Occlusion Therapy

It is scientifically proven that deviations in occlusion (bite position) of 0.01 mm are perceived, deviations of 0.1 mm can disturb the masticatory apparatus to such an extent that bruxism (crunching) occurs. These deviations cause us to “grind in” or reduce the disturbing area with the opposing dentition during sleep. This results in extremely high forces of 200-300 kilopond. The occlusion disorders can be caused by tooth anomalies, anomalies in the number of teeth, malocclusion or by restorative, orthodontic and surgical measures.

Diagnosis

First the teeth are counted. The teeth that have not been replaced usually represent a disturbance in the occlusion. These can grow out of the bone without support and thus become longer, tilting or wandering can also occur.

Then the dentition is assessed: the overbite is checked, it is also checked if all teeth are in contact and if the jaw offers enough space for the teeth. Later the contacts are assessed: first the static ones (without movement of the lower jaw) and the dynamic ones (in movement). These are recorded with different colors using so-called occlusion paper.

It is often helpful to make a model plaster cast. These models are mounted in an articulator (device for imitating the movements of the lower jaw). In this way, the preliminary contacts are much easier to observe. Only after such instrumental analysis is it useful to plan further therapy.

Therapy

There are a couple of rules that should be observed during therapy and assessment: During the right and left movement of the lower jaw only the canines should be in contact At the end of the advancing movement only the upper canines should be in contact with the first premolars of the lower jaw “The right bite is not a bite” means so much that in resting position the lower teeth have no contact with those of the upper jaw, because a distance is unconsciously kept. Occlusion therapy must be individually adapted to each patient and his or her starting position. For patients who are free of complaints and who grind, simple restorations can be adapted to the existing dentition.

Somewhat more complicated measures, such as implantation, require a shape and function analysis. The fabrication must be performed with the aid of the articulator mentioned above. Bite elevation is often required.

This is first ensured with somewhat “too high” temporary crowns. It is observed whether the patient remains symptom-free. Only then are the final crowns cemented in.

Fine grinding is often necessary after extensive treatment. These patients are fitted with a splint that protects the muscles and joints from high forces on the one hand and the teeth and restorations from fractures on the other. The splint can also compensate for the interfering contacts.

The following procedure is recommended: patients should put the splint on for sleeping. In this way, the grinding corrections can be made in a relaxed state. These take place at certain intervals until the patient can take the bite immediately in the morning after removing the splint. The aim of this therapy is the so-called centric occlusion: the lower teeth should have the maximum multi-point contact with the upper teeth.

  • The incisors should not be in contact if possible
  • During the right and left movement of the lower jaw only the canines should be in contact
  • At the end of the advancing movement, only the upper canines should touch the first premolars of the lower jaw
  • “The right bite is no bite” means so much that in resting position the lower teeth do not have contact with those of the upper jaw, because a distance is unconsciously kept.