Clayton J A
Department of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, USA.
Dent Clin North Am. 1995 Apr;39(2):313-33.
Occlusion in prosthodontics is extremely important. Muscle dysfunction can interfere with prosthodontic restoration of occlusion. Occlusal interferences are the primary cause of the hyperactivity that cause muscle dysfunction. Occlusal interference can also place adverse stress on restorations and result in premature failures. Lateral stresses on restorations can cause cement failures, porcelain fractures, and solder joint failures. Our goal in prosthodontics is to restore occlusion that is occlusal interference free. This article gave an overview of how this can be done in phases. In Phase I, a diagnosis is made as to the presence or absence of muscle dysfunction. If it is present, the OIs are hidden. Occlusal splint therapy is needed to get rid of the muscle dysfunction so the OIs can be found. The occlusal splint diagnosis whether OIs are the cause of the dysfunction. The cure is to correct the occlusion. The restoration of the occlusion should be OI free. The various factors to consider in design and restoration of the occlusion were presented. After successful restoration of the occlusion, the recall appointments should include an evaluation of the occlusion. The PRI, COS, and clinical examination can all be helpful in diagnosing whether muscle dysfunction is developing and whether OIs are developing again as a result of the normal changes that can occur. Suggestions were made on how to slow these changes. This article was not meant to cover every aspect of prosthodontic occlusion in detail. The goal was to present an overview for readers to make a self-evaluation as to what areas of their practice might need to be improved to improve the restoration of the occlusion. All was not taught in dental school. As one practices and improves in skill, more knowledge and abilities must be sought through graduate and postgraduate education. Occlusion is too important for a successful practice and happy patients to be ignored. Time will make this obvious; however, the failures may be costly. The best approach would be to anticipate the failures and prepare yourself to reduce the risks. Occlusal interferences are truly the plague of dentistry.
口腔修复学中的咬合极为重要。肌肉功能紊乱会干扰咬合的口腔修复。咬合干扰是导致肌肉功能紊乱的多动的主要原因。咬合干扰还会对修复体施加不利应力，导致过早失败。修复体上的侧向应力会导致粘结失败、瓷体断裂和焊点失败。我们在口腔修复学中的目标是恢复无咬合干扰的咬合。本文概述了如何分阶段实现这一目标。在第一阶段，诊断是否存在肌肉功能紊乱。如果存在，则隐藏咬合干扰。需要进行咬合板治疗以消除肌肉功能紊乱，从而找到咬合干扰。咬合板可诊断咬合干扰是否是功能紊乱的原因。治疗方法是纠正咬合。咬合的恢复应无咬合干扰。文中介绍了在咬合设计和恢复中应考虑的各种因素。咬合成功恢复后，复诊预约应包括对咬合的评估。PRI、COS和临床检查都有助于诊断是否正在发展肌肉功能紊乱以及是否由于可能发生的正常变化而再次出现咬合干扰。文中还就如何减缓这些变化提出了建议。本文并非旨在详细涵盖口腔修复学咬合的各个方面。目标是为读者提供一个概述，以便他们自我评估其临床实践中哪些领域可能需要改进，以提高咬合的恢复效果。牙科学校并未讲授所有内容。随着临床实践和技能的提高，必须通过研究生和博士后教育寻求更多的知识和能力。咬合对于成功的临床实践和患者的满意度至关重要，不容忽视。时间会证明这一点；然而，失败可能代价高昂。最佳方法是预测失败并做好准备以降低风险。咬合干扰确实是牙科领域的一大难题。
