by Clayton A. Chan, DDS
This short posting appear originally on the former genR8TNext internet forum under the subject: Re: [CROWNS] TMD/Wear, No Anterior Guidance on Monday, September 04, 2000 9:44 AM
Anterior breakage, bruxism, disclusion, no disclusion, function vs. parafunctional are concerns that we dentists are faced with in our everyday practices, especially when dealing with aesthetic concerns.
I pose the questions even to myself, why the breakage, why the strains? Dental material companies have done a marvelous job at researching and improving the materials and choices we have in this day and age of dentistry. Adhesive strengths, bonding capabilities, types of materials used, etc. have given us aesthetic oriented dentists choices beyond our wildest dreams. The manufacturers of dental materials continue to work on technology to keep pace with the demands and requirements of durability and longevity.
AN UNDERLYING CAUSE
The human masticatory system is a dynamic system. If the natural dentition also breaks down, chips, fractures, wears out its own original enamel through normal or even abnormal demands, then why would we want to continue to build something on the tooth structures to withstand against forces that sometimes are more powerful than just the excursive or protrusive interfering forces. Eichner (1964), found that the maximum biting forces can be six times as great as the chewing forces which are applied when food is being masticated. The highest forces occurred in the intercuspal positions. Attempting to keep anterior forces and contacts to a minimum is good, yet it sometimes impacts the aesthetic look of ideal lengths of anterior incisors. We all have learned that restoring the anteriors with even the strongest dental materials still takes its toll over time with chips, fractures, breakage, fatigue and abnormal wear, when we do not address the underlying cause of optimal physiologic mandibular positioning. Check with nature! When the masticatory muscles are calm and function at its optimal resting length, as I have posted in the past, “HAPPY MUSCLES DON’T BREAK TEETH”. Again, if the muscles are “happy” the patient will NOT brux!
© 2009 Clayton A. Chan, DDS. All Rights Reserved.