Occlusion: Supporting and Pacing Force Distribution

Abstract

One of the prominent roles of the occlusion would be to support the force balance wobbling in stomatognathic system, thus pacing and minimizing the change of force distribution with age. Patient's demands on the prosthetic treatment have been becoming higher and more complicated during the past several decades. These demands include not only the precise restoration of the decayed tooth but also the treatment to provide stable and comfortable state of the stomatognathic system in the longer term. These demands would deeply be related to ; 1) How to finalize the information on temporary or treatment prosthesis, which has the resulted shape of the precise functional adjustment, on the final prosthesis, and 2) How to cope with the persistent complaints regarding tooth, tongue and other related sensations. In these aspects, patient's subjectivity and/or esthesis might need to be satisfied with the form and/or function of the resulted prosthesis. The clinical difficulties might be related to the following two points, which are 1) the accuracy of the reproduction procedure from the treatment prosthesis to the final one and 2) stability of the mandibular position or the condylar position which support the functional basis for the prosthesis. In order to cope with the complicated requirements, we have been using double-casting method for providing cast restorations. This is a method to produce a cast restoration in two functional parts. The first casting step consists of a base-crown which covers the abutment tooth and adjacent proximal contact point(s). The second step is the molding of the functionally required occlusal form onto the base-crown. The third step is the metal casting onto the base-crown replacing the molded portion. This method could be applied in various situations where we are forced to match the function and the form. The purpose of this paper is to provide a good orientation to the double-casting method and also to discuss the concept that might pace and minimize the change of force distribution in stomatognathic system.