It has been scientifically proven that deviations in the occlusion (bite position) of 0.01 mm are perceived, deviations of 0.1 mm can disturb the chewing apparatus in such a way that bruxism (grinding) occurs. These deviations lead to the fact that we want to "grind in" or reduce the disturbing point with the opposing teeth during sleep. This creates extremely high forces of 200-300 kilopond. The occlusal disorders can be caused by tooth anomalies, tooth number anomalies, misalignments or by restorative, orthodontic and surgical measures.
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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 migration also occur.
Then the dentition is assessed: the overbite is checked, it is also checked whether all teeth are in contact and whether the jaw offers enough space for the teeth. The contacts are assessed later: first the static (i.e. without movement of the lower jaw) and the dynamic (in motion).
These are recorded with different colors using so-called occlusion paper. The production of model plaster is often helpful. These models are mounted in an articulator (device for imitating the movements of the lower jaw). This way the pre-contacts are much easier to observe. Planning further therapy only makes sense after such instrumental analysis.
There are a couple of rules that should be observed during therapy and assessment:
$config[ads_text2] not foundWhen moving the lower jaw to the right and left, only the canines should be in contact
At the end of the feed movement, only the upper canines should touch the first premolars of the lower jaw
“The right bite is not a bite” means that in the resting position the lower jaw teeth have no contact with those of the upper jaw, because a distance is kept unconsciously.
Occlusion therapy must be individually adapted to each patient and their starting position.
For symptom-free patients who grind, simple restorations can be adapted to the existing dentition. Somewhat more complicated measures, such as Implanting, require a shape and function analysis. It must be manufactured using the articulator mentioned above. A bite elevation is often required. This is first ensured with temporary crowns that are somewhat "too high". 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 receive a splint that protects the muscles and joints from high forces on the one hand, and also protects the teeth and restorations from fractures on the other.
The rail can also compensate for the interference contacts. The following procedure is recommended: patients should put on the splint to sleep. 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 after removing the splint in the morning.
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The aim of this therapy is the so-called centric occlusion: the lower jaw teeth should have maximum multi-point contact with the upper jaw teeth.
