Introduction
The interocclusal registration material records the occlusal
relationship between the natural and / or artifi...
Ideal Requirements of Interocclusal Bite3,26
Registration Material:
1. Limited resistance before setting to avoid displaci...
1. Impression Plaster (Type I Gypsum)1,2,3,4,5,13,14,16,15
Impression plaster is basically plaster of paris to which modif...
Technique :
Transfer copings are made. Impression plaster is applied over the top of
copings and the patient is asked to c...
Flow : The flow of several bite registration waxes at 37°C ranges from 2.5%
to % indically that these waxes are susceptibl...
interferences and is returned to the mouth. The trimming for possible
interferences is done by shaving the wax with a shar...
Mixing time : Approximately 1 minute
Setting time : 10 minutes
Dimensional stability : A negligible shrinkage lesser than ...
adjacent tooth. The frame is placed distal to the last tooth to prevent
impingement upon the metal of the frame. The patie...
Mean working time : At 23°C At 37°C
3.1 min 1.8 min
Mean setting time : At 23°C At 37°C
8.9 min 5.9 min
2. Condensation si...
- Stability after setting.
- Minimal Resistance to closure.
- Does not require a carrier.
Disadvantage :
- Resistance to c...
Base paste : Low molecular weight polyether with ethylene amine terminal
group along with fillers such as colloidal silica...
Technique :
Take equal amount of base paste and catalyst paste and mix according
to manufacturers instructions obtaining a...
Technique :
Apply petroleum jelly over occlusal surfaces of teeth. Measure monomer and
polymer according to manufacturers ...
Review of Literature
- Martin Henry Berman (1960) conducted a study to evaluate the
dimensional stability of waxes. He fou...
- Carl G. Wirth and Arthur W. Aplin (1971) introduced a method
to improve wax interocclusal record by using a wax with low...
- Yvonne Balthazar, James L. Sandrik W.F.P. Malone, Boteslaw
Mazur and Timothy Hart (1981) investigated accuracy and
dimen...
most accurate and dimensionally stable. However, exact
reproduction of original wax recording were unlikely and not
achiev...
Summary & Conclusion
An inter occlusal record is a precise recording of maxillomandibular
position it should be capable of...
Bibliography
1. Anusavice – Philips Science of Dental Materials. Tenth Edition, 1996,
W.B. Saunders Company.
2. Carl G. Wi...
8. Philip Millstein, Joseph H. Kornman and R. Ernest Clark – Determination
of accuracy of wax interocclusal registrations ...
15.Thomas E.J. Shanaban and Alexander Leff. – Interocclusal records. J.
Prosthet. Dent. 1960 ; 10, 5.
16.Tylman’s – Theory...
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Inter occlusal records

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Inter occlusal records

  1. 1. Introduction The interocclusal registration material records the occlusal relationship between the natural and / or artificial teeth for planning occlusal rehabilitation and for construction of removable and fixed partial dentures. The goal in the success of removable and fixed partial denture is achieved when maxillomandibular centric relation is recorded accurately. The material used to establish and to record this relationship is very important factor in the accuracy of record, which can effect the validity of centric relation record. 1
  2. 2. Ideal Requirements of Interocclusal Bite3,26 Registration Material: 1. Limited resistance before setting to avoid displacing the teeth of mandible during closure. 2. Rigid or resilient after setting. 3. Minimal dimension changes after setting. 4. Accurate record of the incisal and occlusal surface of teeth. 5. Easy to manipulate. 6. No adverse effects on the tissues involved in recording procedure. 7. The interocclusal record is verifiable. Types of Interocclusal Recording medium1,2,3,4,5,13,14,16,18 1. Plaster of paris. 2. Waves. 3. Zincoxide eugenol pastes. 4. Silicone elastomers. 5. Polyether elastomers. 6. Acrylic resins. 2
  3. 3. 1. Impression Plaster (Type I Gypsum)1,2,3,4,5,13,14,16,15 Impression plaster is basically plaster of paris to which modifiers have been added. These modifiers accelerate setting time and decrease setting expansion. Composition : Calcium sulphate hemihydrate. Water powder ratio : 0.75 to 0.50 Mixing time : 20 to 30 seconds Working time : 5 minutes Initial setting time : Approximately 9 minutes Advantage : Records of impression plasters are accurate, rigid after setting and doubt distort with extended storage. Disadvantage : Impression plaster is difficult to handle because material is fluid and unmanageable prior to setting. 3
  4. 4. Technique : Transfer copings are made. Impression plaster is applied over the top of copings and the patient is asked to close in centric relation. The impression plaster on the adjacent teeth is cut away so that a rectangular contact area in plaster remains. Undertake due to adverse tooth contours are reduced to assure removal of the plaster without chipping or cracking the record. Right angle cuts are made on buccal and lingual / palatal indices of the teeth adjacent to the copings are made. The interocclusal record and the buccal and lingual / palatal indices are removed and are reassembled. The dies are positioned in the record and a master cast is poured. 2. Waxes1,2,3,4,5,7,8,9,12,13,15,16 The bite registrations are frequently made from 28 gauge costing wax on from basepaste wax, specially formulated from bee wax or hydrocarbon waxes such as paraffin are creasin. The thermoplastic waxes are frequently used for interocclusal registration or as a carrier for registration. Combination of Alu wax base plate was reinforced with Ash no.7 metal sheath is also being used. They have been used in the shape of quadrant strips or segments, horce shoe shape wafers and complete or partial arch wafers. Waxes can be applied directly in sheet from or they can be laminated over tinfoil and gauze. 4
  5. 5. Flow : The flow of several bite registration waxes at 37°C ranges from 2.5% to % indically that these waxes are susceptible to distorting on removal from mouth. Advantage : A major factor in popularity is clinical flexibility of waxes and accounts for the broad range are which records can be modified changed, corrected and verified with comparative ease. Disadvantage : However studies have demonstrated that wax interocclusal records are inaccurate unstable inconsistent because they can interfere with passive and active mandibular movement that is they resist to the closure. Technique : A wax interocclusal centric relation record is made before the abutment are prepared. Then the abutments are prepared and another interocclusal record is made with a half of sheet of softened wax. The wax is molded into the shape of the dental arch and is positioned on the teeth and the patient is asked to close the jaws or, the mandible is guided into centric relation. Then patient is asked to open and close the mouth several times. The distinct sound of tooth percussion should be heared. The wax is cooled with water, while the teeth are held together, the patient is asked to open the mouth and the wax is cooled further. The total cooling must be atleast two minutes. The wax record is removed from the mouth and is allowed to cool for one minute under running water. The wax record is trimmed for possible 5
  6. 6. interferences and is returned to the mouth. The trimming for possible interferences is done by shaving the wax with a sharp blade to prevent its distortion. The seating of record on the teeth and closure must be precise. The registration is compared with the record made prior to abutment preparation. The wax record is stored on the opposing cast and is kept in a cool place. 3. Zinc oxide Eugenol Paste1,3,4,5,6,13,16,19 Zinc oxide Eugenol paste is an effective interocclusal registration material. Composition : Tube I (Base) Tube II (Accelerators) Zinc oxide 87% Oil of cloves or eugenol 12% Fixed vegetable 13% Gum polymerised resin 50% Or mineral oil Filler 20% Lonslon 3 % Resinous balsam 10% Accelerator solution (CaCl2) 5% 6
  7. 7. Mixing time : Approximately 1 minute Setting time : 10 minutes Dimensional stability : A negligible shrinkage lesser than 0.1% may occur during hardening Advantages : Fluidity before setting – Fluidity is a critical quality of an interocclusal registration material because it ensures minimal interference with mandibular closure during record making procedures. - Adhesion to its carrier. - Rigidity and inelasticity after final set. - Accuracy in recording occlusal and incisal surfaces of the teeth. - High degree of repeatability. Disadvantages : - Lengthy setting time. - Significant brittleness ? - Accuracy of the registration material may surpass the accuracy of the casts resulting in proper fit. Technique : A Jones frame with a Kerr Bilb is used to carry the paste into position between the teeth. Sufficient paste is mixed to cover both sides of the gauze and to register half of the length of the abutments and at least one 7
  8. 8. adjacent tooth. The frame is placed distal to the last tooth to prevent impingement upon the metal of the frame. The patient is asked to close in centric relation. The record is removed from mouth after the paste has set. The interocclusal record is then removed from the frame and is used for mounting the cast. 4. Silicone Elastomers : 1,3,4,10,11,14,16,17 Two types of elastomers are available as interocclusal registration materials. 1. Addition silicone 2. Condensation silicone. 1. Addition silicone Composition : Base Paste Catalyst Paste Polymethyl hydrogen siloxane Divinyl polydimethyl siloxane Siloxane prepolymers Siloxane pre polymers Fillers Fillers If the catalyst paste contains the platinum salt activator, then the base paste must contain the hybrid silicone. Retarders may also be present in the paste that contains catalyst. 8
  9. 9. Mean working time : At 23°C At 37°C 3.1 min 1.8 min Mean setting time : At 23°C At 37°C 8.9 min 5.9 min 2. Condensation silicone Composition : Base paste Catalyst paste Tetraethyl orthosilicate Stannus acetate Ethyl alcohol is a by-product of condensation setting reaction. Its subsequent evaporation probably accounts for much of the contraction that takes place in a set silicone. Mean working time : At 23°C At 37°C 3-3 min 2-5min Mean setting time : At 23°C At 37°C 11 min 8-9 min Addition silicone has gained acceptance because it is more stable than condensation silicone. Advantages : - Accuracy 9
  10. 10. - Stability after setting. - Minimal Resistance to closure. - Does not require a carrier. Disadvantage : - Resistance to compression of a set material which contributes to difficulty. Technique : Take equal amount of base paste and catalyst paste and mix according to manufacturers instructions obtaining a streak free mixture. Load the syringe by maintaining a slight angle while scraping the pad. Place the material over the occlusal surface of teeth. Guide mandible to centric and ask patient to occlude wait for final set according to manufacturers instructions. Trim the excess and recheck the record. 5. Polyether Elastomer : 1,2,3,6,14,15,18,19 Polyether interocclusal registration materials are supplied as two paste systems. 10
  11. 11. Base paste : Low molecular weight polyether with ethylene amine terminal group along with fillers such as colloidal silica and plasticizor such as glycolether or phthalate. Catalyst paste : An aromatic sulfonic acid ester plus a thickening agent to form a paste along with fillers. Mean working time : At 23°C At 37°C 3-3 min 2-3min Mean setting time : At 23°C At 37°C 9-0 min 8-3 min Advantages : - Accuracy - Stability after polymerization and during storage. - Fluidity and minimal resistance to closure. - Doesnot require carrier. Disadvantage : - Resiliency and accuracy may exceed the accuracy of plaster casts. 11
  12. 12. Technique : Take equal amount of base paste and catalyst paste and mix according to manufacturers instructions obtaining a streak free mixture. Load the syringe by maintaining a slight angle while scraping the pad. Place the material over the occlusal surface of teeth. Guide mandible to centric and ask patient to occlude wait for final set according to manufacturers instructions. Trim the excess and recheck the record. 6. Acrylic Resin : 1,3,4,5,11,14,16,18 The most frequent application of acrylic resin for interocclusal records is the fabrication of single stop centric occlusion records. Composition : Powder - Polymer – Polymethyl methacrylate benzyl peroxide. Liquid - Monomer – Methyl methacrylate - Tertiary amine – Dimethyl para toluidine Initial hardening time : 30 minutes. Advantages : Accurate and rigid after setting. Disadvantage : Polymerization shrinkage. 12
  13. 13. Technique : Apply petroleum jelly over occlusal surfaces of teeth. Measure monomer and polymer according to manufacturers recommendations wait until dough stage is reached. Form dough patty into a flattened shape approximately 2mm thick. Keep it over occlusal surfaces of teeth. Guide mandible to centric position and ask patient to occlude. Wait for final set according to manufacturers instructions. Trim the excess and recheck the record. 13
  14. 14. Review of Literature - Martin Henry Berman (1960) conducted a study to evaluate the dimensional stability of waxes. He found that waxes after some resistance to closure. - Thomas E.J. Shanhan and Alexander Leff (1960) conducted a study to compare the accuracy of wax records with a record made in a autopolymerizing acrylic resin. They found that base plate wax and impression wax do not make satisfactory interocclusal records. Autopolymerising acrylic resin gives more nearly record in centric occlusal contact that with wax. - Harry Shurnik (1969) suggested methods for making interocclusal records by using wax, zincoxide eugenol, plaster and acrylic resin. - Philip L. Millstein, Joseph H. Korman and R. Ernest Clark (1971) carried out a study to determine optimal procedures to be used in making wax interocclusal records. They found that even under controlled conditions, exact reproduction of original wax recordings was not achieved. 14
  15. 15. - Carl G. Wirth and Arthur W. Aplin (1971) introduced a method to improve wax interocclusal record by using a wax with low thermal contraction and with narrowing of thermal plasticity by laminating it over a material which improves its resistance to deformation. - Philip L. Millstein, R. Ernest Clark and Joseph H. Korman (1973) carried a study to determine the accuracy of interocclusal recording medium made with single and double thickness samples of basepaste wax. They found that complete closure of waxes was not achieved, storage of wax records in water produced the greatest change while air cooling produced the least and considerable vertical and rotational changes occurred which checking of record and exact reproduction of original wax record was never achieved. - Philip L. Millstein, R. Ernest Clark and Richard L. Myerson (1975) investigated accuracy of silicone body interocclusal records and associate weight loss due to rolatiles. The results of investigation indicated that a direct relationship exists between dimensional change and percent of weight loss that is weight loss over time was generally proportional to their respective dimensional changes. 15
  16. 16. - Yvonne Balthazar, James L. Sandrik W.F.P. Malone, Boteslaw Mazur and Timothy Hart (1981) investigated accuracy and dimensional stability of zincoxide eugenol, eugenol free zincoxide paste, silicone elastomer and polyether elastomer interocclusal recording materials. They found that the eugenol free zinc oxide paste was the only material which exhibited no statistically significant difference between the die scribes and those of the sample, polyether silicone and zincoxide eugenol paste there was a statistically diference between the die and the respective samples. - Philip L. Millstein and R. Ernest Clark (1981) investigated differential accyracy of silicone body and self curing resin interocclusal records and associated weight loss due to rolatiles. They found that silicone body interocclusal records were more reliable than self curing resin records. However, all materials tested exhibited some degree of weight loss and dimensional change over time. - Philip L. Millstein and R. Ernest Clark (1983) investigated accuracy of laminated wax interocclusal wafers. They found that laminated wax interocclusal wafers were highly significant statistically mostly with confidence levels greater than 99% that is 16
  17. 17. most accurate and dimensionally stable. However, exact reproduction of original wax recording were unlikely and not achieved. - La Deane Fattore, William F. Malone, James L. Sandrik, Boleslaw Mazur, and Timothy Hart (1984) clinically evaluated the accuracy of baseplate wax, reinforced wax, zinc oxide eugenol paste, non rigid polyether recording medium with carrier and polyether without carrier. They found that polyether interocclusal recording material without a carrier was the most accurate. Polyether and zincoxide eugenol paste with carriers were the next most accurate recording medium, recording waxes were consistently unreliable. - Veija Lassila and John F. McCabe (1985) studied properties of polyether and eugenol free zincoxide paste, zincoxide and eugenol paste and silicone interocclusal recording medium. They concluded that the elastomers and eugenol free oxide paste have a brief working time and increase in viscosity for zincoxide and eugenol paste is slower than that of others elastomers and eugenol free zincoxide materials showed marked shrinkage during setting. Dimensional changes of elastomers can be reduced by storage in sealed dry container and elastomeric materials acquire relatively good elastic properties in approximately 30 minutes. 17
  18. 18. Summary & Conclusion An inter occlusal record is a precise recording of maxillomandibular position it should be capable of maintaining extreme accuracy even under such varying condition as storage and handling even though a record may appear to be fixed and accurate it may still undergo dimensional changes which can only be evaluated microscopically the clinical change in interocclusal record can be only evaluated by dentist or by the patient in reference to high points. The cause of occlusal discrepancies attributable to the interocclusal record can be divided into three categories one cause is related to biologic characteristics of stomatognathic system, a second cause is attributed to iatrogenic errors and third cause is associated with the properties of interocclusal recording material. To avoid diagnostic treatment errors conducted with meticulous attention to manipulation of these materials with specific instruction for each material. The ideal material technique combination for making interocclusalr records would allow the placement of indirectly fabricated prosthesis in patients mouth with no occlusal adjustments 18
  19. 19. Bibliography 1. Anusavice – Philips Science of Dental Materials. Tenth Edition, 1996, W.B. Saunders Company. 2. Carl G. Wirth and Arthur W. Aplin – An improved interocclusal record of centric relation. J. Prosthet. Dent. 1971 ; 25, 3. 3. Combe – Notes on Dental Materials. Fifth Edition, 1986, Churchill Livingstone. 4. Craig – Dental Materials Properties and Manipulations. Fourth edition, 1987, Mosby and Company. 5. Hary Shurnik – Accurate interocclusal records. J. Prost. Dent. 1969 ; 21, 2. 6. LaDeane Fattore, William F. Malone, Jame L. Sandrik, Boleslaw Mazur and Timothy Hart – Clinical evaluation of the accuracy of interocclusal recording materials. J. Prosth. Dent. 1984 ; 51, 2. 7. Martin Henry Berman. – Accurate interocclusal records. J. Prosth. Dent. 1960 ; 10, 4. 19
  20. 20. 8. Philip Millstein, Joseph H. Kornman and R. Ernest Clark – Determination of accuracy of wax interocclusal registrations I. J. Prosth. Dent. 1971 ; 25, 2. 9. Philip Millstein, Joseph H. Kornman and R. Ernest Clark. – Determination of accuracy of wax interocclusal registrations. J. Prosth. Dent. 1973 ; 29, 1. 10.Philip Millstein, R. Ernest Clark and Richard L. Mycrson. – Differential accuracy of silicone body interocclusal records and associated weight loss due to volatiles. J. Prosthet. Dent. 1975 ; 33, 6. 11.Philip L. Millstein and R. Ernest Clark. – Differential accuracy of silicone body and self curing resin interocclusal records and associated weight loss. 1981 ; 46, 4. 12.Philip L. Millstein and R. Ernest Clark – Determination of the accuracy of laminated wax interocclusal wafers. J. Prosthet. Dent. 1983 ; 50, 3. 13.Reisbick M.H. – Dental Materials in Clinical Dentistry. Vol-11, Edition 1982. 14.Stephen F. Rosensteil. – Contemporary fixed partial prosthodontics. Second edition. 20
  21. 21. 15.Thomas E.J. Shanaban and Alexander Leff. – Interocclusal records. J. Prosthet. Dent. 1960 ; 10, 5. 16.Tylman’s – Theory and practice of fixed prosthodontics. W.F.B. Malone et al. Eighth edition. 17.Veija Lassila and John F. McCabe – Properties of interocclusal registration material. J. Prosth. Dent. 1985, 53, 1. 18.William J.O. Brien – Dental Materials Properties and Selection. Quintessence Publishing Co., 1989. 19.Yvonne Balthazar, James L. Sandrik, W.F.P. Malone, Boleslaw Mazur and Timothy Hart. – Accuracy and dimensional stability of four interocclusal recording materials. J. Prosth. Dent. 1985 ; 45, 6. 21

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