The key to success in restoring anterior teeth is the precise location of the incisal edges; where those incisal edges are will determine many things regarding the anterior restoration (including long-term success). It’s important to understand that there is no norm that works for every patient. In fact, the anterior guidance on each case will differ notably.
We're going to answer some questions regarding the webinar that I did the other night on anterior guidance, and we have some very good questions.
What about group function? Is it only for dentures?
The answer to this is that group function is routinely, very applicable to dentures, but not typically for natural teeth, with the exception of patients who do not have an anterior guidance. If they don't have an anterior guidance to disclude the balancing side in excursions, then we have to use the working side in group function to disclude the balancing side. As long as we have an anterior guidance though, we do not want group function. We want just lines in front, dots in back with the anterior guidance separating all the posterior teeth in all excursions.
In this webinar, Dr. Dawson discusses in depth the often discussed and debated concepts of Anterior Guidance. This discussion includes understanding how the envelope of function, incisal edge position, and lingual contours work in harmony with the anatomy of the TMJ and muscles of mastication, which are concepts that must be mastered by the restorative dentist.
Hear him revisit timeless principles that he has spent a career and lifetime in understanding and teaching to our profession.
Here’s the scenario:
If a patient presents with a dull ache in the joint before load testing and the three stages of load testing don't cause any additional discomfort, but there is still that same dull ache present throughout. Should you proceed to occlusal treatment?
If you answered yes, I caution you.
At one point or another in your career, you’ll likely have a patient that was treated by another dentist who made some sort of mistake.
Having had the advantage of more than 60 years in dentistry, I’ve had an opportunity to see the long-term differences that result from different attitudes about what it means to have a “successful practice.”
I was recently talking with a student who described a patient who could not load the joint comfortably. Additionally, the patient had severe wear, an uneven occlusal plane, broken crowns, and despite deprogramming with a cotton roll, he would feel quite a bit of tenderness when the TMJs were load tested.
When you're checking long centric, it's a postural closure, a very gentle closure from postural position where the jaw might posture slightly forward out of centric relation.
Load testing is an important part of verifying centric relation. The purpose is to verify that your patient is in centric after you think they are there. In order to master this technique, it takes a solid understanding of how the masticatory system works and some practice through repetition.