Hi Andy,
Thank for your interest in this article. The article by no means is comprehensive in nature, but designed to stir interest into a more objective, measurable and quantifiable arena which as you and I know, most in the dental profession do very little if none when it comes to determining ones level of physiologic and functional health. For the sake of keeping my response simple I will use the term optimization or optimal as being similar in nature for this particular response.
There are elite athletes (olympic level and competative performane) and top pro trainers who have come to recognize by quantitative measurement tests, levels of efficacy and efficiency, what one means by optimal. Thus optimal vs. non optimal, physiologic vs. pathologicy, health vs. unhealth becomes tangible when one measures physiologic responses. Oxygen consumption (Vo2), levels of speed, strength, heart rate and blood pressure responses for a level aerobic exercise, body balance/equilibirum force measurements, reaction times, for example can be quantified and determined whether optimal or not…
- Optimization or optimal: to make effective, perfect, or useful as possible.
- To make the best,
- To prepare a program that automatically adjusts itself to operate a computer at maximum efficiency,
- thus optimized. (Random House Dictionary, Unabridged edition).
Optimization of the bite fundamentally relates anatomical structures as well as bio-physiologic relationships coming together in a relaxed (isotonic) state within the human body.
Optimization is the science and art of determining and maintaining specific relationships of the teeth, muscles, joints and discs using sound principles of gneuromuscular occlusion that allows not only the stomatognathic system to rest, but the entire body.
Optimization is determined and validated from the neuromuscular muscle relaxed position. Low frequency TENS has been used to establish homeostasis (true physiologic rest position).
Optimization goes beyond classic electronic instrumentation techniques (modified Myotronics Scan 4/5 technique) and is validated by objective measuring technology using CMS (computerized mandibular scanning). It goes beyond classical understanding and use of electromyography (EMG) that scientifically quantifies before and after jaw relationship with before and after TENs. It measures and confirm “true optimization” scientifically. CMS measures jaw positioning and location. EMGs measures muscle activity status of the mandible and cervical relationships.
An Optimized Bite can only be determined and confirmed objectively with the K7 instrumentation to within tenths of a millimeter. Without instrumentation the dentist cannot confirm or validate whether the bite is optimized or not. (Different than a habitual or accommodate bite relationship which can also be related synchronously to muscle activity status of that person).
Optimization recognizes that the condyle and disc must function free of any impingement – no clicking, no popping. When the disc is reduced and the condyle is properly positioned within the glenoid fossa an optimal bite position can exist. In order for the disc to be optimized it must be properly positioned over the condylar head – not anterior or medially displaced. It recognizes that the condyle is not positioned in a posterior superior position within the glenoid fossa. (CMS can objectively record and measure these functional jaw movements vs. pathologic functional movements).
Muscles of the face, head, lower jaw as well as the cervical neck and shoulder regions including the skeletal structural system must be balanced with proper body posture to bring optimal body balance and function. (Again, and Optimized Bite can be measured and quantified with CMS and EMG technology – most in the dental profession don’t measure…so their reference to efficacy, level of health or so called “physiologic” are good sounding terms with no objective and measured reference).
Optimization is a term used to distinguish itself different than the classical neuromuscular jaw positioning. The Optimized Bite™ is a technique and protocol that uses a systematic bite finding protocol using jaw tracking instrumentation (Myotronics K7, Scan 4/5) to “Optimize the Bite”. It is a bite recording protocol that goes beyond classical TENs bite, modified TENS bite techniques, classic scan 4/5 bite protocols and “modified Scan 4/5 bite” taking protocols developed and pioneered by the originator Dr. Clayton Chan. The Optimized Bite® technique and protocol is scientific and can be measured to within 0.1-0.3 mm accuracy.
Thus, the words, optimal in the context I am using them refer to something that I am able to quantify and measure specific levels of physiologic muscle status and specific levels of terminal end points of health relative to a habitual accommodated occlusal position. “Optimal” also includes the numerous signs and symptoms (unhealth) and quality of occlusal health that would be deamed physiologic within the standard of care. Relating these terms are not causally done, but rather in an objective manner to raise the bar of levels of dental health to our profession that can be accountable.
Evidence:
There are a number of scientific studies have show that the use of CMS, EMG and low frequency TENS are reliable tools to measure and scientifically quantify physiologic responses, quantify functional movements, and status of temporomandibular joint conditions. Manual palpation and visual assessments are now able to be greatly helped to new levels in ones diagnostic and treatment methodology. The Optimized Bite™ is an objective, measured and quantifiable approach that uses specific protocol. It was created and developed for the GNM dentists.
– Clayton A. Chan, D.D.S. – Las Vegas, NV
DR. CLAYTON CHAN'S BLOG NOTES 