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Disharmony Between The TMJs

ocluzologie

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Laura Dima
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86 views2 pages

Disharmony Between The TMJs

ocluzologie

Uploaded by

Laura Dima
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Dawson Academy Whitepaper

How Disharmony Between the TMJs and


the Occlusion Causes Harm
Peter E. Dawson, DDS

If I were writing the curriculum for a four-year dental education, I would start in the
freshman year by asking the question, How does disharmony between the TMJs and
the occlusion cause harm? I would then tell every student that this question will be a
dominant centerpiece for their dental education. I would let them know that during
their four years, they will be expected to understand the answer to this question so
clearly that when they start practice they will be at a tremendous advantage over more
than 90% of the usual and customary dentists.
Excuse my political incorrectness for being so bluntbut a dentist who does not
understand the relationship between occlusion and the TMJs can never be better than a
mediocre dentist. Let me explain why.
Disharmony between the TMJs and the occlusion is
responsible for excessive tooth wear, fractured teeth,
loose teeth, teeth that shift out of position. This
disharmony is also the single most common cause of
discomfort and patient dissatisfaction with the dentistry
that is done. If this sounds like an exaggeration
I can assure you it is not. I can tell you from many
years of treating thousands of patients, and working
with thousands of dentists in our curriculum at The
Dawson Academy that an understanding of occlusion
is life changing for any dentist, regardless of specialty.
Lets start with an understanding of what a perfected occlusion looks like.
An oversimplified formula is Lines in front...Dots in back. What does this mean?
It means that when the jaw closes to maximum tooth contact (MIP), both condyle/disc
assemblies are completely seated up as high as they can go into their respective sockets.
This is called centric relation and it is the starting point for everything that we do with
an occlusion.

Stopping points for jaw closure


in a perfected occlusion

Peter E. Dawson, D.D.S. is considered


to be one of the most influential
clinicians and teachers in the history of
dentistry. He authored the best selling
dental text, Evaluation, Diagnosis
and Treatment of Occlusal Problems,
which is published in 13 languages.
His latest book is entitled Functional
Occlusion: From TMJ to Smile Design.
He is the founder of the Concept of
Complete Dentistry Seminar Series
as well as The Dawson Academy. In
addition to numerous awards and
special recognitions, Dr. Dawson is the
past president and life member of the
American Equilibration Society, a past
president of the American Academy of
Restorative Dentistry and the American
Academy of Esthetic Dentistry.

The formula for a perfected occlusion

The second thing we look for in a perfected occlusion is proper contact of


the lower incisors with the upper incisors in centric relation. Next, we do not
want premature contact of any back tooth before the condyles are completely
seated and the anterior teeth are in contact. This results in equal intensity,
simultaneous contact of all the teeth, including the front teeth in centric
relation. If the condyles are completely seated at this described tooth contact,
it is impossible to overload any tooth. That is the essential starting point for a
perfected occlusion.

2014 The Dawson Academy. All rights reserved.

This material may not be reproduced, displayed, modified or distributed without the express prior written permission of
the copyright holder. For permission, contact [email protected].

Dawson Academy Whitepaper

The Goal: Immediate disclusion

After that ideal starting point is achieved, the next goal is for the anterior guidance to
immediately separate all the posterior teeth at the moment the mandible moves from
centric relation in any direction. This is called immediate posterior disclusion.
If you put a marking ribbon between all the teeth and have the patient squeeze hard and
move their jaw in all directions there will be lines on the front teeth as those inclines
are used to separate the back teeth in all jaw positions except when the condyles are
completely seated in centric relation. This is what makes lines in front dots in back.

Why is this considered the ideal? Because in a perfected occlusion with immediate posterior disclusion, it is impossible
to overload the posterior teeth. It is impossible to wear posterior teeth. It is impossible to create horizontal forces on
posterior teeth that can work them loose or move them. The simple explanation is: You cannot wear what you cannot
rub.

Understanding the above makes the answer to our original question simple to understand:

If the back teeth are in the way of how the jaw moves, or if the anterior guidance can not separate the back teeth when
the jaw moves from centric relation, the back teeth are not only in a position of vertical overload, they are also subject
to lateral forces that they arent made to resist. The result is what we call occlusal disease. Occlusal Disease comes in
many different forms, any one of which is undesirable.

Principle: Occlusal disease is always progressive

Now I have oversimplified both the question and the answer, because in order to accomplish a perfected occlusion
you must understand the temporomandibular joints. You must understand when they are or are not stableand you
absolutely must understand when they are seated in their physiologic, uppermost position of centric relation. If you
didnt learn all this in dental school, it is not too late. The curriculum at The Dawson Academy is here to answer all the
questions you might have in addition toteaching you the skills necessary for finding and verifying centric relation. Also
you can learn the precisely accurate methodology for determining an exactly correct anterior guidance. Incidentally that
is also the key to establishing the very best smile design.
And I can promise you this...your life as a dentist will never be the same when you learn what it is like to be predictable
in every thing you do for a patient...not to mention the added production that comes when you eliminate remakes,
reworks and making excuses to patients.
At the Dawson Academy, we love to make good dentists even better. Come see us.
Yours for an exciting practice,

2014 The Dawson Academy. All rights reserved.

This material may not be reproduced, displayed, modified or distributed without the express prior written permission of
the copyright holder. For permission, contact [email protected].

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