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Leles CR, Curado TFF, Nascimento LN, Silva JR, de Paula MS, McKenna G, Schimmel M. Changes in masticatory performance and bite force after treatment with mandibular overdentures retained by four titanium-zirconium mini implants: One-year randomised clinical trial. J Oral Rehabil 2024. [PMID: 38685704 DOI: 10.1111/joor.13722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium-zirconium mini implants. METHODS Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two-colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue-VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre-treatment) and the 3-, 6- and 12-month after implant loading. Descriptive statistics, independent t-test, and linear mixed-effect model (LMM) regression were used for data analysis. RESULTS Seventy-four participants were assessed and 73 completed the 1-year follow-up. Statistically significant improvements in functional parameters were observed in all follow-up periods compared to baseline (p < .001). The flapless protocol was associated with higher improvement in MP at the 3-month follow-up (p = .004), while less resorbed ridges were associated with better MP (p = .038) and higher MBF (p < .001). CONCLUSION The mandibular overdenture protocol using four titanium-zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre-treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. CLINICAL TRIAL REGISTRATION ClinicalTrials.Gov ID NCT04760457.
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Affiliation(s)
- Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil
- Division of Gerodontology, Department of Reconstructive Dentistry, School of Dental Medicine of the University of Bern, Bern, Switzerland
| | | | | | | | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Martin Schimmel
- Division of Gerodontology, Department of Reconstructive Dentistry, School of Dental Medicine of the University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Puljic D, Petricevic N, Celebic A, Kovacic I, Milos M, Pavic D, Milat O. Mandibular Overdenture Supported by Two or Four Unsplinted or Two Splinted Ti-Zr Mini-Implants: In Vitro Study of Peri-Implant and Edentulous Area Strains. Biomimetics (Basel) 2024; 9:178. [PMID: 38534864 DOI: 10.3390/biomimetics9030178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
Clinical indications for the newly released Ti-Zr (Roxolid®) alloy mini-implants (MDIs) aimed for overdenture (OD) retention in subjects with narrow alveolar ridges are not fully defined. The aim of this study was to analyze peri-implant and posterior edentulous area microstrains utilizing models of the mandible mimicking a "real" mouth situation with two (splinted with a bar or as single units) or four unsplinted Ti-Zr MDIs. The models were virtually designed from a cone beam computed tomography (CBCT) scan of a convenient patient and printed. The artificial mucosa was two millimeters thick. After MDI insertion, the strain gauges were bonded on the oral and vestibular peri-implant sites, and on distal edentulous areas under a denture. After attaching the ODs to MDIs, the ODs were loaded using a metal plate positioned on the first artificial molars (posterior loadings) bilaterally and unilaterally with 50, 100, and 150 N forces, respectively. During anterior loadings, the plate was positioned on the denture's incisors and loaded with 50 and 100 N forces. Each loading was repeated 15 times. The means with standard deviations, and the significance of the differences (two- and three-factor MANOVA) were calculated. Variations in the MDI number, location, and splinting status elicited different microstrains. Higher loading forces elicited higher microstrains. Unilateral loadings elicited higher microstrains than bilateral and anterior loadings, especially on the loading side. Peri-implant microstrains were lower in the four-MDI single-unit model than in both two-MDI models (unsplinted and splinted). Posterior implants showed higher peri-implant microstrains than anterior in the four-MDI model. The splinting of the two-MDI did not have a significant effect on peri-implant microstrains but elicited lower microstrains in the posterior edentulous area. The strains did not exceed the bone reparatory mechanisms, although precaution and additional study should be addressed when two Ti-Zr MDIs support mandibular ODs.
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Affiliation(s)
- Dario Puljic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Nikola Petricevic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Asja Celebic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Ines Kovacic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Manuela Milos
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Dalibor Pavic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
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Jauregi M, Amezua X, Iturrate M, Solaberrieta E. Improving the precision of recordings acquired with digital occlusal analyzers: A dental technique. J Prosthet Dent 2023:S0022-3913(23)00503-6. [PMID: 37661547 DOI: 10.1016/j.prosdent.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023]
Abstract
A technique to improve the precision of recordings acquired with the 2 main digital occlusal analyzers on the market (T-Scan and OccluSense) is presented. This technique consists of using digital occlusal analyzers with a customizable centering tray. The virtual design of the centering tray is available online, together with that of the adapters required for both digital occlusal analyzers. The designs can be downloaded and additively manufactured for clinical use. These parts improve the positioning of the piezoelectric film sensors of the digital occlusal analyzers in the patient's mouth and thus the precision of their records. Improving the precision of the records of the digital occlusal analyzers is especially important for the comparison of records obtained at different stages of rehabilitation treatment.
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Affiliation(s)
- Mikel Jauregi
- Associate Professor, Department of Mechanical Engineering, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Xabier Amezua
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Mikel Iturrate
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Eneko Solaberrieta
- Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain.
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Zhou T, Mirchandani B, Li XX, Mekcha P, Buranawat B. Quantitative parameters of digital occlusal analysis in dental implant supported restorative reconstruction recent 5 years: a systematic review. Acta Odontol Scand 2023; 81:1-17. [PMID: 35617455 DOI: 10.1080/00016357.2022.2077980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aims of this systematic review were to evaluate the clinical masticatory performance of implant-supported restorations, observe the occlusal force changes in the distribution of the implant restoration and reveal the positive and negative contributing factors of implant design and components based on the outcomes of digital occlusal measurement. MATERIAL AND METHODS An extensive search was conducted through PubMed and CENTRAL to identify clinical trials on implant-retained restorations using digital occlusal analysis methods. Two researchers assessed the identified studies and data extraction independently, and the data synthesis strategies without meta-analysis that summarizes the effect estimates were adopted. RESULTS The search screened 3821 titles and abstracts, then full-text analysis for 26 articles was performed, and 14 studies were included in the quantitative synthesis. Four of six studies for implant-retained overdenture showed statistically significant improved bite force when immediate loading (p = .00045, .00005, .00055, and .00005, respectively), and no statistically significant results in the other two studies (p = .225, .371, respectively.) However, the results of the favoured intervention were not statistically significant (p = .104, .166, respectively) in two studies of single posterior implant restorations. In all three studies, the bite force distributed on the implant prostheses of partially fixed implant-retained restoration increased statistically significantly (p = .013, .001, .05, respectively). CONCLUSIONS The edentulous restoration supported by implants seems to significantly improves bite force and chewing efficiency compared with conventional dentures. Regular quantitative occlusal measurement is recommended to avoid the possible risk of overload. Smaller implants size and relatively small and flexible attachment designs may be more conducive to the stability and retention of the restoration of atrophy of alveolar bone.
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Affiliation(s)
- Ting Zhou
- Department of Orthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China.,Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Bharat Mirchandani
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Xing-Xing Li
- Department of Prosthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China
| | - Pichaya Mekcha
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Borvornwut Buranawat
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
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Chatrattanarak W, Aunmeungtong W, Khongkhunthian P. Comparative clinical study of conventional dental implant and mini dental implant-retained mandibular overdenture: A 5- to 8-Year prospective clinical outcomes in a previous randomized clinical trial. Clin Implant Dent Relat Res 2022; 24:475-487. [PMID: 35675561 DOI: 10.1111/cid.13098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022]
Abstract
AIM To compare the long-term prospective clinical outcomes in a previous randomized controlled clinical trial (RCT) of 2 Mini Dental Implant (2MDI), 4 Mini Dental Implant (4MDI), and 2 Conventional Dental Implant (2CDI)-retained mandibular overdenture with follow-up between 5 to 8 years. MATERIALS AND METHODS Thirty-seven patients formerly participated in the Comparative Clinical Study of CDI and MDI for Mandibular Overdenture were requested for examination of clinical outcomes. A total of 104 implants were placed with mean follow-up periods 6.64 ± 0.60 years. In Group 1 (2MDI) and Group 2 (4MDI), implants were placed and immediately loaded with Equator® attachments to retained mandibular overdenture. In Group 3 (2CDI), implants were placed and delayed 3 months for denture loading with ball attachment. The success rate, survival rate, clinical implant performance scale (CIP scale), peri-implant tissue status, prosthetic complication, implant stability quotient (ISQ), marginal bone level change (MBLC), and patient satisfactions were analyzed. RESULTS After 5 to 8 years follow-up, the success rate in Groups 1, 2, and 3 were 90.91%, 93.33%, and 54.55%, respectively. The success rate in Group 3 was significantly lesser than Group 1 (p = 0.016) and Group 2 (p < 0.001). The survival rate in Groups 1, 2, and 3 was 100%, 96.67%, and 90.91%, respectively, and showed no significant differences. Mean ISQ reported no significant differences between groups. Mean MBLC were 0.57 ± 1.19 mm, 0.68 ± 0.90 mm, and 1.55 ± 1.60 mm in Groups 1, 2, and 3, respectively. Group 3 reported significantly greater mean MBLC than Group 1 (p = 0.016) and Group 2 (p = 0.011), but Groups 1 and 2 were not significantly differences. The overall patient satisfactions were reported as not significant differences between groups. CONCLUDE Two MDI-retained mandibular overdentures with immediate loaded protocol performed had favorable clinical outcomes, cost effectiveness, and overall patient satisfactions after 5 to 8 years follow-up.
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Affiliation(s)
- Wipawan Chatrattanarak
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Weerapan Aunmeungtong
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Pathawee Khongkhunthian
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Topić J, Poljak-Guberina R, Persic-Kirsic S, Kovacic I, Petricevic N, Popovac A, Čelebić A. Adaptation to New Dentures and 5 Years of Clinical Use: A Comparison between Complete Denture and Mini-implant Mandibular Overdenture Patients based on Oral Health-Related Quality of Life (OHRQoL) and Orofacial Esthetics. Acta Stomatol Croat 2022; 56:132-142. [PMID: 35821720 PMCID: PMC9262111 DOI: 10.15644/asc56/2/4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Objective of work It is unclear how long patients need to adapt to new dentures. This study assessed adaptation and five years of clinical use, comparing complete denture wearers (CDs) and mini-implant mandibular overdenture wearers opposing a maxillary CD (MDI-OD), based on oral health reported quality of life (OHRQoL) and orofacial esthetics (OES). Material and Methods A total of 36 subjects in the CD group (25 females) and 30 subjects in the MDI group (20 females) completed the 5-year study. All patients received new CDs, but in the MDI-OD group, four mini-implants were inserted interforaminally in the mandible before denture manufacture. Participants filled in the OHIP-EDENT and OES questionnaires one day after dentures’ delivery, on the 3rd, 8th, 15th, 30th day, and at the 1-, 3- and 5-year follow-up examinations. Statistical analysis comprised descriptive methods, X2 test, independent t-test, Friedman, and Mann-Whitney test. Results and Conclusions Both groups' adaptation to new dentures was completed within a month. The MDI-OD group had significantly better OHRQoL in all follow-ups except for the 3rd and 8th day, probably due to soreness and pain, the reason why the MDI-OD group had limitation in functioning in the first days after new dentures’ delivery. Already after the third year and at the fifth year, OHRQoL worsened (p<0.01) in both groups. However it was significantly more pronounced in the conventional CD wearers (p<0.01) than in the MDI-OD group. Orofacial esthetics was highly scored in both groups. The scores dropped down only after three years, equally in both groups. Keywords OHRQoL, OES, prospective study, complete dentures, mini-implants, adaptation MeSH Terms Complete Dentures; Dental Implants; Quality of Life; Dental Esthetics
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Affiliation(s)
- Jolanda Topić
- Ph.D. student at the School of Dental Medicine University of Zagreb and Private Dental Office Makarska
| | - Renata Poljak-Guberina
- Department of Dental Prosthodontics, School of Medicine, University of Split, Croatia; corresponding author
| | - Sanja Persic-Kirsic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - Ines Kovacic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - Nikola Petricevic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - Aleksandra Popovac
- Higher Assistant, University of Belgrade, School of Dental Medicine, Clinic for Prosthetic Dentistry, Serbia
| | - Asja Čelebić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
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Vi S, Pham D, Du YYM, Arora H, Tadakamadla SK. Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph18084377. [PMID: 33924167 PMCID: PMC8074399 DOI: 10.3390/ijerph18084377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.
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Affiliation(s)
- Serena Vi
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Damon Pham
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Yu Yian Marina Du
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Himanshu Arora
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
- Correspondence:
| | - Santosh Kumar Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
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Lee SKY, Salinas TJ, Wiens JP. The Effect of Patient Specific Factors on Occlusal Forces Generated: Best Evidence Consensus Statement. J Prosthodont 2021; 30:52-60. [PMID: 33474770 DOI: 10.1111/jopr.13334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The purpose of this Best Evidence Consensus Statement was to search the literature to determine if there is a relationship between patient specific factors and occlusal force. MATERIALS AND METHODS A literature review was conducted in the following databases: Evidence-Based Medicine Reviews (EBMR), Cochrane Database of Systematic Reviews, Embase, and Ovid MEDLINE(R) and Epub Ahead of Print. Articles on patient factors and occlusal force were compiled by using a combination of the key words: "bite force," "occlusal force," "partial and complete edentulism," "bruxism," and "orthognathic class." Inclusion criteria included meta-analyses, systematic reviews, randomized controlled trials, case series, and journal articles. Exclusion criteria were case reports, studies in children, animals, and bench studies. RESULTS Of the 1502 articles that met the initial search criteria, 97 related to patient-specific factors affecting occlusal forces. These articles were evaluated, rated, and organized into appropriate categories addressing questions of foci. CONCLUSIONS The range of occlusal force is highly variable among subjects correlated to patient specific factors such as age, gender, partial and complete edentulism, the presence of a maxillofacial defect, location of edentulous area, orthognathic profile, and magnitude of occlusal vertical dimension. Tooth replacement therapies targeted at increasing occlusal contact seem to have a positive effect on increasing occlusal force. Bruxism does not necessarily demonstrate higher occlusal powering but may have greater tooth contact time. Occlusal force is not clearly affected by the type of dental restoration or restorative material used. The clinical significance of the changes in occlusal forces is yet to be determined.
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Affiliation(s)
| | | | - Jonathan P Wiens
- Department of Restorative Dentistry, University of Detroit Mercy School of Dentistry, Detroit, MI
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