GNEUROMUSCULAR (GNM) Approach – The OC Difference

Clinician’s are wondering what makes OCCLUSION CONNECTIONS teaching and occlusal concepts different and unique compared to other neuromuscular teachings. The following are some highlighted points that dentist have come to recognize as distinguishing characteristics in their OC training, learning and understanding about “Gneuromuscular” (GNM) occlusion compared to previous neuromuscular teachings:

1.  The Optimized Bite is totally different from the classic scan 4/5 or even the so called “Chan Scan” that many neuromuscular clinicians have learned from in the past. It is a technique that focuses on careful observation of the patient’s mandibular positioning as well as detailed protocols designed by Dr. Chan to streamline the process.  Dr. Chan has made the complex simple using both low frequency Myomonitor TENS and Jaw Tracking in such a manner and sequence that makes sense even to those who are familiar with the K7 technology.  The Optimized Bite protocols (as taught by Dr. Clayton Chan) are advanced techniques beyond previous methods used in all classic TENS, Myobites, so called “Chan Scan K7  Scan 4/5 bites” and other K7  bite recording techniques.

OC’s advanced protocol acknowledges that there exist mandibular torques strains that contribute to many occlusal problems.  OC recognizes that changing the bite relationship is only required when pain, joint derangement and masticatory problems exist.  If these problems don’t exist and the patient is comfortable with no symptoms there is no need to alter a bite relationship.  If there are problems that exist, than it is prudent that the doctor finds the most physiologic, accurate and precise bite relationship to which the stabilization process begins.  Casually increasing one’s vertical dimension of the jaw should not be hastily determined to some “neuromuscular position”, but one that requires precision, accuracy  and understanding.  OC’s Optimized Bite  protocol is being recognized by clinicians abroad to speed up the diagnostic and treatment process of their patients.  This is what makes OC’s Optimized Bite protocol unique and highly desirable.

2.  Clinicians and laboratory technicians abroad have recognized the shortcomings with the HIP plane concept as well as other facebow/ear bow techniques.  Because of this OC has continued to promote and teach a simple and logical technique using the Fox Plane in a modified way that makes complete sense both clinically and for the laboratory technician’s ease when registering the maxillary occlusal plane orientation to a Maxillary Transfer Table relative to horizontal level.  OC believes when the head is physiologically level and stable an angled maxillary occlusal plane exists and must be acknowledged and properly registered accurately to replicate a correct maxillary arch orientation for restorative reconstruction, lab communication and optimal smile design.  OC’s maxillary leveling and clinical transferring techniques are by far the most simple, advanced and accurate of other techniques taught.

 

 

  1.  Fatigued Muscle EMG scans are not OC’s focus.  Establishing stable balanced masticatory muscles if a fundamental focus when locating an accurate and precise jaw relationship.  Achieving a physiologic “bite” (Optimized) registration can only be done when sound concept of physiologic health are predominant.  All occlusally minded clinicians who use the K7, TENS and EMG technology recognize that fatigued tired muscles does not render the best bite relationship to finish and restore any case.  Clinicians have discovered that using fatigued muscle EMG scans become less important and of lesser value when locating a physiologic bite in 6 dimensional space.  Combining the use of low frequency TENS with Jaw Tracking are key technologies that guide the clinician to identifying the most optimal jaw relationship.  Not EMGs.  Neuromuscular clinician’s have recognized from experience that electromyography (EMG) are not definitive enough in locating the patients mandibular position, especially if muscle fatigue EMG patterns are present.  This is why low frequency TENS to relax the muscle is significant and jaw tracking to locate a more precise starting point to visualize the proper jaw position is crucial.

Doctor’s who come to OC’s discover the answers to their unanswered questions regarding muscle fatigue problems.

 

4.  OC training encourages our clinician’s to treat to “physiologic” EMG muscle patterns, not to fatigued EMG patterns which is very different from unhealthy.  Treating to Low EMG amplitude values  is by themselves not our objective, neither our emphasis.  To accomplish this we train doctors with low frequency Myomonitor J5 TENS how to achieve normalized EMGs including physiologic healthy cervical group EMG patterns and not ignore them as most dentists end up doing.

Muscle Stability is what OC teaches – Treatment does not move forward until all symptoms are first resolved.
Diagnostic Awareness – OC does not believe the lingering pain at the angle of the jaw or pain in the cervical neck region is an ascending issue alone.  We instruct doctors in unique occlusal management techniques to try to eliminate them before coming to a wrong diagnostic and clinical treatment conclusion.

 

 

5.  Optimized Jaw Closing Path (Trajectory) – Just because one may have good looking neuromuscular trajectory does not always mean the doctors has achieved an Optimized Jaw Closing Path (Trajectory).  Just because a neuromuscular trajectory is “Parallel” to the habitual trajectory does necessarily mean it is Optimal.  OC’s teachings have advanced their techniques beyond classic Neuromuscular Trajectory teachings, yet upholding all the principles Dr. Jankelson, the  Father of Neuromuscular Dentistry has taught.

 

 

 

 

6.  Conservative Vertical Opening of the occlusal dimension during bite recording is emphasized and taught at OC to avoid over opening of the vertical dimensions during cosmetic reconstructions.  Over opening bites is just as harmful as under opening bites.

Why is it that dentist are afraid to change someones bite if the following dental problems exists?  Because they are not taught how to properly find the unique vertical occlusal dimension of occlusion for their patients, especially when crowded teeth are present, lingually tipped bicuspids and molars exists, abnormal tongue swallowing patterns, narrow dental arches, high vaulted palates, retrognathic mandibles, anterior open bites and or retrognathic maxillary arches exists to name a few.  These malocclusal problems are  clear indications that the vertical dimension of one’s bite is deficient to properly support one’s overall posture of the temporomandibular joints, the head, neck and alignment of the masticatory muscles.  Dentist’s should not continue to ignore these vertical problems in their clinical examination and health care of their patients.

Dentist should learn to stop giving excuses back to their patients as to why gum levels reseed in the anterior region of the mouth, why patients clench and or grind their teeth,  why they have deep bites and narrow dental arches and or why muscles ache and strain.  There are logical  and rational growth and development issues that have been overlooked.

 

7.  Gnathologic Orthotic Design (Anatomical) is important to the OC clinician.  OC does not endorse the casual grinding and equilibration of the occlusal surfaces to only end up with myocentric occlusal stops.  OC strongly teaches as well as encourages a proper use of the removable orthotic for those cases which present with numerous musculoskeletal signs and symptoms.   OC is different in that it de-emphasizes the use of a fixed orthotics as a first line of diagnostic modality (although in certain vertically compromised conditions it is used).  OC believes in  anterior tooth contact during mandibular side shifting movements.  This is once again very different than classical neuromuscular occlusal teachings which do not advocate anterior tooth contact, neither does this teaching properly understands the importance of disclusive occlusal schemes beyond myocentric.

OC Upholds Gnathic Principles – OC believes in not overlooking the principles of canine rise and posterior dis-occlusion.  (Class IV posterior interferences must be eliminated).
Orthotic Design – OC has not one orthotic design principles, but four different areas of design emphasis are implemented based on the diagnosis of the case cranio-mandibular problem.  OC believes anterior guidance is important to optimal mandibular function.

8.  An Emphasis on Conservative Treatment – A focus on the patient with less emphasis and abnormal use of EMG interpretation technology.

OC Upholds sound balanced Gneuromuscular Principles in its Approach using  TENS, Jaw Tracking (computerized mandibular scanning (CMS) and electromyographic (EMG) technologies.  This more conservative, balanced approach to clinical dentistry and use of diagnostic instrumentation (scan data interpretation) leads to conservative treatment and health dentistry.
Less Dependancy on Adjunctive Therapy – Since we get rid of the symptomatic complaints using proper Gnathology, Neuromuscular and “Micro Occlusion” principles of dentistry.

OC Dentists are trained to focus on disciplines of dentistry they are able diagnose and treat based on their license of care.