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PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith Mays Dr. Pauline Hayes Garrett

PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

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Page 1: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

PRINCIPLES OF ARTICULATION

Department of Endodontics, Prosthodontics, and Operative Dentistry

University of Maryland, Baltimore

Dr. Gary Hack

Dr. Keith MaysDr. Pauline Hayes Garrett

Page 2: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

PRINCIPLES OF ARTICULATION

• What is an articulator?• What is the purpose of an articulator.• Discuss the types of articulators and applicable uses?• Discuss the terminology of Articulators.• Define Arcon vs Non-Arcon.• Discuss patient cast orientation to the articulator.

ObjectivesObjectives

Page 3: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

PRINCIPLES OF ARTICULATION

• A mechanical instrument that represents the temporomandibular joints and jaws, to which maxillary and mandibular casts may be attached to simulate some or all mandibular movements

Page 4: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

TYPES OF ARTICULATORS

Page 5: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Articulator Design

• Arcon - condylar element on lower– Just like the condyles are attached to

the mandible– Mechanical fossae located on the

upper member just like the glenoid fossae

• Non Arcon - condylar element on upper– Unlike natural anatomy– The condylar path (glenoid fossae) is

located on the lower member

Page 6: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Arcon Articulator: condylar element on lower element. Glenoid fossa on upper.

Arcon Articulator:Hanau Modular Semi Adjustable Articulator

Page 7: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

DETERMINANTS OF OCCLUSION

Posterior

1) Right TMJ2) Left TMJ

Anterior1) Anterior Teeth

Page 8: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Posterior Determinants of Occlusion

The condylar guidance is a fixed factor, and the TMJs are the posterior controlling factor in mandibular movement.

Posterior Determinants1) Right TMJ2) Left TMJ

Page 9: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Anterior Determinants of Occlusion

The anterior teeth:

Determine the movement of the anterior portion of the mandible.

• Anterior guidance is variable since it can be altered by:

• restorations, • extractions, • orthodontics, • attrition, etc.

Page 10: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

ARTICULATOR REVIEW:Hanau Modular Arcon Articulator

Posterior Determanants

Page 11: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Horizontal Condylar Guidance:Angle of Condylar Descent

Page 12: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

POSTERIOR ARTICULATOR GUIDES

• Horizontal Condylar Guide– Angle of Condyle descent

• protrusive wax record• bite registration materials

• Bennett Angle (there may or may not be associated Bennett Movement or Side Shift with lat. Mandibular Movement)

– Associated with Mediotrusive side during Laterotrusive movement

• Lateral wax check bites• Pre-programmed in your

articulator

Page 13: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Bennet Angle• BENNET ANGLE The angle made by a line

drawn from the point of origin of the balancing condyle to the final positions in Protrusion and mediotrusion.– One leg of the angle

is formed by a line made in a protrusive movement

– The other is made from a line drawn from the point of origin and the final point of the ant. Teeth after the mediotrusive orbit.

Illustration modified and Reprinted from: Ramfjord & Ash (1971), Occlusion, W. B. Saunders Company., Philadelphia, Pa. with permission from Elsivier, Pg. 75

Page 14: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

REVIEWHanau Modular Arcon Articulator

and the Anterior Determinant:Anterior Teeth

Mechanical Guide Table

Page 15: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

ANTERIOR GUIDE TABLE

• Maintain the relationship between casts – Protecting the cast from wear

• Uses of articulated casts– Evaluation of occlusion– Evaluation of tooth position– Evaluation of tooth form– Evaluation of gingival tissues– Fabrication of indirect restorations

Purpose of Guide Table

Page 16: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

CAST ORIENTATION

• Hinge Axis is a repeatable reference

• For the highest possible accuracy cast should be mounted as close to this axis of rotation as possible.

Page 17: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

CAST ORIENTATION:Centric Relation vs. Maximum Intercuspation

If the patient is asymptomatic, and has a sufficient number of teeth to consistently close into maximum intercuspation, then maximum intercuspation should be used for cast orientation.

Page 18: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

CAST ORIENTATION

• To Orient the Maxillary Cast – Facebow• To Orient the Mandibular Cast- Interocclusal record or

hand articulation depending on # teeth.

Page 19: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Patient Face Bow TransferCenter anterior teeth in wax on bite plane.Ear bow is carefully placed into the ears.

Page 20: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Transfer the Face Bow Transfer to the Articulator

Page 21: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Attaching Maxillary Cast to the Articulator via the Face Bow

Transfer

Page 22: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Attaching Maxillary Cast to the Articulator via the Face Bow

Transfer

***Cast Must Be Wet Before Articulating with Plaster

Page 23: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Mandibular Cast Orientation

• Hand articulation when patient has sufficient number of teeth to place casts into maximum intercuspation

• Interocclusal records• -Bimanual manipulation• -With insufficient

number of teeth to establish a reproducible relationship

Page 24: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Articulate Mandibular Cast

Page 25: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Clean Up as you go

Page 26: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Setting the Condylar Inclination

Page 27: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

Setting the Anterior Guidance: Mechanical Guide Table

Page 28: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith

TYPES OF ARTICULATORS

Hinge Axis (facebow)

CR Record Protursive Lateral Excursion

Bennet

NONADJUSTABLE No No No No No

SEMI ADJUSTABLE Approximate Yes Yes

Straight line

Yes Straight line

Approximate

FULLY ADJUSTABLE Yes

(exact) Yes Yes

Curved Yes Curved

Yes Side Shift

Page 29: PRINCIPLES OF ARTICULATION Department of Endodontics, Prosthodontics, and Operative Dentistry University of Maryland, Baltimore Dr. Gary Hack Dr. Keith