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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Erschienen in:

07.03.2022 | Original Article

A three-dimensional method to calculate mechanical advantage in mandibular function

Intra- and interexaminer reliability study

verfasst von: Alejandro Sánchez-Ayala, DDS MS, Prof. Dr. Alfonso Sánchez-Ayala, DDS MS PhD, Rafaela Cristina Kolodzejezyk, DDS, Prof. Vanessa Migliorini Urban, DDS MS PhD, Prof. Manuel Óscar Lagravère, DDS MS PhD, Prof. Nara Hellen Campanha, DDS PhD

Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Ausgabe 5/2023

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Abstract

Purpose

Masticatory muscles are physically affected by several skeletal features. The muscle performance depends on muscle size, intrinsic strength, fiber direction, moment arm, and neuromuscular control. To date, for the masticatory apparatus, only a two-dimensional cephalometric method for assessing the mechanical advantage, which is a measure for the ratio of the output force to the input force in a system, is available. This study determined the reliability and errors of a three-dimensional (3D) mechanical advantage calculation for the masticatory system.

Methods

Using cone-beam computed tomography images from teenage patients undergoing orthodontic treatments, 36 craniofacial landmarks were identified, and the moment arms for seven muscles and their load moment arms (biomechanical variables) were determined. The 3D mechanical advantage for each muscle was calculated. This procedure was repeated by three examiners. Reliability was verified using the intraclass correlation coefficient (ICC) and the errors by calculating the absolute differences, variance estimator and coefficient of variation (CV).

Results

Landmark coordinates demonstrated excellent intra- and interexaminer reliability (ICC 0.998–1.000; p < 0.0001). Intraexaminer data showed errors < 1.5 mm. Unsatisfactory interexaminer errors ranged from 1.51–5.83 mm. All biomechanical variables presented excellent intraexaminer reliability (ICC 0.919–1.000, p < 0.0001; CV < 7%). Interexaminer results were almost excellent, but with lower values (ICC 0.750–1.000, p < 0.0001; CV < 10%). However, the muscle moment arm and 3D mechanical advantage of the lateral pterygoid muscles had ICCs < 0.500 (p < 0.05) and CV < 30%. Intra- and interexaminer errors were ≤ 0.01 and ≤ 0.05, respectively.

Conclusions

Both landmarks and biomechanical variables showed high reliability and acceptable errors. The proposed method is viable for the 3D mechanical advantage measure.

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Titel: A three-dimensional method to calculate mechanical advantage in mandibular function
Intra- and interexaminer reliability study
verfasst von: Alejandro Sánchez-Ayala, DDS MS
Prof. Dr. Alfonso Sánchez-Ayala, DDS MS PhD
Rafaela Cristina Kolodzejezyk, DDS
Prof. Vanessa Migliorini Urban, DDS MS PhD
Prof. Manuel Óscar Lagravère, DDS MS PhD
Prof. Nara Hellen Campanha, DDS PhD
Publikationsdatum: 07.03.2022
Verlag: Springer Medizin
Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Ausgabe 5/2023
Print ISSN: 1434-5293
Elektronische ISSN: 1615-6714
DOI: https://doi.org/10.1007/s00056-022-00378-7

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A three-dimensional method to calculate mechanical advantage in mandibular function

Intra- and interexaminer reliability study