Wear facets give a massive amount of information
Wear facets between upper and lower teeth can be a telltale sign of how a patient functions. A few points.
- Wear facets on cuspal inclines can indicate posterior function in a non axial direction.
- Linear wear facets (i.e elongated, not a single spot) can indicate a slide from first contact in CR to MIP.
- Large wear facets only indicate wide broad contacts not heavy contacts
- Worn canines can indicate nocturnal bruxism. Be sure to get the patient to manipulate their jaw to match the wear facets up. Patient who contact in extreme laterotrusion almost inevitably sleep brux. This makes a lot of sens to the if you point it out and it can be a good point to convince them to seek more diagnostics
- Patients who still have mammelons are unlikely to brux on anterior teeth so either they are trapped in MIP and exhibit more of a clenching habit or the have an anterior open bite relationship.
"Patient who contact in extreme laterotrusion almost inevitably sleep brux."
ReplyDeleteCan you elaborate on this? Thanks
Hi, Thanks for your question. To clarify, this statement is more reasoning on my part than fact. When I see wear facets e.g on canine, premolar cusp tips I find that the maxillary and mandibular wear facets line up when the patient has their jaw swing to the side at an extreme position (in class 1, class 2 patients). Barring some neurological conditions or drug use most patients will agree that they don't move their jaw to this position during the day so the only way to explain this to them to say that they most likely brux during their sleep. This can be a powerful tool to convince them that there is a problem that they aren't aware of. It can be an "a-ha" moment to ask them how they think they developed that wear.
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