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The 100th Gnathology Anniversary Congress occurred in Istanbul from 29th to 30th June 2024. Here is a summary
and a review of the lecturer's conclusions. The congress was organized by Orehab Minds Academy, attracting an
international audience, both on-site and online.
The Congress slogan Who We Are and What We Can Do! expresses the intention to demonstrate contemporary
possibilities by following gnathological principles in daily dentistry. The speakers at the congress are:
• All dentists.
• Applying gnathology in their daily work.
• Interpreting gnathology is modern, future-oriented, and forward-thinking.
Gregor Slavicek, Stuttgart, Germany, opened the congress, highlighting the Past, the Present, and
the Future of Gnathology. The term Gnathology has already been established for 100 years. Searching
and nding geometrical-mathematical principles of occlusion and the stomatognathic organ starts much
earlier as a pre-gnathological area. In the 1970’s, there was a breakthrough due to the hinge axis recording
(instead of pantographic tracings) and the introduction of a cranial reference plane. Gnathology is often
called a particular discipline for a dysfunctional patient. This does not seem right. Gnathology is, in the spirit
of its fathers and pioneers, the discipline dealing with occlusal functions and occlusal parameters, serving
as a fundament for all dental disciplines. Gnathology is an a-disciplinary discipline, and contemporary
gnathology integrates gnathological instruments and geometrical principles in oral rehabilitation. Today,
practicing gnathologists focus on maintaining and optimizing oral functions (chewing, speech, bruxing) by
occlusal measures in all aspects of oral rehabilitation (orthodontics, prosthodontics, restorative dentistry …).
The visualization as well as the quantitative and qualitative evaluation of chewing eciency and bruxing
activity were demonstrated by Florian Slavicek, Vienna, Austria in his lecture: Objective testing of
occlusal functions. The impressive lecture delighted the audience and answered fundamental questions:
How and why to visualize Occlusal Functions? Why 9 Chewing Sequences are necessary to judge Chewing
Eciency? Why are elastic Standardized Chewing Test Units required to assess the ability to chew well? How
do understand Bruxing activity by analyzing the BruxChecker? How do you explain occlusal functions to the
patients/parents?
A real highlight of the congress was the lecture by Sergey Grishin, Kirov, Russian Federation, titled
Handling the complexity of gnathological parameters in Oral Rehabilitation. The functional parameters
of occlusion and the craniomandibular system require fundamental knowledge and excellent planning and
transferring skills for each patient. The vertical dimension, the therapeutic position, occlusal plane, spheric
arrangement of the teeth (sagittal and transversal), and a clear sequential occlusal guidance concept with
canine dominance are a matter of the consequent application of gnathological principles. The harmonization
of muscles, including mimic muscles, is one of the treatment goals and a vital parameter for judging treatment
eciency. Sergey Grishin reported that patients who require oral rehabilitation are getting younger. This
places a heavy burden on the responsibility of the dental team. Minimal invasive strategies are needed.
Gnathological parameters such as the vertical dimension, occlusal plane, and chewing surface morphology
help to be as minimal as possible. Minimal invasive dentistry is often misinterpreted if the number of teeth
involved in the restorative procedures is the criterion. Minimal invasive means staying in the enamel window,
removing only minimal tooth substance, and avoiding opening the dentin window. In addition, based on
long-term follow-ups of clinical cases, Dr. Grishin demonstrated the practicability and usefulness of the
sequential occlusal concept with canine dominance by R. Slavicek. A key message of this lecture is that
thorough knowledge of all biological aspects and the ability to use the instruments properly are mandatory
and require well-trained skills.
The participants gained perfect insights into TMJ Imaging, both in interpreting and integrating these data in
the gnathological workow. Giulia Tanteri, Torino, IT, and Anastasia Slavicek, Podolsk, RF presented The
temporo-mandibular joint - imaging, tracking, considering. Dealing with the structures and functions
of healthy and disturbed TMJs is part of contemporary oral rehabilitation. The use of imaging techniques
(CT-Scan, MRI) is mandatory. The clinical application of the hinge axis recording techniques is crucial to
understanding the impact of pathologies on mandibular dynamics and establishing a proper treatment
strategy. Considering the temporo-mandibular joints is not only a task for so-called gnathologists but
for all dental disciplines. Giulia Tanteri pointed out that imaging techniques have to be clearly indicated.
Such techniques are to be applied, but the less, the better, considering the overall patient loads. Asking
straightforward questions before the patient is sent helps radiologists to provide detailed answers. Dental
practitioners should be able to recognize general medical conditions that may signicantly inuence
TMJ conditions. Anastasia Slavicek, Podolsk, RF, gave a detailed synopsis of the possibility of merging
Condylographic Data with Imaging techniques, especially MRI. Both techniques provide data that need
to be understood: condylographic trajectories and MRI ndings do not always show the same, e.g., joint
eusion or ligamental status potentially mimics condylographic signals. Condylographic analysis starts
with a systematic description as an integrated part of the systematic functional analysis. Advanced options
PRACTICING GNATHOLOGICAL DENTISTRY:
100Y ANNIVERSARY OF GNATHOLOGY CONGRESS
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provide detailed insights regarding the coordination of the movements, the proprioceptive impairment, the
rotational capacity, and the eects in occlusal dynamics, individual Posselt schemes, and individual occlusal
compass. Especially in growing children and adolescents, monitoring tooth eruption and functional status
is required. Especially in cases with an alteration of the regular tooth eruption in the late mixed dentition
(canine before premolars), possible adverse eects on the TMJ have to be excluded.
The next lecturer from Bucharest, Romania, impressed the audience by showing the consequences of
implementing knowledge, constant education, and improvement. Marian Constantinescu, Bucharest,
Romania, can be regarded as a contemporary witness to the development of dentistry, especially Gnathology
and functional-oriented Dentistry, over decades. He has seen many technologies coming and going, some
still present, others not anymore. He met many opinion leaders in dentistry and is constantly exchanging
ideas with experts in dentistry worldwide. He constantly strives to improve and encourage dental education
in all elds and aspects. Starting with the history of dentistry in Romania, participants learned about the
early international collaboration of Romanian dentistry with Fédération Dentaire Internationale (FDI), the
International Prosthodontic and Gnathological Societies. He initially integrated gnathological instruments
and merged muscle-oriented techniques with jaw-tracking systems. He demonstrated to the audience that
professional curiosity is not a matter of age and not something for younger colleagues only, and it results in
constant improvement of Gnathology. To demonstrate this, he and his son presented the lecture: 4D Digital
Workflow and Planning for Personalized Prosthetic Treatment - the Practical Perspective for Daily
Application in the Dental Clinic. In recent years, there have been signicant advancements in functional
and digital dentistry, with the availability of multiple acquisition systems that provide more detailed
information than ever before. During his lecture 4D Digital Workow and Planning for Personalized Prosthetic
Treatment - the Practical Perspective for Daily Application in the Dental Clinic, Florin Constantinescu,
Bucharest, Romania, pointed out the incredible possibilities of digital technologies in dentistry, including
the laboratory part. With the intraoral scan, facial scan, dynamic CBCT, and registration of free mandibular
movements, dentists can gather the quality and quantity patient data, allowing for more precise diagnoses
and treatment planning.
Integrating patients' anatomical and functional details in CAD design software has improved dramatically
and brought communication between clinicians, dental laboratories, and patients to a new level. 4D
technology has allowed for more predictable treatments, especially in multidisciplinary cases where a
signicant increase in the occlusal vertical dimension (OVD) is required to restore functional occlusion. The
neuromuscular approach, which considers physiologic measurements and patient needs and requests, can
be combined with this technology to provide even more precise treatment planning and deliver optimal
and personalized patient care. Today, laboratory Robots can be called the descendants of the Replicator of
Gibbs/Lundeen (1970 - 1980ies). Lessons learned message from Marian and Florin Constantinescu: Failing
to Plan = Planning to Fail.
Grigory Popov from Tallinn, Estonia, provided a fascinating view of his country. His lecture Who we are
and what we can do! The clinical application of contemporary gnathology dentistry highlighted the
importance of understanding the specic situation of a country and the impact of these factors on dentistry.
Estonia is a fully digitized country; patients and medical doctors accept digital dentistry quickly and
easily. However, the thrust in digital processes and workow increases the possibility of mistakes without
recognition during dental processes – the uncritical application is based on the assumption that it is digital,
so without failures, which may lead to a bounce-back eect. Scandinavian approaches in Estonia inuence
dentistry: evidence-based, holistic, and minimally invasive. Gnathology and functionally oriented dentistry
have been relegated to a subordinate department at most universities. On the other hand, many dental
practitioners are very strongly oriented in this direction. On the one hand, it is necessary to have certainty
in diagnosis and treatment based on comprehensible parameters, and on the other hand, it is necessary
because the demands and expectations of patients require it. These presentations are held under the motto
of the entire meeting: WWAAWWCD! (Who We Are and What We Can Do) – and a growing group of dentists
are interested in Gnathological thinking. It is still a small group, but constantly growing.
Minimal invasive restorative approaches are desirable for the patient. The prevention of dental structures is a
motivator for choosing or declining a particular treatment strategy the dentist oers. Sergey Grishin, Kirov,
Russian Federation, claried substantial misunderstandings and misinterpretation of minimal invasiveness.
Labeling an oral restoration as minimally invasive is often a fraudulent labelling. His lecture Minimal
Invasive Tooth Preparation – Occlusal Planning to Save Dental Structure encouraged the participants
to accept the increasing confrontation with the challenge of restoring caries-free teeth in young adults. The
indication is often severe wear of the teeth and chewing surfaces due to bruxing. The preservation of the
tooth structure requires the correct preparation techniques and knowledge of which occlusion should be
implemented (backward planning). Minimally invasive techniques are a decisive factor in the attractiveness
of the dental practice for patients. Key messages of his lecture: Bonding Systems: every year new products,
but no real breakthrough since the 1990s; we have to know the dental anatomy; understand the dierence
between Minimally invasive vs. As minimal as possible; be able to work correctly with the Vertical Dimension
of Occlusion to preserve tooth substance; the articulator is a tool for the Dentists! Patients start to trust the
dentist due to the systematic approach: what is convincing are the treatment results, not the sales process.
The following session encompasses a wide range of oral rehabilitation, challenging for both, the dental
laboratory and the dental clinic. Massimiliano Veronese, Trento, Italy, started with his lecture, focusing on
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the edentulous and partially edentulous mouth: The challenge Oral rehabilitation: Edentulous mouth –
partially edentulous mouth. These aspects are brought together and discussed in this lecture. The dentists
are in charge of delivering the treatment parameters and strategy, and the dental technician is in charge
of transferring the plan to prosthodontic occlusion. Technicians follow the fundamental geometrics of the
stomatognathic system and use the parameters: Lower Facial Height (LFH), Relative Condylar Inclination,
Occlusal Plane inclination, Radius Curve of Spee, Sequential Occlusal Concept. The second part of this session:
The challenge Oral rehabilitation: Edentulous mouth – partially edentulous mouth – dental abrasion by
Alexey Lyan, Almaty, Kazakhstan focused on the caries free teeth and occlusion. For 40 years now, modern
gnathology has been transforming into a practice-oriented, fundamental discipline. The focus of clinical
gnathology is by no means only on dysfunctional patients. Prosthodontics, especially in the case of severely
reduced residual dentition or an edentulous mouth, benets from gnathological thinking and workows.
Collaboration between the practice and laboratory is of particular importance. These aspects are brought
together and discussed in this lecture.
Without full integration of orthodontics, contemporary oral rehabilitation appears incomplete. A shared
treatment plan, based on mutual understanding and support, and aligned to the same occlusal goals, is
the mandatory fundament of such collaborations. Andrey Zhuk, Moscow, Podolsk Region discussed: Do
Orthodontists need to think gnathological? In the adult? In the child? In the adolescent? The role of
orthodontics is of great importance in many stages of a patient's life. The focus here is on harmonizing the
dental parameters with the individual skeletal structure. This requires knowledge of all developmental stages
of the craniomandibular system, early diagnosis of deviations from normal development, and targeted
intervention. Precise coordination of the occlusion with the temporomandibular joint is also necessary when
treating adults. Modern orthodontics is more than just shaping dental arches. Gnathological principles can
be implemented with today's orthodontic concepts if the orthodontic technique is adjusted to the functional
parameters and not vice versa. Orthodontic Clinics need algorithms for the desired goals of orthodontic
treatments. It applies to all groups of patients: pediatric, adolescents, adults, and elderly. All aspects must be
included, besides from the dental-occlusal the skeletal parameters, as well as progressive and bio-esthetic
factors. Orthodontists are often in charge of making decisions regarding ortho-gnathic surgical approaches.
The patient's chief complaint needs to be respected, but the nal decision should be made only after providing
complete information on all pros and cons, including the alternatives. As an orthodontist, it is crucial to
understand craniofacial growth and to be familiar with the long history of growth studies, at least starting
with the implant studies from Björk. As an orthodontist, ignoring the eect on the TMJ structures during the
mandibular advancement strategy is not acceptable. This applies not only to sleep apnea devices, but also to
skeletal class II treatment strategies. Giorgio Fiorelli, Arezzo, Italy, completed this session with his lecture:
Not the orthodontic method matters, but the orthodontic force system to achieve the desired tooth
position. The desired teeth positions lead to the selection of the best tting orthodontic technique, and not
a particular orthodontic method with unknown force systems should be applied. This approach, although
from completely dierent aspects, merges strongly orthodontic and gnathological-occlusal concepts of oral
rehabilitation: the desired occlusion determines the best therapeutic strategy and only then are the best
tting tools applied (orthodontics, prosthodontics, implants …). Although starting from dierent ways of
therapeutical thinking, the audience understood that the treatment tool (here: the orthodontic force system)
is chosen because of the tooth position that has to be achieved.
Last but not least, Ksenia Nafigina, Moscow, RF, Anastasia Novitskaya, Vienna, Austria, and Florian
Slavicek, Vienna, Austria, completed the second day of the conference with their lecture: The importance
of occlusal functions during diagnostics, treatment, and follow up. A valid measurement procedure has been
developed to measure, visualize, and understand the occlusal processes. The visualization helps the patient
and relatives to recognize the need for detailed diagnostics. The tests are easy to implement clinically and do
not involve a high nancial or technical outlay. The use of the Brux Checker Analysis and the chewing function
test is an eective tool for monitoring the course of treatment. An excellent functional treatment result,
visualized with these tests, increases the value of the treatment enormously. Using the tests as screening, a
diagnostic procedure at the start and during treatment, and subsequently, to measure long-term functional
stability is a modern tool for a patient-oriented dental practice. The key messages of the engaged and
competent lecturers are: Understanding occlusal Functions to motivate the patient to document the starting
point; the use of Chewing Test and BruxChecker during treatment – the follow up; visualization of chewing
and bruxing is an exceptional service for the patients in a dental clinic.
The participants also gained insights into the importance of a proper masticatory function: Mastication
for the mind – the reduced chewing ability and increased risk of cognitive decline/dementia. Anastasia
Slavicek, based on a systematic, comprehensive literature overview, highlighted the crucial role of
maintaining a good chewing ability in the elderly population. The rhythmic muscle activity during chewing
is key to understanding this causal correlation. She proposed that oral rehabilitation, based on gnathological
principles, could be a strategic approach to delay the onset of cognitive decline. This underscores the
signicant positive impact that gnathologists can have on the patients' well-being (physical and psychical),
leading to an improved quality of life for patients and relatives, reduced costs for comprehensive care, and,
to some extent, relieving the burden on the health care system.
The conference went by too fast; just after the opening remarks, it was time to conclude with Closing
remarks – 100y Anniversary of Gnathology. Gregor Slavicek, Stuttgart, Germany, completes the
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meeting. Gnathology has a long history. On the one hand, a constant improvement of our knowledge results
from research, science, and development. New technologies are boosting the instruments and making
clinical applications easier and simpler.
On the other hand, fundamental principles have been established for over 100 years and have yet to be
discarded. However, modern technologies and the search for simplied processes must not lead to the
sacrice and negation of fundamental knowledge. If a fundamental gnathological parameter is declared
invalid, then a robust alternative must be presented - and this must be scientically proven. Pure technical
feasibility in the digital world is not yet proof of coherence. The manufacturers of these systems must
provide this proof. If this proof is not provided, the responsibility lies with the user. Technical developments
and the improvement of knowledge are the tasks of the entire dental community. However, blind faith in
technological progress is very risky and carried out on the backs or in the patients' mouths. In 2024, it is time
to look both back and forward. Traditional gnathology, in its purely technical approach, needs to be updated.
Limiting gnathology to dysfunction has proven to be ineective. Modern gnathology is an interdisciplinary
approach with prophylactic, diagnostic, therapeutic, and communicative tasks between the disciplines.
Modern gnathology is a medical discipline that advances the term occlusal medicine.
The progress made in gnathology, especially the extraordinary exchange of gnathological thoughts during
the two days, has left a sense of optimism and hope for the future of the eld. All have been inspired by the
possibility to apply gnathological principles merged with modern technologies and treatment strategies,
interpreted with the knowledge of 2024. Looking back to the long history of Gnathology allows progress
towards the future. Applied Gnathology does not require a yes or no decision, it supports all aspects of
dentistry as an a-disciplinary discipline
We are thrilled to announce the next edition of the conference, which will take place on 5
th
– 6
th
December
2025. The topic, "It's the occlusion, stupid!" promises to be another engaging and enlightening event. We
look forward to your participation in the 2nd International Meeting of Clinical Expert Consortium Gnathology
and Occlusal Functions.
The Orehab Academy Congress - 101y Anniversary of Gnathology
Save the Date! Don´t miss this event.
*"It's the economy, stupid" is a phrase by James Carville, a political advisor for US Government, in 1992.
The Orehab Academy Congress -101y Anniversary of Gnathology
Save the Date! Don´t miss this event.
* ”It’s the economy, stupid” is a phrase by James Carville, a political advisor for US Government, in 1992.
Gregor SLAVICEK
MD, DDS, MSc, CEO, Head
Orehab Minds GmbH
DE-70567 Stuttgart, Germany
https://doi.org/10.25241/stomaeduj.2024.11(1-2).News
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