Occlusion and prosthodontics.
Occlusion in prosthodontics is extremely important. Muscle dysfunction can interfere with prosthodontic restoration of occlusion. Occlusal interferences are the primary cause of the hyperactivity that cause muscle dysfunction. Occlusal interference can also place adverse stress on restorations and result in premature failures. Lateral stresses on restorations can cause cement failures, porcelain fractures, and solder joint failures. Our goal in prosthodontics is to restore occlusion that is occlusal interference free. This article gave an overview of how this can be done in phases. In Phase I, a diagnosis is made as to the presence or absence of muscle dysfunction. If it is present, the OIs are hidden. Occlusal splint therapy is needed to get rid of the muscle dysfunction so the OIs can be found. The occlusal splint diagnosis whether OIs are the cause of the dysfunction. The cure is to correct the occlusion. The restoration of the occlusion should be OI free. The various factors to consider in design and restoration of the occlusion were presented. After successful restoration of the occlusion, the recall appointments should include an evaluation of the occlusion. The PRI, COS, and clinical examination can all be helpful in diagnosing whether muscle dysfunction is developing and whether OIs are developing again as a result of the normal changes that can occur. Suggestions were made on how to slow these changes. This article was not meant to cover every aspect of prosthodontic occlusion in detail. The goal was to present an overview for readers to make a self-evaluation as to what areas of their practice might need to be improved to improve the restoration of the occlusion. All was not taught in dental school. As one practices and improves in skill, more knowledge and abilities must be sought through graduate and postgraduate education. Occlusion is too important for a successful practice and happy patients to be ignored. Time will make this obvious; however, the failures may be costly. The best approach would be to anticipate the failures and prepare yourself to reduce the risks. Occlusal interferences are truly the plague of dentistry.
Clayton
J A
JA
Department of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, USA.
D001732:Bite Force; D003767:Dental Occlusion, Balanced; D003769:Dental Occlusion, Traumatic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008410:Masticatory Muscles / Q000503:physiopathology; D017090:Occlusal Splints; D011476:Prosthodontics; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000517:prevention & control