Unraveling Coronoplasty in Periodontics

Perioprosthodontics Occlusal Evaluation

Question 1. Write short note on occlusal adjustment.
Answer. Occlusal adjustment is also known as occlusal equilibration or coronoplasty.

Occlusal adjustment is the selective reshaping of occlusal surfaces with goal of establishing a stable non-traumatic occlusion.

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Steps in Occlusal Adjustment

Following are the steps in occlusal adjustment:

• Step 1 – Removal of retrusive prematurities
• Step 2 – Adjustment of intercuspal position
• Step 3 – Test for the excessive contact in incisor teeth in intercuspal position
• Step 4 – Remove posterior protrusive supracontacts
• Step 5 – Correct prematurities on balancing side
• Step 6 – Reduce supracontacts on the working side
• Step 7 – Elimination of undesirable gross occlusal features
• Step 8 – Recheck the occlusal contact relationship in all positions
• Step 9 – Finishing and polishing

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Read And Learn More: Periodontics Question And Answers

Step 1: Removal of Retrusive Prematurities

• Retrusive prematurities should be removed and eliminate the deflective shift from retruded contact position to intercuspal position.
• If there is presence of lateral/forward deflection of mandible in intercuspal position in presence of premature contacts during the retruding movement, this is known as shift from retruded contact position to intercuspal position.
• Locate the retrusive prematurities over mesial inclines of maxillary cusps as well as on distal inclines of mandibular cusps.
• Reduce the prematurities by reshaping the cusps by grinding the inclined planes and deepening the fossae. Maintain the marginal ridges and cuspal height.

Step 2: Adjustment of Intercuspal Position

• Adjusting the intercuspal position causes relieving in supracontacts and provide occlusal stability.
• Stability in intercuspal position is obtained by reducing the size of cusp and deepening the fossa.

Step 3: Test for the Excessive Contact on IncisorTeeth in Intercuspal Position

• Test the contact relationship by mylar strips, also check for fremitus.
• Mark the supracontacts and remove them.

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Step 4: Remove Posterior Protrusive Supracontacts

• Bilateral protrusive movement should be obtained.
• A well distributed, bilateral contact over the incisal edges should be achieved here.
• Correct the prematurities by grinding maxillary teeth.

Step 5: Correct Prematurities on Balancing Side

• Locate the prematurities by mylar strips or articulating paper.
• Prematurities are seen as oblique facets on inner inclines of mandibular buccal cusp and inner inclines of maxillary lingual cusp of first and second molars.

Step 6: Reduce Supracontacts on the Working Side

• Supracontacts should be reduced over the laterotrusive side, i.e. the working side.
• In laterotrusion, unrestricted smooth contact movement is achieved.
• Inner incline of maxillary facial cusps should be reshaped.
• Relieve the premature contacts in lateral extrusion by reducing inclines of buccal upper and lingual lower cusps.

Step 7: Elimination of Undesirable Gross Occlusal Features

At this step correction of plunger cusp, extruded teeth, rotated or malposed teeth, uneven marginal ridges of adjacent teeth, occlusal wear facets, etc. should be done.

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Step 8: Recheck the Occlusal Contact Relationship in all Positions

Occlusal contact relationship should be rechecked in all positions and movements.

Step 9: Finishing and Polishing

Smooth and polish the adjusted surfaces of all the teeth