Table Of Content' I .
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cc us1on
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IMADE EASY
Collection manager: Patrick Simonet
Gerard Duminil
with Olivier Laplariche
Re
Jean-Philippe and earlier
Jean-Fran~ois
Translated from French by Maria Nachib
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Presse Edition Multimedia
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Occlusion made easy
Authors
Gerard DUMINIL
Doctor in Dental Surgery
Doctor in Dental Sciences
Private Practice, Nice France
Olivier LAPLANCHE
Associate Professor (Nice Sophia Antipolis University) France
Hospital practitioner
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Jean-Franc;ois CARLIER
Doctor in Dental Surgery
Former Asistant Professor at the UFR (Teaching and Research Unit) of Reims
France
Jean-Philippe RE
Associate Professor (Aix-Marseille University)
Hospital practitioner (Public Hospitals of Marseille) France
Acknowledgments to
©Printed by Corlet lmprimeur SA - 1411 O Condet-sur-Noireau - Printer Identification
Number: 179111. Legal deposit : 1st quarter 2016- ISBN 978-2-36134-032-2
"Any representation or reproduction, be it partial or complete, without the express approval of the author or
the entitled parties or the legal successors and the publisher, is illegal" (article 40, section 1).
Such representation or reproduction, by any process whatsoever, would thus constitute an infringement
sanctioned by articles 425 et seq. of the French Penal Code.
Foreword
Peter Bausch
T
oday, for many patients, aesthetically appealing prosthetic fittings
plays a major role in lifestyle. In many cases the focus is therefore on
aesthetics, where function often takes a backseat.
Occlusion -antagonist contacts between teeth in static and dynamic,
is an important key to successful therapy, therefore, the physiological
reconstruction of the chewing surfaces in static and dynamic occlusion,
taking into account the biomechanical function of the components
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involved is still an important milestone for a functioning prosthetic or
restorative case.
This book by Dr. Gerard Duminil and Dr. Olivier Laplanche is a competent
advisor with many clinical examples for the practitioner. On the basis of
appealing 3D illustrations, complex treatment is shown in simple steps
therefore easy to follow for self studying. Similarly, the complexities of the
Stomatognathic System, neurological and muscular structures are shown
as descriptive images and explanations.
As a manufacturer of occlusion testing materials for more than 60 years,
we have continuously monitored and accompanied the development
and progress in dentistry.
In the heyday, many important principles researched on Gnathology still
endure. Dr. Gerard Duminil and Dr. Olivier Laplanche have manifested
these basics and developed them further in their book. This can be
seen as Guide and Advisor for every dentist, which aims to implement
successful therapy of prosthetic and restorative treatment in daily practice.
From our point of view, this book stands out to those that have been
written in recent years on the subject of occlusion with a scientific focus.
The authors invested a lot of time and conviction in this project for others
to benefit from their knowledge and experience. We hope that you are
as excited as we at reading this book and would like to thank the authors
Dr. Gerard Duminil and Dr. Olivier Laplanche for an outstanding result.
Occlusion made easy
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Acknowledgments
This work is the outcome of a great collaboration with Olivier Laplanche, my main co-author,
who did me a favour by sharing this adventure with me. I also wish to thank Jean-Franc;ois earlier
and Jean-Philippe Re, which used their skills to help me in the writing of two important chapters,
Patrick Simonet, who asked me to carry out this work and closely followed the process,
and the Information Dentaire staff for their involvement and the quality of their work.
The illustrations are the expression of my son's-Yann Duminil,
aka "Mooz"-, graphic designer talent.
It was a great pleasure to work with him on this project.
I 'd also like to thank Pierre Carpentier who let me use his magnificent anatomy images,
Peter Baush who was kind enough to write the foreword as well as
Jean-Daniel Orthlieb, Edith Hamou, Pierre Pedeutour and Claude Schiff for their advice
and their photographic and radiological documents.
To my mentor Jean-Franc;ois Michel, and to my colleagues and friends at the College National
d'Occlusodontologie.
Finally, I wish to dedicate this work to my wife Pascale whose patience was put to the test
by my unavailability during the writing of this book.
Preface
Patrick Simonet
Doctor in Dental Surgery
Master of Science, University of Michigan; Ann Arbor, USA
Fellow of the International College of Dentists
R
eleasing a new book is always an exciting moment for a publisher.
Suddenly, a virtual idea launched months before becomes actual
and tangible. The view of an author, who dedicated a lot of time and
intellectual energy to arrange his thoughts, can finally be shared with the largest
number. The book written by Gerard Duminil brings this kind of thrill, but it also has
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three other specificities.
it is the first book to be released in a new series published by the Groupe Espace
ID under the name ... Made easy.
The main purpose of this series is to take some distance from what already exists
in our odontological world to dig directly into the core of things, with no useless
speeches, while deliberately adopting a practical, pragmatic and pedagogical
approach. This book has brilliantly overcome all these challenges.
The topic (occlusion) stands itself at the crossroads of almost all our professional
activities. Every practitioner knows that checking and adjusting occlusion is a key
element in the success of many of our treatments.
Unfortunately, this science is still often perceived as too complicated, even
unintelligible. Here again, clinicians able to synthesize their knowledge without
making it ridiculously simplistic were needed.
The pedagogical qualities of the author and his co-authors have been
acclaimed for a long time by our profession.
Finally ahd more personally, a longtime friendship connects me to Gerard
Duminil and a genuine passion for this specialty has always permeated our
respective professional lives. I could not have dreamt of a better collaboration
and topic for this first publication.
I am deeply grateful for his spontaneous trust: from a few guidelines shared one
evening, he accepted the very visual specifications that I wished to develop in
this new book series.
After reading this book, I am convinced you will all agree that the choice of the
author was relevant and that checking and adjusting occlusion can be done ...
Made easy!
Occlusion made easy
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Editor's note
Teeth numbering used in this book is the
International Standards Organization Designation
System (ISO System) recommended by the World
Health Organization.
Contents
Foreword .. . ................ . ... . . . .......... . ......... 3
General notions . . . ......................... . .......... 8
2 Functional occlusion ... .. ........................ . .... 19
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3 Centric relation ... . . . . .. ....... . ... . .. .. .... .. .. . ... . . 37
4 Mandibular movements . ...... . ..... . .... . ... . . . ...... 49
5 Clinical examination of the temporomandibular
disorders (TMD) ............. . .. . ... . ......... . ....... . 61
6 Examination of the occlusion . . ... . ....... . ......... . .. . 85
7 Classification of the TMD ....... .. . ... .. . ........ ~ ..... 111
8 Mounting on the articulator ..... . ..................... 131
9 Instrumental occlusal analysis ......... . ..... .. .... . ... 153
10 Occlusal splints . ..... . ...... .. ........ . ... . .. . . . . .. .. 167
11 Occlusal adjustment . . ....... . ...... . ................ 185
12 Prosthodontic in daily practice ............... . ........ 205
Afterword ....................... . .. . .......... . . . .. . . 223
Occlusion made easy
General notions
Defining the occlusion as the relationship between the dental arches when the jaw closes is
much too restrictive. The dental arches are only one element among several in a biological
entity k0own as the manducatory apparatus. The manducatory apparatus controls the
functions of mastication, deglutition and phonation. It also takes part in the breathing,
yawning as well as in the mimicry. The goal of this chapter is to set the scene and present
the role of the various elements taking part in these functions.
We will not write an elaborate anatomical or physiological description, but rather provide
8 some basic knowledge which is necessary to understand the mechanisms of occlusion;
the reader can refer to more specialized books if he/she wants to learn more about these
notions.
Within the manducatory apparatus, we will describe interactive and interdependent
systems : the temporomandibular joint, the masticatory muscles and the dental arches. These
three components are traditionally called the anatomic determinants of the manducatory
apparatus. The actions and interactions inside this apparatus are coordinated by the central
nervous system, which is the fourth determinant. Let us note that a hierarchy exists in this
functioning which gives the priority to the comfort of the dental arches over the articular
and muscular systems.
The temporomandibular
joint
General notions
The temporomandibular joint (TMJ) presents two
remarkable specificities .cbmpared to the other
articulations in the human body.
"
The first one is that both joints are paired, the
left and right being linked to the same bone: the
mandible. As a result, any movement on one side
simultaneously generates a movement on the
opposite side (Fig. 1).
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Each movement of the mandible simultaneously
involves both articulations of the TMJ.
1 General notions
The second specificity concerns the TMJ
movement capacity. During mandibular
movements, the TMJ is the site of complex
movements, combining at the same time
translation and rotation movements. This is
made possible thanks to the specific anatomical
structure of the TMJ which, between "the osseous
components, has an ,articular disk delimiting two
distinct joint compartments.
A brief anatomical description is necessary to understand
the specificity of these joints; for further information, the
readers are invited to turn to more specialized documents.
One osseous component is located on the mandible, the other
one under the skull:
- The mandibular condyle, also called the head of the mandible,
2
Top view showing
has an oblong shape and its main transverse axis is obliquely and
the orientation
backwards orientated (Fig. 2);
of condyles.
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- The temporal articular surface, called the "mandibular fossa",
is located in front of the external auditory meatus which limits
its posterior aspect. The articular eminence represents the
anterior part of the joint, it is convex in the sagittal direction.
The mandibular and cranial articular surfaces are covered with
fibrocartilage but are not in direct contact (Fig. 3).
External
fossa
Temporal
condyle
3
Lower view of the cranial articular cavity.
