009.

30. Ogawa T, Koyano K, Suetsugu T. The influence of anterior guidance and condylar guidance on mandibular protrusive movement. J Oral Rehabil. 1997. 24:303–309.