In this next post let’s chat about a critical factor between success and failure. Parafunctional envelopes
Again I’ll keep this brief, it get covered fully in my seminar if anyone is interested
The evidence to suggest parafunction can be ‘controlled’ by occlusion has been disproven by EMG testing in the mid 70’s. Whilst occlusion may help in controlling parafunction, it’s a modifying factor as opposed to a driving factor (again the science is given in my seminars)
It is critical that as part of our assessment we look for wear facets. I play a really simple game; make the wear facets fit. This tells you what the neurological drive is and you either need to stay out of this parafunctional envelope or protect whatever you put into it
Be aware of the centric clench which is actually quite common! In these cases you will see very little tooth wear but often muscular and neurological symptoms are very common
The type of tooth wear may actually help you in full mouth reconstructive cases, if a restricted envelope is really quite obvious (what is referred to in universities as ‘rat’ envelope) then this can actually be copied into the final restoratives by way of a custom incisal guidance table. We already know it’s going to be comfortable for the patient!