Abstract:

BACKGROUND: Morphological changes of occlusal surface will affect the contraction of masticatory muscles, the magnitude and direction of the bite force, thus affecting the force environment of the entire stomatognathic system including the temporomandibular joint, so it is the main stimulus for the physiological and pathological alterations of the temporomandibular joint.
OBJECTIVE: To explore the proper position of the condyle in occlusal reconstruction.
METHODS: Twenty-four cases of tooth wear associated with temporomandibular joint disorder received fixed repair occlusal rehabilitation therapy, and the course was 9 months. The CT image of temporomandibular joint in the median occlusal bit was taken before and after treatment, and computer technology was used for linear measurement to analyze the change of joint space.
RESULTS AND CONCLUSION: The relative reference position of condyle in the glenoid fossa after occlusal reconstruction was changed as follows: the left was increased from -(16.96%±2.01)% to +(14.20%±1.24)%, and the right was increased from -(10.64%±1.50)% to (11.51%±3.00)%. The preoperative masticatory efficiency was 62.15%-89.09% of that after treatment, 74.88% on the average, and the difference was significant (P < 0.05). After occlusal reconstruction, the positions of condyles in the glenoid fossa of 24 patients were moved to the position between the 1/3 of articular eminence and top of articular tubercle. The reconstruction of proper position of condyle to the position between 1/3 of articular eminence and top of articular tubercle has achieved good clinical treatment effect, and indicate that the condyle located in the center of the glenoid fossa is not the only physiological position.

Key words: tissue construction, oral tissue construction, bone and joint implants, occlusal reconstruction, infraocclusion, temporomandibular disorders, occlusal pad, masticatory efficiency, computer technology, measurement, joint space