The study of occlusion and its relationship to function of the masticatory system has been a topic of interest in dentistry for many years. This relationship has proved to be quite complex. Tremendous interest in this area accompanied by lack of complete knowledge has stimulated numerous concepts, theories, and treatment methods. This, of course, has led to much confusion in an already complicated field of study. Although the level of knowledge today is greater than ever before, there is still much to learn. Some of today’s techniques will prove to be our most effective treatments in the future. Other methods will be demonstrated as ineffective and will have to be discarded. Competent and caring practitioners must establish their treatment methods based on both their present knowledge and their constant evaluation of information received from the massive amount of ongoing research. This is an enormous task. It is my hope that this text will assist students, teachers, and practitioners in making these important treatment decisions for their patients.
I began my teaching career at the University of Kentucky in 1974 in the area of occlusion. At that time, I believed there was a need for a teaching manual that presented the topics of occlusion and temporomandibular disorders (TMDs) in an organized, logical, and scientific manner. In 1975, I developed such a manual to assist in teaching my dental students. Soon, several other dental schools requested use of this manual for their teaching programs. In 1983, the CV Mosby Publishing Company approached me with the concept of developing this manual into a complete textbook. After 2 years of writing and editing, the first edition was published in 1985.
I am very pleased and humbled to learn that this text is currently being used in most of the dental schools in the United States and has been translated into 11 foreign languages for use abroad. This is professionally very satisfying, and it is my hope that the true benefit of this text is found in the improved quality of care we offer our patients.
It is a privilege to have the opportunity to update this text for the eighth time. I have tried to include the most significant scientific findings that have been revealed in the past 4 years. I believe the strength of a textbook lies not in the author’s words, but in the scientific references that are offered to support the ideas presented. Unreferenced ideas should be considered only as opinions that require further scientific investigation to either verify or negate them. It is extremely difficult to keep a textbook updated, especially in a field in which so much is happening so quickly. Thirty-three years ago, in the first edition of this text, I referenced approximately 450 articles to support the statements and ideas. The concepts in this edition are supported by nearly 2400 scientific references. This reflects the significant scientific growth of this field. It should be acknowledged that as future truths are uncovered, the professional has the obligation to appropriately respond with changes that best reflect the new information. These changes are sometimes difficult for the clinician because they may reflect the need to change clinical protocol. However, the best care for our patients rests in the most scientifically supported information. The purpose of this text is to present a logical and practical approach to the study of occlusion and masticatory function. The text is divided into four main sections: The first part consists of six chapters that present the normal anatomic and physiologic features of the masticatory system. Understanding normal occlusal relationships and masticatory function is essential to understanding dysfunction. The second part consists of four chapters that present the etiology and identification of common functional disturbances of the masticatory system. Significant supportive documentation has been included in this edition. The third part consists of six chapters that present rational treatments for these disorders according to the significant etiologic factors. Recent studies have been added to support existing treatments, as well as for new considerations. The last part consists of four chapters that present specific considerations for permanent occlusal therapy.
The intent of this text is to develop an understanding of and rational approach to the study of masticatory function and occlusion. To assist the reader, certain techniques have been presented. It should be recognized that the purpose of a technique is to achieve certain treatment goals. Accomplishing these goals is the significant factor, not the technique itself. Any technique that achieves the treatment goals is acceptable as long as it does so in a reasonably conservative,cost-effective manner, with the best interests of the patient kept in mind.