The influence of altered occlusal guidance on condylar displacement during submaximal clenching

As cited in literatures, canine protected occlusion has a potential to reduce clenching induced temporomandibular joint loadings. However, these previous studies did not perform a control of the clenching level which differed with the depending occlusal conditions. This result may be due largely to an associated reduced jaw closing muscle activity. The present study has investigated clenching induced condylar displacements with controlled clenching level. Twenty healthy human subjects (15 males and five females with an average age of 26.5 years) volunteered to participate in this study. Metallic occlusal overlays were fabricated for the lower working side canine and overlaid to the second molar and the non-working side second molar in order to simulate a canine protected occlusion, group function occlusion and bilateral balanced occlusion. Electromyographic (EMG) activity from the bilateral masseter, anterior temporalis, and posterior temporalis was recorded. These signals were rectified, summarized, and presented to each subject using an oscilloscope screen. Using this visual feedback, subjects were asked to perform clenching tasks at a 50% level of maximal voluntary contraction exerted with simulated group function occlusion and three-dimensional condylar displacements were recorded. An experimental occlusal pattern that shows statistically significant affects on condylar displacements (anova: P<0.001) was found. When compared with the simulated canine protected occlusion, the simulated group function occlusion caused smaller working side condylar displacement and the simulated bilateral balanced occlusion caused significantly smaller non-working side and working side condylar displacements. These results suggest that the increased working side tooth contacts have a potential to reduce working side joint loadings, and a balancing side contact has a potential to reduce non-working side joint loadings, under the laboratory condition where the clenching level is controlled.