The oral movement trajectories have been studied in a patient with cleft palate to evaluate masticatory capability by monitoring the patient's orofacial movements during mastication of a color-developing chewing gum. In designing a prosthesis for this patient, who presented an overclosure and a retruded maxillary dental arch, oral-movement trajectories at different stages of treatment were tested and compared, i.e., at stage A, before prosthetic treatment ; at stage B, while using a temporary overdenture ; at stage C, using the final prosthesis ; and at stage D, one month after insertion of the final prosthesis.
To monitor orofacial movements, a light-emitting marker that recorded as a shining point with a clear outline when illuminated by a cold spotlight provided trajectory data for the following reference points : the modiolus (Mo), the menton (Me), and the incisal point (IP), which was represented by a point on a wire extending from the lower incisors teeth to the outside of the mouth. Use of an image processor enabled the recording and auto-tracking of multiple reference points.
During 250 strokes of chewing, the subject's face markers were recorded on videotape by two high-speed TV cameras from two different perspectives, i.e., frontally and laterally. After every 50 strokes, the color of the chewing gum was assessed by a Chroma Meter (CR-300, Minolta Co.) with respect to the degree of redness or a* value, one of the coordinates of the L*a*b* color evaluating system. Thus, the same chewing gum was continuously chewed for a total of 250 strokes, with the a* value measured at the end of every 50 strokes.
The videotape recordings of the start of the first period (1F) and the end of each period (1L-4L) were then reproduced on high-speed video and fed into an image processor (Image Data ID-8000, nac) that automatically tracked the movements of each marker, after which the resulting data of the three-dimensional (3-D) coordinates were fed into a computer.
Then, the trajectory of each monitored point for each 16-second period was computed with a 3-D analyzer (Movias 3D) with reference to the following parameters : the total length from start to finish of the trajectory (TL); the distance between the start and finish of the trajectory (SL); the ratio of the TL to the SL (T/S); the volume of the rectangular solid encompassing the entire trajectory (the cubical range); and the mean of the 3-D angles that were created by differences in the direction of the preceding and following trajectories for each measured time point (TH).
Our results have revealed that the time needed for one chewing cycle during the stages decreased gradually from 1F to 4L and at stage D the time needed were significantly shorter (p<0.01) than at stage A. Similarly, the TLs and the THs of the IP, Me, and Mo during the closing phases were significantly smaller (p<0.01) at stage D than at stage A. These findings indicate that as occlusion improves, the range of mouth movements becomes narrower and the trajectories become smoother and more converged.
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