CAD/CAM - international magazine of digital dentistry

I 07 CE article _ Virtual Facebow I CAD/CAM 2_2014 The facebow is a largely omitted during the diag- nosis and treatment-planning phase due to its short- comings.Itcanprovetediousanduncomfortableforthe patient, as the ear canal projections, bite fork and nose bridge can apply pressure and pain. The facebow can prove tedious and frustrating to the clinician, due to the subjective positioning and multiple adjustments3,4,5 (Fig.3). If utilized incorrectly, the facebow can result in errors,whichinclude: _facebowapplication; _assembly; _patientposition; _verification; _inmaxillarycastorientation; _inmandibularcastorientation; _occlusalrelationship. Errors have direct impact on the assessment of inter-arch space, occlusal contacts and force direction (Figs. 1-4). Errors will then affect the diagnosis, treat- ment plan, implant type, abutment angle and pros- thesis.Ifinaccuratemountingerrorsarenotrecognized early, the outcome may yield a compromised result, poor prosthesis (form and function), timely adjust- mentsandaremake. As with any compromised result, the ultimate consequence would include inefficient use of time, unnecessary costs, patient unhappiness, stress on the clinicianandanunnecessaryenvironmentalimpact. VirtualFacebow To rectify these compounded issues, the Virtual Facebow app (VF) (Research Driven, Komoka, Ontario) was developed as a digital substitute for the analog facebow. Several safeguards were incorporated to minimize errors in positioning and orientation. The VF has been developed as an app that incorporates patient photos, alignment verification, anatomical relevance and confirmation of occlusion. The open source tablet app has been developed to be accessible through affordable tablet cost, affordable app cost and un- limiteduse. Datacanbereadilyshared,usedonvariousdevices, requires no specialized software, is simple to open and read and provides an easy-to-email option. The VF wasdesignedtobeefficient,effective,economicaland educational. The VF’s current requirements include: anysupportedtabletdevicewithanAndroidoperating system, a back-facing camera and a minimum system update of 4.0.3. The VF is currently available on the GooglePlaymarket. Although the VF app has been designed to be used as a standalone substitute for the analogue facebow, several peripherals have been developed to offer even more simplicity to the process. A patient positioner verifies patient orientation, a vertical tablet stand sim- plifies operation and an articulator mount positions themaxillarycast. _Methodology: Case study Clinical The following is a step-by-step instruction on the VFutilization.Properlypositionthepatientandconfirm orientation. Place the tablet in the stand within 6 to 12inchesofthepatient.LaunchtheVFapp(Fig.5). Fig. 3_Facebow application. Fig. 4_Incorrect mounting. Fig. 4Fig. 3 CAD0214_06-10_Kalman 13.05.14 11:13 Seite 2