West China Journal of Stomatology ›› 2024, Vol. 42 ›› Issue (2): 268-276.doi: 10.7518/hxkq.2024.2023327

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Effect of the application of digital technology-assisted optimization in the process of adjusting jaw position

Gong Yanji1(), Liu Yang1(), Yin Deqiang2   

  1. 1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.Dept. of Engineering Mechanics, College of Aerospace Engineering, Chongqing University, Chong-qing 400044, China
  • Received:2023-10-02 Revised:2024-01-17 Online:2024-04-01 Published:2024-03-26
  • Contact: Liu Yang E-mail:gongyanji_kq@163.com;liu@scu.edu.cn
  • Supported by:
    National Key Research and Development Program of China(2023YFC3605600);The National Natural Science Foundation of China(11972097);Natural Science Foundation of Sichuan Province(23NSFSC1708);Research and Development Program of West China Hospital of Stomatology, Sichuan University(RD-03-202005);Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ2023-YF-3)

Abstract:

Objective The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). Methods A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient’s initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient’s CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. Results In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. Conclusion Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients’ disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.

Key words: jaw position adjustment, digital technology, AVIA software, temporomandibular disorders

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