Functional approach in 4 simple steps and... a jump in sport! Part 1

1. Concept of “health”, as medical science increasingly evaluates the individual as a whole, physical, metabolic and psychological. Therapy set keeping in mind the interactions between the various systems of our body. The collaboration between specialists from different sectors is therefore essential.

2. Clinical analysis of the patient: listening to the patient ’s (close and remote) anamnesis, and performing simple clinical tests, it is possible to formulate a suspicion diagnose it, frame it in the general context of the patient’s health and plan a gnathological, prosthetic or orthodontic therapeutic plan, to be confirmed later by acquiring instrumental data.

3. The terms “overload” and “malocclusion”, literature about entrusting occlusion with a determining causal role in temporomandibular joint disorders. How to approach the patient respecting his function: occlusal, articular, muscular, postural, bringing the dentist back to the central role that he has in the treatment of dysfunctions and rehabilitation of the stomatognatic apparatus.

4. The least adaptable part of the system is the temporomandibular joint: joint function, which must always be respected to prevent adaptations in the shape and position of the meniscus and in the anatomy of the heads. bones, eminence planes and condyles. Condylography: useful data are obtained to set up an articulator with individual value and analysis of the movement patterns.

5. Dental occlusion, stable and repeatable maximum intercuspation position, frontal and lateral sided guides, facial bow with arbitrary values or with a joint rotation axis, different types of articulators with different prerogatives, articulating papers, of different thickness,must be interpreted in a different way depending on the type used.

6. Analysis by surface electromyography of muscles that are inserted on the jaw, whose behavior on one hand is affected by an incorrect occlusal balance, on the other hand and capable of exerting anomalous stresses from the quantitative point of view towards the dental elements, natural or prosthodontic. The Teethan synchromiographic method for diagnostic purposes and for the correct balancing of the occlusion in order to make it balanced.

7. Evaluation by the stabilometric platform allows to evaluate the air and the length of the oscilla-tions, the presence of postural torsion and anomalies in the support of the foot. The data obtained from this examination are compared by inserting them into a simple card that allows to compare different conditions (open and closed eyes, contact teeth and in rest position, for example) in search of intercuspation relationships and strategies for postural control.

8. Functional loads of the athlet, dangerous for quantity, duration and direction, exposed to both direct macrotrauma and functional microtrauma.

9. PROTECTION: from overload, with a splint mouthguard perfectly balanced and stable The grinding patient, parafunctional for emotional, muscular or postural stress.

10. Case-report, to show how to record and increase Vertical Dimension avoiding overload and insuccess, applying this diagnostic protocol. Facial Bow, cross mounting on individualized articulator, electromyography testing DV and balance of occlusion, use of stabilometric platform to unmask extra oral relationship, use of occlusal splint to test the new mandibular position.

11. Final control of balance : anterior and lateral-sided guidance , balance of occlusion static and dynamic, using Brux-checker and s-Electromyography.