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METHODS OF RECORDING OCCLUSION

OCCLUSION

It is the static relationship between the incising or masticating surfaces of the maxillary
or mandibular teeth or tooth analogues

CENTRIC RELATION

a maxillomandibular relationship, independent of tooth contact, in which the condyles

articulate in the anterior-superior position against the posterior slopes of the articular
eminences; in this position, the mandible is restricted to a purely rotary movement; from
this unstrained, physiologic, maxillomandibular relationship, the patient can make
vertical, lateral or protrusive movements; it is a clinically useful, repeatable reference
position
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CENTRIC OCCLUSION

The occlusion of opposing teeth when the mandible is in centric relation; this may or
may not coincide with the maximal intercuspal position.

MAXIMUM INTERCUSPATION

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.

VERTICAL DIMENSION
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The distance between two selected anatomic or marked points (usually one on the tip of
the nose and the other on the chin), 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.

OCCLUSAL REGISTRATION

A registration of the positional relationship of opposing teeth or arches; a record of the

positional relationship of the teeth or jaws to each other.

OBJECTIVES OF OCCLUSAL RECORD

To obtain harmonious relation between oral structures.

To provide masticatory apparatus which is efficient and comfortable and esthetically

pleasing.

For even distribution of occlusal forces to all supporting structures within their capability
withstand stress.

Harmonious occlusion contributes materially to control of damaging, leverage induced

stresses whereas faulty occlusion adds in destructive forces.

Materials for bite registration

Ideal requirements

 Limited resistance before setting to avoid displacement of mandible while

closure.
 Rigid/ resilient after setting
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 Dimensionally stable
 Should provide ideal recording of occlusion
 Easy manipulation
 Biocompatible
 Interocclusal record should be verifiable.

Materials used are:

1. Impression plaster
2. Waxes
3. Zinc oxide eugenol
4. Silicone elastomers
5. Polyether elastomers
6. Acrylic resins
7. Bite rims
8. Other materials

Impression plaster

Adv: accurate, rigid after setting, do not distort after extended period of time.

Disadv: difficult to handle and manipulate, final record is brittle.

Waxes

Thermoplastic waxes are used.

Adv: easy to manipulate

Disadv: inaccurate, dimensionally unstable

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Inconsistence due to interference with passive and active movement of mandible.

Zinc oxide eugenol paste

Adv:

1. fluidity before setting- ensures minimal interference- provides free closure of

movement of mandible.
2. Rigid and elastic after final setting.
3. Accuracy in recording
4. High degree of repeatability.

Disadv:

 lengthy setting time, Brittleness

 the accuracy of registration material may surpass the accuracy of casts, resulting
in improper fit.

ELASTOMERS

Silicone based: Virtual CADbite Registration, Ivoclar Vivadent, Leicenstein

Two types: addition silicone, condensation silicone

Stability- additional>condensation

Adv:

Accuracy, dimensional stability

Minimal resistance to closure and movements

Doesn’t require carrier.

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Disadv:

Its resistance to compression of set material- causes difficulty in seating of plaster cast.

Polyether:

Adv- accuracy, stability, fluidity and minimal resistance to closure,

can be used without a carrier.

Disadv- Resiliency and accuracy may exceed the accuracy of plaster casts.

These factors can make the mounting of cast difficult.

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

RECENT METHODS
Bite registrations for CAD/CAM procedures

 There are digital impression taking procedures, which are employed in

conjunction with the computer-aided design/computer-aided manufacturing
(CAD/CAM) of tooth restorations.
 Digital impressions are taken either : -
 Of the model in the dental lab.
 Directly in the mouth at chairside using an intraoral scanning device or camera.
 In order to determine the occlusal relationship, an antagonist bite registration is
required.
 Being able to directly capture images of this bite record with a scanning device or
camera without having to apply a contrast medium.
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Scannable bite registration materials

 StoneBite Scan from Dreve.

 Metal-Bite from R-Dental .
 Kanibite Scan from Kaniedenta .
 Virtual CADbite from Ivoclar. No contrast medium required.
 All of these materials are vinyl polysiloxanes.
 Saves considerable time and eliminates a possible source of error.

Scannable bite registration materials

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T-Scan 1984

 The development of a prototype computerized occlusal analysis (T-Scan;

Tekscan Inc,USA) was reported by Mannes et al.

 The T-Scan instrument was designed to examine

and record occlusal contacts by computer
analysis of information from a pressure-sensitive
film.

 The T-Scan system digitally records both the

location and timing of tooth contacts.
 Time moments are defined as the sum of distances of the tooth contacts in
millimeters from the x axis of the occlusal plane multiplied by their relative time
value (1-sec) and divided by the sum of the onset times.

Occlusion Sonography Dental Sound Checker

 was produced in the mid 1980s

 was developed to evaluate occlusal contact sound patterns during closure in an
attempt to detect occlusal disturbances.
 (Klifune et al ,1985) measured the duration of the occlusal sound in a single
subject before and after occlusal adjustment and reported a clear decrease in the
duration of the occlusal sound with adjustment.
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PRESSURE-SENSITIVE FILMS

 A newer but essentially similar device has been introduced (Dental Prescale, Fuji
Film, Tokyo, Japan).
 This device also records the location and force of contacts with the force-
sensitive film.
 Hattori et al. evaluated the reliability of this device for occlusal force
measurement both on a subject and on casts. They reported the linear
relationship between the applied and measured loads.

Limitation

 The recording medium is far too thick and results in heavier contacts on the
posterior teeth than the anterior teeth.
 Sensor thickness disturbs the persons finding attempts to close into the
intercuspal position.

TRANSPARENT ACETATE SHEET

 It is based on occlusal sketch technique that aimed to provide a simple and

reliable means of recording and transferring information about the location of
marked occlusal contacts.
 As per Daves et al., the sketch consists of an acetate sheet on which a
schematic representation of the teeth is drawn, including the occlusal surfaces of
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the posterior teeth, the palatal surfaces of the maxillary anterior teeth, and the
labial surfaces of the mandibular anterior teeth.
 The aim of the occlusal sketch technique is to provide a simple and reliable
means of recording and transferring information about the location of marked
occlusal contacts.

3D BITE
[Kachoei M, Behroozian A. "3D bite": A new appliance device for registration of
construction bite. Dent Res J (Isfahan). 2012;9(6):826‐827.]

• It controls the position of the mandible in three planes (sagittal, transverse, and
vertical)

• The amount of anterioposterior advancement, vertical opening, and lateral shift is

not limited.
• It can hold the mandible forward during cooling of the wax.
• There is a minimal need for patient cooperation.
• Numerical amount of change can be determined.
• The clinician can separate fork and wax and send it
to the laboratory for the fabrication of a functional
appliance.
• Less chair time
• It is very useful in clinical studies that address functional appliances because of
its numerical documentation and high reproducibility.
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OTHER METHODS & MATERIALS

Silk Strips

Some researchers have stated that silk strips are the best material for indicating
occlusal contacts.

Typewriter Ribbon

(Ziebert and Donegan ,1979 ) used typewriter ribbon to mark supra contacts or occlusal
interferences in their patients for occlusal adjustments.

Occlusal Sprays 

When testing occlusion all contact points will be immediately visible. These are
available in colors: red, blue, green and white.

Wax articulation paper

• The color coating of many articulating papers consists of waxes, oils and
pigments, a hydrophobic mixture which repels saliva (hydrophilic) consisting
mainly of water.
• High spots can be detected easily as dark marks and contacts as light marks.
Articulating paper come sin strips and horse shoe shaped sheets (Bausch
articulating paper Inc, Nashua, NH, USA).

• When grinding selectively it should be noted that only dark colored spots should
be ground.
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• The major disadvantages : can be easily ruined by saliva, are thick, and they
have a relatively inflexible base material; all of these factors result in a greater
number of pseudo contact markings .

ACRYLIC RESINS
• The most frequent application of acrylic resins for interocclusal records is in the
fabrication of single-stop centric occlusion records.
• Adv:
accurate& rigid after setting.
• Disadv:
dimensional instability- continued polymerization shrinkage
Strength and rigidity may damage the plaster casts and dies during articulator
mounting.

Stabilized bite rims

• Constructed on replica of diagnostic casts.The rims are inserted in mouth to
record centric.
• Indicated- Positioning of cast prior to formation of t/t plan and tooth preparation.

Le Dean Fattore, William F. Malone- conducted study to compare and check accuracy
of diff interocclusal record material.

• They compared:
• two thickness pink base plate wax
• Reinforced wax
• Zoe paste
• Non rigid polyether with carrier
• Polyether without carrier
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CONCLUDED THAT:

 Polyether without carrier was most accurate.

 Polyether with carrier and zoe paste next most accurate.
 Recording waxes consistently unreliable.
 Distortion occurred more frequently in a vertical direction followed by an aterio-
posterior direction.

Dawson's technique

In 1974 suggested:

• to place the dental chair in reclined position

• the patient's head stabilized by the dentist standing behind the patient.
• Place both thumbs on the chin and the 4 fingers resting on the inferior border of
the mandible.
• Then by gentle downward pressure by thumbs and upward pressure, pull the
patient's mandible into centric and let the patient bite on the registration material.
Dawson’s Method
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Procedure:

1 Select the bite frame.

2. Mixed the registration paste and apply it on both sides of fiber glass.

3. Place the frame with past over the prepared teeth without interference with patient
closure.

4. Ask the patient to close using a Dawson’s technique and check the key point of
occlusion.

5. After setting trim the paste to a depth leaving only the tip of the cusp both prepared
and unprepared side, so that the bite material will not interferes with complete seating of
the cast into the bite taken.

6. Put the bite on its placed on one cast bring the other cast on the proper place and
check the key point of occlusion. Mount both casts on articulator.

Triple Tray Technique

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 A plastic registration frame (triple bite impression tray) is used in this method to
carry the interocclusal registration material.
 The frame is tried in the mouth on the side with the prepared teeth. Trim away
the film that covered the unprepared teeth.
 Apply the bite registration material evenly on to both top and bottom of the frame
and insert the tray in the mouth, centering the loaded portion over the prepared
teeth.
 Cut excess material that extends over the unprepared teeth adjacent to
preparation. Remove the excess thickness of the record so that only the imprint
of cusp tip should remain.
 The part of the record facial to the mandibular buccal cusp tips is cut off all the
way through the posterior member of the frame, and the facial segment of the
record is discarded.

Enamel Island Method

This method preserves a centric stop on an abutment as an aid when making

interocclusal record
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Recording of occlusal relationship

 It may vary from simple apposition of casts by occluding sufficient remaining

natural teeth to recording of jaw relationship in the same manner as of
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

a. Direct apposition of cast

b. Interocclusal record with posterior teeth remaining

c. Occlusal relation using occlusal rims on record bases.

d. Jaw relation made entirely on occlusion rims.

e. Establishing occlusion by recording of occlusal pathways.

Direct apposition of cast

Also known as Hand Articulation- Krogh Paulson

Indications:
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 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.

Procedure

 Casts 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.
 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 acceptance of such a jaw relation.
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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 eg.(Kennedy class III or class IV) but the relationship of
opposing teeth does not permit the occluding of cast by hand.

PROCEDURE

o 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.
o All excess wax should be removed with a sharp knife.
o The wax is removed and chilled thoroughly. It is again replaced in mouth to
correct the distortion and chilled again.
o 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.
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 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. 
 one or more distal extension areas are present.

PROCEDURE

o Accurate records bases are to be used to support the occlusal relationship.

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o Occlusal rims are constructed over the record bases by wax occlusion rims or
modeling plastic occlusion rims.
o Vertical dimension is corrected .
o Occlusion rims are reduced in height just out of occlusal
contact.
o A single stop is added to maintain their terminal position.
o Bite registration is made by injecting the recording medium in between the two
occluding surfaces.
o Patient should be guided to the centric position and should be held in position till
the material sets.
o Completed record is examined and it is trimmed so that only cusp tips and
indices remain.
o Cast are then mounted on the articulator by using the record. 

JAW RELATION RECORDS MADE ENTIRELY ON OCCLUSAL RIMS

Indications:

o When no occlusal contact exists between the teeth,

eg. when opposing maxillary complete denture is to be made concurrently with a

mandibular partial denture.

o When few remaining teeth do not occlude and will not influence eccentric jaw
movement.
o When only anterior teeth is present.
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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
NISWONGER’s 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.
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• 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:
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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. 
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 Advantage: dentist is able to observe and correct the movement the patient is
making.
 Disadvantage: At least 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

1. The incisal pin is opened 1mm before the artificial teeth are
positioned.
2. This increase in vertical dimension will be returned to normal by selective
grinding of the teeth.
3. The selective grinding develops occlusal anatomy of the denture teeth to conform
to the functionally generated stone path.
4. After the teeth are set in correct alignment the incisal pin is returned to correct
vertical dimension of occlusion.
5. 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.
6. Spots of dye are transferred to the denture teeth. selective grinding is done till
the incisal tip touches the incisal table.
7. The articulator is not moved into protrusive and lateral movements because
these positions are incorporated in the pathway. 
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ADVANTAGES

 The method makes the registration of inter occlusal records or a face bow
transfer unnecessary and dispenses the need for a complicated articulator.
 Jaw movements and tooth pathways are reproduced under more nearly
functional conditions than in 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 patient’s 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
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 PROCEDURE
 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 been 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.
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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. 

Occlusal consideration in implant retained partial denture

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• Axial displacement of teeth in the socket are 25-100 μm, while that of the
osseointegrated dental implants has been reported approximately 3-5 μm. 
• Natural tooth moves56-108 μm and rotates at the apical third of the root upon a
lateral load, while dental implant moves 10-50μm under a similar lateral load.
• An ‘ideal occlusion’ in removable prosthodontics is one which reduced de-
stabilisating forces to a level that is within the denture’s retentive capacity

CONCLUSION
• During restorative phase of any dental treatment, the proper articulation of
patient’s diagnostic or working casts is essential for fabrication of clinically
acceptable prosthesis.
• Bite registration materials such as wax and zinc oxide eugenol are used for
registering intermaxillary relationship.
• The introduction of polyether and polyvinyl siloxane bite registration materials
has made clinicians unclear of which material to be used. To increase the chance
of success of the recording properties, alterations have been made by adding
plasticizers and catalyst to bring in different handling charactestics; however, it
remains anonymous whether these modifications in the parent impression
materials have modified their properties such as accuracy and dimensional
stability.
• Polyether bite registration paste is gaining acceptance due to its ease of
manipulation and accuracy. Polyether exhibited outstanding flow characteristics
than addition silicone and waxes.
• To summarize, in the past 2–3 decades, many new materials have been
introduced along with new techniques.
• Many of these materials have shown promising results, but clearly, there is a
need for long-term studies to identify the best material for obtaining the better or
best maxilla-mandibular relations or the interocclusal records.