Artículos de Investigación

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Chewing Index: A Pilot Trial to Measure Masticatory Effort
(2026)
Franco Marinelli
;
Camila Venegas-Ocampo
;
Josefa Alarcón-Apablaza
;
Rosemarie Schneider
;
Pablo Navarro
<jats:p>Background/Objectives: Population aging presents new challenges for achieving healthy aging. Edentulism is a condition that diminishes quality of life. Several studies have attempted to analyze the impact of edentulism on masticatory function either by evaluating the final stage of the food bolus or the masticatory process itself. The present study aims to develop a chewing index (Ci) based on chewing time, the number of cycles, and the muscular activity of the masseter and temporal muscles. Methods: Two groups (n = 10 each, 60–80 years old), one with functional dentition (21 or more teeth) (Group F) and one with complete denture wearers (Group D), were used. Participants were asked to chew a total of 36 food samples. The number of chewing cycles (N), chewing time (T), and bilateral activity of the masseter and anterior temporal muscles were recorded and quantified using the root mean square. This activity was normalized with respect to a 5 s maximum voluntary clenching (TMAV). A chewing index (Ci) was calculated using the equation Ci = N × V%¯ × T/TMAV, where V%¯ represents the average normalized activity of the four muscles. Results: Ci values ranged from 0 to 62 for Group F and 0 to 262 for Group D. For 15 out of the 36 food samples, Ci was higher in Group D than in Group F. Conclusions: The results of this study are consistent with previous research showing that complete denture wearers must chew for a longer time and perform a greater number of chewing cycles compared with subjects with functional dentition.</jats:p>
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Evaluation of Mandibular Border Movements and Mastication in Patients with Temporomandibular Disorders: A Pilot Study with 3D Electromagnetic Articulography and Surface Electromyography
(2025)
Camila Cerda
;
Franco Marinelli
;
Jarpa-Parra, Marcela
;
Pablo Navarro
;
Ramón Fuentes
Temporomandibular disorders (TMD) are characterized by pain and restricted functionality of the temporomandibular joint (TMJ). The objective of this study was to characterize the kinematic and electromyographic patterns of mandibular border movements and mastication in patients with different forms of TMD compared with healthy controls, through a simultaneous three-dimensional electromagnetic articulography (EMA-3D) and surface electromyography (sEMG) recording protocol. Sixteen participants were included and divided into three groups according to the TMD diagnosis (articular, muscular and mixed) and one healthy control group. Kinematic data were recorded using EMA-3D, and electromyographic activity of the masticatory muscles was assessed using sEMG. Variables analyzed included trajectories, areas, ranges, and electrical activity during mandibular border movements and mastication. Patients with TMD exhibited reduced movement trajectories but larger areas within the mandibular polygons, particularly in the frontal and sagittal planes. During mastication, the number of cycles was higher in the muscular group and lower in the healthy controls. Patients with TMD showed greater mean electromyographic activity, which could suggest compensatory muscle strain. The EMA-3D system provided an accurate threedimensional analysis, while sEMG captured detailed patterns of muscle activation and strain, that help better understand the neuromuscular alterations associated with TMD. Differentiation between TMD types (articular, muscular and mixed) for the study of its kinematic and electromyographic characteristics, is essential to improve diagnosis and treatment strategies. This study highlights the relevance of advanced tools such as EMA-3D and sEMG in the evaluation of TMD using a simultaneous recording protocol such as the one proposed in this study.
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Análisis Cinemático de la Masticación de una Granola Prototipo en Contraste con la Masticación de Maní
(2020)
Constanza Farfán
;
Joel Jerson Coaquira-Quispe
;
María Florencia Lezcano
;
Alain Arias
;
Pablo Navarro
La masticación se ha estudiado desde diferentes puntos de vista, utilizando alimentos de prueba naturales y artificiales. La evidencia es escasa cuando se analizan alimentos a base de cereales, que van desde cereales para el desayuno hasta barras de granola. El investigar este tipo de alimentos, se vuelve importante para entender el comportamiento de la masticación frente a alimentos con diferentes composiciones y texturas, y como estas características pueden influir en el proceso masticatorio. Se analizó la masticación desde un punto de vista cinemático, en sujetos jóvenes dentados. El alimento de prueba utilizado fue granola prototipo y maní, este último se ha estudiado en sujetos con rehabilitación protésica y su consumo se recomienda en esta población. Se analizaron las características cinemáticas de la masticación como numero de ciclos, frecuencia masticatoria, velocidad de masticación de ascenso y descenso, y el área de masticación en los tres planos del espacio. Se relacionaron los movimientos masticatorios con los movimientos mandibulares bordeantes que conformaron el polígono de Posselt, este también se analizó en los tres planos espaciales. En todas las variables analizadas la granola presento valores mayores, excepto en el número de ciclos masticatorios, sólo se encontraron diferencias estadísticamente significativas (p= 0,03) al comparar la velocidad (ascenso y descenso) y el área de masticación en el plano horizontal.
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Characteristics of Mandibular Movement and Mastication in Older Adults with Removable Dental Prostheses: Three-Dimensional Analysis
(2020)
Paloma Rivera
;
Constanza Farfán
;
Alain Arias
;
María Florencia Lezcano
;
Fernando José Dias
Aging is a dynamic process that includes various alterations in the oral cavity, with tooth loss being the most frequent. Rehabilitative treatment may include removable or fixed prostheses and implants. The aim of this study was to describe the geometric (trajectory, ranges, areas) and kinematic (speed) characteristics of the mandibular and masticatory movements threedimensionally in participants with dental prostheses. A sample of 10 participants with removable prosthetic rehabilitation was divided into three groups (complete, atypical and overdenture) the characteristics of mandibular movements bordering and chewing with 3D Electromagnetic Articulography were measured. The Posselt polygonin was obtained, the frontal and sagittal plans, its areas, trajectories and ranges are analyzed. The masticatory movements were analyzed in the area of each cycle, the frequency, the speed and the reason between the masticatory cycle and the bordering movements, no significant differences between the groups. Subjects with dental prostheses, regardless of the type, they showed low of motion (border and functional) compared to dentate subjects with no functional alterations whose values have been reported in the literature. The subjects with overdenture have values closer to what is described for young dentate subjects.
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Location and course of the mandibular canal in dentate patients: morphometric study using cone-beam computed tomography
(2019)
Alain Arias
;
C. Venegas
;
N. Soto
;
I. Montiel
;
C. Farfán
Background: The morphometric characteristics of the mandibular canal (MC) may vary according to the characteristics of the population studied. Correct location of the MC is fundamental for the indication and planning of different dental treatments, and it is therefore essential to have clinical parameters indicating its approximate location. The aim of this study was to describe the location and course of the MC by morphometric relations in the mandibular body, from the mental foramen to distal of the first molar, in dentate adult patients. Materials and methods: We analysed 55 cone-beam computed tomography (CBCT) of male and female patients, aged over 18 years and with fully dentate to the first molar. In each CBCT we selected five coronal sections (A-E) of the mandibular body at different levels using the teeth as references. We determined different morphometric measurements in each section to relate the MC with the corticals of the mandibular body (m1, m2, m3, m4), their orientation to lingual (F) and the thickness of the mandibular corticals (B1, B2 and B3). Results: The distance between the MC and the alveolar crests was greater in males than in females in all the sections. In general, in all the hemiarches, the MC courses away from the vestibular cortical of the mandible (and in some cases significantly towards the lingual cortical) from anterior to posterior in the mandibular body. In the left hemiarch of dentate females the MC describes a descent in the molar zone within the mandibular body. Any intervention in the mandible must be carried out with extreme caution to avoid damaging the vasculo-nervous bundle which passes through the MC. Conclusions: Cone-beam computed tomography is the best tool currently available for the planning and execution of surgical procedures, and is the only tool in clinical use which allows the precise course of the MC to be identified.
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Relación entre Síntomas de Trastornos Témporomandibulares Auto-Reportados y el Movimiento Mandibular de Sujetos Adultos Jóvenes
(2019)
Alain Arias
;
Diego Saravia
;
Melanie Quintana
;
Fernando Dias
;
María Florencia Lezcano
Tanto la limitación del movimiento mandibular como el auto reporte de síntomas de trastornos témporomandibulares (TTM) son utilizados como elementos para el diagnóstico de pacientes en la clínica. Sin embargo, la relación entre la presencia de síntomas y el movimiento mandibular no está del todo clara. Por ello, el objetivo de este estudio fue relacionar la presencia de síntomas asociados a TTM con el movimiento mandibular en una muestra de sujetos adultos jóvenes y sanos. En este estudio exploratorio participaron 40 estudiantes de Odontología, médicamente sanos, con arco dentario maxilar y mandibular continuo y completo (hasta el primer molar). A cada uno se les solicitó responder un cuestionario de auto-reporte de síntomas asociados a TTM recomendado por la American Academy of Orofacial Pain (AAOP). También se realizó un registro y análisis de sus movimientos mandibulares utilizando articulografía electromagnética 3D, con el objetivo de correlacionar la presencia de síntomas con el rango y trayectoria de apertura, y el área comprendida en lo que se describe como polígono de Posselt en el plano frontal y sagital. No se encontraron diferencias significativas entre las respuestas a cada pregunta entre hombres y mujeres. De acuerdo a las respuestas y según Delcanho (1994), 12 participantes resultaron necesitar una evaluación más exhaustiva. En este grupo se encontró que el área del polígono de Posselt en el plano frontal, fue significativamente menor que el de aquellos participantes que no requieren una evaluación más exhaustiva (p=0,003). Los valores de la trayectoria de apertura mandibular varían según de que síntoma se trate. Los principales síntomas que afectarían los valores de los movimientos bordeantes son la “dificultad para abrir la boca” y el “ruido en las articulaciones mandibulares”. Con este estudio, hemos puesto de manifiesto que la limitación del movimiento mandibular como signo de TTM debe evaluarse con cautela, debido a que según la presencia de determinados síntomas y otras características de los sujetos (como el sexo), su valor podría variar.
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Platelet‐rich fibrin and collagen membrane in the preservation of the alveolar bone: Feasibility of the elemental inorganic composition and scanning electron microscopy analysis
(2019)
Fernando José Dias
;
Alain Arias
;
Eduardo Borie
;
Ramón Fuentes
<jats:title>Abstract</jats:title><jats:p>The success of dental implants is related to the amount, quality, and composition of the alveolar bone. The placement of platelet‐rich fibrin (PRF) clot associated with a resorbable collagen membrane (RCM) in a postextraction alveolus is a technique used for ridge preservation. This case report study analyzed the ultrastructural characteristics of cross‐sectioned alveolar bone that received PRF and RCM using scanning electron microscopy and the inorganic composition using “energy dispersive X‐ray spectrometry,” in order to explore the feasibility of this method to clinical studies. Three alveolar bone samples from two male patients (37 and 58 years old), obtained in the procedure of placing the dental implant, were analyzed. Two bone samples previously received PRF and RCM (M37 and M58), the third sample represented a physiological bone formation without treatment (M37‐control). The bone sample M37 showed irregularly shaped islets of calcified material intermingled with connective tissue. The other samples, from the 58‐year‐old patient with PRF and RCM (M58); and the other untreated bone sample from the same 37‐year‐old patient (M37‐control) showed similar ultrastructural morphology with trabecular conformation without islets agglomerations. The inorganic composition analysis showed higher concentrations of calcium and phosphorus in both samples treated with PRF and RCM in comparison to the untreated bone sample. The Ca/P ratio was higher in the M37 sample compared to the others samples. The results showed morphology and inorganic composition differences among the treatments used, suggesting that this method is feasible to analyze parameters of the alveolar bone tissue.</jats:p>
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Comparison of Morphological Quantitative Characteristics of the Newly Formed Alveolar Bone After the Application of Demineralized Bone Matrix and Cortical Bone Allografts
(2019)
Fernando José Dias
;
Alain Arias
;
Eduardo Borie
;
Maria Florencia Lezcano
;
Manuel Arellano-Villalón
The allografts were used to obtain sufficient alveolar bone tissue for proper dental implant placement. The objective of the present study was to evaluate the morphological and quantitative characteristics (cellular and collagen densities) of the newly formed alveolar bone with the application of cortical bone (CB) and demineralized bone matrix (DBM) allografts. Six samples of alveolar bone tissue from 5 patients (50 ± 6.3 years) were obtained after 6 months of application of the allografts and immediately before the placement of the dental implants. The samples were fixed (buffered formaldehyde, pH7.2), decalcified (EDTA 10 %) and histologically processed (HE and Picro-Sirius) for histologic analysis. Morphological analysis revealed presence of osteocytes and trabeculae in neoformed bone tissue near the allografts and absence of inflammatory and allergic cells; the remnants of CB were located mainly in the periphery of the bone tissue and the remnants of DBM were more incorporated into the tissue. Osteogenitor cells were observed around the remaining material. The cell density was not modified in newly formed bone tissue with the application of both allografts as compared to mature bone tissue. The density of the type I and III collagens present in the osteoids interspersed with the remainder of the materials showed a tendency to increase in the samples treated with DBM. It was concluded that by the histological characteristics observed both grafts were biocompatible, however the bone treated with DBM presented better incorporation and a tendency of increase of the collagen content in the remnant region of the allografts.
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Assessment of Maxillary Premolar Region in Relation to Maxillary Sinus Floor and Buccal Bone Plate: A Cone Beam Computed Tomography Study
(2019)
Ramón Fuentes
;
Manuel Arellano Villalón
;
Soto-Faúndez, Natalia
;
Alain Arias
;
Montiel, Ignacio
The maxillary sinus floor location and the buccal bone plate are factors to be considered in the long-term success with implant treatments mainly in the premolar region. the aim of this study was to establish morphometric characteristics of the buccal cortical bone (BCB) thickness of maxillary premolars and its relation to maxillary sinus floor through CBCT. In this study 350 first and second maxillary premolars were analyzed from 110 CBCT images and the buccal cortical bone (BCB) was measured in a coronal view at the major axis level of each premolar. In addition, in 200 first and second maxillary premolars CBCT images were measured the distance from premolar apex to maxillary sinus floor (MSF) in both frontal and sagittal plane. The type of relationship between the apex and MSF was classified according to Ok et al. (2014). The second premolar was observed with higher values of BCB (p<0.001). In first premolar, higher values were observed in the male sex (p>0.05). In second premolar, only significantly higher values were observed in the male sex in MA-MB-MC (p>0.05). Regarding to MSF and its relation to premolar roots, it was observed that 10 % of the sample was classified as type I, 19 % as type II, 55.5 % as type III and 15.5 % as type IV. The BCB of the upper premolar region is thicker in the apical region and decreases toward the coronal region. Almost 50 % of apex of second premolars are closely and risky related MSF (Type I and II).
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Patrones de Deglución y Metodología de Evaluación. Una Revisión de la Literatura
(2019)
Priscila Chuhuaicura
;
Giannina Álvarez
;
Lezcano, María Florencia
;
Alain Arias-betancur
;
Fernando Jose Dias
La deglución es una función indispensable para el ser humano, es una actividad compleja que necesita de la participación y coordinación de múltiples estructuras. Actualmente existen diferentes métodos para evaluar este proceso, sin embargo, la capacidad de describir el comportamiento de las estructuras en sus tres dimensiones es limitada. Se ha demostrado que el movimien to lingual, es clave para la formación del bolo alimenticio y la propulsión de este a la orofaringe. Es así como se han identificado patrones de movimiento lingual a través de diferentes técnicas. El objetivo de esta revisión es reportar las diferentes técnicas de evaluación de la deglución e identificar los patrones que establece cada una de ellas. Se realizó una revisión de la literatura en distintas bases de datos, a través de una estrategia de búsqueda sistematizada. Se utilizaron las palabras clave “Deglutition” “Swallowing” “Movement Tracking” “evaluation” y “patterns” en inglés y español. Se incluyeron estudios sin límite en la fecha de publicación, realizados en humanos, en idioma inglés, español y portugués. Se encontraron diferentes técnicas para evaluar la deglución, videofluoroscopía, endoscopía, articulografía electromagnética, electromiografía, tomografía computarizada, manometría, electropalatografía y ultrasonido. Entre las cuales la videofluoroscopía es una de las más utilizadas, con esta técnica se ha intentado describir patrones del movimiento durante la deglución, al igual que la articulografía electromagnética. Por otro lado, la electromiografía ha descrito patrones de deglución, pero en relación a la contracción y relajación de ciertos grupos musculares. Existen diferentes métodos para evaluar la deglución, cada una de estas técnicas ha permitido dilucidar de mejor forma este proceso, no obstante, es necesario una mayor cantidad de estudios comparativos que permitan resolver las dudas sobre la validez y la eficacia de las técnicas descrit

Artículos de Investigación

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