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There is a specific sequence to follow when applying the 5 requirements of occlusal stability. The first step, and one
which is extremely critical, is to evaluate the TMJs for stability and comfort. Once the TMJs have been determined
to be stable, the occlusion can be evaluated for long-term stability. The 5 requirements of occlusal stability are now
applied to create equilibrium so that the teeth are in harmony with the muscles and the TMJs.
These requirements are not new. They have been tried and tested over many decades of studies and clinical
experience. Let’s look at each requirement.
Criteria 1: Stable contacts on all teeth of equal intensity in centric relation.
Centric relation is defined as the relationship of the mandible to the maxilla
when the properly aligned condyle-disc assemblies are in the most anterior-
superior-medial position in the glenoid fossa. This is consistent with the
direction of force of the masseter, temporalis and medial pterygoid muscles
when they contract in closure of the mandible.
Part of this first criterion is to shape the teeth so they contact each other with
equal force, thereby distributing the forces evenly so as not to allow any one
tooth to take more force than another. Also, the equal intensity contacts must
be in a direction that reduces stress on the teeth and periodontium. Therefore posterior tooth contacts should be
directed axially, not on inclines.
Criteria 2: Anterior guidance in harmony with the envelope of function.
Because the anterior teeth are designed to protect the posterior teeth,
an anterior guidance that is in harmony with the envelope of function
is essential for a successful, long-term, stable result. Furthermore,
proper anterior guidance reduces elevator muscle activity when teeth
guide in excursive movements. When anterior guidance is in harmony
with the muscles, joints and tooth function, harmony with the envelope
of function is also achieved. Therefore, proper anterior guidance,
determined by the mandibular anterior teeth and the lingual contours
of the maxillary anterior teeth, ensures there are no interferences with
the normal, functional movements of the patient’s mandible.
So, when solving occlusal problems, establishing an acceptable anterior guidance is the first key decision to make once
the TMJs are stable.