Examination of the Occlusion and Fabrication of Study Casts “This chapter will discos the specific examination of the schon, the snaking of study casts nd special examination methods sucha ingot ‘rexing and panographic survey. amination of the ocanon sould follow the history taking end ese examination described in Chapter I. altho ii implied tat {cot etonships wl be observed, mperntine that the pntion a the ‘mandible reniveo the mils sao connicered The clini egneance ‘ofthe observation sil be comsidered ia Chaps 4 ‘Ocetusal relationships ‘The following shouldbe observed: the intercupal poston, the setruded ‘intact positon, the movement between the seruded contac poston nd {ntersrpl porn sid osason ltl cntact potas and enc soa, protsive contact postons and excursion and the set prison Tris inporaar forthe practioner to know where to look at what 10 took fo “The inercuspal position (ICP) “This the relationship of the mane ro the mala when the ect are meshed maximally together (i. 21). Location “The patie asked obrng his weet together in the posion obeseoat 4 0.20 Therma sna (7 sit ntosion teh anne Otersaion The overall ach rlaonships are note recording deta of Sich regulars au croiebite and overepted teh. Horizontal ove ind oveble should be menured and recorded, copecially noting i the “operand Ie ocnors and anes contact. “The retruded contact position (RCP) “The tsaonship ofthe mandi othe mail in which initial aclaion| fontact har oecrzed following closure about the posterior and most Super rotatory ai ofthe mandible (0 22), =F ~ lla tae Aca ‘SE. tong guns gchnce by he Gt eo pone man mre Posten gee 2 hfe of ve fe compos owe Location "Many techniques have been described fortis procedure, but ‘he mos useful stat descbed by Dawaon," However slight madi: tous to Dawson's ecnique may be neceary to su India ese Ptente ifr inthe relative eae of lation of his Poston an the technique for tre tage of efculy wl be esrb Technique for a5" patient ‘The parents placed ina tecining position in the dental char and made a ‘ele ax ponible. The hea i cradled between the operator's chest nd fom to offer stability” The patient should be apaten to elmly and nfhdently. The thumbs ae placed onthe cin andthe fingers suppor the ‘dy ofthe mandible asin higure 2.3. With slight downoad pressure oes the thumbs, and upward pressure rom the Bngers the mand gets ‘manipulate with only movements option jus shoo ec fontacts. When the putin i fl tobe flaed, conan contd ‘tinal contat fel bythe patient andi faked wo ety the aca St such contact The commonly used method of shaking the mandi Welly des nothing more than precipitate fer in the patient and = Yaheening ofthe muscles which contrary Yo what i oqitd, Patients who present slight dificulty in manipulation to RCP ‘The aplication ofthe tongue spataatechnigne’ it umetne aed, The 4tongue sparul is placed between the upper and lower eth a in igure 2.4 [nthe pet eked contact ih the ower incor mati this Denia for approximately 5 min, so ato “break up" propriosptive ‘efexer and allow the muscles to Morge the habitual poston of the Imanaibe "The mandible ean then be manip a descsbedpocviowly {Sepen and lowe apne the tongue spatula which athe slowly semoved tnd the patient's jaw cloned to sal contac a Before, aN ‘ga Teo using RE pt i ah ey nn Patients who present more dificaley 2 manipulation maybe ncesary to abit an anterior ig, he Fncton of which eo teak up the propsicepive eer” (ig. 2) The equipment needed i: natopolerining acrylic such as Red Dura la, peoleum fly straight Randpiece, tungsen-carbde trimmer ac ‘The techntgue for making a ji is follows: Apply petroleum jy othe upper anterior teeth and block ou. smtroe dite, (2) Mix autopaymerising resin (G) At the dough stage theresa should be applied to the strc teeth (fg, 26(a) and shaped ito «platform covering the palatal saraces (hg 26) and extending about Smm over the inital ge eno the abi sorts. (i. 26 (@ While resin sot guide the mandible ax lsely a posible othe retmded postion, making sure that she lower inciors conte the alta ‘ltform, and that there i sficent material #9 allow poseior wath ‘epurton of approintely 2mm. (G) AS the rein begins et, pie off gly to prevent locking into undercuts and an excessive bud of polymerisation het. (6) Ale ie has st replace dhe jg iathe mouth and ene that i "ily retained on he antvioe eth if ot ad more atrial the iting ‘lace and repeat unl gly retained (7) Plce blue atculating paper onthe fg and guide the mandible slong lec and righ Ira paths (28 (8) Remove the ig and lok st the making nd identify the movements of ingle lower incor again the upper plator (2.0), (@) Because of the dicen of overeat ofthe mandible (ig 2.609) © lower incor wiltaceVshaped marks wih the apex pointing palatal Be sare tht somecimes more than one tooth mare, ent the mark om heincor and remove the others, *"(Q0) Tee the imbs of he Vand epeat ming until the apex becomes ch “SGD im of int fhe Vain nly the apex i 2.6. {1 Rep noth snd ie pst cs hs {33} Ede in pt th for apron 0 ae and then ces or eto of avec oe mane openings in. ‘Gide th mani aa ke te pt pop hand When fee ‘povment occ rove hcg and he i conacs ‘Sometime itm be omy beef pcr al an hour(6) Remove the tape, warm a mouth mir and obeerve the black math on the be backpound. I must be emphasised that i impure Joes ochsal contacts precnly ith thee ttclating pape tse, ‘owing to its thickness." ‘The blue lyer metly aie the sebeguent making withthe hin ec tape adeno lays secs. Obersaton Note txt in contact, aes of conta, horizontal and veri ‘vei and exe of manipulation Movement from RCP t0 ICP. Lecaron Manipulate the mandible to the RCP and then instruct she Datiot to squere’ the teeth together ns posi of ea i faced Repeat the procedure using octal apes a flows (0) Teeth dred (2) Blue ape and teeth raed in al dietons, (3) Mouth open and dryness of teeth obtained byasistant sing suction, (3) Insert ee actual pe: (Double-sided rod GHIM tape isha eat able. Ct asp of single-sided ape, twice the length ofthe forceps teak flit bck on self apd secure in he forceps: Ensure hat the Ghul sides re facing outwards) (©) Manipulate w RCP and mach hen instruct the patient wo squeeze (Remove ro ae (@) Manipulate to RCP and tp test togser once, (10) Tap ence in 1CP (fe, 29, Fe, 25) Teal ue ye aig ta eh Th eo a do ae ‘comet ot aoe ued fb) Ra) ae RE ce oeObreoaton [At the incors note he {2} Dimeasons of ie rom rtrd to itercsepa positions (2) Direton- whether side staightforwards, forwards (0 one side oF only w one side (9) Vero and horizontal components of sid. Tiss the change in he stance between the upper and lower Inclsors in the vetal and ‘noon plans occurring during the side from RCP 10 ICP. Figuree 210) and (show large vertical component end sal horizontal omponent athe incl raion. Compare this with gure 2.11(0) and {e) ich show a smal etal en «lrg hotoatl component ‘Note the cntting surfaces from the mas tne By the socal ‘apes lg 210) the inal contact im the RCP (lack the uae ‘Stct while the ide if ny) occurs (re) and ICP contacts (gree) (dy Ene ofa, Detemine the dg of eedom af movement ra RCP to ICP and whether this movernenc i infenced Ia aay way by the Inclined plane of the opposing camp. In other words the movement forced? Dein frthe Gow Pacer 21 Se tr () REP (8 IP. El ved re hrc omen. ame eon ety Sec seme Semin fh eon a Ftc fay ans » Lateral positions and excursion Lcatons and observations are made on both the working sie andthe on-working side, Working side contacts Contacts of teth made on the side ofthe occlusion towards which the ‘aundible has bec move (2.12 Location "The patient is instructed to lose nto the ICP and then move Whichever side'i to be investigated. Frequently the patent may have {uly In moving 6 the required tide Ths may be ated bythe faint using a face miro to observe the movement af the wer fm Eastruct the patent w mave eo the edge-to-edge positon, an sighty ‘ejond (he cros-over postion). Ideally the contac shold be bated fiom the RCP as well bu this is fequenly dic. Once located the contacting surfaces ean be mate before Obseroason With the teeth in contict dutig Lateral excursion, note (0) Theres group function (contact of mulipe test on the working side) ie 21210) 0 (@) There is canine gudance (contact only between the canine wih he other seth separated or dsclada) (2.120), Frequently, there wll bea combination of (1) and (2) such that ily there ls up funtion, but inthe ee edge poston only the eine conta 9) The guiding teth move excess (@) The lateral movement i smooth or resid, (3) The teeth are in contact athe eo over postion. win, el renin mi et a ant ingNon-working side contacts (balancing side contacts) Comacs of eth radeon the ide of the oceuson fm which she Inandble move drag Intral excursion, that the side opposite the trrking side, For example, right lateral excursion, working tde—sight Son-working dell Location ‘The lation non-working sie contacts cn be made athe same tinea the working se contac. However the operator should suppor the mandible on te noa-working side while doing this (Bg 2.13) thetes |Nendeny forthe pater to et round te non-working side contacts Obrvation Note: (0) Presence o absence of non-working side contacts {2} Movement of teeth onthe non-working sie (3) Comesponding working side conte Protrusive portions and excursions “Thee are two relationship: sgh potrsion, or ler protoson that iemovement forward apd slit to one sie Locarion Instruct the paint o clos ito the ICP and then ide forward ‘at the inioes ame egeto-dge. Aga he fice itor simplifies his Fa. 212 ng tal mann Supine man ge. rowenta rocedue.Simies, fo teralprorsion instruc the patient o close wo the ICP then move forward an to onesie. Spec conics may be Tost with apes, oberon Nowe: (0) The diecton of movements (2) The mobility of reth ding jaw movements (3) Whether she tect ten contact during movement (4) The presence or absence of posterior contact during protrsie move “The rest postion “The relationship of themandibieto the mails when the patents relaxed snd sng up, Location Poston the patient comfortably and upright in the chair, Use tne ofthe many prosthetic methods to aes interoclsal clearance: For ‘ripe ell the pain oie the lip and swallows Mn reat ‘hen pt the lip and ssn he space been lt ad JT COberation Ioteroclaa lsrance observed, However, be aware that many factor can influence theres postion chaste, pi, and mle Special investigations Study cases Sead cats provide an ese record of he denon spd its important that here cantare crcl fabriested. Compare fue 2140) wth igure 214() and note the derepany between the ocrusal surface owing Sistrtion of the alginate impressions caused fn this cae by ccc Slowing cacss lpia a the hess ofthe tay to contac Se works ‘ile he stone was sein in he preston Equipment quired: eter reversible bydrooli orireversble hy roculod (alsnate),"Ramlock tery" (conventional perforated. ey ‘Mlequnt) 252 ich gause quae, rubber bow! and spa, “The teeth should be cleaned andthe corer ined tye selected. The ocean surfaces ae phy wiped with gure whilethe cherie sientfe, 2.14 Oitoned sty cae eating fete enone ho he owe the onc ales ce eo ee a) ries the impression materia according to the manafctre’s instruc {ows A sl amount of inate i aken onthe Ginger nd applied to the ‘easel surface ofthe eth, forcing isto Ue grooves Bg. 2.19) (With ‘Sree hyocoll, syringe material maybe vesd) Iie importa tht {Svs does no contamiat the surface of hi lye, x may alec the ‘form sting ofthe whole impression. The loaded ay aete. The [tmpresion is removed when set and covered withthe damp gauze or Paced na humidor prio #0 poring. Ensue hat aby unsupported ees of the impreson material re ot left esting on the worktop, otherwise this wil {ne dsurtinf the mpression, The cart sould be poured with minimal ‘tay and bse T should ave wate and be sored for future reference. (I ‘Sequenty useful to makes second model for diagnostic ating” and ‘evcng of teh) se of study caste GOP fame roeronce It may ace be possible ro make a deine Co er operate pen eer Ge = lang of st, Co edi i LN ue Seite tet eniciecat ae enteed peas ee Edin patie Teepe cen are be deseribed im Chapeer 5 AICTULS LON Gh Dlaong bat NN pak wing to song i219 tire team basco es Sores ea gous ae ee ne erin ieee eles Fash ab cuinarpringties ser saee er Sea ee Pantographic survey | dental pantograph i «device wed o tage mandibular movement and "e218 5s nun no ade so Whi Mi),consists esesilly of an per and lower faecbow each attached 19 the eesponding dental arch (fg. 218) Styl atached to one bow contact fat pte on the opponite Bow. Ab dhe pleat performs lateral i ‘movements, the sy will ace thee paths om the ples. Some author ‘Sides tha she nonepeoducblty of pantograph eacings provides ‘alle gap lforaton rearing the ned for oclsal therapy Por TDentesive restorative dente “This article hat dveribe the procedares used to acte and observe the ‘aru ovelusal relationships, The advantages of study cats have been ‘uid and he pantograph bre mentones In Chapter 5 mounting of the ct in avicultrs wl be described. Te cll sgniance of he [beratons wil be describes in Chapters 3 and 4 2 DUE EE Rin dwt me fw pm 5: en 4 Lae th red cn 7. Pt Da 2-0 3 Chm 8 Nges GB. Cavin f'n