Dental Video: How the principles of Bioesthetics give you a better looking & better working smile

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Chad Burtless Creps, DDS:As Doctor Lee looked at people with exceptional dentitions he realized that he had to have some model for treatment for his patients that needed care and so instead of trying to reinvent the wheel and come up with his own best idea of what that treatment should be or to mimic what’s done with dentures where we look at one out dentition with flat teeth Doctor Lee looked at nature and when he looked it nature he found some commonalities the first thing you saw was that the jaw joints were stable that means that the jaw joint is comfortable and secure the chewing muscles weren’t in spasm or painful they were comfortable the periodontal tissues that is the supporting soft tissue and bone were healthy and stable the nerves to the teeth were comfortable, the teeth weren’t sensitive or aching. When the patient bit together they hadn’t even bite and that means that there was simultaneous contact the ball the teeth with equal pressure and with time there was very little wear and that resulted in the teeth adding this beautiful aesthetics.

While Doctor Lee observed these patients he came to the conclusion that there were three principles that these that each of these patients possessed and let’s go through those. The first of these is a stable condylar position and, and to discuss this I just want to give you a little bit of anatomy if we take a close look at the joint, the part of the lower jaw that fits into the fossa on the underside of the skull is called the condyle between those two boney parts there’s an articular disc that acts as a cushion when the patient’s muscles function when they close to swallow that contraction brings the condyle up into the fossa in a position that with these patients is stable and comfortable long-term so that’s our first principle.

Our second principles what’s called anterior guidance that Doctor Lee being a biologist took meticulous notes and found that if you looked at the upper lower front teeth you found they were very strikingly similar measurements for the lengths in the upper lower teeth for the amount of horizontal and vertical overlap even for what we call vertical dimension where you measure from the gum line of the upper teeth to the gum line of the lower teeth when the teeth are together and what he found was a when the patient functioned that the upper and lower front teeth guided the jaw home to a position where all the back teeth hit at the same time and the condyle went back to that stable condylar position and by doing that it protected the back teeth from wear. If you look at this from the front the cuspid teeth also acted in lateral movements to protect the back teeth from wear.

And that resulted in our third principle which is natural genetic form because the teeth don’t wear, they maintain the shape that they had when they erupted. What Doctor Lee found is that when the patient closed even the shape and the fit of the back teeth sent information to the muscles and joints that this was the correct position to close into and that maintained that stable condylar position.

If you look at this system then there’s information coming from the muscles, from the joints, from the supporting tissues of the teeth all sending information back to the brain saying this is the place to close, so at the same time yet that stable conydlar position you have the front teeth guiding the teeth home and all the back teeth it at the same time with equal pressure. As he studied those exceptional patients he realized that the patients in his practice that did not possess exceptional dentition had big problems. And one of the things that he saw was that if the back teeth did not hit at the same time that the condyle went to that stable kind of our position if there is an interference between those back teeth the jaw actually had to move to avoid that inference and the problem with that is it’s it’s a great adaptation to avoid painful interference but there’s a big price to pay for that. When you do that the condyle has to come down out of the fossa that destroys the relationship that those upper lower front teeth have and it ends up causing wear since the muscles have to do extra work. That hyperactivity results in pain and spasm and the movement out of the joint causes inflammation within the joints so in essence you end up losing the first principle that stable condylar position and the second principal anterior guidance just to avoid that interference he concluded because of that that the best rule to follow in treating patients was to simulate the tooth relationships found in untreated non traumatic long-lasting natural dentitions as Doctor Lee looked at nature he saw these relationships …