I am not even going to pretend to know much about Occlusion, so please take this post with a grain of salt. One thing that is great about CEREC restorations is that you need to go back and study dental anatomy to make a nice crown. Now that I am making a lot of my own night guards, I need to go back and re read all of my textbooks on Occlusion and TMD. So if you are a guru or just know a lot about the subject please school me! Patient had no TMJ symptoms but grinds her teeth so I wanted to make a flat plane splint. Took a bite open in centric with about 4mm open in the posterior. Used that to articulate my models in CEREC. Also took a CBCT of with the patient still biting on the bite registration.
There is a cool feature in ExoCAD that allows your to superimpose the CBCT 3D rendering onto the models as well as an articulator to simulate jaw movements. Now here is where I will show my ignorance in occlusion. When you take a face bow (I am guessing) you want to relate the maxilla to the condyles and to mimic the patient’s occlusal cant. So if we line up the actual condyles of the patient to the condyles of the articulator we now have a little closer approximation to what the patient’s bite is like, as opposed to a generic hinge articulator. We relate the CBCT to the upper model. Built up the anterior a bit so get the occlusion level. This is not a Michigan appliance and I did not factor canine guidance into it. Just something to grind on to protect the teeth.
The fit was awesome!! The bite took a little bit to adjust, but definitely was less work than ones I have made in the past with a pressure former. Anyway, just keep on learning!
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