Occlusal Equilibration: Steps & Challenges

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Dental pain is often diagnosed as endodontic or periodontal in nature. And often, root canal therapy or surgery is performed in order to resolve the symptoms. However, I am finding that, more and more, the issues we see are often occlusion related and misdiagnosed. Many of our patients come to our office seeking solutions to their symptoms, and the unresolved cases are usually due to occlusion.
Knowing when to adjust or equilibrate vs open the vertical is a multi-faced question and requires greater analysis than this video. However, in this video, I address traumatic occlusion resulting in localized bone loss, how to adjust it, and how to know when to stop and consider other options.
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Опубликовано:

21 мар 2022

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Комментарии : 11

@Cavanho Год назад

Working on the model first is genius

@dr.agathabis 10 месяцев назад

@Cavanho Thanks! I started doing it to be able to gauge how much reduction I would need but it ended up being an amazing patient education tool.

@scuggy707 10 месяцев назад

@dr.agathabis, Hi Dr. Agatha! Thank you so much for your insightful videos, they do help a lot. I have a quick question regarding the equilibrium if you do not mind.. I have suffered from a deviated jaw (to the L) and TMJ for years before finally finding out this was a root cause to many of my neck issues etc. I wear a splint 24/7 that is working wonderfully so far, and my neck has never felt better. My jaw is continuing to rest in a better position, as well. My question is, why is an equilibrium necessary and are there times it is not? For example, we’ve found the two situations in which my jaw deviated the most was during high intensity workouts (when clenching my jaw, normal) and during my sleep (habitual). There is a point of initial contact, or interference, on both sides near the molars which is what was causing the deviation. However, my splint in both of these cases counteracts the deviation that used to occur (working out is no longer painful), and I’ve been told to wear my splint indefinitely during sleep and working out, even after the initial 5 months of 24/7 wearing is complete. My understanding is that the teeth should not touch during normal resting position during the day anyways though? For example, I took my splint out for a couple hours during a wedding and had no issues what so ever, because my teeth were never touching or clenching and hitting the interference. And food itself creates different points of contact across the entire spectrum of teeth as they mash.. so why would I need the equilibrium if I am going to wear my splint during the two cases that I had issues with, working out and sleeping?? I also do notice my resting tongue position has also made a huge impact in relaxing the jaw, as I used to not rest it on the roof of my mouth. The tongue position and splint seem to be the key, and I am very uncertain that I want to spend another $2k to start shaving teeth down if I can control this through these changes I’ve already made.

@dr.agathabis 10 месяцев назад

@scuggy707 I am a bit confused as to what you are describing. But from what I am understanding, you are asking there are a couple things that may help clarify some of your inquiries: 1) when you take the splint out, and you say that you have no issues whatsoever, what you are missing is the swallowing and chewing and any other times your teeth come together that you are not aware of. When you swallow, for example, and you swallow 2,000-3,000 times a day, your back teeth touch! Try it. Do it now. Swallow and see what happens to your back teeth. So even though you didn't know it, your mandible gets retruded in order for your back teeth to touch while you swallow. So let's say that's 2,000 times a day. Then add meals and the number of times you chew. Let's say you have 3 meals a day and your chewing causes your back teeth to touch 200 times. So that's an additional 600 times your back teeth touch. Then you add other activities: you get pissed off and you clench, you lift a heavy weight and you clench, you are in deep thoughts or deep focus and you clench, each time your back teeth touch. That's what causes the symptoms if your mandible is in the incorrect position. This is why you need to wear the appliance ALL the time. To help with healing of the condyle. While reducing the trauma from back teeth touching all the time. Hope this makes sense.

@Cavanho Год назад

How do you choose your articulator values?

@dr.agathabis 10 месяцев назад

I have a number of other equipment and technology that help me measure each patient's angles and slides.