WEBVTT

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*This machine-generated transcript may have errors. If remediation or a manually-generated transcript is needed, please contact NLM Support at https://support.nlm.nih.gov.*

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Gnathology is concerned with the correlation

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between the ACLU cell services of the teeth and

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the pattern of job open as dictated by the

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temporal mandibular joints and

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modified by the inside cell guidance.

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The a crucial scheme should allow mandibular

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movement to occur without tooth interference.

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When an a crucial disharmony does exist,

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it can cause a collision between opposing teeth.

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Such an interference transmits direct trauma to

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the temporal mandibular joint.

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As illustrated here

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also,

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apparent impulses arise from the teeth and joint.

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They trigger a neuro muscular self

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protective feedback mechanism,

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which sends different impulses to the muscles of

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mastication to alter the pattern of jaw

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movement.

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This alteration attempts to avoid the

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noxious tooth contacts in order to

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prevent the direct trauma to the teeth and joint.

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However,

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the more seriously a crucial interference and the

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more complex the neuro muscular avoidance

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pattern.

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The greater the tendency to develop symptoms of

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temporal mandibular pain dysfunction.

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For diagnostic and corrective procedures

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we must record the unaltered pattern

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of jaw movement.

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This is accomplished by bypassing the

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teeth,

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registering the patient's border movements and

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reproducing these movements on an an atomic

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articulator.

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This film demonstrates two methods of recording the

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patient panta graphic technique and

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the engraving technique.

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These procedures will be accomplished in such a manner

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as to allow a comparison of their results

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during the pata.

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Graphic recording the patient's head is supported by

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the dentist's left arm while he

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depresses the valve to activate the style I

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the patient is passively guided through all of the border

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excursions.

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Notice the finger support of the go neal angle

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the mandible is always guided from pro truce if to

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terminal hinge position before any of the

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lateral excursions are recorded

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after the recordings have been made,

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they are covered with a transparent tape and the

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graphic display is rechecked for accuracy of the border

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movements.

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Again one hand is used to support the

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head while the other hand guides the

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jaw through the border excursions.

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A close up view of the left posterior

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recording plates shows the right lateral

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movement,

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then the pro truce of movement and

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then the right lateral movement.

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Again

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the interior recording presents the typical gothic

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arch display.

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The lateral excursions are repeated several times to

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verify the accuracy of the recordings.

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Vice locks are placed in position on the

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crossbars

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to index the pantagraph.

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The mandible is held in terminal hinge position,

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and paper cups filled with bite stone are placed

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over the vice locks.

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The locked pantagraph with its extra oral three

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dimensional graphic recordings is separated

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from the clutches.

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In preparation for making the intra oral three

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dimensional engrave recordings.

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Patient practices the required movements.

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Firm pressure is applied to aid in

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developing the effect of the Bennett movement.

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It is important that the patient be well

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rehearsed.

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The recording discs have been modified to be incorporated

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within the clutches.

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Also shown are the four cutting studs and the central

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bearing screw.

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This central bearing screw is adjustable for vertical

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clearance.

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It produces the classic arrowpoint tracing on

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the upper disc.

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When the recording material of auto problem arising

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Rosin is placed on the lower disk.

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It will be shaped by the maxillary cutting studs.

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The recording material has been placed on the mandibular

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disc and both clutches are seated in the

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mouth.

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The patient is guided to closure,

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displacing some of the excess of the recording

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material.

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The clutches are rechecked for separation and

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stability.

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The patient is guided from pro truce if to terminal

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hinge position before any of the lateral

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excursions are developed.

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Then the patient is guided through the lateral border

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positions and is allowed active

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movement to develop the full extent of border

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movements and the horizontal range of

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motion.

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Firm pressure is used to engrave the effect of

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the side shift.

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These procedures are repeated during a period of two

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minutes

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after this initial engraving,

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the clutches are removed so the excess

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bulk of material can be trimmed away.

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Lastly additional movement is allowed to refine the

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details of the recordings.

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The diamond shaped engravings include the effect of the

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Bennett movement as shown in

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detail in this close up view.

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The engraved recordings are maintained in centric

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relation and they are transferred from the mouth by

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means of an axis orbital face bowl record.

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The centric relation records must be made by using

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an acceptable method.

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The final patient record is a second axis

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orbital transfer.

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This will be used to mount the maxillary cast in the

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articulator.

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The TMJ face bow is attached

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to the transfer fork.

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The first face bowl record with the

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clutches attached is transferred to the TMJ

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articulator.

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This is stabilized by a rubber band.

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The upper member of the articulator is placed in

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position.

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The inside cell pin has been removed so the

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orbital level will rest upon the orbital pointer.

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The recording.

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This will be looted to the articulator with bite

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stone.

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The consular heads of the vertical posts

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are covered with a layer of graphite by

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rubbing a soft lead pencil against them.

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The upper member of the articulator is carefully

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replaced.

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This produces a graphite mark on the

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M.

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In intial blanks at the terminal hinge position.

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Also the upper member is moved through the

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entire range of motion dictated by the

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engravings.

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Additional points of contact have been disclosed.

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Their location is outlined with a pencil.

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The M initial blanks are removed from the

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instrument and the excess plastic is trimmed away

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to the pencil marks.

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The terminal hinge points must be left intact

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as they maintain the accuracy of the recordings.

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All interfering contacts are removed.

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The M.

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Initial blanks are replaced in the articulator

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and the instrument is run through the entire range of

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motion to verify that there are no points of

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contact except the original terminal

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hinge points.

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Auto problem arising.

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Rosin has been mixed and placed on the evidential

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blanks.

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The upper member is returned to the instrument,

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which is then opened and closed to establish a

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hinge movement

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with the recording disc held in contact.

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The articulator has moved through all of the engraved

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areas to produce the full extent of

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movement recorded from the patient.

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This motion of the articulator is the

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analog of the patient's jaw movement,

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which is being duplicated as an effect of the engraved

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recordings.

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The eminences demonstrate the terminal Hinze

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centric whole point showing through

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their custom form shapes have been determined by the

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articulator movements which were controlled by the

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engraved recordings.

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When the engravings are removed from the articulator,

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these eminences will dictate the same movements.

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Mhm.

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An experiment is used to demonstrate the validity of the

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engraving technique.

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The TMJ articulator whose controls

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have been determined by the engraved recordings

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will be manipulated to determine its

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ability to duplicate the jaw motions as

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recorded by the pantagraph IQ procedure.

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The panda graphic recording is attached to the

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articulator by means of the clutches.

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The vice locks are removed to free the maxillary and

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mandibular members from each other

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to manipulate the articulator.

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The left hand is placed on the upper member.

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This provides stability and is necessary to

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affect the pro truce it and side shift movements.

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The right hand moves the inside cell guide pin.

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A characteristic of most pathologic

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instruments is that they require time

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consuming mechanical adjustment of the fossa

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elements.

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This has been eliminated by the custom form face.

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I

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note how the style I follow precisely.

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The pantagraph IQ tracings is shown here on the right

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posterior recording plates.

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The articulator movement is dictated by the custom

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formed eminences whose shapes were

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determined by the engraved recordings.

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Similarly on the left posterior

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recording plates.

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The style I tracked the pantagraph recordings

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exactly

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also on the interior recording plates.

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The stylist tracks the panda graphic,

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tracing

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a sectional view of one of the feminine Shal elements

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shows how the custom form face.

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I determined the articulator movement.

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A direct comparison of the graphic and engraved recording

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shows the right lateral left lateral

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and produces recordings as accomplished by each

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method.

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Both procedures also incorporate the Bennett

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shift and include the entire range

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of motion.

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The maxillary cast is transferred to the

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articulator by means of the second

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axis orbital face,

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bow transfer,

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record

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the mounting of the mandibular cast is accomplished by use of

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the previously registered wax check bites.

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The articulator can now be manipulated to

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allow a crucial analysis of the patients mounted

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diagnostic casts,

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notice the A kruzel interference in terminal

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hinge closure.

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The articulator has also moved through lateral

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excursions to check for working and

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balancing interferences.

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These mounted diagnostic casts will duplicate the

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patient's jaw movements.

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This is due to the accuracy of the engraved recording

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technique,

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which was used to determine the custom form

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shapes of the m initial elements

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which control the articulator movement.

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Once the patients,

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the clues and interference are identified,

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appropriate treatment can be instituted