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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
A robust and accessible resource on occlusion for general dental practitioners
Practical Procedures in Dental Occlusion delivers a solid and reliable exploration of dental occlusion. The book offers practical and accessible information about evidence-based techniques applicable to everyday clinical situations encountered in general practice.
The authors provide a straightforward guide to the optimisation of restorative treatment outcomes, including occlusion in simple and advanced restorative care. The inclusion of questions at the end of the book, a glossary of useful terms and phrases in occlusion encourages self-assessment.
Readers will also find:
- Thorough introductions to common prosthodontic terms, neuromuscular philosophies, and the equipment and techniques used in occlusal examination
- Practical explorations of typical problems faced by practitioners when recording occlusal contacts using different articulating papers
- Overviews of “high crown” clinical scenarios, including the importance of opposing alginate impressions and cast mounting
- An insightful treatment of the clinical scenario of a fractured upper central incisor composite restoration
Perfect for undergraduate dental students and general dental practitioners, Practical Procedures in Dental Occlusion is a valuable resource for those seeking a systematic and logical treatment of the management of occlusal problems.
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Table of Contents
Cover
Dedication Page
Title Page
Copyright Page
Acknowledgements
About the Companion Website
About the Book
1 Terminology
References
2 Neuroanatomy – Why is It Important?
Introduction
Neuroanatomy
Mastication
Deglutition (Swallowing)
Cognitive Trap
Conclusion
References
Further Reading
3 What's of Use to Me in Practice? Armamentarium, Equipment and Techniques
The Occlusal Examination Tray
Shimstock Foil
Articulating Papers
Miller's Forceps
Registration Media and Techniques
Polyvinyl Siloxane Syringable Materials
Centric Relation Record
Facebow Registration
Articulators
How to Make a Stabilisation Splint (SS)
Further Reading
4 I Don't Know What I Am Recording. Where Are the True Contacts?
Scenario
Rationale
Procedure
Conclusion
References
Further Reading
5 The Crown is High
Scenario
Rationale
Procedure
References
6 My Bite Feels Different
What was the Most Likely Cause of the Patient's Complaint?
How Can This Conformative Approach Be Adopted Practically?
Can the Dentist Adjust the Teeth Opposing the Bridge to Improve the Occlusion and Hopefully Reduce the Patient's Discomfort? No!
Further Reading
7 ‘My Front Tooth Filling Keeps Fracturing’
Scenario
Rationale
Procedure
Summary
References
8 TMD and Occlusion – Is There a Link?
Is There Any Evidence to Support the Use of Occlusal Adjustment as an Initial Therapy in TMD Management?
Occlusal Adjustment for Treating TMD Patients
Further Reading
9 How Would I Adjust a High Occlusal Contact?
Scenario
Rationale
Equipment
Procedure
References
10 How Would I Ensure a Good Occlusion on Posterior Composite Restorations?
Static Occlusion
Occlusal Surface Morphology and Anterior Guidance
Further Reading
11 My Front Teeth Feel Loose and Are Moving
Retruded Contact Position Can Be Associated with Occlusal Problems
Conforming to Existing Guidance When Restoring Anterior Teeth: Copying Anterior Guidance
Clinical Case
Further Reading
12 Canine Guidance or Group Function?
Canine Guided Occlusion
Introduction
Group Function Occlusion
Mastication
References
Further Reading
13 Replacing Missing Teeth – Abutment is Involved with Guidance
14 The Space is Lost! Loss of Occlusal SpaceFollowing Crown Prep
Dealing with This Problem Clinically
Further Reading
15 My Front Teeth are Worn
Scenario
Rationale
Procedure
References
Further Reading
16 All My Teeth Are Restored But Don't Meet Like They Did Before
Scenario
Rationale
Procedure
References
Further Reading
17 I Am Breaking My Teeth and Veneers and Lost a Tooth Due to Grinding
Scenario
Rationale
Occlusal Vertical Dimension
Procedure
References
Further Reading
18 Occlusion on Implants. Any Difference?
Good Occlusal Practice in Implantology
Implant‐Protected Occlusion (IPO): The Ten General Principles
Suggested Clinical Protocols
Further Reading
Glossary of TermsGlossary of Terms
Further Reading
Short Answer QuestionsShort Answer Questions
Index
End User License Agreement
List of Tables
Chapter 9
Table 9.1 Optimal speed usage for burs.
Chapter 16
Table 16.1 Typical symptoms mentioned by patients.
Chapter 17
Table 17.1 Methods of analysing occlusion.
List of Illustrations
Chapter 2
Figure 2.1 Signal pathways. PDMR (afferent neurons) are triggered (sensory a...
Figure 2.2 Chewing cycle data collected using MODJAW (for further details on...
Chapter 3
Figure 3.1 The occlusal examination tray. (1) Paper tissues held in Miller's...
Figure 3.2 (a) Shimstock foil and (b) Shimstock in use as a feeler gauge bet...
Figure 3.3 Shimstock can be used to ensure the accuracy of the mounting of t...
Figure 3.4 Different shapes of articulating papers.
Figure 3.5 The articulating papers must be placed simultaneously on the two ...
Figure 3.6 Y‐type articulating paper holder.
Figure 3.7 Articulating papers held by Miller's forceps.
Figure 3.8 ‘Squash bite’ technique using pink sheet wax is not recommended....
Figure 3.9 Full arch detailed occlusal registration.
Figure 3.10 Excessive details on the occlusal registration may hinder seatin...
Figure 3.11 A carefully trimmed registration limited to the area of tooth pr...
Figure 3.12 Virtual bite registrations can be accurately obtained using intr...
Figure 3.13 Passive manipulation of the mandible of a supine patient used fo...
Figure 3.14 Greenstick impression compound used as a template into which the...
Figure 3.15 (a–d) A suitable bite registration material is syringed between ...
Figure 3.16 Earbow and accessories needed for facebow registration. (1) Slid...
Figure 3.17 Marking the anterior reference point.
Figure 3.18 A silicone bite registration material can be used as a bitefork ...
Figure 3.19 The bitefork is placed on to the patient's upper teeth and stabi...
Figure 3.20 Light indexing impression of the maxillary teeth on the bitefork...
Figure 3.21 The earbow is guided into the patient's ears.
Figure 3.22 The pointer is aligned with the anterior reference point on the ...
Figure 3.23 Looking at the patient from the front, verify that the bow is ho...
Figure 3.24 Finger screws 1 and 2 are securely tightened before removing the...
Figure 3.25 The earbow assembly, transfer jig and bitefork are removed from ...
Figure 3.26 (a) Transfer jig after detachment from the earbow, (b) screws 1 ...
Figure 3.27 (a) A mounting shoe replaces the incisal guide table. (b) Transf...
Figure 3.28 Simple hinge articulators (non‐anatomical occlude).
Figure 3.29 Comparison of the radius from transverse horizontal axis to toot...
Figure 3.30 Restorations constructed on a non‐anatomical articulator. Note t...
Figure 3.31 Semi‐adjustable articulators allow adjustment to simulate mandib...
Figure 3.32 Arcon type semi‐adjustable articulators have their condyles in t...
Figure 3.33 Parts and components of the semi‐adjustable articulator. (1) Bit...
Figure 3.34 The intercondylar distance in semi‐adjustable articulators is us...
Figure 3.35 Condylar inclination (condylar guidance) is the angle made by th...
Figure 3.36 (a) Condylar guidance on a semi‐adjustable articulator. The cond...
Figure 3.37 The effect of altering the condylar guidance on the posterior te...
Figure 3.38 Bennett angle.
Figure 3.39 Bennett angle set in a semi‐adjustable articulator.
Figure 3.40 Bennett movement set in a semi‐adjustable articulator.
Figure 3.41 Movements of working side and non‐working side condyles in a sem...
Figure 3.42 Fully adjustable articulator.
Figure 3.43 Stabilisation splint (Michigan splint).
Figure 3.44 Upper and lower models are mounted on a semi‐adjustable articula...
Figure 3.45 Adequate relief of undercuts and initial polishing are carried o...
Figure 3.46 Autopolymerising acrylic is used to reline a stabilisation splin...
Figure 3.47 The SS was relined with autoploymerising acrylic intraorally at ...
Figure 3.48 Thin articulating papers (two different colours) and straight ha...
Figure 3.49 A balanced occlusion should be provided between the splint and o...
Figure 3.50 (a) Centric relation stops marked using blue articulating paper,...
Chapter 4
Figure 4.1 The masticatory system and its components.
Figure 4.2 Basic terminology related to occlusion.
Figure 4.3 A cross‐section through the cusps showing dish effect as shown on...
Figure 4.4 Occlusal contacts and risks associated with incline contacts.
Figure 4.5 The occlusal contacts in a Class 1 relationship. The contacts the...
Figure 4.6 Articulating paper difference and precision related to minimal in...
Figure 4.7 Shimstock hold and how to use.
Figure 4.8 Dynamic occlusion assessment.
Figure 4.9 Fremitus assessment.
Figure 4.10 Completion of the scenario.
Figure 4.11 Summary of the chapter.
Chapter 5
Figure 5.1 Supraoccluded crown causing occlusal issues.
Figure 5.2 Fractured cusp following restoration of adjacent tooth with a cro...
Figure 5.3 Progression of occlusal instability resulting in cuspal fracture ...
Figure 5.4 Analysis of dynamic occlusion.
Figure 5.5 Digital scan showing WS and NWS contacts on a digital articulator...
Figure 5.6 Restorability assessment in planning stage.
Figure 5.7 Assessment of opposing impressions to ensure no separation.
Figure 5.8 Bite record taking with polyvinyl siloxane.
Figure 5.9 Trimming silicone to aid study cast fabrication.
Figure 5.10 Digital design of provisional crown.
Figure 5.11 (a–c) Cementation of a crown.
Figure 5.12 (a) Provisional restoration seated. Note fossa and marginal ridg...
Chapter 6
Figure 6.1 Intraoral view of the fitted bridge.
Figure 6.2 (a) Shimstock is 8 μm thick metal foil used as a feeler gauge bet...
Figure 6.3 (a) CR incisal view and (b) CO incisal view.
Chapter 7
Figure 7.1
Figure 7.2 The important aspects of the incisors and their role.
Figure 7.3 Incisal relationships.
Figure 7.4 Horizontal and vertical overlap of the incisors.
Figure 7.5 Anterior composites and occlusal design when incising or protrusi...
Figure 7.6 Phonetics in a Class 1 incisal relationship.
Figure 7.7 Fracture resulting from a nail‐biting habit (hypernormal function...
Figure 7.8 (a, b) A case showing conformative management of Class 3 incisal ...
Figure 7.9 (a) Preoperative assessment. (b) CRCP‐CO slide resulting in a for...
Figure 7.10 Migration resulting from deflective contact.
Figure 7.11 Summary of the chapter.
Chapter 8
Figure 8.1 Occlusal adjustment or equilibration should always be planned on ...
Chapter 9
Figure 9.1 This patient had a crown fitted recently but has now presented wi...
Figure 9.2 Bur shape allowing correct morphological adjustment. Yellow band ...
Figure 9.3 Summary of essential steps when adjusting.
Figure 9.4 Dish contact and point contact on an indirect restoration.
Figure 9.5 Restoration of first premolar using occlusal principles.
Figure 9.6 How to adjust a high spot maintaining correct morphology.
Figure 9.7 Clinical case detailing steps on how to adjust a high spot.
Figure 9.8 Clinical case detailing steps on how to adjust a high spot on a n...
Chapter 10
Figure 10.1 A contact formed against a single cusp slopes, potentially allow...
Figure 10.2 Tripodization.
Figure 10.3 Tripodization on a posterior tooth newly restored with composite...
Figure 10.4 The occlusal contacts of a posterior tooth should be marked usin...
Figure 10.5 Occlusal contacts occurring at the tooth–restoration interface s...
Figure 10.6 (a) The best approach is to mark the occlusal contacts of the pr...
Figure 10.7 (a, b) The crow's foot pattern.
Chapter 11
Figure 11.1 Lack of freedom in centric can be detected by placing a finger o...
Figure 11.2 ‘Freedom in centric’ natural teeth and implants.
Figure 11.3 Fremitus can be detected by placing gloved fingers on the upper ...
Figure 11.4 Drifting of upper incisors could be a sign of anterior thrust or...
Figure 11.5 Localised palatal wear could be a sign of anterior thrust or a d...
Figure 11.6 (a–c) Copying anterior guidance.
Figure 11.7 (a) Intraoral view of the preoperative case showing marked pre‐e...
Chapter 12
Figure 12.1 Preoperative assessment – all guidance on the posterior teeth.
Figure 12.2 Diagrammatic steps detailing how to provide a canine riser.
Figure 12.3 Clinical case showing canine riser using composite.
Figure 12.4 (a, b) Laboratory stages detailing functional wax‐up and canine ...
Figure 12.5 Functionally generated pathway technique.
Figure 12.6 MODJAW 4D equipment.
Figure 12.7 Data incorporated within Exocad laboratory software to design re...
Figure 12.8 Group function assessed on MODJAW.
Figure 12.9 Mastication proper.
Figure 12.10 Masticatory cycle.
Figure 12.11 Cycle in–cycle out movements in mastication.
Figure 12.12 Clinical case showing replication of masticatory cycle.
Chapter 13
Figure 13.1 Clinical presentation of the case.
Figure 13.2 Examination of the pre‐existing dynamic occlusion revealed that ...
Figure 13.3 (a–c) The design of the restoration can allow the conformative a...
Chapter 14
Figure 14.1 Clinical presentation.
Figure 14.2 (a–c) Following preparation of the last tooth for a crown, the c...
Figure 14.3 (a, b) Marking RCP contact.
Figure 14.4 (a, b) The island technique.
Figure 14.5 The RCP contact appears as an island protruding from the crown t...
Figure 14.6 The transfer coping in use in the laboratory and clinically.
Chapter 15
Figure 15.1 Initial presentation.
Figure 15.2 Tooth surface loss and tooth wear.
Figure 15.3 CCP test.
Figure 15.4 Diagram showing the condyle against the posterior wall of the gl...
Figure 15.5 Restorative correction; see option 2 for explanation.
Figure 15.6 Anterior bite platform created using the Dahl concept with the c...
Figure 15.7 Vertical and horizontal reference lines. This photo shows the IP...
Figure 15.8 Facial proportions.
Figure 15.9 Detailed TMD flow chart.
Figure 15.10 E‐line and nasio‐labial angle.
Figure 15.11 Incisal view at rest.
Figure 15.12 Central incisor proportions.
Figure 15.13 (a) Occlusal and incisal plane. A full face frontal retracted v...
Figure 15.14 Curve of Spee.
Figure 15.15 Incisal visibility at rest.
Figure 15.16 Preoperative case photos for planning.
Figure 15.17 Illustrating the options where material can be placed once an i...
Figure 15.18 Rule of thirds.
Figure 15.19 CR record and clinical steps and assessment.
Figure 15.20 Laboratory steps and assessment.
Figure 15.21 Laboratory wax‐up and assessment.
Figure 15.22 Postoperative result.
Chapter 16
Figure 16.1 Clinical presentation of the patient.
Figure 16.2 Preoperative clinical photographs.
Figure 16.3 Stabilisation splint guidelines.
Figure 16.4 Clinical records stage.
Figure 16.5 Provisionalisation stage.
Figure 16.6 Records for cross‐mounting.
Figure 16.7 Customised incisal guidance table platform creation.
Figure 16.8 Articulator switch deactivated to allow lateral movements.
Figure 16.9 Incisal guidance table – lateral movements.
Figure 16.10 Final restorations.
Figure 16.11 Anterior final restorations and post stabilisation splint.
Chapter 17
Figure 17.1 Patient presenting with chipped and lost veneers related to occl...
Figure 17.2 Articulated models detailing OVD increase with the ‘rule of thir...
Figure 17.3 Diagrammatic illustration detailing increasing OVD.
Figure 17.4 Facially driven digital planning. The smile design program Smile...
Figure 17.5 Articulated study casts before wax‐up showing non‐working side c...
Figure 17.6 Mock‐up smile preview.
Figure 17.7 Functional mock‐up transferred.
Figure 17.8 Mock‐up preassessment allowing for preparation through the added...
Figure 17.9 Digital biocopy scan to allow duplication into definitive restor...
Figure 17.10 Final restorations designed using functional data from MODJAW....
Figure 17.11 T‐Scan.
Chapter 18
Figure 18.1 (a) Bone loss (funnelling) around anterior implants caused by ex...
Figure 18.2 In implants, orient the total masticatory force loading to the f...
Figure 18.3 Only one centric stop must be received on the occlusal surface o...
Figure 18.4 Centric stop (red) should be centred over central fossa, and sec...
Figure 18.5 Occlusal contact on the cusp incline leads to an increase in the...
Figure 18.6 The occlusal table is too large, resulting in detrimental shear ...
Figure 18.7 In an upper posterior implant, the occlusal table width should b...
Figure 18.8 In a lower posterior implant, the buccal contour of the implant ...
Figure 18.9 If the abutment of the implant crown is mesially or distally loc...
Figure 18.10 (a) Large cusp angles create an increased contact surface area,...
Figure 18.11 Freedom in centric concept must be adopted in posterior implant...
Figure 18.12 A suggested protocol in implant dentistry. In centric occlusion...
Figure 18.13 A long, parallel proximal contact area is recommended for bette...
Figure 18.14 Buccal and lingual cusps are shortened to avoid any gliding act...
Figure 18.15 An ideal anterior guidance for an implant on a lower six. In th...
Figure 18.16 Posterior implant‐supported restorations should be discluded du...
Figure 18.17 (a–f) A suggested protocol for a single implant‐supported crown...
Figure 18.18 (a–d) A suggested protocol for a full arch implant‐supported pr...
Guide
Cover Page
Dedication Page
Title Page
Copyright Page
Acknowledgements
About the Companion Website
About the Book
Table of Contents
Begin Reading
Glossary of Terms
Short Answer Questions
Index
Wiley End User License Agreement
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To my 2Ms: my wife Manal and son in law MohsiTo my 3Ls: my daughters Loujin, Lilas and Leanne
Ziad Al-Ani
To the Creator, My Mother and Father, Wife Azmat and my 4 children Zayd, Adam, Esa, Khadijah
Riaz Yar
Practical Procedures in Dental Occlusion
Ziad Al‐Ani, BDS, Oral Surg PG Dip, Fixed Pros PG Dip, PGCAP, MSc, PhD, MFDS RCS(Ed), FHEA, RET Fellow
Senior LecturerSchool of Medicine, Dentistry & NursingUniversity of Glasgow, UK
Riaz Yar, BDS, MFDS RCS (Edin), MPhil (Restorative), DPDS, Dip Implant Dent RCS (Edin), MPros Dent RCS (Edin), FDS RCS (Edin), Masters in Soft Tissue around Teeth and Implants (Bologna)
Director and Visiting ProfessorThe Square Advanced Dental CareHale Barns, UK
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Library of Congress Cataloging‐in‐Publication Data
Names: Al‐Ani, M. Ziad, author. | Yar, Riaz, author.Title: Practical procedures in dental occlusion / Ziad Al‐Ani, Riaz Yar.Description: First edition. | Hoboken, NJ : John Wiley & Sons, 2022. | Includes bibliographical references and index.Identifiers: LCCN 2021013458 (print) | LCCN 2021013459 (ebook) | ISBN 9781119678519 (paperback) | ISBN 9781119678489 (adobe pdf) | ISBN 9781119678526 (epub)Subjects: MESH: Dental Occlusion | Malocclusion–prevention & control | Orthodontics, Corrective–methodsClassification: LCC RK523 (print) | LCC RK523 (ebook) | NLM WU 440 | DDC 617.6/43–dc23LC record available at https://lccn.loc.gov/2021013458LC ebook record available at https://lccn.loc.gov/2021013459
Cover Design: WileyCover Image: © Ziad Al‐Ani
Acknowledgements
The authors wish to acknowledge the kind permission of Claire O'Connor, Neil Sparkes and Deborah Khadem in using them as photographic models in some chapters of this book.
We are very grateful to Tanya McMullin, Loan Nguyen and Bhavya Boopathi for their advice and support in the production of this text.
We would like to thank Mr Robert Gandy, Ceramist, The Cube Advanced Dental Laboratory for the Wax up on the front page and all the ceramic restorations documented in the book.
About the Companion Website
Don’t forget to visit the companion website for this book:
www.wiley.com/go/al‐ani‐and‐riaz/dental‐occlusion
There you will find valuable material designed to enhance your learning, including:
Videos
Figures from the book as downloadable PowerPoint slides
About the Book
The subject of occlusion has traditionally been very difficult to learn, understand and manage. As a result, an unwanted mystique has been built around it that has intimidated a large part of the dental profession.
It is now more important than ever that dental practitioners familiarise themselves with a subject that so intimately affects their daily professional lives.
Restorative treatment outcome is highly dependent on the occlusion of the restoration when the treatment is complete and therefore sound up‐to‐date knowledge of all evidence‐based aspects of this commonly encountered condition is essential.
General practitioners usually have very limited practical clinical experience in occlusion and most of the books available for them are theory‐based resources.
This book aims to enable readers to gain a solid foundation of knowledge of occlusion, by providing practical, learnable, usable information and techniques which are demonstrated in a practical and easy‐to‐understand style. The intention is to explain current evidence‐based practical concepts in the field of dental occlusion so that they can be reflected in the reader's clinical practice.
The book contains a series of everyday clinical situations in occlusion, that may be encountered in general practice, to help readers understand and engage with the information and to promote effective clinical management.
It aims to provide practical guidance to what is required to optimise restorative treatment outcomes, including occlusion, in simple and advanced restorative care. The book also promotes learning as a dynamic process of active involvement. It encourages valuation by self‐assessment with questions at the end of the book.
Chapter 1 – Terminology
It is important we address terminology right at the start to reduce the confusion that has been created throughout the history of occlusion. As a source, Glossary of Prosthodontic Terms 2017 edition is used throughout the book.
Chapter 2 – Neuroanatomy – Why is It Important?
This chapter will address neuromuscular philosophies and introduce the neurolink between all systems from the periodontal mechanoreceptors on teeth through to central pattern generators in the pons and muscles and temporomandibular harmony.
Chapter 3 – What's of Use to Me in Practice? Armamentarium, Equipment and Techniques
This is a ‘how‐to’ chapter. It is important for the clinician to know the equipment and techniques used in occlusal examination, registration and record. This chapter also discusses facebow, articulators and how to make a stabilisation splint.
Chapter 4 – I Don't Know What I Am Recording Where are the True Contacts?
This chapter illustrates a classic problem most of the practitioners face when recording occlusal contacts using different articulating papers. It will highlight the following:
morphology and type of occlusal contacts in class 1, class 2 and class 3 relationships
the importance of selecting the correct size of articulating papers
the appropriate techniques in recording occlusal contacts
how to properly mark shiny occlusal surfaces.
Chapter 5 – The Crown is High
This clinical scenario will highlight the possible factors which may contribute to this situation (a high crown). It discussed the importance of accurate opposing alginate impression and mounting of the casts. The laboratory handling of the cast and the provisional crown will be covered.
Chapter 6 – My Bite Feels Different
Using a clinical scenario of a change of patient bite following fitting of an indirect restoration, this chapter will mainly focus on the importance of adopting the conformative approach in restorative dentistry. The possibility of introducing iatrogenic changes to a patient's bite is quite real and can have immediate consequences. Avoidance of the problem is the best approach but to do this, you must be aware of the potential pitfalls in restorative care.
Chapter 7 – My Front Tooth Filling Keeps Fracturing
This clinical scenario of a fractured upper central incisor composite restoration will highlight the importance of checking premature contacts in centric relation and dynamic occlusion.
Chapter 8 – TMD and Occlusion – Is There a Link?
Opinion regarding the importance of occlusion as an aetiological factor in the development of TMDs has shifted between it being the main causative factor and there being no correlation at all. This chapter will discuss this controversy and provides the reader with findings from contemporary literature.
Chapter 9 – How Would I Adjust a High Occlusal Contact?
This chapter will explain the proper techniques which should be adopted when adjusting the occlusal contacts and interferences by the dentist.
Chapter 10 – How Would I Ensure a Good Occlusion on Posterior Composite Restorations?
This chapter will illustrate the concepts and practical steps of achieving occlusal surfaces which provide proper reconstruction of natural morphology. It will highlight the following aspects:
conforming to existing guidance in restored teeth
creating departure clearance spaces
the importance of the location of the occlusal contact.
Chapter 11 – My Front Teeth Feel Loose and Are Moving
This chapter will discuss occlusal trauma from functional or parafunctional forces. Lack of freedom in centric and the effect of RCP–ICP slide on anterior teeth will be also covered.
Chapter 12 – Canine Guidance or Group Function?
This has been an ongoing debate over many years with discussions on which lateral‐based occlusal scheme is the best for the patient. This chapter will discuss the rationale behind both and how to achieve them clinically.
Chapter 13 – Replacing Missing Teeth – Abutment is Involved with Guidance
This clinical scenario will highlight the flowing points:
checking the guidance prior to commencing treatment
conforming to the guidance by selecting a treatment plan which avoids changing it.
Chapter 14 – The Space is Lost! Loss of Occlusal Space Following Crown Prep
This chapter will discuss the significant concepts which need to be understood and planned when considering restoration of a tooth involved in the centric relation/retruded contact position. How to manage when the space is suddenly lost during crown preparation on a tooth that is the last in the arch.
Chapter 15 – My Front Teeth Are Worn
Management of tooth surface loss is a complex treatment but some straightforward rules will help in diagnosis of the cause, monitoring of the situation and its management.
This chapter will illustrate the principles of management of non‐carious tooth surface loss (TSL) cases and will focus on:
achieving an appropriate OVD (when and how)
review of mounted study casts
diagnostic wax‐up
Dahl concept.
Chapter 16 – All My Teeth Are Restored But Don't Meet Like They Did Before
In this chapter, a patient has presented with a restored mouth with multiple crowns and they feel the teeth do not meet like before. They cannot find a comfortable position. The use of material that allows testing the increase of OVD when managing advanced restorative care cases will be discussed. A full description of clinical procedure will be offered here.
Chapter 17 – I Am Breaking My Teeth and Veneers and Lost a Tooth Due To Grinding
The following points are discussed in this chapter:
OVD increase
improving incisal and occlusal relationships
rule of thirds
aesthetic and functional analysis.
Chapter 18 – Occlusion on Implants. Any difference?
Dental implants may be more prone to occlusal overloading. A primary cause of peri‐implantitis and bone loss around implants is the excessive force applied from unwanted occlusal contact. The occlusal prescription of an implant‐supported restoration, therefore, has to be much more carefully designed than that on a natural tooth. The 10 principles of occlusion over implants are discussed in this chapter.
Glossary of Terms
This is more of a dictionary of terms than merely a glossary of terms used in this book. This chapter isolates the relevant terms from the glossary of prosthodontic terms. published regularly in the Journal of Prosthetic Dentistry.
Short Answer Questions
This chapter includes short answer questions for the reader to practise. The knowledge gained from reading this book will enable the reader to answer these questions effectively.
1 Terminology
It is important we address terminology right at the start to reduce the confusion that has been created throughout the history of occlusion. As a source, we will use the Glossary of Prosthodontic Terms (GTP) (2017) edition for the most part.
The three most important terms are defined below.
Centric occlusion(CO)
