 |
| Introduction |
| Occlusion plays a fundamental role in the longevity, stability, and functional success of dental restorations. Proper occlusal analysis ensures even stress distribution, minimizes trauma, and enhances restoration durability. This article explores the impact of occlusion on dental restorations, integrating insights from research, clinical practices, and advancements in diagnostic tools. |
| Occlusal Considerations for Restoration Success |
Restoration
Type |
Occlusal
Considerations |
Key
Features |
Clinical
Recommendations |
| Fixed Prosthodontics |
Use mutually protected or group function occlusion based on clinical needs. |
Group function distributes lateral forces; canine guidance reduces stress on posterior teeth. |
Select group function for multiple contacts; use canine guidance when posterior stress reduction is critical. |
| Complete Dentures |
Neurocentric, lingualized, and balanced occlusion are common schemes. |
Lingualized focuses on palatal cusps; balanced occlusion ensures simultaneous bilateral contact. |
Use lingualized or balanced occlusion for patients with severe ridge resorption. |
| RPDs |
Balanced, neutrocentric, and mutually protected occlusion are common. |
Balanced occlusion is ideal for RPDs opposing complete dentures; neutrocentric reduces interference. |
Align teeth with anatomical landmarks and ensure occlusal plane accuracy for stability. |
| Adhesive/Bonded Restorations |
Typically adopts a conformative approach unless major occlusal changes are needed. |
Porcelain/zirconia require substructure support to handle loads; pontics should avoid excursive contact. |
Perform functional assessments pre- and post-restoration; use occlusal splints for bruxism patients. |
|
| Occlusal Factors Impacting Restoration Longevity |
| Aspect |
Description |
Key Features/Factors |
Limitations/Challenges |
| Impact of Occlusion on Restoration Longevity |
Improper occlusion leads to stress on restorations, causing fractures, wear, or failure. |
Multi-surface restorations (e.g., Class II or IV) are prone to failure under heavy loads. |
Failure to manage occlusion results in stress, especially in large or complex restorations. |
| Occlusal Trauma and Its Effect on Restorations |
Excessive forces cause trauma to periodontium and increase failure risk, especially in implants. |
Implants lack periodontal ligaments, so forces directly impact surrounding bone. |
Managing excessive forces is challenging and can lead to irreversible damage. |
| Parafunctional Habits and Their Impact |
Habits like bruxism cause wear, fractures, and damage to restorations and natural teeth. |
Occlusal splints distribute forces evenly, reducing wear on restorations. |
Splints do not address the root cause and can be uncomfortable for long-term use. |
| Material Considerations |
Restorative material choice affects ability to withstand occlusal forces. |
Amalgam handles heavy loads well; composites and ceramics are prone to fractures. |
Esthetically appealing materials (e.g., ceramics) may fail under heavy occlusal forces. |
| Failure of Restorations Due to Occlusion |
Common failures include fractures, chipping, loosening, or wear, especially in posterior areas. |
Metal-ceramic restorations frequently fail in anterior regions due to load distribution. |
Without proper occlusal management, mechanical failures are more likely. |
| Role of Splints in Managing Occlusal Forces |
Splints mitigate occlusal overload effects, particularly in bruxism patients. |
Reduce wear and muscle activity; effective formanaging bruxism-induced stresses. |
Splints are not a permanent solution and don’t address underlying habits. |
|
| Tools and Devices for Occlusal Analysis |
| Device/Tool |
Description |
Key Features |
Limitations |
| Occlusal Sonography |
Detects teeth contact sounds to identify occlusal disturbances. |
Identifies occlusal disturbances based on sound patterns during closure. |
Accuracy is limited by sound variations due to different closure forces. |
| T-Scan |
A computerized occlusal analysis system using color-coded pressure visualization. |
Displays occlusal forces with a color range (blue to red) for diagnosing trauma and discrepancies. |
Film thickness (0.1 mm) affects precision compared to thinner tools. |
| OccluSense |
Wireless system transmitting occlusal force data to an app for real-time visualization. |
Thin 60-micron sensor with Wi-Fi connectivity and app-based data analysis. |
Scientific validation is limited compared to T-Scan; requires daily calibration. |
| Articulating Paper & Shimstock |
Traditional tools for occlusal contact analysis; shimstock is a thin metallic film. |
Articulating paper provides visible force marks; shimstock (8-12 microns) detects high points. |
Articulating paper is too thick (40 microns) for precise detection of subtle discrepancies. |
|
| Conclusion |
| Occlusion remains a critical aspect of restorative dentistry, influencing the longevity, functionality, and comfort of dental restorations. The integration of advanced diagnostic tools, tailored occlusal schemes, and protective measures ensures better patient outcomes. By addressing occlusal challenges, dental professionals can optimize restoration durability and enhance overall oral health. |
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| GGI-CO-A1-AQS-300032384-AM-B25-0187 |
| Reference: |
| Aldowish AF, Alsubaie MN, Alabdulrazzaq SS, et al. Occlusion and Its Role in the Long-Term Success of Dental Restorations: A Literature Review. Cureus. 2024;16(11):e73195. Published 2024 Nov 7. doi:10.7759/cureus.73195 |
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