THE JOURNAL OF
PROSTHETIC DENTISTRY
Vol. 3 November,
THROUGH THE EYES
Louis S. Block has written about den-
ture problems from a viewpoint opposite that
of most authors. He has searched for the
things that are similar rather than those
which are different in the procedures used
by many prosthetic authorities. Strangely
enough he has found that the various tech-
niques are not as far apart in principle
as they seem at first glance. By this ap-
proach, he has stated some principles which
could be used to unconfuse those confused
by the apparently divergent viewpoints ex-
pressed in some other articles. It is obvious
that not all will agree with the author on all
of the points discussed, but everyone will
find many points with which he can agree.
This article represents a fresh approach to
the problems of prosthodontics.
M. A. Pleasure favors nonanatomic teeth
over anatomic teeth in his comparison. He
criticizes the reasoning of those who favor
anatomic teeth at several points. Some of
the criticism may have merit, but some is
“slanted.” No one can say what nature
intended. We can only speculate as to
cause and effect. Various interpretations are
made of the wear that does occur on teeth.
He apparently feels that occlusal wear is a
protective mechanism, but points of wear can
be predicted by considering the relative time
any point is in contact with any other given
point during a given movement. A single
point on a buccal cusp of a lower molar, for
instance, may be in contact with its op-
ponent throughout an entire gliding move-
ment, but it will make contact with many
points on its opponent. Naturally, more
abrasion will result on that point on the
lower buccal cusp than will occur on any one
point with which it makes contact. It is
true that bilaterally balanced occlusion is in-
effective when the bolus of food is sufficiently
large to hold the teeth apart, but unfor-
tunately this is true regardless of the type
of teeth used. However bilateral balance is
beneficial when there 5s no food in the
mouth. This may be observed by comparing
the health of anterior ridges with the two
occlusal patterns on dentures when the teeth
are arranged so the anterior teeth make con-
tact in protrusive positions. There may be
merit in the analysis that the anatomic cusps
733
1953 No. 6
OF THE EDITOR
provide resistance to closure on food in the
cyclic movement, but it is well to keep in
mind that without resistance there is no
work. The anti-Monson curve favors the
Iower denture, but by that very fact it is
more unfavorable to the upper denture.
It should be noted that not all periodontal
disease results from occlusion, although mal-
occlusion can certainly contribute to the loss
of periodontal structure. It seems most
likely that the occlusal disharmony is the
cause rather than cusps per se when occlu-
sion is a factor in periodontal destruction.
Pleasure is certainly correct when he states
that much research is necessary before this
problem can be resolved. This research
should be done to find out and not to prove.
Reasoning that nature has developed the
best tooth has been rightly criticized. The
situation is certainly different after the teeth
are lost. It is too bad that about a million
years ago, nature did not start evolving the
forms of artificial teeth. Most people who
have lost their teeth have already con-
tributed their share to the evolution of
future denture patients. Let’s keep an open
mind until we have more of the answers.
Russell H. Augsburger has found wide
deviations in the location of the occlusal
plane as it is described in dental literature.
In an effort to find the true location in nat-
ural dentitions, two hundred lateral cranial
roentgen-ray projections were made. The
methods used for the study are sound. The
facial types of the various subjects were de-
termined, and the position of the occlusal
plane was located for each type. The lind-
ings indicate ‘a strong correlation between
the occlusal plane and the facial type. The
practical application of this research is pos-
sible, but it is complicated by some factors
the author mentions. The data regarding
tongue position and anterior tooth position
in relation to the occlusal plane in each facial
type are significant. It may serve as a
guide for variations in impression require-
ments as well as tooth position.
George Wood Clapp shows that it is not
necessary to have elaborate apparatus to
carry out some research. He has described
a simple means for measuring the pull of
the inframandibular muscles. While the re-
 tishue side of the complctctl denture for this
reline imoression. ‘l‘hc dnnrrrrs of the
mctlir~l a& from “light hit&g pressures”
of rlcclusion as they relate to full or partial which might displace the denture saddles
prosthesis. kIe favors the use of a shallow too much if a prcmnturr wclusal contact
incisal guitlancr, and on the basis of his exists. Any relining method requires cs-
analysis it seems sound. ‘ThC St:lt~mWlt that tremc care in its esccution.
anterior teeth should hc “in contact in tht I:rank II. Sealon reports his studies of
centric relation” should nnt apply to com- the working properties of alignatc impres-
plcte clentures as it doer: tr, natural teeth. sion materials. The work is significant he-
tic rcrognizcs I~wnctt mowment a< thr Vera cause of the imp~~rtance c,f the exacting trch-
important posterior guiclancc. but 011 ac - niqucs that arc shown to 1~ rcquitcd. Flow
count of its sm.all mw,qnitude is satisfier! of the material (when it is placed in the
with a11 approximate adjustment for thi, mouth too sooni is suggest4 as a possible
m~mment. Ire suggests that articulators hc cause of inaccuracies in upper impressions.
adjust4 for a slight excess of Bemwtt mow
fTlrttt rather than too !ittle. (kint l-an Huvscri and iIrexel1 :I. Koyd
311 analysis II~
the effect of the Bennett mrwemellt 01, th< 11ave shed new Ii&t on the effects of opera-
relations of inclines of tlw teetll will show tive nrocedures on tile oulns of t&h. Bath
that IIC is correct. Correction of the occlu- hum& and dog teeth L\& used in the es-
sion of the restorations prrimrnts. The effects of cavity prepara-
in 1~0fwfll twth ill
the mouth seems to he a necessity hecaus~ tion hv airhrasive and rotating instruments
every articulating instrullittnt falls short. at \vcrc foun(l to he no cliff crcnt. ‘2 calcium
some point. in Se csact tlul)lication of’ all h~droxitlc cavity lining was foulid to he the
possihlt~ tooth contacts. I\-(, ajircc. also. that hcst available protection for the IIU~II. Their
rnrnplett~ tienturt~s should IX remounted after ohsrrvation that pull) csposures &a; he made
proccssinp for final occlusal corrections. \Vc which arc not visible to the naked eye seems
feel that he is absolutely correct when II< important. hTechanical pressure of filling
materials and foreign material forced into
says that an understandinn of occlusion is
more important than the ‘instruments usctl. the pulp chamlw are slwwn to hare caused

;2rthur II. Schmidt sets up five basic prin pulp inflammation and death.
riples for partial denture construction. Thesr I.. .\. Bavetta discuss3 the causes and
I)rincipk*s are thoroughly. sound and ~~cll cHccts of oh&y. This is important to den-
thu~ht out. There call he little criticism I>( tists for t\vo C~SOll5. Icirst. it is of vital
thcsc principles or of the functions and re Tr,,,CCr,, to SOme of our nrosthetic natients.
sponsihiiities assigned to rach part of ;i and sco)iid, it is 0i pdriicular concern to
llilrtial denture. The c~tijrctivcs and prc I- dentists themselves. He sho\vs that those
cedurcs of surveying arltl designing arc \vho are too fat arc nhcinn too areat a bur-
rlearlv stated. The various types of clasps den on their cardiovascular system, just to
arc discussed. and indications for their us< carry the addition weight. The effect can
are listed. IYe question thr illclusion of the hi. seen in the numhrr of our contrmporaries
hack-action clasp becauw of thr damage \vlio pass on to their reward even in the
it can (10 to periodontal tissues. The prca- IJritnc of their lift. It is notewortlly that too
cctiures usrtl in planning. tlcsignirlg-. and coli- often those in the healing orofessions can
structirig partial dentures are described in prolong the lives c>f thcir”&ients, but are
detail. These procedures arc based on the not sn successful in doing so for themselves.
principles which were discussed and upon Paul C. Kitchin reports his evaluation of
the nsc of prefabricated forms for thr vari- the claims for the various methods for the
ous parts of the metal friimf2,VOrk. The haiis control of dental decay. IIis analysis seems
for the procedure is sound because it iii-- to he a good annraisal of the mesent situa-
volvcs an csacting diagnosis and planning tion. 11: reco$&zes Illat this -situation can
a logical procedure for design on goo~l h- change at any time. This problem is one of
cblogic and mechanical principles. and coil- vital. cnncerl; to anyone doing restorative
struction in orderlv _ senuencr. Some narts dentistry for patients who havr some natural
elf the procedure may be open to q&&~~~. tcctll remaining.
hut in an over-all apT)raisal the rn-orcthiw Hobart II. Proctor discusses oral path-
seems to he mod. 111ogy in r&&n to prosthesis. He urges
John II. w.1.I son recommends the relining that more attention he given to the diag-
of all new distal extension partial dentures nosis of oral lesions hy prostlintlontists. This
in order to use tlic soft tissuh sui~nort to the is a definite responsibility of dentists. 14-r
suggest that a greater nsc c)f qualified oral
pathologists he made if tliere is any doubt
:rhout the diaeuosis. Moniliasis. a funaus
tlisease, is sho\vIl to be the cause of some
rlenture sore mouths. His suggestion that
the surgeon and the prosthodontist should
cooperate in the treatment of tumors is very
timely. Many times the prosthetic problem
Volume 3
Number 6 THROUGH THE EYES OF THE EDITOR 735

can be simplified through this cooperation. ments of a classification for it to be of value

The suggested restorations are both in- for descriptive purposes and treatment plan-
genious and effective. ning. His classification is simple enough to
Jerome C. Strain has reviewed the vari- be practical and descriptive enough to be
ous classifications of clefts in the palate and complete. It is to be hoped that it can be
has found each of them inadequate in some adopted by all who treat cleft palate pa-
respects. He sets up four logical require- tients.
-Carl 0. Boucher.