29. Methods for functional evaluation of masticatory system. Gnatho-dynamometrics. Static methods. Dynamic functional methods.
Covers how the masticatory system is assessed before prosthetic treatment, starting with the clinical functional examination and its six groups of orthopaedic tests. It then describes gnathodynamometry for measuring biting force, followed by static methods that estimate chewing ability from the teeth present, using a tooth chart with chewing coefficients and worked subtraction for missing antagonists. Dynamic methods such as chewing tests, masticatiography, EMG and occlusal analysis are tabulated, and the note closes with the myotatic and nociceptive masticatory reflexes.
Topic 29 of 75 in the MU Sofia syllabus for Preclinics of Dental Prosthetics (Dental Medicine, Year 2). The free AceMed note covers it in 5 sections, about 296 words (3 min of reading), with 15 flashcards.
In this note
Introduction
Clinical functional examination
Gnathodynamometry
Static methods
Dynamic functional methods
Introduction
Before any prosthesis, the clinician has to know how well the masticatory system works and whether it has a disorder. Diagnosis means telling one disease from another: first, whether the complaints come from a temporomandibular disorder (TMD) at all, then which kind.
Clinical functional examination
It starts with a questionnaire and history, then examines active movements (the patient moves), passive movements (the examiner moves the jaw), traction and translation of the mandible, compression of the joints and resistance tests. The main clinical tool is palpation of muscles and joints.
Six orthopedic tests
To make the diagnosis reliable between examiners, six groups of tests are used:
Gnathodynamometry
A gnathodynamometer measures the biting force between upper and lower teeth. The patient bites on a sensor with an adjustable central bearing point, at the incisors or at the molars. It shows the maximum bite force and, compared with normal values or the other side, how much chewing power the patient has lost.
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