Force Finishing in Dental Medicine: A Simplified Approach to Occlusal Harmony

Force Finishing in Dental Medicine: A Simplified Approach to Occlusal Harmony

Sushil Koirala (Thammasat University, Thailand & Vedic Institute of Smile Aesthetics (VISA), Nepal)
DOI: 10.4018/978-1-4666-6587-3.ch020
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Abstract

This chapter introduces the Force Finishing concept that is based upon the T-Scan technology. During case finishing, the aesthetic components are clinically visible and guided by the subjective analyses of the patient and the clinician. Alternatively, the case occlusal force components are invisible and do not become apparent until their adverse effects become chronic. When the force components are not properly addressed, clinicians may encounter Occlusal Force Disorder (OFD) symptomatology. Often, clinicians focus on the aesthetic finishing while placing a low priority on the occlusal Force Finishing by relying on subjective articulating paper mark interpretation and the patient's subjective “feel” with which to guide occlusal adjustments. Because articulating paper is a poor indicator of occlusal force and timing, the T-Scan technology can greatly improve the occlusal case finishing. This chapter details how to integrate the Force Finishing concept into conventional case finishing to simplify achieving occlusal force harmony in every case.
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Introduction

It is now more than 100 years that both dentists and researchers have debated how to identify and define concepts of Dental Occlusion that could be practically applied in both diagnostic and therapeutic situations. Occlusion has been, and still to some extent, is a controversial discipline, as there are numerous questions related to occlusal characteristics which have not yet been answered with scientific certainty. There are many diverse and polarized opinions regarding this subject that are seldom based on current scientific evidence, such as the etiology of Bruxism, the role of occlusion in Temporomandibular Disorders (TMD), Orthodontic treatment and its effects on TMD pain, and determining a correct mandibular position as a reference point for treatment.

Clinicians around the world routinely perform various diagnostic and therapeutic procedures that involve Dental Occlusion (fillings, crowns, bridges, removable prosthesis, implant supported restorations, full mouth reconstruction, and orthodontics). However, there is a lack of scientific studies verifying the success of the different advocated concepts of occlusion used restoratively and during occlusal therapy. Nor are the methods to validate or the variable of an individual clinician’s knowledge, clinical skills, and comfort zone with successfully treating occlusal problems. Generally, during the undergraduate education, dental students are not fully trained in Dental Occlusion. When these new graduates enter into clinical practice and begin accepting complex clinical cases to treat, many become confused with the differing theoretical recommendations and varied concepts about Dental Occlusion that are taught within academic and clinical Dental Medicine.

This chapter first discusses the many mandibular positional theories and the controversies surrounding each one, based upon their available clinical evidence. Next, the occlusal and other intraoral forces (applied stresses) are briefly discussed, that act on the Stomatognathic system during function and parafunction. Lastly, the chapter introduces the Force Finishing concept and its protocol to diagnose, prevent, and manage the occlusal force disorders in clinical practice.

Key Terms in this Chapter

Occlusal Force Disorders: The disorders of teeth, muscles, Temporomandibular joints, and airway, resultant from the presence of excess occlusal force that is greater than the individual’s resistive and adaptive capacity.

Preventative Force Finishing: A procedure to optimize the occlusal force components of the masticatory system, to protect and maintain a physiologic, accepted original occlusal scheme, while preventing existing restorations from future failure.

Occlusal Harmony: The Physiologic and functional balance of the occlusion.

Therapeutic Force Finishing: A procedure to customize the occlusal force components in the treatment of the specific signs and symptoms of occlusal force disorder conditions.

Occlusion: The physiologic action that generates occlusal forces within the Stomatognathic system.

Force Finishing: A clinical concept and technique employed to optimize the occlusal force components of the masticatory system, using objective T-Scan based occlusal force and timing measurements. The goals are to obtain ideal occlusal force and timing occlusal clinical parameters, so that long-term health, function, and craniofacial aesthetics are maintained.

TMJA Harmony: The physiologic and functional harmony of the entire Stomatognathic system; the teeth, muscles, Temporomandibular joints, and airway.

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