Mandibular adaptive reposturing: the etiology of a common and multifaceted autodestructive syndrome

Maximum dental intercuspation (MI) is directed through sensory feedback from periodontal proprioceptors and is a neuromuscularly favored and protective mandibular position for the dentition. MI literally drives the stomatognathic system. When MI and centric relation (CR) are not in harmony, the mandible assumes adaptive reposturing in an effort to achieve as much MI as mechanically possible. This can lead to an autodestructive syndrome that damages various stomatognathic elements. Diurnal and nocturnal clenching and/or bruxism as well as other parafunctional activities mediated at different neurologic levels may complicate the problem further. Effective management of this syndrome requires establishment of harmony between CR and MI.