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Book Details
Abstract
This book uses an interdisciplinary approach to explain the origin of and possible solutions to many different occlusal problems. Dr. Peter E. Dawson guides the reader along the way providing balanced explanations of theory and technique. He also debunks many popular misconceptions through practical discussion of their origins and the deficiencies of the arguments behind them. Different sides of many philosophies are presented while guiding the reader to the most functional and esthetic solution to various occlusal situations. Hundreds of full-color photographs, illustrations, and diagrams show aspects of the masticatory system, the epidemiology of occlusal problems, and procedures for finding the ideal occlusion. Whether the reader is a general dentist or a specialist, they will find this book applicable to their treatment methods and philosophies.
OUTSTANDING FEATURES
- Special atlas sections break down complex information accompanied by descriptive diagrams and photographs to further explain sources of occlusal disorders and related pain.
- Hundreds of full-color photographs and illustrations show problems and procedures.
- Procedure boxes offer step-by-step explanations of specific procedures.
- Important Considerations boxes in the Treatment chapters outline treatment plans and describe what is to be accomplished.
- Programmed treatment planning, a specific process that guides a clinician through every step for solving even the most complex restorative or esthetic challenge.
- The role of TMJs and occlusion in "everyday" dentistry.
- The role of occlusion in orofacial pain and TMD, and in anterior esthetics.
- Simplified occlusal equilibration and how to explain this process to patients.
- The functional matrix concept for exceptional, foolproof smile design.
- The five options for occlusal correction and how to apply them to practice.
- Use and abuse of occlusal sprints.
- Coordinating occlusal treatment with specialists for a fully interdisciplinary approach.
- Specific criteria for success and how to test for each.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Functional Occlusion: From TMJ to Smile Design | iii | ||
| Copyright Page | iv | ||
| Table of Contents | xiii | ||
| Dedication | v | ||
| Foreword | vii | ||
| Preface | ix | ||
| Acknowledgments | xi | ||
| Part I: Functional Harmony | 1 | ||
| Chapter 1. The Concept of Complete Dentistry | 3 | ||
| COMPLETE DENTISTRY | 4 | ||
| GOALS FOR COMPLETE DENTISTRY | 4 | ||
| Chapter 2. Perspectives on Occlusion and “Everyday Dentistry” | 11 | ||
| OCCLUSAL PRINCIPLES AT EVERY LEVEL OF PRACTICE | 12 | ||
| RELEVANCE OF OCCLUSION TO “EVERYDAY DENTISTRY” | 13 | ||
| Chapter 3. Occlusal Disease | 17 | ||
| SIGNS AND SYMPTOMS | 18 | ||
| BASIC MECHANISMS FOR TOOTH SURFACE DEFORMATION | 18 | ||
| Chapter 4. The Determinants of Occlusion | 27 | ||
| DESIGN OF THE MASTICATORY SYSTEM | 28 | ||
| PRIMARY REQUIREMENTS FOR SUCCESSFUL OCCLUSAL THERAPY (FIGURE 4-3) | 31 | ||
| THE DYNAMICS OF EQUILIBRIUM | 31 | ||
| FORMULA FOR A PERFECTED OCCLUSION | 32 | ||
| Chapter 5. The Temporomandibular Joint | 33 | ||
| THE FIRST REQUIREMENT | 34 | ||
| THE ARTICULATING SURFACES | 34 | ||
| UNDERSTANDING CONDYLE DISK ALIGNMENT | 38 | ||
| HOW MUSCLE CONTROLS DISK ALIGNMENT | 39 | ||
| THE TEMPOROMANDIBULAR LIGAMENT | 41 | ||
| THE ARTERIOVENOUS SHUNT | 41 | ||
| ARTICULATION | 42 | ||
| Chapter 6. The Masticatory Musculature | 45 | ||
| THE DOMINANT DETERMINANT | 46 | ||
| THE MASTICATORY MUSCLES | 53 | ||
| THE IMPORTANCE OF OCCLUSAL HARMONY | 53 | ||
| Chapter 7. Centric Relation | 57 | ||
| UNDERSTANDING CENTRIC RELATION | 58 | ||
| COORDINATED MUSCLE ACTION SEATS AND LOADS THE TMJs | 62 | ||
| THE POSITIONER MUSCLE: THE INFERIOR LATERAL PTERYGOID | 63 | ||
| THE EXTREMELY IMPORTANT SIGNIFICANCE OF TMJ SOCKET DESIGN | 64 | ||
| IN CENTRIC RELATION, ONLY THE MEDIAL POLE ROTATES ON A FIXED AXIS | 64 | ||
| SUMMARY | 68 | ||
| Chapter 8. Adapted Centric Posture | 69 | ||
| LATERAL POLE DISK DERANGEMENTS | 71 | ||
| COMPLETE DISK DERANGEMENT WITH FORMATION OF A PSEUDO-DISK | 71 | ||
| COMPLETE DISK DISPLACEMENT WITH PERFORATION | 72 | ||
| OTHER PARTIAL DISK DERANGEMENTS AND CLICKING TMJs | 72 | ||
| SUMMARY | 73 | ||
| Chapter 9. Determining Centric Relation | 75 | ||
| DETERMINING CENTRIC RELATION OR ADAPTED CENTRIC POSTURE | 76 | ||
| IS CENTRIC RELATION REALLY REPEATABLE? | 79 | ||
| WHY USE BILATERAL MANIPULATION? | 80 | ||
| OTHER METHODS FOR DETERMINING CENTRIC RELATION OR ADAPTED CENTRIC POSTURE | 81 | ||
| Chapter 10. Load Testing for Verification of Centric Relation | 85 | ||
| RATIONALE FOR LOAD TESTING OF TMJS | 86 | ||
| PROPER LOAD TESTING MUST BE DONE IN INCREMENTS | 86 | ||
| COMMON MISTAKES | 87 | ||
| MISLEADING CONCERNS ABOUT LOAD TESTING | 87 | ||
| RESPONSE TO LOAD TESTING IF THE CONDYLES ARE NOT COMPLETELY SEATED (MUSCLE BRACED) | 88 | ||
| RESPONSE TO LOAD TESTING IF THE DISK IS MISALIGNED | 89 | ||
| RESPONSE TO LOAD TESTING IF THERE IS INTRACAPSULAR PATHOLOGY OR INJURY | 89 | ||
| Chapter 11. Recording Centric Relation | 91 | ||
| ACCURATE RECORDING OF CENTRIC RELATION | 92 | ||
| CRITERIA FOR ACCURACY | 92 | ||
| WHY CASTS MUST BE RELATED TO THE CONDYLAR AXIS | 96 | ||
| Chapter 12. Classification of Occlusions | 103 | ||
| EFFECTIVE CLASSIFICATION | 104 | ||
| DAWSON’S CLASSIFICATION21 | 107 | ||
| CLINICAL APPLICATION | 110 | ||
| Chapter 13. Vertical Dimension | 113 | ||
| UNDERSTANDING VERTICAL DIMENSION | 114 | ||
| VERTICAL DIMENSION AT REST | 117 | ||
| WHEN THE VERTICAL DIMENSION MUST BE CHANGED | 121 | ||
| WHY NOT INCREASE VERTICAL DIMENSION? | 122 | ||
| WHY SOME PATIENTS REQUEST BITE RAISING | 123 | ||
| CLOSING THE VERTICAL DIMENSION | 124 | ||
| HOW THE CONDYLE POSITION AFFECTS VERTICAL DIMENSION | 125 | ||
| ESTABLISHING VDO WHEN THERE ARE NO OPPOSING TEETH | 127 | ||
| SUMMARY | 128 | ||
| Chapter 14. The Neutral Zone | 131 | ||
| UNDERSTANDING THE NEUTRAL ZONE | 132 | ||
| RELATING MALOCCLUSION TO THE NEUTRAL ZONE | 135 | ||
| Chapter 15. The Envelope of Function | 141 | ||
| FUNCTION | 142 | ||
| THE ENVELOPE OF MOTION | 142 | ||
| THE ENVELOPE OF FUNCTION | 142 | ||
| LATERAL ENVELOPE OF FUNCTION | 145 | ||
| THE EXQUISITELY SENSITIVE MECHANORECEPTOR SYSTEM | 145 | ||
| Chapter 16. Functional Smile Design | 149 | ||
| NATURAL ESTHETICS | 150 | ||
| DECISIONS IN SMILE DESIGN | 150 | ||
| THE MATRIX OF FUNCTIONAL ANATOMY | 157 | ||
| Chapter 17. Anterior Guidance and Its Relationship to Smile Design | 159 | ||
| THE IMPORTANCE OF ANTERIOR GUIDANCE | 160 | ||
| CUSTOMIZING THE ANTERIOR GUIDANCE | 160 | ||
| DETERMINING INCISAL EDGE POSITION | 164 | ||
| STEPS IN HARMONIZING THE ANTERIOR GUIDANCE | 167 | ||
| ESTHETIC CONTOURING | 171 | ||
| COMMUNICATING PRECISE DETAILS TO THE TECHNICIANS | 173 | ||
| Chapter 18. Restoring Lower Anterior Teeth | 177 | ||
| THE STARTING POINT FOR THE OCCLUSAL SCHEME | 178 | ||
| LOWER ANTERIOR QUALITY CONTROL | 178 | ||
| INCISAL EDGE POSITION | 179 | ||
| LOWER INCISAL EDGE CONTOUR | 186 | ||
| Chapter 19. Long Centric | 189 | ||
| THE CONCEPT OF LONG CENTRIC | 190 | ||
| PROVIDING LONG CENTRIC BY EQUILIBRATION | 195 | ||
| PROVIDING LONG CENTRIC WHEN THE OCCLUSION IS TO BE RESTORED | 196 | ||
| Chapter 20. The Plane of Occlusion | 199 | ||
| OCCLUSAL PLANE DESIGN | 200 | ||
| THE CURVE OF SPEE | 200 | ||
| THE CURVE OF WILSON | 204 | ||
| SUMMARY | 206 | ||
| Chapter 21. Posterior Occlusion | 207 | ||
| NONINTERFERING POSTERIOR TEETH | 208 | ||
| LOWER POSTERIOR TEETH | 208 | ||
| PORCELAIN OCCLUSAL VENEERS | 220 | ||
| UPPER POSTERIOR TEETH | 220 | ||
| LENGTH OF GROUP FUNCTION CONTACT IN WORKING EXCURSION | 222 | ||
| BALANCING EXCURSIONS | 222 | ||
| TYPES OF POSTERIOR OCCLUSAL CONTOURS | 224 | ||
| TYPES OF CENTRIC HOLDING CONTACTS | 225 | ||
| VARIATIONS OF POSTERIOR CONTACT IN LATERAL EXCURSIONS | 227 | ||
| SELECTING OCCLUSAL FORM FOR STABILITY | 230 | ||
| SUMMARY | 232 | ||
| Part II: Dysfunction | 257 | ||
| Chapter 22. Simplifying Instrumentation for Occlusal Analysis and Treatment | 233 | ||
| THE LOGIC OF SIMPLIFICATION | 234 | ||
| SIMPLIFYING INSTRUMENTATION | 241 | ||
| HOW DIFFERENT ARTICULATORS RECORD CONDYLAR PATHS | 244 | ||
| USING INSTRUMENTS TO ADVANTAGE: A SUMMARY | 255 | ||
| Chapter 23. Differential Diagnosis of Temporomandibular Disorders | 259 | ||
| MAKING SENSE OF TERMINOLOGY | 260 | ||
| CATEGORIES OF TMDs | 264 | ||
| Chapter 24. Occluso-Muscle Disorders | 265 | ||
| HOW TO DETERMINE IF THE TMJS ARE HEALTHY | 266 | ||
| DIAGNOSING OCCLUSO-MUSCLE PAIN WITH NO TMD | 268 | ||
| MASTICATORY MUSCLE RESPONSES | 272 | ||
| Chapter 25. Intracapsular Disorders of the TMJ | 277 | ||
| INTRACAPSULAR PAIN | 278 | ||
| STAGES OF INTRACAPSULAR DISORDERS | 278 | ||
| THE PROGRESSIVE NATURE OF DISK DERANGEMENTS | 278 | ||
| THE HEALTHY JOINT | 279 | ||
| BEGINNING LATERAL-POLE DERANGEMENT | 280 | ||
| PROGRESSIVE LATERAL-POLE DERANGEMENT | 282 | ||
| LATERAL-POLE DISK DISPLACEMENT | 283 | ||
| LATERAL-POLE CLOSED LOCK | 285 | ||
| LATERAL-POLE DISK DISPLACEMENT, NONREDUCIBLE | 288 | ||
| COMPLETE ANTERIOR DISK DISPLACEMENT | 290 | ||
| TREATING COMPLETE DISK DISPLACEMENTS | 296 | ||
| Chapter 26. Classification of Intracapsular Disorders | 307 | ||
| PRACTICAL TEMPOROMANDIBULAR JOINT ANALYSIS | 308 | ||
| SYSTEMIZED APPROACH TO CLASSIFICATION | 308 | ||
| Chapter 27. Imaging the TMJs | 321 | ||
| WHY DENTISTS MUST UNDERSTAND TEMPOROMANDIBULAR JOINT IMAGING | 322 | ||
| TYPES OF TMJ IMAGING | 322 | ||
| Chapter 28. Bruxism | 333 | ||
| CLENCHING (CENTRIC BRUXISM) | 334 | ||
| ECCENTRIC BRUXISM | 335 | ||
| TREATING THE BRUXISM PROBLEM | 336 | ||
| BRUXISM IN CHILDREN | 339 | ||
| DENTAL COMPRESSION SYNDROME | 339 | ||
| Part III: Treatment | 343 | ||
| Chapter 29. Requirements for Occlusal Stability | 345 | ||
| WHAT A STABLE OCCLUSION “LOOKS LIKE” | 346 | ||
| HOW TO RECOGNIZE A STABLE OCCLUSION REGARDLESS OF WHAT IT LOOKS LIKE | 346 | ||
| HOW TO RECOGNIZE AN UNSTABLE OCCLUSION REGARDLESS OF WHAT IT LOOKS LIKE | 346 | ||
| THE FIVE REQUIREMENTS FOR OCCLUSAL STABILITY | 347 | ||
| Chapter 30. Solving Occlusal Problems Through Programmed Treatment Planning | 349 | ||
| STRATEGY FOR THE EXAMINATION | 350 | ||
| STRATEGY FOR TREATMENT PLANNING | 351 | ||
| CHECKLIST FOR FIRST REQUIREMENT ANALYSIS | 358 | ||
| MULTIPLE PROBLEMS | 359 | ||
| PROBLEM SOLVING | 360 | ||
| DESIGNING OCCLUSAL TREATMENT BASED ON THE REQUIREMENTS FOR OCCLUSAL STABILITY | 361 | ||
| SUMMARY | 363 | ||
| Chapter 31. The Diagnostic Wax-up | 365 | ||
| THE WAX-UP: THE PROCESS MOST DENTISTS WANT TO SKIP | 366 | ||
| ESTHETIC ANALYSIS ON THE DIAGNOSTIC WAX-UP | 375 | ||
| Chapter 32. Occlusal Splints | 379 | ||
| UNDERSTANDING OCCLUSAL SPLINTS | 380 | ||
| FABRICATION OF OCCLUSAL SPLINTS | 383 | ||
| SUMMARY | 391 | ||
| Chapter 33. Occlusal Equilibration | 393 | ||
| THE IMPORTANCE OF OCCLUSAL EQUILIBRATION | 394 | ||
| ELIMINATING FEAR OF EQUILIBRATION | 394 | ||
| EQUILIBRATION PROCEDURES | 395 | ||
| THE SECRET OF FINISHING AN EQUILIBRATION | 411 | ||
| VERIFICATION OF COMPLETION | 412 | ||
| EQUILIBRATION ON PATIENTS WITH EMOTIONAL PROBLEMS | 413 | ||
| PROPHYLACTIC EQUILIBRATION | 413 | ||
| EQUILIBRATING THE ORTHODONTIC PATIENT | 414 | ||
| EFFICIENCY IN EQUILIBRATION | 415 | ||
| ARMAMENTARIUM FOR EQUILIBRATION | 415 | ||
| COMPUTER-ASSISTED DYNAMIC OCCLUSAL ANALYSIS | 416 | ||
| LONG-TERM OCCLUSAL STABILITY | 417 | ||
| Chapter 34. Neuromuscular Dentistry: Bioelectronic Instrumentation | 419 | ||
| EXAMINING THE RHETORIC | 420 | ||
| MAKING SENSE OF THE LITERATURE | 422 | ||
| NMD CRITICISM AGAINST CENTRIC RELATION | 424 | ||
| ACCEPTABLE INSTRUMENTATION | 424 | ||
| SUMMARY | 428 | ||
| Chapter 35. Solving Occlusal Wear Problems | 429 | ||
| IDENTIFY THE CAUSE OF THE WEAR | 430 | ||
| TREATMENT PLANNING FOR WEAR PROBLEMS | 433 | ||
| PREVENTING OCCLUSAL WEAR PROBLEMS | 452 | ||
| Chapte 36. Solving Deep Overbite Problems | 453 | ||
| DEEP ANTERIOR OVERBITE | 454 | ||
| DEEP OVERBITE WITH TISSUE CONTACT | 459 | ||
| DEEP OVERBITE PROBLEMS ASSOCIATED WITH AN ANTERIOR SLIDE | 459 | ||
| DEEP OVERBITE WITH SEVERE WEAR | 461 | ||
| DEEP OVERBITE PROBLEMS WITH NO DEFLECTIVE INTERFERENCES | 461 | ||
| DEEP OVERBITE PROBLEMS WITH NO CENTRIC CONTACT | 462 | ||
| SOLVING DEEP OVERBITE PROBLEMS ORTHODONTICALLY | 463 | ||
| SOLVING DEEP OVERBITE PROBLEMS BY RESTORATIVE RESHAPING | 464 | ||
| SOLVING DEEP OVERBITE PROBLEMS BY SPLINTING | 464 | ||
| MINIMIZING OPERATIVE INTERVENTION THROUGH THE USE OF BITE PLANES TO SOLVE DEEP OVERBITE PROBLEMS | 464 | ||
| USING REMOVABLE PARTIAL DENTURES TO SOLVE DEEP OVERBITE PROBLEMS | 465 | ||
| SUMMARY | 466 | ||
| Chapter 37. Solving Anterior Overjet Problems | 467 | ||
| EXTREME ANTERIOR OVERJET TREATMENT CHOICES | 468 | ||
| THE PROBLEMS OF ANTERIOR OVERJET | 468 | ||
| SOLVING THE PROBLEM OF STABILIZING THE LOWER ANTERIOR TEETH | 469 | ||
| PROVIDING PROTRUSIVE DISCLUSION OF THE POSTERIOR TEETH | 471 | ||
| PROVIDING DISCLUSION OF THE NONFUNCTIONING INCLINES | 471 | ||
| IMPROVING THE POSITION OR SHAPE OF UPPER ANTERIOR TEETH WITH EXCESSIVE OVERJET | 471 | ||
| EQUILIBRATING THE OVERJET PROBLEM | 476 | ||
| SOLVING OVERJET PROBLEMS WHEN THERE IS INSUFFICIENT POSTERIOR ANCHORAGE | 477 | ||
| SURGICAL CORRECTION | 477 | ||
| Chapter 38. Solving Anterior Open Bite Problems | 479 | ||
| FINDING THE CAUSE | 480 | ||
| APPLYING THE PRINCIPLES | 481 | ||
| MINIMAL ANTERIOR OPENING | 484 | ||
| SEVERE ANTERIOR OPEN BITES (5 mm OR GREATER SEPARATION) | 485 | ||
| TREATING PROTRUSIVE LATERAL TONGUE-THRUST PROBLEMS | 490 | ||
| ORTHODONTIC CORRECTION OF ANTERIOR OPEN BITES | 492 | ||
| Chapter 39. Treating End-to-End Occlusions | 493 | ||
| ANTERIOR END-TO-END RELATIONSHIPS | 494 | ||
| RESTORING END-TO-END ANTERIOR TEETH | 494 | ||
| POSTERIOR END-TO-END RELATIONSHIPS | 497 | ||
| RESTORING END-TO-END POSTERIOR TEETH | 497 | ||
| UNILATERAL END-TO-END\r\nRELATIONSHIPS | 499 | ||
| Chapter 40. Treating Splayed or Separated Anterior Teeth | 501 | ||
| SPLAYING AS A RESULT OF AN ENLARGED TONGUE | 503 | ||
| APPLYING THE PRINCIPLES | 504 | ||
| NEUTRAL ZONE CONSIDERATIONS | 510 | ||
| USE OF LAMINATES TO CLOSE SPACE | 511 | ||
| Chapter 41. Treating the Crossbite Patient | 513 | ||
| ANTERIOR CROSSBITE | 514 | ||
| ANALYSIS OF ANTERIOR CROSSBITE | 514 | ||
| Chapter 42. Treating Crowded, Irregular, or Interlocking Anterior Teeth | 525 | ||
| ANALYSIS OF CROWDED, IRREGULAR, OR INTERLOCKING ANTERIOR TEETH | 526 | ||
| METHODS OF CORRECTING ANTERIOR INTERLOCKING BITES | 528 | ||
| CORRECTING ANTERIOR IRREGULARITY WITH SELECTIVE EXTRACTION | 536 | ||
| COMBINING RESTORATIVE PROCEDURES WITH ORTHODONTICS | 537 | ||
| RELATIONSHIP OF ANTERIOR TEETH TO POSTERIOR TEETH | 544 | ||
| GROWTH PROBLEMS AND CROWDED LOWER ANTERIOR TEETH | 544 | ||
| Chapter 43. Solving Severe Arch Malrelationship Problems | 547 | ||
| ANALYSIS OF SEVERE ARCH MALRELATIONSHIPS | 548 | ||
| DESIGNING TREATMENT WHEN THE SKELETAL BASE IS ACCEPTABLY ALIGNED | 550 | ||
| NONSURGICAL TECHNIQUES FOR STABILIZING SKELETAL MALRELATIONSHIPS | 561 | ||
| Chapter 44. Using Cephalometrics for Occlusal Analysis | 565 | ||
| LIMITS OF CEPHALOMETRICS | 566 | ||
| ELEMENTS OF CEPHALOMETRICS | 566 | ||
| HOW THE PLANES ARE USED FOR OCCLUSAL PROBLEM ANALYSIS | 568 | ||
| CONCERNS ABOUT THE USE OF CEPHALOMETRICS | 574 | ||
| Chapter 45. Postoperative Care of Occlusal Therapy Patients | 577 | ||
| A GOOD EXAMPLE OF POSTOPERATIVE CARE | 578 | ||
| OCCLUSAL THERAPY FOLLOW-UP | 578 | ||
| POSTTREATMENT USE OF OCCLUSAL APPLIANCES | 580 | ||
| POSTOPERATIVE PERIODONTAL MAINTENANCE | 580 | ||
| THE HEALTHY MOUTH: DENTISTRY’S GOAL | 580 | ||
| Chapter 46. The Technological Future for Occlusal Restoration Lee Culp, CDT | 581 | ||
| COMPUTERIZED OCCLUSION IN THE LABORATORY | 582 | ||
| COMPUTERIZED DESIGN AND FABRICATION | 583 | ||
| COMPUTERIZED OCCLUSAL VERIFICATION | 592 | ||
| SUMMARY | 593 | ||
| Chapter 47. Criteria for Success of Occlusal Treatment | 595 | ||
| MEASURING SUCCESS OBJECTIVELY | 596 | ||
| SUMMARY | 602 | ||
| Index | 603 |