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News Bulletin : ADA News Bulletin September 2010
23 SEPTEMBER 2010 aesthetic update Compiled by Geoffrey M Knight A patient presented seeking a solution for the excessive wear in the anterior segments of his dentition -- especially the lower incisors and canines. Examination showed a Class II occlusion that had collapsed in the anterior segments. This resulted in pronounced wear facets on the lingual surfaces of his upper incisors and canines and loss of tooth structure from the incisal edges of his lower incisors (Fig 1). The proposed treatment plan involved opening his bite with composite resin. To compensate for his Class II malocclusion, composite resin was to be added to the lingual aspects of his upper canines and upper first bicuspids and the facial aspects of his lower canines and lower first bicuspids. This will align the mandible in a slightly more open and retruded position (Fig 2). The technique relies upon Okeson's studies of the nociceptive reflex that inhibits subjects from applying excessive occlusal force solely to the anterior segments of their dentition. Readers can confirm this by feeling their masseter muscles contract when biting firmly with their teeth closed, compared to being unable to initiate the masseters when an object, such as a pencil, is placed between their central incisors. MANAGING excessive occlusal wear Fig 1. Fig 2. "The technique relies upon Okeson's studies of the nociceptive reflex that inhibits subjects from applying excessive occlusal force solely to the anterior segments of their dentition."
ADA News Bulletin August 2010
ADA News Bulletin October 2010