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Dawson Quick Tips: Creating Stable, Equal-Intensity Centric Stops

Hey everybody. Welcome to Quick Tips. Today I want to talk to you about creating stable, equal intensity stops when we're looking at occlusion.

5 Requirements of Occlusal Stability

We talk about five requirements of occlusal stability, and number one is making sure that when we close our mouth that we have as many teeth as possible, hopefully 14 teeth, hitting 14 teeth simultaneously with equal intensity contact.

Equal Intensity Centric StopsAnd so when we think about how a jaw closes, we want to make sure that we are aligning the cusp tip into the appropriate fossa or marginal ridge. So when we look at this stable bite, we are visualizing that cusp tip landing on a flat surface. If it's landing on an incline, it's going to cause the tooth to shift positions, get loose, move out of the way, or not be optimally stable.

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So you look at a reconstruction like this where we have control over everything, we do want stops all the way around. Lower incisors are going to be touching under the singulums hopefully, and then we want those upper lingual cusps landing on a marginal ridge or a central fossae and the lower buckle cusp doing the same thing.

So for our quick tip today I want you to think about if you see a mark on an incline, what do we grind?

Rules of Grinding Stamp CuspsDo we grind the inside of the fossa or do we start sharpening cusps? The key to remember is to look at the sides of the stamp cusps if the cusp isn't aligned properly.

Now a stamp cusp is a cusp that fits into a fossa. It's a lower buckle cusp or an upper lingual cusp.

From a grinding standpoint, we never ever want to shorten or lop off a cusp.

That is not what we do when we're adjusting somebody's bite, whether it's restorations that we've just placed or the natural dentition. What we're going to do is grind on the side of the stamp cusp, lower buckle cusp and upper lingual cusp, and align the cusp tip towards the opposite fossa or marginal ridge.

I think if you do that, you're going to find it unbelievably easy to get the cusp to land in a place that is going to be stable. And it also allows you to do this very, very rapidly.

Proper Equilibration TechniqueSo, as we look at our situations that we see again, if you have a pre-op situation where you see that mark on the side of the stamp cusp, do not open fossae up. If you're opening fossaes up we often are grinding on the incline of a non-functional cusp - upper buckle cusp or lower lingual cusp - which can severely weaken those cusps. Grinding on the side of the stamp cusp is where to go.

The other thing we can do, we have the marks in the right place, is just narrow the marks.

So if we, to identify precisely where we want the cusp to land, then use something like a carbide finishing bur - a football shaped carbide finishing bur - and just narrow your cusp. Ideal OcclusionThis is an extremely good example of an ideal occlusion. Very light and precise stops on cusp tips and marginal ridges.

So my quick tip today is look at the sides of those stamp cusps. They are the place you should be adjusting. Get them aligned with the opposite central fossa and marginal ridge and I think you'll have a lot of success.

Good luck with that and we will see you next time on Quick Tips.

How to Schedule an Occlusal Equilibration Appointment

John C. Cranham, DDS has an esthetic oriented practice in Chesapeake, Virginia. An honors graduate of the Medical College of Virginia in 1988, Dr. Cranham maintains a strong relationship with his alma mater as an Associate Clinical Professor. He is an internationally recognized speaker on the Esthetic Principles of Dentistry, Contemporary Occlusal Concepts, Treatment Planning, Restoration Selection, Digital Photography, Laboratory Communication, and Happiness and Fulfillment in dentistry. As a published author, Dr. Cranham has a strong commitment to developing sound educational programs that exceed the needs of today’s dental professional. He is an active member of numerous professional organizations including the American Dental Association, The American Academy of Cosmetic Dentistry, The American Academy of Fixed Prosthodontics, and The American Equilibration Society. Dr. Cranham is co-chair of Advanstar Dental Media’s CE Advisory Board (Advanstar is the publisher of Dental Products Report). Dr. Cranham is the Clinical Director of The Dawson Academy where he is involved with many of the lecture and hands-on courses within the curriculum. As an active educator, he has provided over 650 days of continuing education for dental professionals throughout the world.