Sunteți pe pagina 1din 4
paper deals with a period in dentistry in which we have both been D R.
paper deals with a period in dentistry in which we have both been D R.
paper deals with a period in dentistry in which we have both been D R.
paper deals with a period in dentistry in which we have both been D R.

paper

deals with

a period

in dentistry

in which

we

have both

been

D R. Hardy’s active

participants,

and

it

is

with

pleasure

that

I

join

him

briefly

 

in

a

dis-

cussion

of nonanatomic

posterior

tooth forms.

 

The advent

of new

ideas very

often

inspires

effusive

reactions

and

I

am sure

that Dr.

Hardy

will

agree with

me when

I

say

that

this

has been particularly

 

true

 

.

in dentistry

when

anyone

has been bold

enough

to present,

or

even support,

the

idea that nonanatomic

typks

of posterior

 

tooth

forms

might

better

meet

 

the

re-

quirements

for artificial

dentures

than would

the anatomic

types.

Progress

does

not

usually

result

from

strict

adherence

to

tradition.

It

is

fortunate

that

in most

groups

there

are

a few

individuals

who

are willing

to assume

the

roll

of pioneers

in

an attempt

to improve

upon

widely

accepted

concepts

rc-

gardless

of the immediate

reaction

of their

associates.

This

has been particularly

true

of such

men

as

Dr.

\?ctor

Sears and others

whom

Hardy

has mentioned.

Tt is my personal

opinion

that

Sears

made one of the really

tooth,

great

principally

contributions

because

of occlusion,

areas

for

and

As

when

of the influence

bo?h in natural and artificial

centric

their

a result

to dentistry

he brought

out the “chamiel

form

dentures.

;ireas

similar

of selective

posterior”

which

this tooth

had on our present

These

for

teeth

the various

concepts

to

occlusions

day concepts

provided

tccentric

all tooth

specific

occlusion

use

led

and other

specific

occhlsions,

occlusions.

to the

idea of applying

in terms

we began

to think

and selective

spot grind-

ing in the correction

of malocclusions,

instead

of the hit+nd-miss

tnethods

which

had previously

been employed.

 

\Vh\-

should

we

concern

ourselves

about

the occlusa!

surface

forms

of

arti-

ficial posterior

teeth when

nature

has already

given

us posterior

occlusal

patterns

which,

in normal

natural

dentures,

are admittedly

superior

in masticating

efficiencv

to any artificial

substitute

which

we could hope to devise?

 

The

answer

which

I

would

give

to

this

question

would

be influenced

l)];

the

fact

that

the support

which

is provided

to artificial

denture

bases

by

edrntulous

ridges

is entirelv

different

from

that

provided

to natural

dentures,

and

also 1,~ the

fact that

edentuious

ridges

undergo

constant

morphologic

changes,

whether

or

not

nrtifici:Ll

tlenturcs

art’

IGig

worn.

j’\s

prostliotlontist~,

we

are

facet1 \vith

the

Read before the American Denture Society, Atlantic Receiwtl for publication, Dec. 16, 1950.

City, N.J

Octobel~. 19X

the Read before the American Denture Society, Atlantic Receiwtl for publication, Dec. 16, 1950. City, N.J
problem of constructing artiticial btti)stittttes for natural cletttttres \\,hich \\31 best .*erve their intended
problem of constructing artiticial btti)stittttes for natural cletttttres \\,hich \\31 best .*erve their intended

problem

of constructing

artiticial

btti)stittttes

for

natural

cletttttres

\\,hich

\\31

best

.*erve

their

intended

~~ttrl~ose under

conditions

which

art

Ixe-est;~l~lishetl

;t~~il

ttsttall\~

vet-1. ut~favoral~le.

 

_

\\‘hen

an engineer

is called tt~)n

tcl design

a machine

to accomplish

:t sl)ecitic

purpose

it is expected

that

he

will

also design

or

designate

3 foundation

for

thr

machine which will properly

support

its

\vorking

parts

itt

cbrder that

they

ma!

accomplish

Natttrv

\-cry

support

along

their

efticient

their

tlitl

intended

jttFt

that

masticator!.

purpose.

when

tmits;

she provided

she also

units.

ff

the

human

dental

mechanism

with

of

provided

it

were

for

a highly

not f&the

plan, human

specialized

fact that

beings

dentures.

txl)e

for each of these \vorltittg

the line there

natural

teeth,

somewher!:

N-ould

retain

has been a break

and there

nould

in Sature’s

he no

need

artificial

The

human

dental

dental

legs.

l)owerful

arches

constitute

In

the presence

rif

influence

upon

mechanism

one leg and the tenlporomandibular

is actually

a tripod

in

\vhich

joints

uf the

the

the other

teeth

occluding

two

natural

jaw

dentures

relationshil)s.

the intercuspation

even to

exerts

trattnta

the extent

of causitq

a

of the tem~~oroeutntlil~ular

joint

in some

cases

of occlusal

disharmony

:

hut

when

the natural

teeth

are

lost

in

one

or

both

jaws

it

I)ecnmes

advisable

to accept

the

tet~~yoromai~dil,ular

joints

as the principal

guiding

factors

if

we

are to minimize

the shifting

of artiticial

denture

bases.

Artificial

dentures

cailnot

and should

not

lbe expected

to exert

the 5:tnie directing

influence

upon

jaw

relation5

as

did

the

natttral

dentures.

 

Time

will

not

permit

elaborating

upon

this

point

here,

hut

I

recommend

that

ample

time

be devoted

to

the study

of

“The

Xatttre

of

the

Temporo~~~andibul;ir

Joint-

as it Affects

Artificial

Denture

Construction.”

In effect

the tetnporomarttlil)-

ttlar

joint

is comparable

to a mechanical

joint

in which

the condyle

rests

against

a resilient-like

pad, \vhile

being maintained

in this position

by strong

rtthber

hantls,

and with

to visualize the multiplicity

that wi~ttld be possible when varying

ntore

or

less

freedom

of trtoretnent

of changes,

from

degres

of

to

the

to indicate

ridge

in the horizontal

the

rest

strains

position

joint

plane.

of

is

of the guiding

tripod

in

It

is

cask

a11

a cotid~lc.

are placed upon the condyle.

to

\vhirh

such

\lthough

such

it

a comparison

does

serve

to the mandil~ular

temporomandihular

the nature

1,. two

a degree

alwtw

exaggeration,

are supplied

influences

the

legs of the dental

of rigid

guiding

influences

from

the dental arches.

 

The

centric

occlusion

of

unaltered

anatontic-type

])osterior

teeth

is

cwt-

I!aral)le

to

;L I)all

resting

part

way

down

in ;I conical-like

cup.

Surli

art r)cclttsioti

is the equivalent

of

a point

in space.

and would

result

only

when

the approaching

occlusal surfaces

were

directed

1)~

precision-like

guidances.

The

human

dental

mechanism

does

not

furnish

such

precise

closing

guidances

to either

natural

or

artificial

teeth.

 
 

Tn the

case

of artificial

dentures,

especially,

it

is logical

to assume

that

the

use

Uf

occlusal

patterns,

which

offered

centric

occlusion

areas

instead

of

centric

occlusion

points

only,

would

result

in less denture

base movement

on the edentulous

ridges. Clinical experience proves this assumption   to be true, and no doubt ac-

ridges.

Clinical

experience

proves

this

assumption

 

to

be true,

and

no doubt

ac-

counts

for

the fact

that

a growing

number

of prosthodontists

are using

nonanatomic

posterior

tooth forms

on artificial

dentures.

 

It

has

been

my

esperience

that

the

use

of

certain

nonanatomic

posterior

tooth

p;:tterns

and

arrangements

have

resulted

in

better

denture

base

stability

and comfort

to the patient

over

a longer

period

of time

than

I

have been a.hlc to

ol)tain with

conventional

anatomic

types.

 

.Uthough

many dentists

adhere rigidly

to the use of anatomic

occlusal

patterns,

it

has

been

my observation

that

many

artificial

dentures,

in which

anatomic

type

posteriors

have been used,

present

posterior

occlusal

surfaces

which

are definitely

nonanatomic

in form

by

the time

the dentures

have heen

adjusted

to the functional

rquirements

of the patient.

 

;I11 artificial

surfaces

offer

dentures

seem to fmiction

better

centric

occlusion

contacts

\vhich

are

when

not

their

limited

posterior

to

one

occlusal

specific

static

jaw

relation

at

a given

vertical

dimension.

Unaltered

anatomic

posterior

teeth

do not

meet this

requirement.

It

would,

however,

he

a comparatively

simple

nlatter

for

tooth

manufacturers

to

improve

the

present

anatomic

types.

in

this

regard.

with

a very

slight

alteration

of their

manufacturing

molds.

1 have

stressed

the centric

occlusion

feature

of artificial

teeth

hecatlse,

anti

T believe

that

most prosthodontists

will

agree with

me, the majority

of full

denture

 

patients

develop

the habit of depending

primarily

upon centric

occlusion

for

the mas-

tication

of food.

This

is,

no doul)t,

due

to the

facr that,

in most

the!

crperience

less clrnture

I)ase movement

in the centric

occlusion

cases at least, range.

\Ye

sl~oultl,

therefore,

plan

the centric

occlusion

of artificial

teeth

so that

it

offers

areas

instead

of

limited

point

contacts,

while

at

the

same

time

offering

a

reasonable

degree of masticator\-

efficiency

in the centric

occlusion

range

of the

arti-

ficial

dentures.

In

addition

 

to

this

function,

artificial

occlus:~l

patterns

should

contribute

to

denture

base

stability

and

retention,

as well

as contribute

to

the

fa~orabk

distribution

of forces

which

result

from

masticatory

function.

In

this

regard

1 have

fomltl

that

a slight

modification

of

the general

principles

of

arti-

ficial

denture

occlusion

as advocated

1)~

Pleasure.

13oswel1, and Kurth

to

he

ver!

adv:mt:tgeous,

not

only

because

it

contributes

to

mandibular

base

stability

and

retentioir,

hit

also

hecause

it

tends

to

direct

functional

masticatory

forces

onto

those areas of the mandibular

ridge which

seem best

aide

to receive

and resist

them.

 

1 am glad

to find

that

Hardy’s

posteriors

are applicable

to this type of occlusion.

Although

Hardy’s

posteriors

are

a

bold

departure

from

conventional

concepts,

they

do seem

to offer

many

desirable

features.

They

not

only

provide

a wide

range

of centric

occlusion

contact

hut

they

also offer

a high

degree

of masticating

efficiency

within

this

area, with

a minimum

of

closing

force

being

required.

 

I

have

not

as l-et

used

Hardy’s

posteriors

on

practical

cases,

hut

T expect

to

da

so

as

soon

as they

are

available

in the desired

shades

and molds.

I

was

glad

to

from

note that

these

Hardy

teeth.

made special

relerence

T would

suggest

that

to the possibility

he keep

the

cutting

of tongue

irritation

blades

a sufficient

special relerence T would suggest that to the possibility he keep the cutting of tongue irritation
tlis;tance from the lingual surfaces hlatles in the lingual of the t&l1 to guarantee against
tlis;tance from the lingual surfaces hlatles in the lingual of the t&l1 to guarantee against

tlis;tance from

the lingual

surfaces

hlatles in the lingual

of

the t&l1

to guarantee

against

ftittlrr

c~spg.,r~~

of the cutting

area as woiild

occur

ironI

the weariljg

;~u‘;~j , I(

tlw plastic material

in this

arm.

 
 

‘l’hose

of

IIS who

have

usrtl

plastic

posterior

teeth

k.nr~~ that

they

(10 ,IXA;LI

away

quite

rapidly-

in some mouths.

 

This

wear

would,

of cow-se,

1~: advantagruu5

in

the

areas

between

the cutting

Hades

because

it

would

tend

to inipvc

their

cutting efficiency,

as occurs

of rodents.

It

would

not

he desirahk

in the lingual

areas

because

\vith the incisors oi tht. possil)ilitv

of future

tollpe

irritation.

This

iz

especially

true

in the mouths

of those

patients

who

 

do

not

return

to

the

psi-ho-

dentist

for

periodical

examinations,

as all artificial

denture

wearers

should.

 

It

has

heen my

observation

and

experiedce

that

we

dentists

are

p-one

to

theorize

new

ideas out of existence,

so far

as \ve are concernetl

at least,

hut T have

learned

that

this

is

a very

pm-

policy.

\I7e must

not

forget

that,

accortliil~

II)

themy

alone, the l~mlk

bee lmitively

cannot fly,

but

1 am sure th:lt

there xc

those of iis who can testify to the fact that he actually tl4-m so with efficiency.

vet-y itnprezsi\ I.

Clinical experience still rrnlains

one of our best sources of iniorination

r(.-

garding new ideas. The best of artificial

comprot~lisrs, hut

directions.

assmle the roll of researchers, in the interests of the patients whom \ve are privi-

leged to serve.

dentures are actually the result of man!

conqmmises

us, therefore,

which have been made ia the most favoraltlc

as members of the American

‘Denture Society,

Let

1801

EYE

%TEET,

N.W

\ir.ci~r~~~~o~,D.C.