Functional Occlusion: From TMJ to Smile Design

Front Cover
Copyright Page
Dedication
Foreword
Preface
Acknowledgments
Chapter 1. The Concept of Complete Dentistry
	COMPLETE DENTISTRY
	GOALS FOR COMPLETE DENTISTRY
Chapter 2. Perspectives on Occlusion and “Everyday Dentistry”
	OCCLUSAL PRINCIPLES AT EVERY LEVEL OF PRACTICE
	RELEVANCE OF OCCLUSION TO “EVERYDAY DENTISTRY”
Chapter 3. Occlusal Disease
	SIGNS AND SYMPTOMS
	BASIC MECHANISMS FOR TOOTH SURFACE DEFORMATION
Chapter 4. The Determinants of Occlusion
	DESIGN OF THE MASTICATORY SYSTEM
	PRIMARY REQUIREMENTS FOR SUCCESSFUL OCCLUSAL THERAPY (FIGURE 4-3)
	THE DYNAMICS OF EQUILIBRIUM
	FORMULA FOR A PERFECTED OCCLUSION
Chapter 5. The Temporomandibular Joint
	THE FIRST REQUIREMENT
	THE ARTICULATING SURFACES
	UNDERSTANDING CONDYLE DISK ALIGNMENT
	HOW MUSCLE CONTROLS DISK ALIGNMENT
	THE TEMPOROMANDIBULAR LIGAMENT
	THE ARTERIOVENOUS SHUNT
	ARTICULATION
Chapter 6. The Masticatory Musculature
	THE DOMINANT DETERMINANT
	THE MASTICATORY MUSCLES
	THE IMPORTANCE OF OCCLUSAL HARMONY
Chapter 7. Centric Relation
	UNDERSTANDING CENTRIC RELATION
	COORDINATED MUSCLE ACTION SEATS AND LOADS THE TMJs
	THE POSITIONER MUSCLE: THE INFERIOR LATERAL PTERYGOID
	THE EXTREMELY IMPORTANT SIGNIFICANCE OF TMJ SOCKET DESIGN
	IN CENTRIC RELATION, ONLY THE MEDIAL POLE ROTATES ON A FIXED AXIS
	SUMMARY
Chapter 8. Adapted Centric Posture
	LATERAL POLE DISK DERANGEMENTS
	COMPLETE DISK DERANGEMENT WITH FORMATION OF A PSEUDO-DISK
	COMPLETE DISK DISPLACEMENT WITH PERFORATION
	OTHER PARTIAL DISK DERANGEMENTS AND CLICKING TMJs
	SUMMARY
Chapter 9. Determining Centric Relation
	DETERMINING CENTRIC RELATION OR ADAPTED CENTRIC POSTURE
	IS CENTRIC RELATION REALLY REPEATABLE?
	WHY USE BILATERAL MANIPULATION?
	OTHER METHODS FOR DETERMINING CENTRIC RELATION OR ADAPTED CENTRIC POSTURE
Chapter 10. Load Testing for Verification of Centric Relation
	RATIONALE FOR LOAD TESTING OF TMJS
	PROPER LOAD TESTING MUST BE DONE IN INCREMENTS
	COMMON MISTAKES
	MISLEADING CONCERNS ABOUT LOAD TESTING
	RESPONSE TO LOAD TESTING IF THE CONDYLES ARE NOT COMPLETELY SEATED (MUSCLE BRACED)
	RESPONSE TO LOAD TESTING IF THE DISK IS MISALIGNED
	RESPONSE TO LOAD TESTING IF THERE IS INTRACAPSULAR PATHOLOGY OR INJURY
Chapter 11. Recording Centric Relation
	ACCURATE RECORDING OF CENTRIC RELATION
	CRITERIA FOR ACCURACY
	WHY CASTS MUST BE RELATED TO THE CONDYLAR AXIS
Chapter 12. Classification of Occlusions
	EFFECTIVE CLASSIFICATION
	DAWSON’S CLASSIFICATION21
	CLINICAL APPLICATION
Chapter 13. Vertical Dimension
	UNDERSTANDING VERTICAL DIMENSION
	VERTICAL DIMENSION AT REST
	WHEN THE VERTICAL DIMENSION MUST BE CHANGED
	WHY NOT INCREASE VERTICAL DIMENSION?
	WHY SOME PATIENTS REQUEST BITE RAISING
	CLOSING THE VERTICAL DIMENSION
	HOW THE CONDYLE POSITION AFFECTS VERTICAL DIMENSION
	ESTABLISHING VDO WHEN THERE ARE NO OPPOSING TEETH
	SUMMARY
Chapter 14. The Neutral Zone
	UNDERSTANDING THE NEUTRAL ZONE
	RELATING MALOCCLUSION TO THE NEUTRAL ZONE
Chapter 15. The Envelope of Function
	FUNCTION
	THE ENVELOPE OF MOTION
	THE ENVELOPE OF FUNCTION
	LATERAL ENVELOPE OF FUNCTION
	THE EXQUISITELY SENSITIVE MECHANORECEPTOR SYSTEM
Chapter 16. Functional Smile Design
	NATURAL ESTHETICS
	DECISIONS IN SMILE DESIGN
	THE MATRIX OF FUNCTIONAL ANATOMY
Chapter 17. Anterior Guidance and Its Relationship to Smile Design
	THE IMPORTANCE OF ANTERIOR GUIDANCE
	CUSTOMIZING THE ANTERIOR GUIDANCE
	DETERMINING INCISAL EDGE POSITION
	STEPS IN HARMONIZING THE ANTERIOR GUIDANCE
	ESTHETIC CONTOURING
	COMMUNICATING PRECISE DETAILS TO THE TECHNICIANS
Chapter 18. Restoring Lower Anterior Teeth
	THE STARTING POINT FOR THE OCCLUSAL SCHEME
	LOWER ANTERIOR QUALITY CONTROL
	INCISAL EDGE POSITION
	LOWER INCISAL EDGE CONTOUR
Chapter 19. Long Centric
	THE CONCEPT OF LONG CENTRIC
	PROVIDING LONG CENTRIC BY EQUILIBRATION
	PROVIDING LONG CENTRIC WHEN THE OCCLUSION IS TO BE RESTORED
Chapter 20. The Plane of Occlusion
	OCCLUSAL PLANE DESIGN
	THE CURVE OF SPEE
	THE CURVE OF WILSON
	SUMMARY
Chapter 21. Posterior Occlusion
	NONINTERFERING POSTERIOR TEETH
	LOWER POSTERIOR TEETH
	PORCELAIN OCCLUSAL VENEERS
	UPPER POSTERIOR TEETH
	LENGTH OF GROUP FUNCTION CONTACT IN WORKING EXCURSION
	BALANCING EXCURSIONS
	TYPES OF POSTERIOR OCCLUSAL CONTOURS
	TYPES OF CENTRIC HOLDING CONTACTS
	VARIATIONS OF POSTERIOR CONTACT IN LATERAL EXCURSIONS
	SELECTING OCCLUSAL FORM FOR STABILITY
	SUMMARY
Chapter 22. Simplifying Instrumentation for Occlusal Analysis and Treatment
	THE LOGIC OF SIMPLIFICATION
	SIMPLIFYING INSTRUMENTATION
	HOW DIFFERENT ARTICULATORS RECORD CONDYLAR PATHS
	USING INSTRUMENTS TO ADVANTAGE: A SUMMARY
Chapter 23. Differential Diagnosis of Temporomandibular Disorders
	MAKING SENSE OF TERMINOLOGY
	CATEGORIES OF TMDs
Chapter 24. Occluso-Muscle Disorders
	HOW TO DETERMINE IF THE TMJS ARE HEALTHY
	DIAGNOSING OCCLUSO-MUSCLE PAIN WITH NO TMD
	MASTICATORY MUSCLE RESPONSES
Chapter 25. Intracapsular Disorders of the TMJ
	INTRACAPSULAR PAIN
	STAGES OF INTRACAPSULAR DISORDERS
	THE PROGRESSIVE NATURE OF DISK DERANGEMENTS
	THE HEALTHY JOINT
	BEGINNING LATERAL-POLE DERANGEMENT
	PROGRESSIVE LATERAL-POLE DERANGEMENT
	LATERAL-POLE DISK DISPLACEMENT
	LATERAL-POLE CLOSED LOCK
	LATERAL-POLE DISK DISPLACEMENT, NONREDUCIBLE
	COMPLETE ANTERIOR DISK DISPLACEMENT
	TREATING COMPLETE DISK DISPLACEMENTS
Chapter 26. Classification of Intracapsular Disorders
	PRACTICAL TEMPOROMANDIBULAR JOINT ANALYSIS
	SYSTEMIZED APPROACH TO CLASSIFICATION
Chapter 27. Imaging the TMJs
	WHY DENTISTS MUST UNDERSTAND TEMPOROMANDIBULAR JOINT IMAGING
	TYPES OF TMJ IMAGING
Chapter 28. Bruxism
	CLENCHING (CENTRIC BRUXISM)
	ECCENTRIC BRUXISM
	TREATING THE BRUXISM PROBLEM
	BRUXISM IN CHILDREN
	DENTAL COMPRESSION SYNDROME
Chapter 29. Requirements for Occlusal Stability
	WHAT A STABLE OCCLUSION “LOOKS LIKE”
	HOW TO RECOGNIZE A STABLE OCCLUSION REGARDLESS OF WHAT IT LOOKS LIKE
	HOW TO RECOGNIZE AN UNSTABLE OCCLUSION REGARDLESS OF WHAT IT LOOKS LIKE
	THE FIVE REQUIREMENTS FOR OCCLUSAL STABILITY
Chapter 30. Solving Occlusal Problems Through Programmed Treatment Planning
	STRATEGY FOR THE EXAMINATION
	STRATEGY FOR TREATMENT PLANNING
	CHECKLIST FOR FIRST REQUIREMENT ANALYSIS
	MULTIPLE PROBLEMS
	PROBLEM SOLVING
	DESIGNING OCCLUSAL TREATMENT BASED ON THE REQUIREMENTS FOR OCCLUSAL STABILITY
	SUMMARY
Chapter 31. The Diagnostic Wax-up
	THE WAX-UP: THE PROCESS MOST DENTISTS WANT TO SKIP
	ESTHETIC ANALYSIS ON THE DIAGNOSTIC WAX-UP
Chapter 32. Occlusal Splints
	UNDERSTANDING OCCLUSAL SPLINTS
	FABRICATION OF OCCLUSAL SPLINTS
	SUMMARY
Chapter 33. Occlusal Equilibration
	THE IMPORTANCE OF OCCLUSAL EQUILIBRATION
	ELIMINATING FEAR OF EQUILIBRATION
	EQUILIBRATION PROCEDURES
	THE SECRET OF FINISHING AN EQUILIBRATION
	VERIFICATION OF COMPLETION
	EQUILIBRATION ON PATIENTS WITH EMOTIONAL PROBLEMS
	PROPHYLACTIC EQUILIBRATION
	EQUILIBRATING THE ORTHODONTIC PATIENT
	EFFICIENCY IN EQUILIBRATION
	ARMAMENTARIUM FOR EQUILIBRATION
	COMPUTER-ASSISTED DYNAMIC OCCLUSAL ANALYSIS
	LONG-TERM OCCLUSAL STABILITY
Chapter 34. Neuromuscular Dentistry: Bioelectronic Instrumentation
	EXAMINING THE RHETORIC
	MAKING SENSE OF THE LITERATURE
	NMD CRITICISM AGAINST CENTRIC RELATION
	ACCEPTABLE INSTRUMENTATION
	SUMMARY
Chapter 35. Solving Occlusal Wear Problems
	IDENTIFY THE CAUSE OF THE WEAR
	TREATMENT PLANNING FOR WEAR PROBLEMS
	PREVENTING OCCLUSAL WEAR PROBLEMS
Chapte 36. Solving Deep Overbite Problems
	DEEP ANTERIOR OVERBITE
	DEEP OVERBITE WITH TISSUE CONTACT
	DEEP OVERBITE PROBLEMS ASSOCIATED WITH AN ANTERIOR SLIDE
	DEEP OVERBITE WITH SEVERE WEAR
	DEEP OVERBITE PROBLEMS WITH NO DEFLECTIVE INTERFERENCES
	DEEP OVERBITE PROBLEMS WITH NO CENTRIC CONTACT
	SOLVING DEEP OVERBITE PROBLEMS ORTHODONTICALLY
	SOLVING DEEP OVERBITE PROBLEMS BY RESTORATIVE RESHAPING
	SOLVING DEEP OVERBITE PROBLEMS BY SPLINTING
	MINIMIZING OPERATIVE INTERVENTION THROUGH THE USE OF BITE PLANES TO SOLVE DEEP OVERBITE PROBLEMS
	USING REMOVABLE PARTIAL DENTURES TO SOLVE DEEP OVERBITE PROBLEMS
	SUMMARY
Chapter 37. Solving Anterior Overjet Problems
	EXTREME ANTERIOR OVERJET TREATMENT CHOICES
	THE PROBLEMS OF ANTERIOR OVERJET
	SOLVING THE PROBLEM OF STABILIZING THE LOWER ANTERIOR TEETH
	PROVIDING PROTRUSIVE DISCLUSION OF THE POSTERIOR TEETH
	PROVIDING DISCLUSION OF THE NONFUNCTIONING INCLINES
	IMPROVING THE POSITION OR SHAPE OF UPPER ANTERIOR TEETH WITH EXCESSIVE OVERJET
	EQUILIBRATING THE OVERJET PROBLEM
	SOLVING OVERJET PROBLEMS WHEN THERE IS INSUFFICIENT POSTERIOR ANCHORAGE
	SURGICAL CORRECTION
Chapter 38. Solving Anterior Open Bite Problems
	FINDING THE CAUSE
	APPLYING THE PRINCIPLES
	MINIMAL ANTERIOR OPENING
	SEVERE ANTERIOR OPEN BITES (5 mm OR GREATER SEPARATION)
	TREATING PROTRUSIVE LATERAL TONGUE-THRUST PROBLEMS
	ORTHODONTIC CORRECTION OF ANTERIOR OPEN BITES
Chapter 39. Treating End-to-End Occlusions
	ANTERIOR END-TO-END RELATIONSHIPS
	RESTORING END-TO-END ANTERIOR TEETH
	POSTERIOR END-TO-END RELATIONSHIPS
	RESTORING END-TO-END POSTERIOR TEETH
	UNILATERAL END-TO-END
RELATIONSHIPS
Chapter 40. Treating Splayed or Separated Anterior Teeth
	SPLAYING AS A RESULT OF AN ENLARGED TONGUE
	APPLYING THE PRINCIPLES
	NEUTRAL ZONE CONSIDERATIONS
	USE OF LAMINATES TO CLOSE SPACE
Chapter 41. Treating the Crossbite Patient
	ANTERIOR CROSSBITE
	ANALYSIS OF ANTERIOR CROSSBITE
Chapter 42. Treating Crowded, Irregular, or Interlocking Anterior Teeth
	ANALYSIS OF CROWDED, IRREGULAR, OR INTERLOCKING ANTERIOR TEETH
	METHODS OF CORRECTING ANTERIOR INTERLOCKING BITES
	CORRECTING ANTERIOR IRREGULARITY WITH SELECTIVE EXTRACTION
	COMBINING RESTORATIVE PROCEDURES WITH ORTHODONTICS
	RELATIONSHIP OF ANTERIOR TEETH TO POSTERIOR TEETH
	GROWTH PROBLEMS AND CROWDED LOWER ANTERIOR TEETH
Chapter 43. Solving Severe Arch Malrelationship Problems
	ANALYSIS OF SEVERE ARCH MALRELATIONSHIPS
	DESIGNING TREATMENT WHEN THE SKELETAL BASE IS ACCEPTABLY ALIGNED
	NONSURGICAL TECHNIQUES FOR STABILIZING SKELETAL MALRELATIONSHIPS
Chapter 44. Using Cephalometrics for Occlusal Analysis
	LIMITS OF CEPHALOMETRICS
	ELEMENTS OF CEPHALOMETRICS
	HOW THE PLANES ARE USED FOR OCCLUSAL PROBLEM ANALYSIS
	CONCERNS ABOUT THE USE OF CEPHALOMETRICS
Chapter 45. Postoperative Care of Occlusal Therapy Patients
	A GOOD EXAMPLE OF POSTOPERATIVE CARE
	OCCLUSAL THERAPY FOLLOW-UP
	POSTTREATMENT USE OF OCCLUSAL APPLIANCES
	POSTOPERATIVE PERIODONTAL MAINTENANCE
	THE HEALTHY MOUTH: DENTISTRY’S GOAL
Chapter 46. The Technological Future for Occlusal Restoration Lee Culp, CDT
	COMPUTERIZED OCCLUSION IN THE LABORATORY
	COMPUTERIZED DESIGN AND FABRICATION
	COMPUTERIZED OCCLUSAL VERIFICATION
	SUMMARY
Chapter 47. Criteria for Success of Occlusal Treatment
	MEASURING SUCCESS OBJECTIVELY
	SUMMARY
Index