MODEL ANALYSIS

Doctors Name____________________ Patient’s Name_______________

Open Bite_______________________________________________
Crossbite_______________________________________________
Occlusal Plane ___________________________________________
Mandibular Dental Midline- Right___mm Left ___mm Matches max.__

Initial point of contact in Centric Relation: ______________________

Matches Clinical Examination  Yes  No
Degree and Direction of Slide: _______________________________

Right lateral working #s: _________ Right Non working Contacts #s: _______
Left lateral working #s: __________ Left Non working Contacts #s: ________
Protrusive #s: _________________________________________________

Anterior Guidance

Describe the Guidance___________________________

____________________________________________

____________________________________________
____________________________________________

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 MODEL ANALYSIS
Attrition

Diagnosis _______________________________________________

Erosion

Diagnosis _______________________________________________

Abfraction

Diagnosis _____________________________________________________

Describe the Patients Pattern of Wear__________________________________

Front to Back________Side to Side___________Equal Opportunity___________

MPI Analysis and Graph

Right TMJ Left TMJ

Describe the MPI Analysis _________________________________________

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