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An articulator is a mechanical hinged device used in dentistry to which plaster casts of the maxillary (upper) and mandibular (lower) jaw are fixed, reproducing some or all the movements of the mandible in relation to the maxilla. The human maxilla is fixed and the scope of movement of the mandible (and therefore the dentition) is dictated by the position and movements of the bilateral temperomandibular joints, which sit in the glenoid fossae in the base of the skull. The temperomandibular joints are not a simple hinge but rotate and translate forward when the mouth is opened.
The principal movements reproduced are: at rest (centric jaw relation), in protrusion (to bite), from side to side (lateral excursion) to chew, in retrusion, and any possible combination of these. Counter-intuitively, it is the cast of the maxilla which moves relative to the cast of the mandible and the articulator.
An articulator assists in the accurate fabrication of the biting surfaces of removable prosthodontic appliances (dentures), fixed prosthodontic restorations (implants, crowns, bridges, inlays and onlays) and orthodontic appliances. Used with skill it ensures correct interdigitation of the teeth and an anatomically functional biting plane. This means less occlusal adjustments before and after fitting dental appliances and fewer chronic conflicts between the teeth and the jaw joints.
Articulators are used mainly by dental technicians in fabrication of prostheses and information regarding bite can be communicated from the prescribing dentist via a facebow alone. However it is advantageous when a system is utilised jointly in which case the clinician should adopt the articulator system currently in use in the dental laboratory as they are not compatible with each other.
A fully-adjustable articulator reproduces the movement of the temporomandibular joints in all possible dimensions and functional movements. They are necessary for large or complex restorative cases where a correct occlusion is being substantively restored. The relationship between the temporomandibular joints and the maxilla and the functional relationship of the jaws are transferred to the articulator by means of a separate facebow. Individual patient's casts may be mounted and dismounted from a single articulator using a variety of disposable baseplates, either mechanical or magnetic.
A semi-adjustable articulator uses some fixed values based on averages and is not therefore capable of reproducing any particular jaw relationship, or occlusions which are not close to the average. Values which may or may not be fixed include centric jaw relation, protrusion angle, centric shift, lateral and Bennett movements, immediate side-shift and retrusion. The advantage of a semi-adjustable articulator is that it may be adequate for most cases and is less costly.
Fixed articulators emulate a simple hinge and disregard all functional movements of the jaw. They are used commonly for single-unit crowns or Angles Class III bites where there is little or no lateral excursion in chewing. Modern hinge articulators are made of a disposable plastic material which may be incorporated into or over the casts and are subject to bending.
In 1840 the first US patent for dental articulators was issued to two Philadelphia, Pennsylvania, dentists: James Cameron and Daniley T. Evens. [1] One glaring weakness that became evident shortly after its release was its inability to manage mandibular movement. Through the 1850s and 60s dental scientists investigated the nature of mandibular movement. By the 1900s the single-hinge dental articulators became commonplace. It wasn't until 1910 that dentistry had its first articulator breakthrough due to the work of scientists like W. E. Walker, Alfred Gysi and George Snow. From their work two major schools of articulators developed. On one side there was the new condylar (anatomic) movement and on the other side there was the geometric (non anatomic) movement. The debate between anatomic and non anatomic is demonstrated in this article for an articulator that boasted a simple design. [2] Dr. Rudolph L. Hanau is credited with developing the Hanau articulator in the 1920s.
Temporomandibular joint dysfunction is an umbrella term covering pain and dysfunction of the muscles of mastication and the temporomandibular joints. The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life; this is because the symptoms can become chronic and difficult to manage.
Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking. Bruxism is a common behavior; reports of prevalence range from 8% to 31% in the general population. Several symptoms are commonly associated with bruxism, including aching jaw muscles, headaches, hypersensitive teeth, tooth wear, and damage to dental restorations. Symptoms may be minimal, without patient awareness of the condition. If nothing is done, after a while many teeth start wearing down until the whole tooth is gone.
In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the mandible below; it is from these bones that its name is derived. The joints are unique in their bilateral function, being connected via the mandible.
The jaws are a pair of opposable articulated structures at the entrance of the mouth, typically used for grasping and manipulating food. The term jaws is also broadly applied to the whole of the structures constituting the vault of the mouth and serving to open and close it and is part of the body plan of humans and most animals.
Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction may be considered to improve facial aesthetics and self-esteem.
In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855–1930), the "father of modern orthodontics", popularised it. The word "malocclusion" derives from occlusion, and refers to the manner in which opposing teeth meet.
Hemifacial microsomia (HFM) is a congenital disorder that affects the development of the lower half of the face, most commonly the ears, the mouth and the mandible. It usually occurs on one side of the face, but both sides are sometimes affected. If severe, it may result in difficulties in breathing due to obstruction of the trachea—sometimes even requiring a tracheotomy. With an incidence in the range of 1:3500 to 1:4500, it is the second most common birth defect of the face, after cleft lip and cleft palate. HFM shares many similarities with Treacher Collins syndrome.
Orthodontic technology is a specialty of dental technology that is concerned with the design and fabrication of dental appliances for the treatment of malocclusions, which may be a result of tooth irregularity, disproportionate jaw relationships, or both.
Occlusion, in a dental context, means simply the contact between teeth. More technically, it is the relationship between the maxillary (upper) and mandibular (lower) teeth when they approach each other, as occurs during chewing or at rest.
In dentistry, centric relation is the mandibular jaw position in which the head of the condyle is situated as far anterior and superior as it possibly can within the mandibular fossa/glenoid fossa.
Overjet is the extent of horizontal (anterior-posterior) overlap of the maxillary central incisors over the mandibular central incisors. In class II malocclusion the overjet is increased as the maxillary central incisors are protruded.
Crossbite is a form of malocclusion where a tooth has a more buccal or lingual position than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral misalignment of the dental arches.
A jaw abnormality is a disorder in the formation, shape and/or size of the jaw. In general abnormalities arise within the jaw when there is a disturbance or fault in the fusion of the mandibular processes. The mandible in particular has the most differential typical growth anomalies than any other bone in the human skeleton. This is due to variants in the complex symmetrical growth pattern which formulates the mandible.
In jawed vertebrates, the mandible, lower jaw, or jawbone is a bone that makes up the lower – and typically more mobile – component of the mouth.
Condylar resorption, also called idiopathic condylar resorption, ICR, and condylysis, is a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process. This disorder is nine times more likely to be present in females than males, and is more common among teenagers.
Bite registration is a technique carried out in dental procedures, by taking an impression of the teeth, to capture the way the teeth meet together. This is then used to accurately make restorations which will not change the position the teeth meet in.
A face-bow is a dental instrument used in the field of prosthodontics. Its purpose is to transfer functional and aesthetic components from patient's mouth to the dental articulator. Specifically, it transfers the relationship of maxillary arch and temporomandibular joint to the casts. It records the upper model's (maxilla) relationship to the External Acoustic Meatus, in the hinge axis. It aids in mounting maxillary cast on the articulator.
Posselt's envelope of motion or Posselt's envelope of movement refers to the range of motion of the lower jaw bone, or mandible.
Occlusion according to The Glossary of Prosthodontic Terms Ninth Edition is defined as "the static relationship between the incising or masticating surfaces of the maxillary or mandibular teeth or tooth analogues".
The Herbst appliance is an orthodontic appliance used by orthodontists to correct class 2 retrognathic mandible in a growing patient, meaning that the lower jaw is too far back. This is also called bitejumping. Herbst appliance parts include stainless steel surgical frameworks that are secured onto the teeth by bands or acrylic bites. These are connected by sets of telescoping mechanisms that apply gentle upward and backward force on the upper jaw, and forward force on the lower jaw. The original bite-jumping appliance was designed by Dr. Emil Herbst and reintroduced by Dr. Hans Pancherz using maxillary and mandibular first molars and first bicuspids. The bands were connected with heavy wire soldered to each band and carried a tube and piston assembly that allowed mandibular movement but permanently postured the mandible forward. The appliance not only corrected a dental Class II to a dental Class I but also offered a marked improvement of the classic Class II facial profile.