100 YEARSanniversary of GnathologY

The term Gnathology was established 100 years ago. Searching and finding geometrical-mathematical principles of occlusion and the stomatognathic organ starts much earlier as pre-gnathological area. In the 1970ies, a breakthrough emerged due to hinge axis recording (instead of pantographic tracings) and the introduction of a cranial reference plane. Gnathology is often called a special discipline for the dysfunctional patient. This is wrong. Gnathology is, in the spirit of the fathers and pioneers, the discipline of occlusal functions and occlusal parameters, serving as fundament for all dental disciplines.

Functional parameters of occlusion and the craniomandibular system require a fundamental knowledge and excellent skills in planning and transferring for each individual patient. Vertical dimension, the therapeutic position, occlusal plane, spheric arrangement of teeth (sagittal and transversal) and a clear sequential occlusal guidance concept with canine dominance are a matter of the consequent application of gnathological principles

Dealing with the structures and functions of healthy and disturbed TMJs is part of contemporary oral rehabilitation. The use of imaging techniques (CT-Scan, MRI) is mandatory. The clinical application of hinge axis recording techniques is crucial to understand not only the impact of pathologies on the mandibular dynamics, but also to establish a proper treatment strategy. Considering the temporo-mandibular joints is not only the task for so-called gnathologists, but for all dental disciplines.

Gnathology and functionally oriented dentistry have been relegated to a subordinate department at most universities. On the other hand, many dental practitioners are very strongly oriented in this direction. On the one hand, in order to have certainty in diagnosis and treatment based on the comprehensible parameters, and on the other hand because the demands and expectations of patients require this. These presentations are held under the motto of the entire meeting: WWAAWWCD! (Who we are and what we can do)

Practicing dentists are increasingly confronted with the challenge of restoring caries-free teeth in young adults. The indication is often severe wear of the teeth and chewing surfaces due to bruxing. The preservation of the tooth structure requires the correct preparation techniques and knowledge of which occlusion should be implemented (back ward planning). Minimally invasive techniques are a decisive factor in the attractiveness of the dental practice for patients.

For 40 years now, modern gnathology has been transforming itself into a practice-oriented, fundamental discipline. The focus of clinical gnathology is by no means only on dysfunctional patients. Prosthodontics, especially in the case of severely reduced residual dentition or an edentulous mouth, benefits from gnathological thinking and workflows. Collaboration between the practice and laboratory is of particular importance. These aspects are brought together and discussed in this lecture.

The role of orthodontics is of great importance in many stages of a patient's life. The focus here is on harmonizing the dental parameters with the individual skeletal structure. This requires knowledge of all developmental stages of the craniomandibular system, early diagnosis of deviations from normal development and targeted intervention. Precise coordination of the occlusion with the temporomandibular joint is also necessary when treating adults. Modern orthodontics is more than just shaping dental arches. Gnathological principles can be implemented with today's orthodontic concepts if the orthodontic technique is adapted to the functional parameters and not vice versa.

A valid measurement procedure has been developed to measure, visualize and understand the occlusal processes. The visualization helps the patient and relatives to recognize the need for detailed diagnostics. The tests are easy to implement clinically and do not involve a high financial or technical outlay. The use of the Brux Checker Analysis and the chewing function test is therefore an effective tool for monitoring the course of treatment. A good functional treatment result, which is visualized with these tests, increases the value of the treatment enormously. The use of the tests as screening, as a diagnostic procedure at the start and during the course of treatment and subsequently to measure long-term functional stability is a modern tool for a patient-oriented dental practice.

Gnathology has a long history. On one hand, the continuous improvement of our knowledge is the result of research, science, and developments. On the other hand, foundational principles were established over 100 years ago and have not been discarded. In 2024, it's time to look back and look forward. Traditional gnathology, in its purely technical approach, has become outdated. Limiting gnathology to dysfunction has proven to be ineffective. Today, modern gnathology represents an interdisciplinary approach, placing preventative, diagnostic, therapeutic, and communicative tasks among disciplines.