CATEGORY 76 AUSTRALASIAN DENTIST CLINICAL between groups. This author concluded from evaluating these studies that the design of both lateral guidance groups resulted in a vertico-lateral vector or protective mandibular movement and the similarity in results were to be expected. For occlusal reconstruction, the use of molar rise in dolichofacial patients instead of canine rise for brachyfacial and normal skeletal patients to create a protective lateral occlusion has the same common dominator, a vertico-lateral mandibular vector. The horizonto-lateral vector (bovine-like mandibular movement) has been commonly associated with negative signs and symptoms emanating from the TMJ ligaments, discs, and muscles of mastication. The author has noted that the presence of a disto-horizontal lateral mandibular vector directs the condyle towards the TMJ and then ear. This has often been associated with profound TMJ pain and ear symptoms, such as otalgia, tinnitus, hyperacusis and reported partial hearing loss. Intractable TMJ pain and otalgia was noted in patient six who had a pure distal vector (2-3 mm posterior slide) in the hinging arc of closure at hinge occlusion. In the authors’ experience, molar guidance (for dolichofacial types) and anterior guidance (for brachyfacial and normal skeletal types) form the basis of occlusal protection as they generate a protective vertico-lateral mandibular vector. Conclusion The design criteria for bio-designing molar guidance for dolichofacial TMD patients have been presented along with three case studies. The patients claimed 100% resolution of their TMD following sequential treatment of ‘Formal Fully Protective Occlusal Splint Therapy’, occlusal equilibration and bio-designing molar guidance at their respective follow-up of nine, 17 and nine years. The observations from this preliminary investigation require a placebo orientated parallel, randomized, controlled and blind study to determine the therapeutic efficacy of ‘Full Occlusal Therapy’ involving molar guidance for dolichofacial TMD patients with premolar and anterior open bites. Acknowledgements I am grateful to ceramist Paul Buchanan for all his technical support and skill in bio-designing occlusal schemes for these complex occlusal reconstructions. 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. I am appreciative to John Rogers, former statistician from the University of Queensland, for all the statistical analyses and his scholarly advice. u For a complete list of references email gapmagazines@gmail.com The idea for this book was conceived at a critical time for humanity, during the lockdown following the Covid 19 pandemic. An international group of fellow clinicians set out to create a book to analyze all aspects of a common problem in implant dentistry: the loss of one or more teeth, and the subsequent physiologic resorption of both hard and soft tissue. Defects resulting from tooth loss can be treated in several different ways, with similar but different surgical techniques, materials, and methods. GBR is an approach that has been around for over 30 years, during which time we have learnt its pros and cons. Understanding how to select the optimal GBR technique ensures reduced risks for patients and clinicians alike. This book is intended to be a “recipe manual” for how to help build better bone and includes varied protocols representing the state of the art in modern dentistry, without commercial bias. The book is also enriched by 14 videos that provide detailed explanations of the techniques adopted, and each chapter illustrates expert recommendations for optimizing the techniques presented. u https://quinted.com.au/product/buildingbetter-bone/ BOOK OF THE MONTH Building better bone – A comprehensive guide to GBR techniques WWW.PROFDENT.COM.AU #SUPPORTAUSTRALIAN LED, LITE Filter & Mirror Paddles LED and LITE filter paddles protect eyes from potentially harmful light emitted by composite resin curing lights. Lightweight mirror paddles for patient viewing. Smooth, crevice-free design make them easy to clean and disinfect By Roberto Rossi
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