Group Leadership: Function, Tasks, Role & Diseases

Group guidance refers to a certain position of the teeth of the upper and lower jaws in relation to each other and thus belongs to a certain type of occlusion. Here, the lateral tooth contact of the upper and lower teeth takes a dominant position in the chewing movement.

What is group guidance?

Group guidance refers to a particular position of the maxillary and mandibular teeth in relation to each other, and thus belongs to a particular type of occlusion. Group guidance is a special type of dynamic occlusion. It characterizes the dynamic meeting of several teeth of the upper and lower jaw on the laterotrusion side. Here, a group contact of the upper and lower teeth takes place on the working side, with the lower jaw moving laterally and thus creating an occlusion there. A balance contact takes place on the opposite side. An occlusion generally describes a contact of teeth of the upper and lower jaw when biting together. The teeth are exactly above each other and the contact is completely closed in this area. There are several forms of contact. First, a distinction is made between static and dynamic occlusion. In static occlusion, tooth contact takes place without the movement of the lower jaw. Dynamic occlusion always means tooth contact between the upper and lower jaws while the lower jaw is moving. Occlusal concepts are developed and discussed on the basis of various occlusal possibilities. These concepts are used to develop ideal ideas about how and when the teeth should come into contact with each other in order to achieve the best possible effect in terms of dentition development and general health. During group guidance, the teeth of the maxilla and mandible meet on the laterotrusion side, as mentioned earlier, with the mandible moving forward and inward on one side and backward and outward on the other.

Function and task

Group guidance occurring in occlusion is a special type of occlusion. In this context, the individual occlusion types and the associated occlusion concepts do not have general validity and are scientifically evaluated differently. In connection with occlusion, the terms habitual, centric, forced dynamic, bilaterally balanced and unilaterally balanced occlusion are important. For example, habitual occlusion represents habitual contact of the teeth. Unilaterally balanced occlusion is important for group management. It means a unilateral group contact of teeth of the upper and lower jaw. This contact occurs on the working side, but there is also tooth contact on the balance side (mediotrusion side or non-working side), which is called balance contact. The occlusal concepts are again based on the study of how and which tooth contacts occur and which should be prevented so that the existing dentition can be preserved for as long as possible. The same applies to the durability of an artificially created denture. The concepts range from anterior-guided, canine-guided, canine-premolar-guided, unilaterally-guided, bilaterally-guided, fully-guided to sequentially-guided occlusion. The unilaterally guided occlusion represents the unilateral group guidance. In this conception, the teeth on the working side are united with disclusion of all other teeth. The general application of these concepts is still the subject of controversial debate. Today, individual solutions must be found for each patient. Thus, in addition to chewing habits, individual peculiarities in the structure of the dentition also play a role. The fabrication of a functional denture in the dental laboratory requires a reproducible transfer of the occlusion in order to provide the dental technician with a three-dimensional image of the individual movement sequences in the dentition of the respective patient. Group guidance is treated as an equal concept to the others. Which concept is used in each case depends on both individual characteristics and the priorities of the practitioner. Regardless of the equivalence of the concepts, however, it must be prevented that the temporomandibular joint is subjected to an unusual pressure load after insertion of the denture.

Diseases and ailments

Occlusal abnormalities can have an impact on both dental health and overall health. The causes of these discrepancies are varied and can include misalignment of individual teeth, jaw deformities, premature contact when biting together, or mismatched crowns or fillings. Regardless of the type of occlusion, such as group guidance, centric occlusions or other forms of occlusion, no denture has a perfectly ideal occlusion. A malocclusion is also referred to as a malocclusion or dysocclusion. Severe malocclusions can cause significant pressure loads in the dentition. In the long term, pressure ulcers develop as a result, which in turn promote infections in the oral region. Non-regular occlusions can cause temporomandibular joint disorders (craniomandibular dysfunction). Craniomandibular dysfunction represents a disturbance of neuromuscular balance. Localized rheumatic diseases develop, which can also affect the masticatory muscles, for example. By modifying the existing occlusion, good success has been achieved in combating these disorders in some cases. However, occlusal disorders are thought to be only one of several factors in triggering craniomandibular dysfunction. Periodontitis may be exacerbated by an unfavorable occlusion. Furthermore, occlusal disorders are suspected to be related to spinal disorders and tension. Thus, it can be assumed that disorders in occlusion can cause considerable health complaints. In addition, a non-adjusted occlusion after the insertion of dentures can lead to an accelerated degeneration of the jaw bones due to incorrect pressure distribution in the dentures. In addition to limiting the bite force, this also provokes inflammation, which in the long term can also lead to systemic diseases in the whole organism.