OCCLUSION,

OCCLUSION,
ARTICULATORS, FACEBOW
ARTICULATORS, FACEBOW
Dr Zuryati Ab
Dr Zuryati Ab
-
-
Ghani
Ghani
BDS, Grad Dip
BDS, Grad Dip
Clin
Clin
Dent, FRACDS,
Dent, FRACDS,
D
D
Clin
Clin
Dent (
Dent (
Prosthodontics
Prosthodontics
)
)
11.02.08
11.02.08
CONTENT
CONTENT

INTRODUCTION
INTRODUCTION
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-
OCCLUSION
OCCLUSION

OCCLUSION
OCCLUSION
-
-
DEFINITIONS
DEFINITIONS

POSSELT
POSSELT

S BORDER MOVEMENTS
S BORDER MOVEMENTS

ARTICULATORS +FACEBOW RECORD

ARTICULATORS +FACEBOW RECORD
I NTRODUCTI ON
I NTRODUCTI ON
OCCLUSION
OCCLUSION

Dynamic biological
Dynamic biological
relaitonship
relaitonship
of
of
components of the
components of the
masticatory
masticatory
system
system
that control tooth contacts during
that control tooth contacts during
function and dysfunction
function and dysfunction

It is the integrated action of the jaw

It is the integrated action of the jaw
muscles, TMJ and teeth
muscles, TMJ and teeth
OCCLUSION
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Occlusion
Occlusion

Important to the provision of
Important to the provision of
comprehensive patient care.
comprehensive patient care.

Relevant to all disciplines in dentistry
Relevant to all disciplines in dentistry

Restorative dentistry and
Restorative dentistry and
prosthodontics
prosthodontics
:
:
tooth restoration requires recognition of the
tooth restoration requires recognition of the
importance of
importance of
occlusal
occlusal
form and tooth
form and tooth
contact patterns at an appropriate OVD, for
contact patterns at an appropriate OVD, for
optimizing jaw function
optimizing jaw function

An understanding of the importance of

An understanding of the importance of
the occlusion is paramount for
the occlusion is paramount for
enhancing jaw function, defining lower
enhancing jaw function, defining lower
face height and aesthetic needs, as
face height and aesthetic needs, as
key issues in optimizing oral health.
key issues in optimizing oral health.
OCCLUSION
OCCLUSION
-
-
DEFINITIONS
DEFINITIONS
Contact between cusps,
Contact between cusps,
fossa
fossa
, marginal ridges of
, marginal ridges of
opposing teeth
opposing teeth
Position of the jaw when teeth are in IC
Position of the jaw when teeth are in IC
Contact of teeth with maximum clenching
Contact of teeth with maximum clenching
Intercuspal
Intercuspal
contact
contact
(IC)
(IC)
Intercuspal
Intercuspal
position (ICP)
position (ICP)
Maximum
Maximum
intercuspation
intercuspation
(MI)
(MI)
The tooth contact position when the jaw
The tooth contact position when the jaw
is in centric relation
is in centric relation
CO may or may not be the same tooth
CO may or may not be the same tooth
contact R/S as ICP
contact R/S as ICP
Tooth contact (CO) when the jaw is in
Tooth contact (CO) when the jaw is in
CR may be more
CR may be more
retruded
retruded
than at ICP
than at ICP
Centric occlusion (CO)
Centric occlusion (CO)
The position of the jaw when the
The position of the jaw when the
condyles
condyles
are in a physiologically
are in a physiologically
acceptable guided position for the
acceptable guided position for the
recording of transfer record
recording of transfer record
The contact position of the teeth when
The contact position of the teeth when
the jaw is in RP
the jaw is in RP
Retruded
Retruded
jaw position (RP)
jaw position (RP)
Retruded
Retruded
contact position (RCP)
contact position (RCP)
The
The
maxillomandibular
maxillomandibular
relationship in which
relationship in which
the
the
condyles
condyles
articulate with the thinnest
articulate with the thinnest
avascular
avascular
portion of their respective discs
portion of their respective discs
with the complex in the anterior
with the complex in the anterior
-
-
superior
superior
position against the slopes of the
position against the slopes of the
articular
articular
eminence.
eminence.
This position is independent of tooth contact
This position is independent of tooth contact
Centric relation (CR)
Centric relation (CR)
TMJ
TMJ
-
-
Condyle
Condyle
at CR
at CR
Iven Iven Klineberg Klineberg, Rob , Rob J agger J agger, 2004 , 2004
www.baileydds.com www.baileydds.com
Summary of definitions
Summary of definitions
ICP, CR, RP
IC, CO, RCP
Position of the jaw when an individual is
Position of the jaw when an individual is
sitting or standing upright when relaxed and
sitting or standing upright when relaxed and
alert
alert
A free way space or speaking space is present
A free way space or speaking space is present
The vertical height of lower third of the face
The vertical height of lower third of the face
when teeth contact in ICP
when teeth contact in ICP
Postural jaw position (PJ P)
Postural jaw position (PJ P)
Occlusal
Occlusal
vertical dimension (OVD)
vertical dimension (OVD)
Lateral jaw positions
Lateral jaw positions
The side of the jaw that moves towards midline
The side of the jaw that moves towards midline
The side opposite the chewing side
The side opposite the chewing side
The side of the jaw that moves laterally
The side of the jaw that moves laterally
away from the midline
away from the midline
Chewing side (where the chewing occurs)
Chewing side (where the chewing occurs)

Canine guidance
Canine guidance

Group function
Group function
Non working/balancing
Non working/balancing
Working side
Working side
Bennet
Bennet
movement
movement
: The bodily lateral
: The bodily lateral
movement of the mandible resulting from
movement of the mandible resulting from
the movements of the
the movements of the
condyles
condyles
along the
along the
lateral inclines along the
lateral inclines along the
mandibular
mandibular
fossa
fossa
Bennet
Bennet
Angle
Angle
: Angle formed by movement of
: Angle formed by movement of
balancing
balancing
condyle
condyle
with
with
sagittal
sagittal
plane during
plane during
lateral jaw movement
lateral jaw movement
POSSELT
POSSELT

S BORDER
S BORDER
MOVEMENT
MOVEMENT
Posselt
Posselt
(1952) described the full range
(1952) described the full range
of jaw movement in 3 planes by
of jaw movement in 3 planes by
tracing the path of lower incisor teeth
tracing the path of lower incisor teeth
as the jaw is guided through the
as the jaw is guided through the
border paths
border paths
POSSELT
POSSELT

S BORDER MOVEMENTS
S BORDER MOVEMENTS
Sagittal view
Frontal view
Horizontal view
Iven Iven Klineberg Klineberg, Rob , Rob J agger J agger, 2004 , 2004
ARTICULATORS
ARTICULATORS
A hinged mechanical device to which
A hinged mechanical device to which
maxillary and mandible casts are
maxillary and mandible casts are
attached,
attached,
to reproduce relationship of
to reproduce relationship of
patient
patient

s maxilla to mandible
s maxilla to mandible
in ICP
in ICP
and for lateral and protrusive jaw
and for lateral and protrusive jaw
movements
movements
Uses of articulators
Uses of articulators

Study the way teeth occlude for

Study the way teeth occlude for
diagnosis and treatment planning
diagnosis and treatment planning

Allow formation of
Allow formation of
occlusal
occlusal
surfaces
surfaces
during lab preparation and adjustment
during lab preparation and adjustment
of fixed and removable prostheses and
of fixed and removable prostheses and
indirect dental restorations
indirect dental restorations
TYPES OF ARTICULATORS
TYPES OF ARTICULATORS

SIMPLE HINGE
SIMPLE HINGE

AVERAGE VALUE (PLANE

AVERAGE VALUE (PLANE
-
-
LINE)
LINE)

SEMI ADJ USTABLE

SEMI ADJ USTABLE

FULLY ADJ USTABLE

FULLY ADJ USTABLE
SIMPLE HINGE
SIMPLE HINGE

Single hinge movement only

Single hinge movement only

No lateral movement
No lateral movement

Smaller than patient

Smaller than patient

s jaws
s jaws

Very limited value in restorative

Very limited value in restorative
dentistry and
dentistry and
prosthodontics
prosthodontics
but may
but may
allow preliminary evaluation of static
allow preliminary evaluation of static
tooth arrangement on study casts
tooth arrangement on study casts
SIMPLE HINGE
SIMPLE HINGE
AVERAGE VALUE
AVERAGE VALUE

Condylar
Condylar
angle fixed at 30
angle fixed at 30

No provision of adjustment for lateral
No provision of adjustment for lateral
mandibular
mandibular
shift
shift

Adjustable
Adjustable
incisal
incisal
guidance
guidance

Considered sufficient for reproducing ICP on
Considered sufficient for reproducing ICP on
study casts
study casts

Produce an approximation of
Produce an approximation of
condylar
condylar
movements and used to design and prepare
movements and used to design and prepare
complete dentures and simple restorations
complete dentures and simple restorations
AVERAGE VALUE (PLANE
AVERAGE VALUE (PLANE
-
-
LINE)
LINE)

Allow adjustment of
Allow adjustment of
condylar
condylar
inclination and
inclination and
Bennet
Bennet
angle
angle

Intercondylar
Intercondylar
width fixed at 110mm
width fixed at 110mm

Condylar
Condylar
and
and
Bennet
Bennet
angle are obtained
angle are obtained
from protrusive and lateral
from protrusive and lateral
occlusal
occlusal
records
records
or are set an average values
or are set an average values

Incisal
Incisal
guidance are made by reference to
guidance are made by reference to
the O/B and O/J of anterior teeth, or if the
the O/B and O/J of anterior teeth, or if the
teeth are lost, an average value can be set.
teeth are lost, an average value can be set.
SEMI ADJ USTABLE
SEMI ADJ USTABLE

Recommended for most dental

Recommended for most dental
restorations
restorations

More accurate than average value

More accurate than average value

Allows increase of OVD by raising the

Allows increase of OVD by raising the
height of articulator pin
height of articulator pin

Arcon/non
Arcon/non
-
-
arcon
arcon
: the choice is
: the choice is
operator preference
operator preference
SEMI ADJ USTABLE
SEMI ADJ USTABLE
Arcon
Arcon

Fossa
Fossa
box in the upper
box in the upper
member
member

Condylar
Condylar
sphere in the
sphere in the
Lower member
Lower member

Duplicates arrangement
Duplicates arrangement
of TMJ
of TMJ
Non
Non

arcon
arcon

Condylar
Condylar
ball is attached
ball is attached
to upper member
to upper member

Slot mechanism attached
Slot mechanism attached
to lower member
to lower member
SEMI ADJ USTABLE
SEMI ADJ USTABLE
SEMI ADJ USTABLE
SEMI ADJ USTABLE
-
-
ARCON
ARCON
Stratos
SEMI ADJ USTABLE
SEMI ADJ USTABLE
-
-
NON
NON
ARCON
ARCON
Dentatus
Condylar guidance
Iven Iven Klineberg Klineberg, Rob , Rob J agger J agger, 2004 , 2004
FULLY ADJ USTABLE
FULLY ADJ USTABLE

Complex
Complex

Designed to duplicate TMJ features

Designed to duplicate TMJ features

Condylar
Condylar
settings may be determined
settings may be determined
by
by
pantograohic
pantograohic
and stereographic
and stereographic
records
records
FULLY ADJ USTABLE
FULLY ADJ USTABLE
Iven Iven Klineberg Klineberg, Rob , Rob J agger J agger, 2004 , 2004
ARCON TYPE
FACEBOW
FACEBOW

An instrument that
An instrument that
records the
records the
relationship of the maxilla to the hinge
relationship of the maxilla to the hinge
axis of rotation
axis of rotation
of the mandible
of the mandible

It allows the maxillary cast to be

It allows the maxillary cast to be
placed in an equivalent relationship on
placed in an equivalent relationship on
the articulator
the articulator
FACEBOW
FACEBOW

In order to identify true hinge axis, hinge
In order to identify true hinge axis, hinge
axis locator and hinge axis face bow are
axis locator and hinge axis face bow are
necessary
necessary

Facebows
Facebows
are commonly used with an
are commonly used with an
arbitrary hinge axis that is located 13mm
arbitrary hinge axis that is located 13mm
along a line drawn from the upper aspect of
along a line drawn from the upper aspect of
the superior border of the tragus of the ear
the superior border of the tragus of the ear
to the outer
to the outer
canthus
canthus
of the eye
of the eye

Other arbitrary point of reference of the
Other arbitrary point of reference of the
TMJ
TMJ
-
-
external ear canal.
external ear canal.
FACEBOW
FACEBOW

Allows transfer of
Allows transfer of
intercondylar
intercondylar
distance
distance

In dentate patients, the
In dentate patients, the
facebow
facebow
fork is
fork is
used to locate the
used to locate the
occlusal
occlusal
and
and
incisal
incisal
surfaces of the maxillary teeth. Wax
surfaces of the maxillary teeth. Wax
impression compound attached to the fork
impression compound attached to the fork
must locate the tooth cusp
must locate the tooth cusp

In edentulous patients, the fork is attached
In edentulous patients, the fork is attached
to a maxillary
to a maxillary
occlusal
occlusal
rim
rim
FACEBOW
FACEBOW
FACEBOW
FACEBOW

Iven
Iven
Klineberg
Klineberg
, Rob
, Rob
J agger
J agger
.
.
Iven Iven Klineberg Klineberg, Rob , Rob J agger J agger, 2004 , 2004
Maxillary cast mounted using facebowrecord
-Slidematic facebowwith Denar articulator-
Iven Iven Klineberg Klineberg, Rob , Rob J agger J agger, 2004 , 2004
Summary
Summary

Remember and understand occlusion

Remember and understand occlusion
-
-
definitions
definitions

Function and types of articulators

Function and types of articulators

Function of a
Function of a
facebow
facebow
References
References

Occlusal
Occlusal
and clinical practice. An Evidence
and clinical practice. An Evidence
-
-
based
based
approach.
approach.
Iven
Iven
Klineberg
Klineberg
, Rob
, Rob
J agger
J agger
. Elsevier
. Elsevier
Limited, London, 2004
Limited, London, 2004

Textbook of
Textbook of
Prosthodontics
Prosthodontics
. Deepak
. Deepak
Nallaswamy
Nallaswamy
.
.
J aypee
J aypee
brothers medical publishers (p) LTD. 2003
brothers medical publishers (p) LTD. 2003

Management of
Management of
Temporomandibular
Temporomandibular
Disorders and
Disorders and
Occlusion. J effrey P
Occlusion. J effrey P
Okeson
Okeson
. 5
. 5
th th
Edition, Mosby
Edition, Mosby
Inc., St Louis, 2003
Inc., St Louis, 2003

www.uic.edu.com
www.uic.edu.com

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www.myotronics.com

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