Posterior Dysfunction – Evaluation & Treatment Planning

This series of videos follows a patient with pain, worn and damaged teeth, and an unattractive smile with Posterior Dysfunction through evaluation and treatment planning. It emphasizes the use and diagnostic value of a DATA Appliance as well as the importance of understanding a patient’s complete biomechanical status prior to planning functional treatment.

Only when the status of the TMJ’s, Functional occlusal relationships, and parafunctional activity are identified is it possible to determine appropriate functional and, in this case, esthetic treatment. The DATA Appliance is a fundamental tool for doing this.

As previously described in the main introduction of this “Case Examples” section, it is important to understand that some of the terminology has been changed since these videos were produced. The term “Occlusal Dysfunction” that was used in these videos is now referred to as “Posterior Dysfunction”. The term “Kois Deprogrammer” is now referred to as a “DATA Appliance” and the term “Equilibration” has been replaced with “RedAddibration”. It would also be helpful to read Dr. Hegyi’s article “A Classification System for the Management of Biomechanical Factors in Dentistry”, located in the “Online Media Library” section of this site prior to viewing these videos.


Posterior Dysfunction Evaluation 1 – History, Complaints and Goals: This is the first of sixteen chapters covering the evaluation and treatment of a patient suffering from pain, damaged teeth, and an unattractive smile resulting from Posterior Dysfunction. In this chapter, the patient describes her history, problems, and goals of treatment.


Posterior Dysfunction Evaluation 2 – DATA Appliance Seating and Adjustment: Dr. Hegyi demonstrates the initial seating and adjustment of a DATA Appliance.


Posterior Dysfunction Evaluation 3 – Patient Response to the DATA Appliance and Deprogramming: Dr. Hegyi and his patient discuss her response to wearing the DATA Appliance and the resultant masticatory muscle engram deprogramming. – her response being typical of a patient with Posterior Dysfunction.


Posterior Dysfunction Evaluation 4 – Bite Registration with a DATA Appliance:
Dr. Hegyi demonstrates the clinical procedures for recording his patient’s Physiologically Seated Condylar Position with a DATA Appliance.This is the position the mandible assumes after deprogramming of muscle engrams and the resulting physiologic activity of the elevator muscles. This position is referred to as “PSCP”, or, depending upon which of seven published definitions is chosen, “Centric Relation”. Coordinating maximum intercuspation with this condylar position is the single most important requirement for restoring biomechanical harmony.


Posterior Dysfunction Evaluation 5 – Lab Procedure for Accurate Cast Mounting: Dr Hegyi demonstrates an accurate method of mounting casts with a Futar D bite registration.


Posterior Dysfunction Evaluation 6 – Treatment Options and Expectations: Dr. Hegyi and his patient discuss treatment and management options and expectations for her functional and parafunctional problems – based on her response to the DATA Appliance.


Posterior Dysfunction Evaluation 7 – Treatment Preview – the Mounted Cast RedAddibration: Dr. Hegyi previews the reductive and additive adjustments that would be necessary for RedAddibration treatment. This critical step allows both Dr. Hegyi and the patient to accurately know what treatment will involve and result in prior to deciding if RedAddibration is the right treatment – before committing to treatment (Note: Dr. Hegyi currently does the “Verification” procedure demonstrated in the following chapter prior to this preview procedure to assure its validity).


Posterior Dysfunction Evaluation 8 – Mounted Cast Verification and Treatment Rationale: Dr. Hegyi discusses the rationale and expectations of RedAddibration treatment with his patient and reduces the DATA Appliance stop to “first contact”. This verifies the accuracy of the mounted casts and the validity of the previously demonstrated model RedAddibration. (Note: Dr. Hegyi currently does this “Verification” procedure prior to the model RedAddibration to assure its validity)


Proceed to: Example Cases – Complete Series: Posterior Dysfunction – Conservative Function & Esthetic Treatment