Dental Tribune United Kingdom Edition

‘The smallest oc- clusal interference of just a few mi- crons is disruptive to the propriocep- tors of the stomato- logical system’ 19ClinicalMarch 11-17, 2013United Kingdom Edition page 20DTà T he correct physiologi- cal restoration of oc- clusion poses a major challenge for every dentist and technician. Even the smallest high spot, measuring just a few microns, can cause dysfunction in a patient’s mas- ticatory system. In restorative dentistry, occlusal propor- tions are constantly chang- ing. It is therefore essential, for the benefit of the patient, to understand and monitor the function of teeth in static and dynamic occlusion. Func- tional occlusion is important for the overall health of the patient. The interdisciplinary verification of symptoms and treatment is an integral part of daily practice. Therefore, checking the occlusion during treatment is strongly encour- aged. Occlusion and the potential effects of occlusal interfer- ence on patients Every restoration, extraction, prosthetic device and ortho- dontic treatment changes the static and dynamic occlusion. The smallest occlusal inter- ference of just a few microns is disruptive to the proprio- ceptors of the stomatological system. This can cause brux- ism (clenching or grinding), which can result in functional disorder of the cranio -man- dibular system. Overstraining teeth, periodontium, muscles and joints are the effects. It is important not only to detect, but also to avoid fur- ther functional disorder in the cranio-mandibular system. The smallest interference to habitual occlusion can cause serious disturbances for the patient. An acute functional disorder such as clenching or grinding can become chronic in the long term. Patients with new fillings, crowns and bridges, or who have undergone orthodon- tic treatment, who complain of typical symptoms (cranio mandibular dysfunction syn- drome) should undergo ex- amination of their occlusion specifically. Premature con- tacts are often uncomfortable, as the proprioceptors are sen- sitive to pressure. The patient will try to compensate for the occlusal interference by adopting a new habitual po- sition, with consequences for the attached tissue structures. Position for occlusal restoration Essential to any kind of oc- clusal restoration is the po- sition of the mandible. Most patients are treated in their habitual position of the man- dible, which is the correct po- sition for most patients. For patients with more complex restorations or patients suffer- ing from temporomandibular joint disorders, a new physi- ological positioning of the mandible is essential. In most cases, centric occlusion is the new therapeutic position. The importance of occlusion Peter Bausch discusses occlusion and function