Helkimo developed the occlusal index (index for the occlusal state) to evaluate a patient for disturbances in occlusion or articulation. The author is from the University of Gotesborg in Sweden.
Parameters:
(1) number of teeth
(2) number of occluding teeth
(3) occlusal disturbances between retruded contact position (RCP) and intercuspal position (IP)
(4) articulation interferences (articulation = contact relationships of the dental occlusal surfaces while in action)
Measurement of occlusal interference (page 107):
(1) The patient is placed leaning back in a dental chair with the head resting on a neck support.
(2) The jaw is relaxed and the mandible is guided by the examiner in the terminal hinge movement with simultaneous, strong backward pressure (2 kp) against the chin.
(3) When there is initial contact between the mandibular and maxillary teeth the movement is stopped and the patient is asked if there was unilateral or bilateral contact between the teeth.
(4) The passive hinge closure was repeated until the teeth again made initial contact in the RCP, and the patient is asked to continue the movement actively until maximal dental contact is established in the intercuspal position (IP).
(5) During the slide from RCP to IP the mandible is examined for any lateral deviations from a straight anterior path of movement.
Criteria for mild occlusal interference – one or both of the following:
(1) unilateral contact in RCP and during the slide to IP, with distance <= 2 mm
(2) lateral deviation of the mandible <= 0.5 mm during the slide from RCP to IP
Criteria for severe occlusal interference – one or both of the following:
(1) unilateral contact in RCP and during the slide to IP, with distance > 2 mm
(2) lateral deviation of the mandible > 0.5 mm during the slide from RCP to IP
Measurement of articulation interferences (pages 107-108):
(1) The patient is asked to do lateral excursions with the teeth in contact.
(2) Next the lateral excursions are guided by the operator's hand o the patient's jaw starting from the intercuspal position. The protrusive gliding contact movement is actively performed by the subject.
(3) If during lateral contact movements there is contact on the mediotrusion side but not on the laterotrusion side, then mediotrusion interference is present.
Criteria for mild interference in articulation – one or both of the following:
(1) interference (single tooth contact) on the laterotrusion side distally to 3 +/- 3
(2) unilateral contact on protrusion
Criteria for severe interference in articulation: unilateral or bilateral interference on the mediotrusion side.
Parameter |
Finding |
Points |
number of teeth |
28 to 32 teeth |
0 |
|
20 to 27 teeth |
1 |
|
< 20 teeth |
5 |
number of occluding teeth |
24 to 32 teeth |
0 |
|
16 to 23 teeth |
1 |
|
< 16 teeth (2 to 15) |
5 |
occlusal interference |
none (straight symmetric anterior slide from RCP to IP with distance < 2 mm) |
0 |
|
mild interference |
1 |
|
severe interference |
5 |
articulation interferences |
no disturbances |
0 |
|
mild interferences |
1 |
|
severe interferences |
5 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
Total Score |
Occlusal Index |
Disturbance in Occlusion or Articulation |
0 |
0 |
none |
1 to 4 |
I |
moderate |
5 to 20 |
II |
severe |
where:
• I would think that occlusal index I would correspond with a mild disturbance.
• The range of scores for occlusal index II seems large and could be subdivided.
Specialty: Otolaryngology
ICD-10: ,