OCCLUSION
Cite this article:
Meyer GB, Bernhardt O,
Constantinescu MV,
Fundamentals of Occlusion
and Masticatory Function.
Stoma Edu J. 2014;
116-122
FUNDAMENTALS OF OCCLUSION
AND MASTICATORY FUNCTION
Georg B. Meyer1a*,
Olaf Bernhardt2b,
Marian-Vladimir Constantinescu3c
1. Zentrum für Zahn- Mund-,
und Kieferheilkunde, Universitätsmedizin
Greifswald, Greifswald, Germany
2. Poliklinik für Zahnerhaltung, Parodontologie
und Endodontologie, Universitätsmedizin
Greifswald, Greifswald, Germany
3. Department of Prosthetic Dentistry,
“Carol Davila” University of Medicine and
Pharmacy Bucharest, Romania
a. DMD, PhD, Dr hc, Professor and Chairman
b. DMD, PhD, Professor
c. DDS, PhD, Professor
Abstract
Aim: Craniomandibular dysfunction is an expression of the dysfunctional masticatory
system. It may have diverse risk factors, like occlusal interferences, including traumatic
amalgam fillings and other fillings.
The article aims to present three cases of craniomandibular dysfunction generated by
occlusal interferences.
Methodology: Three patients with different forms of craniomandibular dysfunction
were referred to dentist for evaluation and treatment.
Results: Occlusal interferences were identified as the main risk factor for uncoordinated
hyperactive muscles and for craniomandibular dysfunction diagnosed in three cases
presented. After occlusal correction, muscular dysfunction disappeared.
Conclusions: In case of reasonable suspicion of craniomandibular dysfunction, an
estimate for the detailed clinical and possibly instrumental diagnostics and optionally
(grinding teeth guare/bite splint) pre-treatment must be done. Only after pre-treatment
definitive treatments can be planned and carried out.
Keywords: craniomandibular dysfunction, occlusal interferences, masticatory function
Physiological aspects of the masticatory function
Received: 17 October 2013
Accepted: 24 November 2013
* Corresponding author:
Professor Georg B. Meyer,
DMD, PhD, Dr hc, Chairman
Zentrum für Zahn-, Mund- und Kieferheilkunde,
Ernst-Moritz-Arndt Universität,
Rotgerberstraße 8, D-17475 Greifswald,
Germany.
Tel: +493834867130, Fax:+493834867171.
e-mail: [email protected]
116
In the undisturbed masticatory system, the teeth are in neutral occlusion with each other
(Fig. 1). That is why, the most important is the natural contact of the cusps and fissures of
the antagonist teeth, in order that all the eccentric movements won’t bring any disturbance
(Fig. 2). The temporo-mandibular joints are in statics but also in dynamics of the same
growth-related geometry, in order to have the temporo-mandibular joints as “distal pairs
of occlusion”.
When loaded during chewing, the involved teeth will be depending on the consistency
of the alimentary bolus to be crushed, and they will be deflected spatially within their
physiological mobility (Fig. 3). This requires the elastic and damping properties of the
periodontal apparatus. In this area there are nerve endings, on which on which are generally
mechano-receptors (Fig. 4).
The capture caused by the respective bolus changes the position of the teeth by
approximately10 to 20 microns, which corresponds approximately to the thickness of a human
hair. This information is passed via afferent nerve pathways (sensors) in the central nervous
system (Fig. 5). Here, a coordination of afferents and a conversion via synaptic structures in
efferent signals is induced, which are passed to the motor units of the muscles, so that finally in
the right place (localization of the bolus) with adequate power use (consistency of the bolus)
chewing can occur. Overall, these are physiological control loop mechanisms, programmed in
the growth phase and matched, that is why, for example, grinding and clenching in children may
be physiologically. Ultimately, in the adult undisturbed masticatory all the geometric occlusal
forces and temporo-mandibular joint functions with neuromuscular function sequences are
working together in harmony. Temporary psycho-emotional stress situations with a clenching
of the teeth does not lead to any direct damage to normal mastication, but are apparently even
planned by nature for reducing the stress.
STOMA.EDUJ (2014) 1 (2)