Occlusal adjustment in patients with residual or recurrent signs of mandibular dysfunction

Abstract

T he role of occlusal interferences in the development of mandibular dysfunction is controversial, as is occlusal adjustment in the treatment of bruxism and mandibular dysfunction. Is4 Several authors agree, however, that optimal occlusion should include (1) a stable intercuspal position (IP) with bilateral occlusal contacts in the retruded contact position (RCP), and bilateral occlusal contacts at all positions between IP and RCP (the distance between IP and RCP should be small with no lateral deviation); and (2) eccentric mandibular movements without interference (eccentric occlusal contacts should be present on the working side only with total absence of balancing side interferences).5 The authors have often used these principles in the treatment of patients with mandibular dysfunction.6 Therefore, it was surprising to find a high percent of patients with occlusal interferences at a clinical examination 1 year after stomatognathic treatment.6,7 As part of a 2%-year clinical study of patients diagnosed to have been treated for mandibular dysfunction, a study was made of those patients with residual or recurrent deviations from optimal occlusion and chnical signs of dysfunction. This article will attempt to explain the reasons for persisting occlusal interferences and ascertain the results of occlusal adjustment in alleviation of the signs and symptoms of continued dysfunction.