Biofunctional dentistry combines optimal chewing function with natural aesthetics and long‑term stability of the masticatory system.
Teeth, masticatory muscles, and temporomandibular joints function together as a highly sensitive, complex, and extensively interconnected biomechanical unit. A masticatory system can only function correctly and remain stable and healthy in the long term if:
- the temporomandibular joints are able to return to the “zero point” (centric relation of the TMJs) in the socket at the end of each chewing cycle
- in this moment, all teeth of the upper and lower jaw come together at the same time, without affecting the centric position of the temporomandibular joints
- certain – very precise – biological principles of spatial relationships between the teeth of the upper and lower jaw are maintained, and teeth are naturally shaped and have not been worn down
If these conditions are not met, the individual anatomical structures and tissues are inevitably subjected to unnatural stress.
Affected patients often do not notice these disturbances for a long time, as the masticatory system can temporarily adapt and become “accustomed” to the situation. As a result, teeth may wear down progressively over many years – a process that is neither natural nor part of normal aging. If the body can no longer compensate for these disturbances, a wide range of diseases and symptoms may develop. Since the masticatory system is not an isolated organ, these disturbances can affect the entire body. They are summarized under the term temporomandibular disorders (TMD).
BIOFUNCTIONAL RECONSTRUCTION OF THE MASTICATORY SYSTEM
As a rule, biofunctional reconstruction consists essentially of three treatment steps:
1. Pretreatment of the Temporomandibular Joints and Masticatory Muscles
A key characteristic of healthy masticatory systems is the physiologically correct position of the temporomandibular joints. In the first treatment step, we guide the temporomandibular joints into their natural healthy positions. For this purpose – excluding certain joint diseases – we use an elaborate MAGO occlusal splint therapy, a further development of the proven “Michigan splint.” It has been refined and perfected in many details based on years of experience and has nothing in common with simple grinding or night guards.
During this phase, no changes to the teeth are necessary, as existing biomechanical disturbances are fully eliminated by the MAGO splint. At the end of MAGO therapy, the joint structures are regenerated and stabilized to such an extent that their physiological centric position can be reproducibly determined. This is imperative to the functional accuracy of the subsequent reconstruction, and thus to the longevity of your teeth.
2. Diagnosis and Treatment Planning
Based on the established correct joint position and subsequent precise measurements of the temporomandibular joints, we determine which changes to individual teeth are necessary to create a harmoniously functioning masticatory system.
To do this, the future shape of each individual tooth needed to create a perfectly functioning overall system is worked out in hinge-axis related jaw models. The required changes to the teeth can be anything from minimal shape corrections to major restorations. In some cases, orthodontic pretreatment is the best way to remedy major malalignments of individual teeth in advance.
The creation of this so‑called wax‑up requires great skill, a deep understanding of masticatory biomechanics, and a strong sense of responsibility. We discuss the completed wax‑up with each patient and explain the individual treatment steps required for its realization in the mouth.
3. Realization of the Wax‑Up in the Mouth
The long‑term successful implementation of a wax‑up requires extensive and precise planning of the treatment sequence.
It must be ensured, for example, that the previously established joint position is not disturbed and it is important to understand that individual teeth exhibit significantly higher tactile sensitivity than during splint therapy. Taking such details into account and mastering them is crucial for long‑term success.
For these reasons, several groups of teeth are usually first restored with long‑term provisional restorations made of high‑performance composite. These restorations are fabricated in the laboratory with the same precision as the final, usually all‑ceramic restorations, but they can still be adjusted intraorally – a necessity due to biological processes in the periodontal tissues, muscles, and temporomandibular joints.
After a certain period (usually several months) and the necessary adjustments, the long‑term provisionals are replaced step by step with definitive, usually all‑ceramic restorations.
