SlideShare une entreprise Scribd logo
1  sur  114
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
 Terminologies
 Occlusal Schemes
 Articulators
 Facebows (including methods of recording)
 Centric relation records (including technique)
 Anterior programming device
 Jaw relations in a partially edentulous
dentition
 Articulation of casts
 Eccentric interocclusal records
 Pantographs
 Anterior guidance
2www.indiandentalacademy.com
Jaw Relation (or maxillo-mandibular
relationship) :
Any spatial relationship of the
maxillae to the mandible; any one of the
infinite relationships of the mandible to the
maxillae1.
1 Glossary of Prosthodontic Terms - 8
3www.indiandentalacademy.com
A registration of the positional
relationship of the opposing teeth or
arches; a record of the positional
relationship of the teeth or jaws to each
other1.
1 Glossary of Prosthodontic Terms – 8
4www.indiandentalacademy.com
Balanced Occlusion:
The bilateral, simultaneous, anterior,
and posterior occlusal contact of
teeth in centric and eccentric
positions1.
5
1 Glossary of Prosthodontic Terms – 8
www.indiandentalacademy.com
Mutually Protected articulation:
An occlusal scheme in which the posterior
teeth prevent excessive contact of the anterior
teeth in maximum intercuspation and the
anterior teeth disengage the posterior teeth in all
mandibular excursive movements. Alternatively,
an occlusal scheme in which the anterior teeth
disengage the posterior teeth in all mandibular
excursive movements, and the posterior teeth
prevent excessive contact of the anterior teeth
in maximum intercuspation1.
1Glossary of Prosthodontic Terms - 8 6www.indiandentalacademy.com
Group Function:
Multiple contact relations between
the maxillary and mandibular teeth in
lateral movements on the working side
whereby simultaneous contact of several
teeth acts as a group to distribute
occlusal forces1.
1Glossary of Prosthodontic Terms - 8
7www.indiandentalacademy.com
 Bilateral Balanced Occlusion
 Unilateral Balanced Occlusion
 Mutually Protected Occlusion
8
Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
 Bilateral occlusal schemes are based on the
work of von Spee and Monson. It is a
concept not used as frequently today as it
has been in the past.
 It is largely a prosthodontic concept which
dictates that a maximum number of teeth
should contact in all excursive positions of
the mandible.
 This concept is particularly useful in
complete denture construction, in which the
contact on non-working side is important to
prevent tipping of the prosthesis.
9
Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
 Subsequently, this concept of was
applied to natural teeth in complete oral
rehabilitation.
 But, studies suggest that as a result of
multiple tooth contacts that occur as the
mandible moves through various
excursions, there is excessive frictional
wear.
10
Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
 Also known as group function, is a widely
accepted and used method of
arrangement of teeth in restorative dental
procedures.
 A study by Schuyler, where he observed the
destructive nature of tooth contacts on the
non-working side, concluded that cross-
arch balance was not necessary in natural
teeth, it would be best to eliminate all tooth
contact on the non-working side.
11
Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
 The absence of tooth contact on the
nonworking side prevents those teeth
from being subjected to the destructive,
obliquely directed forces found in non
working interferences.
 The functionally generated path
technique as described by Meyers is used
for producing unilateral balanced
occlusion.
 It has also been adapted by Mann and
Pankey for use in complete mouth
rehabilitation.
12
Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
 Also known as canine protected occlusion.
 Here, the teeth are arranged so that the
overlap of the anterior teeth prevents the
posterior teeth from making any contact
on either the working or non-working sides
during mandibular excursions. This sepration
from occlusion is termed disocclusion.
 According to this concept of occlusion, the
anterior teeth bear all the load and the
posterior teeth are disoccluded in any
excursive positions of the mandible, the
desired result is absence of frictional wear.
13
Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
A mechanical instrument that
represents the temporomandibular joints
and jaws, to which maxillary and
mandibular casts may be attached to
simulate some or all mandibular
movements1.
1Glossary of Prosthodontic Terms - 8
14www.indiandentalacademy.com
Articulators are divisible into four classes1:
Class I articulator: a simple holding
instrument capable of accepting a
single static registration; vertical motion
is possible.
Class II articulator: an instrument that
permits horizontal as well as vertical
motion but does not orient the motion
to the temporomandibular joints.
1Glossary of Prosthodontic Terms - 8
15www.indiandentalacademy.com
Class III articulator: an instrument that
simulates condylar pathways by using
averages or mechanical equivalents for all
or part of the motion; these instruments
allow for orientation of the casts relative to
the joints and may be arcon or nonarcon
instruments.
Class IV articulator: an instrument that will
accept three dimensional dynamic
registrations; these instruments allow for
orientation of the casts to the
temporomandibular joints and simulation
of mandibular movements
1Glossary of Prosthodontic Terms - 8
16www.indiandentalacademy.com
Handheld casts can provide
information concerning alignment of the
individual arches but do not permit
analysis of functional relationships. For an
analysis, the casts need to be attached
to an articulator.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 17www.indiandentalacademy.com
 They are classified according to how closely they
can reproduce mandibular border movements.
Because the movements are governed by the
bones and ligaments of the TMJs, they are
relatively constant and reproducible.
 Most articulators use mechanically adjustable
posterior controls to simulate these movements,
although some use plastic premilled or customized
fossa analogs. If an articulator closely reproduces
the actual border movements of a given patient,
this will significantly reduce chair time because the
dental laboratory can then design the prosthesis to
be in functional harmony with the patient's
movements. In addition, less time will be needed
for adjustments at the time of fit in.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 18www.indiandentalacademy.com
 On some instruments, the upper and lower
members are permanently attached to each
other, while on others they can be readily
separated. The latter group may have a latch
or clamplike feature that locks the two
components together in the hinge position.
 Instrument selection depends on the type and
complexity of treatment needs and the
demands for procedural accuracy.
 For instance, when waxing a fixed partial
denture, it is advantageous to be able to
separate the instrument into two more easily
handled parts. Use of the proper instrument for
a given procedure can translate into
significant timesaving during subsequent
stages of treatment.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 19www.indiandentalacademy.com
20www.indiandentalacademy.com
 Many cast restorations are made on small
nonadjustable articulators. Their use often
leads to restorations with occlusal
discrepancies, because these instruments
do not have the capacity to reproduce the
full range of mandibular movement.
 Some discrepancies can be corrected
intraorally, but this is often time consuming,
also leading to increased inaccuracies.
 If discrepancies are left uncorrected,
occlusal interferences and associated
neuromuscular disorders may result.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 21www.indiandentalacademy.com
 Of practical significance are differences
between the hinge closure of a small
articulator and that of the patient. The
distance between the hinge and the tooth to
be restored is significantly less on most
nonadjustable articulators than in the patient.
This can lead to restorations with premature
tooth contacts because cusp position is
affected.
 This type of arcing motion on the
nonadjustable articulator results in steeper
travel than occurs clinically, resulting in
premature contacts subsequently on
fabricated restorations between the distal
mandibular inclines and the mesial maxillary
inclines of posterior teeth.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 22www.indiandentalacademy.com
 Depending on the specific design of the
articulator, ridge and groove direction
may be affected in accordance with
the same principle. This is important to
note, because resulting prematurities are
likely on the nonworking side.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 23www.indiandentalacademy.com
24www.indiandentalacademy.com
 For most routine fixed prostheses, the use of a
semiadjustable articulator is a practical
approach to providing necessary information
while minimizing the need for clinical adjustment
during treatment.
 Semiadjustable instruments do not require an
inordinate amount of time or expertise. They are
about the same size as the anatomic structures
they represent. Therefore, the articulated casts
can be positioned with sufficient accuracy so
that arcing errors are minimal and usually of
minimal clinical significance (i.e., minimal time
should be required for chairside adjustments of
fabricated prostheses).
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 25www.indiandentalacademy.com
 There are two basic designs of
the semiadjustable articulator:
› arcon
› nonarcon
 Nonarcon instruments gained
considerable popularity in
complete denture
prosthodontics because the
upper and lower members are
rigidly attached, permitting
easier control when positioning
artificial teeth. As a
consequence of their design,
certain inaccuracies occured in
cast restorations, which led to
the development of the arcon-
type instrument.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 26www.indiandentalacademy.com
 In an arcon articulator, the condylar
spheres are attached to the lower
component of the articulator, and the
mechanical fossae are attached to
the upper member of the instrument.
 Thus, the arcon articulator is
anatomically "correct," which makes
understanding of mandibular
movements easier, as opposed to the
nonarcon articulator.
 The angulation of the mechanical
fossae of an arcon instrument is fixed
relative to the occlusal plane of the
maxillary cast; in the nonarcon design,
it is fixed relative to the occlusal plane
of the mandibular cast.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 27www.indiandentalacademy.com
28
Condylar inclination of the mechanical fossa
www.indiandentalacademy.com
 Most semiadjustable articulators permit
adjustments to the condylar inclination
and progressive and/or immediate side
shift. Some have straight condylar
inclined paths, although more recent
instruments have curved condylar
housings, which are anatomically more
correct.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 29www.indiandentalacademy.com
 The mechanical fossae on semiadjustable
articulators can be adjusted to mimic the
movements of the patient through the use
of interocclusal records.
 These consist of several thicknesses of wax
or another suitable material in which the
patient has closed. Because these records
can be several millimeters thick, an error is
introduced when setting nonarcon
articulators with protrusive wax records,
because its condylar path is not fixed
relative to the maxillary occlusal plane.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 30www.indiandentalacademy.com
 As the protrusive record used to adjust
the instrument is removed from the arcon
articulator, the maxillary occlusal plane
and the condylar inclination become
more parallel to each other, leading to
reduced cuspal heights in subsequently
fabricated prostheses.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 31www.indiandentalacademy.com
McCollum’s Gnathoscope
32www.indiandentalacademy.com
A fully (or highly) adjustable articulator
has a wide range of positions and can be
set to follow a patient's border movements.
The accuracy of reproduction of
movement depends on the care and skill of
the operator, the errors inherent in the
articulator and recording device, and any
malalignments due to slight flexing of the
mandible and the nonrigid nature of the
TMJs.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 33www.indiandentalacademy.com
A caliper-like instrument
used to record the spatial
relationship of the maxillary
arch to some anatomic
reference point or points and
then transfer this relationship to
an articulator; it orients the
dental cast in the same
relationship to the opening axis
of the articulator. Customarily
the anatomic references are
the mandibular condyles
transverse horizontal axis and
one other selected anterior
point; called also hinge bow1.
1Glossary of Prosthodontic Terms - 8 35www.indiandentalacademy.com
An imaginary line around which the
mandible may rotate within the sagittal
plane1.
1Glossary of Prosthodontic Terms - 8
36www.indiandentalacademy.com
 The mandibular hinging
movement around the
transverse horizontal axis is
repeatable. That makes
this imaginary "hinge axis"
around which the
mandible may rotate in
the sagittal plane of
considerable importance
when fabricating fixed
prostheses.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 37
 Facebows are used to record the
anteroposterior and mediolateral spatial
position of the maxillary occlusal surfaces
relative to this transverse opening and closing
axis of the patient's mandible.
www.indiandentalacademy.com
 The facebow is then attached to the articulator to
transfer the recorded relationship of the maxilla
by ensuring that the corresponding cast is
attached in the correct position relative to the
hinge axis of the instrument.
 After the maxillary cast has been attached to the
articulator with mounting stone or plaster, the
mandibular cast is subsequently related to the
maxillary cast through the use of an interocclusal
record.
 If the patient's casts are accurately transferred to
an instrument, considerable time is saved in the
fabrication and delivery of high-quality
prostheses.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 38www.indiandentalacademy.com
 Most facebows are rigid, caliper-like
devices that permit some adjustments.
Two types of facebows are recognized:
arbitrary and kinematic.
 Arbitrary facebows are less accurate
than the kinematic type, but they suffice
for most routine dental procedures.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 39www.indiandentalacademy.com
 Kinematic facebows are indicated when
it is critical to precisely reproduce the
exact opening and closing movement of
the patient on the articulator.
 For instance, when a decision to alter the
vertical dimension of occlusion is to be
made in the dental laboratory during the
fabrication of fixed prostheses, the use of
a kinematic facebow transfer in
conjunction with an accurate CR
interocclusal record is indicated.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 40www.indiandentalacademy.com
41www.indiandentalacademy.com
A facebow with adjustable caliper
ends used to locate the transverse
horizontal axis of the mandible1.
1Glossary of Prosthodontic Terms - 8
Definition:
42www.indiandentalacademy.com
 The hinge axis of the
mandible can be
determined to within 1 mm
by observing the
movement of kinematic
facebow styli positioned
immediately lateral to the
TMJ close to the skin.
 A clutch, which is essentially
a segmented impression
traylike device, is attached
onto the mandibular teeth
with a suitable rigid material
such as impression plaster.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 43www.indiandentalacademy.com
 The kinematic facebow consists of three
components: a transverse component
and two adjustable side arms.
› The transverse rod is attached to the portion
of the clutch that protrudes from the
patient's mouth.
› The side arms are then attached to the
transverse member and adjusted so that the
styli are as close to the joint area as possible.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 44www.indiandentalacademy.com
 The mandible is then
manipulated to produce a
terminal hinge movement,
and the stylus locations are
adjusted with thumbscrews
(superiorly and inferiorly,
anteriorly and posteriorly)
until they make a purely
rotational movement.
 Because the entire assembly
is rigidly attached to the
mandible, a strictly
rotational movement
signifies that stylus position
coincides with the hinge
axis. When this purely
rotational movement is
verified, the position of the
hinge axis is marked with a
dot on the patient's skin.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 45www.indiandentalacademy.com
46
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. www.indiandentalacademy.com
 The kinematic facebow technique is
time consuming, so it is generally limited
to extensive prosthodontics, particularly
when a change in the vertical dimension
of occlusion is to be made.
A less precisely derived transfer would lead to
unacceptable errors and a compromised result.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 49www.indiandentalacademy.com
50www.indiandentalacademy.com
A device used to relate the maxillary
cast to the condylar elements of an
articulator using average anatomic
landmarks to estimate the position of the
transverse horizontal axis on the face1.
1Glossary of Prosthodontic Terms - 8
Definition:
51www.indiandentalacademy.com
 Typically, an easily
identifiable landmark such as
the external acoustic meatus
is used to stabilize the bow,
which is aligned with
earpieces. Such facebows
can be used single-handedly
because they are self-
centering and do not require
a complicated assembly.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 52
 Arbitrary hinge axis facebows approximate
the horizontal transverse axis and rely on
anatomic average values. They are
designed in such a manner that the true axis
falls within an acceptable degree of error.
www.indiandentalacademy.com
 They give a sufficiently accurate
relationship for most diagnostic and
restorative procedures.
 However, regardless of which arbitrary
position is chosen, a minimum error of 5
mm from the axis can be expected.
 When coupled with the use of a thick
interocclusal record made at an
increased vertical dimension, this factor
can lead to considerable inaccuracy.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 53www.indiandentalacademy.com
 The use of an anterior reference point
enables the clinician to duplicate the
recorded position on the articulator at
later appointments.
 This saves time, as previously recorded
articulator settings can be used again.
 An anterior reference point, such as the
inner canthus of the eye or a freckle or
mole on the skin, is selected.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 54www.indiandentalacademy.com
 After this has been marked, it is used
along with the two points of the hinge
axis, to define the position of the
maxillary cast in space.
This has the following advantages:
1) After the posterior controls have been
adjusted initially, subsequent casts can
be mounted on the articulator without
repeating the facebow determinations
and having to reset the posterior
articulator controls.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 55www.indiandentalacademy.com
2) Because the maxillary arch is properly
positioned relative to the axis, average
values for posterior articulator controls can
be used without having to readjust the
instrument on the basis of eccentric
records.
3) When the articulator has been adjusted,
the resulting numerical values for the
settings can be compared with known
average values to provide information
about the patient's individual variations
and the likelihood of encountering
difficulties during restorative procedures.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 56www.indiandentalacademy.com
Definition:
The process of transferring the
facebow record of the spatial
relationship of the maxillary arch to some
anatomic reference point or points and
transferring this relationship to an
articulator1.
1Glossary of Prosthodontic Terms - 8
57www.indiandentalacademy.com
Procedure:
1. Add modeling compound to the facebow
fork.
2. Temper in water and seat the fork, making
indentations of the maxillary cusp tips. The
facebow fork is positioned in the patient's
mouth, and an impression is made of the
maxillary cusp tips. The impression must be
deep enough to permit accurate
repositioning of the maxillary cast after the
facebow fork has been removed from the
mouth. Only the cusp tips should be
recorded.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 58www.indiandentalacademy.com
3. Remove the fork from the mouth. Chill
and reseat the fork, and check that no
distortion has occurred. Trim the
recording medium as necessary before
reseating. After reseating, check for
stability.
4. Have the patient stabilize the facebow
fork by biting on cotton rolls. As an
alternative, wax can be added to the
mandibular incisor region of the fork. The
mandibular anterior teeth will stabilize the
fork as they engage the wax.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 59www.indiandentalacademy.com
5. Slide the universal joint onto the fork
and position the caliper to align with
the anterior reference mark.
6. Tighten the screws securely in the
correct sequence.
7. If the articulator has an adjustable
intercondylar width, record this
measurement.
8. Remove the facebow from the
mouth.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 60www.indiandentalacademy.com
A centric relation record provides the
orientation of mandibular to maxillary
teeth in Centric Relation in the terminal
hinge position, where opening and
closing are purely rotational movements.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 61www.indiandentalacademy.com
Definition:
A registration of the relationship of the
maxilla to the mandible when the
mandible is in centric relation. The
registration may be obtained either
intraorally or extraorally1.
2 Glossary of Prosthodontic Terms - 8
62www.indiandentalacademy.com
Centric Relation:
The maxillomandibular relationship in
which the condyles articulate with the
thinnest avascular portion of their
respective disks with the complex in the
anterior-superior position against the shapes
of the articular eminences. This position is
independent of tooth contact. This position
is clinically discernible when the mandible is
directed superior and anteriorly. It is
restricted to a purely rotary movement
about the transverse horizontal axis2.
2 Glossary of Prosthodontic Terms - 5
63www.indiandentalacademy.com
 Maximum intercuspation may or may not
occur coincident with the centric
relation position.
 The centric relation record is transferred
to the maxillary cast on the articulator
and is used to relate the mandibular cast
to the maxillary cast.
 Once the mandibular cast is attached to
the articulator with plaster, the record is
removed. The casts will then occlude in
precisely the CR position as long as the
maxillary cast is correctly related to the
hinge axis with a facebow.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 64www.indiandentalacademy.com
65www.indiandentalacademy.com
 When the articulator controls are set
properly, using appropriate excursive
records, translated mandibular positions
can be reproduced from CR.
 A CR/MI slide will be readily reproducible
on casts that have been articulated in
CR. Thus, premature tooth contacts
(deflective contacts) can be observed,
and it can be determined whether an
occlusal correction is necessary or
appropriate before fixed prosthodontic
treatment.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 66www.indiandentalacademy.com
 Casts articulated in the maximum
intercuspation (MI) do not permit the
evaluation of CR and retruded
contact relationships.
 Therefore, the articulation of
diagnostic casts in CR is of greater
value.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 67www.indiandentalacademy.com
 When using a kinematic facebow(in
theory), the thickness of a terminal hinge
record is unimportant; a thicker record
merely increases the amount of rotation.
When using an arbitrary facebow, any
arcing movement will result in some
degree of inaccuracy.
Both techniques are subject to small
errors, which can be minimized by
keeping the record thin.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 68www.indiandentalacademy.com
Accurately mounted casts depend on
precise manipulation of the patient's
mandible by the clincian. The condyles
should remain in the same place
throughout the opening-closing arc.
Trying to force the mandible backward
will lead to downward translation of the
condyles, and restorations made to such
a mandibular position will be in supra-
occlusion at the try-in stage.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 69www.indiandentalacademy.com
70www.indiandentalacademy.com
 The load-bearing surfaces of the condylar
processes, which face anteriorly, should be
manipulated into apposition with the
mandibular fossae of the temporal bones, with
the disk properly interposed. The ease with
which this can be accomplished depends on
the degree of the patient's neuromuscular
relaxation and on sound technique.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 71
The latter, in turn, depends on the patient permitting
the dentist to control the mandible. Attempts to force
or shake the mandible will lead to a protective muscle
response by the patient.
www.indiandentalacademy.com
 The bimanual manipulation technique
described by Dawson is recommended as a
reproducible technique that can be reliably
learnt.
 In this technique, the dental chair is reclined
and the patient's head is cradled by the
examiner. With both thumbs on the chin and
the fingers resting firmly on the inferior border of
the mandible, the examiner exerts gentle
downward pressure on the thumbs and
upward pressure on the fingers, manipulating
the condyle-disk assemblies into their fully
seated positions in the mandibular fossae.
Next, the mandible is carefully hinged along
the arc of terminal hinge closure.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition.,
72Peter E. Dawson. Functional Occlusion: From TMJ to Smile Design.www.indiandentalacademy.com
73Peter E. Dawson. Functional Occlusion: From TMJ to Smile Design.www.indiandentalacademy.com
In patients in whom CR does not
coincide with IP, protective reflexes may be
encountered. Because of well-established
protective reflexes that are reinforced every
time the teeth come together, such patients
will not allow their mandible to be
manipulated and hinged easily. If tooth
contact can be prevented, they will "forget"
these reflexes, and manipulation becomes
easier. The teeth can be kept apart with
cotton rolls, a plastic leaf gauge, or a small
anterior programming device made of
autopolymerizing acrylic resin (also known as
a Lucia jig)."
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 74www.indiandentalacademy.com
75www.indiandentalacademy.com
If the mandible cannot be
manipulated satisfactorily after an
anterior programming device has been
in place for 30 minutes, marked
neuromuscular dysfunction is likely.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 76www.indiandentalacademy.com
Different techniques can be used to
make a CR record. The choice of
recording medium is to some degree a
function of the casts to be articulated.
For instance, very accurate casts made
from elastomeric impression materials
can be articulated with a high-accuracy
interocclusal record material such as
polyvinyl siloxane.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 77www.indiandentalacademy.com
On the other hand, less accurate
diagnostic casts poured from irreversible
hydrocolloid are better articulated using
a more forgiving material such as
interocclusal wax, provided that the
record is properly reinforced. Most
studies have shown considerable
variability among various registration
materials and techniques, so particular
care is needed with this procedure.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 78www.indiandentalacademy.com
Fattore et al (1984) studied the clinical
accuracy of waxes, zinc-oxide eugenol and
polyether interocclusal recording medium
and found that:
Polyether interocclusal recording medium
without a carrier was the most accurate.
Polyether and zinc-oxide eugenol pastes with
carriers were the next most accurate
recording medium but they required a
disciplined technique.
Recording waxes were consistency unreliable.
Distortion occurred more frequently in a
vertical direction, followed by an
anteroposterior direction.
79
Fattore et al. Clinical evaluation of the accuracy of the interoccusal recording
materials. J Prosthet Dent 1984;51:152-157.www.indiandentalacademy.com
The reinforced Aluwax record is a
forgiving method for recording the CR
position. It is a reliable technique,
originally described by Wirth and Aplin,
and has provided consistent results.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 80www.indiandentalacademy.com
1. Half a sheet of occlusal wax is softened
in warm water and adapted to the
maxillary cusp tips. The patient is asked
to close lightly and cuspal indentations
of the mandibular teeth are recorded.
These indentations form no part of the
record, but they thin the wax slightly
and indicate the approximate positions
of the mandibular teeth for later
reference.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 81www.indiandentalacademy.com
2. Baseplate wax is added to the mandibular
anterior region of the record and sealed
along the periphery.
3. The record is readapted to the maxillary
teeth, resoftened if necessary. The patient
is guided into centric closure, making
shallow indentations in the baseplate wax.
(Verify that no posterior tooth contact occurs. If it does, add an
additional layer of baseplate wax).
4. The record is then removed carefully and
verified that no distortion has occurred.
And chilled thoroughly in ice water.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 82www.indiandentalacademy.com
83www.indiandentalacademy.com
5. The record is reseated on the maxillary
teeth and evaluated for stability. If the
maxillary cast is available, the fit on this
must be evaluated as well.
6. Heat-retaining wax is added in the
mandibular incisor region only and the
mandible is manipulated. Having the
patient in a supine position for this
manipulation allows better control.
7. Indentations of the mandibular incisor tips
are made in the wax, repeated several
times to ensure reproducibility. Wax record
is Removed and re-chilled in ice water until
the anterior indentations are hard.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 84www.indiandentalacademy.com
8. A small amount of wax is added in the
mandibular posterior region and the
record is reseated. The mandibular teeth
are guided into the anterior indentations
and the patient is made to close lightly.
9. The record is removed and chilled. If there
is difficulty in obtaining an undistorted
record, the palatal area can be
reinforced with the soft metal sheet.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 85www.indiandentalacademy.com
The advantage of this sequential
technique is that the CR position is
reproduced multiple times as the record
is generated. The heat-retaining Aluwax
is soft and distorts easily. Therefore, if the
patient is not guided into exactly the
same position, this problem will become
readily apparent. Once the completed
record has been obtained, the same
arcing motion is reproduced four times,
confirming that the CR position has been
accurately captured.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 86www.indiandentalacademy.com
Other alternatives include using
elastomeric material, a gauze mesh with
zinc oxide-eugenol occlusal registration
paste, impression plaster or
autopolymerizing resin as the recording
medium.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 87www.indiandentalacademy.com
88www.indiandentalacademy.com
When there are insufficient teeth to
provide bilateral stability, obtaining a CR
record as described may not be possible.
As a result, acrylic resin record bases must
be fabricated. To avoid errors caused by
soft tissue displacement, which prevents
accurate transfer of rigid materials from one
set of casts to another, these bases should
be made on the casts that are to be
articulated.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 89www.indiandentalacademy.com
90www.indiandentalacademy.com
Maxillary Cast:
 The maxillary cast is seated in the
indentations on the facebow fork after the
facebow is attached to the articulator.
Wedges or specially designed braces can
be used to support the weight of the cast
and to prevent the fork from flexing or
moving. After it has been scored and
wetted, the cast is attached to the
mounting ring of the articulator with a low
expansion plaster.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 91www.indiandentalacademy.com
92www.indiandentalacademy.com
Mandiblular Cast:
 To relate the mandibular cast properly to the
maxillary cast, the incisal guide pin should be
lowered sufficiently to compensate for the
thickness of the centric relation record.
 The articulator is inverted, and the record is
seated on the maxillary cast. The mandibular
cast is then carefully seated in the record, and
each cast is checked for stability. The maxillary
and mandibular casts can be luted together with
metal rods, or pieces of wooden tongue blade,
and sticky wax. The mandibular member of the
articulator is closed into mounting plaster; the
condylar balls should be fully seated in the
corresponding fossae.
 The articulator should be held until the plaster has
reached its initial set.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 93www.indiandentalacademy.com
94www.indiandentalacademy.com
Arbitrary Values:
Based on clinical investigations, certain
generally applicable average anatomic
values have evolved for condylar
inclination, immediate and progressive
sideshift. These values have been described
relative to the Frankfort horizontal plane
and the midsagittal plane.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 95www.indiandentalacademy.com
When arbitrary values are used to
adjust posterior articulator controls, the
actual instrument settings will vary from
one manufacturer to another. However,
depending on the degree of
adjustability of the articulator, using
arbitrary values is not necessarily less
accurate than alternative techniques.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 96www.indiandentalacademy.com
97www.indiandentalacademy.com
Eccentric interocclusal records have been
recommended for setting the posterior
controls of a semiadjustable articulator.
These consist of wax or another recording
material interposed between the maxillary
and mandibular arches; they record the
position of the condyles in eccentric
mandibular positions.
Static positional records are made in
translated jaw positions: a protrusive record
and two lateral records. The protrusive record
can be used to adjust both condylar
inclinations on the articulator, and the lateral
records are used to adjust the side shift on
semiadjustable articulators.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 98www.indiandentalacademy.com
An articulator set by an eccentric record
is accurate in only two positions: at CR and
at the position recorded by the record. This
occurs because the path taken between
these may differ significantly on the
articulator from what is actually performed
by the mandible.
A semiadjustable instrument may have a
protrusive and a sideshift path that are
straight lines, whereas the true paths will
invariably be curved. In an attempt to
minimize errors, many contemporary
semiadjustable articulators come with
curved fossae.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 99www.indiandentalacademy.com
1. Practice the three excursive positions with the
patient until they can be reproduced. The
patient can be guided into an anterior end-to-
end position and left and right lateral positions
where the canines are end-to-end when
viewed from the front.
2. Wax record is adapted to the maxillary arch
and the patient is guided into a protrusive
position. The patient is made to close to form
indentations in the recording medium.
Technique to Record the Eccentric Relation
Records:
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 100www.indiandentalacademy.com
101www.indiandentalacademy.com
3. For the lateral records, additional wax is
added to one posterior quadrant of the
wax record to compensate for the
additional space on the patient's
nonworking side.
4. This is adapted to the patient's maxillary
arch and the patient's mandible is guided
into an excursive position, again verifying
that the canines are end to end.
5. Repeat this step for the other lateral
excursion.
6. Each record is marked to facilitate its
identification when using it to adjust the
posterior articulator controls.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 102www.indiandentalacademy.com
A simplified pantograph measures
only certain components of mandibular
movement thought to be of greatest
clinical significance, usually the condylar
inclinations and mandibular sideshift. This
device can be quickly assembled.
Numerical values are measured directly
from the recordings and are used to set
a semiadjustable articulator.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 103www.indiandentalacademy.com
Simplified pantographs may reveal an
excessively shallow condylar inclination
or an exaggerated mandibular sideshift.
If either of these conditions are
identified, restoration of the posterior
teeth is likely to be complex, and the use
of a fully adjustable articulator is
recommended.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 104www.indiandentalacademy.com
 Fully adjustable articulators are usually
programmed on the basis of a
pantographic recording.
 Jaw movements are registered by
directional tracings on recording plates. The
plates are rigidly attached to one jaw, and
the recording styli are attached to the
other.
 A total of six plates are needed to achieve
a precise movement record of the
mandible. Left and right lateral border, and
protrusive tracings are made on each
plate.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 105www.indiandentalacademy.com
106www.indiandentalacademy.com
 The pantograph is then attached to the
articulator, and the controls are adjusted
and modified until the instrument
reproduces the movements of the styli
on the tracings.
A simpler, though less accurate, procedure is to
measure the tracings directly and adjust the
condylar controls without transferring the recordings.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 107www.indiandentalacademy.com
 The electronic pantograph is designed
to record and measure functional and
border movements.
 It consists of upper and lower bows that
record and measure mandibular
movements and has been shown to
provide valid and reliable measures of
condylar determinants.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 108www.indiandentalacademy.com
109
Electronic Registration with CADIAX COMPACT®
www.indiandentalacademy.com
Another approach to reproducing
posterior condylar controls is to cut or
mould a three-dimensional recording of
the jaw movements. This stereogram is
then used to form custom-shaped fossae
for the condylar heads.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 110www.indiandentalacademy.com
Border movements of the mandible are
governed by tooth contacts and by the shape
of the left and right temporomandibular joints.
In patients with normal jaw relationships, the
vertical and horizontal overlap of anterior teeth
and the lingual concavities of the maxillary
incisors are highly significant during protrusive
movements.
In lateral excursions, the tooth contacts
normally existing between the canines are
usually dominant, although the posterior teeth
may also be involved.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 111www.indiandentalacademy.com
Restorative procedures that change
the shape of the anterior teeth can have
a profound effect on excursive tooth
contacts. For this reason, when
preparation of anterior teeth is
contemplated, the exact nature of the
anterior contacts should be transferred
to the articulator, where it can be
studied before these teeth are prepared.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 112www.indiandentalacademy.com
Most articulator manufacturers
supply a mechanical anterior guidance
(incisal guidance) table. Such tables can
be pivoted anteriorly and posteriorly, to
simulate protrusive guidance, and they
have lateral wings that can be adjusted
to approximate lateral guidance.
However, the sensitivity of these
adjustments is insufficient for successfully
transferring the existing lingual contours of
natural teeth to newly fabricated
restorations. Therefore, the principal use
for these mechanical tables is in the
fabrication of complete dentures and
occlusal devices.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 113www.indiandentalacademy.com
This simple device is used for
accurately transferring to an
articulator the contacts of anterior
teeth when determining their
influence on border movements of
the mandible.
Acrylic resin is used to record this
information, even after the natural
lingual contours of the teeth have
been altered during preparation for
complete coverage restorations.
Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics,
fourth edition. 114www.indiandentalacademy.com
1. Stephen F. Rosensteil, Martin F. Land, Junhei
Fujimoto. Contemporary Fixed Prosthodontics,
Fourth Edition.
2. Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell
D. Whitsett, Richard Jacobi, Susan E. Brackett.
Fundamentals of Fixed Prosthodontics, Third
Edition.
3. Peter E. Dawson. Functional Occlusion: From
TMJ to Smile Design.
4. Fattore et al. Clinical evaluation of the
accuracy of the interoccusal recording
materials. J Prosthet Dent 1984;51:152-157.
115www.indiandentalacademy.com
116
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
117www.indiandentalacademy.com

Contenu connexe

Tendances

Precision attachments
Precision attachmentsPrecision attachments
Precision attachmentsJoel Koshy
 
Esthetics in complete denture
Esthetics in complete dentureEsthetics in complete denture
Esthetics in complete denturePriya Gupta
 
Dental Implant failures
Dental Implant failuresDental Implant failures
Dental Implant failuresRavi banavathu
 
Implant abutment and implant abutment connections
Implant abutment and implant abutment connectionsImplant abutment and implant abutment connections
Implant abutment and implant abutment connectionsDR.BHAVESH JHA
 
PLATFORM SWITCHING
PLATFORM SWITCHINGPLATFORM SWITCHING
PLATFORM SWITCHINGshari kurup
 
Occlusion in implant ss
Occlusion in implant ssOcclusion in implant ss
Occlusion in implant ssMurtaza Kaderi
 
Normal occlusion.pptx
Normal occlusion.pptxNormal occlusion.pptx
Normal occlusion.pptxAyushJain509
 
Over dentures and its attachment
Over dentures and its attachmentOver dentures and its attachment
Over dentures and its attachmentChaithraPrabhu3
 
Prosthetic options in implant dentistry
Prosthetic options in implant dentistryProsthetic options in implant dentistry
Prosthetic options in implant dentistryBibin Bhaskaran
 
Functionally Generated Pathway
Functionally Generated Pathway Functionally Generated Pathway
Functionally Generated Pathway Sabnoor Aujla
 
Surgical implant placement guides/ dentistry dental implants
Surgical implant placement guides/ dentistry dental implantsSurgical implant placement guides/ dentistry dental implants
Surgical implant placement guides/ dentistry dental implantsIndian dental academy
 
Occlusion in Fixed Dental Prosthesis
Occlusion in Fixed Dental Prosthesis Occlusion in Fixed Dental Prosthesis
Occlusion in Fixed Dental Prosthesis Dr. Vanshree Sorathia
 
Full mouth hobo
Full mouth hoboFull mouth hobo
Full mouth hoboAnish Amin
 
journal club presentation on prosthodontics
journal club presentation on prosthodonticsjournal club presentation on prosthodontics
journal club presentation on prosthodonticsNAMITHA ANAND
 
Attachments in implant retained overdentures/ cosmetic dentistry training
Attachments in implant retained overdentures/ cosmetic dentistry trainingAttachments in implant retained overdentures/ cosmetic dentistry training
Attachments in implant retained overdentures/ cosmetic dentistry trainingIndian dental academy
 
Precision attachments
Precision attachmentsPrecision attachments
Precision attachmentsAmit Bhargav
 
Dental implant.ppt
Dental implant.pptDental implant.ppt
Dental implant.pptTheoNistor
 
Different implant abutment connections
Different implant abutment connectionsDifferent implant abutment connections
Different implant abutment connectionsMohammad Algraisi
 
Rest of lost vert dim/ academy general dentistry
Rest of lost vert dim/ academy general dentistryRest of lost vert dim/ academy general dentistry
Rest of lost vert dim/ academy general dentistryIndian dental academy
 
Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...
Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...
Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...Indian dental academy
 

Tendances (20)

Precision attachments
Precision attachmentsPrecision attachments
Precision attachments
 
Esthetics in complete denture
Esthetics in complete dentureEsthetics in complete denture
Esthetics in complete denture
 
Dental Implant failures
Dental Implant failuresDental Implant failures
Dental Implant failures
 
Implant abutment and implant abutment connections
Implant abutment and implant abutment connectionsImplant abutment and implant abutment connections
Implant abutment and implant abutment connections
 
PLATFORM SWITCHING
PLATFORM SWITCHINGPLATFORM SWITCHING
PLATFORM SWITCHING
 
Occlusion in implant ss
Occlusion in implant ssOcclusion in implant ss
Occlusion in implant ss
 
Normal occlusion.pptx
Normal occlusion.pptxNormal occlusion.pptx
Normal occlusion.pptx
 
Over dentures and its attachment
Over dentures and its attachmentOver dentures and its attachment
Over dentures and its attachment
 
Prosthetic options in implant dentistry
Prosthetic options in implant dentistryProsthetic options in implant dentistry
Prosthetic options in implant dentistry
 
Functionally Generated Pathway
Functionally Generated Pathway Functionally Generated Pathway
Functionally Generated Pathway
 
Surgical implant placement guides/ dentistry dental implants
Surgical implant placement guides/ dentistry dental implantsSurgical implant placement guides/ dentistry dental implants
Surgical implant placement guides/ dentistry dental implants
 
Occlusion in Fixed Dental Prosthesis
Occlusion in Fixed Dental Prosthesis Occlusion in Fixed Dental Prosthesis
Occlusion in Fixed Dental Prosthesis
 
Full mouth hobo
Full mouth hoboFull mouth hobo
Full mouth hobo
 
journal club presentation on prosthodontics
journal club presentation on prosthodonticsjournal club presentation on prosthodontics
journal club presentation on prosthodontics
 
Attachments in implant retained overdentures/ cosmetic dentistry training
Attachments in implant retained overdentures/ cosmetic dentistry trainingAttachments in implant retained overdentures/ cosmetic dentistry training
Attachments in implant retained overdentures/ cosmetic dentistry training
 
Precision attachments
Precision attachmentsPrecision attachments
Precision attachments
 
Dental implant.ppt
Dental implant.pptDental implant.ppt
Dental implant.ppt
 
Different implant abutment connections
Different implant abutment connectionsDifferent implant abutment connections
Different implant abutment connections
 
Rest of lost vert dim/ academy general dentistry
Rest of lost vert dim/ academy general dentistryRest of lost vert dim/ academy general dentistry
Rest of lost vert dim/ academy general dentistry
 
Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...
Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...
Occlusion concepts in fixed partial dentures  / dental implant courses by Ind...
 

En vedette

Articulators / fixed orthodontic courses
Articulators / fixed orthodontic coursesArticulators / fixed orthodontic courses
Articulators / fixed orthodontic coursesIndian dental academy
 
Articulators Manual /certified fixed orthodontic courses by Indian dental ac...
Articulators Manual  /certified fixed orthodontic courses by Indian dental ac...Articulators Manual  /certified fixed orthodontic courses by Indian dental ac...
Articulators Manual /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
 
Articulators in complete dentures by dr. anil goud asiandentalacademy
Articulators in complete dentures by dr. anil goud asiandentalacademyArticulators in complete dentures by dr. anil goud asiandentalacademy
Articulators in complete dentures by dr. anil goud asiandentalacademyAnil Goud
 
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...Indian dental academy
 
centric relation recording in edentulous pateints /certified fixed orthodonti...
centric relation recording in edentulous pateints /certified fixed orthodonti...centric relation recording in edentulous pateints /certified fixed orthodonti...
centric relation recording in edentulous pateints /certified fixed orthodonti...Indian dental academy
 
Centric relation
Centric relation Centric relation
Centric relation Raga Ahmed
 
Horizontal jaw relation /certified fixed orthodontic courses by Indian denta...
Horizontal jaw relation  /certified fixed orthodontic courses by Indian denta...Horizontal jaw relation  /certified fixed orthodontic courses by Indian denta...
Horizontal jaw relation /certified fixed orthodontic courses by Indian denta...Indian dental academy
 
Centric and eccentric record in complete denture 3rd yr
Centric and eccentric record in complete denture 3rd yrCentric and eccentric record in complete denture 3rd yr
Centric and eccentric record in complete denture 3rd yrMuaiyed Mahmoud Buzayan
 
Treatment Plan in Periodontics
Treatment Plan in PeriodonticsTreatment Plan in Periodontics
Treatment Plan in PeriodonticsDRAMITDE
 
Horizontal jaw relations ppt
Horizontal jaw relations pptHorizontal jaw relations ppt
Horizontal jaw relations pptPreeti Kalia
 
Interocclusal records and mounting of casts on articulator/ online orthodonti...
Interocclusal records and mounting of casts on articulator/ online orthodonti...Interocclusal records and mounting of casts on articulator/ online orthodonti...
Interocclusal records and mounting of casts on articulator/ online orthodonti...Indian dental academy
 
Gingivitis
GingivitisGingivitis
Gingivitisdentist
 
bite registration for fixed Prosthodontic restoration
bite registration for fixed Prosthodontic restorationbite registration for fixed Prosthodontic restoration
bite registration for fixed Prosthodontic restorationBotan Khafaf
 

En vedette (20)

Articulators / fixed orthodontic courses
Articulators / fixed orthodontic coursesArticulators / fixed orthodontic courses
Articulators / fixed orthodontic courses
 
023.periodontal pocket
023.periodontal pocket023.periodontal pocket
023.periodontal pocket
 
Articulators Manual /certified fixed orthodontic courses by Indian dental ac...
Articulators Manual  /certified fixed orthodontic courses by Indian dental ac...Articulators Manual  /certified fixed orthodontic courses by Indian dental ac...
Articulators Manual /certified fixed orthodontic courses by Indian dental ac...
 
Articulators in complete dentures by dr. anil goud asiandentalacademy
Articulators in complete dentures by dr. anil goud asiandentalacademyArticulators in complete dentures by dr. anil goud asiandentalacademy
Articulators in complete dentures by dr. anil goud asiandentalacademy
 
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
 
centric relation recording in edentulous pateints /certified fixed orthodonti...
centric relation recording in edentulous pateints /certified fixed orthodonti...centric relation recording in edentulous pateints /certified fixed orthodonti...
centric relation recording in edentulous pateints /certified fixed orthodonti...
 
Centric relation
Centric relation Centric relation
Centric relation
 
Horizontal jaw relation /certified fixed orthodontic courses by Indian denta...
Horizontal jaw relation  /certified fixed orthodontic courses by Indian denta...Horizontal jaw relation  /certified fixed orthodontic courses by Indian denta...
Horizontal jaw relation /certified fixed orthodontic courses by Indian denta...
 
Centric and eccentric record in complete denture 3rd yr
Centric and eccentric record in complete denture 3rd yrCentric and eccentric record in complete denture 3rd yr
Centric and eccentric record in complete denture 3rd yr
 
Treatment Plan in Periodontics
Treatment Plan in PeriodonticsTreatment Plan in Periodontics
Treatment Plan in Periodontics
 
Horizontal jaw relations ppt
Horizontal jaw relations pptHorizontal jaw relations ppt
Horizontal jaw relations ppt
 
Interocclusal records and mounting of casts on articulator/ online orthodonti...
Interocclusal records and mounting of casts on articulator/ online orthodonti...Interocclusal records and mounting of casts on articulator/ online orthodonti...
Interocclusal records and mounting of casts on articulator/ online orthodonti...
 
8.boxing impressions and making casts
8.boxing impressions and making casts8.boxing impressions and making casts
8.boxing impressions and making casts
 
Gingivitis
GingivitisGingivitis
Gingivitis
 
Gingivitis presentation
Gingivitis presentationGingivitis presentation
Gingivitis presentation
 
Peridontal pocket
Peridontal pocketPeridontal pocket
Peridontal pocket
 
Gingivitis
GingivitisGingivitis
Gingivitis
 
bite registration for fixed Prosthodontic restoration
bite registration for fixed Prosthodontic restorationbite registration for fixed Prosthodontic restoration
bite registration for fixed Prosthodontic restoration
 
Gingivitis
GingivitisGingivitis
Gingivitis
 
8.boxing impressions and making casts
8.boxing impressions and making casts8.boxing impressions and making casts
8.boxing impressions and making casts
 

Similaire à Indian Dental Academy's Guide to Occlusion Terminology & Articulators

Jaw relation in fixed partial denture prosthesis/ online orthodontic courses
Jaw relation in fixed partial denture prosthesis/ online orthodontic coursesJaw relation in fixed partial denture prosthesis/ online orthodontic courses
Jaw relation in fixed partial denture prosthesis/ online orthodontic coursesIndian dental academy
 
Overdenture / orthodontic straight wire technique
Overdenture / orthodontic straight wire techniqueOverdenture / orthodontic straight wire technique
Overdenture / orthodontic straight wire techniqueIndian dental academy
 
Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...
Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...
Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...Indian dental academy
 
Retention and relapse /certified fixed orthodontic courses by Indian dental a...
Retention and relapse /certified fixed orthodontic courses by Indian dental a...Retention and relapse /certified fixed orthodontic courses by Indian dental a...
Retention and relapse /certified fixed orthodontic courses by Indian dental a...Indian dental academy
 
Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...
Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...
Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...Indian dental academy
 
Interocclusal/ online orthodontic courses
Interocclusal/ online orthodontic coursesInterocclusal/ online orthodontic courses
Interocclusal/ online orthodontic coursesIndian dental academy
 
Interocclusal records (2/ dental courses
Interocclusal records (2/ dental coursesInterocclusal records (2/ dental courses
Interocclusal records (2/ dental coursesIndian dental academy
 
Occlusion / orthodontic continuing education
Occlusion / orthodontic continuing educationOcclusion / orthodontic continuing education
Occlusion / orthodontic continuing educationIndian dental academy
 
Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
 
Occulasl consideration for implant supported prostehsi /certified fixed ortho...
Occulasl consideration for implant supported prostehsi /certified fixed ortho...Occulasl consideration for implant supported prostehsi /certified fixed ortho...
Occulasl consideration for implant supported prostehsi /certified fixed ortho...Indian dental academy
 
Splints in orthodontics /certified fixed orthodontic courses by Indian denta...
Splints in orthodontics  /certified fixed orthodontic courses by Indian denta...Splints in orthodontics  /certified fixed orthodontic courses by Indian denta...
Splints in orthodontics /certified fixed orthodontic courses by Indian denta...Indian dental academy
 
Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...
Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...
Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...Indian dental academy
 
occlusal considerations for Implant supported Prosthesis /certified fixed or...
occlusal considerations for Implant supported Prosthesis  /certified fixed or...occlusal considerations for Implant supported Prosthesis  /certified fixed or...
occlusal considerations for Implant supported Prosthesis /certified fixed or...Indian dental academy
 
Rationale-and-technique-for-occlusal-equilibration.pdf
Rationale-and-technique-for-occlusal-equilibration.pdfRationale-and-technique-for-occlusal-equilibration.pdf
Rationale-and-technique-for-occlusal-equilibration.pdfAntonioCasteloBranco2
 
Occulasl consideration for implant supported prostehsis
Occulasl consideration for implant supported prostehsisOcculasl consideration for implant supported prostehsis
Occulasl consideration for implant supported prostehsisIndian dental academy
 

Similaire à Indian Dental Academy's Guide to Occlusion Terminology & Articulators (20)

Jaw relation in fixed partial denture prosthesis/ online orthodontic courses
Jaw relation in fixed partial denture prosthesis/ online orthodontic coursesJaw relation in fixed partial denture prosthesis/ online orthodontic courses
Jaw relation in fixed partial denture prosthesis/ online orthodontic courses
 
Overdenture / orthodontic straight wire technique
Overdenture / orthodontic straight wire techniqueOverdenture / orthodontic straight wire technique
Overdenture / orthodontic straight wire technique
 
Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...
Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...
Orthopedic biomechanics /certified fixed orthodontic courses by Indian dental...
 
Gnathology/endodontic courses
Gnathology/endodontic coursesGnathology/endodontic courses
Gnathology/endodontic courses
 
Retention and relapse /certified fixed orthodontic courses by Indian dental a...
Retention and relapse /certified fixed orthodontic courses by Indian dental a...Retention and relapse /certified fixed orthodontic courses by Indian dental a...
Retention and relapse /certified fixed orthodontic courses by Indian dental a...
 
Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...
Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...
Biomechanics in orthopedics /certified fixed orthodontic courses by Indian de...
 
Interocclusal/ online orthodontic courses
Interocclusal/ online orthodontic coursesInterocclusal/ online orthodontic courses
Interocclusal/ online orthodontic courses
 
Interocclusal records (2/ dental courses
Interocclusal records (2/ dental coursesInterocclusal records (2/ dental courses
Interocclusal records (2/ dental courses
 
Occlusion / orthodontic continuing education
Occlusion / orthodontic continuing educationOcclusion / orthodontic continuing education
Occlusion / orthodontic continuing education
 
orthodontic dental casts the case against
orthodontic dental casts the case againstorthodontic dental casts the case against
orthodontic dental casts the case against
 
Definitive obturation treatment concepts
Definitive obturation  treatment conceptsDefinitive obturation  treatment concepts
Definitive obturation treatment concepts
 
Biomechanics in edentulous state
Biomechanics in edentulous stateBiomechanics in edentulous state
Biomechanics in edentulous state
 
Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...
 
Gnathology / periodontics courses
Gnathology / periodontics coursesGnathology / periodontics courses
Gnathology / periodontics courses
 
Occulasl consideration for implant supported prostehsi /certified fixed ortho...
Occulasl consideration for implant supported prostehsi /certified fixed ortho...Occulasl consideration for implant supported prostehsi /certified fixed ortho...
Occulasl consideration for implant supported prostehsi /certified fixed ortho...
 
Splints in orthodontics /certified fixed orthodontic courses by Indian denta...
Splints in orthodontics  /certified fixed orthodontic courses by Indian denta...Splints in orthodontics  /certified fixed orthodontic courses by Indian denta...
Splints in orthodontics /certified fixed orthodontic courses by Indian denta...
 
Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...
Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...
Copy of biomech of head gear /certified fixed orthodontic courses by Indian d...
 
occlusal considerations for Implant supported Prosthesis /certified fixed or...
occlusal considerations for Implant supported Prosthesis  /certified fixed or...occlusal considerations for Implant supported Prosthesis  /certified fixed or...
occlusal considerations for Implant supported Prosthesis /certified fixed or...
 
Rationale-and-technique-for-occlusal-equilibration.pdf
Rationale-and-technique-for-occlusal-equilibration.pdfRationale-and-technique-for-occlusal-equilibration.pdf
Rationale-and-technique-for-occlusal-equilibration.pdf
 
Occulasl consideration for implant supported prostehsis
Occulasl consideration for implant supported prostehsisOcculasl consideration for implant supported prostehsis
Occulasl consideration for implant supported prostehsis
 

Plus de Indian dental academy

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian dental academy
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Indian dental academy
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeIndian dental academy
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesIndian dental academy
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Indian dental academy
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  Indian dental academy
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Indian dental academy
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesIndian dental academy
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Indian dental academy
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesIndian dental academy
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Indian dental academy
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesIndian dental academy
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Indian dental academy
 

Plus de Indian dental academy (20)

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdom
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics pratice
 
online fixed orthodontics course
online fixed orthodontics courseonline fixed orthodontics course
online fixed orthodontics course
 
online orthodontics course
online orthodontics courseonline orthodontics course
online orthodontics course
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant courses
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental courses
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic courses
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic courses
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic courses
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry courses
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  
 

Dernier

Dust Of Snow By Robert Frost Class-X English CBSE
Dust Of Snow By Robert Frost Class-X English CBSEDust Of Snow By Robert Frost Class-X English CBSE
Dust Of Snow By Robert Frost Class-X English CBSEaurabinda banchhor
 
Integumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.pptIntegumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.pptshraddhaparab530
 
EMBODO Lesson Plan Grade 9 Law of Sines.docx
EMBODO Lesson Plan Grade 9 Law of Sines.docxEMBODO Lesson Plan Grade 9 Law of Sines.docx
EMBODO Lesson Plan Grade 9 Law of Sines.docxElton John Embodo
 
ROLES IN A STAGE PRODUCTION in arts.pptx
ROLES IN A STAGE PRODUCTION in arts.pptxROLES IN A STAGE PRODUCTION in arts.pptx
ROLES IN A STAGE PRODUCTION in arts.pptxVanesaIglesias10
 
Grade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdf
Grade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdfGrade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdf
Grade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdfJemuel Francisco
 
Concurrency Control in Database Management system
Concurrency Control in Database Management systemConcurrency Control in Database Management system
Concurrency Control in Database Management systemChristalin Nelson
 
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...Nguyen Thanh Tu Collection
 
Active Learning Strategies (in short ALS).pdf
Active Learning Strategies (in short ALS).pdfActive Learning Strategies (in short ALS).pdf
Active Learning Strategies (in short ALS).pdfPatidar M
 
INTRODUCTION TO CATHOLIC CHRISTOLOGY.pptx
INTRODUCTION TO CATHOLIC CHRISTOLOGY.pptxINTRODUCTION TO CATHOLIC CHRISTOLOGY.pptx
INTRODUCTION TO CATHOLIC CHRISTOLOGY.pptxHumphrey A Beña
 
ClimART Action | eTwinning Project
ClimART Action    |    eTwinning ProjectClimART Action    |    eTwinning Project
ClimART Action | eTwinning Projectjordimapav
 
Virtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdf
Virtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdfVirtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdf
Virtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdfErwinPantujan2
 
The Contemporary World: The Globalization of World Politics
The Contemporary World: The Globalization of World PoliticsThe Contemporary World: The Globalization of World Politics
The Contemporary World: The Globalization of World PoliticsRommel Regala
 
Presentation Activity 2. Unit 3 transv.pptx
Presentation Activity 2. Unit 3 transv.pptxPresentation Activity 2. Unit 3 transv.pptx
Presentation Activity 2. Unit 3 transv.pptxRosabel UA
 
MULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptx
MULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptxMULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptx
MULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptxAnupkumar Sharma
 
ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...
ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...
ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...JojoEDelaCruz
 
Measures of Position DECILES for ungrouped data
Measures of Position DECILES for ungrouped dataMeasures of Position DECILES for ungrouped data
Measures of Position DECILES for ungrouped dataBabyAnnMotar
 
Field Attribute Index Feature in Odoo 17
Field Attribute Index Feature in Odoo 17Field Attribute Index Feature in Odoo 17
Field Attribute Index Feature in Odoo 17Celine George
 
4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptx4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptxmary850239
 

Dernier (20)

Dust Of Snow By Robert Frost Class-X English CBSE
Dust Of Snow By Robert Frost Class-X English CBSEDust Of Snow By Robert Frost Class-X English CBSE
Dust Of Snow By Robert Frost Class-X English CBSE
 
Integumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.pptIntegumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.ppt
 
EMBODO Lesson Plan Grade 9 Law of Sines.docx
EMBODO Lesson Plan Grade 9 Law of Sines.docxEMBODO Lesson Plan Grade 9 Law of Sines.docx
EMBODO Lesson Plan Grade 9 Law of Sines.docx
 
YOUVE GOT EMAIL_FINALS_EL_DORADO_2024.pptx
YOUVE GOT EMAIL_FINALS_EL_DORADO_2024.pptxYOUVE GOT EMAIL_FINALS_EL_DORADO_2024.pptx
YOUVE GOT EMAIL_FINALS_EL_DORADO_2024.pptx
 
ROLES IN A STAGE PRODUCTION in arts.pptx
ROLES IN A STAGE PRODUCTION in arts.pptxROLES IN A STAGE PRODUCTION in arts.pptx
ROLES IN A STAGE PRODUCTION in arts.pptx
 
Grade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdf
Grade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdfGrade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdf
Grade 9 Quarter 4 Dll Grade 9 Quarter 4 DLL.pdf
 
Concurrency Control in Database Management system
Concurrency Control in Database Management systemConcurrency Control in Database Management system
Concurrency Control in Database Management system
 
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - CẢ NĂ...
 
Active Learning Strategies (in short ALS).pdf
Active Learning Strategies (in short ALS).pdfActive Learning Strategies (in short ALS).pdf
Active Learning Strategies (in short ALS).pdf
 
INTRODUCTION TO CATHOLIC CHRISTOLOGY.pptx
INTRODUCTION TO CATHOLIC CHRISTOLOGY.pptxINTRODUCTION TO CATHOLIC CHRISTOLOGY.pptx
INTRODUCTION TO CATHOLIC CHRISTOLOGY.pptx
 
ClimART Action | eTwinning Project
ClimART Action    |    eTwinning ProjectClimART Action    |    eTwinning Project
ClimART Action | eTwinning Project
 
Virtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdf
Virtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdfVirtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdf
Virtual-Orientation-on-the-Administration-of-NATG12-NATG6-and-ELLNA.pdf
 
The Contemporary World: The Globalization of World Politics
The Contemporary World: The Globalization of World PoliticsThe Contemporary World: The Globalization of World Politics
The Contemporary World: The Globalization of World Politics
 
Presentation Activity 2. Unit 3 transv.pptx
Presentation Activity 2. Unit 3 transv.pptxPresentation Activity 2. Unit 3 transv.pptx
Presentation Activity 2. Unit 3 transv.pptx
 
MULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptx
MULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptxMULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptx
MULTIDISCIPLINRY NATURE OF THE ENVIRONMENTAL STUDIES.pptx
 
LEFT_ON_C'N_ PRELIMS_EL_DORADO_2024.pptx
LEFT_ON_C'N_ PRELIMS_EL_DORADO_2024.pptxLEFT_ON_C'N_ PRELIMS_EL_DORADO_2024.pptx
LEFT_ON_C'N_ PRELIMS_EL_DORADO_2024.pptx
 
ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...
ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...
ENG 5 Q4 WEEk 1 DAY 1 Restate sentences heard in one’s own words. Use appropr...
 
Measures of Position DECILES for ungrouped data
Measures of Position DECILES for ungrouped dataMeasures of Position DECILES for ungrouped data
Measures of Position DECILES for ungrouped data
 
Field Attribute Index Feature in Odoo 17
Field Attribute Index Feature in Odoo 17Field Attribute Index Feature in Odoo 17
Field Attribute Index Feature in Odoo 17
 
4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptx4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptx
 

Indian Dental Academy's Guide to Occlusion Terminology & Articulators

  • 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  • 2.  Terminologies  Occlusal Schemes  Articulators  Facebows (including methods of recording)  Centric relation records (including technique)  Anterior programming device  Jaw relations in a partially edentulous dentition  Articulation of casts  Eccentric interocclusal records  Pantographs  Anterior guidance 2www.indiandentalacademy.com
  • 3. Jaw Relation (or maxillo-mandibular relationship) : Any spatial relationship of the maxillae to the mandible; any one of the infinite relationships of the mandible to the maxillae1. 1 Glossary of Prosthodontic Terms - 8 3www.indiandentalacademy.com
  • 4. A registration of the positional relationship of the opposing teeth or arches; a record of the positional relationship of the teeth or jaws to each other1. 1 Glossary of Prosthodontic Terms – 8 4www.indiandentalacademy.com
  • 5. Balanced Occlusion: The bilateral, simultaneous, anterior, and posterior occlusal contact of teeth in centric and eccentric positions1. 5 1 Glossary of Prosthodontic Terms – 8 www.indiandentalacademy.com
  • 6. Mutually Protected articulation: An occlusal scheme in which the posterior teeth prevent excessive contact of the anterior teeth in maximum intercuspation and the anterior teeth disengage the posterior teeth in all mandibular excursive movements. Alternatively, an occlusal scheme in which the anterior teeth disengage the posterior teeth in all mandibular excursive movements, and the posterior teeth prevent excessive contact of the anterior teeth in maximum intercuspation1. 1Glossary of Prosthodontic Terms - 8 6www.indiandentalacademy.com
  • 7. Group Function: Multiple contact relations between the maxillary and mandibular teeth in lateral movements on the working side whereby simultaneous contact of several teeth acts as a group to distribute occlusal forces1. 1Glossary of Prosthodontic Terms - 8 7www.indiandentalacademy.com
  • 8.  Bilateral Balanced Occlusion  Unilateral Balanced Occlusion  Mutually Protected Occlusion 8 Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
  • 9.  Bilateral occlusal schemes are based on the work of von Spee and Monson. It is a concept not used as frequently today as it has been in the past.  It is largely a prosthodontic concept which dictates that a maximum number of teeth should contact in all excursive positions of the mandible.  This concept is particularly useful in complete denture construction, in which the contact on non-working side is important to prevent tipping of the prosthesis. 9 Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
  • 10.  Subsequently, this concept of was applied to natural teeth in complete oral rehabilitation.  But, studies suggest that as a result of multiple tooth contacts that occur as the mandible moves through various excursions, there is excessive frictional wear. 10 Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
  • 11.  Also known as group function, is a widely accepted and used method of arrangement of teeth in restorative dental procedures.  A study by Schuyler, where he observed the destructive nature of tooth contacts on the non-working side, concluded that cross- arch balance was not necessary in natural teeth, it would be best to eliminate all tooth contact on the non-working side. 11 Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
  • 12.  The absence of tooth contact on the nonworking side prevents those teeth from being subjected to the destructive, obliquely directed forces found in non working interferences.  The functionally generated path technique as described by Meyers is used for producing unilateral balanced occlusion.  It has also been adapted by Mann and Pankey for use in complete mouth rehabilitation. 12 Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
  • 13.  Also known as canine protected occlusion.  Here, the teeth are arranged so that the overlap of the anterior teeth prevents the posterior teeth from making any contact on either the working or non-working sides during mandibular excursions. This sepration from occlusion is termed disocclusion.  According to this concept of occlusion, the anterior teeth bear all the load and the posterior teeth are disoccluded in any excursive positions of the mandible, the desired result is absence of frictional wear. 13 Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition.www.indiandentalacademy.com
  • 14. A mechanical instrument that represents the temporomandibular joints and jaws, to which maxillary and mandibular casts may be attached to simulate some or all mandibular movements1. 1Glossary of Prosthodontic Terms - 8 14www.indiandentalacademy.com
  • 15. Articulators are divisible into four classes1: Class I articulator: a simple holding instrument capable of accepting a single static registration; vertical motion is possible. Class II articulator: an instrument that permits horizontal as well as vertical motion but does not orient the motion to the temporomandibular joints. 1Glossary of Prosthodontic Terms - 8 15www.indiandentalacademy.com
  • 16. Class III articulator: an instrument that simulates condylar pathways by using averages or mechanical equivalents for all or part of the motion; these instruments allow for orientation of the casts relative to the joints and may be arcon or nonarcon instruments. Class IV articulator: an instrument that will accept three dimensional dynamic registrations; these instruments allow for orientation of the casts to the temporomandibular joints and simulation of mandibular movements 1Glossary of Prosthodontic Terms - 8 16www.indiandentalacademy.com
  • 17. Handheld casts can provide information concerning alignment of the individual arches but do not permit analysis of functional relationships. For an analysis, the casts need to be attached to an articulator. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 17www.indiandentalacademy.com
  • 18.  They are classified according to how closely they can reproduce mandibular border movements. Because the movements are governed by the bones and ligaments of the TMJs, they are relatively constant and reproducible.  Most articulators use mechanically adjustable posterior controls to simulate these movements, although some use plastic premilled or customized fossa analogs. If an articulator closely reproduces the actual border movements of a given patient, this will significantly reduce chair time because the dental laboratory can then design the prosthesis to be in functional harmony with the patient's movements. In addition, less time will be needed for adjustments at the time of fit in. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 18www.indiandentalacademy.com
  • 19.  On some instruments, the upper and lower members are permanently attached to each other, while on others they can be readily separated. The latter group may have a latch or clamplike feature that locks the two components together in the hinge position.  Instrument selection depends on the type and complexity of treatment needs and the demands for procedural accuracy.  For instance, when waxing a fixed partial denture, it is advantageous to be able to separate the instrument into two more easily handled parts. Use of the proper instrument for a given procedure can translate into significant timesaving during subsequent stages of treatment. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 19www.indiandentalacademy.com
  • 21.  Many cast restorations are made on small nonadjustable articulators. Their use often leads to restorations with occlusal discrepancies, because these instruments do not have the capacity to reproduce the full range of mandibular movement.  Some discrepancies can be corrected intraorally, but this is often time consuming, also leading to increased inaccuracies.  If discrepancies are left uncorrected, occlusal interferences and associated neuromuscular disorders may result. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 21www.indiandentalacademy.com
  • 22.  Of practical significance are differences between the hinge closure of a small articulator and that of the patient. The distance between the hinge and the tooth to be restored is significantly less on most nonadjustable articulators than in the patient. This can lead to restorations with premature tooth contacts because cusp position is affected.  This type of arcing motion on the nonadjustable articulator results in steeper travel than occurs clinically, resulting in premature contacts subsequently on fabricated restorations between the distal mandibular inclines and the mesial maxillary inclines of posterior teeth. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 22www.indiandentalacademy.com
  • 23.  Depending on the specific design of the articulator, ridge and groove direction may be affected in accordance with the same principle. This is important to note, because resulting prematurities are likely on the nonworking side. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 23www.indiandentalacademy.com
  • 25.  For most routine fixed prostheses, the use of a semiadjustable articulator is a practical approach to providing necessary information while minimizing the need for clinical adjustment during treatment.  Semiadjustable instruments do not require an inordinate amount of time or expertise. They are about the same size as the anatomic structures they represent. Therefore, the articulated casts can be positioned with sufficient accuracy so that arcing errors are minimal and usually of minimal clinical significance (i.e., minimal time should be required for chairside adjustments of fabricated prostheses). Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 25www.indiandentalacademy.com
  • 26.  There are two basic designs of the semiadjustable articulator: › arcon › nonarcon  Nonarcon instruments gained considerable popularity in complete denture prosthodontics because the upper and lower members are rigidly attached, permitting easier control when positioning artificial teeth. As a consequence of their design, certain inaccuracies occured in cast restorations, which led to the development of the arcon- type instrument. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 26www.indiandentalacademy.com
  • 27.  In an arcon articulator, the condylar spheres are attached to the lower component of the articulator, and the mechanical fossae are attached to the upper member of the instrument.  Thus, the arcon articulator is anatomically "correct," which makes understanding of mandibular movements easier, as opposed to the nonarcon articulator.  The angulation of the mechanical fossae of an arcon instrument is fixed relative to the occlusal plane of the maxillary cast; in the nonarcon design, it is fixed relative to the occlusal plane of the mandibular cast. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 27www.indiandentalacademy.com
  • 28. 28 Condylar inclination of the mechanical fossa www.indiandentalacademy.com
  • 29.  Most semiadjustable articulators permit adjustments to the condylar inclination and progressive and/or immediate side shift. Some have straight condylar inclined paths, although more recent instruments have curved condylar housings, which are anatomically more correct. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 29www.indiandentalacademy.com
  • 30.  The mechanical fossae on semiadjustable articulators can be adjusted to mimic the movements of the patient through the use of interocclusal records.  These consist of several thicknesses of wax or another suitable material in which the patient has closed. Because these records can be several millimeters thick, an error is introduced when setting nonarcon articulators with protrusive wax records, because its condylar path is not fixed relative to the maxillary occlusal plane. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 30www.indiandentalacademy.com
  • 31.  As the protrusive record used to adjust the instrument is removed from the arcon articulator, the maxillary occlusal plane and the condylar inclination become more parallel to each other, leading to reduced cuspal heights in subsequently fabricated prostheses. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 31www.indiandentalacademy.com
  • 33. A fully (or highly) adjustable articulator has a wide range of positions and can be set to follow a patient's border movements. The accuracy of reproduction of movement depends on the care and skill of the operator, the errors inherent in the articulator and recording device, and any malalignments due to slight flexing of the mandible and the nonrigid nature of the TMJs. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 33www.indiandentalacademy.com
  • 34. A caliper-like instrument used to record the spatial relationship of the maxillary arch to some anatomic reference point or points and then transfer this relationship to an articulator; it orients the dental cast in the same relationship to the opening axis of the articulator. Customarily the anatomic references are the mandibular condyles transverse horizontal axis and one other selected anterior point; called also hinge bow1. 1Glossary of Prosthodontic Terms - 8 35www.indiandentalacademy.com
  • 35. An imaginary line around which the mandible may rotate within the sagittal plane1. 1Glossary of Prosthodontic Terms - 8 36www.indiandentalacademy.com
  • 36.  The mandibular hinging movement around the transverse horizontal axis is repeatable. That makes this imaginary "hinge axis" around which the mandible may rotate in the sagittal plane of considerable importance when fabricating fixed prostheses. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 37  Facebows are used to record the anteroposterior and mediolateral spatial position of the maxillary occlusal surfaces relative to this transverse opening and closing axis of the patient's mandible. www.indiandentalacademy.com
  • 37.  The facebow is then attached to the articulator to transfer the recorded relationship of the maxilla by ensuring that the corresponding cast is attached in the correct position relative to the hinge axis of the instrument.  After the maxillary cast has been attached to the articulator with mounting stone or plaster, the mandibular cast is subsequently related to the maxillary cast through the use of an interocclusal record.  If the patient's casts are accurately transferred to an instrument, considerable time is saved in the fabrication and delivery of high-quality prostheses. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 38www.indiandentalacademy.com
  • 38.  Most facebows are rigid, caliper-like devices that permit some adjustments. Two types of facebows are recognized: arbitrary and kinematic.  Arbitrary facebows are less accurate than the kinematic type, but they suffice for most routine dental procedures. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 39www.indiandentalacademy.com
  • 39.  Kinematic facebows are indicated when it is critical to precisely reproduce the exact opening and closing movement of the patient on the articulator.  For instance, when a decision to alter the vertical dimension of occlusion is to be made in the dental laboratory during the fabrication of fixed prostheses, the use of a kinematic facebow transfer in conjunction with an accurate CR interocclusal record is indicated. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 40www.indiandentalacademy.com
  • 41. A facebow with adjustable caliper ends used to locate the transverse horizontal axis of the mandible1. 1Glossary of Prosthodontic Terms - 8 Definition: 42www.indiandentalacademy.com
  • 42.  The hinge axis of the mandible can be determined to within 1 mm by observing the movement of kinematic facebow styli positioned immediately lateral to the TMJ close to the skin.  A clutch, which is essentially a segmented impression traylike device, is attached onto the mandibular teeth with a suitable rigid material such as impression plaster. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 43www.indiandentalacademy.com
  • 43.  The kinematic facebow consists of three components: a transverse component and two adjustable side arms. › The transverse rod is attached to the portion of the clutch that protrudes from the patient's mouth. › The side arms are then attached to the transverse member and adjusted so that the styli are as close to the joint area as possible. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 44www.indiandentalacademy.com
  • 44.  The mandible is then manipulated to produce a terminal hinge movement, and the stylus locations are adjusted with thumbscrews (superiorly and inferiorly, anteriorly and posteriorly) until they make a purely rotational movement.  Because the entire assembly is rigidly attached to the mandible, a strictly rotational movement signifies that stylus position coincides with the hinge axis. When this purely rotational movement is verified, the position of the hinge axis is marked with a dot on the patient's skin. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 45www.indiandentalacademy.com
  • 45. 46 Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. www.indiandentalacademy.com
  • 46.  The kinematic facebow technique is time consuming, so it is generally limited to extensive prosthodontics, particularly when a change in the vertical dimension of occlusion is to be made. A less precisely derived transfer would lead to unacceptable errors and a compromised result. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 49www.indiandentalacademy.com
  • 48. A device used to relate the maxillary cast to the condylar elements of an articulator using average anatomic landmarks to estimate the position of the transverse horizontal axis on the face1. 1Glossary of Prosthodontic Terms - 8 Definition: 51www.indiandentalacademy.com
  • 49.  Typically, an easily identifiable landmark such as the external acoustic meatus is used to stabilize the bow, which is aligned with earpieces. Such facebows can be used single-handedly because they are self- centering and do not require a complicated assembly. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 52  Arbitrary hinge axis facebows approximate the horizontal transverse axis and rely on anatomic average values. They are designed in such a manner that the true axis falls within an acceptable degree of error. www.indiandentalacademy.com
  • 50.  They give a sufficiently accurate relationship for most diagnostic and restorative procedures.  However, regardless of which arbitrary position is chosen, a minimum error of 5 mm from the axis can be expected.  When coupled with the use of a thick interocclusal record made at an increased vertical dimension, this factor can lead to considerable inaccuracy. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 53www.indiandentalacademy.com
  • 51.  The use of an anterior reference point enables the clinician to duplicate the recorded position on the articulator at later appointments.  This saves time, as previously recorded articulator settings can be used again.  An anterior reference point, such as the inner canthus of the eye or a freckle or mole on the skin, is selected. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 54www.indiandentalacademy.com
  • 52.  After this has been marked, it is used along with the two points of the hinge axis, to define the position of the maxillary cast in space. This has the following advantages: 1) After the posterior controls have been adjusted initially, subsequent casts can be mounted on the articulator without repeating the facebow determinations and having to reset the posterior articulator controls. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 55www.indiandentalacademy.com
  • 53. 2) Because the maxillary arch is properly positioned relative to the axis, average values for posterior articulator controls can be used without having to readjust the instrument on the basis of eccentric records. 3) When the articulator has been adjusted, the resulting numerical values for the settings can be compared with known average values to provide information about the patient's individual variations and the likelihood of encountering difficulties during restorative procedures. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 56www.indiandentalacademy.com
  • 54. Definition: The process of transferring the facebow record of the spatial relationship of the maxillary arch to some anatomic reference point or points and transferring this relationship to an articulator1. 1Glossary of Prosthodontic Terms - 8 57www.indiandentalacademy.com
  • 55. Procedure: 1. Add modeling compound to the facebow fork. 2. Temper in water and seat the fork, making indentations of the maxillary cusp tips. The facebow fork is positioned in the patient's mouth, and an impression is made of the maxillary cusp tips. The impression must be deep enough to permit accurate repositioning of the maxillary cast after the facebow fork has been removed from the mouth. Only the cusp tips should be recorded. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 58www.indiandentalacademy.com
  • 56. 3. Remove the fork from the mouth. Chill and reseat the fork, and check that no distortion has occurred. Trim the recording medium as necessary before reseating. After reseating, check for stability. 4. Have the patient stabilize the facebow fork by biting on cotton rolls. As an alternative, wax can be added to the mandibular incisor region of the fork. The mandibular anterior teeth will stabilize the fork as they engage the wax. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 59www.indiandentalacademy.com
  • 57. 5. Slide the universal joint onto the fork and position the caliper to align with the anterior reference mark. 6. Tighten the screws securely in the correct sequence. 7. If the articulator has an adjustable intercondylar width, record this measurement. 8. Remove the facebow from the mouth. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 60www.indiandentalacademy.com
  • 58. A centric relation record provides the orientation of mandibular to maxillary teeth in Centric Relation in the terminal hinge position, where opening and closing are purely rotational movements. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 61www.indiandentalacademy.com
  • 59. Definition: A registration of the relationship of the maxilla to the mandible when the mandible is in centric relation. The registration may be obtained either intraorally or extraorally1. 2 Glossary of Prosthodontic Terms - 8 62www.indiandentalacademy.com
  • 60. Centric Relation: The maxillomandibular relationship in which the condyles articulate with the thinnest avascular portion of their respective disks with the complex in the anterior-superior position against the shapes of the articular eminences. This position is independent of tooth contact. This position is clinically discernible when the mandible is directed superior and anteriorly. It is restricted to a purely rotary movement about the transverse horizontal axis2. 2 Glossary of Prosthodontic Terms - 5 63www.indiandentalacademy.com
  • 61.  Maximum intercuspation may or may not occur coincident with the centric relation position.  The centric relation record is transferred to the maxillary cast on the articulator and is used to relate the mandibular cast to the maxillary cast.  Once the mandibular cast is attached to the articulator with plaster, the record is removed. The casts will then occlude in precisely the CR position as long as the maxillary cast is correctly related to the hinge axis with a facebow. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 64www.indiandentalacademy.com
  • 63.  When the articulator controls are set properly, using appropriate excursive records, translated mandibular positions can be reproduced from CR.  A CR/MI slide will be readily reproducible on casts that have been articulated in CR. Thus, premature tooth contacts (deflective contacts) can be observed, and it can be determined whether an occlusal correction is necessary or appropriate before fixed prosthodontic treatment. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 66www.indiandentalacademy.com
  • 64.  Casts articulated in the maximum intercuspation (MI) do not permit the evaluation of CR and retruded contact relationships.  Therefore, the articulation of diagnostic casts in CR is of greater value. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 67www.indiandentalacademy.com
  • 65.  When using a kinematic facebow(in theory), the thickness of a terminal hinge record is unimportant; a thicker record merely increases the amount of rotation. When using an arbitrary facebow, any arcing movement will result in some degree of inaccuracy. Both techniques are subject to small errors, which can be minimized by keeping the record thin. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 68www.indiandentalacademy.com
  • 66. Accurately mounted casts depend on precise manipulation of the patient's mandible by the clincian. The condyles should remain in the same place throughout the opening-closing arc. Trying to force the mandible backward will lead to downward translation of the condyles, and restorations made to such a mandibular position will be in supra- occlusion at the try-in stage. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 69www.indiandentalacademy.com
  • 68.  The load-bearing surfaces of the condylar processes, which face anteriorly, should be manipulated into apposition with the mandibular fossae of the temporal bones, with the disk properly interposed. The ease with which this can be accomplished depends on the degree of the patient's neuromuscular relaxation and on sound technique. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 71 The latter, in turn, depends on the patient permitting the dentist to control the mandible. Attempts to force or shake the mandible will lead to a protective muscle response by the patient. www.indiandentalacademy.com
  • 69.  The bimanual manipulation technique described by Dawson is recommended as a reproducible technique that can be reliably learnt.  In this technique, the dental chair is reclined and the patient's head is cradled by the examiner. With both thumbs on the chin and the fingers resting firmly on the inferior border of the mandible, the examiner exerts gentle downward pressure on the thumbs and upward pressure on the fingers, manipulating the condyle-disk assemblies into their fully seated positions in the mandibular fossae. Next, the mandible is carefully hinged along the arc of terminal hinge closure. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition., 72Peter E. Dawson. Functional Occlusion: From TMJ to Smile Design.www.indiandentalacademy.com
  • 70. 73Peter E. Dawson. Functional Occlusion: From TMJ to Smile Design.www.indiandentalacademy.com
  • 71. In patients in whom CR does not coincide with IP, protective reflexes may be encountered. Because of well-established protective reflexes that are reinforced every time the teeth come together, such patients will not allow their mandible to be manipulated and hinged easily. If tooth contact can be prevented, they will "forget" these reflexes, and manipulation becomes easier. The teeth can be kept apart with cotton rolls, a plastic leaf gauge, or a small anterior programming device made of autopolymerizing acrylic resin (also known as a Lucia jig)." Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 74www.indiandentalacademy.com
  • 73. If the mandible cannot be manipulated satisfactorily after an anterior programming device has been in place for 30 minutes, marked neuromuscular dysfunction is likely. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 76www.indiandentalacademy.com
  • 74. Different techniques can be used to make a CR record. The choice of recording medium is to some degree a function of the casts to be articulated. For instance, very accurate casts made from elastomeric impression materials can be articulated with a high-accuracy interocclusal record material such as polyvinyl siloxane. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 77www.indiandentalacademy.com
  • 75. On the other hand, less accurate diagnostic casts poured from irreversible hydrocolloid are better articulated using a more forgiving material such as interocclusal wax, provided that the record is properly reinforced. Most studies have shown considerable variability among various registration materials and techniques, so particular care is needed with this procedure. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 78www.indiandentalacademy.com
  • 76. Fattore et al (1984) studied the clinical accuracy of waxes, zinc-oxide eugenol and polyether interocclusal recording medium and found that: Polyether interocclusal recording medium without a carrier was the most accurate. Polyether and zinc-oxide eugenol pastes with carriers were the next most accurate recording medium but they required a disciplined technique. Recording waxes were consistency unreliable. Distortion occurred more frequently in a vertical direction, followed by an anteroposterior direction. 79 Fattore et al. Clinical evaluation of the accuracy of the interoccusal recording materials. J Prosthet Dent 1984;51:152-157.www.indiandentalacademy.com
  • 77. The reinforced Aluwax record is a forgiving method for recording the CR position. It is a reliable technique, originally described by Wirth and Aplin, and has provided consistent results. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 80www.indiandentalacademy.com
  • 78. 1. Half a sheet of occlusal wax is softened in warm water and adapted to the maxillary cusp tips. The patient is asked to close lightly and cuspal indentations of the mandibular teeth are recorded. These indentations form no part of the record, but they thin the wax slightly and indicate the approximate positions of the mandibular teeth for later reference. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 81www.indiandentalacademy.com
  • 79. 2. Baseplate wax is added to the mandibular anterior region of the record and sealed along the periphery. 3. The record is readapted to the maxillary teeth, resoftened if necessary. The patient is guided into centric closure, making shallow indentations in the baseplate wax. (Verify that no posterior tooth contact occurs. If it does, add an additional layer of baseplate wax). 4. The record is then removed carefully and verified that no distortion has occurred. And chilled thoroughly in ice water. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 82www.indiandentalacademy.com
  • 81. 5. The record is reseated on the maxillary teeth and evaluated for stability. If the maxillary cast is available, the fit on this must be evaluated as well. 6. Heat-retaining wax is added in the mandibular incisor region only and the mandible is manipulated. Having the patient in a supine position for this manipulation allows better control. 7. Indentations of the mandibular incisor tips are made in the wax, repeated several times to ensure reproducibility. Wax record is Removed and re-chilled in ice water until the anterior indentations are hard. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 84www.indiandentalacademy.com
  • 82. 8. A small amount of wax is added in the mandibular posterior region and the record is reseated. The mandibular teeth are guided into the anterior indentations and the patient is made to close lightly. 9. The record is removed and chilled. If there is difficulty in obtaining an undistorted record, the palatal area can be reinforced with the soft metal sheet. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 85www.indiandentalacademy.com
  • 83. The advantage of this sequential technique is that the CR position is reproduced multiple times as the record is generated. The heat-retaining Aluwax is soft and distorts easily. Therefore, if the patient is not guided into exactly the same position, this problem will become readily apparent. Once the completed record has been obtained, the same arcing motion is reproduced four times, confirming that the CR position has been accurately captured. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 86www.indiandentalacademy.com
  • 84. Other alternatives include using elastomeric material, a gauze mesh with zinc oxide-eugenol occlusal registration paste, impression plaster or autopolymerizing resin as the recording medium. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 87www.indiandentalacademy.com
  • 86. When there are insufficient teeth to provide bilateral stability, obtaining a CR record as described may not be possible. As a result, acrylic resin record bases must be fabricated. To avoid errors caused by soft tissue displacement, which prevents accurate transfer of rigid materials from one set of casts to another, these bases should be made on the casts that are to be articulated. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 89www.indiandentalacademy.com
  • 88. Maxillary Cast:  The maxillary cast is seated in the indentations on the facebow fork after the facebow is attached to the articulator. Wedges or specially designed braces can be used to support the weight of the cast and to prevent the fork from flexing or moving. After it has been scored and wetted, the cast is attached to the mounting ring of the articulator with a low expansion plaster. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 91www.indiandentalacademy.com
  • 90. Mandiblular Cast:  To relate the mandibular cast properly to the maxillary cast, the incisal guide pin should be lowered sufficiently to compensate for the thickness of the centric relation record.  The articulator is inverted, and the record is seated on the maxillary cast. The mandibular cast is then carefully seated in the record, and each cast is checked for stability. The maxillary and mandibular casts can be luted together with metal rods, or pieces of wooden tongue blade, and sticky wax. The mandibular member of the articulator is closed into mounting plaster; the condylar balls should be fully seated in the corresponding fossae.  The articulator should be held until the plaster has reached its initial set. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 93www.indiandentalacademy.com
  • 92. Arbitrary Values: Based on clinical investigations, certain generally applicable average anatomic values have evolved for condylar inclination, immediate and progressive sideshift. These values have been described relative to the Frankfort horizontal plane and the midsagittal plane. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 95www.indiandentalacademy.com
  • 93. When arbitrary values are used to adjust posterior articulator controls, the actual instrument settings will vary from one manufacturer to another. However, depending on the degree of adjustability of the articulator, using arbitrary values is not necessarily less accurate than alternative techniques. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 96www.indiandentalacademy.com
  • 95. Eccentric interocclusal records have been recommended for setting the posterior controls of a semiadjustable articulator. These consist of wax or another recording material interposed between the maxillary and mandibular arches; they record the position of the condyles in eccentric mandibular positions. Static positional records are made in translated jaw positions: a protrusive record and two lateral records. The protrusive record can be used to adjust both condylar inclinations on the articulator, and the lateral records are used to adjust the side shift on semiadjustable articulators. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 98www.indiandentalacademy.com
  • 96. An articulator set by an eccentric record is accurate in only two positions: at CR and at the position recorded by the record. This occurs because the path taken between these may differ significantly on the articulator from what is actually performed by the mandible. A semiadjustable instrument may have a protrusive and a sideshift path that are straight lines, whereas the true paths will invariably be curved. In an attempt to minimize errors, many contemporary semiadjustable articulators come with curved fossae. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 99www.indiandentalacademy.com
  • 97. 1. Practice the three excursive positions with the patient until they can be reproduced. The patient can be guided into an anterior end-to- end position and left and right lateral positions where the canines are end-to-end when viewed from the front. 2. Wax record is adapted to the maxillary arch and the patient is guided into a protrusive position. The patient is made to close to form indentations in the recording medium. Technique to Record the Eccentric Relation Records: Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 100www.indiandentalacademy.com
  • 99. 3. For the lateral records, additional wax is added to one posterior quadrant of the wax record to compensate for the additional space on the patient's nonworking side. 4. This is adapted to the patient's maxillary arch and the patient's mandible is guided into an excursive position, again verifying that the canines are end to end. 5. Repeat this step for the other lateral excursion. 6. Each record is marked to facilitate its identification when using it to adjust the posterior articulator controls. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 102www.indiandentalacademy.com
  • 100. A simplified pantograph measures only certain components of mandibular movement thought to be of greatest clinical significance, usually the condylar inclinations and mandibular sideshift. This device can be quickly assembled. Numerical values are measured directly from the recordings and are used to set a semiadjustable articulator. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 103www.indiandentalacademy.com
  • 101. Simplified pantographs may reveal an excessively shallow condylar inclination or an exaggerated mandibular sideshift. If either of these conditions are identified, restoration of the posterior teeth is likely to be complex, and the use of a fully adjustable articulator is recommended. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 104www.indiandentalacademy.com
  • 102.  Fully adjustable articulators are usually programmed on the basis of a pantographic recording.  Jaw movements are registered by directional tracings on recording plates. The plates are rigidly attached to one jaw, and the recording styli are attached to the other.  A total of six plates are needed to achieve a precise movement record of the mandible. Left and right lateral border, and protrusive tracings are made on each plate. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 105www.indiandentalacademy.com
  • 104.  The pantograph is then attached to the articulator, and the controls are adjusted and modified until the instrument reproduces the movements of the styli on the tracings. A simpler, though less accurate, procedure is to measure the tracings directly and adjust the condylar controls without transferring the recordings. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 107www.indiandentalacademy.com
  • 105.  The electronic pantograph is designed to record and measure functional and border movements.  It consists of upper and lower bows that record and measure mandibular movements and has been shown to provide valid and reliable measures of condylar determinants. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 108www.indiandentalacademy.com
  • 106. 109 Electronic Registration with CADIAX COMPACT® www.indiandentalacademy.com
  • 107. Another approach to reproducing posterior condylar controls is to cut or mould a three-dimensional recording of the jaw movements. This stereogram is then used to form custom-shaped fossae for the condylar heads. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 110www.indiandentalacademy.com
  • 108. Border movements of the mandible are governed by tooth contacts and by the shape of the left and right temporomandibular joints. In patients with normal jaw relationships, the vertical and horizontal overlap of anterior teeth and the lingual concavities of the maxillary incisors are highly significant during protrusive movements. In lateral excursions, the tooth contacts normally existing between the canines are usually dominant, although the posterior teeth may also be involved. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 111www.indiandentalacademy.com
  • 109. Restorative procedures that change the shape of the anterior teeth can have a profound effect on excursive tooth contacts. For this reason, when preparation of anterior teeth is contemplated, the exact nature of the anterior contacts should be transferred to the articulator, where it can be studied before these teeth are prepared. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 112www.indiandentalacademy.com
  • 110. Most articulator manufacturers supply a mechanical anterior guidance (incisal guidance) table. Such tables can be pivoted anteriorly and posteriorly, to simulate protrusive guidance, and they have lateral wings that can be adjusted to approximate lateral guidance. However, the sensitivity of these adjustments is insufficient for successfully transferring the existing lingual contours of natural teeth to newly fabricated restorations. Therefore, the principal use for these mechanical tables is in the fabrication of complete dentures and occlusal devices. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 113www.indiandentalacademy.com
  • 111. This simple device is used for accurately transferring to an articulator the contacts of anterior teeth when determining their influence on border movements of the mandible. Acrylic resin is used to record this information, even after the natural lingual contours of the teeth have been altered during preparation for complete coverage restorations. Stephen F. Rosensteil, Martin F. Land, Junheo Fujimoto. Contemporary Fixed Prosthodontics, fourth edition. 114www.indiandentalacademy.com
  • 112. 1. Stephen F. Rosensteil, Martin F. Land, Junhei Fujimoto. Contemporary Fixed Prosthodontics, Fourth Edition. 2. Herbert T. Shillingburg, Jr., Sumiya Hobo, Lowell D. Whitsett, Richard Jacobi, Susan E. Brackett. Fundamentals of Fixed Prosthodontics, Third Edition. 3. Peter E. Dawson. Functional Occlusion: From TMJ to Smile Design. 4. Fattore et al. Clinical evaluation of the accuracy of the interoccusal recording materials. J Prosthet Dent 1984;51:152-157. 115www.indiandentalacademy.com
  • 113. 116 For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

Notes de l'éditeur

  1. An advantage of the arcon design is that the condylar inclination of the mechanical fossae is at a fixed angle to the maxillary occlusal plane. With the nonarcon design, the angle changes as the articulator is opened, which can lead to errors when a protrusive record is being used to program the articulator.