Programming the semiadjustable articulator

Programming the
semiadjustable articulator

1. Programming DR Ajmal Khan Kattak S

2. Programming the semiadjustable articulator

3. Levels of Programming Objective Method Record used Level 1 To establish 3 D relationship of maxilla to hinge axis Face bow transfer Maxillary base Transfer rod Transfer jig Level 2 Relating mandibular cast to the maxilla Check bite Sealed occlusal rims Level 3 Setting the c ondylar path inclination Gothic arch tracing, plaster records Centric and p rotrusive record Level 4 Incisal table adjustment Esthetics and phonetics of anteriors Position of anteriors

4. Records Fully adjustable Semi adjustable Non adjustable Face bow Centric jaw relation Protrusive records Lateral records Intercondylar distance Rihani Awni, Classification of articulators, J Prosthet Dent, 1980; 43 (3):43-47

5. Hinge articulator has limited operating system

6. Semiadjustable articulator has an operating system

7. Intercondylar distance similar to human

8. Rectified condylar path

9. Adjustable centric lock

10. Adjustable Bennet angle

11. Adjustable protrusive path

12. Adjustable incisal table

13. Adjustable incisal table

14. At the end of level 1 – maxilla is fixed to upper member of articulator

15. Level 2 - Relating mandibular cast to maxillary cast – at centric – identify centre of rotation

16. End of Level 2 - Articulator is capable of performing hinge movement

17. Levels of Programming Objective Method Record used Level 1 To establish 3 D relationship of maxilla to hinge axis Face bow transfer Maxillary base Transfer rod Transfer jig Level 2 Relating mandibular cast to the maxilla Check bite Sealed occlusal rims Level 3 Setting the c ondylar path inclination Gothic arch tracing, plaster records Centric and p rotrusive record Level 4 Positioning of anteriors Esthetics and phonetics Incisal table adjustability

18. Level 3 : Horizontal and lateral condylar inclination Records are made at two points – centric and protrusive ( 6 mm )

19. The starting point is to verify whether check bite centric matches with graphic centric Level 3 : Horizontal and lateral condylar inclination

20. Two pencil marks

21. Holes drilled

22. Adhesive placed

23. Bobby pins

24. Bobby pins placed in to the holes drilled

25. Bobby pins placed in to the holes drilled

26. Centric record

27. Centric record placed on the mandibular record base

28. Maxillary record base placed on the centric record

29. The mandibular cast, mandibular record base with tracing unit , centric record, maxillary record base with tracing unit, maxillary cast

30. To find out whether check bite centric matches with graphic centric - Two conditions have to be met Obliteration of split space Sphere in contact with centric stop

31. Obliteration of split

32. Sphere in contact with centric stop

33. Split not obliterated

34. But sphere in contact with centric stop

35. Obliteration of split

36. Sphere not in contact with centric stop

37. If check bite centric does not match with graphic centric go back to reregister check bite centric

38. Protrusive record gives – horizontal condylar inclination – protrusive path Horizontal condylar inclination

39. Protrusive record

40. PR Screw adjustment may be necessary to facilitate obliteration of split

41. Lateral condylar inclination The Lateral condylar inclination is obtained from the formula L = H/8+12 in Hanau

42. L = H / 8 + 12

43. Level 4 : Incisal guide table The movement of mandibular anterior teeth against the lingual inclines of maxillary anterior teeth – anterior guidance

44. Straight protrusive - from centric / terminal hinge position to edge to edge position Lateral excursion – from centric to canine tip contact

45. The adjustable incisal guide acts as a platform to adjust the anterior guidance Incisal pin moves on a tilted platform thereby simulating anterior guidance

46. First the anterior teeth are arranged based on the esthetic, phonetic requirements of the patient A uniform overjet of 2 mm is provided

47. Adjusting incisal guide table – straight protrusive

48. Level 4 : Adjusting incisal guide table – lateral excursion

49. End of 7 Video 7

50. Objective - Prosthesis should not interfere with functional jaw movements Functional jaw movements occur within 6 mm from terminal hinge position (anterior and lateral) Angle formed by the superior wall of glenoid fossa in relation to horizontal plane - horizontal condylar inclination Angle formed by the medial wall of glenoid fossa in relation to midsaggital plane - lateral condylar inclination/ Bennet angle Anterior guidance – straight protrusive and lateral protrusive

51. Records from the patient : Face bow, centric, protrusive record, overjet and overbite Selection of articulator – Semiadjustable Familiarise operating system of Semiadjustable Programming Level 1 : Face bow transfer - Maxilla mounted to upper member Level 2 : Centric relation – Mandible mounted to lower member Level 3 : Horizontal and lateral condylar inclination - Level 4 : Anterior guidance

52. www.prosthodonticsandimplantology.com prosthoguru.blog.co.uk

53. Thank you

54. The Bennett Angle: angle formed between the mid-sagittal plane and the medial wall of the glenoid fossa on the non-working side (7-8 degrees) The more the intercondylar distance, the more distal the grooves are in the lower molars, and the more mesial they are in the upper molars. The lesser the intercondylar distance, the more mesial the grooves are in the lower molars, and the more distal they are in the upper molars. (fig 14)

55. Therefore the distance from the condyle to the teeth is crucial We obtain a measurement of this distance with a facebow

56. Level 4 : Adjusting incisal guide table In complete denture patients, when the patients protrude the lower jaw straight and bring the mandibular teeth just lingual to incisal edges of maxillary teeth, there has to be posterior teeth contact – to provide stability Similarly when the patient protrude their lower jaw laterally , the balancing contacts have to be provided by the posterior teeth. For this , first the anterior teeth are arranged based on the esthetic, phonetic requirements of the patient. A uniform overjet of 2 mm is provided.

57. Level 4 : Adjusting incisal guide table Similarly when the patient protrude their lower jaw laterally , the balancing contacts have to be provided by the posterior teeth.

58. An articulator is required to arrange the teeth

59. Programming the articulator Data from patient Transfer to articulator Adjust articulator according to the data Articulator now behaves like patient

60. Semi adjustable articulator is selected – for complete denture prosthesis

61. Levels of Programming Objective Method Record used Level 1 To establish 3 D relationship of maxilla to hinge axis Face bow transfer Maxillary base Transfer rod Transfer jig

62. Objectives of level 1 Make patient’s mandibular hinge axis (MHA) coincide with articulator hinge axis(AHA) Relating articulator hinge axis to maxillary cast 3 dimensionally

63. How farther or closer is the maxilla from hinge axis– horizontal plane 3 D relationship of maxilla to hinge axis

64. Where is the maxilla situated in between the condyles– horizontal plane 3 D relationship of maxilla to hinge axis

65. How high or low is the maxilla placed in relation to hinge axis – vertical plane 3 D relationship of maxilla to hinge axis

66. Level 1 programming – face bow transfer

67. Because both the condylar path and incisal pin are attached to upper member, the movement of the condyle along the slope and the movement of mandibular anterior teeth along the lingual inclines of upper anterior teeth occur at the same time.