Clinical Significance of Occlusion

Abstract

What can be a good guide for the initial evaluation, diagnosis and the subsequent treatment in practice? There may be 3 points: centric position, occlusal plane and vertical dimension constituting practical oclusion observed in daily practice.
Dental examinations of patients very often reveal discrepancy between the centric and intercuspal positions and premature contact. Sometimes, premature contact has been artificially created by the inserted restorations such as crowns and bridges.
It is clinically often seen that the occlusal plane has not been flat but has created concave and convex due to abrasion and attrition, loss and elongation of teeth, excessive contact between anterial teeth caused by reduced vertical dimension or the form of artificial restorations.
Vertical dimension has been occasionally lowered too much by abrasion and attrition, the disposition of the remaining teeth due to the loss of teeth or inproper height of occlusion of artificial restorations such as crowns and dentures. Peter K. Thomas stated thated that you should never change the vertical dimension and if not change, full mouth reconstruction would work well. In dental practice in Japan, we often see the case where vertical dimension is too low partially due to indifference to oral hygeine and oral function, and it is true that we cannot always do a good job without changing vertical dimension.
Based on these facts, the author believes that three points consisting of centric position, occlusal plane and veritical dimension are important reference points for evaluation, diagnosis and the subsequent treatment. He calls them“three cornerstones of occlusion”on practical basis.
If centric position, occlusal plane and vertical dimension are considered in working with the patient's oral cavity, not only treatment will go well but your efforts merit patient's trust.