title: Clinical protocol for occlusal adjustment: Rationale and application.
abstract: BACKGROUND
  Occlusal adjustment can optimize the result of orthodontics, orthognathic surgery, and comprehensive restoration, and resolve adverse forces to the dentition that affect the entire masticatory system. Mounted diagnostic casts and computerized occlusal analysis offer complementary advantages for evaluating occlusal problems. Predictable occlusal adjustment is facilitated by precise, measured documentation of occlusal force by computerized occlusal analysis.
  
  
  METHODS
  A conservative, structural correction of a pronounced, chronic occlusal problem by additive and subtractive occlusal adjustment was performed after a previous failed occlusal adjustment. The patient's chief concerns were significant anterior teeth fremitus in maximum intercuspation and "pain in the teeth and a poor bite" after 30+ adjustments over 2.5 years.
  
  
  CONCLUSIONS
  Confirmation of specific criteria for a therapeutic occlusion resolved the anterior teeth fremitus and uneven bite. Traumatic occlusal contact on posterior teeth may elicit protective mandibular repositioning affecting anterior teeth relationships and should be considered during comprehensive diagnosis.
authors.affiliation: a Private Practice , Mill Valley , CA , USA.|b Visiting Faculty , The Pankey Institute , Key Biscayne , FL , USA.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Solow
mesh_terms: D000368:Aged; D001732:Bite Force; D002985:Clinical Protocols; D003735:Dental Casting Technique; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008310:Malocclusion / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D019558:Occlusal Adjustment; D011862:Radiography, Panoramic
keywords: Occlusion; additive occlusal adjustment; computerized occlusal analysis; diagnostic casts; occlusal adjustment; occlusal analysis; occlusion; subtractive occlusal adjustment