Prof. Dr. Bernd Kordaß
stellv. Studiendekan Medizin/Studiendekan Zahnmedizin
Leiter der Abteilungen
– Digitale Zahnmedizin – Okklusions- und Kaufunktionstherapie
– Zahnmedizinische Propädeutik/Community Dentistry
– Zahnärztliche Radiologie
Zentrum für Zahn-, Mund- und Kieferheilkunde Fleischmannstraße 42
17475 Greifswald eMail: kordass@uni-greifswald.d
Adequate occlusion is one of the fundamental tasks in dental diagnostics and treatment. When looking at the occlusion, dentists must always be aware that the oral cavity is a space of the highest sensitivity and spatial resolution. The smallest dimensions in the order of 8-15 µm can be felt and perceived as a disturbance. If the patient glides over the teeth with the tongue, the feeling of space and sensation is different to that of simply feeling with the fingers. Everything in the oral cavity feels large or “enlarged”. The correct bite is therefore particularly important for patients, as the smallest deviations are perceived as unpleasant. [1]
A particular advantage of digitization is that we can connect movement recordings of the mandibular function (Jaw Motion Analyser JMA-Optic, zebris Medical) and thus obtain additional information. (Fig. 1). Suitable coupling trays match the anatomical scan data of the occlusal surfaces and jaws with those of the mandibular movement. This is comparable to the application of a face bow. As a result, occlusal contacts can be recorded during physiological movements, but of course digital articulators can also be controlled. [2]
“Occluding movement patterns can be viewed in terms of the frequency with which an approximation between the functionally relevant occluding occlusal surfaces takes place.”
Due to the physiological dispersion of occlusal movements, individual areas of the occlusal surfaces are “addressed” and loaded more or less frequently during occlusion or the approach movement of antagonistic occlusal surfaces. (Fig. 2). This data provides the basis for determining the extent to which functional loading occurs at these points. This can be of great diagnostic interest, for example to specifically counteract local overload and avoid effects such as chipping in zirconium crowns. [3,4] Freely selectable tooth sections in function make it possible to analyze the collision of the occlusal surfaces spatially precise layer by layer (Fig. 3).
Conclusion
The “digitalization” of occlusion with the “Function and Digital Occlusion (zebris Medical)” module opens up a new dimension with a much more comprehensive view of the occlusion. For the first time, the complexity of occlusal function can be visualized – especially when additional information is included in addition to the pure contact relationships. This brings dentists much closer to the occlusal process than was possible with previous analog methods.
SOURCES
1) Kordaß B, Lotze M: Aufbiss, Zähne und Gehirn. In: Böhme H, Slominski B (Hrsg): Das Orale. Wilhelm Fink Verlag, München, 2013
2) Kordaß B, Ruge S. Lösungsansätze für einen Virtuellen Artikulator. wissen kompakt 2018; DOI 10.1007/s11838-018-0075-1
3) Ruge S, John D, Kordass B. Perspectives for the CAD/CAM world on the visualization of a digital occlusion during mastication. J Craniomandibular Function 2013; 5:163–75
4) Hugger A, Kordaß B: Handbuch Instrumentelle Funktionsanalyse und funktionelle Okklusion. Wissenschaftliche Evidenz und klinisches Vorgehen. Quintessenz 2018, S.234-248
NOTES
zebris JMA-Optic – The World of Functional Digital Dentistry on YouTube.
The video shows the measurement possibilities and features of the zebris Jaw Motion Analyzer System – JMA-Optic. The measurement sequence includes the input of the bipupillary and mouth position, the manual and physiological determination of jaw relations, options for dynamic occlusion analysis through to smile design and export to external CAD systems.
Complete dental playlist on YouTube.
All further information about zebris Medical can be found here.
Download zebris Brochure.