Abstract
The diagnosis of dental arch defect has conventionally tended to be performed in order to serve as an index for prosthetic treatment rather than to grasp the affected state. Nevertheless, such a diagnosis has often failed to establish a distinct therapeutic strategy and thus seemed to have been so far used as a scale for determining the severity of disorder called “defect” and/or the degree of stability. In other word, this implies that the dental prosthesis per se plays a significant role in the rehabilitation for disorder called “defect”. On the other hand, it is hardly denied that the diagnosis of diseases which may result in a dental defect has been replaced by the diagnosis of caries or periodontal disease. In recent years, however, some clinicians began to have a common recognition on a case which is hardly explained by caries and/or periodontal disease alone, and a term of “occlusal force” or “force” is now widely added to the concept of its pathogenesis. Although no established consensus is not yet available in the definition of these terms, this third “force” gives an opportunity for re-examining the pathogenesis. When the pathogenesis is considered in relation to the time elapsed, caries and periodontal disease have been weighed on the so-called vector of the affected state including a general tendency produced by the progress or the patient's age at the time examined.
In the affected state due to occlusal habits or force for example, however, the total dose accumulated during the past years or even an organic defect may be required to consider depending on the case involved. In addition, a risk management for caries and periodontal disease by preventing exogenous bacterial infection is quite different from that for individual intrinsic neuromuscular system. A possible involvement of advanced age and/or general condition is naturally different and the accumulated period of disharmony may influence the speed of decay in some cases. In so-called intractable cases, a more deepened understanding seems to become frequently possible through the examination of self-uncontrollable excessive occlusal force or satisfaction but not through the diagnosis of static defect morphology.
We thus emphasize the necessity of diagnosing the occlusal force when the prosthetic treatment is started.
