Jaw Relation Record Dr Mostafa Elsayed - Minia relation … · JAW RELATION IT IS THE RELATION...
Transcript of Jaw Relation Record Dr Mostafa Elsayed - Minia relation … · JAW RELATION IT IS THE RELATION...
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Jaw Relation Record
Dr Mostafa Elsayed Sem1 11.4.2020
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JAW RELATION
IT IS THE RELATION BETWEEN MANDIBLE
(LOWER JAW) AND MAXILLA (UPPER JAW)
IN VARIOUS POSITIONS OF THE MANDIBLE
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static contact relationship that exist after
the jaw movement has stopped and the
tooth contact are identified
OCCLUSION
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CENTRIC RELATION • Bone to bone contact.
• The most retruded relation of the mandible to the
maxilla when the condyles are in the most posterior
unrestrained position in the glenoid fossa from which
lateral movements can be made, at any given degree of
jaw separation.
• Maxillo-mandibular relationship when the condyle is in
the rear most upper most midmost (RUM position)
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CENTRIC RELATION This position is clinically discernable
when the mandible is directed superiorly
And anteriorly and restricted to a purely
rotary movement about a transverse horizontal axis.
CENTRIC OCCLUSION
The occlusion of opposing teeth when the mandible is in centric
relation.
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POUR MASTER CASTS
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RECORD BASES AND OCCLUSION RIMS
FOR MAKING JAW RELATIONSHIP RECORDS
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Significance of jaw relation 1.Function and esthetics
2.Stability
3.Health
4.Establitioning maxillo-mandibular relation in
several directions
5. Building up occlusion of denture
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RECORDING JAW RELATIONSHIPS 1. Check denture foundation.
2. Establish facial contour.
3. Establish occlusal plane.
4. Maxillary face-bow record.
5. Determination of vertical dimension
of centric occluding relation.
6. Equalize pressure of occluding forces.
7. Determine centric relation at the
accepted vertical dimension.
8. Locking device ( recording the C.O.R.
)
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I- CHECK DENTURE FOUNDATIONS.
Extension
Retention
Stability
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II-ESTABLISH FACIAL CONTOUR
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OCCLUSAL PLANE = PLANE OF OCCLUSION
A common plane established by the incisal edges
and occlusal surfaces of the teeth.
[This is usually curved and is therefore not strictly a
plane]
Camper’s line
III- Determination of
the occlusal plane
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3- DETERMINATION OF THE OCCLUSAL PLANE Anatomical determinants of the orientation of occlusal
plane:
1- The lip line.
2- The interpupillary line.
3- The ala-tragus line.
4- The Retromolar Pad.
5- The Linea Alba.
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Ala-tragal line(Camper’s line): A line passing through the inferior border of the ala of the nose and the superior border of the tragus of the ear. [This line is approximately parallel to the occlusal plane of the natural teeth]
Ala-tragal line
(Camper’s line)
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By the use of FOX occlusal guide
It is advisable to use an occlusal plane indicator (fox plane) for obtaining the correct anterior and anteroposterior planes.
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DETERMINATION OF THE OCCLUSAL PLANE
Posteriorly starting
from the canine
backwards, parallel to
the naso-auricular line
(ala-tragus or
Camper's line).
The posterior teeth
are set to a slight
anteroposterior curve.
The incisal and occlusal surfaces of the teeth
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3- DETERMINATION OF
THE OCCLUSAL PLANE
Factors must be considered:
1- Aesthetic base
2- Functional base (chewing and speech)
3- Physical and mechanical (leverage
action and parallelism)
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DETERMINATION OF THE OCCLUSAL PLANE
The Height Of Occlusal Plane Should Be 1-2 Mm. Below The Upper
Lip.
Anteriorly Is Influenced By:
The Length Of The Lip,
Ridge Fullness,
Ridge Height,
The Amount Of The Maxillomandibular Space And
The Incisal Guide Angle.
• Aesthetic base.
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2- FUNCTIONAL BASE
(CHEWING AND SPEECH)
Chewing
The tongue works in coordination with the
buccinator muscle to keep the food on the
occlusal surface of the teeth. When the teeth
meet during the chewing cycle, they mash the
food. The food is pushed away from the occlusal
table to the cheek and tongue side. Then the
tongue and cheek put the food again on the
occlusal surface of the teeth and another
masticatory cycle starts.
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2- FUNCTIONAL BASE (CHEWING AND SPEECH)
1)Chewing
The height of occlusal plane should be
convenient and at a level familiar to the
tongue to perform its action easily and stop
food escaping to the floor of the mouth.
The occlusal surface of the teeth should be below the
greatest convexity of the tongue.
• This also improves the stability of lower denture.
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2- FUNCTIONAL BASE
(CHEWING AND SPEECH)
2) Speech:
During speech, the tongue pushes against the sides
of the teeth to produce a seal for better
pronunciation of words.
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1) Leverage action
2) Parallelism
3) Arch form
3- Principle of Physics
and Mechanics
The amount of leverage or torque exerted on the occlusal plane is a function of the
height of the plane above the ridge. Torque X = force (f) x Distance from fulcrum (R).
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1) Leverage action:
The nearer the occlusal plane to the basal bone of the jaws, the less the leverage action and the better the stability.
3- Principle of physics and
mechanics
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EFFECT OF OCCLUSAL PLANE ORIENTATION ON DENTURE STABILITY
2) Parallellism:
The occlusal plane should be parallel to both supporting ridges. In
this way the biting forces are vertical on the ridges and there is no
tendency for horizontal displacement of the dentures.
3- Principle of physics and
mechanics
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3- Principle of physics and
mechanics
3) Arch form
Both the width of the occluding surfaces and the contour of the
arch form of the occlusion rims should be individually
established to simulate the desired arch form of artificial teeth
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SIMULATE THE DESIRED ARCH FORM OF ARTIFICIAL
TEETH TO ACHIEVE THE CONCEPT OF A NEUTRAL ZONE
APPEARANCE
LEVER BALANCE
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The central line.
The high lip line.
The corner lines.
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IV- DETERMINATION OF VERTICAL
DIMENSION OF CENTRIC
OCCLUDING RELATION
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Vertical Dimension
V D O
The vertical dimension of the face when the teeth are in contact in centric occlusion.
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Occlusal Vertical Dimension
• The distance measured between two points when occluding members are in contact in centric occlusion.
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Vertical Dimension
V D R
The vertical dimension of the face when the mandible is in rest position.
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REST RELATION
The postural relation of the mandible
to the maxilla when the patient is
resting comfortably in an upright
position and the condyles are in a
neutral unstrained position in the
glenoid fossa.
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PHYSIOLOGIC REST POSITION IS:
The postural position of the mandible
when an individual is resting
comfortably in an upright position and
the associated muscles are in a state of
minimal contractile activity. and
the condyles are in a neutral
unstrained position in the glenoid
fossa.
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INTEROCCLUSAL CLEARANCE FREEWAY SPACE
The space between the maxillary and mandibular occlusal surfaces when the mandible is in the rest position.
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V D R
V D O
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Inter Occlusal Distance
(Free Way Space) = 2 to 4 mm.
( F W S ) (0 to 10 mm.)
Vertical Dimension
V D R - F W S = V D O
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Variables Affecting V D R :
Short Term Variables :
1. Position of the patient's head .
2. Respiration.
3. Stress Situations .
Long Term Variables :
1. Loss of the properioceptives impulses from the
periodontal ligament.
2. Age.
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Willis gauge
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VALUE OF VERTICAL DIMENSION
Biological importance of correct registration of the occlusalvertical dimension ; the patient can
1 - Masticate his food efficiently.
2 - Speak without impediment.
3 - Present a normal facial appearance.
4 - Experience a minimum amount of discomfort in
using his dentures.
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1- inharmonious facial proportions (Appearance).
2- Flexor muscles are in constant strain.
3- The lips are unnaturally separated and have a strained appearance.
4- The free-way space will be obliterated, inability to find comfortable resting
position.
5- Clicking of teeth may occur during speech and mastication.
Sequelae Of Improper Registration Of V.D.0.
A . High Vertical Dimension Of Occlusion :
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Sequel Of Improper Registration Of V.D.0.
6- Generalized soreness of the residual ridge.
7. Difficulty in swallowing and gagging sensation (Discomfort).
8. Loss of biting power and muscular fatigue.
9. Interference with speech .
10. Pain under the basal seat and trauma to the supporting structures .
11. Accelerate bone resorption.
A . High Vertical Dimension Of Occlusion :
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High Vertical Dimension
Flabby Tissue
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High Vertical Dimension
High Plane of Occlusion
Obliterated free-way space
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B. LOW VERTICAL DIMENSION OF OCCLUSION :
1- Extensor muscles are strained.
2- Facial appearance is distorted.
3- Corners of the mouth may be inflamed ( angular
chielitis ).
4- Pain in tempro-mandibular joint (Custon’s syndrome).
5- Cheek biting.
6- Inefficiency: reduces biting force
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TROUBLE IN THE T.M.J. The symptoms of the joint due to reduced V.D. are
manifested by
Obscure pains and discomfort,
Clicking sounds,
Headaches and neuralgia running in the ear.
These symptoms may be resulted from pressure on the
tympanic nerve.
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Cheek Biting
Monoplane Heavy Bite No Horizontal Overlap
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Angular Cheilitis
Corner of Mouth
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MOUNTING OF THE CASTS ON THE
ARTICULATOR FACEBOW:
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SCORING (INDEXING)OF THE CASTS
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A) MOUNTING OF MAXILLARY CAST
Using facebow record
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Using bonwill triangle
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MOUNT MAXILLARY CAST
SAME RELATIONSHIP TO TRANSVERSE
HINGE AXIS
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Mounting the upper cast
1.By face bow record.
2.By Bonwill triangle.
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METHODS OF DETERMINATION
OF CENTRIC RELATION
1- Wax registration method (check bites).
2- Terminal hinge axis determination method (mandibular face bow).
3- Graphic tracing or excursive method.
4- Chew in or functional record method.
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CHECK BITE METHOD
Notch Preparation
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1- Maintain even contact throughout
all occluding surfaces of the hard
occlusion blocks at the predetermined
Equalizing occluding forces can be done on two steps:
vertical dimension of
centric occluding
relation.
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CHECK BITE METHOD
Guiding the mandible into centric position (Wax wafer method)
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METHODS TO GUIDE THE MANDIBLE
IN CENTRIC RELATION
1- Tongue retrusion .
2- Swallowing .
3- Biting operator’s fingers .
4- Relaxation .
5- Fatigue .
6- Head position .
7- The temporalis muscle check .
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CHECK BITE METHOD
Locking device
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Wax Registration Method
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2- TERMINAL HINGE AXIS METHOD
Kinematic Face Bow
( Mandibular Face Bow )
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TYPES OF TRACERS
A-Intraoral tracer
B-Extraoral tracer
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ECCENTRIC JAW RELATIONSHIPS
Protrusive Record
Right Lateral Record
Left Lateral Record
Any jaw relation other than centric relation .
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ECCENTRIC JAW RELATIONS
Methods of Registration
1.Wax registration method.
2.Graphic tracing method.
3.Chew – in or Functional method.
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Christensen Phenomena
When the mandible moves to edge to edge position , separation occurs distally between the natural dentition or occlusion rims .
Protrusive Record
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THE PROTRUSIVE RELATIONSHIP
DETERMINES THE ANGLE OF THE
HORIZONTAL CONDYLAR PATH
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LATERAL RELATIONS:
Right Lateral Record Left Lateral Record
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Gothic Arch Tracing Method
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Gothic Arch Tracing Method
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Gothic Arch Tracing Method
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Graphic Tracing Method
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THANK YOU