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Interocclusal registration. Active bitecheck Interocclusal registrationhabitual occulsioncentric condyle position. on the basis of new insights into the anatomy and function of the TMJ joint. . Interocclusal Registration in Habitual Occlusion. ? manual positioning
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1. Interocclusal Registration ??? ???
???
2. Interocclusal registration Active bitecheck
Interocclusal registration
habitual occulsion
centric condyle position
3. Interocclusal Registration in Habitual Occlusion ? manual positioning
in maximum intercuspation
maximum multiple-point contact? ???
??? cast? ??
centric relation? lost? ??, arbitrary positioning
method?? non-occlusion? correct? ? ??
4. Interocclusal Registration in Habitual Occlusion habitual occlusion? centric relation? ???? ?? hardening registration material ??
impression plaster
impression stone
polymerized registration silicone
registration ?, fine burr? ridge?? ??
allow correct matchup of the casts around the
fissures
5. Interocclusal Registration in Centric Condyle Position Electronic recording techniques
intraoral gothic arc registration
classic centric records
6. Electronic recording techniques opto-electronic and ultrasonic technology
greater time and material expense
in dynamic occlusion
?? ?? function
projection error ?? ??
temporal dimension ??
in static occlusion
display function? technique? ?? ??? ??
? not assumed a practical role in interocclusal
registration in the centric condyle position
7. Intraoral gothic arc registration technique in the field of total prosthesis and partial prosthesis with considerably reduced dentition
8. Classic/traditional centric records based on neuramuscular self-centering of the condyles in relaxed patients
first step is patient relaxation
all tooth contacts must be
suspended temporarily
dental reflex arc? ??
neuromuscular reflex ?? ??
ant. guidance? ??, posterior
structure? ?? ??? ??
9. Disagreement on
suitable registration material
design of the anterior jig
necessity supportive manipulative measures during the self-centering process
patient position
10. supportive manipulative measures during the self-centering process forced guidance
based on radiographic image
only provide information on
the lateral joint gap
maximum posterior position
? ???? ??? registration? ?? ? ??
current theory
more anterior position is based on histologic data
revealing variations in the quality and quantity of
cartilaginous structures in the joint region
11. supportive manipulative measures during the self-centering process bimanual manipulation by DAWSON
???? pressure X
? condyle? anterior-cranial,
centered position? ??
?? physiologic condyle position
? ??? ??
? ???? ??? hinge axis?
??? ?? undisturbed rotation
? ????? ??
12. Patient position Supine registration position
? ???? muscular relaxation? ?? ????
dysfunctional symptom? ?? ?? ???? ???
?? ?? masticatory organ? active?? ??
upright seated position
???? ??(??? ????)? ? ??? ??? ???
? ???? occlusal dental restoration? ??
normal chair ?? standing position?? ??
13. Patient position ?? ???? ? position? ?? ?? ??? ?? ?? ?? ???
?? supine position?? registration
upright position?? recheck
? position ??? reproducible discrepancy? ???
upright position? ???? ???? retrusive space?
open
14. Anterior jig inclined plane or horizontal
plane? ?? ?? contact
?? ???? ?????
??? guide ???? ??
position? ?? ????,
???? ??? ??? ???
??? ???? ?????? ?? ???
15. Material
impression compound
light-curing composite plastics
16. cut back around the palatal impression
to form a horizontal plateau
horizontal mobility? ?? ???? ? 1mm
17. Centric interocclusal Record with Curing stone or Plastic plastic registration material
autopolymerizing plastic? ?? ?? ? discomfort
retarded reaction characteristic
polymerization shrinkage
polyether-based product
?? cast? reposition? ??? ??? ?? X
Modern addition cross-linked registration silicone
thixotropic characteristic ??? stability
registration ? ?? ???? ?? ??? 95%
18. Centridur(Plaster)
21. Centric Interocclusal Record with Base plate wax
22. anterior jig? ?? ????, ?? ???? four separate position? contact?? ?? wax? ??? ??? ??
space? ??? alluwax? ??
space? ????
wax plate? ?? ???
ang. jig? ???
wax plate? underside? registration material
Aluwax lower melting point
?? ? ??, ??? ??
Super Bite or Temp Bond
23. Problems related to use of wax low level of mechanical strength
risk of incorrect positioning
lack sufficient storage
minimum thickness? ?? stability ??
thermoplastic character
optimum results? ?? ??? ??? ?? ? ??
24. Centric Interocclusal Record with Metal Foil Template tinfoil carrier template
classic alternative to wax plate registration
high degree of thermal stability
be made thinner
error is reduced proportionately as the record grows thinner
facilitating use in connection with arbitrary hinge axis localization
single registration procedure? ??? ??? adaptation ??
25. ????? procedure? wax plate? ??
two perforation ??
registration material? upper and lower side? ??
actual registration ?? check bite ????
??? ?? ???? vibration test ??
registaratio paste(Super Bite, Temp Bond)? template?
perforation ??? apply
?? ? sudden jerk motion?? ??
lead-like pliablity ??? plate? ???? ??? registration? ?? ?? ? ??
26. Centric Interocclusal Record with Sliding Guide and Leaf Wafer anterior jig Sliding Guiding Inclined Gauge
0.5mm ???? marking? curved plastic wedge
incisor? inclined plane? bite
does not guide the mandible.
condyle find physiologic position in reproducible fashion
27. wax or metal carrier Leaf Wafer
pre-fabricated cardboard template
flexible : metal carrier < Leaf wafer < metal foil
0.15mm : metal foil? ??
0.25mm : elastic shape-retaining memory
bending deformation ??? elastic registration paste ??
28. Procedure
29. Centric Interocclusal Record with Plastic Plate photocuring plate blanks
??, ?? ?? ?? ? ?? ?? ??
arbitrary hinge axis localization? ??? ??? error ??
highly rigid and flat record ?? ??
?? ??
considerable distortion of the plastic plates
30. Procedure
31. ?? ??? record type? ?? time-consuming patient preparation procedure
difficult handling of record and anterior jig
unstable record
?? record? ??? ??? ? ??, ???? incisal pin? presetting X
large amount of registration paste or aluwax
record carrier? registration material? bonding? ??? ??? ??
32. Centric Interocclusal Record with Plastic Plate, Integrated Programmer(jig) and Controlled Bite Opening Angle ??? opening angle? setting? ?? diagnostic cast? skull-based arbitrary facebow? mounting
???? restoration work? skull-based registraton and transfer of maxillary position? ??
restoration ??? ???? condition? ?? condition?? registration plate ?? ??
arbitrary articulator simulation? transferred patient reality? equivalence check ??
33. Transparent self-hardening
reduced shrinkage, distortion on the cast
avoidance of damage to the cast surface
improved patient adaptation
reduction of the opening angle
occlusal stop position predetermined through the transparent plate material
simplified production technique and no light polymerization
34. Forming the blank on the cast incisal opening setting of 3mm
articulator turned over to create tongue room
2 additional supports are attached in the canine and premolar region
36. Detailed adaptation to the morphology of the maxillary cast shrinkage ??? ?? ??? ?? incisal pin? 4mm? setting
plate bottom? canine? terminal molar ??? stop position mark
plate upper side? stop position? adhesive wax apply? ? ???? closed
37. occlusal programmer? ?? incisal pin 5mm? setting
upper side? occlusal jig ??? marking
?? cast? plate? ????? pattern resin apply ? ??? closed
39. Patient fitting session fit of the record template on the patients maxilla
diagnostic impression?? pouring??? ?? ??
occlusal agreement between articulator and patient
incisal contact? ??, molar region? no occulsal contact
Arbitrary hinge axis? actual rotational axis? ???? ??
40. Effects of hinge axis deviation by Zuckermann location of the hinge axis
amount of vertical build up in the incisal area
variation in distance between the incisors and the hinge axis
41. Realization of centric interocclusal registration aluwax application
on the underside
of the plate
42. Realization of centric interocclusal registration
43. Advantages stable individually fitted plastic plate, despite minimum thickness
plateau-shaped anterior jig? neuromuscular self-centering? ???? ?
plate? ?? opening angle? ?? arbitrary hinge axis localization? effect? ??
adhesive wax? plate? ? ?? good stability
44. Advantages wax record? ??? chair time? ??
lateral tab? lack of separate jig? handling? ??
registaration material? ???? ?? potential error factor? ??
??? opening angle? incisal pin? ???? ?? ?? ?? ??