Articulators
Transcription
Articulators
Articulators lek. dent. Krzysztof Gawriołek Oral Rehabilitation Clinic An Articulator is a mechanical device used in dentistry to which casts of the maxillary (upper) and mandibular (lower) teeth are fixed and reproduces recorded positions of the mandible in relation to the maxilla. An articulator assists in the fabrication of removable prosthodontic appliances (dentures), fixed prosthodontic restorations (crowns, bridges, inlays and onlays)and orthodontic appliances. A mechanical representation of the jaws and temporo-mandibular joints An articulator may be defined as a mechanical device that represent the temporomandibular joint and jaw members to which maxillary and mandibular casts may be attached to simulate jaw movement. What can we obtain? • With an articulator we can transfer the relationship between the occlusal surface to the hinge axis to the articulator (tech. lab.) • In this way, like in the natural state, occlusal surfaces of restorations will be reffered condyles position, both in the static and dynamic situation. Relationship between maxilla and mandibule Wax bite Silicone bite Toothed arches Facial bow and articulator Wax rims Toothless arches Facial bow and articulator Relationship between occlusal plane and hinge axis USES 1. To diagnose the state of occlusion in both the natural and artificial dentition. 2. To plan the dental procedures based on the relationship between opposing natural and artificial teeth (Ex. Evaluation of the possibility of balance occlusion). 3. To aid in the fabrication of restorations and prosthodontics replacements. 4. To correct and modified complete restorations. 5. To arrange artificial teeth. Divisions • Arcon • Non-arcon • Standard • Semi-adjustable (semi-individual) • Fully adjustable (individual) Arcon type articulator: An articulator where the condylar housings are part of the upper member and the condyles are located on either side of the lower member. This configuration looks more like human anatomy, and is sometimes preferred when using the instrument to describe and explain treatment to patients. Non-Arcon type articulator: An articulator with the equivalent condylar guides attached to the lower member and the hinge axis to the upper member. In a non-arcon articulator, unlike human anatomy, the components representing condylar housings are found in the lower member of the articulator, and the spheres representing condyles are attached to either end of an axle that is part of the upper member. Types of articulators: - Standard articulators All condylar parameters are not adjustable (averange values are stock set ) - semi-individual articulators An articulator which is adjustable in one or more, but not all of the following parameters: saggital condylar path, horizontal condylar path (Bennett movement), Horizontal condylar path (ISS - Immediate Side Shift), Side-shift (shift angle, Bennett angle) protrusion, retrusion, distraction (shape of the glenoid fossae and eminintiae). -Individual articulators All condylar parameters can be set Occludator (cast holder) Types of articulators: - Simple hinge - Averange hinge - Semi-adjustable - Fully adjustable Build of articulator Facial bow articulator Upper member Lower member Upper member Lower member lock mounting pad lock lever mounting plate Support pin Incisal pin Incisal guide table Nasal support Facial bow Joint piece Biting fork Refference pointer Ear pieces PRACTICAL SIDE: An analysis of occlusion • When casts are mounted in articulators an analyse of occlusion should be performed • Occlusion should be checked in static and dynamic situation Analysis of occlusion Static occlusion • cental occlusion contacts • Centric relation Dynamic occlusion • guidances L & R • working and non-working side interferences • protrusion Analysis of static occlusion -Contacts in central occlusion (triads and forces) -Does central occlusion occurs in centric relation ? -Does the patient have freedom in CO (is CO locked in)? Analysis of dynamic occlusion Excursive movements of mandible - contacts during left and right laterotrusion - anterior guidance: incisal g., canine g., group function g. - interferences on working and non-working side during the movement Recording of occlusion Two dimentional marking the static and dynamic occlusal between teeth and then describing those marks in writing, by diagram or photograph. -Articulating paper -Articulating foil -T-Scan Advantage : determine contacts between actual teeth Disadvantage: inherent 2D record of a 3D entity Recording of occlusion Three dimentional Analysis with study models Advantage : permanent copy of patient’s occlusion, freedom of usage Disadvantage: host of potential errors in production stage (ex. Not accurate impressions, models not well casted or related each other, choice of face bow, articulator, range of impressions, regitration and casting materials) Progressive articulating paper occlusal contact Surface around bite point In this region appearance bite forse is highest (in normal contact should have a point appearance) zone around the contact pointpoint contact point intense contact = premature contact poor contact = normal force A tooth movement in alveolar on periodontal ligaments during ex. mastication is 20 µm. A difference in 15 µm can be sensed by human receptors in periodontium. Conclusion: the final articulating foil must be thinner than 15-20 µm ARTICULATING PAPERS 200 – 40 µm, 11 µm Initial occlusal recording Final oclusal recording (11 µm only) ARTICULATING SILK 200 Initial occlusal recording more break-resistant than paper More pigment inside (up to 10 usage on model) ARTICULATING FOIL 28 – 8 µm initial and final occlusal recording metal stripe with two-sides pigment ARTICULATING INDICATORS AND SPRAYS Indicator leaves a 3µm layer Prosthetic restorations fitting control, recording contacts on smooth surfaces of crowns etc. T-SCAN electronic measurement of occlusal contacts The choice of articulator depends upon such factors as: - Clinical purpose - Availability of equipment - Patient’s occlusion - Skill of technician - Expense - Skill of the operator The more closely the articulator matches the patients anatomy (especially face type) , usually the better the outcome and the less adjustment is required at dental chair on fitting process. CONCLUSION An articulator is an important device that mechanical analogues the temporomandibular joint & upper and lower dental arches. A device to which maxillary and mandibular casts can be attached with the intend of simulating the functional & parafunctional contact relationships of one arch to the other. Refferences: -Wheeler's Dental Anatomy, Physiology And Occlusion (9th Edition) By Stanley J. Nelson, DDS, MS Management of Temporomandibular Disorders and Occlusion (6th Edition) by Jeffrey P. Okeson -Functional Occlusion, From TMJ to Smile Design by Peter E. Dawson -Oral Rehabilitation: Clinical Determination of Occlusion by Sumiya Hobo and Hisao Takayama
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