Articulators / fixed orthodontic courses

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Articulators / fixed orthodontic courses

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
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  4. 4. Introduction Definition History and Development Parts of an Articulator Classification Requirements, Uses and Limitations “Mouth is the best Articulator” Selection of an Articulator Non-adjustable (Arbitrary) Semi-adjustable (Arcon Vs NonArcon) Fully-adjustable www.indiandentalacademy.com
  5. 5. Individual Articulators Mean Value Articulator Hanau Articulator Whipmix Articulator Denar Articulator Programming an Articulator Face bow Horizontal Condylar guidance Lateral Condylar guidance Incisal guidance Custom Anterior guidance www.indiandentalacademy.com
  6. 6. Gothic arch tracing Care and Maintenance of Articulators Conclusion References www.indiandentalacademy.com
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  8. 8. A mechanical instrument that represents the temporomandibular joint and jaws, to which maxillary and mandibular casts may be attached to simulate some or all mandibular movements. (GPT-8) ARTICULATORARTICULATOR www.indiandentalacademy.com
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  11. 11. . The Plaster Articulator The slab articulator devised by Philip Pfaff in 1756 www.indiandentalacademy.com
  12. 12. The origin of mechanical hinge articulator -1805 J B Garriot. The first mechanical articulator www.indiandentalacademy.com
  13. 13. The Howarth Plaster Articulator 1830s. www.indiandentalacademy.com
  14. 14. The Barn door hinge articulator (Plane line articulator) Vertical stop at anterior end introduced www.indiandentalacademy.com
  15. 15. James Cameron’s articulator 1840 Evans’ articulator 1840 The first US patented articulators www.indiandentalacademy.com
  16. 16. Daniel T Evans’ articulator 1840 First to imitate mandibular movements – but not successful www.indiandentalacademy.com
  17. 17. Fixed condylar guide articulators (1858) Bonwill’s Starr’s Ante-Lewiswww.indiandentalacademy.com
  18. 18. 30 years later………..www.indiandentalacademy.com
  19. 19. Richmond Hayes 1889 Fixed descending condylar path - incorporated www.indiandentalacademy.com
  20. 20. History to be continued………..www.indiandentalacademy.com
  21. 21. MANDIBULAR MOVEMENTS ANY MOVEMENT OF THE LOWER JAW (GPT)www.indiandentalacademy.com
  22. 22. Frontal plane Horizontal plane Sagittal plane www.indiandentalacademy.com
  23. 23. Intra border functional movements www.indiandentalacademy.com
  24. 24. Condylar Guidance 1. Mandibular guidance generated by the condyle and articular disc traversing the contour of the glenoid fossa 2. The mechanical form located in the upper posterior region of an articulator that controls the movements of its mobile members. www.indiandentalacademy.com
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  26. 26. Sir Norman Godfrey Bennett British Dental Surgeon (1870-1947) Condylar movement on the working side in the horizontal plane. The angle formed by the sagittal plane and the average path of the advancing condyles as viewed in the horizontal plane during lateral mandibular movements www.indiandentalacademy.com
  27. 27. Bennet’s movement Bodily shift of the mandible toward the working side during lateral excursion. Immediate / Early side shift Progressive side shift www.indiandentalacademy.com
  28. 28. Gritmans articulator 1889 George B Snow- 15 degrees condylar guidance www.indiandentalacademy.com
  29. 29. A caliper like instrument used to record the spatial relationship of the maxillary arch to some anatomic reference point(s) and then transfer this relationship to an articulator; it orients the cast in the same relationship to the opening axis of the articulator. Hingebow www.indiandentalacademy.com
  30. 30. Early development of face-bow (1889) Articulating caliper Jaw gauge-1894 www.indiandentalacademy.com
  31. 31. Traditional face- bow 1899 George B snow-Face-bow & orientation of occlusal planewww.indiandentalacademy.com
  32. 32. Wadsworth articulator and face-bow 1921 Third point of reference - Naso-optic condylar triangle www.indiandentalacademy.com
  33. 33. Later-infra orbital pointer - Hanau www.indiandentalacademy.com
  34. 34. Francis H Balkwil 1886 Angle formed between the plane of two lines drawn from the articulating surfaces of the condyles to the occlusal plane - estimated to be 26 degrees.www.indiandentalacademy.com
  35. 35. But a puzzle was still to be answered ? Why should be condylar guides fixed? www.indiandentalacademy.com
  36. 36. First adjustable condylar guide articulators William Earnest Walker-Physiological articulators www.indiandentalacademy.com
  37. 37. Walkers Facial clinometer www.indiandentalacademy.com
  38. 38. Carl Christensen, Danish Dentist and EducatorCarl Christensen, Danish Dentist and Educator The space that occurs between opposing occlusal surfaces during mandibular protrusion www.indiandentalacademy.com
  39. 39. Recording the condylar guidance Christensens interocclusal wax record www.indiandentalacademy.com
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  41. 41. Incisal Pin & Guide Feature Luce articulator 1911 Eltner articulator 1912 Anterior guidance concept introducedwww.indiandentalacademy.com
  42. 42. Anterior guidance 1. The influence of the contacting surfaces of anterior teeth on mandibular movements for analysis and treatment of occlusion. 2.The fabrication of restorations in harmony with mandibular movements as guided by the anterior teeth. www.indiandentalacademy.com
  43. 43. Condylar guidance Incisal guidance Compensatory curve Orientation of occlusal plane Thielmann Formula CG *IG = CI*CC*OP Functional movements Cuspal inclination www.indiandentalacademy.com
  44. 44. Gysi series of articulators Snow acme articulator www.indiandentalacademy.com
  45. 45. Articulators based on Geometric theories of Mandibular movements Monson’s spherical theory Hall’s conical theory Bonwill’s Equilateral theory www.indiandentalacademy.com
  46. 46. Bonwill’s Equilateral theory www.indiandentalacademy.com
  47. 47. Monson’s spherical theory www.indiandentalacademy.com
  48. 48. Hall’s conical theory Alligator Hall articulatorwww.indiandentalacademy.com
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  63. 63. Adaptable or Adjustable Average or Fixed type Two dimensional instrument Three dimensional instrument i. Suspension instrument ii. Axis instrument iii. Tripod instrument GILLIS(1926) BOUCHER (1934) BECK’S (1962) www.indiandentalacademy.com
  64. 64. i. Arbitrary ii. Positional iii. Semi adjustable iv. Fully adjustable 1. Plain line 2. Mean value 3. Adjustable WEINBERG (1963) POSSELT’S (1968) www.indiandentalacademy.com
  65. 65. Functional Axis type Non axis type Static type Functional type Axis type Non axis type C.J. THOMAS (1973) Arbitrary Positional www.indiandentalacademy.com
  66. 66. 1. Simple hinge type 2. Fixed guide type, 3. Adjustable instruments JOHN J. SHARRY (1974) HALPERIN et al i. Simple or Hinge articulators ii. Fully adjustable articulators iii. Semi adjustable articulators Arcon Non-arcon www.indiandentalacademy.com
  67. 67. Rectilinear Curvilinear (1)The theories of occlusion (2) The types of records used for their adjustment. a) Those utilizing the Inter occlusal records. b) Those using the Graphic record adjustment. c) Those utilizing hinge-axis location for adjusting the articulator. HALPERIN BOUCHER www.indiandentalacademy.com
  68. 68. CHARLES M. HEARTWELL Jr Class II Type 1 (Hinge) Type 2 (Arbitrary) Types 3 (Average) Type 4 (Special) Class I www.indiandentalacademy.com
  69. 69. Class I. Subdivision A Subdivision B Class II. Subdivision A Subdivision B Subdivision C Class III. Subdivision A Subdivision B Class IV. Subdivision A Subdivision B International prosthodontics workshop (University of Michigan in 1972) www.indiandentalacademy.com
  70. 70. A Simple holding instrument capable of accepting a single static registration. Subdivision A: Vertical motion is possible, but only for convenience. The Corelator (Denar Corp.) The Verticulator (Jelenko) Class I. Articulator International prosthodontics workshop (university of michigan in 1972) www.indiandentalacademy.com
  71. 71. Subdivision B: Vertical motion is joint related. The Centric relator (Denar Corp) This instrument rotates on the terminal arc registered by a face-bow that ensures a positive centric . International prosthodontics workshop (university of michigan in 1972) Class I. Articulator www.indiandentalacademy.com
  72. 72. Subdivision A: Eccentric motion permitted is based on average or arbitrary values Gysi Simplex Articulator An instrument that permits horizontal as well as vertical motion but does not orient the motion to the temporomandibular joints. Class II. Articulator International prosthodontics workshop (university of michigan in 1972) www.indiandentalacademy.com
  73. 73. Subdivision B: Eccentric motion permitted is based on theories of arbitrary motion. The Monson Maxillo-mandibular articulator International prosthodontics workshop (university of michigan in 1972) Class II. Articulator www.indiandentalacademy.com
  74. 74. Subdivision C: Eccentric motion permitted is determined by the patient using engraving methods. The Gnathic Relator International prosthodontics workshop (university of michigan in 1972) Class II. Articulator www.indiandentalacademy.com
  75. 75. Instruments that simulate condylar pathways by using averages or mechanical equivalents for all or part of the motion. These instruments allow for orientation of the cast relative to the joints and may be arcon or nonarcon instruments, accept facebows, and have mounting plates for unlimited case load. Subdivision A: Instruments that accept static protrusive registrations and use equivalents for the rest of the motion. Class III. Articulator International prosthodontics workshop (university of michigan in 1972) www.indiandentalacademy.com
  76. 76. Dentatus articulator Hanau Nonarcon H2 Articulator www.indiandentalacademy.com
  77. 77. Subdivision B: Instruments that accept static lateral protrusive registrations and use equivalents for the rest of the motion. Gysi trubyte Denar Mark II Articulator Hanau-TeledynePanadent Model P ArticulatorWhipmix Articulator International prosthodontics workshop (university of michigan in 1972) Class III. Articulator www.indiandentalacademy.com
  78. 78. Subdivision A: The cam representing the condylar paths are formed by registration engraved by the patient. Class IV. Articulator Instruments that will accept three dimensional dynamic registrations. These instruments allow for orientation of the casts to the temporomandibular joints and replication of all mandibular movements. TMJ-Stereographic instrument Denar Combi articulator International prosthodontics workshop (university of michigan in 1972) www.indiandentalacademy.com
  79. 79. Class IV. Articulator Subdivision B: Instruments that have condylar paths that can be angled and customized either by selection from a variety of curvatures, by modification, or both. Stuart ArticulatorDenar D5A Articulator International prosthodontics workshop (university of michigan in 1972) www.indiandentalacademy.com
  80. 80. Can accept one or two of the following records: 1. Face bow 2. Centric jaw relation record 3. Protrusive record. Can accept all the following three records. 1. Face bow 2. Centric jaw relation record 3. Protrusive record. Can accept all the following five records. 1. Face bow 2. Centric jaw relation record 3. Protrusive record. 4. Lateral records 5. Intercondylar distance record Rihani A: classification of articulators, J Prosthet Dent 1980;43:344-347 Fully adjustable Semiadjustable Nonadjustable RIHANI 1980 www.indiandentalacademy.com
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  82. 82. Basic Requirements Hold casts in correct horizontal and vertical position Positive anterior stopAccept face bow transfer Open and close in hinge movement And Allow for protusive &lateral motion Moving parts should move freely & be accurately machined Non moving parts should be of rigid construction www.indiandentalacademy.com
  83. 83. Adjustable horizontal and lateral condylar guide elements Conylar element - lower frame Condylar guide - upper frame Accept third point of referenceTerminal hinge position locking deviceRemovable mounting platesAdjustable incisal guide tableAdjustable Intercondylar width – graphic tracings Additional Requirements www.indiandentalacademy.com
  84. 84. 1. Diagnosis, treatment planning and patient presentation in both the natural and artificial dentitions. 2. To plan dental procedures 3. To aid in the fabrication of dental restorations and lost dental parts. 4. To correct and modify completed restorations. 5. Teaching and studying of occlusion and mandibular movements. USES www.indiandentalacademy.com
  85. 85. LIMITATIONS Subject to error in tooling and to error resulting from metal fatigue and wear. Does not completely duplicate the condylar movements in the temporomandibular joints. Movements simulated are empty-mouth sliding motions, not functional movements. www.indiandentalacademy.com
  86. 86. M uth is the best articulatorwww.indiandentalacademy.com
  87. 87. ..then why not use it Patient’s saliva, tongue, and cheeks  Shifting denture bases  Resiliency of the supporting tissues  Inability of humans to detect visually subtle changes in motion  The inability to know exact location of the condyles  More chair time www.indiandentalacademy.com
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  89. 89. NON-ADJUSTABLE ARTICULATORS For complete dentures For fixed prosthodontics*Arc of opening www.indiandentalacademy.com
  90. 90. SEMI-ADJUSTABLE ARTICULATORS For complete dentures For fixed prosthodontics KAVO WHIPMIX HANAU www.indiandentalacademy.com
  91. 91. Arcon v/s Non-arcon Derived from Articulator & Condyle Beck 1956,Weinberg 1963 : No difference Survey 1985 : Out of 81 ,67 were arconwww.indiandentalacademy.com
  92. 92. Rectilinear or Curvilinear Sagittal condylar path-Convex S-shaped curvature Aull 1965 : 8%-Straight line 92%-Curved path Diameter:10mm in 34% Population Curvature noticeable appeared when 5-10mm tracings were drawn Within 2-3mm from centric condylar path is almost a straight line.www.indiandentalacademy.com
  93. 93. FULLY ADJUSTABLE ARTICULATORS For complete dentures For fixed prosthodontics The Denar D5A Articulator Cyberhoby Articulator www.indiandentalacademy.com
  94. 94. Denar articulators www.indiandentalacademy.com
  95. 95. Pantographic tracing www.indiandentalacademy.com
  96. 96. www.indiandentalacademy.com
  97. 97. STEREOGRAPHS www.indiandentalacademy.com
  98. 98. Stereograph (TMJ articulator) www.indiandentalacademy.com
  99. 99. Stereograph (TMJ articulator) www.indiandentalacademy.com
  100. 100. Fully adjustable….Do we really need it ? According to Dawson  Bilaterally balanced occlusion is traumatogenic (Dentulous)  Condylar guidance does not dictate anterior guidance  Tripod contact no more stable than cusp tip to fossa contact  Posterior disclusion by anterior guidance most desirable (Christenson’s phenomenon/mutually protected occlusion)  Immediate side shift cannot occur from centric (medial part of the condyle will be in close proximity with the glenoid fossa)  Not necessary to reproduce Fischer’s anglewww.indiandentalacademy.com
  101. 101. Fischer’s angle Rudolph Fischer, Swiss Dentist The angle formed by the intersection of the protrusive and nonworking side condylar paths as viewed in the sagittal plane. www.indiandentalacademy.com
  102. 102. Articulators for Functionally generated path Verticulator Twin-Stage occluderwww.indiandentalacademy.com
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  104. 104. Mean value articulator • Upper member can be moved upward and backward . • Condylar inclination of 30 degrees on both side . • Anterior part is supported by the incisal guide rod above and incisal guide table below with 10 to 15 inclination.www.indiandentalacademy.com
  105. 105. Hanau Articulators Hanau H (Arcon) : • Rudolf L. Hanau in 1923. • Arcon • Intercondylar distance - 110 mm • Horizontal condylar guidance - 40 to +800 • Lateral condylar guidance 0 to 200 • Hanau formula : L =H/8 + 12. www.indiandentalacademy.com
  106. 106. Hanau H2 (Model 96) ( Non Arcon): • Has all features of original Hanau and additions as auditory pins have been added to the condylar mechanism. • Lateral condylar guidance increased to 0 to 300 Hanau H2 (Model 158) (Arcon) 1977 • Retained all the features of H2 model 96 but it is of arcon type. www.indiandentalacademy.com
  107. 107. Hanau wide vue (models183 & 184) • Vue 1 has close condylar track. • Vue 2 has open condylar track. Also has condylar retainers to avoid accidental separation. • Has micrometer protrusive, retrusive condylar adjustments. • Horizontal condylar guidance -20 to +600 • Lateral condylar angle is from 0 to 300 www.indiandentalacademy.com
  108. 108. Hanau Radial shift (Model 166) : 1981 • Arcon type • Upper member can be removed for waxing • A curved immediate side shift ( Radial shift) with adjustable progressive Bennet angle of 0 to 600 • Radial shift of 3mm is provided. • Has a curved superior wall with 0.75” radius. www.indiandentalacademy.com
  109. 109. Hanaumate – 165 (Average articulator) : • Condylar width is 110 mm. • Horizontal condylar inclination 300 • 100 protrusive and lateral incisal guide table. • 150 fixed progressive side shift. (Bennet) • Upper frame can be separated • Receives most average face bows. www.indiandentalacademy.com
  110. 110. Whipmix Articulators Introduced by Dr Charles Stuart in 1963. His main objective was 1. Aid in teaching the principles of occlusion for better diagnosis of the occlusion 1. To provide simplified instrument for fabrication of prosthodontic restorations. www.indiandentalacademy.com
  111. 111. Whipmix Articulator www.indiandentalacademy.com
  112. 112. Features (8500) • Adjustable Intercondylar distance S(96mm), M(110) and L(124) by means of removable condylar guidance spacer. • Horizontal and lateral condylar inclinations are set by interocclusal records. Horizontal 0 to 700. Lateral 0 to 450. ) • The upper and lower member are attached by means of spring latch assembly. www.indiandentalacademy.com
  113. 113. Model 8300 : • Retains all normal features and • Has 3/4th inch curved superior and medial wall. • Immediate side shift from 0 to 4mm with progressive angle of 60 Model 8340 : • Has been modified so that the casts are interchangeable through a special fixture called as “accumount” (precise special mounting plate) www.indiandentalacademy.com
  114. 114. Model 8800: • This provides a additional 1/2inch space to mount the maxillary cast. Model 9000 : • This provides a additional ½ inch space to mount the mandibular cast. Model 9800 : • This provides ½ inch space for both maxillary and mandibular casts www.indiandentalacademy.com
  115. 115. Denar Articulators In 1968 Dr Miles Guichet introduced the Denar 4A articulator. The current model is D5A. Advantage : Saves time and effort needed to manually transfer the recordings and to programme the articulator. www.indiandentalacademy.com
  116. 116. Denar D5A Articulator www.indiandentalacademy.com
  117. 117. Features : • Denar reference plane locator and marker is useful for locating the reference points. • Pantronic digital recorder in which the condylar guidance settings are determined automatically. • For condylar guidance a precurrent inserts are available which are made up of nylon or acrylic resins. www.indiandentalacademy.com
  118. 118. Denar mark II : • Introduced in 1975 and developed to satisfy the undergraduate needs of education for a simpler arcon articulator. • Has adjustable horizontal inclinations of 0 to 600. • Has immediate side shift of 0 to 4mm + progressive shift of 0 to 150. • The posterior wall is inclined posteriorly 250. to allow backward movement of condyle. www.indiandentalacademy.com
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  120. 120. Face Bow Record & Transferring it to Articulator www.indiandentalacademy.com
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  125. 125. Obtaining Protrusive Record for adjusting HORIZONTAL CONDYLAR GUIDANCE www.indiandentalacademy.com
  126. 126. Hanau Bennett angle formula L = H/8 + 12 How far is it valid ?  Even with large variation in condylar guidance Bennet angle changes to a small degree  Gradations with 5mm difference  But yet it is popularly followed www.indiandentalacademy.com
  127. 127. Adjusting LATERAL CONDYLAR GUIDANCE ( Bennet angle ) www.indiandentalacademy.com
  128. 128. Adjusting ANTERIOR GUIDANCE www.indiandentalacademy.com
  129. 129. Custom Anterior guidance www.indiandentalacademy.com
  130. 130. For Complete Dentures Gothic arch tracing www.indiandentalacademy.com
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  132. 132. LUBRICATION  Light application of quality hand piece oil  Excess oil should be wiped off  Thin coating of petroleum jelly-when in contact with gypsum www.indiandentalacademy.com
  133. 133. CLEANING Cleaning solvent or mild detergent Liberal use of fluid with small brush removes all wax and abrasive grit NO to Scraping or Abrasive cleanser Effect of chlorine in abrasive cleansers Blow dry air, re-lubricate Watch for thumb screw AWASH !!!! www.indiandentalacademy.com
  134. 134. STORAGE When not in use ,store in clean, dry atmosphere-free of plaster and abrasive dust A corrugated carrying carton NOT near acids, alkalies or medicaments-Fumes may be of corrosive nature. DONOT CONFINE THE ARTICULATOR in a instrument case www.indiandentalacademy.com
  135. 135. Carl O Boucher, “It must be recognized that the person operating the instrument is more important than the instrument. If dentists understand articulators and their deficiencies, they can compensate for their inherent inadequacies”. www.indiandentalacademy.com
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  137. 137. • Teledyne (Hanau) Industries: Illustrated Instruction Manual for the Hanau Wide Vue Arcon Articulator and Wide Vue II Articulator. • Thomas C. J. “A Classification of Articulators”. J.Prosthet Dent 1993 ; 30 : 11-14. • Walker PM: Discrepancies between arbitrary and true hinge axes, J Prosthet Dent 43:279-285, 1980. • Winkler Sheldon: Essentials of complete Denture Prosthodontics, 2nd edition, U.S.A. JEA, 1996, p 142-182. www.indiandentalacademy.com
  138. 138. • Dawson - Occlusion • Gross M, Nissan J, Ormianer Z et al: The effect of increasing occlusal vertical dimension on face height, Int J Prosthodont 15:353-357, 2002. • Heartwell Cm Jr, Rahn AO : Textbook of complete dentures, 5th edition, Philadelphia, Lea and Febiger, 1993, p- 59. • Hobo - Occlusal Rehabilitation www.indiandentalacademy.com
  139. 139. • J Prosthodont 2000 (9) ;1 : 51 • J Prosthodont 2000 (9) ;2 : 110 • J Prosthodont 2000 (9) ;3 : 161 • J Prosthodont 2000 (9) ;4: 217 • J Prosthodont 2001 (10) ;1 : 52 • J Prosthodont 2001 (10) ; 2 : 115 • J Prosthodont 2001 (10) ;3 : 170 • J Prosthodont 2001 (10) ;4 : 240 • J Prosthodont 2002 (11) ;1 : 53 • J Prosthodont 2002 (11) ;2 : 134 • J Prosthodont 2002 (11) ;3 : 183 • J Prosthodont 2002 (11) ;4 : 305 • J Prosthodont 2003 (12) ;1 : 51-62 HISTORY OF ARTICULATORS www.indiandentalacademy.com
  140. 140. • Keshvad A, Winstanley RB: An appraisal of the literature on centric relation, part III, J Oral Rehabil 28:55-63, 2001. • Morneburg TR, Proschel PA: Predicted incidence of occlusal errors in centric closing around arbitrary axes, Int J Prosthodont 15:358-364, 2002. www.indiandentalacademy.com
  141. 141. • Noel D. Wilkie, Donald L. Mitchell : Articulators through the years. Part – I J Prosthet dent 1978 ; 39 :140-141. • Noel D.W., Donald L. Mitchell: Articulators through the years. Part – II J Prosthet dent 1978 ; 39 :168-181. • Rihami A. “Classification of Articulators”. J.Prosthet Dent 1980 ; 43:344-47. • Rosenstiel s., Land M.F. And Fujimoto “Contemporary fixed prosthodontics”. 3rd Edition, Mosby, St. Louis, USA, 2001. . • Sharry J.J. : Complete denture Prosthodontics, 1st edition, New York, McGrew–Hiel, 1962, p-196. • Shillingburg H. T. “Fundamentals of fixed prosthodontics”. 3rd Edition, Quintessence Publishing Co., Chicago, 1997. www.indiandentalacademy.com
  142. 142. Ash and Ramford “Occlusion” Beck Ho, Morrison We : Investigation of an Arcon Articulator, J Prosthet dent 1956 ; 6 : 359 – 372. Boucher’s : Prosthetic Treatment for edentulous patients, 11th edition, 1997, p.220. www.indiandentalacademy.com
  143. 143. • Bowley JF, Bowman HC: Evaluation of variables associated with the transverse horizontal axis, J Prosthet Dent 68:537- 541, 1992. • Bowley JF, Pierce CJ: Reliability and validity of a transverse horizontal axis location instrument ,J Prosthet Dent 1990;64:646-650. • Cabot L.B. “using articulators to enhance clinical practice”. BDJ 1998 ; 184:272-276. www.indiandentalacademy.com
  144. 144. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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