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Dental Clinics of North America Apr 1998Despite volumes of publications on the theory of occlusion, occlusal design, and equilibration techniques, there have been few well-designed human studies directed at... (Review)
Review
Despite volumes of publications on the theory of occlusion, occlusal design, and equilibration techniques, there have been few well-designed human studies directed at answering the question does occlusal trauma modify the progression of attachment loss in periodontitis. The articles reviewed indicate that occlusal forces can cause changes in the alveolar bone and periodontal connective tissue both in the presence and in the absence of periodontitis. These changes can affect tooth mobility and clinical probing depth. Although occlusal forces do not initiate periodontitis, results are inconclusive as to if or how these forces affect attachment loss owing to plaque-induced inflammatory periodontal disease. Although some studies reported a relationship between increased attachment loss and tooth mobility, others found no relationship between attachment loss and abnormal occlusal contacts. Tooth mobility results from a variety of factors, including alveolar bone loss, attachment loss, disruption of the periodontal tissues by inflammation, widening of the PDL in response to occlusal forces (physiologic adaptation), PDL atrophy from disuse, and other processes that effect the periodontium. Therefore, any relationship found between tooth mobility and progressing periodontitis does not necessarily implicate or defend occlusion as a cofactor in the progression of inflammatory periodontal disease. Periodontitis can be treated and periodontal health maintained without occlusal adjustment and in the presence of traumatic occlusal forces. Statistically greater gains in clinical periodontal attachment level have been reported, however, when occlusal adjustment was included as a component of periodontal therapy. The extent to which this is clinically meaningful is unclear. Once periodontal health is established, occlusal therapy can be used to reduce mobility, to regain bone lost owing to traumatic occlusal forces, and to treat a variety of clinical problems related to occlusal instability and restorative needs. The clinician's decision whether or not to use occlusal adjustment as a component of periodontal therapy should be related to an evaluation of clinical factors involving the patient's comfort and function and not based on the assumption that occlusal adjustment is necessary to stop the progression of periodontitis.
Topics: Adaptation, Physiological; Alveolar Process; Bite Force; Connective Tissue; Dental Occlusion; Dental Occlusion, Traumatic; Disease Progression; Humans; Occlusal Adjustment; Periodontal Attachment Loss; Periodontal Ligament; Periodontitis; Tooth Mobility
PubMed: 9597338
DOI: No ID Found -
British Dental Journal Dec 2001Periodontal disease does not directly affect the occluding surfaces of teeth, consequently some may find a section on periodontics a surprising inclusion. Trauma from...
Periodontal disease does not directly affect the occluding surfaces of teeth, consequently some may find a section on periodontics a surprising inclusion. Trauma from the occlusion, however, has been linked with periodontal disease for many years. Karolyi published his pioneering paper, in 1901 'Beobachtungen uber Pyorrhoea alveolaris' (occlusal stress and 'alveolar pyorrhoea'). (1) However, despite extensive research over many decades, the role of occlusion in the aetiology and pathogenesis of inflammatory periodontitis is still not completely understood.
Topics: Animals; Dental Occlusion, Traumatic; Humans; Occlusal Adjustment; Periodontal Diseases; Periodontal Splints; Periodontitis; Tooth Mobility
PubMed: 11770945
DOI: 10.1038/sj.bdj.4801245 -
General Dentistry 2015
Topics: Dental Occlusion; Dental Occlusion, Balanced; Dental Stress Analysis; Humans; Malocclusion; Middle Aged; Occlusal Adjustment
PubMed: 26545269
DOI: No ID Found -
International Journal of Dental Symposia 1994Implant-Protected Occlusion is that occlusal scheme which reduces the forces at the crestal bone/implant interface. Biomechanical principles form the basis of this...
Implant-Protected Occlusion is that occlusal scheme which reduces the forces at the crestal bone/implant interface. Biomechanical principles form the basis of this concept. The direction of force, force magnification, and implant position relative to arch or location are blended together for a consistent approach to implant reconstruction. The direction of force demonstrates that angled forces increase the type of forces, alter their point of application, and reduce bone strength. Force magnifiers include cantilevers, offset loads, and monumental forces to the implant body. These magnifiers dramatically increase the among of force applied to a prosthesis. The implant position relative to arch or arch position often determines the density of bone and the amount of force. Adequate surface area of implant bodies considers width, length, and number. The surface area is a primary component in the resistance of force factors. In addition occlusal table width and occlusal contacts contribute to the force amount type and direction and may be modified to reduce crestal loads.
Topics: Bite Force; Dental Abutments; Dental Implants; Dental Occlusion; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Humans; Occlusal Adjustment
PubMed: 9117850
DOI: No ID Found -
Journal of Prosthodontics : Official... Jul 2016The subject of occlusion has been deemphasized by academia over the last 30 years. This marginalization in turn has negatively impacted recent graduates who are largely...
The subject of occlusion has been deemphasized by academia over the last 30 years. This marginalization in turn has negatively impacted recent graduates who are largely unfamiliar with the use of occlusal adjustment by selective reshaping as a treatment modality. Use of proper occlusal therapy enables clinicians to more effectively help patients recover from parafunctional wear of the anterior and posterior teeth. In addition, familiarity with this field enhances the correction of progressive posterior and anterior reverse articulations. This article aims to highlight the importance of occlusal principles in treatment planning. In addition, we illustrate the benefits of occlusal adjustment by using a conservative technique, selective reshaping, as an option to correct anterior reverse articulation in a 20-year-old patient. The knowledge of occlusal principles enhances diagnosis of malocclusion in the development of a treatment plan. When properly employed, the technique of occlusal adjustment by selective reshaping may be used to correct an adaptive anterior reverse articulation with a high degree of predictability for select patients.
Topics: Dental Occlusion; Humans; Malocclusion; Occlusal Adjustment; Tooth
PubMed: 26216490
DOI: 10.1111/jopr.12323 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2015Muscular hyperactivity is a potential source of symptoms in patients with temporal-mandibular disorders. An adequate occlusal adjustment may relieve such symptoms. This...
OBJECTIVES
Muscular hyperactivity is a potential source of symptoms in patients with temporal-mandibular disorders. An adequate occlusal adjustment may relieve such symptoms. This study aims to measure the effect of shortening the protrusive disclusion time (DT) and balancing the center of occlusal forces (COF) on the EMG recordings and assess the pain reported by chronic patients one month after the computer-guided occlusal adjustment.
STUDY DESIGN
The sample studied comprised 34 patients suffering from chronic facial pain in which the EMG activity of both masseters was recorded by electromyography. By selective grinding we alleviated all the occlusal interferences during the mandibular protrusion from the habitual closure position in order to establish an immediate posterior disclusion and an equilibration of the COF.
RESULTS
At follow-up 76.5% of the patients reported no facial pain. Moreover, the EMG activity and protrusive DT were significantly reduced, and occlusal and muscular function were significantly more symmetric than at baseline.
CONCLUSIONS
According to this EMG study, this computer-guided occlusal adjustment is able to reduce the activity of the masseters and the self-reported muscular pain of patients one-month after treatment.
Topics: Adult; Bite Force; Chronic Pain; Diagnostic Self Evaluation; Electromyography; Facial Pain; Female; Follow-Up Studies; Humans; Male; Middle Aged; Occlusal Adjustment; Prospective Studies; Therapy, Computer-Assisted; Treatment Outcome; Young Adult
PubMed: 25475783
DOI: 10.4317/medoral.20272 -
Journal of Medical and Dental Sciences Sep 2013In prosthodontic treatment, reconstruction of a proper occlusal contact relationship is very important as well as reconstruction of a proper interproximal relationship... (Comparative Study)
Comparative Study
In prosthodontic treatment, reconstruction of a proper occlusal contact relationship is very important as well as reconstruction of a proper interproximal relationship and marginal fitness. Unfortunately, occlusal relationships are sometimes lost in the process of occlusal adjustment of crowns. The purpose of this study was to compare the occlusal contacts of single crown fabricated by two different types of impression techniques. Nine subjects, whose molars required treatment with crown restoration, were enrolled in this study. Full cast crowns were fabricated using two types of impression techniques: the conventional impression method (CIM) and the bite impression method (BIM). The occlusal contacts of crowns were precisely evaluated at the following stages: after occlusal adjustment on the articulator (Step 0), before occlusal adjustment in the mouth (Step 1), after occlusal adjustment at the intercuspal position (Step 2), and after occlusal adjustment during lateral and protrusive excursions (Step 3). The number of occlusal contacts of the crowns on the functional cusps fabricated with BIM was significantly greater than that with CIM after occlusal adjustment. For this reason, the crowns fabricated with BIM might have a more functionally desirable occlusal surface compared to the crowns fabricated with CIM.
Topics: Alginates; Calcium Sulfate; Colloids; Crowns; Dental Abutments; Dental Articulators; Dental Impression Materials; Dental Impression Technique; Dental Occlusion; Dental Prosthesis Design; Female; Humans; Jaw Relation Record; Male; Middle Aged; Models, Dental; Molar; Occlusal Adjustment; Polyvinyls; Post and Core Technique; Siloxanes; Surface Properties; Tooth Preparation, Prosthodontic; Tooth, Nonvital
PubMed: 24146169
DOI: No ID Found -
Australian Dental Journal Mar 2009Non-carious cervical lesions involve loss of hard tissue and, in some instances, restorative material at the cervical third of the crown and subjacent root surface,... (Review)
Review
Non-carious cervical lesions involve loss of hard tissue and, in some instances, restorative material at the cervical third of the crown and subjacent root surface, through processes unrelated to caries. These non-carious processes may include abrasion, corrosion and possibly abfraction, acting alone or in combination. Abfraction is thought to take place when excessive cyclic, non-axial tooth loading leads to cusp flexure and stress concentration in the vulnerable cervical region of teeth. Such stress is then believed to directly or indirectly contribute to the loss of cervical tooth substance. This article critically reviews the literature for and against the concept of abfraction. Although there is theoretical evidence in support of abfraction, predominantly from finite element analysis studies, caution is advised when interpreting results of these studies because of their limitations. In fact, there is only a small amount of experimental evidence for abfraction. Clinical studies have shown associations between abfraction lesions, bruxism and occlusal factors, such as premature contacts and wear facets, but these investigations do not confirm causal relationships. Importantly, abfraction lesions have not been reported in pre-contemporary populations. It is important that oral health professionals understand that abfraction is still a theoretical concept, as it is not backed up by appropriate clinical evidence. It is recommended that destructive, irreversible treatments aimed at treating so-called abfraction lesions, such as occlusal adjustment, be avoided.
Topics: Bite Force; Bruxism; Dental Occlusion, Traumatic; Dental Restoration, Permanent; Dental Stress Analysis; Finite Element Analysis; Humans; Occlusal Adjustment; Occlusal Splints; Terminology as Topic; Tooth Cervix; Tooth Diseases
PubMed: 19228125
DOI: 10.1111/j.1834-7819.2008.01080.x -
The Journal of Prosthetic Dentistry Sep 1979A study was undertaken to analyze the possible relationship between the number and type of tooth contacts before, immediately after and 16 weeks after occlusal... (Comparative Study)
Comparative Study
A study was undertaken to analyze the possible relationship between the number and type of tooth contacts before, immediately after and 16 weeks after occlusal adjustment and their influence upon occlusal stability. The data collected from 10 adult subjects who required an occlusal adjustment indicated the following: 1. Six of the ten subjects had no clinically perceptible "slide from centric relation" 6 weeks after occlusal adjustment, and the number of teeth and number of contacts were virtually the same immediately after 6 weeks after occlusal adjustment. 2. The remaining four subjects, whose occlusions had relapsed after adjustment, had one dental arch that included a missing tooth. It would seem that dental arches interrupted with extraction spaces do not remain stable with occlusal adjustment alone. 3. The type of tooth contacts that are the most stable are those of a cup against a flat plane (e.g., bottom of a fossa or marginal ridge) or those of a combination of a cup against a flat plane and one or more inclined planes.
Topics: Adult; Bruxism; Dental Occlusion; Dental Occlusion, Balanced; Dental Occlusion, Centric; Dental Occlusion, Traumatic; Humans; Malocclusion; Middle Aged; Recurrence; Tooth
PubMed: 289761
DOI: 10.1016/0022-3913(79)90216-6 -
Operative Dentistry 2002Food impaction occasionally occurs in interproximal sites even though the contacts are tight. In this study of 14 patients with food impaction involving tight contacts,...
Food impaction occasionally occurs in interproximal sites even though the contacts are tight. In this study of 14 patients with food impaction involving tight contacts, the lack of adequate food escape grooves was common to all 14 sites. Uneven marginal ridges and prominent opposing cusps were less common and, together, made up slightly more than half of the contact sites. An occlusal adjustment technique to create adequate food escape grooves, as well as reduce prominent opposing cusps and correct uneven marginal ridges, completely eliminated food impaction in all but one site. This site achieved an 80% reduction in food impaction. Based on the results of this retrospective study, the lack of adequate food escape groves in teeth adjacent to a contact point manifesting food impaction appears to be the primary factor. Creating food escape grooves adjacent to the marginal ridges eliminates, or nearly eliminates, food impaction in tight contact sites.
Topics: Adult; Dental Occlusion, Traumatic; Food; Humans; Middle Aged; Occlusal Adjustment; Retrospective Studies
PubMed: 11817474
DOI: No ID Found