The gestalt of occlusion--A clinical appraisal

1. Occlusion, with its many ramifications, cannot be over simplified. It should not be considered so varied that a sequential and subtle analysis of its ramifications defies simplification. 2. The same mechanisms produce the correct or incorrect physiologic position of the dental units. A faulty mechanism must be recognized and all efforts made to return it to efficiency as soon as possible for the benefit of the entire system. 3. The correct physiologic terminal position of the mandibular condyles is the ideal relationship in the TMJ and activates the posterior component forces of the neurologic system. This forms the dentition into its most harmonious relationship. 4. Any teminal position of the condyle in the mandibular fossa, other than the physiologic terminal position, compromises the potential of a harmonious interdental forming process. The results range from simple deflective occlusal contacts to severe malocclusions. 5. The constancy of the occlusal plane relationship, easily determined from a cephalometric tracing offers a clinical guide as to its best functioning position. 6. A TMJ radiographic technique that ensures repeatable, reproducible, and traceable radiograms is an essential diagnostic aid. It is necessary to know the position of the condyle in the fossa before, during, and after procedures that alter the interocclusal relationship. 7. Not all TMJ problems are necessarily symptomatic. Occlusal adjustment procedures should be utilized to ensure a harmonious interocclusal relationship manifest by the muscles of mastication functioning in a nonsymptomatic, optimal, and physiologic manner, in all working jaw relations. The ideal physiologic terminal position must be established as closely as possible during saliva swallowing. 8. Only occlusal adjustment techniques utilizing the natural forces of the neuromuscular system to reestablish the ideal physiologic terminal position within the TMJ should be used. A technique such as that developed by Long satisfies this requirement. 9. Although there are many imperfections in knowledge, there are no imperfections in truth.