Derick Mussen Healthcare

Clinical Occlusal Adjustment

Patient Selection. Careful analysis of the diagnostic occlusal adjustment is necessary to determine whether the patient is a good candidate for such irreversible subtractive treatment. Precise reduction and close attention to the sequence are essential. A written record of each reduction is also recommended. If too much is ground off a tooth, it cannot be put back on. The following should be considered as contraindications to definitive occlusal adjustment:

1 A bruxer whose habit cannot be controlled

2. A diagnostic correction that indicates that too much tooth structure will be removed

3. A complex spatial relationship (e.g., an Angle Class II and a skeletal Class 111)

4. Maxillary lingual cusps contacting mandibular buccal cusps

5. An open anterior occlusal relationship

6. Excessive wear

7. Before orthodontic or orthognathic treatment

8. Before physical or occlusal appliance therapy

9. A patient with temporomandibular pain 10 A patient whose jaw movements cannot be manipulated easily Occlusal adjustment needs to be undertaken in a logical sequence to avoid repetition and improve the efficacy of treatment. Although different sequences have been proposed, we find the one described next to be successful.