docOcclusal Adjustment: A Method
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Occlusal Adjustment: A Method
Occlusal Adjustment: A Method Objectives CR Adjustment: Intercuspal Occlusion • Eliminate CR-IP slide, “create new IP in CR” • VDO slightly closed from original IP VDO • Simultaneous posterior contact • Axial loading of posterior teeth • Anterior lighter contact Objectives CR Adjustment: Excursive Occlusion • Working: canine guidance or group function • Nonworking: eliminate contacts • Protrusive: anterior guidance, eliminate posterior contacts Occlusal Adjustment: A Method Occlusal Adjusment: Limitations • Enamel thickness/ restoration • Tooth position • Skeletal relationship Occlusal Adjustment: A Method #14 Contact made by #19 Distobuccal Cusp: • Move #14 contact buccal towards the central fossa: Reduce #19 Dbuc from lingual Occlusal Adjustment: A Method #13 contact made by #20 Buccal Cusp: • Move #13 contact buccal: Reduce #20 Buc from lingual Occlusal Adjustment: A Method #15 contact made by #18 Mesiobuccal Cusp: • Move #15 contact buccal: Reduce #20 MBuc from lingual #13 contact made by #20 Buccal Cusp: • Move #14 contact mesiobuccal: Reduce #20 Buc from distolingual Occlusal Adjustment: A Method • Proceed around the arch making sequential decision on each Mx/Mn contact pair…tedious but necessary. • Erase all marks by light scraping of stone before remarking. • Don’t forget the incisal pin will contact at some point preventing contact, raise it from the table and keep going. • Preserve centric contacts when making excursive adjustments. Occlusal Adjustment: A Method HOW MUCH TO TAKE OFF? • Save the just the contact “edge” of the cusp you are adjusting towards the direction you are moving the contact WHAT IF IT IS DIFFICULT TO GET THE CUSP IN THE CORRECT FOSSA? • Create a flat fossa in the opposing incline to receive the cusp, I.e. Mn 1st premolar. Occlusal Adjustment: A Method #31 nonworking contact made by #2 Mesiolingual Cusp: • Cut distobuccal groove in #31. Occlusal Adjustment: A Method If lose centric contact, must have at least one centric contact between these 2nd molars by the completion of the adjustment. Occlusal Adjustment: A Method Goal: All centric cusps contacting and every posterior tooth pair holding shimstock. Occlusal Adjustment Limitations: • Enamel thickness 2.0-2.5 mm @ cusp and < fossa. • Tooth position • Underlying skeletal relationship Guideline: • “Rule of Thirds” (Fox, Okeson) Deprogrammer • Provides a vertical stop to allow use of low viscosity occlusal registration materials, e.g. addition silicone • “Deprograms” masticatory mm engrams, facilitating CR guidance Deprogrammer Deprogrammer Deprogrammer CR Occlusal Registration with Deprogrammer Panadent Articulator Panadent Earbow Procedure Panadent Earbow Procedure Panadent Earbow Procedure Panadent Earbow Procedure Panadent Earbow Procedure Panadent Earbow Procedure Thank you!
