Evaluation of occlusal forces using T scan analysis following mandibular fracture fixation

Vishal Kulkarni; Hemant Gupta; Swati Gupta; Sirsendu Ghosh

doi:10.4103/njms.njms_143_22

Evaluation of occlusal forces using T scan analysis following mandibular fracture fixation

Natl J Maxillofac Surg. 2023 Jan-Apr;14(1):35-40. doi: 10.4103/njms.njms_143_22. Epub 2023 Apr 14.

Authors

Vishal Kulkarni¹, Hemant Gupta², Swati Gupta³, Sirsendu Ghosh⁴

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Command Military Dental Centre, Lucknow, Uttar Pradesh, India.
² Department of Oral and Maxillofacial Surgery, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India.
³ Department of Prosthodontics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India.
⁴ Department of Biostatistics, Command Military Dental Centre, Lucknow, Uttar Pradesh, India.

Abstract

Introduction: Mandible receives maximum impact following maxillofacial trauma. The dentate segment in particular is of importance as it has a direct bearing on the occlusive forces. The studies that have been carried out are either based on crude clinical evaluations or make use of elaborate and labor-intensive techniques. This study made use of T-scan analysis for objective identification of occlusive forces following mandibular fracture fixation.

Materials and methods: Eighty clinic-radiologically diagnosed cases of dentate segments of the mandible were considered, after random sampling method. The occlusion analysis was done by use of a T scan to obtain Relatively Occlusal Force. The procedure was repeated at 04-, 24-, 36-, and 48-weeks intervals. The data was recorded on Excel Spreadsheet (Microsoft Inc) and analysis was done using SPSS software.

Results: The cases were predominantly males with a homogenous distribution of cases of age. The age versus gender distribution was more skewed in the female subgroup with a higher kurtosis value. Both evaluative (Pearson's) and inferential (paired t) tests were applied to reason the study. It was observed that the ROF values decreased in values as compared to pre-operative/post-treatment (Difference of Mean = 2.19, SE = 2.13) compared to 4 (Difference of Mean = -0.40 SE = 0.188),24 (Difference of Mean = -1.22, SE = 0.24) and 36 (Difference of Mean = -3.24, SE = 0.30) weeks, which however surpassed the pre-operative levels at 48 weeks post-operative period. This is suggestive of impending muscular imbalance in the initial periods. The surpass of 48 weeks may be due to optimal forces that were their pre-trauma.

Conclusion: Mandibular fracture fixation is the most widely used and also a time-tested modality in the management of mandibular trauma. The evaluation of occlusive forces needs an understanding of their behavior following such fixation. The present study used T-scan analysis to objectify such forces and added extra insight apart from clinical evaluations of tooth contact and parafunctional movements.

Keywords: Mandibular fracture; T scan; occlusal forces; post-fixation; post-trauma; trauma.