Diagnosis and treatment planning

Abstract

Summary It is the responsibility of the profession to maintain the oral cavity in a healthy functional condition for a maximum length of time. Diet is and always will be of such importance that it cannot be overlooked. A careful analysis of contributing destructive factors must be made. This includes systemic and organic imbalance, with particular emphasis on the endocrine system. Accurate study casts mounted in an adjustable articulating instrument on the patient's axis orbital plane, with both condyle path and condyle shift movements set to duplicate the existing movements of the patient's mandible, are equally as important as are diagnostic roentgenograms. Before reconstructive work is started, the individual teeth of the study casts should be waxed to the contour necessary to produce a balanced distribution of stress over the upper and lower teeth throughout the functional centric and eccentric movements. Dental service must be a complete evaluation of health factors and balanced functional occlusion, rather than a reparative service to individual teeth, if the life expectancy of the masticatory organ is to reach maximum life span. Many weakened individual teeth can be strengthened and placed back into function if they are splinted into fixed or semifixed contact with their approximating members. Experience has proved that careful alignment, directly in the mouth, of accurately fitting mucostatic bases with retainer units will reduce displacement of the bases and retainer units, thereby eliminating excessive torsional strain. It is not unreasonable to think that the life expectancy of the natural dental organ can survive over the complete life span of the individual, if a reasonable state of good health is maintained, if mouth hygiene habits are instituted and supervised, and if functional maxillomandibular stress can be balanced properly and distributed throughout the entire dentition.