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The Facebow
Definition: - A caliper-like instrument used to record the spatial relationships of the Maxillary Arch to the same anatomic reference points and then transfer this relationship to an articulator Purpose: - The facebow orients the Maxillary Cast to the rotational axis in 3 Planes - It positions the Maxillary Anterior Teeth to the Frontal Plane - It provides a reproducible mounting position for subsequent Maxillary Casts - It allows the same path of opening and closure as in the mouth 3 Reference Points Used: - Arbitrary Hinge Axis o 1) Right o 2) Left An Arbitrary Hinge Axis is the axis passing through each of the Mandibular Condyles This is ~8mm under the soft tissue in front of the Tragus of the Ear This is also known as BERGSTROMs Point - Orbitale o This is the Infraorbital Notch Types of Facebows: Kinematic o This type of facebow locates the TRUE physiological axis of rotationthe Terminal Hinge Axis o This is the most accurate type of facebow, but it is very time-consuming
Arbitrary o This type of facebow locates an AREA near the axis by using anatomical landmarksthis is the type we use!
Dental Articulators
Definition: - A mechanical device to which the Mandibular and Maxillary Casts are attached and which simulates some jaw positions and movements Articulator Classifications: - 3 Basic Classifications: 1) Simple/Non-Adjustable 2) Semi-Adjustable 3) Fully-Adjustable -
LIKE OURS!!
Further Classification: o ARCON The Condylar Element is on the LOWER Member The guiding mechanism is on the Upper Member This is LIKE OURS! o NON-ARCON The Condylar Element is on the UPPER Member The guiding mechanism is on the Lower Member Non-Arcons CANNOT ACCEPT Lateral Records They ONLY use Protrusive Record
Semi-Adjustable Articulators
Type of Adjustments Allowed: Condylar Inclination / Angle Bennett Angle Anterior Guidance Condylar Guidance Angle: - The angle at which the Condyle moves away from a horizontal reference plane - BOTH Lateral & Protrusive Records are accepted on our Semi-Adjustable o The difference between these two records = FISHERS ANGLE This is generally 5 10 PROTRUSIVE Movement: o When a patient makes a posterior movement, the R & L Condyles move down the posterior slopes of the R & L Articular Eminences o This will measure: R & L Condylar Guidance Angles -& The Angle at which the Condyle moves away from a HORIZONTAL Reference Plane LATERAL Movement o The angle for Lateral Movement is generally LARGER than Protrusive Records o When a patient makes a Lateral Excursive movement: The WORKING Condyle Rotates The NON-WORKING Condyle moves downward, forward, & medially o We record the movement of the NON-WORKING Condyle o This will measure: Bennett Angle of the NWS This is the angle at which the NWS Condyle moves away from the Sagittal Reference Plane Condylar Guidance of the NWS This is the angel at which the NWS Condyle moves away from the Horizontal Reference Plane o To program RIGHT Condylar Guidance Record Left Lateral Movement o To program LEFT Condylar Guidance Record Right Lateral Movement
Bennett Angle: - The angle at which the NWS Condyle moves away from the sagittal reference plane - This is programmed by the LATERAL Movement Record L = H/8 + 12 o L= Bennett Angle o H= Condylar Angle (Lateral Record)
Anterior Guidance: - This customizes the Incisal Guidance - This is an occlusal philosophy in excursive movement stating: o Anterior Teeth (canines, laterals, centrals) should disclude the posterior teeth in excursive movements
Selective Grinding
Selective Grinding is a procedure by which the occlusal surfaces of the teeth are precisely altered to improve the overall contact pattern and establish a stable occlusion fulfilling treatment goals This procedure is IRREVERSIBLE The Maxillary Canine sometimes contact Mandibular 1st Premolars during Protrusive Movementthis is OKAY and does not require grinding AVOID Grinding Functional Cusps, if possible Grind Away IF: o Working-Side Interfering Contacts Eliminate these interferences by grinding NON-Functional Cusps o Eliminate any Balancing Interfering Contacts
Occlusal Interferences
This is an unwanted or- premature interocclusal contact Types of Interferences: o Centric o Working Side o Non-Working Side o Protrusive
1) Centric Interferences - This is a premature contact that occurs when condyles are manipulated into Centric Relation (CR) - Only adjust this type of occlusion when TRAUMA results from anterior teeth hitting one another forcefully o Characterized by wear of anterior teeth and mobility of 1+ tooth - Most of us live with Centric Interferences and are fine 2) Working Side Interferences - This is NOT Group Functionits Working Side Interference - This is the SAME as Laterotrusive Interference Characterized By: - Contact between the Maxillary and Mandibular POSTERIOR Teeth on the Working Side as the patient makes a Lateral Movement - These contacts may be heavy enough to disclude the anterior teeth 3) Non-Working Side Interferences - These are the MOST DESTRUCTIVE of ALL Interferences o They change the Class III Lever System of the Mandible, placing stress on the TMJ joints Characterized By: - Contact between the Maxillary and Mandibular Teeth on the Non-Working Side as the patient makes a Lateral Movement
How Far DOWNWARD & FORWARD the Condyle moves gives us the: Condylar Guidance Angle How far MEDIALLY the Condyle moves gives us the: Bennett Angle Right Lateral Records program Left Condylar Settings Left Lateral Records program Right Condylar Settings Angles Class I - This is when the ML Cusp of the Maxillary 1st Molar occludes in the Central Fossa area of the Mandibular 1st Molar - The DB Cusp of the Mandibular 1st Molar occludes in the Central Fossa of the Maxillary 1st Molar