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)
5. An open anterior occlusal relationship
6. Excessive wear
7. Before orthodontic or orthognathic treatment
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.
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