In order to properly describe an occlusion, we must not look at teeth in a vacuum, but as if we're starting at plaster models sitting on a table. We have to understand that teeth are one part of a larger system. Now, if one or both condyles have to displace in order for our teeth to come together in maximum intercuspation, or what we call MI.
Here at The Dawson Academy, we get a lot of questions. Among all of the questions I hear from our students, one of the main questions that we get is why is my dentistry breaking? And what can I do to prevent that from happening again?
One of the questions we get asked a lot is, is centric relation really repeatable?
And I want to look at this in two perspectives. A lot of people look at the reason we use centric relation is that we want to have a position that's repeatable, when we're doing our prosthetics, and that is absolutely true, particularly when we're doing larger cases and we're changing the vertical dimension of occlusion.
Dental occlusion is the absolute backbone of everything that we do here at The Dawson Academy. Dental occlusion is important because it affects how the teeth react, how the muscles react, how the joint reacts.
As we go through our treatment we talk about three different phases.
Phase one is to stabilize the biology, Stage two is to stabilize the occlusion. Then stage three is to do all the sort of final restorations. Now, certainly, getting the biology correct is going to be incredibly important.
I'd like to take a moment and talk with you about what we should be thinking when we see patients that have wear.
So one thing I have been doing a lot in my office lately is utilizing composite resin. It is a great way to stabilize the occlusion and get the function right in a patient, especially when patients are not ready to proceed with more definitive restorations or they just do not have the finances to.
A lot of people have the question, "What centric relation is?"
Centric Relation is defined as the most anterior superior position of the condyle disc assembly within the glenoid fossa.
And one thing to remember about centric relation is it's irrespective of where the teeth are. If the teeth weren't present, the muscles of mastication would guide the condyle and pull that joint up into centric relation.
When we consider the temporomandibular joint, ideally, what we would like to have if we are talking about centric relation is a joint which is unaltered, which means that the condyle disc assembly is in its proper position, fully seated into the glenoid fossa.
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.