Habitual Force Patterns help to diagnostically evaluate the occlusion and get the true picture of its function and dysfunction: past, present and future. Chronic parafunction has a beginning and every patient has a force pattern. Digital force patterns tell us how the bones line up. The adult force pattern is present around age 12. However, force on the occlusion between the ages of 6 and 8 gives the dentist a “heads up” as to how the mandible lines up to the maxilla. Asymmetric force patterns at a young age are diagnostic to the future envelope of destruction which follows when the resistance in the anatomy is projected over millions of chewing cycles.
Keep in mind that the HFP is a movie recording of how force is transferred throughout the occlusal cycle. The diagnostic patterns show direction, sequence, intensity, and repetition of force. HFPs isolate to different positions in the dental arch. Some patterns dominate the front teeth and others are located on the back teeth. All dental patients fall into one of the six different occlusion patterns. The six basic patterns are illustrated as follows:
Digital force movies have the ability to change our understanding of traditional concepts of occlusion. A class I occlusion can behave like a unilateral crossbite. A class II or III occlusion can be balanced. Many orthodontic cases present with dysfunctional patterns and new reconstruction cases can often act like an anterior open bite. Good or bad, it is what it is on the computer.
How to use a Habitual Force Pattern
First, digital force recordings are a diagnostic tool, much like a radiograph. Understanding how the occlusion developed and the status of the current function are the initial steps to a successful and predictable treatment plan.
The HFP starts young and the adult pattern is complete at age 12. Some additional growth may alter the force signature, but not by much. Most 8-year olds have a straight center horizontal pattern. By age 12, children have picked a dominant chewing side, usually on the side where the airway is limited. Habitual Force Patterns relate to the anatomy. For example, airway anatomy, muscle anatomy, teeth anatomy, condyle anatomy, periodontal anatomy, and head posture anatomy patterns all have an effect on the overall function of the occlusion. The sensory input from the teeth is directly related to the motor output of the cranium.
The anatomical components (1. Airway 2. Trapezius Attachment 3. Occlusion & Periodontal 4. Lateral Pole of Condyle) from growth set the framework for the force distribution we see in digital occlusion. Asymmetric anatomy at a young age will, over time, stress the anatomical systems to adapt or fail by altering the muscles, TM joints, teeth, and foundation that support the teeth.
Poor posture pulls the mandible off center and increases cranio pain disorders. (Posterior HFPs all have elevated neck triggers.)
Excessive force over time (functional and dysfunctional) cracks teeth as demonstrated below.
The most powerful diagnostic information about digital occlusion is the ability to predict future stress on the occlusion. The patterns are present a decade ahead of most occlusion-related disorders, like fractured teeth, chronic muscle trigger, and condyle ligament pathology.
Dr. Gordon Christensen asks the question in his Occlusion Confusion article in the April 2006 issue of Dental Town: “Can occlusion be implemented into a general practice and become a service-oriented, profit producing area of practice?” The answer has always been ‘yes’, but with digital scans, the potential is greater to make occlusion faster, easier, and higher quality for all dentists. The new paradigm shift in 3-D occlusion will be to identify stressed occlusions and develop treatment options that are conservative and effective income-producing procedures.
Effective treatment options may be the ultimate goal, but digital force scans also teach how to:
- Identify and slow down pathologic patterns
- Record and store force scans for future reference
- Measure and verify changes made to the occlusion
- Expand your knowledge of bite splints
- Expand your equilibration skills
- Increase value and education to your diagnosis and treatment
- Grow your career. Dentistry is a journey!
Digital Occlusion will teach dentists how Habitual Force Patterns are clinically related to extra-articular masticatory and cervical muscle dysfunction, as well as intra-articular bio-mechanical dysfunction. A new paradigm!!! Occlusion is a 3-D thinking game and you cannot fix what you do not understand. In digital occlusion, the game is more transparent and opens the door to more effective solutions. A digital scan takes only a minute and now you have a record of what the ink marks look like in a movie format. That’s powerful!