A Comparison of Change in Condylar Position in Asymptomatic Volunteers Utilizing a Stabilization and a Pivot Appliance

Abstract

Although different occlusal appliances with various designs have been described in the literature, little is known about their influence on condylar position. The purpose of the present study was to compare the effect of two occlusal appliances (pivot appliance, stabilization appliance) on condylar position with respect to normal and maximum clenching force. Electronic-positioning-analysis was performed in 22 healthy volunteers with an ultrasound-based registration system. After randomized insertion of the appliances, the volunteers were asked to clench five times using normal and then maximum force. Data was compared using ANOVA for repeated measurements, with occlusal design and clenching force as covariables (α=0.05). Insertion of appliances caused an anterior-downward movement of the condylar reference point (pivot appliance: 0.3 mm ± 0.5 mm sagittally, 0.8 mm ± 0.5 mm vertically; stabilization appliance: 0.2 mm ± 0.5 mm sagittally, 0.8 mm ± 0.5 mm vertically). In both appliances, maximum clenching force enhanced the anterior and reduced the downward position (pivot appliance: 0.4 mm ± 0.5 mm sagittally, 0.6 mm ± 0.5 mm vertically; stabilization appliance: 0.4 mm ± 0.5 mm sagittally, 0.4 mm ± 0.6 mm vertically). Within groups, the positions for normal and maximum clenching force were significantly different (p<0.001 in the sagittal and vertical dimension for both appliances). Comparison of occlusal design with respect to clenching force revealed no significant differences between both appliances. Insertion of both appliances induced an anterior-downward movement of the condylar reference point, whereas the two different occlusal designs had no influence on condylar position.

Additional information

Notes on contributors

Anton Demling

Dr. Anton Demling has worked at the Department of Orthodontics of the Hannover Medical School as a senior lecturer since 2006. From 2004 to 2006, he was a member of the scientific staff of the Department of Prosthetic Dentistry and Biomedical Research of Hannover Medical School. His scientific research is focused on the clinical outcome of treatment strategies in temporomandibular disorders (TMD), particularly the efficacy of physiotherapy and splint therapy.

Kerstin Fauska

Dr. Kerstin Fauska is a dentist in private practice in Osnabrueck, Germany since 2005. She is a postgraduate student in the Department of Prosthetic Dentistry and Biomedical Research of Hannover Medical School.

Fadi Ismail

Dr. Fadi Ismail has worked for the Department of Prosthetic Dentistry and Biomedical Research of Hannover Medical School since 2004. He has been a member of the scientific and clinical team for temporomandibular disorders in the department since 2005. His scientific research is focused on the efficacy of physiotherapy, electronic registration systems and treatment concepts in temporomandibular disorders.

Meike Stiesch

Dr. Meike Stiesch became the head of the Department of Prosthetic Dentistry and Biomedical Research of Hannover Medical School in 2005. Her research is focused on pharmacological and physical treatment in temporomandibular disorders, electronic registration systems, and the functional relationship between the craniomandibular system and the cervical spine.