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CONTENTS
Introduction Important terms History Philosophies of occlusion Organization of occlusion Determinants of occlusal morphology Importance of occlusal harmony Treatment goals for occlusion to be in harmony
occlusal equilibration Occlusal interferences Occlusal Correction Therapy
Conclusion References
Introduction
oc means up
clusion means closing
occlusion
means closing up
IMPORTANT TERMS
Occlusion
The static relationship between incising or masticating surfaces of maxillary and mandibular teeth or tooth analogues (GPT 8)
Centric occlusion
The occlusion of opposing teeth when the mandible is in centric
relation. This may or may not coincide with the maximal intercuspal position (GPT-8)
Maximum Intercuspation
The complete intercuspation of the opposing teeth independent of
Articulation
History
Gliding of teeth
Millo hellman
Milo Hellaman
interdigitation
of
teeth
status
of
controlling
1.
2 School of thoughts
Gnathology Functionalism
2.
Gnathology is the Science that treats the biologics of the masticating mechanisms; that is, the morphology, anatomy,
In 1927, Harvey Stallard recognized that the teeth dictate the arc of
closure and the occluded position of the mandible. If articulators were to be used to reveal mal-occluded teeth, then "interocclusal records" would be needed to mount the casts in the centric relation position.
In 1930, Dr. Charles Stuart and Dr. McCollum developed the first
ARNE G. LAURITZEN
Direction of occlusal stresses located close to the long axis of teeth allows
movement
Ash
Max. Intercuspation & centric relation are
concident but flat areas on the depth of fossae, on which opposing cusps occlude will allow for a certain degree of freedom in both centric & eccentric movements without guiding influences of occlusal inclines
Characteristics:
i.
ii. iii.
Stable & static contacts over greatest no. Of teeth in centric relation
Long centric Group function during lateral excursions No contact on balancing side During protrusive movements, an immediate disocclusion of post. Teeth might occur
iv.
v.
DAWSONS CONCEPT
CRITERIA FOR IDEAL OCCLUSION:
i.
Stable contacts on all teeth at the level of centric relation with positioning of condyles at highest point aganist eminentia Anterior guidance must be in harmony with border movements of envelope of motion Disocclusion of all post. Teeth during protrusive movements & on balancing side Gp. Function on working side
1.
2.
3.
Dawson presented his theory of nutcracker The nut ant. Teeth is from fulcrum (condyles), lesser would be the
Concepts of occlusion
Disadvantages
desirable because of the increased amount of force that can be placed as they are near the fulcrum and force vectors.
Advantages
Distributes occlusal loads better Absence of contacts on non-working side prevents those teeth from
Disadvantages
Excessive load on posterior teeth of working side.
micron)
Anterior teeth protect posterior teeth in excursions & post. Teeth
excessive contact of the anterior teeth in maximum intercuspation, and the anterior teeth disengage the posterior teeth in all mandibular excursive movements. Alternatively, an occlusal scheme in which the anterior teeth disengage the posterior teeth in all mandibular excursive movements, and the posterior teeth prevent excessive contact of the anterior teeth in maximum intercuspation
( GPT -8)
LATERAL EXCURSION
horizontal overlap of the anterior teeth disengages the posterior teeth in all mandibular excursive movements(GPT-8)
Centric relation position and maximum intercuspation are coincident .
The posterior teeth are in a cusp fossa relationship, one tooth to one
tooth contact .
Also k/a CANINE GUIDED OCCLUSION A form of mutually protected articulation in which the vertical and
horizontal overlap of the canine teeth disengage the posterior teeth in the excursive movements of the mandible (GPT-8)
CanineGuided Occlusion
During crossover, guidance is from anterior teeth. Cuspid rise in other direction. No posterior contacts. During crossover, none of the posterior teeth on other side are contacting either.
LINGUAL OFCANINE THE CANINE RISE LINGUAL VIEW VIEW OF THE RISE
Advantages: Absence of frictional wear Minimizes horizontal loading of post. Teeth as they come in contact at
Disadvantages
Good periodontal health of anterior teeth must Angles class II or III can not be guided by ant. Teeth Cannot be used in Crossbite situations Missing / prosthetic canine
Posterior determinants
Right & left TMJ & associated structures.
Posterior determinants of occlusion. A, Angle of the articular eminence (condylar guidance angle). 1, Flat; 2, average; 3, steep. B, Anatomy of the medial walls of the mandibular fossae. 1, Greater than average; 2, average; 3, minimal sideshift.
A shallow protrusive condylar inclination requires short cusps (A), while a steeper path permits the cusps to be longer(B)
A pronounced immediate lateral translation requires that the cusps to be short (A), while gradual lateral translation allows the cusps to be longer (B).
The angle between the working (W)and the non-working path(NW) is greater on teeth located farther from the condyle
Anterior Determinants
PATIENT ADAPTABILITY
There may be differences in the adaptive response of a patient to
occlusal abnormalities.
occlusal deficiencies
muscle balance, a stressful and tiresome protective role is forced onto the muscle
teeth.
fall on teeth.
Unstable occlusion. Removal of a tooth without replacement has led to tilting and drifting.
Widened periodontal ligament space and increased mobility of mandibular molars. Occlusal premature contacts were noted in lateral and protrusive movements
Midline deviation during opening and closing movements can be indicative of asymmetric muscle activity or joint derangement. Here, during opening, less than optimal translation occurs on the patient's left side.
Occlusal treatment should be: tooth movement through orthodontics, elimination of deflective occlusal contacts
surfaces of teeth,
the restoration and replacement of missing
1.
EQUILIBRATION PROCEDURES :
Reduction of all contacting tooth surfaces that interfere with terminal hinge axis closure
2.
3.
produce mandibular deviation during closure to maximum intercuspation or may hinder smooth passage to and from the intercuspal position. (GPT-8)
Working
Nonworking Protrusive
The CENTRIC INTERFERENCE is a premature contact - occurs when the mandible closes with the condyles in their optimum
direction.
1.
2.
If the patient slides his mandible to obtain tight closure it indicates the presence of occlusal discrepancies.
an arc of closure all the way to the most closed occlusal position without any deviation off this arc.
Any tooth structure that interferes with this closing arc has the effect of
displacing the mandible forward of interference to reach the most closed occlusal position
Anterior Slide
1.
2.
both inclines
If interferences produce deviations off both arc of closure & the line of closure at same time : Upper inclines are adjusted on inclines that face the same direction as slide. Lower teeth are adjusted by grinding off inclines that face the opposite direction from path of slide.
1.
2.
A WORKING INTERFERENCE
may occur when there is contact between the maxillary and mandibular
posterior teeth on the same side of the arches as the direction in which the mandible has moved.
The potential for damaging the masticatory apparatus has been attributed to
changes in the mandibular leverage, the placement of forces outside the long axes of the teeth, and disruption of normal muscle function.
Teeth to be closed on terminal axis arc until they contact, hold onto
this position
On working side, thumb is released & all 4 fingers used to exert upward
While maintaining pressure with both hands, ask pt. To slide jaw to left
or right
interferences
Grinding rule :
BULL - grind the buccal inclines of upper or lingual inclines of lower
Protrusive interferences
A premature contact Only front teeth should touch in protrusive excursions
Occurring between the mesial aspects of mandibular posterior teeth and the
Occlusal splints, occlusal appliances or orthotics Used extensively in the management of TMJ disorder & bruxism Helpful in determining where a proposed change in a patients occlusal
matrix(autopolymerized)
Indirect procedure with autopolymerizing acrylic
resin
Indirect procedure with heat-polymerized acrylic
resin
CONCLUSION
Most restorative procedures affect the shape of occlusal surfaces.
Proper dental care ensures that functional contact relationships are restored in harmony with both dynamic & static conditions.
optimum function, minimal trauma to supporting structures, & an even load distribution throughout dentition
References
Books Iven klineberg,rob jagger; Occlusion And Clinical Practice-an Evidence-based Approach John Dos Santos Jr; Occlusion- Principles & concepts Dawson; functional occlusion From TMJ To Smile Design Dawson; Evaluation, diagnosis & treatment of occlusal problems Okeson; Shillingburg , Hobo, Whitsett, Jacobi, Brackett; Fundamentals Of Fixed Prosthodontics Rosensteil, Land, Fujimoto; Contemporary Fixed Prosthodontics
Journals
JPD1983;49;816-823 Ogawa, Ogimoto: Pattern Of Occlusal Contacts In Lateral Position:
JPD 1998;80;67
Schuyler: Factors of Occlusion As Applicable To Restorative