THE GENERAL PART

1. INTRODUCTION

Biomechanics is applied in dentistry in order to estimate the clinical results of all

elements of the stomatognathic system subjected to the action of forces that develop at this
level.

The stomatognathic system, being a multitude of structures with complex

biomechanical behaviors, with variable geometries, as well as with an insufficient knowledge
of the conditions of the adjacent tissues, estimating the response to the action of different
forces applied at this level is very difficult. However, the fundamental laws of mechanics
enunciated by the great physicist Isaac Newton can be applied at this level as well.

The application of biomechanical principles will give the clinician a better

understanding of the specific clinical situations that have arisen, helping him in establishing
the treatment plan with improved prognosis.

Spencer tells Newton the following words shortly before his death: "I don't know what
I look like in front of the world, but it seems to me that more colorful pebbles than usual, or a
red shell, while the great ocean of truth stretches unknown before me. "

"If I saw it further than others, it was because I was standing on the shoulders of some giants."

In recent decades, the treatment of edentulousness has undergone major changes due
to multiple causes, including increasing the length of maintenance of teeth on the arch,
increasing the level of dental education, the introduction of new techniques, methods and
materials, etc.

Addressing the dentist to resolve the edentulousness, many patients do not accept, at
least in the first stage, the mobilizable prosthesis, insisting on the fixed prosthesis variants,
regardless of the costs (of any nature) that they have to bear. In these cases, the doctor has the
task to examine correctly and competently the case and to establish with the patient,
depending on his particularities, the optimal treatment in the given conditions (clinical
situation, technical, material and financial possibilities, biological and functional benefit). of
the prosthesis, etc.).

Prosthetic edentulous treatment should be seen as a product of the comparative

analysis of the bio-functional advantages and disadvantages that the case implies. In addition
to the partial restoration of the functions of the stomatognathic system, a prosthetic treatment
raises a number of shortcomings related to endangering the integrity of various structures of
the stomatognathic system (eg vitality of teeth), facilitating the occurrence of other diseases
(secondary caries, periodontal disease), sometimes cost very high treatment and, last but not
least, the risk of its failure.

The partial denture over time has remained and is still a difficult field to understand in
dental prosthetics. Now, more than ever, the time has come to recognize, correct, and respect
the concepts behind treatment with partial dentures. Partial prosthesis has acquired new values
today, being indicated for several reasons:

- the average age has increased, being recovered as many teeth as possible;

-joint implants and gnathoprosthetic devices cannot always be indicated;

-represents the only solution in the case of strongly organic patients, as well as those who
have been prosthetic with implants.

The prosthetic field-prosthesis complex presupposes conditions of biomechanical

stability. The gnathoprosthetic device becomes a prosthesis when applied and integrated into
the prosthetic field system, achieving morphological completion and functional restoration of
an organ (dento-alveolar arch). In order to exercise the attributes of the organ it replaces, the
prosthesis must have a very good congruence and stability, so that it does not suffer the
prosthetic field (required on a limited portion) nor the prosthesis (which can fracture).

Fulfilling the functions of the stomatognathic system becomes possible by performing

mandibular dynamics with and without dental contact. Along with the remaining dental arch,
the adjunct gnathoprosthetic device will withstand various demands such as direction,
direction, point of application, intensity.

2. BIOMECHANICAL ASPECTS AT THE LEVEL OF THE PARTIALLY EDENTED

PROSTHETIC FIELD

The masticatory forces are transmitted through the tooth to its support structures,
neutralizing at the level of the resistance pillars at the level of the two jaws. In addition to
carious lesions, dental health is affected by traumatic forces, which are harmful not because of
the magnitude, but because of the direction. Lateral forces, which result in mucosal
resorptions, the formation of periodontal pockets, are more harmful than vertical ones.

DENTAL MANIFESTATIONS are translated primarily by changes in the position

of the teeth of the outstanding arrears. As a result, the following may occur:

-horizontal migrations of the teeth that limit the breach , these having the tendency to occupy
the edentulous space, thus producing mesializations, distalizations, vestibular rotations or
oralizations. Horizontal migrations can be done by total translation of the tooth or by
inclination, these being more frequent in the mandible. If the first molar is lost until the age of
9, the second molar can migrate, through a translational movement, and may even close the
edentulous space. After the age of 12

For years, dental migrations are frequent by tilting the crowns to the edentulous space, which
results in a non-physiological stress on the periodontium of these teeth, because the vertical
forces during mastication no longer act in the long axis of the tooth. For this reason,
inclinations above 30 ° lead to the loss of the prosthetic value of these teeth, because towards
the part where the inclination was made, pressure is exerted on the alveolus and not traction
through the periodontal fibers.

If to this reason is added the overuse in mastication of the respective teeth (to
compensate for dental absences), the loss of contact points with neighbors, as well as the
occurrence of incorrect contacts with antagonists (premature and interfering contacts), we can
understand why teeth limited to the breccia become mobile in a short time.

The cause of horizontal migration is explained by the lack of resistance of the teeth to
the horizontal forces tangent to the arches, as a result of the loss of interdental contact points
in the edentulous area. The tooth becomes isolated, and the functional occlusal stresses, which
until now could be tolerated, end up having a pathological effect on the implantation of the
tooth, thus determining the appearance of a primary trauma.

Horizontal migrations to the edentulous space lead to other complications such as: the
appearance of tremors that favor food retention, tartar deposits, caries, direct trauma of the
marginal periodontium at the interdental papilla, individual stress of teeth during chewing; by
tilting the teeth, a retentive area for food and microorganisms appears, which affects the
periodontium and the supporting tissues of the tooth; Teeth tilting makes it difficult to insert
movable prostheses or joint work.

Rotations cause problems with the placement of the hook and often require the
coverage of the tooth with microprostheses.

Lingualizations can make it difficult or impossible to insert partial dentures, especially

those with the lingual bar, and vestibularizations create exaggerated retention areas for
crochet, or even the impossibility of inserting the prosthesis.

- Vertical migrations occur at the level of the teeth antagonistic to the edentulous space. These
teeth, lacking functional stimuli, tend to migrate to space

edentate. The causes of this displacement are not fully elucidated. Vertical migration can
occur together with the alveolar process (excretion), encountered especially in teeth with
healthy periodontium, in the upper I, II molars. Following the excretion, the edentulous space
can be completely occupied, the vertically migrated teeth coming in contact with the mucosa
of the antagonistic ridge. In these situations, the prosthetic treatment has been delayed too
long and can no longer be performed without the extraction of the migrated teeth and even the
surgical remodeling of the alveoli of these teeth. Egression may also be due to excessive
periodontal osteogenic activity devoid of occlusal inhibitory stimuli. Vertical migration
without the alveolar process (extrusion) occurs mainly in periodically affected teeth,
occurring in a faster time than excretion. Vertical migrations are followed by a series of
consequences, namely: unevenness of the occlusion plane with the appearance of premature
contacts and interferences that determine the deviation or limitation of some movements of
the mandible with the occurrence of a necessity occlusion, which, if it does not affect any
stomatognathic tissue, it turns into an occlusion of habit; the disappearance of the interdental
contact points, with the appearance of the same phenomena as at the teeth bordering the gap;
the appearance of 6-year-old molar syndrome, which is due to the loss of the lower I molar
during childhood and which, due to vertical and horizontal migrations, leads to interference in
propulsion in the molars, as well as interference in lateral movement, the active side . The
forces become traumatic not because of the magnitude, but because of the direction, knowing
that the horizontal forces are the ones that determine the appearance of complications of the
stomatognathic system (mucosal resorptions, periodontal pockets, periodontal recessions

When a body is in balance, there can be no unbalanced forces acting; otherwise, it

would imprint a translational motion and cause the body to move. Sometimes forces can cause
a tooth to rotate around an axis; this is the torq movement, as found in uni- or biterminal
edentations. In order to be in balance, the torq motion will be balanced by a torq having the
same amplitude, but in the opposite direction.

PERIODONTAL EVENTS.

Each component of the periodontium (cells, fibers, fundamental substance, vessels, nerves)
contributes to the transmission of masticatory forces from the tooth to the supporting bone.
Periodontal disease can also occur through other mechanisms than those mentioned above.
Thus, the loss of a tooth affects the ligamentous apparatus of the teeth adjacent to the
edentulous, due to the disappearance of the transseptal interdental fibers, to which is added
the thinning and thinning of the bone trabeculae of the interdental septum. Sometimes, after
extraction, the osteoligamentary involution is marked, the root of the tooth next to the
edentation being exposed on a large surface, which can compromise the tooth, especially if an
occlusal trauma is added. In the case of vertically migrated teeth, due to the lack of functional
stimuli, the orientation of the periodontal fibers also disappears. They become horizontal or
have the opposite orientation to the usual one, and in the periodontal space, the unoriented
loose connective tissue predominates, which, according to some authors, causes the resorption
of the hard lamina. Periodontal fibers decrease in number, and those that remain are thinned.
The periodontal space is significantly reduced, an aspect that can be highlighted
radiographically.

Periodontal damage, as a result of edentation, can also occur at a distance, as happens

in the "Thielemann phenomenon".

If the occlusal force is within the physiological limits, a balance is maintained between
atrophy / resorption and bone apposition, which determines the preservation of the trophicity
of the tissues, especially of the bone in the sense that the trabeculation is continuous from one
hard lamina to another, parallel to the crest edge. withstands pressure. The force within the
physiological limits will increase the width of the periodontium by increasing the diameter of
the Sharpey fibers, as well as the thickening of the fibers between the root and the alveolar
bone.

Forces greater than this limit cause injuries characteristic of occlusal trauma. If the
teeth no longer make dento-dental contacts, being deprived of liminal stimuli, resorption and
atrophy phenomena appear due to the insufficient gradient of forces. In this case, the fibers
are reduced in number and intensity, eventually becoming oriented parallel to the root surface.

The fibers hold 2/3 of the periodontium volume, and 1/3 is occupied by the
fundamental substance, tissue fluid, neuro-vascular elements (1% -2%; with a tendency to
decrease with age). Most collagen fibers are arranged in binding fibers. Each fiber resembles
a rope in which each strand can continue to be reshaped, while its sheath retains its shape and
function. This remodeling allows the periodontium to adapt to continuous and repeated
stresses.

Oxytalam fibers are immature elastin fibers, which are placed along the collagen
fibers. The oxytalamic fibers form a network to which the vessels are attached to the root
cementum. Periodontal vessels are the meshes of the net placed vertically by the fibers that
form the tracts. Some researchers have hypothesized that these fibers acquire the function of
vessel support when the periodontium loses its functionality. These fibers can influence
vascularity, thus having a supporting effect on the teeth.

The basic substance contains hyaluronic acid, glycoproteins and proteoglycans;

hyaluronic acid together with the polysaccharides in proteoglycans form glycosaminoglycans.
Sulfurized glycosaminoglycans are also present in other tissues exposed to mechanical loads,
such as articular cartilage. The stiffness of the articular hyaline cartilage has been shown to be
dependent on the sulfate glycosaminoglycans present. The connection of the water to them
facilitates the ability of the articular cartilage to return to its initial position after the cessation
of the action of the compressive forces. In the fundamental substance, the percentage of 70%
water gives the periodontium the viscoelastic effect .

The main vessels inside the periodontium run parallel to the axis of the tooth, having a
path between the collagen fibers near the alveolar bone. These main vessels form a flat
surface, the network of capillaries chaining the root of the tooth similar to the basketball hoop.
These vascular elements give the periodontium the role of hydraulic system, along with the
structure of the fibers, the viscoelasticity of the fundamental substance and the extracellular
fluid.

The influence of occlusion on the periodontium

The structural and metabolic stability of the periodontal ligaments and alveolar bone
depends on the mechanical simulation of the occlusal force. The effect of occlusal force on
the periodontium depends on its amplitude, direction, duration of action and frequency. An
increase in occlusal force leads to an increase in the volume of the periodontium; duration,
frequency of occlusal force affects the balance between resorption and apposition of alveolar
bone; constant pressure favors resorption, while intermittent force will favor bone apposition.
Occlusal trauma occurs when the occlusal force is much greater than the tissue's ability to
adapt. In this case, the occlusion is traumatic, causing a decrease in the ability of the tooth to
adapt to the occlusal forces.

Primary trauma is considered when the pathological occlusal force is considered the
main cause that caused the periodontal changes.

Secondary trauma in occlusion is the set of changes that occur on a periodontium

already compromised by inflammation and bone resorption. Occlusal forces, which can be
well tolerated by a healthy periodontium, can now cause injury to the inflamed periodontium.

The application of biomechanical principles can reduce the high level of stress and the
stress that interferes in all clinical aspects. These principles must be based on the fundamental
concepts of muscle function, as well as the distribution of forces in the stomatognathic
system.

The importance of tissue fluids, vascular pressure, vascular elasticity, and viscoelastic
properties of tissues in the transfer process has been established in numerous in vitro and in
vivo studies.

These biomechanical concepts must be observed in the correct establishment of the

treatment plan, as well as in the effective prosthetic achievements. For example, the design of
adjacent gnathoprosthetic devices can reduce the concentration of unwanted stress to protect
the remaining teeth and ATM. This cannot be done without giving due weight to the
functional forces acting as well as the structures that support them.

Not only is the morphological restoration of the oral cavity important, but the
biomechanical principles must always be taken into account in order to contribute to the
harmony and good functionality of the stomatognathic system.

OCCLUSIVE MANIFESTATIONS

Due to dental migration following edentation, premature contact and occlusal

interference may occur, as mentioned. Changes in occlusal relationships occur even when a
single tooth is missing, hence the conclusion that urgent prosthetic treatment is needed.

The occlusal pathological manifestations that appear as a result of dental migrations

are varied, from the simplest to the most severe, and are the subject of the study of the
dysfunctional syndrome of the stomatognathic system.

According to some authors, loss of the teeth in the lateral support area can lead to a
decrease in the vertical size of the occlusion, with an increase in the degree of frontal
occlusion, or with vestibularization of the upper front teeth, or lingualization of the lower
ones. Even when some changes in the vertical size of the occlusion are noticed, they appeared
slowly and determined in time a readaptation of the neuromuscular system to the new
situation.
 In some cases of bimaxillary biterminal edentations, due to an exaggerated abrasion of
the remaining teeth, an occlusion ends.

Multiple factors have been suggested as causative agents in TMJ dysfunction,

including: structural abnormalities, stress-induced muscle hypertension, joint overload due to
edentulous-induced occlusal trauma, especially extensive ones treated improperly; however,
the role of occlusion remains unknown. This may be due to the specific adaptive abilities of
each patient. Some studies have suggested that the type of guidance influences muscle activity
(group function causes increased activity, while canine guidance causes its decrease).
Although the type of guidance may influence muscle activity, Selingman and Pullinger
believe that there is no link between guidance and the symptoms of ATM algodysfunction
syndrome. It seems that 2 occlusal features are related to ATM: inactive contacts and a gap
between the centric relationship and the maximum intercuspation. Mohlin and Kopp
suggested that patients with ATM dysfunction had more frequent inactive contact than
healthy patients.

Although the type of guidance influences muscle activity, there is no certainty that it
would have an impact on the treatment or prevention of TMJ dysfunction. Butler found no
difference in the frequency of cracks, joint structure, or muscle tone in 56 patients when
comparing lateral guidance types. Araoberts found no difference between patients with
meniscus movement and those with normal meniscus, regardless of the type of guidance.

Donegan found that the frequency of canine guidance in asymptomatic patients was
30% and in symptomatic patients 22%. The study by Droukas showed that symptomatic
patients with intact joints and symptomatic patients with joint meniscus movement have fewer
inactive contacts than asymptomatic volunteers with normal ATM. These results are
consistent with those of Agerberg and Sandstrom. It was considered that the number of
contacts on the balance side could not be established as an etiological factor in the occurrence
of ATM dysfunction. (as material: 82 asymptomatic volunteers and 263 volunteers with
temporo-mandibular dysfunction completed a questionnaire related to pain syndrome, cracks,
blockage of mandibular movements. Participants were examined clinically for common signs
and symptoms associated with TMJ and other of the 345 subjects, 95 were partially
edentulous, representing 28% of the total.)

Magnusson conducted a 10-year longitudinal study on 84 subjects with a mean age of

43 years at the start of the study; 41% of them were partially edentulous, and after 10 years
57% became completely edentulous. Magnusson found a 32% increase in the frequency of
contacts on the inactive side during the 10 years of the study. He believes that the number of
contacts is not an etiological factor in the occurrence of ATM dysfunction, but influences its
development.

Classically, the occlusal force depends on the periodontal health, the periodontal
support area, the height of the clinical crown, as well as the angle of contact with the
antagonistic teeth. Also particularly important is the number of occlusal stops in the side areas
of the arch. New research based on computer modeling and orthodontic studies indicate other
important variables. The musculoskeletal factor may influence the distribution of forces at the
level of the remaining teeth.

Profit showed that a person with an increased angle value between the Frankfurt plane
and the mandibular plane can generate half the occlusal force developed at the level of the
first molar, compared to an individual with a reduced value of the same angle. In addition,
Hannam and Wood showed that the occlusal force developed at the level of the first molar is
strongly influenced by the masseter muscle.

METHODS FOR QUANTIFYING THE RESPONSE OF THE ELEMENTS OF THE

EDENTED PROSTHETIC FIELD TO FORCE ACTION

1) Finite element analysis

Features:

- divides the structure into discrete elements

- the elements are connected by nodes

- the elements have the properties of the structure

- it is necessary to know the number of elements and nodes, the spatial coordinates of
the nodes, the mechanical properties of each element, as well as the specific
conditions of the adjacent tissues.

This method has the advantage of being able to accurately obtain stresses throughout
the structure under consideration. The inclusion of any type, anisotropy (different
characteristics) and inhomogeneity (heterogeneity) is conceptually possible by inserting the
specific properties of materials at the nodes of the elements. This is plausible but, from a
practical point of view, the mechanical properties of the structures tooth, periodontium, bone,
mucosa are not well known. Finite element analysis is not limited to a simple geometric
configuration. The main factor that may limit the application of the finite element method is
the inability to accurately specify the conditions of boundary tissues (eg the specific forces
acting on partial dentures during its functionalization and the relative movements of the
abutment teeth and supporting mucosa are virtually impossible to reproduce).

For example, in the case of the mathematical simulation of the behavior of the bone
tissue in the case of the partially removable prosthesis, the three-dimensional representation of
the bone tissue, the dental tissue and the periodontium of the abutment will be taken into
account.
 In order to follow the stress distribution on the abutment teeth in the case of
edentulation class I Kennedy treated with a partially removable skeletal prosthesis retained by
means of cast hooks , the finite element method was used. Studiul (European Cells and
Materials Vol. 9. Suppl. 1, 2002 (pages 1-2) ISSN 1473-2262- Stress Distribution In
Abutment Teeth Involved In The Treatment With Removable Partial Dentures - A Finite
Elements Analysis Lavinia Ardelean 1, Liliana Sandu 1, Cristina Bortun 1 & Nicolae Faur 2)
was made in two distinct situations. In the first case, the elements of maintenance, support and
stabilization of the prosthesis were represented by the Ackers open dental hook applied on the
premolar 2, while in the second case a Bonwill double hook was used applied on the upper 1.2
premolars, at both hemiarcades. . The calculation model highlighted the stress distribution on
the abutment teeth under the action of occlusal forces. The resistance structure of the
abutment teeth was discretized into 10416 elements. Considering that the biomechanics of the
partial prosthesis whose tilting movement cannot be reversed, the leverage effect on the
abutment teeth induced by the terminal saddle was simulated. The computer program was
able to make it possible to evaluate the stress distribution at the level of the abutment teeth
under the action of occlusal forces, evaluated by the Mises equivalent stress. The distribution
of the equivalent stress was represented by the color spectrum, each color representing a
certain value of the equivalent stress. In the first case, of the location of the Ackers hook at
the level of the upper premolar 2, the results of the analysis indicate that the maximum value
of the recorded stress was 11,697Mpa, with a stress concentration near the support area with
the prosthesis. In the second situation, of the location of the Bonwill hook on the upper 1.2
premolars, the maximum equivalent stress has a much diminished value (4,481 MPa at the
level of premolar 2 and 4,392 MPa at the level of premolar 1.). In this case the stress is
distributed throughout the prosthesis and the values are insignificantly higher in the area of
the premolar 2 and distal to the first premolar, near the occlusal support point, but without
massive stress concentrations.

2. Photoelasticity

The analysis of stress by the photoelasticity method is based on the property of

transparent materials to expose color patterns when they are crossed by polarized light. These
patterns are the result of altered polarized light by internal stresses in two waves that have
different speeds. This phenomenon of double refraction is known as birefringence. The
patterns that develop depend on the internal stress and are called the photoelastic effect. For
this purpose, a model made of transparent material capable of exposing a photoelastic
response is made when the analyzed body is subjected to the action of force and develops
internal tensions.

The method has the following advantages:

- stress can be determined in models with very different shapes, such as the oral cavity;

- the stress resulting from the load complex (such as the masticatory force and the forces
produced by the prosthetic restorations) can be determined;
- the stress can be observed through the whole model, in this way the magnitude of the stress
can be located.

From the point of view of the modeling concept, two main considerations are taken
into account:

1. is the account of the geometric reproduction of the situation. The model may reflect all or
part of the three-dimensional fidelity. Also, the model can be made either life-size or larger or
smaller.

2. the second consideration of the modeling is represented by the simulation of the mechanical
properties of the studied system. It is not possible to model all the mechanical properties of
the element structures. The decision must therefore be made on the basis of the most relevant
property.

Types of photoelastic analysis

- two-dimensional;

- three-dimensional;

- quasi-three-dimensional.

dimensional photoelastic analysis uses a model that maintains its geometric fidelity in
a single plane, for example the sagittal plane of the tooth. It can be applied when there are no
variations of the eraser in the thickness of the model.

The advantages of this method are:

- ease of making the model;

- applying a very large number of loads on the model;

- different gnathoprosthetic devices can be tested on the model.

The main disadvantage is the impossibility of reproducing the three-dimensional geometry of

the oral cavity.

Three-dimensional photoelastic analysis

Among the advantages of the method are highlighted both the geometric fidelity and
the three-dimensional image of stress, and the disadvantages, the destruction of the model for
obtaining data, the need to make separate models for each load, limit the frequent use of the
method. The method uses a specific property of plastic models: when they are loaded at
specific high temperatures and the loads are maintained while the temperature gradually drops
to 20 ° C (room temperature) the stresses remain after the loads have been removed. This
stress-blocking procedure is called stress freezing.

To determine the three-dimensional stresses, the model must be cut into thin slices.
Each section is analyzed separately, the analysis of all sections allowing the construction of
the three-dimensional image of stress. Sometimes it is necessary to cut the model for each
load and for each removable gnathoprosthetic device, and for this reason the decision to use
this method will be made only if a high level of clean information is desired.

Quasi-three-dimensional photoelastic analysis This method arose from the desire to

minimize the disadvantages of the photoelasticity techniques presented above.

A conclusive example was demonstrated by the correlation between the three-

dimensional model and the histological characteristics in the case of the root of the lower
canine following its movement by tilting. Where the tension was observed in the photoelastic
model, the corresponding histological material highlighting the elongation of the periodontal
fibers. If the photoelastic pattern indicates pressure, histological examination reveals
compression of the periodontal fibers. The photoelastic, homogeneous, hydropic model could
predict the cellular response in case of tilting the root distally of the lower canine root. This
fact demonstrates that the photoelastic technique is useful in elucidating the biomechanical
principles in dental prosthetics. The stomatognathic system presents great difficulties in
interpreting, analyzing, as well as measuring the effects of the application of forces at the
level of each of its elements. These difficulties include structures with complex, variable
mechanical behavior, geometry, and unspecified boundary tissue conditions. The application
of the exposed principles will allow the clinician to better understand the specific situations
that arise, in the future it will be possible to improve the treatment plan and the prosthetic
therapeutic solutions.

BIBLIOGRAPHY

1. Design of metal frames to prevent rocking movements of partial removable prostheses

K. Joullie, C. Nublat, J. Margerit, Prosthesis Notebooks March 2003 Nr. 12
2. The Effect Of Occlusal Rest Size And Shape On Yield Strength - Yuuji Sato, Dds, Phd,
Nobuaki Shindoi, Dds, Phd, Katsunori Koretake, Dds, Phd, And Ryuji Hosokawa, Dds,
Phd The Journal Of Prosthetic Dentistry Volume Number 5, May 2003.
3. Stewart K, Rudd K, Keubker W. Clinical removable partial prosthodontics. St. Louis:
CV Mosby Co., 1983: 65.
4. Indirect retention JC Davenport, RM Basker, JR Heath, JP Ralph, PO. Glantz and P.
Hammond February 10 2001, Volume 190, no. 3.
5. Age-related Changes in Brain Regional Activity during Chewing: A Functional
Magnetic Resonance Imaging Study M. Onozuka, M. Fujita, K. Watanabe, Y. Hirano,
M. Niwa, K. Nishiyama, and S. Saito J Dent Res 82 ( 8): 657-660, 2003
6. Human Masticatory Muscle Forces during Static Biting J. C. Nickel, LR Iwasaki, RD
Walker, KR McLachlan, and WD McCall, Jr. J Dent Res 82 (3): 212-217, 2003
7. Number Crunching with the Human Masticatory System Jan Harm Koolstra Department
of Functional Anatomy-ACTA, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands
J Dent Res 82 (9): 672-676, 2003
8. The removable partial denture equation JC Davenport, RM Basker, JR Heath, JP Ralph
and P. Glantz A Cinical Guide to Removable Partial Dentures (ISBN 0-904588-599)
and A Clinical Guide to Removable Partial Denture Design (ISBN 0-904588- 637).
9. Occlusal Considerations in Determining Treatment Prognosis By Richard T. Kao, DDS,
PhD; Raymond Chu, DDS; and Donald A. Curtis, DMD 2000 Journal of the California
Dental Association.
10. Biomechanics of the Human Temporomandibular Joint during Chewing M. Naeije, and
N. Hofman Department of Oral Function, Section of Oral Kinesiology, Academic
Center Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The
Netherlands; J Dent Res 82 (7): 528-531, 2003
11. Stresses in mandibular cortical bone during mastication: biomechanical considerations
using a three-dimensional finite element method. Hirabayashi M, Motoyoshi M,
Ishimaru T, Kasai K, Namura S. Department of Orthodontics, Nihon University School
of Dentistry, Tokyo, Japan.
12. Analysis of the prevalence of different topographical characteristics of the residual ridge
in mandibular free-end arches Carlos Gramani Guedes; Artêmio Luiz Zanetti, Pedro
Paulo Feltrin Braz. oral res. vol.18 no.1 São Paulo Jan./Mar. 2004
13. Dental prosthetics - V. Burlui, Course-1989, Iași
14. Gnatologie- V.Burlui, Cătălina Morăraşu- Apollonia Publishing House, Iași, 2000
15. Clinic and laboratory technique of skeletal prosthesis, A. Ionescu, National Publishing
House, 2000
16. Clinic and therapy of extended partial edentation, V.Burlui, Norina Forna, Ed.
Apollonia, 2004