lec.:6 Crown&bridge ‫ثناء غني السعيدي‬.

‫د‬

Interocclusal record (Bite registration):

Bite registration transfers the relation between the upper & lower
contacting dental arches from the patient mouth to the articulator
(closing mouth, static occlusion) ..

The objectives of Inter occlusal record (bite registration):

1. Fabrication of fixed prosthesis for the patient without
changing the normal occlusion (In cases of ideal
occlusion).

2. Fabrication of fixed prosthesis with Correction of occlusal

relation in cases of deflective contacts and/or other occlusal
discrepancies in the primary casts at the diagnostic stage.

A distinction must be made between mounting for diagnosis and

mounting for treatment to make corrective measures on the occlusion
of the patient.

Ideal requirements of bite registration material:

1. Rigid material with good dimensional stability.

2. It should give a reproducible record (verifiable record).

3. Accurately record the incisal edges and occlusal surfaces of

teeth.

4. It won't affect the normal closure of the mandible.

5. Easy to manipulate.

Techniques for bite registration:

1- Guided methods:

- Dawson’s technique (bimanual manipulation technique).

- Chin point guidance.

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2- The unguided method (digital devices). With a computer-
assisted three dimensional mandibular recording devices.

Dawson’s technique (bimanual manipulation) technique

The most consistent, repeatable centric
relation results can be accomplished by
using this technique.

1. The patient should be seated with the

chair back approximately 45 degrees from
the floor. The patient’s head should be
tilted back with the chin up so that the face
is parallel with the floor. This position
tends to keep the patient from protruding the mandible.
2. The dentist should take a position behind the patient; all four
fingers of each hand should be placed on the lower border of the
mandible. The thumbs should be placed lightly over the patient
chin or lower anterior teeth.
3. The patient is instructed to open approximately 35 mm and then
asked to relax the jaw as the dentist close it.
4. Dispend the bite registration material between the max.& mand.
Teeth. Guiding the mandible posteriorly into a terminal hinge
relationship with a gentle motion by thumb & upward by the fingers
as mentioned before and let the patient bite on the registration mat.
in centric relation.

The temporomandibular ligament (TML) acts as the

posterior limit and fulcrum (F). The downward force
of the thumbs and upward force of the fingers help
to seat the condyles in the posterosuperior portion
of the glenoid fossa.

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 -In the single handed approach (chin
point guidance), the fingers exert
upward pressure. In this way, it is
more difficult to ensure that the
condyles are properly located,

Note: Trying to force the mandible backwards leads to downward

translation of the condyles, and restorations made to such a
mandibular position are in supraclusion (centric interference) at the
evaluation stage.

Incorrect centric relation (CR) recording. A, If the mandible is forced backward (F), the
condyles are not in their most superior position but are moved backward and downward
(small arrow). B, Any restorations made on casts related with this CR record are in
supraclusion when tried in the mouth. C, Note the relationship of the anterior teeth.

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Anterior Programming Device

In some patients in whom CR does not coincide with MI, resistance

may be encountered when the mandible is hinged. Such patients do
not allow their mandibles to be manipulated and hinged easily.
The programming devices are the guiders for mand.The examples of
ant.prog.devices are:

1. Lucia jig
It is customized from cold cure acrylic resin adapted to the
maxillary central incisors. The patient’s mouth is guided into
closure and stopped when the posterior teeth are about 1 mm
apart. The completed device should allow free movement to
mand. Incisor on lateral and protrusive movement.
2. green stick wax

2.5cm (1inch) length of green stick compound is softened in hot

tap water and bent into a J shape piece and constructed like
Lucia jig.

3) Plastic leaf gauge.

This gauge containing 0.01inch thickness is used consequently till the

post. Teeth become apart about 1mm.

Note: If the patient has an adequate number of teeth and normal

Occlusion, simply occlude the master casts manually without bite

registration & do mounting in the maximum intercuspal position.

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 Materials used for Centric Relation Record
1. Reinforced Aluwax Record (pink base plate wax):

Apiece of wax is placed on the maxillary teeth and ask the patient to
close in centric relation then the wax is removed and placed in water
for cooling. Excess wax covering buccal and lingual teeth surfaces
should be cut with sharp blade. Then wax record should be put
between upper and lower casts & secured with elastic band until
mounting on the articulator is performed.

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2. Bite registration paste (Anterior Programming
Device with Elastomeric silicone or ZOE Record).
1. An anterior programming device is
used to facilitate centric relation
recording.
2. Verify that no posterior contact
remains and that the only occlusal
contact is on the anterior
programming device.
3. Dispense and mix the elastomeric
material according to the
manufacturer’s instructions onto the
occlusal surface of the mandibular arch.(B)
4. Guide the patient’s mandible into hinge movement until the
mandible comes to rest on the anterior programming device.
5. Remove the record from the mouth and trim with the scalpel
blade.(C)

As an alternative to the use of elastomeric

material, a gauze mesh with fast set zinc
oxide-eugenol occlusal registration paste can
be used to coat the posterior teeth & guide
centric relation as the previous method that
used elastomeric imp. Mat.

Luxa bite material

Elastomeric impression mat. introduced between
the dental arches with the special cannula.

advantages of luxa bite rigid bite registration:

1- Highly accurate to the models.( better

than wax)
2- Can be used with or without bite registration trays.
3- No interference with closure of teeth.
4- Fast setting and easy to trim.

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3. Bite rim or occlusal rim.
It used in the following cases:

1. Free end saddle.

2. When we need to restore the anterior teeth.

3. When we don’t have enough teeth to obtain the centric

relation.

Digital systems for recording Centric Relation.

Capturing dynamic mandibular movement and reproducing such in

digital format can be recorded by CAD/CAM & in some instances
evaluated in numbers such as measuring the distance of condylar
border movements (bennet movements) by computerized
tomography, cone beam, T scan devices.