BASICS OF FUNCTIONAL CLINICAL AND INSTRUMENTAL DIAGNOSTICS
AND PRETREATMENT BEFORE FINAL ORAL REHABILITATION
Figure 1. Biomechanics
The form and function of natural teeth and temporo
mandibular joints are part of the physiological masticatory
function. At the origin of each of the 3 arrows on all
teeth lies a load-bearing opponent cusp at maximal
intercuspation. Upon protrusive or lateral movements, the
fissures marked with arrows are run through without contact.
The joints are underlying the same geometric principles.
Dentistry’s foremost goal must be the maintenance of these
occlusal structures or, if necessary, their restoration back to
physiological function.
Figure 2. Physiology
In a healthy maxillofacial system, receptors in the area of
the teeth, periodontium, muscles, and TMJ transmit the
current situation via afferent nerve pathways (aff.n.) to the
central nervous system (CNS). This includes information
about the consistency of the food to be masticated. This
sensory information determines the corresponding motor
activity. Via efferent pathways (eff.n.), the appropriate
motor activity is activated in the muscles, so that all
masticatory functions can proceed in a coordinated
manner. Physiological movement pathways of the TMJ
and the individual anterior guidance are shown as dotted
lines.
of the dental diagnostics and splint therapy of
patients with craniofacial pain. After reaching an
initial diagnosis by a short clinical-screening-test1,22,23
several functional-diagnostic steps in the following
order have proven effective:
Figure 3. Pathology
Hyperactive musculature due to incoordinated signals
from CNS is typical for a dysfu