occlusal analysis

occlusal analysis

1. introduction :

Careful examination of the dental arches as they confront each other during the various functions of the masticatory system constitutes a crucial element in establishing a diagnosis and in directing the treatment plan (periodontal, prosthetic or orthodontic).

2. clinical examination:

Before proceeding with the occlusal analysis, a well-conducted clinical examination will guide us towards the possible anomalies to look for.

1. the anamnesis:

It is important to know the patient’s dental experience: pain, cause of tooth loss, care, dental mobility, etc.

2. the exorbital examination:

While talking with the patient, we will look for muscle hypertrophy.

Palpation will reveal any muscle pain. 

The mouth opening will be assessed, it can be limited, deviated signifying a mandibular-cranial dysfunction of articular or muscular origin. It can be disproportionate (ligamentary hyperlaxity).

3. dental examination

Attention will be paid to:

• the integrity of the dental arches,
• Possible malpositions,
• Tooth loss compensated, or not, by prostheses of correct or incorrect design,
• Healthy or decayed teeth;
• Cracks, fractures and wear facets,
• Dental restorations (bulky, iatrogenic, etc.)
• Sensitivity of teeth, especially to percussion.

4. periodontal examination

Oral hygiene will be assessed, and any possible gingival and/or periodontal pathologies will be looked for.

3. occlusal analysis

The previous examinations have made it possible to analyze the quality of the tooth itself and its environment. It is now a question of studying, in the clinic, the relationships between the teeth and the jaws before completing them with the occlusal analysis on an articulator.

• During the interview, the practitioner notices the possible decrease in the vertical dimension, the “Popeye” facies, and the angular cheilitis are signs. To determine the free space of inocclusion (physiological rest space), the lips are quickly spread apart in the resting position, the anterior inocclusion is 1 to 3mm.
• Mouth opening may reveal an algodysfunctional disorder, a low and deviated amplitude suggests that the disorder is either of muscular origin (bruxism) or articular origin (irreducible disc anteposition). The deviation is always on the diseased side.
• The curve of Spee, in the sagittal plane, is studied briefly. Uncompensated edentulism promotes dental egressions and/or versions, disrupting the regularity of the curve of Spee and the curve of Wilson in the frontal plane.

1. In maximum intercuspation occlusion
2. Anterior relationships: The incisors and canines maintain, like the cuspid units, during intercuspation, punctiform contact relationships. Schematically, the incisal edges of the mandibular anterior teeth are in contact with the marginal ridges of the maxillary incisors and canines.

Classically, that is to say in Angle class I, in intercuspation, the coronoradicular axis of the maxillary and mandibular central incisors forms an angle of approximately 135°

2. Posterior relationships: The primary cusps enter into occlusion in intercuspation. They have contact relationships with receptor areas, the Angle class will be noted and possible cross bites will be looked for.
3. mandibular propulsion movement

Mandibular propulsion movements are supported by the maxillary incisors and canines serving as guides for the mandibular incisors. This path must not be disturbed by posterior contacts. A single anterior tooth supporting propulsion is considered a propulsive interference.

Poor or no anterior guidance contributes to posterior dental collisions , leading to wear facets or tooth mobility.

3. mandibular lateral movement
4. dog protection

When the working mandibular diduction movements are guided by the maxillary canine, we speak of canine protection or function. If a tooth other than the canine alone guides the mandible laterally, it is considered a working interference.

This path prohibits any contralateral or non-working contact, any contact is considered non-working interference.

2. Group protection

one or more incisors may accompany  the canines: this is then an anterior group protection.

Similarly, if one or more cuspid units  accompany  the canine, then the functional kinematic relationship is posterior group protection. 

occlusal analysis

 

  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.
 

occlusal analysis