Occlusograms Revisited
The JCO diagnosis and treatment surveys have shown that no more than 4% of orthodontists routinely use occlusograms as part of their diagnostic regimen. I wasn't trained in the use of occlusograms, nor had I even heard of them until 1976. That was when the AJO published an article by Marcotte, who had learned the technique from Dr. Charles Burstone at Indiana University. Marcotte's article forever changed the way I approached orthodontic diagnosis and treatment planning.
But despite the clarity and thoroughness of Marcotte's presentation, it has had little effect on the profession, for one reason--cost. The specially crafted 4" x 5" box camera and dental cast assembly that produced 1:1 Polaroid photographs of the diagnostic models cost $2,500, even in 1980. Small wonder that few orthodontists elected to use the equipment. Less understandable and more lamentable has been the failure of university programs to teach this valuable method. Students who might have improved or simplified the technique have simply never learned it.
So occlusograms languish--little known, underused, and largely unappreciated. Still, I find that no other diagnostic procedure offers the utility, accuracy, and serendipity of occlusograms, and I hope the article by Dr. Richard Faber in this issue rekindles some interest by showing how photocopies can permit their inexpensive use.
Three-dimensional models will probably remain the most popular out-of-the-mouth occlusal diagnostic tool, but that shouldn't prevent or divert orthodontists from making occlusograms. They can be used in a number of ways:
Occlusograms offer us an accurate way to measure, compare, and evaluate malocclusions, to plan and forecast treatment, and to visualize occlusal objectives before we embark. They do take time, but staff members can easily learn how to do them, just as auxiliaries have freed up orthodontists' time by learning how to make cephalometric tracings. The use of photocopies removes the need for expensive and arcane equipment.
I'm hoping that orthodontists will take one more look at this valuable technique. The rewards to both patient and doctor clearly make occlusograms a worthwhile adjunct to our diagnostic armamentarium.