General therapeutic design and prevention
Plan
I – Introduction
II – Definition
III – General therapies in occlusodontics
1 – Orthodontics
2 – The occlusal gutter
3-Dental prosthesis
4- Occluso-functional balancing
5 – Surgery
IV – Treatment Plan Timeline
V – Occluso-functional balancing
1- Definition
2- Description
VI – Prevention in occlusodontology
VII- Conclusion
I – I NTRODUCTION
Regarding masticatory system dysfunctions (MSD), the main objectives are as follows:
– Reassure the patient and explain their symptoms.
– Eliminate (or reduce) pain.
– Improve or restore correct and comfortable masticatory function.
II – Definition
Any ethical act, even the most benign, as long as it concerns the occlusal surface of the teeth, is finalized by the contact between them. The therapeutic act is therefore the fruit of a more or less conscious reflection.
If the act is trivial, the hand performs it out of habit; if it is more complex, manual intellectualization is essential.
III – General therapies in occlusodontics:
In the presence of a pathology of occlusal origin, a therapeutic arsenal is available to us. It is multidisciplinary and interdependent on each other.
1 – Orthodontics:
Whether active or passive, orthodontics is one of the first therapies considered in occlusal treatments to align crowded arches or level out unharmonious curves or eliminate premature contacts; well-conducted orthodontic treatment is generally sufficient in several cases.
2 – The occlusal gutter:
The use of occlusal splints is a common option in occlusodontic treatment. Considered a non-invasive and reversible treatment, this procedure is part of the current philosophy of protocols for the management of pathologies of the masticatory system. The installation of a splint responds to specific indications and requires careful preparation and adjustments so that the patient can observe the benefits. The splint makes it possible to test a modification of the intermaxillary relationship, either by removing the dental lock to obtain muscle relaxation, or by repositioning the condyle in the joint cavity to re-capture the articular disc or to reduce painful intra-articular hyperpressure in degenerative diseases.
The multifactorial etiology of masticatory dysfunctions places the occlusal splint in a diagnostic role to validate the behavioral, postural and psychosocial implications of the disorders experienced. The simple introduction of a device into the mouth, the expected effects of which would have been explained, serves as a vector for the psychological care of the patient, particularly in the case of bruxism.
General therapeutic design and prevention
3 – Dental prosthesis:
Whether joint or adjoining, the dental prosthesis has several objectives in the treatment of articular and occlusal problems, in particular in order to lock the occlusion and prevent slippage and egression, to relieve the remaining teeth, and to harmoniously distribute the occlusal loads, but nevertheless a balancing of these is essential for the proper progress of the treatment.
4 – Occlusofunctional balancing:
This is one of the most widely used treatments in occlusodontics. It serves to harmoniously distribute occlusal loads over a maximum number of teeth in the oral cavity in order to avoid overloads. At the level of the masticatory system.
5 – Surgery:
In some cases, orthodontics cannot compensate for major orthopedic discrepancies (class III) which cause disorders of the masticatory system, and in these cases the only solution remains orthognathic surgery or orthoscopic surgery for certain disorders of the temporomandibular joint.
IV – Treatment plan timeline:
- Orthopedic treatment of craniomandibular dysfunction
- Mounting on articulator in therapeutic position
- Post orthopedic occlusal analysis
- Diagnostic wax and/or making of removable temporary prostheses on wax
- Treatment plan proposal
- Removal of the occlusal splint and placement of the transitional reconstructions
- Periodontal, endodontic and possible surgical treatment
- Coronary or coronal-radicular reconstructions
- Redeveloped transitional reconstructions
- Occlusal reassessment
- Stabilizing prosthetic treatment
- Making and fitting a night occlusal splint
V – Occlusal-functional equilibration:
1- Definition
It is the restoration at the level of the antagonist teeth of lasting conditions which allow a balanced and stable occlusion to be achieved in functional harmony with all the elements of the stomatognathic complex.
2- Description:
Two techniques exist
A – Technique with semi-articulator:
1* study of occlusal interferences on articulator with articulating paper
2* appearance of maxillary and mandibular interferences
3* adjustment of interferences
4* noting of interferences and adjustment until the distribution of dental contacts on the arch
5* highlighting of propulsive contacts on articulator and correction
6* highlighting and correction of working and non-working interferences in right and left laterality
7* corrections made on the models are reported in the mouth
General therapeutic design and prevention
B- technique with anterior stop
Description :
*Placement of the anterior stop with the tip of the tongue on the palatine papilla
*Neuromuscular relaxation of the patient
*Remove the stop and close lightly to *check the closing path
*Repositioning the stop and controlling chewing cycles
*Correction of disharmonies with composite apposition techniques
*Control of chewing cycles*
General therapeutic design and prevention
VI – Prevention in occlusodontology
As the saying goes, prevention is better than cure, which is why there are principles to follow to avoid dysfunctions of the masticatory system , including:
*
-Interception of dental-dental disharmonies by early orthodontic treatment
-Systematically perform post-orthodontic occlusal analyses
-Interception of parafunctions (bruxism)…. (Gutter, relaxation….)
-Perform good conservative treatments (avoid over-occlusions)
-Replace missing teeth with the prosthesis (risk of egression)
-Perform germectomy of DDS (lack of space) teeth (DDM)
-Systematic balancing of the prosthesis and production using articulators
VII- Conclusion
Understanding occlusal pathology also means knowing how to treat and intercept it with the appropriate means, and above all at the right time and with a treatment timeline that will ensure the best possible integration within the masticatory system.
General therapeutic design and prevention
Untreated cavities can reach the nerve of the tooth.
Porcelain veneers restore a bright smile.
Misaligned teeth can cause headaches.
Preventative dental care avoids costly treatments.
Baby teeth serve as a guide for permanent teeth.
Fluoride mouthwash strengthens tooth enamel.
An annual checkup helps monitor oral health.