Effect of bilateral asymmetric tooth clenching on load distribution at the mandibular condyles.

The effects of balancing-side tooth contacts on temporomandibular joint loads are unclear. We used a 3-D computer model to calculate the magnitude and direction of temporomandibular reaction forces during simulated clenching on interocclusal acrylic resin shims and between natural teeth. Muscle tensions were proportioned according to the task modeled. Working-side tooth contacts included the canine alone, as well as group function, and occlusal loads were progressively shifted toward a posterior contralateral simple balancing contact. In the acrylic resin shim experiments, group function with simple balancing contact yielded the highest forces at the load point and at both temporomandibular joints. Movement of the occlusal load toward the balancing side produced greater, anteriorly oriented forces on the working condyle. For natural teeth, changes in the angle of resultant tooth force (simulating facet angulation) greatly influenced condylar forces. As the occlusal load moved toward the balancing side, greater and more laterally oriented forces were produced on the balancing condyle. Unilateral clenching on the canine produced the least condylar and bite forces. The simulation involving natural teeth offers a possible explanation for deviations in form and osteoarthrosis at the temporomandibular joints.