J Appl Oral Sci 2003; 11(4): 311-8

KINESIOGRAPHIC STUDY OF MANDIBULAR

MOVEMENTS DURING FUNCTIONAL
ADAPTATION TO COMPLETE DENTURES
ESTUDO CINESIOGRÁFICO DOS MOVIMENTOS MANDIBULARES DURANTE
O PERÍODO DE ADAPTAÇÃO FUNCIONAL A PRÓTESES TOTAIS

Cláudio Rodrigues LELES

Professor, Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.

Marco Antonio COMPAGNONI

Professor, Department of Dental Materials and Prosthodontics, Araraquara Dental School, São Paulo State University, Araraquara, São
Paulo, Brazil.

Raphael Freitas de SOUZA

Graduate student, Department of Dental Materials and Prosthodontics, Araraquara Dental School, São Paulo State University, Araraquara,
São Paulo, Brazil.

Débora Barros BARBOSA

Graduate student, Department of Dental Materials and Prosthodontics, Araraquara Dental School, São Paulo State University, Araraquara,
São Paulo, Brazil.

A fter complete denture insertion, edentulous patients usually present transitory difficulties. This is one of the
most critical stages of prosthetic treatment and it is strongly related to the prostheses acceptance. The aim of this
study was to evaluate potential changes in the mandibular movement pattern related to insertion of the complete
denture during the functional adaptation period. The kinesiograph instrument K6-I (Myotronics Research Inc.,
Seattle, WA) was used to evaluate eight edentulous patients that received conventional complete denture treatment.
Recordings of opening and closure movement limits, movement velocity, postural rest position, chewing cycle and
limits of eccentric movements were performed. Each patient was evaluated in four different stages: with the old
dentures, immediately after insertion of the new dentures, and 30 days and 6 months after insertion of the dentures.
The results showed that there were no remarkable changes in the mandibular motion patterns after insertion of the
new dentures. It was suggested that the problems related to the process of utilization of new dentures are not strictly
associated to the mandibular movement. Therefore, functional adaptation after denture insertion is not directly
related to functional changes, but to the quality of the dentures and to individual features.

UNITERMS: Complete denture; Patients; Kinesiography.

INTRODUCTION factors may reduce the patient’s comfort and satisfaction

and influence the wearing of complete dentures on a daily
Denture insertion is the summit of all clinical procedures basis4,19.
of denture construction and is eagerly awaited by both patient Fish5 observed that these initial difficulties are caused
and clinician20. However, after denture insertion, a set of by alterations in the tongue position relative to the oral
adaptive difficulties can emerge. Transitory problems like mucosa, restriction of the space available for the tongue,
masticatory impairment, mandibular incoordination, load transmitted to the supporting tissues, changes in muscle
excessive salivary flow and phonetic troubles are common, proprioceptive impulses, and alteration of vertical facial
even if the denture is well planned and constructed1. Pain height and mandibular rest position.
related to the denture-bearing tissues and faults in denture After this transitory period, the patients acquire a
retention or stability are frequently observed, mainly due to neuromuscular control that compensates eventual
occlusal imbalance, incorrect vertical dimension and deficiencies of the prostheses and maintain long-term
occlusion, or improper contour of the denture base8. These functional balance and comfort16.
311
 KINESIOGRAPHIC STUDY OF MANDIBULAR MOVEMENTS DURING FUNCTIONAL ADAPTATION TO COMPLETE DENTURES

Several factors that influence this adaptation period were a computerized system was used to graphically record the
studied in the natural dentition, such as the vertical mandibular movements. This system has a sensor array
dimension 3,6,13,14,22, oral sensory threshold12 and occlusal (Figure 1) and a 12x6x3mm magnet tracking device (Figure
status30. Research methods include clinical evaluation, 2) that records the spatial three-dimensional position of the
electromyography and kinesiography. mandible during functional movements.
The study of mandibular movement dynamics is not new, Kinesiographic analysis was divided into three different
but only in the 70’s Jankelson, et al.7 introduced the periods of time: (1) immediate, (2) short-term and (3) long-
kinesiograph as an instrument for diagnosis and clinical term. Immediate period was evaluated with old and new
research in dentistry. This instrument was largely used for dentures.
monitoring dentate individuals, although few studies were 1. Immediate: during the denture insertion visit and after
conducted for complete denture patients. Tallgren, et al.27,28 the intraoral adjustments. Assessment of transition between
observed that patients without posterior dental support new and old dentures was recorded in the same visit.
perform irregular movements and the insertion of immediate Measurement series were coded as STAGE I (old dentures),
maxillary dentures opposed to mandibular removable partial and STAGE II (new dentures). Stage I was considered the
dentures restored functional occlusion state and significantly
improved the mandibular movement pattern. Additionally,
a two-year longitudinal study showed that the range of
movement is considerably reduced, probably due to the
progressive loss of retention of the dentures28. Other
kinesiographic studies highlight the importance of the quality
of the denture for restoration and maintenance of the chewing
pattern and cyclic mandibular movements9,10,25.
The aim of the current study was to evaluate, by means
of a kinesiographic instrument, the functional changes of
mandibular movement parameters associated to insertion
of new dentures, during different stages of adjustment of
the patients to complete dentures.

MATERIAL AND METHODS

Completely edentulous patients who attended the
Araraquara Dental School and were treated with complete
dentures were randomly selected. Inclusion criteria included
patients who needed new dentures, mentally receptive
individuals, absence of dysfunctional disorders of the
masticatory system, normal volume and resilience of the
residual edentulous ridges, and absence of debilitating
systemic diseases.
Patients were selected to receive upper and lower
conventional complete dentures constructed according to a FIGURE 1- Sensor array in position
standardized protocol as described by Russi, et al.23 The
Ethics Committee of the school has approved the research
project and an informed consent term was obtained from
the patients before any experimental procedure.
Eight patients met the criteria and were selected for the
study. Six were female and two were male, age ranging from
37 to 77 years (mean age: 61 years). The mean time of
denture usage was 29 years.
After completion of clinical treatment, during the
insertion visit, the quality of retention and stability, comfort
and esthetics were tested. Points of occlusion were
selectively ground and possible pressure spots were
disclosed with a pressure indicator paste and relieved. After
clinical adjustments, kinesiographic analysis was performed
in the same appointment.
A kinesiographic instrument (K6-I Diagnostic System-
FIGURE 2- Magnet tracking device attached to the midline
Myotronics Research Inc., Seattle, WA, USA) connected to
labial surface of the mandibular denture

312
LELES C R, COMPAGNONI M A, SOUZA R F de, BARBOSA D B

pre-insertion pattern of mandibular movement. RESULTS

2. Short-term (STAGE III): to avoid confounding
factors, like sore points that might occur during the post- The results of recordings are listed in Table 2-11,
insertion period, recordings were made after the last follow- according to scan tracings.
up visit, when complete adaptation to the dentures had been
achieved. The estimated maximum time interval for this stage
was 30 days after insertion of the denture. DISCUSSION
3. Long-term (STAGE IV): about six months after
insertion of the dentures. Satisfactory function and comfort are related to a
The mean time interval elapsed between stage II (denture balanced occlusion, correct vertical dimension and proper
insertion) and stage III was 30 days (range: 18 – 32 days), base extension 4. Regardless of general health condition and
and between stage II and IV was 170 days (range: 156 – psychological traits, the quality of the dentures and other
231 days). local favorable aspects are good predictors of treatment
Five tracing modes (scan) were selected for recordings. success2. Nevertheless, functional adaptation to dentures has
Description of mandibular movements and respective tracing multidimensional aspects and consequences that influence
modes are summarized in Table 1. the patient’s satisfaction. Patients must be aware that, after
Recordings were performed according to the insertion of the dentures, a new muscular behavior may
manufacturer’s instructions and three reproducible develop in order to control the functional activities12,15,16.
measurements were recorded for each scan mode. Nearly 60% of denture wearers achieve satisfactory function
Descriptive statistics were performed and comparative within a week after insertion and about 20% within one
analysis was made using the non-parametric Wilcoxon month1.
signed ranks test, at a confidence level of 5%. Data analysis Functional parameters to be considered after dentures’
was done with the Statistical Package for the Social Sciences insertion include patients’ subjective appraisal of
software (SPSS 10.0 for Windows, SPSS Inc., 1999). dentures15,16, chewing efficiency16,29, masticatory frequency
and muscular coordination 15,16, chewing cycle consistency15,
and occlusal perception 11. Previous studies suggest that all
these parameters significantly improve after the post-
insertion period because a compensatory neuromuscular

TABLE 1- Preprogrammed scan numbers corresponding to scan tracings

Scan Description

1 Normal opening and closure of mandibular movement

2 Speed of the mandible during opening and closure
3 Three-dimensional movement of the mandible from rest position to maximal occlusion
8 Three-dimensional movements of the mandible during chewing. Test food – a cube of 15x10x10mm cured polysulfide
(Permlastic Regular – Kerr Corporation, USA)
13 Sagittal and frontal range of motion during maximum opening, closure and lateral movements of the mandible.

TABLE 2- Mean opening mandibular movement recorded in the sagittal plane (in millimeters)

Patient Stage I Stage II Stage III Stage IV

1 56.7 57.8 56.9 57.3

2 56.8 60.3 59.5 57.8
3 41.4 35.8 45.6 42.1
4 27.6 27.2 35.5 42.6
5 66.0 50.6 55.6 54.1
6 41.2 47.5 49.3 47.7
7 47.0 38.2 48.4 45.9
8 54.2 54.9 54.2 59.2

313
 KINESIOGRAPHIC STUDY OF MANDIBULAR MOVEMENTS DURING FUNCTIONAL ADAPTATION TO COMPLETE DENTURES

modification is developed by the patients11,15,16,16,29. However, functional activities17.

these factors are not related to the mandibular coordination Periodontal and temporomandibular joint receptors play
or extension of mandibular range of movement. It is better an important role in controlling occlusal forces and
explained by the patients’ ability to cope with difficulties, mandibular movements, respectively17. Even if periodontal
learning capability and continuous reinforcement of proprioception is absent, as in the edentulous patient, the

TABLE 3- Mean deviation from midline during opening mandibular movement in the frontal plane (in millimeters)

Patient Stage I Stage II Stage III Stage IV

Right Left Right Left Right Left Right Left

1 0.3 14.2 0.5 14.0 0.1 13.7 0.5 7.8

2 0.2 13.7 2.4 12.7 1.5 6.1 1.4 6.0
3 2.9 4.6 4.2 2.3 1.4 5.7 1.6 4.3
4 0.4 6.5 0.1 7.0 0.1 9.7 0.4 3.1
5 0.2 10.4 1.7 10.8 1.4 9.0 2.1 6.2
6 0.9 9.7 0.5 16.1 0.6 12.7 1.1 3.3
7 0.3 8.3 0.6 4.3 0.9 8.9 0.8 3.7
8 0.2 9.8 1.4 11.1 2.1 3.5 1.9 2.7

TABLE 4- Maximum and mean mandibular speed during opening movement (in millimeters per second)

Patient Stage I Stage II Stage III Stage IV

Max. Mean Max. Mean Max. Mean Max. Mean

1 177.1 91.6 152.5 76.3 134.6 75.9 143.8 84.2

2 191.6 107.2 260.8 151.1 276.7 159.1 188.0 182.9
3 120.4 60.7 129.6 76.2 86.3 48.8 135.9 65.7
4 103.8 60.7 83.8 53.3 127.5 74.6 208.4 120.4
5 140.0 79.9 117.5 77.9 120.4 76.1 112.5 69.2
6 230.5 138.1 180.9 108.8 137.5 80.3 131.3 71.7
7 65.5 36.5 82.5 43.8 75.4 54.5 113.4 70.0
8 133.8 88.0 161.4 77.4 150.1 72.8 210.0 185.0

TABLE 5- Maximum and mean mandibular speed during closure movement (in millimeters per second)

Patient Stage I Stage II Stage III Stage IV

Max. Mean Max. Mean Max. Mean Max. Mean

1 145.4 70.5 90.4 53.6 117.1 51.6 108.3 52.4

2 141.1 74.2 250.5 136.1 219.2 123.8 200.5 109.4
3 120.0 67.5 122.1 76.1 107.9 62.4 132.5 75.1
4 95.5 53.5 69.2 34.7 78.8 41.5 95.7 51.0
5 168.4 102.8 139.6 72.8 132.1 79.9 127.1 73.7
6 104.2 61.8 113.4 66.0 91.7 59.3 66.7 42.8
7 81.7 40.2 65.0 36.6 83.8 36.0 66.3 33.4
8 76.3 45.3 66.2 39.3 59.5 31.9 288.3 156.0

314
LELES C R, COMPAGNONI M A, SOUZA R F de, BARBOSA D B

masticatory dynamics remains unaltered because chewing insertion of maxillary immediate denture and mandibular
is controlled by a central neural generator that modulates extension-base removable partial denture. This improvement
rhythmic activities17,24. can be affected by the retention of the dentures28.
The present study reveals that the insertion of dentures Another factor that influences adaptation to new
does not alter the pattern, speed and limits of nonfunctional dentures is the change in occlusion. Investigations in dentate
movements. In contrast, Tallgren et al. 28 observed individuals show that modifications in occlusal guidance
improvement in mastication and range of movement after significantly alter lateral border movements21. Nevertheless,

TABLE 6- Speed of terminal contact during closure movement of mandible (in millimeters per second)

Patient Stage I Stage II Stage III Stage IV

1 17.9 9.2 8.8 7.1

2 13.9 15.8 25.9 26.4
3 7.9 14.2 10.4 20.4
4 12.1 12.9 3.0 4.2
5 12.9 14.2 18.8 15.4
6 20.8 21.3 15.9 8.8
7 14.0 12.9 8.4 5.4
8 4.2 1.9 6.7 7.9

TABLE 7- Mean vertical (V), anteroposterior (AP) and lateral (L) movement between rest position and intercuspal position (in
millimeters)

Patient Stage I Stage II Stage III Stage IV

V A-P L V A-P L V A-P L V A-P L

1 6.0 2.5 0.3 2.0 0.9 0.1 0.8 0.9 0.4 1.5 1.3 0.1
2 2.9 1.9 0.4 3.2 1.9 0.6 3.6 2.1 0.6 3.6 2.1 0.6
3 1.4 0.5 0.1 1.3 0.7 0.1 1.4 0.2 0.2 2.3 0.9 0.4
4 5.1 5.1 1.3 2.8 2.1 0.6 3.7 2.4 0.8 3.9 2.8 0.3
5 12.1 5.7 0.4 3.3 2.5 0.3 2.2 1.6 0.1 2.7 0.5 0.2
6 7.1 3.9 0.8 3.1 3.1 0.2 2.0 1.4 0.1 1.9 1.9 0.4
7 7.5 4.8 1.5 2.9 2.4 0.3 2.6 1.7 0.3 3.6 2.4 0.2
8 3.6 3.0 0.8 2.2 0.8 0.3 1.4 1.3 0.8 5.0 4.1 0.9

TABLE 8- Mean vertical mandibular movement during chewing (in millimeters)

Patient Stage I Stage II Stage III Stage IV

1 7.2 9.2 6.2 8.8

2 11.0 9.2 13.5 13.4
3 6.0 4.8 6.3 13.1
4 11.0 12.6 9.9 11.4
5 14.2 10.4 8.6 11.3
6 7.5 11.0 9.0 6.7
7 8.7 7.2 6.9 7.0
8 9.9 10.6 7.1 8.3

315
 KINESIOGRAPHIC STUDY OF MANDIBULAR MOVEMENTS DURING FUNCTIONAL ADAPTATION TO COMPLETE DENTURES

it is not possible to reach any conclusion on the clinical CONCLUSION

significance of these changes if complaints are not detected
and overall comfort, esthetic satisfaction and functional Within the limitations of this study, it was concluded
improvement are achieved. that the pattern of mandibular movement does not
The most significant modifications are related to the demonstrate significant changes between the pre and post-
vertical dimension. The consequences are variations in insertion stages of utilization of complete dentures.
muscular activity, rest position of the mandible and Functional transitory problems after insertion of the denture
consequently in the interocclusal distance, observed in may not be associated to changes in the coordination of the
dentate6,13,14 and edentulous patients.18,26 However, it is well mandibular movement.
recognized that minor or gradual moderate changes in
vertical dimension do not cause deleterious problems if a
stable and well distributed occlusion is achieved3. ACKNOWLEDGMENTS
It can be suggested that adaptation to new dentures is
not closely related to functional changes. Intrinsic denture This research was supported by The State of Sao Paulo
problems and individual subjective problems related to the Research Foundation (Fapesp – Grant no. 99/06609-8).
patient may play a major role during the post-insertion
process. Consequently, a careful appraisal of clinical and
psychological conditions and a realistic outcome of the RESUMO
treatment are important aspects of patient management. A
comprehensive treatment planning is essential for a Após a instalação de próteses totais, o paciente desdentado
satisfactory post-insertion period and long-term success of geralmente enfrenta dificuldades transitórias. Esse estágio é
treatment. um dos mais críticos durante o tratamento protético desses
pacientes, estando relacionado à aceitação das próteses. O
presente estudo teve como objetivo avaliar as possíveis

TABLE 9- Mean range of anterior (protrusive) and lateral movements (in millimeters)

Patient Stage I Stage II Stage III Stage IV

Ant. Right Left Ant. Right Left Ant. Right Left Ant. Right Left

1 8.1 9.8 6.6 6.7 7.3 8.3 4.4 10.5 8.8 7.2 10.2 9.7
2 3.5 10.6 10.2 2.9 13.8 6.9 2.6 12.1 9.5 2.0 12.4 9.7
3 2.9 3.4 2.2 2.0 6.7 1.7 7.0 4.8 2.4 10.0 8.8 7.7
4 3.2 4.7 5.9 6.7 4.1 9.1 7.1 1.0 8.4 7.1 5.8 7.5
5 4.8 7.9 4.0 9.8 10.3 4.3 11.5 9.7 5.8 9.4 11.5 4.7
6 5.9 5.8 1.2 5.0 5.6 0.4 6.8 5.0 2.3 5.4 5.9 4.9
7 6.5 5.6 7.2 7.3 8.9 6.7 1.8 9.9 4.4 7.9 10.3 8.2
8 4.3 5.5 5.8 4.1 5.8 4.3 9.1 8.0 7.6 7.0 7.1 8.1

TABLE 10- Mean distance (range of movement) between intercuspal position and maximum opening (in millimeters)

Patient Stage I Stage II Stage III Stage IV

1 51.2 54.7 49.9 47.0

2 55.7 62.2 57.3 59.7
3 37.4 38.6 40.0 45.0
4 35.3 28.3 36.8 43.1
5 62.8 54.4 56.1 49.8
6 55.3 48.5 49.7 41.4
7 41.1 38.8 40.6 42.8
8 47.3 49.9 50.5 41.8

316
LELES C R, COMPAGNONI M A, SOUZA R F de, BARBOSA D B

alterações no padrão de movimentos mandibulares decorrentes REFERENCES

da instalação de próteses totais em indivíduos desdentados,
durante o período de adaptação funcional. O sistema de 1- Berg E. Acceptance of full dentures. Int Dent J 1993; 43: 299-
diagnóstico cinesiográfico K6-I (Myotronics Research Inc., 306.
Seattle, WA) foi empregado para avaliação de 08 pacientes
que foram previamente tratados para confecção de próteses 2- Brunello D, Mandikos M. Construction faults, age, gender, and
relative medical health: factors associated with complaints in
totais. Foram realizados registros da amplitude do movimento
complete denture patients. J Prosthet Dent 1998; 79: 545-54.
mandibular de abertura e fechamento, velocidade do
movimento mandibular durante a abertura e fechamento, 3- Carlsson G, Ingervall B, Kocak G. Effect of increasing vertical
movimento da mandíbula entre a posição de repouso postural dimension on the masticatory system in subjects with natural teeth.
e a máxima intercuspidação, movimento da mandíbula durante J Prosthet Dent 1979; 41: 284-9.
a mastigação e registro do limite de movimento mandibular de
abertura e fechamento, lateralidade e protrusão. Os pacientes
foram avaliados com as próteses antigas, no período imediato 4- Fenlon M, Sherriff M, Walter J. Association between the
à instalação das próteses e nos períodos de aproximadamente accuracy of intermaxillary relations and complete denture usage.
J Prosthet Dent 1999; 81: 520-5.
30 dias e 6 meses pós-instalação. Os resultados demonstraram
que o padrão dos movimentos mandibulares pouco se altera 5- Fish S. Adaptation and habituation to full dentures. Br Dent J
entre os períodos pré e pós-instalação e entre diferentes estágios 1969; 127: 19-26.
após a instalação das próteses totais, o que sugere que as
dificuldades funcionais após a instalação de próteses totais não 6- Garnick J, Ramfjord S. Rest position. An electromyographic
estão relacionadas a alterações no padrão de coordenação dos and clinical investigation. J Prosthet Dent 1962; 12: 895-911.
movimentos mandibulares. Assim, a adaptação dos pacientes
após a instalação de próteses totais não se relaciona 7- Jankelson B, Swain C, Crane P, Radke J. Kinesiometric
propriamente a alterações funcionais do paciente, mas a instrumentation: a new technology. J Am Dent Assoc 1975; 90:
834-40.
características intrínsecas das próteses e a aspectos subjetivos
individuais. 8- Jeganathan S, Payne J. Common faults in complete dentures: a
review. Quintessence Int 1993; 24: 483-7.
UNITERMOS: Dentadura completa; Pacientes;
Cinesiografia.

TABLE 11- Result of measurement contrasts

Recordings Comparison between clinical stages

I-II I-III I-IV II-III II-IV III-IV

Range of opening movement

Right deviation during opening movement
Left deviation during opening movement * * *
Maximum speed during opening movement
Mean speed during opening movement
Maximum speed during closure movement
Mean speed during closure movement
Speed of terminal tooth contact
Vertical interocclusal space in rest position * *
Anteroposterior movement between rest position and intercuspal position * *
Lateral movement between rest position and intercuspal position
Vertical movement during chewing
Anterior movement limit
Right lateral movement limit *
Left lateral movement limit *
Range of movement between intercuspal position and maximum opening

*Statistically significant difference (p<0.05)

317
 KINESIOGRAPHIC STUDY OF MANDIBULAR MOVEMENTS DURING FUNCTIONAL ADAPTATION TO COMPLETE DENTURES

9- Jemt T, Hedegård B, Wickberg K. Chewing patterns before and 26- Tallgren A, Holden S, Lang B, Ash Jr M. Jaw muscle activity
after treatment with complete maxillary and bilateral distal- in complete denture wearers – a longitudinal electromyographic
extension mandibular removable partial dentures. J Prosthet Dent study. J Prosthet Dent 1980; 44: 123-32.
1983; 50: 566-70.
27- Tallgren A, Tryde G, Mizutani H. Changes in jaw relations
10- Jemt T, Stålblad P. The effect of chewing movements on and activity of masticatory muscles in patients with immediate
changing mandibular complete dentures to osseointegrated complete upper dentures. J Oral Rehabil 1986; 13: 311-24.
overdentures. J Prosthet Dent 1986; 55: 357-61.
28- Tallgren A, Mizutani H, Tryde G. A two-year kinesiographic
11- Langer A, Michman J. Occlusal perception after placement of study of mandibular movement patterns in denture wearers. J
complete dentures. J Prosthet Dent 1968; 19: 246-51. Prosthet Dent 1989; 62: 594-600.

12- Manly R, Pfaffman C, Lathrop D, Keyser J. Oral sensory 29- Vinton P, Manly R. Masticatory efficiency during the period
thresholds of persons with natural and artificial dentitions. J Dent of adjustment to dentures. J Prosthet Dent 1955; 5: 477-80.
Res 1952; 31: 305-12.
30- Wood W, Gelfant H, Hannam A. Effect of occlusal
13- Manns A, Miralles R, Guerrero F. The changes in electrical reconstruction on the reproducibility of chewing movements. J
activity of the postural muscles of the mandible upon varying the Prosthet Dent 1981; 46: 181-4.
vertical dimension. J Prosthet Dent 1981; 45: 438-45.

14- Michelotti A, Farella M, Vollaro S, Martina R. Mandibular Recebido para publicação em: 26/02/2003
rest position and electrical activity of the masticatory muscles. J Enviado para reformulações em: 26/06/2003
Prosthet Dent 1997; 78: 48-53. Pronto para publicação em: 28/07/2003

15- Michman J, Langer A. Clinical and electromyographic

observations during adjustment to complete dentures. J Prosthet Adress:
Dent 1968; 19: 252-62. Cláudio R. Leles
Faculdade de Odontologia da UFG, Departamento de Prevenção
16- Michman J, Langer A. Postinsertion changes in complete e Reabilitação Oral
dentures. J Prosthet Dent 1975; 34: 125-34. Praça Universitária, s/n, Setor Universitário
CEP 74.605-220 Goiânia-GO
17- Mohl N. Neuromuscular mechanisms in mandibular function. e-mail: crleles@odonto.ufg.br
Dent Clin North Am 1978; 22: 63-71.

18- Morimoto T, Abekura H, Tokuyama H, Hamada T. Alteration

in the bite force and EMG activity with changes in the vertical
dimension of edentulous subjects. J Oral Rehabil 1996; 23: 336-
41.

19- Morstad A, Petersen A. Postinsertion denture problems. J

Prosthet Dent 1968; 19: 126-32.

20- Nagle R. Postinsertion problems in complete denture

prosthesis. J Am Dent Assoc 1958; 57: 183-7.

21- Nishigawa K, Nakano M, Bando E, Clark G. Effect of altered

occlusal guidance on lateral border movement of the mandible. J
Prosthet Dent 1992; 68: 965-9.

22- Rugh J, Drago C. Vertical dimension: a study of clinical rest

position and jaw muscle activity. J Prosthet Dent 1981; 45: 670-
75.

23- Russi S, Lombardo G, Compagnoni M, Nogueira S. Prótese

Total. Manual de Laboratório (Teoria e Prática). Araraquara:
Faculdade de Odontologia; 1982.

24- Schindler H, Stengel E, Spiess W. Feedback control during

mastication of solid food textures - a clinical-experimental study.
J Prosthet Dent 1998; 80: 330-6.

25- Shi C, Ouyang G, Guo T. A comparative study of mastication

between complete denture wearers and dentate subjects. J Prosthet
Dent 1991; 66: 505-9.

318