Clayton A. Chan, D.D.S. – Las Vegas, NV
I would rather term it Physiologic occlusion, or a physiologic position.
Physiologic bite to me is a laymen’s term to convey a more healthier terminal contact position for the body to brace against when doing so. Physiologic position is where the mandibular position allows the various masticatory muscles to simultaneously rest at their resting length yet be in balanced tonus with one another when one clenches to the terminal stopping position along that “isotonic mandibular path” (myo-trajectory only determined with myomonitor TENS). It will be the most physiologically “comfortable” as long as the occlusal noxious interferences are no longer present and freedom of entry and exiting to that idealized terminal position is established in all 6 dimensions. Resting EMG levels with be within physiologic norms…not just low (low EMGs could also be bad – or fatigued low)…but we want healthy low EMG levels from that physiologic “bite” position.
Also, just as importantly when the mandible clenches down and recruits the muscles you want high amplitude EMGs and balanced, but they should also be along the isotonic myo-trajectory…if not you can have increased EMG recruitment (they can look good) but when tested against a bite that is on trajectory you will also have great EMG amplitude retruitment). But there is a finer difference….prior to observing the increase EMG clench patterns one can also see, at an EMG gain = 10 mV, the quality or lack of quality of resting tonus prior to the balanced clench EMGs (temporalis anterior and massetter muscle groups)….also you can see the quality or lack of resting EMG quality after the balanced clench. This is significant and that most NM dentist failed to recognize (we cover this in our OC scan interpretation course)… so you get some special insight to this since you asked a great question…lol What this indicates and is a measurement of is the quality of the CNS calmness.
Yes, many try to dumb NM down to a level that they are now missing many significant aspects of NMD…the K7 to measure position and masticatory responses with TENS and without TENS as seen on jaw tracking is often missing…many have focused on EMG…which are good, but doesn’t accurately tell another story. EMGs are good to a certain degree, but also can be bad when they are missing some signficant things in their diagnostic understanding and treatment methods. TENSing is important, so is CMS and so is EMG as well as ESG. It is all valid. For me I don’t want to know something about my difficult cases…so I try to know what I can with objectivity, yet use my brains to think…not just follow some cookbook process.
GNM is more involved then what I will post here ,…but it is a process many of our NM K7 trained colleagues soon realized that there were some missing pieces in NM occlusal understanding…they realized it makes sense…but when it gets to the clinical application of it..that is where the real challenge began for them…now they know.
GNM is a full body postural concept to help remove dysfunctions and impairments to the masticatory system, but at another level, especially for those 1) cervical dysfunction pain cases, 2) TMJ primary problems who are in pain, 3) Anterior open bite TMD paining cases, and 4) Class II Division 2 type challenges who are still paining. This what GNM answers in our courses.