Gnathology
Gnathology (or functional diagnostics ) is a dental concept from the 1970s that deals with the articulation and occlusion of the rows of teeth. It is based on the assumption that the position of bony structures is transferred in vivo to a technical device, the articulator. The transmission takes place using reference points. It is used as the basis for functional reconstructions with or without implants, in abrasive teeth, in the manufacture of total prostheses and in orthodontics.
The costs of gnathology in terms of functional diagnostic and functional therapeutic measures are not covered by statutory health insurances in Germany in accordance with Section 28 (2) SGB V.
history
The early history of gnathology begins with the findings of A. Vesalius (1514–1564) and goes through FH Balkwill (1866), GWA Bonwill (1885), F. Spee (1890), NG Bennett (1908), GH Wilson (1917) ), RL Hanau (1926), A. Gysi (1929), GS Monson (1932), K. Thielemann (1938), and later with U. Posselt (1952), AE Aull (1965), A. Gerber (1978) , A. Motsch (1978), CH Gibbs (1982), C. Riise (1983), up to HC Lundeen (1987).
A concept was developed by Albert Gerber based on the Costen syndrome . This was followed by the gnathological concept, which was replaced by the concept by Walter Drum , later by the concept by Janet Graeme Travell , and finally followed by the concept by Willi Schulte .
Co-founders of gnathology were u. a. Peter K. Thomas and Charles E. Stuart , both USA, who made significant contributions from 1950 to 1970: fully adjustable articulator , waxing technique, anterior / canine guidance, three-point contacts of the occlusal surfaces, etc. In Germany, Axel Bauer and Alexander Gutowski these concepts. In the 1970s and 1980s this teaching also became an official part of the curriculum at German universities, i.e. that is, a significant number of the dentists presently practicing have been so trained. Overall, this led to an improvement in the quality of dental care, although critics see essential elements of this teaching as insufficiently explained. These include the alleged tooth-guided lower jaw movement and the so-called three-point support of the supporting cusps. Gnathology thus appears - as an attempt to explain phenomena not yet understood - as an example of a theoretical structure that is not yet sufficiently supported by empirical knowledge.
The S2 guidelines of the German Society for Functional Diagnostics and Therapy (DGFDT) and the German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK) currently apply to functional therapy .
Instrumental functional analysis
In the dental field, the term instrumental functional analysis (InstrFA) is understood to mean examination methods which, with the aid of special instruments and devices, enable a quantitative or qualitative assessment of the function of the craniomandibular system. These include:
- kinematic aspects of the lower jaw (recording of movements and their analysis [instrumental movement analysis] for programming articulators and / or for determining the functionality of the craniomandibular system),
- the condyle position (condyle position analysis),
- the jaw relation (horizontal jaw relation determination by means of support pin registration) and
- Aspects of the muscle activity of the jaw muscles in certain lower jaw positions / lower jaw positions, lower jaw movements or complex tasks such as chewing (especially electromyography of the masticatory muscles).
Newer gnathology is increasingly turning to diseases of the temporomandibular joint. What can be observed is a departure from the mechanistic concept and a move towards a holistic view. However, there is still a lack of reliable data from basic research. The critics z. B. the cause of "orofacial facial pain".
To date, there is no teaching of static or dynamic occlusion which, on the basis of science and observation of human physiology, has developed a concept that is not artificially conceived, but rather imitates nature and can thus be integrated into the stomatognathic system without interference.
Individual evidence
- ^ A b Anne End, Static and Dynamic Theories of Occlusion. Dissertation, p. 7. Accessed December 15, 2016.
- ↑ Heinz Spranger: Differential diagnosis of jaw pain: Regulatory medical findings and integrative therapy . Bachelor + Master Publishing, February 1, 2015, ISBN 978-3-95684-868-1 .
- ↑ H. Stemmann, The future needs an origin - from the bent door hinge to the virtual articulator ( Memento of the original from November 17, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , 44th Annual Meeting of the Dental Technology Working Group, June 2015, pp. 6–13. Retrieved September 7, 2015.
- ↑ Alexander Gutowski, Axel Bauer, Gnathologie: Introduction to Theory and Practice, Quintessenz-Verlag, 3rd edition 1984. ISBN 3-87652-158-0 . Retrieved September 6, 2015.
- ^ Instrumental dental functional analysis , S2k guidelines (long version), AWMF register number: 083-017; Status: December 2015. Valid until December 2020. Accessed on May 10, 2016.
