Which Concept on Occlusion Is Correct?

Gordon Christensen, in his annual review New Directions in Dentistry, stated:

“There is extreme controversy about which concept of occlusion is correct, and I do not see any relief to that controversy.”46
In a subsequent article, he wrote that “the profession is in major chaos relative to occlusion.”47
Frank Spear recently wrote that “a byproduct of increased interest in occlusion has been a renewed debate about which occlusal philosophy is correct.”48
Why is this question so difficult to answer?
Because of the different interpretations of the word occlusion, we are not quite sure what the question is asking.
  • If it is asking the best way teeth should touch each other and when, the answer would be that the contact should be confined to the tip of the cusps, and that contact should occur only during swallowing.
  • If it is asking the best way teeth should touch each other during mastication, the answer would be that they shouldn’t.
  • If it is asking for the most efficient way the stomatognathic system should function, the answer would be: without heavy compressive vertical and lateral forces (DCS).
But the question is not focused on any of these interpretations.
What Christensen and Spear are referring to are the two different philosophies taught at the LVI and at the Pankey Institute: the neuromuscular methodology, on the one hand, and the gnathological approach, on the other.
But wait a minute!
These are not concepts on occlusion. These are two different methods of rehabilitation and/or reconstruction to be used when patients are in trouble.
So now the word occlusion has a fourth interpretation. 
Is one method better than the other? That is not the important question.
What we should be asking is:
What is the best way that general practitioners should be doing their work in order to minimize the deleterious effects of DCS so that patients don’t have to go into rehabilitation?
Why general practitioners? Because it is the GPs who are doing the vast majority of the work. Very few patients go into rehabilitation or reconstruction—probably less than 1%. The majority of dental work that is performed each day throughout the world is by increments—a crown here, an amalgam restoration there, facial composites, or some fixed bridgework. Since this is reality, what is the best way GPs can perform this incremental work, maintain the health and effi ciency of the stomatognathic system, and prevent DCS? That is what we really want to know if we are going to interpret “concept on occlusion” objectively. 
What are the guidelines? GPs should: 
  • 1. Be alert to the signs and symptoms of DCS. 
  • 2. Thoroughly explain DCS to their patients. 
  • 3. Determine if an equilibration is necessary. 
  • 4. Determine if a guard is necessary. 
  • 5. Mimic the natural design of teeth when delivering dental prostheses to the mouth. 
from The Truth About Occlusion 
Gene D. McCoy, D.D.S.   Download 528Kb


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