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Dental Articulartors and Facebows Lecture 5 What is the definition of a facebow?

A caliper-like instrument used to record the spatial relationship of the maxillary arch to the rotational hinge axis and then transfer this relationship to an articulator Kinematic Arbitrary The true physiologic axis of rotation Transverse horizontal axis Terminal hinge axis 8mm in front of the tragus of the ear, on each side of the face - Most accurate - Most sophisticated - Most expensive - Requires more elaborate equipment and time - Used with a fully adjustable articulator Dr. Snow An arbitrary hinge axis by using anatomical landmarks - Less accurate - Requires less complicated equipment and less time - Used with semi-adjustable articulators - Simplistic - Rough measurement of position of horizontal axis Beyron Point Gysi Point Bergstrom point A point 13mm anterior to the posterior margin of the tragus on the tragus-canthus line A point 13mm anterior to the anterior margin of the external auditory meatus on the line from the upper margin of the external auditory meatus to the lateral canthus of the eye A point 10mm anterior to the center of a spherical insert in the external auditory meatus and 7mm below the Frankfurt horizontal plane A line that passes through the patients external auditory canal and the lowest border of the bony orbital rim The hinge axis in three reference plane Two on each side of the face One on the anterior face Repeatable, reproducible The type of facebow Orbitaleinfra-orbital fissure (not sure which or if theyre the same thing or something)

What are the two types of facebows? What is the kinematic facebow used to locate? What are two other names for the true physiologic axis of rotation? Where is this true physiologic axis located? What are some other characteristics of the kinematic facebow?

Who invented the artitrary facebow? What does the arbitrary facebow locate? How? What are some other characteristics of the arbitrary facebow?

What are the three points of the arbitrary hinge axis location? What is the Beyron point? What is the Gysi point?

What is the Bergstrom point? What is the Frankfurt horizontal plane? What does the facebow orient the maxillary cast to? Where are the three points that are required by the reference plane? What should the 3rd reference point be? What determines the 3rd reference point? What is the 3rd reference point for a springbow facebow?

What is the 3rd point of reference for a Whip Mix facebow? What is the 3rd point of reference for a Danar facebow? What are the two types of arbitrary facebows? What are distinguishing characteristics of the Ear-bow? What is the definition of an articulator? Ideally, what does an articulator replicate?

Nasion Maxillary incisor incisal edge Facia-bow Ear-bow - Lundeen - springbow is a variation of this kind - 76% accurate (other arbitrary bows can be <50%) A mechanical device to which mandibular and maxillary casts are attached and which stimulates some jaw positions and movements - Jaw positions and movements - Angulations (Bennett, Condylar-protrusive, Lateral) - Pathways - Timing of movements - Orientation of jaw in skull - Distance of elements - Easy to use - Accurate - Sturdy - Reliable - Suitable for use in a wide variety of areas - Not too expensive - Diagnostic mounting (in CR or CO) - Treatment planning - Discussion of care with patient - Fabricating prosthesis Diagnostic wax-up Feasibility study Aesthetics Design of crowns, bridges, partial dentures Occlusal equilibration Orthodontics - Upper member/arm/frame - Lower member/arm/frame - Anterior or incisal pin - Condylar mechanism - Intercondylar distance adjustment - Anterior guiding mechanism - Mounting ring guide and retention system 1. Simple/hinge/non-adjustable 2. Semi-adjustable 3. Fully adjustable The simpler the articulator system, the more chairside adjustments must be made - Most basic articulator - No adjustments possible - Does not accept a facebow - Inexpensive - Simple to use (no programming) - Movements may be different from patients

What should articulators be?

What are uses of articulators?

What areas of treatment planning can articulators be used for?

What are the basic components of an articulator?

What are the three classifications of articulators? What is the general rule for simplicity of articulators and chair-side adjustments? What are some characteristics of the simple/hinge/non-adjustable articulator? What are some advantages of the simple/hinge/non-adjustable articulator? What are some disadvantages of the

simple/hinge/non-adjustable articulator?

What are some characteristics of the semi-adjustable articulator?

How is the facebow transferred?

What are the four types of adjustments allowed with a semiadjustable articulator? What types of records are used for the condylar angle?

How do you use a static record to find the condylar angle? What record is used for the Bennett angle? What is the formula that we have to use for our Hanau articulators to find the Bennett angle (because $30,000 a year cant buy us decent articulators apparently) What is intercondylar distance? What do most semi-adjustable articulators have the intercondylar distance set at? How is the anterior guidance found?

No ability to reproduce mandibular movements accurately (opening, protrusive, lateral) - Limited in diagnosis and treatment planning - Time spend adjusting restorations - Restoration fabricated probably have incorrect ridge and grove pattern - Replicates some but not all of the patients movements - Accepts a facebow - Can be programmed - What we use at UMKC Usually an arbitrary facebow transfer. Casts more correctly related to the condyles. Opening and closing pathways closely resemble those of the patient. 1. Condylar angle 2. Bennett angle 3. Intercondylar distance 4. Anterior Guidance Protrusive records Lateral records **Some articulators only accept protrusive, some accept protrusive and lateral Static records - Only the beginning and end point of the movement are recorded - No information regarding intermediate path - Arbitrary straight or curved Lateral record (protrusive record does not record the Bennet angle) L = H/8 +12 L is the Bennet angle H is the condylar angle distance between the condyles according to the patients intercondylar distance 110 mm Can be mechanically programmed - Protrusive and lateral - Programmed at beginning and end of movement - Arbitrary path in between Can customize incisal guidance - Gives us the beginning, end, and in-between path Nope Protrusive records (one single record) Lateral records (records slope of medial wall of

Do most semi-adjustable articulators accommodate for working condylar movement? What are static records? **not sure if this is correctI had about

20 seconds to copy it down** What are advantages of semiadjustable articulators?

What are some disadvantages of semi-adjustable articulators?

What are sources of error for semiadjustable articulators? What is the error produced by arbitrary hinge axis location? What is the error produced by protrusive vs. lateral record? What is the error produced by curved vs. straight condylar path? What is the error produced by intercondylar distance (when assumed to be 110 mm)? How accurate is your semi-adjustable articulator? What is the fully-adjustable articulator? What movements are reproduced by the fully-adjustable articulator? What qualities of the movements are recorded? What facebow is used with the fully adjustable articulator? What does the fully adjustable articulator allow adjustment for?

articular fossa; records how far medially the condyle moves) - Uses facebow - Can mount casts in MIP or CR - Can program condylar and anterior guidance - Can program and stimulate with good accuracy eccentric movements - More anatomical although maybe not exactly resemble the patient - Restorations require less adjustment - Ridge and groove pattern more closely resembles patients - Less chairside time - Suitable for most work once limitations are understood - More expensive - More time required to make records and program articulator - Must understand how to use an articulator - Must understand occlusion - Cannot increase patients vertical dimension unless actually kinematically locate the patients actual terminal hinge axis - Arbitrary hinge axis location - Protrusive vs. lateral record - Curved vs. straight condylar path - Intercondylar distance 3mm off produces a 0.2mm error at the second molar region (Weinberg) 5 degrees off produces an error of about 0.1mm at the second molar region 0.2mm (cant create curved surfaces) Affects ridge and groove pattern Sufficiently accurate for most procedures. Biggest limitation is in increasing vertical dimension need a kinematic facebow. - Most sophisticated instrument for replicating mandibular movement - Very closely resembles patients movements - Most accurate articulator available Beginning, end, and in-between pathways of all movements Amount Direction Timing Kinematic hinge axis Protrusive condylar angle and curvature Non-working/orbiting condylar angle and curvature Bennett angle and curvature

What are disadvantages of the fully adjustable articulator?

What is another classification of articulators? What are the two types according to this classification? What is the arcon articulator? What is the non-arcon articulator? What are the three steps for mounting casts?

Bennett movement: mandibular lateral translation (timing and amount) - Intercondylar distance - Mechanical replication of a biological system so does not exactly replicate the patient - Materials introduce some errors - Operator error - Needs considerable practice - Time consuming Classification according to condylar element Arcon Non-arcon The condylar element is on the lower member and the guiding mechanism is on the upper member The condylar element is on the upper memberand the guiding mechanism is on the lower member 1. Correct positioning of the maxillary cast in relation to the rotational axis (face-bow transfer) 2. Relating the maxillary cast to the mandibular cast (mounting) 3. Program the articulator (condylar element) 1. Identify the rotational axis of the patient 2. Orient the maxillary arch to this axis in three planes 3. Transfer this relationship to the articulator to mount maxillary cast Centric Relation (CR) Maximum Intercuspation position (MIP) Term used to define a position of the condyles when the condyles are in the most anterior-superior position in the glenoid fossa Teeth must be separated by a centric record made with wax, polyvinylsiloxane, acrylic resin Term used to define teeth position where there is maximum occlusal contact between the teeth (aka centric occlusion) False The same path of opening and closure as in the mouth Using protrusive or lateral records Downward, forward Records the slope of the posterior part of the articular eminence of patient Records how far downward the condyle moves away from a horizontal plane (condylar angle) Programs condylar angle of both condyles Then calculate Bennett angles and program them Downward, forward, medially Records the slope of the medial wall of the

What is the procedure for face-bow transfer?

What are the two positions the mandibular cast can be mounted in? What is centric relation? How can you take a centric relation record? What is maximum intercuspation position? T/F centric relation = MIP What is the outcome of relating the maxillary cast to the mandibular cast? What records do you use to program the condylar element (last step in the mounting cast procedure)? What are protrusive records?

What are lateral eccentric records?

What is the lateral sideshift? Sorry this is in a weird placeno idea where he said it

What is a pantograph?

articular fossa (condylar angle) Records how far medially the condyle moves (Bennett angle) - Angles recorded are of the non-working condyle only - To program condylar/Bennett angles of both condyles, R and L lateral records are needed - Right lateral record to program Left condylar/bennett angles - Left lateral record to program right condylar/Bennett angles - Shift of jaw to the working side before they do the downward/medially/forward movement - Some people can have this - Not that important, but should be accounted for - How compensated? When have a semiadjustable articulator, put a little more Bennett angle in - What effect does this have on teeth/cuspal height? Restorations need more potential movement Graphic recording of mandibular movement in three planes as registered by styli on recordable tables -