CATEGORY 84 AUSTRALASIAN DENTIST CLINICAL definition does not address how the canine teeth engage and the development of vectors during the contacting stages of the opposing canines in early, mid and final lateral mandibular movement (Darveniza 2001). Canine guidance is defined by the author as: the interaction of coupling canines to restrict disto-horizontal mandibular movements while creating a protective vertico-lateral mandibular movement over a long path commensurate with a given skeletal pattern resulting in posterior disclusion (Darveniza 2001). The author believes that this vertico-lateral vector stabilizes the disc ‘cap’ on the condylar head helping prevent disc displacement in lateral occlusion (Darveniza 2001). Also, the length of the canine rise path has not been addressed in the abovementioned literature while the author has noted that short paths encourage crossover to occur often with concomitant disc displacement (Darveniza 2001). In 2001, Darveniza addressed the presence of early, mid and final lateral paths without protective vectors and developed restorative anatomy, instead of accepting classic anatomy, to bio-design protective mandibular vectors (Darveniza 2001). The evidence to date shows no direct association between the lack of canine guidance (using the contemporary definition) and the development of TMD (Manfredini, Lombardo; et al. 2017,Thornton 1990). Although a direct association has been widespread in this author’s TMD practice which records unprotected mandibular vectors in early, mid and final mandibular paths. The author bio-designs lateral guidance using restorative anatomy for malpositioned canines in Angle’s Class 1, 2 and 3 relationships (Darveniza 2001, Darveniza 2023) (Figs. 1 to 7). The author first addressed bio-designing malpositioned canines in 1988 and the results of this study validate bio-designing occlusal shapes to create and re-direct mandibular movement to protect the TMJs, with a 96% improvement in Type 3 TMD/ Occlusal profile patients. A new era in occluso-mandibular analysis requires an emphasis on the length of excursive paths and the presence of protective vectors during the early, mid, and final paths during lateral and protrusive occluso-mandibular movements. The resolved component of each section of an excursive occluso-mandibular movement in the direction towards a TMJ becomes the ‘occluso-mandibular key’ to understand the development of disc displacement. The philosophy of ‘full occlusal therapy’ (Darveniza 2023) involves new terms and a new language to describe ways to evaluate, manage and treat TMD patients (Figs. 1, 2, 3 and 4). Full occlusal therapy requires a multidisciplinary occlusal and prosthodontic approach (Darveniza 2001) executed with ‘great preciseness’ (Dawson 1999) along with communicative skills for behavioural modification (Darveniza 2023, Darveniza 2023). Conclusions and clinical implications ‘Full Occlusal Therapy’ was offered to 200 TMD patients and the mean follow-up period was 6.1 years with an improvement for self-reported symptoms of 90.2%. ‘Formal fully protective occlusal splint therapy’ (OST) with ‘Full Counselling’ for 48 Group A patients resulted in a mean improvement of 84%, 70% in Group B before occlusal equilibration (OE) and 58% in Group C before OE and molar guidance/ anterior guidance (MG/AG). OST with ‘Full Counselling’ for 200 patients resulted in a mean improvement of 71%. When OST with ‘Full Counselling’ was followed by OE this resulted in a mean improvement of 91% for 96 Group B patients and 81% for 56 Group C patients. When the remaining 56 Group C patients who had completed OST with ‘Full Counselling’ and OE and then went on to MG or AG, they achieved a mean improvement of 96%. This preliminary TMD investigation identified three profile types of occlusal therapy affected patients termed TMD/ Occlusal profile groups by their choice of therapy required to achieve their desired outcome. The existence of these three TMD/Occlusal profile groups guide a clinician to accept why TMD patients may decline or have the need to proceed with the different occlusal therapies. The observations from this preliminary investigation suggest a placebo orientated parallel, randomized, controlled and blind design be considered to establish the therapeutic efficacy of ‘Full Occlusal Therapy’. Acknowledgements I would like to acknowledge the late Dr. Bruce Junner, supervisor in my speciality programme, for his solid grounding he gave me in occlusion and prosthodontics. My deepest appreciation to the late Dr. Joe Clayton, from the Crown and Bridge Department at the University of Michigan, for his superior knowledge he imparted on occlusal reconstruction and Pantronic mandibular movement during sabbatical leave. I am grateful to Professor John Meek my Ph.D. supervisor for his rigid direction in research and civil engineering. I am appreciative for all scholarly advice and the statistical analyses performed by statistician John Rogers. I am grateful to ceramist Paul Buchanan for all his technical support and skill in bio-designing occlusal schemes. I would like to thank John Atkins, Honorary Research Fellow in philosophy from the University of Queensland, for the editorial help he afforded me in writing this paper. X Please email gapmagazines@gmail.com or mdarvo@hotmail.com for a complete list of references. õõõŚ©¾ËÙË£¾éËÙŚËÄŚé õõõŚÖÙË£ÅäŚËÄŚé AUSTRALIAN FOR STRONG, HEALTHY TEETH & GUMS Proudly Australian Made & Owned
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