Occlusal adjustment via selective cutting of natural teeth. Part I.

A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible, "take away" procedure and has definite contraindications in some mouths. Before discussing types of treatment, it would be worthwhile to review the indications for any type of occlusal therapy. Although much controversy and confusion have surrounded the etiologic factors leading to occlusalrelated problems, dentistry has recognized that there are two etiologic factors that must be dealt with in treatment. The first is emotional or psychological stress; the second is existing occlusal interferences or maloccluding teeth. Their combined effect leads to periods of parafunctional activity. The parafunctional acts would include any use of the teeth other than the functional activities of chewing, swallowing, and speaking. Parafunctional activities result in much greater forces over a longer period of time than do functional activities. Such activities as bruxism and clenching can result in forces that exceed the gnathic system's ability to resist. Although the psychological stress factor must be recognized and dealt with, it is worrisome that dentistry is drifting toward increasing treatment of this factor. The intent of this article is to deal with the second etiological factor, occlusal interferences, and how to systematically eliminate them. The term occlusal interferences implies that the occlusion is interfering with something or that something is inter-