Functional Occlusion in Restorative Dentistry and Prosthodontics, 1e

259 Pages·2015·58.538 MB·English

by  Eckert, Steven, Klineberg, Iven

Functional Occlusion
Restorative Dentistry
in
Prosthodontics
and
Functional Occlusion
Restorative Dentistry
in
Prosthodontics
and
Edited by
Iven Klineberg
AM RFD BSc MDS PhD FRACDS FICD FDSRCS (Lond, Edin)
Professor, Head of Discipline of Oral Rehabilitation, Nobel
Biocare Chair of Oral Rehabilitation, Faculty of Dentistry,
Westmead Hospital, University of Sydney,
New South Wales, Australia
Steven E. Eckert
DDS MS FACP
Professor Emeritus, Mayo Clinic, College of Medicine,
Rochester, Minnesota, USA
Foreword by
George Zarb
CM, BChD, MS, DDS, MS, FRCD(C)
Emeritus Professor, University of Toronto
Editor-in-Chief, International Journal of Prosthodontics
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2015
3251 Riverport Lane
St. Louis, Missouri 63043
FUNCTIONAL OCCLUSION IN RESTORATIVE DENTISTRY ISBN: 978-0-723438090
AND PROSTHODONTICS
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Library of Congress Cataloging-in-Publication Data
Functional occlusion in restorative dentistry and prosthodontics / edited by Iven Klineberg, Steven E. Eckert;
foreword by Professor George Zarb.
p.; cm.
Includes bibliographical references.
ISBN 978-0-7234-3809-0 (hardcover : alk. paper)
I. Klineberg, Iven, editor. II. Eckert, Steven E., editor.
[DNLM: 1. Dental Occlusion. 2. Dental Implantation–methods. 3. Prosthodontics–methods.
4. Temporomandibular Joint–physiopathology. WU 440]
RK651
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2015015057
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Printed in the United States of America
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FOREWORD
The topic of Occlusion has tended to languish at the This book certainly provides it!
bottom of the scientific heap. It either struggled to It is a welcome reminder that while still a relatively
sustain a position as a stand-alone clinical academic young science, the study of Occlusion does not pre-
entity in dental school curricula, or else fell between clude the virtues of synthesizing clinical observations
the cracks of discipline-driven territorial conflicts. and experiences to ensure that they are reconcilable
It consequently tended to fare better in continuing with scientifically based insights and explanations;
education programs where gifted and assertive den- and more especially when confronted with unresolved
tists often packaged their empirical clinical experi- clinical issues. It also reminds us that any health dis-
ences and observations in cult-like offerings. The net cipline that neglects addressing concerns derived
outcome of these educational agendas was to lose from clinical observations risks usurping its claim to
sight of the relatively recent scientific method’s chal- scientific advancement. The two Editors’ insistence
lenge to traditional perceptions—to question and that occlusion changes as chronology, diseases and
refine past convictions on Occlusion’s true signifi- therapeutic interventions place demands on muscles
cance, irrespective of their presumed or contrived and bones that require a far more complex under-
scientific pedigree. standing of biological processes, is both compelling
A few books sought to place Occlusion in its and challenging. Moreover, their recruitment of
deserved scientific context; and I continue to believe uniquely qualified colleagues to advance their schol-
that the one Norman Mohl, Gunnar Carlsson, John arly objective via this book’s message proves to be a
Rugh and I co-edited in 1988 was a particularly good brilliant initiative. The profession owes this text’s
start. However, three decades of compelling scientific authors—indeed the entire team—a sincere vote of
advances have profoundly changed the dental profes- gratitude for a rational and nondoctrinaire approach
sional landscape e.g. Osseointegration, CAD/CAM to a topic whose relevance has been frequently
influenced bio-technology, pain management, neuro- under-estimated.
plasticity etc, and what is now needed is a newer and
more robust consideration of Occlusion’s expanded George Zarb CM, BChD, MS, DDS, MS, FRCD(C)
biological context. Emeritus Professor, University of Toronto
Editor-in-Chief, International Journal
of Prosthodontics
vi
PREFACE AND INTRODUCTION
PREFACE AND INTRODUCTION
This book is an up-to-date statement on occlusion marginal gap that improve upon the traditional lost-
and its implications for contemporary dental practice wax technique (Almasri et al. 2011) as the crucial
and prosthodontics. It provides an insight into a new feature for optimizing clinical restorative outcomes
dimension for prosthodontic practice with the intro- (Renne et al. 2012).
duction of the crucial role of the occlusion of the Given that three-dimensional (3D) images of
teeth and mastication for maintenance of cognition patients are nearly ubiquitous, the ability to combine
and higher-level cognitive skills. This is a new para- these images with recordings of the natural dentition
digm: one that emphasizes the singular importance of and opposing tooth surfaces portends near-natural
maintaining an occlusion with teeth ideally or through replication of tooth anatomy in static and dynamic
rehabilitation for function and expands the impor- conditions. Predictably accurate imaging of tooth
tance of prosthodontics and the general well-being of preparations followed by accurate milling of restora-
individuals. tions can be anticipated with enhanced prognosis
The book also stands at the crossroads as dentistry as well, as a direct product of the quality of tooth
and prosthodontics, having embraced biology as the preparation.
fundamental construct within which case manage- More recent extensions of this technology into
ment is considered as well as the far-reaching implica- many fields have impacted dentistry and introduced
tions of the principles of implant dentistry utilizing the concept of the virtual articulator. Software devel-
osseointegration for implant rehabilitation in treat- opment for virtual treatment planning for implant
ment planning and decision-making, are to be funda- placement allows the interface between a 3D radio-
mentally transformed within the digital revolution. graphic image, such as computerized tomography
Industry has progressively introduced computer tech- (CT) or volumetric cone beam CT of jaw bone
nology to enhance production, accuracy, precision, anatomy, and software systems (such as Nobel
and efficiency. Clinical science has been the benefi- Biocare—with progressive developments from Nobel
ciary of these changes. In prosthodontics, the digital Guide, Nobel Clinician to Nobel Connect, and an
revolution is already gaining traction, and the vision- alternative in SimPlant) for manipulation of virtual
ary implications of the digital workflow will continue implant placement to optimize 3D location within
this transformation. The availability of computer- available bone. The template developed as an imaging
aided design and computer-aided manufacture (CAD/ guide contains possible location markers for implants
CAM) has had a major impact on restorative dental derived from a diagnostic preparation of the potential
practice, linked with the availability of contemporary final restorations, as determined and guided by the 3D
ceramic materials. CAD/CAM applications for inlays, images.
onlays, and, more recently, full-coverage restorations Computer-aided planning has also been embraced
are being embraced progressively in clinical practice. to facilitate complex craniofacial surgery. Computer
The introduction of the chair-side CEREC (Sirona, software is used as a virtual articulator, and planning
Bensheim, Germany) CAD/CAM system was of con- is undertaken on a computer. Traditionally, as with
siderable interest to dental practitioners; however, the implant placement, the initial preparation of gypsum
early versions of the system provided a poor marginal casts, articulated with the patient’s transfer records
fit of restorations, and it has taken over a decade for (facebow and maxillomandibular record), can be ana-
the technology to develop to the point where it can lyzed and altered on the casts to provide a defined
generate the desired restoration accuracy for practice plan for each patient.
(Tsitrou et al. 2007, Lee et al. 2008). Contemporary A 3D imaging and computer simulation study
CAD/CAM now generates marginal accuracy and (Schendel & Jacobson 2009), applied contemporary
vii
PREFACE AND INTRODUCTION
software with imaging interpretation to develop what Section 4, on clinical practice and occlusion manage-
the authors described as a patient-specific reconstruc- ment, provides specific clinical approaches for
tion along with a virtual patient record. The authors patient care and includes chapters on temporo-
reported that the precision was significantly improved mandibular joint disorders (Gunnar Carlsson),
over traditional 2D imaging and articulated study- jaw muscle disorders (Merete Bakke), occlusion
cast analysis. A further study by Ghanai et al. (2010) and periodontal health (Jan De Boever and
compared the traditional technique of using plaster AnnMarie De Boever), occlusion and orthodontics
models, transfer records, and an articulator with com- (Ali Darendeliler and Om Karbanda), occlusion
puter-assisted 3D surgical planning and development and fixed prosthodontics (Terry Walton), occlu-
of a virtual technique. A validation tool was devel- sion and removable prosthodontics (Rob Jagger),
oped to assess the virtual and traditional techniques. maxillofacial prosthetics and occlusion (Rhonda
Data indicated that the virtual approach resulted in Jacob), occlusal splints and management of the
outcomes that were at least as accurate as the tradi- occlusion (Tom Wilkinson), and occlusal adjust-
tional technique while overcoming the need for ment in occlusion management (Anthony Au and
study-cast analysis and transfer recording for articula- Iven Klineberg).
tor mountings, with their associated inaccuracies.
The book is presented in four sections: Iven Klineberg
Section 1 covers biological considerations of the Steven E. Eckert
occlusion. Comprehensive overviews of the neuro-
physiological mechanisms by Barry Sessle and REFERENCES
periodontal biology by Stefan Heinz and Sašo Iva-
Almasri R, Drago CJ, Seigel SC, et al: Volumetric misfit in
novski give important statements on the biological
CAD/CAM and cast implant frameworks: a university
framework. This is complemented by occlusion
laboratory study, J Prosthodont 20:267–274, 2011.
and health (Iven Klineberg), occlusion and adapta-
Ghanai S, Marmulla R, Wiechnik J, et al: Computer-
tion to change (Sandro Palla), jaw movement and
assisted three-dimensional surgical planning: 3D
its control (Greg Murray), and anatomy and virtual articulator: technical note, Int J Oral Maxillofac
pathophysiology of the temporomandibular joints Surg 39:75–82, 2010.
(Sandro Palla). Lee KB, Park CW, Kim KH, et al: Marginal and internal
Section 2, on assessment, includes chapters on occlu- fit of all-ceramic crowns fabricated with two different
sal form and clinical specifics (Iven Klineberg), CAD/CAM systems, Dent Mater J 27:422–426, 2008.
treatment planning and diagnostics (Iven Kline- Renne W, McGill ST, Forshee KV, et al: Predicting
marginal fit of CAD/CAM crowns based on the
berg), and transfer records, articulators, and study
presence or absence of common preparation errors,
casts (Rob Jagger and Iven Klineberg).
J Prosthet Dent 108:310–315, 2012.
Section 3, on oral implant occlusion, includes chap-
Schendel SA, Jacobson R: Three-dimensional imaging and
ters on the physiological considerations of oral
computer simulation for office-based surgery, J Oral
implant function (Krister Svensson and Mats
Maxillofac Surg 67:2107–2114, 2009.
Trulsson), ccclusion and principles of oral implant Tsitrou EA, Northeast SE, van Noort R: Evaluation of the
restoration (John Hobkirk), and implant rehabili- marginal fit of three margin designs of resin composite
tation and clinical management (Steven Eckert). crowns using CAD/CAM, J Dent 35:68–73, 2007.
viii
CONTENTS
ACKNOWLEDGMENT
The editors wish to acknowledge the assistance and the start and has assisted in meeting time lines, inter-
commitment of Mrs. Rita Penos, of Sydney, Australia, acting with authors and managing the progressively
who worked with Iven Klineberg on the project from increasing database to the conclusion.
ix
CONTRIBUTORS
Anthony Au, BDS, MDSc, FRACDS, FICD, Stefan A. Hienz, DMD, PhD
MRACDS(Pros) Associate Professor Periodontology, Program
Clinical Associate Professor, Faculty of Dentistry, Director MClinDent Implantology,
University of Sydney, Sydney, New South Regenerative Medicine Center, Griffith
Wales, Australia Health Institute, School of Dentistry and
Oral Health, Griffith University, Queensland,
Merete Bakke, DDS, PhD, DrOdont Australia
Associate Professor, Department of Odontology,
University of Copenhagen, Copenhagen, John A. Hobkirk, BDS, PhD, DrMedhc, FDSRCS (Ed),
Denmark FDSRCS (Eng)
Professor Emeritus, Prosthetic Dentistry,
Gunnar E. Carlsson, LDS, OdontDr/PhD, Eastman Dental Institute, Faculty of Medical
DrOdonthc, FDSRDS (Eng) Sciences, University College, University of
Professor Emeritus, Institute of Odontology, London, UK
University of Gothenburg, Gothenburg,
Sweden Sašo Ivanovski, BDSc, BDentSt, MDSc (Perio),
PhD, FICD
M. Ali Darendeliler, BDS PhD, DipOrtho Professor of Periodontology, School of Dentistry
Professor and Chair of Orthodontics, Faculty of and Oral Health, Griffith Health Institute,
Dentistry, University of Sydney, Sydney, New Griffith University, Queensland, Australia
South Wales, Australia
Rhonda F. Jacob, DDS, MS
AnnMarie De Boever, DDS Formerly Professor of Maxillofacial
Department of Fixed Prosthodontics and Prosthodontics, MD Anderson Cancer
Periodontology, Faculty of Medicine and Center, Houston, Texas, USA
Health Sciences, Ghent University, Ghent,
Belgium Rob Jagger, BDS, MScD, FDSRCS
Consultant Senior Lecturer, Bristol Dental
Jan De Boever, DDS, DrMedDent, PhD School, University of Bristol, UK
Professor Emeritus, Department of Fixed
Prosthodontics and Periodontology, Faculty Om Prakash Kharbanda, BDS, MDS, MOrth, RCS
of Medicine and Health Sciences, Ghent (Edin), M MEd (Dundee)
University, Ghent, Belgium Professor and Head, Division of Orthodontics
and Dentofacial Deformities, Centre for
Steven E. Eckert, DDS, MS, FACP Dental Education and Research, All India
Professor Emeritus, Mayo Clinic, College of Institute of Medical Sciences, New Delhi,
Medicine, Rochester, Minnesota, USA India
x
CONTRIBUTORS
Iven Klineberg, AM, RFD, BSc, MDS, PhD, FRACDS, Mats Trulsson, DDS, OdontDr/PhD
FICD, FDSRCS (Lond, Edin) Professor and Head, Department of Dental
Professor, Head of Discipline of Oral Medicine, Karolinska Institute, Stockholm,
Rehabilitation, Nobel Biocare Chair of Oral Sweden
Rehabilitation, Faculty of Dentistry,
Westmead Hospital, University of Sydney, Terry Walton, BDS, MDSc, MS (Mich), FRACDS
New South Wales, Australia Clinical Professor, Faculty of Dentistry,
University of Sydney; Specialist Private
Greg M. Murray, BDS, MDS, PhD Practitioner, Sydney, New South Wales,
Professor, Faculty of Dentistry, University of Australia
Sydney, New South Wales, Australia
Tom Wilkinson, BDS, MSc, MDS,
Sandro Palla, Prof Dr Med Dent GradDip (Orofacial Pain)
Professor Emeritus, Clinic of Masticatory Private Practitioner, Specialist Prosthodontist
Disorders, Removable Prosthodontics and Practice limited to Orofacial Pain and
Special Care Dentistry, Center for Dental Temporomandibular Disorders, Adelaide;
Medicine, University of Zurich, Switzerland Clinical Senior Lecturer University of
Adelaide, South Australia, Australia
Barry J. Sessle, BDS, MDS, BSc, PhD, DSc (hc)
Professor and Canada Research Chair, Thomas J. Vergo, Jr DDS, FACD, FAAMP
University of Toronto, Toronto, Canada Professor Emeritus, Department of Restorative
Dentistry, Tufts University School of
Krister G. Svensson, DDS, MSc, PhD Dentistry, Boston, Massachusetts, USA
Assistant Professor, Department of Dental
Medicine, Section for Oral Rehabilitation,
Karolinska Institute, Stockholm Sweden
xi
CHAPTER 1
The Biological Basis of a Functional
Occlusion: The Neural Framework
Barry J. Sessle
CHAPTER OUTLINE CHAPTER POINTS
Peripheral Mechanisms: Sensory • The neural framework pertinent to a
Processes, 4 functional occlusion and occlusal
Central Mechanisms, 6 rehabilitative approaches includes the
Brainstem Sensory Nuclei and Pathways, 6 peripheral and central nervous system
Thalamic and Cerebral Cortical Sensory Areas (CNS) processes underlying orofacial
and Pathways, 9 perceptual, emotional and cognitive
Brainstem Motor Nuclei and Reflex behaviors and the control of the orofacial
Pathways, 9 musculature, as well as the adaptive
Descending Influences on Sensory and Motor potential of these peripheral and central
Processes, 11 components.
Effects of Occlusal and Other Intraoral • Receptors in and around the teeth and in
Changes on Sensory and Motor Control other orofacial tissues provide the CNS
Mechanisms, 14 with feedback and feedforward sensory
Peripheral Effects, 14 information that is used for these CNS
Central Effects, 16 processes.
Summary, 19 • The excitability of the central components
of the orofacial sensory and motor
systems is subject to neural and
nonneural modulatory influences in the
SYNOPSIS
CNS that underlie different behavioral
This chapter outlines the neural framework states and that use a variety of
that determines and influences the occlusal endogenous chemical mediators.
interface. This framework includes also the • Chewing, swallowing, and other orofacial
neural underpinning of our ability to learn sensorimotor functions depend on
to adapt our masticatory behavior to an brainstem neural circuits (e.g., central
altered intraoral state produced by pain or pattern generators), as well as on
changes to the occlusal interface following modulatory influences from higher brain
loss of teeth or their replacement by dental centers such as the facial sensorimotor
rehabilitative procedures. cortex.
3