Systematic additive occlusal therapy - when, why, how, and what next?

For over 10 years, systematic additive occlusal therapy (SAOT) has played a valuable role as a component of an integrated approach to the diagnosis and treatment of temporomandibular dysfunction (TMD)1. SAOT is used as a therapeutic alternative to 24-hour splints, its occlusal approach being in accord with the rules of splint therapy. SAOT can be carried out by means of either a direct or an indirect procedure. Patients are able to find their own muscle-guided jaw relation and assess the effectiveness of this in terms of their symptoms. The procedure is reversible, since with correct handling the composite build-ups can be removed without damage to teeth or dental restorations. The practical implementation of SAOT is described, the indications, contraindications, and limitations of the technique are described, and the subsequent treatment is discussed. Keywords: TMD, canine guidance, functional therapy, occlusion, stepwise approach, systematic additive occlusal therapy, therapeutic jaw relation, 24-hour splint