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Semelhante a Transferring records on articulator and programming
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Transferring records on articulator and programming
- 1. Transferring records on articulator and programming Prepared by: Dr Amal Guided by: Dr Shanoj Approved by: Dr Radhi, Dr Juraise
- 2. Introduction • An accurate determination, recording and transfer of jaw relation records from patient to the articulator is essential for the dental restoration function, facial appearance and maintenance of patient's oral health. Das R. Clinical Steps to Record Facebow. J Prosthodont Dent Mater 2021;2(1): 68-69.
- 3. Types of occlusal records • Static record • Interocclusal record • Dynamic record Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 4. Static record Das R. Clinical Steps to Record Facebow. J Prosthodont Dent Mater 2021;2(1): 68-69. Facebow record The registration obtained by means of a facebow- GPT 9
- 5. Facebow record Impression compound Green stick compound Polyvinyl siloxane Bite registration materials Extra hard wax Banerji, S., & Mehta, S. B. (2017). Facebows: The Facebow Recording. Practical Procedures in Aesthetic Dentistry, 51–54.
- 6. Facebow transfer Das R. Clinical Steps to Record Facebow. J Prosthodont Dent Mater 2021;2(1): 68-69. The process of transferring the facebow record of the spatial relationship of the maxillary arch and related anatomic reference point or points to an articulator- GPT 9
- 7. Direct and indirect transfer Mishra A, Palaskar J. Effect of direct and indirect face-bow transfer on the horizontal condylar guidance values: A pilot study. J Dent Allied Sci 2014;3:8-12.
- 8. Effect of Direct and Indirect Face-Bow Transfer on the Horizontal Condylar Guidance Values: A Pilot Study CONCLUSION: Mean HCG values obtained from indirect face-bow transfers are significantly more than those obtained from direct transfers and are also closer to the values obtained from the lateral cephalograms. Mishra A, Palaskar J. Effect of direct and indirect face-bow transfer on the horizontal condylar guidance values: A pilot study. J Dent Allied Sci 2014;3:8-12.
- 9. Interocclusal record 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 other- GPT 9 Centric relation record Maximum intercuspation record Eccentric records Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 10. Materials used Alginate impression material Zinc oxide– eugenol paste Hard wax Metallized wax Elastomers T-scan Acrylic resin Impression plaster Sonawane A, Sathe S. Interocclusal records: A review. J Datta Meghe Inst Med Sci Univ 2020;15:709-14.
- 11. Centric relation record Cotton wool roll between the teeth Spatula or mirror handle between the teeth Leaf gauge Lucia Jig/central bearing apparatus Stabilisation splint Ladder for deprogramming the patient Bi- manual manipulation to attain CR position Cowan C. Occlusal records in the production of mounted study casts for tooth wear planning and management. Br Dent J. 2023 Mar;234(6):385-392.
- 12. Cowan C. Occlusal records in the production of mounted study casts for tooth wear planning and management. Br Dent J. 2023 Mar;234(6):385-392. Reinforced Aluwax record Anterior deprogramming device with elastomers CR for completely edentulous patient CR for partially edentulous patient
- 13. Centric record transfer The arrow (a) shows the incisal pin set at +3 mm on Denar articulator Centric record transfer on Whipmix articulator Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 14. Hanau H2 manual
- 15. Verification of centric record Verification of articulator mounting Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 16. Denar Centri- Check marking system Rosenstiel S, Land M, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Missouri: Mosby, 2006.
- 17. Maximum intercuspation record Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 18. Eccentric records 1 protrusive record 2 lateral records Rosenstiel S, Land M, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Missouri: Mosby, 2006.
- 19. Eccentric record for dentate patients Rosenstiel S, Land M, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Missouri: Mosby, 2006.
- 20. Interocclusal record for completely edentulous patients Rosenstiel S, Land M, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Missouri: Mosby, 2006.
- 21. Dynamic record Pantographic tracing Stereographic tracing Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 22. Pantographic tracing Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 23. A comparison of articulator settings obtained by using an electronic pantograph and lateral interocclusal recordings. Price RB, Bannerman RA. A comparison of articulator settings obtained by using an electronic pantograph and lateral interocclusal recordings. J Prosthet Dent 1988 Aug;60(2): 159-164. Conclusion: Articulator (Denar D5A) settings obtained from the electronic pantograph were more consistent than those obtained from interocclusal records
- 24. Stereographic tracing Stereographic TMJ system. The stereographic articulator allows customized condylar fossa moldings to be prepared individually for each patient. Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128.
- 26. Whipmix 2200 series • Casts mounted on one of these articulators can be transferred accurately to another instrument of the same type that has been set to the same parameters. • There are many advantages to this feature, including the ability to send casts to the laboratory without sending the instrument. Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 27. Facebow record transfer Immediate lateral translation guide is moved to zero The transfer base is placed on the articulator Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 28. The transfer base is placed on the articulator Maxillary cast seated in the bite fork registration Mandibular cast mounted with centric record Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 29. Zeroing of articulator The condylar inclination is set at 0 degrees The lateral translation controls are set at maximum opening Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 30. Programming of articulator With the right lateral interocclusal record in place, the left condyle does not contact the condylar guide. The condylar inclination is increased until the condyle contacts the superior wall of the guide. Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3. Required: • Right and left lateral interocclusal record
- 31. The medial wall of the guide is moved (a) until it contacts the condyle (b) Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 32. Denar articulator Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3. Protrusive condylar path inclination Calibrated in 5 degrees Immediate Side Shift Adjustment- 0.2 mm Progressive Side Shift Adjustment (5-15 degrees)
- 33. Facebow record transfer Immediate side shift- 0˚ Progressive side shift- 5˚ Protrusive condylar path- 30˚ Incisal pin- 0 Zeroing of articulator Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 34. Programming of articulator Required: • Right and left lateral interocclusal record • Protrusive record SIMULATING THE ORBITING CONDYLAR PATH • Progressive side shift- 6˚ • Loosen protrusive and immediate side shift adjustment locksrews • Protrusive condylar path- 0˚ • Use lateral record and program SIMULATING THE PROTRUSIVE CONDYLAR PATHS • Protrusive condylar path set at 0˚ • Use protrusive record and program Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 35. LATERAL RECORD SIMULATES ORBITING CONDYLAR PATH Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3. Balancing inclines of posterior teeth on the orbiting side
- 36. PROTRUSIVE RECORD SIMULATES PROTRUSIVE CONDYLAR PATH Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3. Protrusive contacts of posterior teeth – the mesial aspects of mandibular cusps and the distal aspects of maxillary cusps.
- 37. Hanau Wide-Vue articulator Condylar guidance Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 38. Zeroing of articulator 1. Condylar guidance- 30˚ 2. Bennett angle- 30˚ 3. Incisal pin alignment to mid- line calibration 4. Incisal guide- 0˚ 5. Slide platform to align zero indicating line 6. Tighten the centric locks Zeroing of articulator Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 39. Facebow record transfer Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 40. Programming of articulator WITH PROTRUSIVE RECORD Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 41. HANAU Formula L = H/8 + 12 “H” is the Horizontal Condylar (Protrusive) Inclination and “L” is the calculated lateral Condylar Guidance (Bennett Angle). Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 42. Programming of articulator WITH LATERAL RECORD Brass to brass contact The left record is used for the right condylar inclination and the right record for the left condylar inclination. Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 43. CONCLUSION: Making a lateral interocclusal record and then programming the articulator is a more reliable method. Shetty R, Shetty S, Shetty N, et al. Comparative evaluation of lateral condylar guidance angle measured using Hanau’s Formula & lateral interocclusal records. J Evolution Med Dent Sci 2021;10(26):1917- 1920,
- 44. Aluwax, poly vinyl siloxane, poly ether as interocclusal recording materials Conclusion: The study concluded that the protrusive condylar guidance angles obtained by panoramic radiograph can be used in programming the semi- adjustable articulator and among the materials polyether gave the highest Condylar Guidance values with less variability and wax gave lowest values with greater variation. Keerthana SR, Mohammed HS, Hariprasad A, Anand M, Ayesha S. Comparative evaluation of condylar guidance obtained by three different interocclusal recording materials in a semi-adjustable articulator and digital panoramic radiographic images in dentate patients: An in vivo study. J Indian Prosthodont Soc 2021;21:397-404.
- 45. Hanau H2 articulator 1. Condylar guidance- 70˚ 2. Bennett angle- 0˚ 3. Incisal pin alignment to mid- line calibration of upper member 4. Incisal guide- 0˚ 5. Tighten the centric locks Zeroing of articulator Hanau H2 manual
- 47. Stratos 300 This appliance enables individual setting of the Bennett angle from 0° to 30° This screw enables a centric shift of up to 4 mm in a protrusive direction The ISS screw of the Stratos 300 enables an immediate side-shift of 0 – 1.5 mm. This component enables a stable inclined position of the articulator Stratos manual
- 48. Stratos manual
- 50. Programming of articulator CADIAX Compact System Stratos with the Zebris JMA System Condylocomp LR3 System Stratos manual
- 51. Rosenstiel S, Land M, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Missouri: Mosby, 2006.
- 52. Recent advances • Virtual articulators • Jaw motion sensors • Virtual facebows Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry
- 53. Conclusion • To properly evaluate a patient’s occlusion, it is mandatory that diagnostic casts be placed in an articulator in approximately the same relationship to the temporomandibular joints (TMJs) as that which exists in the patient. This is achieved with the help of interocclusal records and programming of articulators Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 54. References • Das R. Clinical Steps to Record Facebow. J Prosthodont Dent Mater 2021;2(1): 68-69. • Jagger, R., & Klineberg, I. (2016). Articulators, Transfer Records, and Study Casts. Functional Occlusion in Restorative Dentistry and Prosthodontics, 117–128. • Banerji, S., & Mehta, S. B. (2017). Facebows: The Facebow Recording. Practical Procedures in Aesthetic Dentistry, 51–54. • Mishra A, Palaskar J. Effect of direct and indirect face-bow transfer on the horizontal condylar guidance values: A pilot study. J Dent Allied Sci 2014;3:8-12. • Sonawane A, Sathe S. Interocclusal records: A review. J Datta Meghe Inst Med Sci Univ 2020;15:709-14. • Cowan C. Occlusal records in the production of mounted study casts for tooth wear planning and management. Br Dent J. 2023 Mar;234(6):385-392. • Rosenstiel S, Land M, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Missouri: Mosby, 2006. • Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
- 55. Cross references • Price RB, Bannerman RA. A comparison of articulator settings obtained by using an electronic pantograph and lateral interocclusal recordings. J Prosthet Dent 1988 Aug;60(2): 159-164. • Shetty R, Shetty S, Shetty N, et al. Comparative evaluation of lateral condylar guidance angle measured using Hanau’s Formula & lateral interocclusal records. J Evolution Med Dent Sci 2021;10(26):1917- 1920. • Keerthana SR, Mohammed HS, Hariprasad A, Anand M, Ayesha S. Comparative evaluation of condylar guidance obtained by three different interocclusal recording materials in a semi-adjustable articulator and digital panoramic radiographic images in dentate patients: An in vivo study. J Indian Prosthodont Soc 2021;21:397-404. • Chun JH, Pae A, Kim SH. Polymerization shrinkage strain of interocclusal recording materials. Dent Mater 2009;25:115-20.
- 56. Cross references • Chun JH, Pae A, Kim SH. Polymerization shrinkage strain of interocclusal recording materials. Dent Mater 2009;25:115-20. • Tripodakis AP, Vergos VK, Tsoutsos AG. Evaluation of accuracy of interocclusal records in relation to two recording techniques. J Prosthet Dent 1997;77:141-6. • Combe EC. Notes on Dental Materials. 5th ed. Churchill Livingstone; 1999. • Savabi O, Nejatidanesh F. Interocclusal record for fixed implant-supported prosthesis. J Prosthet Dent 2004;92:602-3. • Muller J, Gotz G, Horz W, Kraft E. Study of the accuracy of different recording materials. J Prosthet Dent 1990;63:41-6. • Nandal S, Shekhawat H, Ghalaut P. Inter-occlusal record materials used in prosthodontic rehabilitations. Int J Enhanced Res Med Dent Care 2014;1:8-12. • Sato Y, Hosokawa R, Tsuga K, Kubo T. Creating a vertical stop for interocclusal records. J Prosthet Dent 2000;83:582-5.
- 57. Thank you
Notas do Editor
- An accurate determination, recording and transfer of jaw relation records from patients to the articulator is essential for the dental restoration function, facial appearance and maintenance of patient's oral health.1-3 During prosthodontic treatment, it is important for both the dentist and the dental technician to construct indirect restorations that are well fitted in patient’s masticatory system in a minimum amount of time and effort.
- Occlusal records are an associated component of restorative dentistry and prosthodontics. They are used to record the jaw movements of the patient. Basically there are three types of records. They are:
- A static record provides the position of the maxilla in relation to the hinge axis, or rather the ideal axis that joins the two condyles of the mandible. In dentate patients, the facebow fork is used to record the maxillary occlusal surfaces using a variety of different media.
- These materials should offer dimensional stability, a suitable working time and ease of use. Typically applied recording materials include impression compound, greenstick, polyvinyl siloxane (PVS) biteregistration materials (such as Stonebite, Dreve Dentamid GmbH, Unna, Germany) or extra-hard wax, such as Moyco beauty wax (Integra Miltex, Rietheim-Weiltheim, Germany).
- The face-bow has been regarded as an indispensable accessory of semi-adjustable articulators for transferring the maxillary cast. When the face-bow is used, maxillary cast is mounted in relation to the temporomandibular joints and in close proximity to the condylar hinge axis.
- This record is used to articulate casts for diagnosis and treatment planning. The CR is recorded with the teeth slightly apart in order to avoid any deflection by tooth contacts. RCP or CR is also used for complex or multiple restorations to restore an occlusal scheme and for complete denture construction. The first stage in recording a CRR is to ensure that the clinician is able to reproducibly rotate the patient's mandible with the condyles fully seated. An accurate CRR can be time-consuming to achieve depending on the degree of muscle guarding the patient has. It is best to test the degree of muscle guarding by gently manipulating the mandible up and down If muscle guarding is present, then the clinician should seek to achieve muscle relaxation, or deprograming, before proceeding to record the CRR. There is a variety of different techniques that can be used to achieve this and they are best thought of like a ladder of increasing complexity (Box 1). The clinician should only ascend to the next rung as each of the simpler techniques has been exhausted and failed to deprogramme the muscles successfully. The most straightforward technique that can be successful in achieving muscle relaxation is to simply hold the teeth apart for 2-3 minutes. This is easily achieved using cotton wool rolls
- When there are insuffificient 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
- The arrow (a) shows the incisal pin set at +3 mm to account for the thickness of the wax transfer record.
- Invert the Articulator and place the mandibular occlusal rim and cast onto the maxillary rim without the aid of a centric relation record (Figure 9). Measure and note the “X” dimension. The centric relation record is then interposed and luted to the maxillary and mandibular occlusal rims. The maxillary base is securely seated an luted to the maxillary cast and the mandibular base is seated and luted to the mandibular cast Adjust the Incisal Pin so that the “X” dimension is the same as that previously determined when the centric relation record was not in place (Figure 10). This measurement assures a parallelism of the Upper and Lower Members subsequent to the cast mounting and the removal of the centric relation record.
- Verification is desirable to ensure that the articulated dental casts are an accurate representation of the intraoral dental relationships. This is particularly important if occlusal analysis of casts is required and/or a diagnostic wax-up for treatment planning. A, Occlusal surface of the articulated maxillary cast. B, Kerr Indicator Wax strips placed on the posterior tooth segments of the maxillary cast; the strips have been used intraorally to record the initial tooth contact positions of the jaw in the retruded (guided) position. The first contacts are evident as perforations in the wax and a soft pencil is used to mark the cast through these initial contacts. The articulator is then closed onto a strip of red plastic articulating ribbon and placed along each posterior segment
- The Denar Centri-Check marking system. The casts are positioned in the same relationship as on the articulator, but the condylar elements are replaced by styli. Each stylus marks graph paper attached to the maxillary half of the articulator. Successive centric relation records can be compared by examining these marks. The Centri-Check can be used with the Denar® Combi, Automark, Anamark PLUS and Mark II PLUS Articulators or other Denar articulators with condyle ball channels.
- Though diagnostic mountings are done with the condyles in a centric relation position, casts that are to be used for the fabrication of restorations for a small portion of the occlusion are attached to the articulator in a position of maximal intercuspation. Mounting them in a centric relation position could result in a restoration with a built-in interference.
- These records are used to set the condylar angles of the articulator.
- A pantograph is a device used in conjunction with a matched, fully adjustable articulator that traces border paths of jaw movement in three planes. These tracings in three axes are used to set the articulator condylar guidance mechanisms. Six tracing plates are attached to the mandibular clutch. Six tracing pins are attached to the maxillary clutch. When the mandible is guided along the border movements, the individual pins capture both horizontal and vertical tracings on the plates. The pantograph is then attached to the articulator, and the controls are adjusted and modified until the instrument can faithfully reproduce the movements of the styli on the tracings The traces allow the determination of CR (in addition to a Gothic arch record) and degree and timing of condylar side shift. In general terms, dental pantography includes mechanical, mechano-electronic, and opto-electronic recording methods. Mechanical pantography, the traditional method, is considered both accurate and reliable.1,21-24 However, clinical procedures necessary to perform mechanical pantography are relatively time consuming and technique sensitive. Additionally, incorporating mechanical pantographic information in an appropriate three-dimensional articulator can prove cumbersome.25,26 Mechano-electronic recorders and opto-electronic recorders have been developed with the goal of improving both recording accuracy and procedural efficiency. These instruments permit easier and quicker recording of mandibular movements, programming the articulator and storing permanent records compared with the traditional pantograph. Mechano-electronic recorders are so named because styli physically move across digital recording plates. Mandibular movement is recorded by the digital contact plates and processed by the software. Values for programming most articulators are then generated by the computer.
- Price et al13 compared articulator settings obtained using lateral interocclusal records with settings obtained from an electronic pantographic recording (Denar Pantronic). They noted that articulator (Denar D5A) settings obtained from the electronic pantograph were more consistent than those obtained from interocclusal records
- These are sometimes referred to as scribing articulators. The posterior and anterior guidance mechanisms of the articulator are customized to exactly reproduce the patient’s jaw movement. The TMJ Articulator is an example. Stereographic articulators accept dynamic, threedimensional, functionally engraved records to set the condylar and anterior guidance elements (Fig 15). These records are registered using intraoral studs that mould auto polymerizing resin placed in receptacles. On curing, the condylar inclines and the Bennett shift will be carved on these templates which are then used to program the articulator
- The articulator is prepared to receive the cast. The upper and lower members of the articulator are separated. The immediate lateral translation guide on the front of each condylar guide is moved outward to a setting of zero (Fig 5-17).This will prevent any lateral movement during mounting of casts
- The incisal guide pin is replaced in the upper frame of the articulator with the rounded end down and set at a 2-mm opening.
- The medial pair of clamp thumbscrews on the top or backside of the upper frame of the articulator are loosened slightly. The incisal guide pin is raised so that it will not touch the plastic incisal stop in any position.
- The inclination of the left guide is set by releasing its clamp screw. The guide is rotated inferiorly until the superior wall again touches the condylar element (Fig 5-31). The holding screw is tightened. The right condylar guidance is set by using the record for the left lateral excursion and repeating these steps.
- Mandibular lateral translation is accommodated by releasing the lateral translation clamp screw and sliding the lateral translation guide laterally until it touches the medial surface of the condylar element (Fig 5-32). The clamp screw is retightened.
- To produce restoration by means of checkbite records and/ or the functionally generated path technique. The inclination of the protrusive condylar path can be adjusted by loosening the protrusive adjustment lockscrew. The protrusive condylar path inclination scale is below the protrusive adjustment lockscrew and is calibrated in increments of 5 degrees The medial fossa wall can be displaced straight medially by means of the immediate side shift adjustment. The scale is a Vernier scale calibrated in .2 millimeter increments The angle of inclination of the medial fossa wall to the sagittal plane be adjusted by loosening the progressive side shift adjustment lockscrew and moving the insert from 5 to 15 degrees.
- First remove the maxillary bow from the articulator and confirm that both progressive side shift adjustments are set to the 6˚ settings. establish the character of the orbiting path on the left side of the articulator.
- The rationale for utilizing the diagnostic data obtained from protrusive and lateral checkbite records is as follows When the protrusive inclination of the superior fossa wall is adjusted to the lateral checkbite record, a characteristic of the orbiting condylar path is diagnosed. This characteristic is associated with the balancing inclines of posterior teeth on the orbiting side – the mandibular buccal cusps’ lingual inclines’ mesial aspects and the maxillary lingual cusps’ buccal inclines distal aspects.
- When the protrusive inclination of the superior fossa wall is adjusted to the protrusive checkbite record, the inclination of the patient’s protrusive condylar path is diagnosed. This inclination of the superior fossa wall is associated with the protrusive contacts of posterior teeth – the mesial aspects of mandibular cusps and the distal aspects of maxillary cusps.
- The Condylar Guidances are the control centers of the Articulator and they adjustably assimilate the multiple function of the glenoid fossa. The Condylar Track may be adjustably inclined on the horizontal transverse axis from a “zero” to a plus 60 degree or to a minus 20 degree. These inclinations are termed the protrusive inclination and simulate the patient’s superior wall of the fossa. The Condylar Track may also be adjusted on the vertical axis from a “zero” sagittal to 30˚. This angle is termed the progressive Bennett angle and corresponds to the medial wall of the patient’s fossa. CLOSED CONDYLAR TRACK, Figures 3 and 4: The Condylar Guidance Track rotates in an enclosed housing which stops the Condylar Element, preventing the accidental disengagement of the Upper Member.
- Upon complete set of the mount, the Articulator is placed into an upright position. Carefully cut the tacking at the occlusal surface and remove the centric interocclusal relation record. Loosen the Centric Locks and the Thumbnuts for horizontal inclination of the Condylar Guidances. Raise the Incisal Pin to remove the possibility of mechanical interference with the Incisal Guide. Seat the protrusive interocclusal relation record onto the lower occlusal rim. Carefully guide the Upper Member into protrusion, lightly engaging the upper rim into the imprint of the protrusive relation record. Grasp the upper cast to maintain a tactile feel of the casts at the protrusive record and Rotate the Right and Left Guidances back and forth to accurately seat the upper and lower rims into the protrusive relation record. Observe that the rims seat without rocking in or deforming the record and tighten the Thumbnuts for horizontal inclination. The protrusive relation record is then removed.
- The right protrusive inclination of 38 degrees is divided by 8 and is accepted as 5, to which 12 is added, totaling 17. The right Condylar Guidance is then adjusted to a 17 degree lateral indication at the calibration on the Upper Member and is locked by the Thumbnut. The same method is used for adjustment of the left lateral – dividing the protrusive inclination by 8 and adding 12 – then setting the left Condylar Guidance to the computed angle.
- An alternate method of Condylar Loosen the Centric Locks, the Thumbnuts for condylar inclination and Bennett Angles of both Condylar Guidances. Raise the Incisal Pin to eliminate possible interference with the Incisal Guide. 39. Seat the RIGHT lateral interocclusal record onto the lower occlusal rim, Figure 30. Carefully guide the Upper Member into a right lateral, lightly engaging the upper rim onto the imprint in the seated RIGHT record. Grasp the upper cast to maintain an unstrained and tactile feel of the casts at this RIGHT lateral relation and – Slowly rotate the Left Condylar Guidance back and forth until the upper and lower rims seat into the lateral record. Observe that the rims seat without rocking in or deforming the record and tighten the Thumbnut for this condylar inclination. 40. The lateral of this balancing Condylar Guidance is then slowly rotated from 30 degrees inward until the flat side of the Condylar Element contacts the shoulder on the Condylar Shaft, “brass to brass,” Figure 31. Tighten the Thumbnut to secure this left Bennett Angle.Guidance adjustment utilizing lateral interocclusal relation records is described
- With UTS 3D transfer bow
- For the recording and determination of the individual patient parameters with regard to articulator programming, we recommend using the following electronic TMJ movement measuring systems which support the Stratos articulators.
- Several systems have been developed that use a motion sensor to track mandibular movement (e.g., ARCUSdigma KaVo GmbH, Biberach, Germany). Data are transferred via Bluetooth connection to a computer. Software allows a wide range of parameters to be determined that can be used for the settings for semiadjustable or fully adjustable articulators or for a virtual articulator.