OCCLUSION

By Clayton A. Chan, D.D.S.

The Subject of OCCLUSION:

GNM Optimized
OC Occlusion/TMD Courses
MYOCENTRIC
Truth About Centric Relation: An Evolving Term

Dental occlusion is defined as: “The act of bringing the mandibular teeth into contact with the maxillary teeth.”

“Occlusion \a-kloo΄shun\ n (1645): 1. the act or process of closure or of being closed or shut off; 2. the static relationship between the incising or masticating surfaces of the maxillary or mandibular teeth or tooth analogues;” [Glossary of Prosthodontic Terms GPT 9].

OCCLUSION – Is no longer a mystery

Acentric occlusion: “a condition in which the habitual voluntary closer pattern of the mandible does not coincide with centric relation, producing primary premature tooth contacts in the centric path of closure.” – Dorland’s Medical Dictionary, 26th Edition.

The act of closure.
The state of being closed.
An obstruction.
The relation of the maxillary and mandibular teeth when in functional contact during activity of the mandible…

I define it as:

Occlusion is the ACT of closing to a terminal contact.
OCCLUSION is the “thinking process” before you do the irreversible deed.”

As dentists…

We all know how to examine and prep teeth. . .
We know how to fill and crown teeth. . .
We know how to bond teeth. . .
We know how to grind on and adjust teeth. . .
We know how to clean teeth. . .
We know how to do root canals. . .
We know how to image teeth. . . Identify decay, failing margins. . .
Extractions
We know how to take impressions. . .
Implant teeth. . . Etc.

Your patient’s occlusion is ACTing in one of the following ways:

Supportive – It acts in a healthy way – Stable
Destructive – It acts in an unhealthy way – Unstable.
OCCLUSION is the UNSEEN ACTOR.

YOU can control the kind of occlusion you provide your patients!

QUESTION TO ASK ONESELF:

How is your patient’s occlusion acting? It is either acting in a healthy comfortable manner….or is it acting in a manner that is unhealthy, uncomfortable, contributing to muscles strains, joint issues that destroys the surrounding structures and your restorative dentistry? For some TMDer’s occlusion contributes to disability of their bodily functions – impairs normal healthy function and living quality of life. This is why occlusion matters! One can learn how to resolve the grinding and stop the clenching or one can ignore it.

Each groove, each fossa, each ridge height on the occlussal surface must function in very particular ways in order to allow muscles, joint/condyle disc and jaw positioning to occur whether positively or negatively. it all matters. If there are high spots the patient feels during the chewing cycle, the muscles will not calm down.

. . . . So what else is there to know?

MOST DENTISTS HAVE NEVER TAKEN AN OCCLUSION COURSE or Really Learned It Completely!

All dental occlusion courses are valuable to any clinically oriented dentist who is mindful of TMD issues. Good dentists to learn both gnathologic based occlusion concepts as well as neuromuscular based concepts. Any occlusion course that trains dentists how to implement micro occlusal adjustments both intra orally and extra orally on removable anatomical appliances in a detailed manner (cusp fossa) relationships vs. gross removable of occlusal form would be hugely beneficial to understanding complex TMD patient cases.

Dentists don’t always have to agree on philosophies, but they will need to meet the needs of complicated TMD cases who present with masticatory dysfunctions, joint derangement and pain. Patient’s don’t worry about occlusal philosophies, but more importantly they are looking for a clinical result to stop their suffering of pain, masticatory dysfunctions and joint problems that contribute to failing restorative/prosthetics, implant and orthodontic treatment.

All dentists should learn how to find and identify the terminal contact position that is physiologic vs. pathologic as well as occlusally manage all functional jaw relationships involving Class II division 2, anterior open bite, TMJ primary and cervical neck issues that effect the occlusal schemes.

HOW COMPLETE IS YOUR OCCLUSAL and TMD UNDERSTANDING TO DEAL WITH THE MORE COMPLEX PROBLEMS IN DENTISTRY?

Failures will continue when they don’t understand these fundamental bio-physiologic occlusal issues that must be learned if one desires clinical success and stability. Stable occlusion should not be considered optional, especially when dealing with the more complex TMD comprehensive full mouth cases.

Maximum dental improvement with physiologically stable occlusion is the goal to homeostasis of the gneuromuscular (GNM) system.

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www.occlusionconnections.com

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