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OCCLUSION psyche stress Central nervous system Coordination Central nervous system Cortex reduced performance incoordination neuralgical symptoms headache Jaws Muscles Muscles pain noises altered movement Jaws hyperactivity asymmetries pain Bruxism Occlusal trauma Occlusion Figure 5. Information from the region of the teeth, e.g., consistency and position of a bolus, go through afferent nerves (aff. N.) to the central nervous system. After appropriate coordination (eff. N.) the muscles are controlled from there via efferent nerves, so that the masticatory function can proceed undisturbed Occlusal interferences tilted, elongated teeth defective restorations, incl. Orthodontics unserved gaps Figure 6. As the occlusal interference may give contradictory signals from the area of the teeth to the central nervous system that can be no longer well-coordinated there. There is a malfunction in the chewing system that may develop in a very different way in different individuals Psycho-emotional stress “gnash your teeth” “grit your teeth ...” “show your teeth …” Hyperactive muscle grinding, bruxism tension neuromuscular incoordination craniomandibular dysfunction Other risk factors (general medicine, and others) Risk factor for wear facets, fractures, pseudopulpitis periodontal overloading hypersensitive tooth necks, wedge-shaped defects head and facial pain, migraine tinnitus, vertigo TMJ, cervical spine and spinal problems Figure 7. Craniomandibular dysfunctions (CMD) have multiple risk factors, which include occlusal interferences. CMD in turn is a risk factor for symptoms that are not often associated with dentistry 118 STOMA.EDUJ (2014) 1 (2)