Occlusal Registration in Removable Partial Denture / Orthodontic Courses by Indian Dental Academy

INDIAN DENTAL ACADEMY
Leader in continuing dental education

www.indiandentalacademy.com

OCCLUSAL
REGISTRATION IN
REMOVABLE PARTIAL
DENTURE
OCCLUSION
The static relationship between the
incising or masticating surfaces of the
maxillary or mandibular teeth or tooth
analogues. (GPT-7)
CENTRIC RELATION
The maxillomandibular relationship in which the
condyles articulate with the thinnest avascular
portion of their respective disks with the complex
in the anterior-superior position against the
shape of the articular eminences. This position is
independent of tooth contact. This position is
clinically discernible when the mandible is
directed superior and anteriorly.it is restricted to
a purely rotary movement about a transverse
horizontal axis.(GPT-7)
CENTRIC OCCLUSION
The occlusion of opposing teeth when the
mandible is in centric relation.(GPT-7)
MAXIMAL INTERCUSPAL
POSITION
The complete intercuspation of the
opposing teeth independent of condylar
position, sometimes referred to as the best
fit of the teeth regardless of the condylar
position.(GPT-7)
VERTICAL DIMENSION
The distance between two selected
points, one on a fixed and one on a
movable member.

OCCLUSAL VERTICAL DIMENSION : the
distance between two points when the
occluding members are in contact.

PHYSILOGICAL REST POSITION :the
mandibular position assumed when the
head is in an upright position and the
involved muscles, particularly the
elevators and depressor groups, are in
equilibrium and tonic contraction, the
condyles are in a neutral, unstrained
position.(GPT-7)
OCCLUSAL REGISTRATION
A registration of the positional relationship
of apposing teeth or arches; a record of
the positional relationship of the teeth or
jaws to each other.(GPT-7)

OBJECTIVES:
To establish & maintain a harmonious
relationship with all oral structures & to
provide a masticatory apparatus which is
efficient, comfortable & esthetically
pleasing.
Necessary for distribution of functional
forces evenly as possible to all supporting
structures within their capability of
withstanding the stress.
A harmonious occlusion contributes
materially to the control of damaging,
leverage induced stresses where as a
faculty occlusion compounds the
destructive forces.
IDEAL REQUIREMENTS OF
BITE REGISTRATION
MATERIAL
Limited resistance before setting to avoid
displacing the teeth or mandible during
closure.
Rigid or resilient after setting.
Minimal dimensional change after setting.
Ideal recording of occlusal & incisal
surface of the teeth.
Easy to manipulate.

No adverse effects on the tissues involved
in recording procedures.

Interocclusal record should be verifiable.
IMPRESSION PLASTER
Basically plaster of Paris in which
modifiers have been added. Modifiers
accelerates setting time &decreases
setting expansion.
ADVANTAGES:
Accurate.
Rigid after setting.
Do not distort after extended storage.
DISADVANTAGES:
Difficult to handle because the material is
unmanageable prior to setting.
The final interocclusal record is brittle.
WAXES
Thermoplastic waxes are frequently used
for interocclusal registration as records or
as a carrier for registration.
Wax is widely accepted as an interocclusal
recording material.
ADVANTAGES:
Easy to manipulate

DISADVANTAGES:
Inaccurate
Unstable
Inconsistent due to interference with
passive and active movements of
mandible.

ZINC OXIDE EUGENOL
PASTES
Is an effective interocclusal registration
material
ADVANTAGES
Fluidity before setting.
Fluidity is a critical quality of an
occlusal registration material because it
ensures minimal interference with
mandibular closure during record making
procedures.

Adhesion to its carrier
Rigidity and inelasticity after final set
Accuracy in recording occlusal and incisal
surfaces of the teeth
High degree of repeatability

DISADVANTAGES
Lengthy setting
time
Significant
brittleness
The accuracy of
the registration
material may
surpass the
accuracy of the
casts, resulting in
improper fit.

SILICONE ELASTOMERS

Two types of silicone elastomers are
available as interocclusal registration
materials
Condensation silicone
Additional silicone
Currently, additional silicone has gained
acceptance because it is more stable than
condensation silicone


ADVANTAGES:
Accuracy
Stability after setting
Minimal resistance to closure
Does not require a carrier

DISADVANTAGES:
its resistance to compression of the set
material ,which contributes to difficulty in
seating of plaster cast

POLYETHER ELASTOMERS
These were introduced to dentistry in the
early 1970s.
Poly ether interocclusal registration
material consists of the basic impression
material augmented by plasticizers and
fillers
ADVANTAGES:
Accuracy
Stability after polymerization and during
storage
Fluidity and minimal resistance to closure
Polyether can be used without a carrier
DISADVANTAGES
Resiliency and accuracy may exceed the
accuracy of the plaster casts. Both of
these factors can interfere with the
placement of the plaster cast into the
recording medium during mounting
procedures.

The records are trimmed to remove
excess material and preserve only the
teeth indentations, avoiding distortions.

ACRYLIC RESINS
The most frequent application of acrylic
resins for interocclusal records is in the
fabrication of single stop centric
occlusion records

ADVANTAGES
Accurate
Rigid after setting

DISADVANTAGES:

Dimensional instability of some
commercial formulations due to continued
polymerization resulting in shrinkage.

The strength and rigidity of the material
can damage plaster cast and dies during
articulator mounting.

STABILIZED BITE RIMS
Stabilized rims may be constructed on the
replicas of the diagnostic cast. The rims
are transferred to the mouth and the
centric closure position recorded.
Stabilized rims are indicated for the
positioning the cast prior to the formation
of the treatment plan and tooth
preparation.

LaDeane Fattore ,William F.malone and
associates conducted a study to compare the
clinical accuracy of various inter occlusal
recording materials (JPD 1984:51(2) 152-157) .
THEY COMPARED
1. Two thickness pink base plate wax
2. Reinforced wax
3. Zinc -oxide eugenol paste
4. A modified ,non rigid poly ether recording
medium with a carrier
5. Poly ether without a carrier

AND they concluded that
Polyether inter occlusal recording medium
without a carrier was the most accurate
Polyether and Zinc -oxide eugenol paste
with carriers were the next most accurate
recording mediums.
Recording waxes were consistently
unreliable.
Distortion occurred more frequently in a
vertical direction followed by an antero-
posterior direction.

RECORDING OF OCCLUSAL
RELATIONSHIP
It may vary from simple apposition of the
apposing casts by occluding sufficient
remaining natural teeth to recording of jaw
relationship in the same manner as for a
completely edentulous patient.
The horizontal jaw relation (planned
intercuspal position or centric relation) in
which restoration is to be fabricated should
be determined during diagnosis &
treatment planning.

Mouth preparation should be based on this
determination including occlusal
adjustment of natural dentition wherever
indicated.
METHODS OF RECORDING
OCCLUSION
Direct apposition of casts.
Interocclusal records with posterior teeth
remaining.
Occlusal relation using occlusal rims on
record bases.
Jaw relation made entirely on occlusion
rims.
Establishing occlusion by recording of
occlusal pathways.

DIRECT APPOSITION OF CASTS

Also known as
HAND
ARTICULATION
coined by
KROGH
POULSEN.

INDICATIONS
Sufficient opposing teeth that remain in
contact to make the existing jaw
relationship obvious.

Only few teeth are to be replaced on short
denture bases.

There is no evidence of occlusal
pathology.

The opposing
casts are occluded
by hand.

It can be moved
slightly in various
lateral
anteroposterior
direction of
movement by
observation of
facets on
remaining teeth.

The occluding
casts are secured
together either
with wooden
sticks/wire nails &
sticky wax .

They are
mounted in a
articulator.
ADVANTAGES:
Though there are limitation, yet it is better
than using an inaccurate record between
the remaining natural teeth.
It eliminates the clinical appointment for
establishing occlusal relationship.

LIMITATIONS
The principle danger is this method may
perpetuate the existing vertical dimension
and any existing occlusal disharmony.
So occlusal analysis and correction of any
occlusal disharmony should precede the
accepting of such a jaw relation.
INTEROCCLUSAL RECORDS
WITH POSTERIOR TEETH
REMAINING
INDICATION:
It is the modification of the first
method and is used when sufficient teeth
remain to support the partial denture
(Kennedy class III or class IV) but the
relationship of opposing teeth does not
permit the occluding of cast by hand.
PROCEDURE
A uniformly
softened, metal
reinforced wafer of
base plate or set
up wax is placed
between the teeth
and the patient is
guided to close in
centric relation.
All excess wax
should be removed
with a sharp knife.

The wax is
removed and
chilled thoroughly.
It is again replaced
in mouth to correct
the distortion and
chilled again.

The wax record should be further corrected
with a bite registration paste to obtain a
more accurate and dimensionally stable
record.
For this procedure the opposing surface of
teeth is coated with petroleum jelly for ease
of removal of record.

The impression
paste is applied to
both the side of the
wax record and the
patient is assisted
to close in centric
relation guided by
the wax record.

After the paste is
set, the record is
removed and
excess is trimmed
off.
Record is secured
to the maxillary
cast and then
mounted in an
articulator.
ADVANTAGES
Provides an accurate interocclusal record.

If an intact opposing arch is present stone
can be directly poured into the record to
serve as a opposing cast.

Acceptable procedure in fabricating
unilateral fixed partial denture.
OCCLUSAL RELATIONALSHIPS
USING OCCLUSAL RIMS ON
RECORD BASES
INDICATION:
When tooth supported edentulous space is
long.

When opposing teeth do not meet.

When one or more distal extension areas
are present.

PROCEDURE
Accurate
records
bases are to
be used to
support the
occlusal
relationship.
Occlusal rims are
constructed over
the record bases
by wax occlusion
rims or modeling
plastic occlusion
rims.
Vertical dimension
is corrected .
Occlusion rims are
reduced in height
just out of occlusal
contact. A single
stop is added to
maintain their
terminal position.
Bite registration is
made by injecting
the recording
medium in
between the two
occluding surfaces.
Patient should be
guided to the
centric position and
should be held in
position till the
material sets.
Completed record
is examined and it
is trimmed so that
only cusp tips and
indices remain.
Cast are then
mounted on the
articulator by using
the record.
JAW RELATION RECORDS
MADE ENTIRELY ON OCCLUSAL
RIMS
When no occlusal contact exists between
the teeth, such as when opposing
maxillary complete denture is to be made
concurrently with a mandibular partial
denture.
When few
remaining teeth do
not occlude and
will not influence
eccentric jaw
movement.

When only anterior
teeth is present
OBJECTIVES
Static relation of the maxillary and
mandibular casts to each other should be
established in three planes. This is
accomplished clinically by establishing the
vertical ,centric and orientation
relationship.
Dynamic relationship of the two cast to be
established by protrusive and lateral
interocclusal records. These records can
be used to program the articulator to
simulate the natural movements of the
jaw.
PROCEDURE
Stable record bases and rims are required.
Vertical dimension at rest and at occlusion
is established by means of
NISWONGERs precepts.
Centric relationship can be established by
direct interocclusal method or by stylus
tracing is used.
Eccentric records such as protrusive and
lateral records are made.
Facebow transfer is made and the casts
are mounted on a semi adjustable
articulator.
Articulator is programmed to simulate
natural movements of the lower jaw.
Desired occlusion is obtained.
ADVANTAGES
Method of choice when edentulous areas
are to be restored are opposed by
edentulous areas in a opposing jaw.
Better method when the prosthesis is
opposed by a completely edentulous arch.
Occlusion can be developed rather simply
for a typical partial denture, in a minimum
amount of time.
Does not require patient co-operation as
that needed for generating functional
pathway.
LIMITATION
Skill and care is necessary to obtain the
intraoral records, accuracy and
thoroughness with which they are used to
program the instrument.
ESTABLISHING OCCLUSION BY
RECORDING OF OCCLUSAL
PATHWAYS
FUNCTIONALLY
GENERATED PATH
METHOD.

It is a dynamic record
of movement of
opposing tooth
surface.
Theory:
when the pathways each tooth opposed
to the edentulous space makes throughout
all functional movements of the mandible
are recorded, the artificial teeth may thus
be positioned and formed so that it will
remain in harmonious contact with its
antagonist all the times.

CLINICAL PROCEDURE
Stable acrylic resin record base with
compound hard wax or hard inlay wax
(purple) can be used to record the occlusal
pathways.
Occlusal rims is
constructed slightly
higher than the
occlusal plane so
that the natural
teeth are apart by
0.5 to 0.75mm.
Buccolingual width
of rim is several
millimeters wider
than that of
opposing teeth.
This is necessary
to record the full
range of motion.
There are two methods of having the patient
grind the occlusal pathways.

First method : the patient is instructed to
wear the occlusal rims continuously for 24
hrs excepting when eating and drinking
hot or chilled drinks.
He should be told to close the jaws
intermittently and grind the wax in all
possible jaw position.
The patient is asked to wear the
prosthesis overnight so that any
involuntary or bruxism contacts can be
records.

The resulting pathway will be record of all
possible jaw movements and tooth
contacts.
Second method: is for the patient to create
the pathway directly under the supervision
of the dentist.

Advantage: dentist is able to observe and
correct the movement the patient is
making.

Disadvantage: atleast 30min of active
movement of the mandible is necessary.
The wax pattern is
boxed and poured
in improved stone
to provide
permanent record
of the generated
pathways.
The stone record is
mounted on a
articulator and the
artificial teeth are
set to contact the
record.
ARTIFICIAL TEETH SET TO THE
GENERATED PATHWAY
The incisal pin is opened 1mm before the
artificial teeth are positioned. This increase
in vertical dimension will be returned to
normal by selective grinding of the teeth.
The selective grinding develops occlusal
anatomy of the denture teeth to conform to
the functionally generated stone path.
After the teeth are set in correct alignment
the incisal pin is returned to correct vertical
dimension of occlusion.
Prussian blue dye is painted on to the
surface of generated pathway. Opening
and closing tapping movements are made
of stone path against the denture teeth.
Spots of dye are transferred to the denture
teeth. selective grinding is done till the
incisal tip touches the incisal table.

The articulator is not moved into protrusive
and lateral movements because these
positions are incorporated in the pathway.

ADVANTAGES
The method makes unnecessary the
registration of inter occlusal records or a
face bow transfer and dispenses with the
need for a complicated articulator.
Jaw movements and tooth pathways are
reproduced under more nearly functional
conditions than is the case when static
registration are transferred to an
instrument.
LIMITATIONS
Not indicated when the opposing occlusion
is provided by a complete denture or when
all the teeth is not present in the opposing
occlusion.
Resistance may be encountered by the
mandible as the teeth shear through the
wax, which may serve to deflect the
mandible from its natural path.
The patients masticatory force and
direction may vary with foods of different
types. So the masticatory pattern of the
teeth during actual function differs from
that which they follow as they generate
pathways.
Cannot be used to replace the anterior
teeth.
ESTABLISHING JAW
RELATIONS FOR A
MANDIBULAR PARTIAL
DENTURE OPPOSING A
MAXILLARY COMPLETE
DENTURE

It is the most common situation.

The maxillary denture may be already
present or it may be made concurrently
with the opposing partial denture.
ESTABISHMENT OF JAW
RELATION WITH EXISTING
MAXILLARY COMPLETE
DENTURE
If the existing maxillary denture is
satisfactory and has acceptable occlusal
plane, it can be treated as natural
dentition. Face bow transfer is made and
the cast obtained from the denture
impression is mounted on the articulator.
centric and eccentric records are made.
The stylus must be carefully removed from
the denture and attached to the same
palatal location on the stone
cast.Mandibular cast is orientated by
means of centric records.
After processing the partial denture is
mounted against the complete denture for
occlusal correction. It will ensure more
accurate cuspal relationship.
When the mandibular partial denture
replaces all posterior teeth and the
anterior teeth are noninterfering, a central
bearing point tracer may be mounted in
the palate of maxillary denture and centric
relation recorded by means of an intraoral
stylus tracing against a stable mandibular
base.
If the relationship of maxillary posterior
teeth to the mandibular ridge is favorable
and the complete denture is stable
functionally generated method can be
used to obtain the records.
If the maxillary denture has be made with
occlusal plane too low and improper
interarch relationship due to any
malposition of the natural teeth and if
those teeth has been lost ,repositioning of
the maxillary posterior teeth should be
done before the construction of the partial
denture.
MAXILLARY DENTURE TO BE
MADE CONCURRENTLY WITH
THE PARTIAL DENTURE
If the mandibular partial denture will be
tooth supported it should be restored first
and so the maxillary complete denture is
made to occlude with an intact arch.
If the mandibular partial denture has one
or more distal extension bases, the
occlusion on both the arches should be
accomplished simultaneously.

All mouth preparations and restorative
procedures need should be accomplished
on remaining natural teeth.
Occlusion should be established with
favorable tooth-to-ridge relationship,
optimal occlusal plane and cuspal
harmony between all occluding teeth.
After try-in both dentures can be
processed at the same time or the
maxillary denture alone is fabricated and a
record is obtained using functionally
generated pathway and mandibular partial
denture teeth can be set to accommodate
the record. This gives good occlusal
harmony.
FIXED PARTIAL DENTURE
AGAINST REMOVABLE PARTIAL
DENTURE
In this situation fixed partial denture
should be fabricated and then the
construction of removable partial denture
should be made.
Better occlusion is possible if the occlusal
plane is restored with the abutment
restorations and pontics for the fixed
prosthesis and the teeth of removable
partial denture are then arranged to
articulate with them.

REFERENCES
Removable partial denture-McCrackens.
Clinical removable partial prosthodontics-Stewart
Partial dentures Osborne
Removable partial prosthodontics-Grosso & Miller.
Partial dentures -Swenson
Occlusion in removable partial denture-JPD, Jan-2004
Accurate occlusal relationship in partial denture
construction-JPD,Nov 1953.
Clinical evaluation of the accuracy of interocclusal
recording materials-JPD ,Feb 1984

Occlusal Registration in Removable Partial Denture / Orthodontic Courses by Indian Dental Academy

Hochgeladen von

Dokumentinformationen

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Occlusal Registration in Removable Partial Denture / Orthodontic Courses by Indian Dental Academy

Hochgeladen von

Copyright:

Verfügbare Formate

INDIAN DENTAL ACADEMY

Leader in continuing dental education

Das könnte Ihnen auch gefallen