Neuromuscular Position of the TMJ Condyle in Fully Dentate Volunteers Characteristics and Potential Indications.

Karl-Heinz Utz, Walter Lückerath, Peter Schwarting, Wolfgang Noethlichs, Ralph Büttner, Manfred Grüner, Edgar Fuß, Helmut Stark, Frauke Müller
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Abstract

Purpose: This study comprises the fifth and final part of a comprehensive investigation of the positions of the temporomandibular joint condyles. In this evaluation, we wanted to investigate the neuromuscular position of the mandible.

Materials and methods: The neuromuscular condylar positions were recorded by four independent operators in 81 fully dentate subjects with healthy oral function using a central bearing point system and rapid closing movements. The "most frequent adduction point" was determined, and the recordings were repeated twice for each subject. The subjects' maxillary casts were mounted in an articulator using an individual facebow transfer, subsequently the mandibular. casts were mounted with a central-bearing-point registration on the tip of the Gothic arch, i.e. in centric condylar position. A custom-made electronic measuring articulator was used to determine the spatial distance between the condyles in centric relation, maximal occlusion and the newly determined neuromuscular position.

Results: The reproducibility of the neuromuscular registrations was on average 0.52±0.16 mm (range 0.04-2.53 mm) with the right and left side averaged. The spatial distances of the condyles between maximal intercuspal position and neuromuscular positions were 0.88±0.30 mm (range 0.12-5.98 mm), again averaged for the right and left sides, whereas the ones between the centric condylar position and the neuromuscular positions were 0.83±0.27 mm (range 0.10-7.89 mm).

Conclusions: The neuromuscular mandibular position is neither identical to maximal intercuspal position nor to centric relation. It can therefore be concluded, that the registration of the neuromuscular adduction field should not be recommended for prosthodontic restorations in dentate or edentulous patients.

全齿状志愿者颞下颌髁神经肌肉位置特征及潜在适应症。
目的:本研究是全面研究颞下颌关节髁位置的第五部分,也是最后一部分。在这次评估中,我们想要研究下颌骨的神经肌肉位置。材料和方法:对81例口腔功能健康、牙齿发育完整的受试者,由4名独立操作者使用中心轴承点系统和快速闭合运动记录神经肌肉髁的位置。最常内收点";并对每个受试者重复两次录音。受试者的上颌模型通过单独的脸弓转移安装在关节器中,随后安装在下颌骨上。在哥特式拱门的尖端,即在中心的髁位置上,用中心轴承点进行安装。使用定制的电子测量关节仪测量髁突在中心关系、最大咬合和新确定的神经肌肉位置之间的空间距离。结果:神经肌肉配准的再现性平均为0.52±0.16 mm(范围0.04 ~ 2.53 mm),左右两侧平均。髁突最大尖间位置与神经肌肉位置之间的距离为0.88±0.30 mm(范围0.12-5.98 mm),左右两侧均为平均值,而髁突中心位置与神经肌肉位置之间的距离为0.83±0.27 mm(范围0.10-7.89 mm)。结论:下颌神经肌肉位置与最大尖间位置不相同,与中心位置也不相同。因此可以得出结论,神经肌肉内收野的登记不应该推荐用于有齿或无牙患者的修复修复。
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