A preliminary study of the effects of tooth guidance on working-side condylar movement

Clinical observations have indicated that lateral working-side tooth contacts can produce a posterior shift of the working-side condyle, resulting in pain in the temporomandibular joint. This study examined the influence of lateral retrusive and lateral protrusive tooth guidance on the movements of working condyles of the lateral pole. Four patients with lateral retrusive natural tooth contacts and four patients with lateral protrusive natural tooth contacts were studied. Movement of the lateral pole of the working condyle was recorded under the following conditions: (1) natural teeth in contact, (2) wearing of a mandibular acrylic resin splint that created lateral protrusive or lateral retrusive tooth guidance, and (3) a central bearing screw and bearing plate separating the teeth. The results indicated that the condition of the patient's temporomandibular joints was a crucial factor in consistency of condylar tracings. Condylar tracings from patients with temporomandibular joint condyle-disk lacking coordination were inconsistent and unreproducible. Consistent, reproducible tracings for patients without condyle-disk disorders indicated that lateral retrusive guidance can cause a more posterior pathway of the lateral pole of the working condyle than lateral protrusive guidance. Future studies are necessary to establish the relationship between lateral tooth guidance and temporomandibular disorders.