on and to note any interferences that can be identified on both working and non-working sides. left lateral excursion it is important to examine which teeth the guidance is on and to note any interferences that can be identified on both working and non-working sides. occlusal-vertical dimension where necessary, measure the ovd i.e. in cases where there has been a loss of ovd or where interocclusal space is required or aesthetics are poor. clinical applications of occlusion occlusion is a fundamental concept in dentistry yet it is commonly overlooked as it's perceived as being not important or too difficult to teach and understand. clinicians should have a sound understanding of the principles regarding occlusal harmony in order to be able to recognise and treat common problems associated with occlusal disharmony. some of the advantages associated with a working knowledge of these include: improved patient comfort: for example, some people experience pain or sensitivity after the placement of a new restoration due to occlusal overload or an interference which possibly could be avoided should the practitioner consider these at time of placement increased occlusal stability: teeth are less likely to drift , occlusal contacts are likely to be maintained etc. increased success of restorations: excessive wear, fractures, cracks are less commonly observed where there is an ideal occlusion better aesthetics: when the anterior teeth conform to ideal occlusal function and stability, the best aesthetic result is achieved simple occlusal adjustment involves simply grinding down involved cusps or restorations and may be indicated after careful examination when: overloading of occlusal forces has resulted in pain, tooth fracture or mobility interocclusal space is required for restoration provision (e.g. in the case of an overerupted tooth where occlusal plane corrections required) complex occlusal adjustment or reorganisation may be required in more severe circumstances and some examples of these include: elimination of an anterior thrust causing pain, wear, drifting or mobility to provide space for anterior restorations management of bruxism (however, uncommon) the elimination of a temporomandibular joint disorder (however, as previously mentioned, occlusion is rarely an aetiological factor for tmd so there should be significant evidence to support this before alteration of the occlusion is pursued) achieving a satisfactory occlusal reorganisation involves choosing a desired jaw relationship (either conforming to existing icp or producing a new icp coincident with cr), deciding on the intercuspal contacts (removing deflective contacts and adjusting shapes/inclines of teeth), adjusting excursive contacts (removing interferences) and aiming for a mutually protected occlusion. this is an extremely complex process and entails a clinical occlusal examination as described above, along with detailed examination of mounted study casts and diagnostic wax-ups. mounted study casts it is common practice to mount mandibular and maxillary casts (impressions are made of the teeth and poured in dental stone) in an articulator in icp when constructing restorations that conform to the patient's existing occlusion. casts mounted on an articulator in icp are useful for diagnostic purposes or simple restorations, but where more extensive treatment is planned it is necessary to consider occlusal contacts relative to cr e.g. rcp -> icp slide. other situations a cr registration may be more appropriate than icp include where there are plans to reorganise or adjust the existing occlusion (including changes to the occlusal vertical dimension). in these circumstances, in order to accurately stimulate mandibular movement around cr (particularly opening and closing of the mouth), using a facebow transfer, the maxillary cast should be mounted in a semi-adjustable articulator and then the mandibular cast should be mounted using a cr registration. the patient's new occlusion is then arranged so that the new icp occurs when patient is in cr. diagnostic wax-ups wax-ups are indicated where changes to the occlusion or aesthetics are planned. diagnostic wax-ups are when changes are made to the shapes of the teeth by methodically adding wax to the articulated stone casts representing the patient's teeth. this can be done in order to demonstrate to the patient what the planned restorations will look like, but can also be invaluable when simulating different occlusal schemes, studying the functional occlusion as well as providing temporary coverage whilst the restoration is being constructed by the lab through use of a matrix. once an established plan has been constructed using the wax-ups, these can be used as a tool to guide the desired outcome in the mouth and provide a useful communication tool with both the dental laboratory and the patient.