Influence of Simulated Loss of Posterior Occlusal Support on Three-dimensional Condylar Displacement.

Abstract

The objective of this study was to verify whether loss of posterior occlusal support induced displacement of the mandibular condyles from a physiological point of view. Stabilization-type splints were fabricated for 12 healthy dentulous individuals. Each splint was designed to cover the bilateral maxillary teeth up to the second molars. To reproduce loss of posterior occlusal support, the extent of the splint was reduced one tooth at a time, bilaterally, starting from the back and moving forward sequentially. Tapping movement and lateral excursions were performed with each splint and a jaw movement tracking device with 6-degrees of freedom used to observe condylar displacement. Evaluation of 3-dimensional (3-D) displacement of the kinematic axis of the condyle during experimental jaw movement was performed under each occlusal condition with occlusal contact on all teeth, including the maxillary second molars. The habitual closing position was used as the reference. An increase was observed in 3-D displacement of the kinematic axis at the terminal point of the tapping movement with loss of occlusal support, and significant differences were observed in both condyles. An increase was also observed in 3-D displacement of the kinematic axis on the working side during lateral excursion with loss of occlusal support, and a statistically significant difference was observed in the left condyle. A small increase was observed in 3-D displacement of the kinematic axis on the non-working side during lateral excursion with loss of occlusal support. The results of this study suggest that loss of posterior occlusal support induces displacement of the mandibular condyles, suggesting that occlusal support in the molar region is an important factor in stabilization of the condylar position.