Review articleJaw relation records for fixed prosthodontics
Section snippets
General principles
If the goal of restorative treatment is to maintain a patient's pretreatment intercuspation and vertical dimension of occlusion (VDO), casts should be mounted in a manner that maintains the same tooth-to-tooth relationship that existed before treatment. This maximum intercuspal position (MIP) facilitates treatment and works with the patient's existing occlusion. The vast majority of cases treated fall within this MIP category. The situation becomes more difficult if a patient requires extensive
Articulator choice
When fabricating fixed and removable prostheses, the use of an adjustable articulator usually reduces the amount of intraoral adjustment needed. A more anatomically sized articulator, such as a programmed adjustable or a semiadjustable articulator, better reproduces the mandibular border movements compared with a simple hinge articulator. An articulator that is more true to human size allows the restoration to be adjusted by the technician to a greater degree and to a closer approximation of
Purpose of a facebow
The purpose of a facebow transfer is to orient the maxillary cast to the transverse axis of the articulator. Its use is limited to adjustable and semi-adjustable articulators. Facebows are not necessary if there will be no change in the VDO. However, if any alteration of the VDO is planned, as in a full-mouth rehabilitation, a facebow (and a full-sized articulator) should be used. Another positive aspect of using a facebow is that it makes it easier to mount a maxillary cast to a full-sized
Avoiding errors and inaccuracies
Inaccuracies in jaw relations can be caused by a number of factors besides a poor interocclusal record. Errors can be introduced anywhere from impressions to cast accuracy to problems with the articulation of the casts. These areas are often overlooked and are as important for overall accuracy as the interocclusal record.
All impression materials, all dental stones or plasters, and all interocclusal materials have inherent inaccuracies: they shrink or expand. Learning how to minimize these
Materials for interocclusal records
The most commonly used materials for interocclusal records are the fast-setting elastomeric interocclusal registration materials or wax. Elastomeric materials such as polyvinylsiloxane are well suited for making interocclusal records where only horizontal stability is needed. However, their accuracy can be compromised if they are not properly trimmed. These records should be carefully trimmed to remove all areas of the record that contact soft tissues and the axial surfaces of the teeth. This
Summary
This article discusses and reviews general principles of jaw relation records, including the purpose of a jaw relation record and the concept of a tripod of vertical support with adequate horizontal stability to allow opposing dental casts to be mounted accurately on an articulator. The use of the MIP position for the vast majority of patients is favored when the goal of restorative treatment is to maintain a patient's pretreatment intercuspation and vertical VDO. In addition, articulator
Acknowledgements
The author thanks Dr. Martin Freilich for his expertise and guidance in the writing of this article.
References (5)
- et al.
Principles for selecting interocclusal records for articulation of dentate and partially dentate casts
J Prosthet Dent
(1992) - et al.
Accuracy and dimensional stability of four interocclusal recording materials
J Prosthet Dent
(1981)
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