BASICS OF FUNCTIONAL CLINICAL AND INSTRUMENTAL DIAGNOSTICS
AND PRETREATMENT BEFORE FINAL ORAL REHABILITATION
Figure 13. Carefully-made alginate impression
with dammed and stopped Rim-Lock trays are
essential for creating flawless working casts
Figure 14. After pouring with dental stone, the
models should be kept in a hygrophoree (air-tight
plastic container) to harden
Figure 15. The completed casts of this patient fit
tightly with no play in habitual position.
Figure 16. To prepare a centric relation record, the
top side of a mounting tin foil plate is thinly coated
with TempBond to take cusp impressions of the
maxilla
in a hygrophore (e.g., air-tight plastic container
with a damp sponge); it is never appropriate to
wrap the alginate impression in wet paper towels
or napkins, even for short-term storage. After
pouring the impressions with dental stone, they
should be stored in the hygrophore until the stone
has hardened (Fig. 14), since this greatly improves
the quality of the casts.5
In the habitual relation, this patient’s finished casts
fit tightly with no play, so that occlusal interferences
were not discernable in this phase (Fig. 15). The
casts are then mounted in the articulator and
adjusted to the TMJ, as follows.
down with moderate force, creating a minimal
opening of the bite. Next, the top and bottom
surfaces of the mounting plate are coated with
an adhesive polish. The top surface is then thinly
coated with a eugenol liner (Temp Bond). Without
using pressure, the plate is adapted to the maxilla,
and held by two fingers in the area of the rows of
teeth until hardening and removal (Fig. 16).
In preparation for taking the actual registration, the
patient should sit upright and relaxed in the chair;
the head should never be turned or stretched in
any direction20 To decouple occlusion and relax
the muscles, slightly moistened cotton rolls are
placed in the premolar region (Fig. 17)
In this case, a protrusion record for individually
adjusting the horizontal condylar path inclination
was not necessary, since the values for these angles
(SKN) and the mediotrusion paths (TKN) were
already available from the electronic registration
(see Fig. 12).
Centric relation record
Preparations are made for taking the centric
relation record (synonym: bite registration). A
mounting tin foil plate (or “Beauty Pink” wax) is
cut to maxillary size, placed between the patient’s
teeth, and individually pre-formed through biting
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