Accurately analysing occlusionUncategorised
Posted by: The Probe 6th May 2020
Occlusion remains one of the most important – if controversial – topics within the dental profession. Having a sound knowledge of occlusion is vital in order to improve treatment outcomes, particularly in restorative dentistry where a key goal is to achieve a long-lasting restoration. Put simply, occlusion refers to how the maxillary and mandibular teeth come together when a patient’s mouth is at rest, or when a patient bites into something, chews or swallows.
Most clinicians know that if a patient’s teeth or jaws are not properly aligned, the patient may suffer from malocclusion – otherwise known as a “bad bite”. This condition can lead to a range of problems in relation to teeth, gums, the temporomandibular joint (TMJ), and the muscles that facilitate jaw movement. In fact, malocclusion can cause severely misaligned or worn teeth, and loosen or even fracture restorations such as dental crowns or fillings. A bad bite can also exacerbate the effects of gingival recession, and can lead to debilitating aches and pains in the jaw, neck and shoulders – especially if the patient has a habit of grinding their teeth.
Therefore, accurate assessment of a patient’s occlusion is vital for identifying and treating any potential dental problems. There are a variety of materials available that clinicians can use to register occlusion, which is essential to ensuring the survival and success of a restoration. Articulation paper remains one of the most widely accepted materials for recording occlusal contacts. As a cost-effective solution, it is often used to indicate “high spots” on teeth that come into premature contact with opposing dentition. These areas are marked by the dye of articulation paper, which comes in a wide range of colours, sizes and thicknesses.
Although articulation paper is easy to use, it is neither a scientific or particularly reliable material for ascertaining more comprehensive occlusal information. It is not capable of measuring occlusal forces or sequence contact timing, for instance. Articulation paper also requires the clinician to “subjectively interpret” its occlusal representations. Therefore, any interpretations of the size, shape and colour intensity of articulation paper marks recorded can often lead to incorrect clinical diagnosis of where in the dental arches occlusal force problems may exist, and where occlusal treatment should be performed, if at all.
If treatment is provided based solely on what is determined from these occlusal marks, dental practitioners could detrimentally alter a patient’s occlusion. The potential to cause the patient discomfort, pain or occlusal dysfunction increases, as does the practitioner’s risk of facing complaints and litigation. Taking this into consideration, it is absolutely vital that clinicians are equipped with appropriate solutions that can effectively assess occlusion. Articulation paper may no longer be the most suitable product for this purpose, particularly when one needs to determine which areas of the dentition come into contact first or release last.
Often overlooked, this information is vital to maintaining a fully functional and comfortable occlusion. It helps create a causal timeline of occlusion, so that practitioners better understand the individual nature of a patient’s teeth, and how they can be protected or their function enhanced. It goes without saying that the more information clinicians have at their disposal, the more accurately they are able to diagnose, analyse and treat any potential problems. This ensures restorative treatment – including minimally invasive cosmetic dental reconstructions – can be completed to the highest possible standard.
According to one study, occlusal treatment of a restoration should achieve specific occlusal force and contact timing goals that prevent excessive damage, friction and wear on the prosthesis in the long-term. To avoid these destructive forces on a new restoration, the T-scan digital occlusal analyser – available from Clark Dental – can be used to help balance patients’ occlusions with precision and accuracy. In fractions of a second, the T-scan predictably detects and records information regarding occlusal timing and force problems that are present throughout the dental arches. These sequential recordings enable clinicians to identify what percentage of force is being placed on a specific restoration or tooth, at any time during the intercuspation process. Based on this data, treatment can then be adjusted so that occlusal forces are aligned throughout the arches and future complications can be avoided.[i]
New technology can make diagnosis and treatment easier, safer and more predictable, preventing undue stress on both natural teeth and restorations. Cutting-edge digital occlusal analysers can help to measurably improve case finishing occlusal endpoints far beyond that of traditional solutions such as articulation paper. This ensures a highly satisfactory restorative outcome can be achieved, whereby patients benefit from a well-balanced and comfortable occlusion.
Raine Leary is a sales manager at Clark Dental, specialising in digital systems. Before joining the team in 2008, she was – and still is – a qualified dental nurse, giving a professional insight that is matched only by her loyalty and business acumen.
[i] Kerstein, R. B. (2011) The new rules of occlusion to apply during MiCD cosmetic reconstruction. MiCD Journal. 1(1):6-16.
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