Dental Tribune United Kingdom Edition

October 22 - 28, 201218 United Kingdom EditionComment page 17DTß will really help the dentist a lot. TIP 7: Articulating Papers (Figs 12, 13, 14, 15) Visit www.bauschdental.com to find out a lot more about the different products and pa- pers I use in my private prac- tice. In particular, the big tip I can give dentists is to use the two-phase articulation paper technique. This involves first marking the occlusal con- tacts with a 100-micron thick blue paper with transculase bonding agent in it. Then, you should use a 8-10 micron red articulation foil to precisely mark the exact areas that will actually need adjustment. You will see a blue wider diffuse mark, a halo, and a red dot in the middle. It is this “bull- seye” that you have to aim for – simple! Another great tip is the use of Shimstock foil to record “Shimstock hold positions”. This means making a note of the teeth that are in tight con- tact and prevent the release of the Shimstock foil inter-oc- clusally when the teeth are in contact in centric occlusion. This can then be written on the laboratory docket. You can then expect accurate articu- lations, and restorations that are precise regarding occlusal anatomy and occlusal contact. This will save a lot of time and hassle when fitting crown and bridge work! TIP 8: TMJ Assessment (Figs 16, 17, 18) Before embarking upon a comprehensive course of den- tal treatment, it is vital that the dentist knows how to do a clinical assessment of the tem- poromandibular joints (TMJ), as well as the important facial and neck muscles. The dentist can detect if there are poten- tial TMJ problems and wheth- er referral to a TMJ specialist is required BEFORE dental treatment. I also strongly recommend Joint Vibration Analysis (or JVA), which is computerised equipment and software that is excellent at diagnosing the health of each TMJ. There are special sen- sors that measure the vibra- tions of the TMJ on opening and closing. The data is then presented within the comput- er software and within a few minutes, the dentist can use the Piper Classification of TMJ Health and reach a diagnosis (which supports the clinical findings). I also recommend the use of T Scan, which I think is one of the best occlu- sion assessment computer- ized software available in the world. To find out more about JVA and T Scan, contact David Holland on 07812 201818 or visit www.tekscan.com. There are also some great You Tube videos on occlusion topics that I have posted on my teaching website at www.theacademy- byash.co.uk/Ash-s-Gems/oc- clusion.html. TIP 9: Facebow Records (Figs 19, 20) It is quick and easy to take a facebow record accurately when you know how to. I rec- ommend the Denar system, as well as the Kois Facial Analyz- er. I take the Denar facebow when I am planning bigger cases (eg wear cases that re- quire a new vertical dimen- sion), if I am doing two or more crown/bridge units, and also during a Smile Makeo- ver case. I use the Kois Facial Analyzer if I am doing a Mini Makeover ie only treating the upper four incisors with por- celain restorations, as well as when I am taking the centric relation bite record for mak- ing a Michigan/Tanner type of hard acrylic appliance. If a dentist is thinking of buying an articulator or a facebow, I highly recommend the new Mark 320 Denar Articulator from Whip Mix Corporation. Call Peter Nutkins (on 07714 458215) from Prestige Dental (www.prestige-dental.co.uk) for more advice and a demon- stration. TIP 10: Taking an accurate Centric Relation Record (Figs 21, 22, 23, 24, 25, 26) Many dentists lack the con- fidence to do a “full mouth case”. Once you understand how to do a comprehensive dental examination, diagnose accurately and verify that the vertical dimension has to be altered ie a REORGANISED approach in restorative den- tistry, then it becomes essen- tial to carry out an accurate bite registration in centric relation. I teach practical and easy to follow methods in tak- ing this important record us- ing a variety of techniques, which include the use of a “composite ball” on the lower incisal edges, a leaf gauge, and the bimanual manipula- Fig. 1 ‘Before embarking upon a course of treatment, it is vi- tal that the dentist knows how to do a clinical assessment of the temporo- mandibular joints (TMJ), as well as the important facial and neck muscles’ Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13