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Face bow/endodontic courses

The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit 
www.indiandentalacademy.com

Face bow/endodontic courses

  1. 1. FACE BOWFACE BOW INDIAN DENTAL ACADEMY Leader in continuing Dental Educationwww.indiandentalacademy.com
  2. 2. ContentsContents  IntroductionIntroduction  DefinitionDefinition  HistoryHistory  Indications and contraindicationsIndications and contraindications  ClassificationClassification  Hinge axisHinge axis  Anterior and posterior reference pointsAnterior and posterior reference points  Face bow transferFace bow transfer  ConclusionConclusion www.indiandentalacademy.com
  3. 3. IntroductionIntroduction www.indiandentalacademy.com
  4. 4.  Face bow essentially records the positional relation ofFace bow essentially records the positional relation of the maxilla to the condyles in the centric relation andthe maxilla to the condyles in the centric relation and later transfer this relation to the articulator so that thelater transfer this relation to the articulator so that the maxillary cast is mounted in the same spatialmaxillary cast is mounted in the same spatial relationship.relationship. www.indiandentalacademy.com
  5. 5. DefinitionDefinition Boucher 11th edition:Boucher 11th edition:  The face bow is a caliper like device that isThe face bow is a caliper like device that is used to record the relationship of the jaws to theused to record the relationship of the jaws to the temporo-mandibular joints or the opening axistemporo-mandibular joints or the opening axis of the jaws and to orient the casts in the sameof the jaws and to orient the casts in the same relationship to the opening axis of therelationship to the opening axis of the articulator.articulator. www.indiandentalacademy.com
  6. 6.  Heartwell:Heartwell:  Face bow is a caliper like device used toFace bow is a caliper like device used to record the relationship of maxilla to therecord the relationship of maxilla to the temperomandibular joint.temperomandibular joint. www.indiandentalacademy.com
  7. 7.  GPT-8:GPT-8:  Caliper like instrument used to record theCaliper like instrument used to record the spatial relationship of the maxillary arch to somespatial relationship of the maxillary arch to some anatomic reference point or points and thenanatomic reference point or points and then transfer this relationship to an articulator; ittransfer this relationship to an articulator; it orients the dental cast in the same relationshiporients the dental cast in the same relationship to the opening axis of the articulator”.to the opening axis of the articulator”. www.indiandentalacademy.com
  8. 8. HistoryHistory  Bonwill,Bonwill, (1860) he determined(1860) he determined the distance from the center ofthe distance from the center of each condyle to the medianeach condyle to the median incisal point and the lower teethincisal point and the lower teeth as 10cm. He used this standardas 10cm. He used this standard for mounting his casts in thefor mounting his casts in the articulator.articulator.  Disadvantage:Disadvantage: He did not mention at whatHe did not mention at what level below the condylarlevel below the condylar mechanism the occlusal planemechanism the occlusal plane should be situated.should be situated. www.indiandentalacademy.com
  9. 9.  BalkwillBalkwill (1866)(1866)demonstrated andemonstrated an apparatus with which heapparatus with which he could measure the anglecould measure the angle formed by the occlusal planeformed by the occlusal plane of the teeth and a planeof the teeth and a plane passing through the linespassing through the lines extending from the condylesextending from the condyles to the incisal line of theto the incisal line of the lower teeth. This angle variedlower teeth. This angle varied from 22-30°.from 22-30°. www.indiandentalacademy.com
  10. 10.  Disadvantage:Disadvantage: The articulating caliper howeverThe articulating caliper however did not enable a fixed transfer or 3-dimensionaldid not enable a fixed transfer or 3-dimensional orientation of the cast to the articulator.orientation of the cast to the articulator.  There was no control of the proper orientationThere was no control of the proper orientation of occlusal planeof occlusal plane www.indiandentalacademy.com
  11. 11.  Richmond S.H.HayesRichmond S.H.Hayes introduced first exampleintroduced first example of functional face bowof functional face bow like device intended forlike device intended for locating the position oflocating the position of the casts correctly in thethe casts correctly in the articulator. He namedarticulator. He named the device asthe device as “articulating caliper”.“articulating caliper”. www.indiandentalacademy.com
  12. 12.  WalkerWalker invented theinvented the “clinometer” a new type of“clinometer” a new type of instrument with which itinstrument with which it would have been possible towould have been possible to obtain a relatively good valueobtain a relatively good value for the position of the lowerfor the position of the lower cast in relation to thecast in relation to the condylar mechanism, bettercondylar mechanism, better than with all the previousthan with all the previous apparatus.apparatus.  Disadvantage: BulkyDisadvantage: Bulky exceedingly complicatedexceedingly complicated apparatusapparatus www.indiandentalacademy.com
  13. 13.  GysiGysi constructed anconstructed an instrument for registeringinstrument for registering the condyle path.the condyle path. However, he alsoHowever, he also employed his apparatusemployed his apparatus as a face-bow.as a face-bow.  George B.Snow -1899 invented a device which became prototype for modern facebow www.indiandentalacademy.com
  14. 14. INDICATIONS OF FACE BOWINDICATIONS OF FACE BOW  When disharmonies in occlusion resulting fromWhen disharmonies in occlusion resulting from failure to use the face bow are analyzed, it can befailure to use the face bow are analyzed, it can be concluded that the face bow should be usedconcluded that the face bow should be used when:when:  Cusp teeth are used.Cusp teeth are used.  Balanced occlusion in the centric positions isBalanced occlusion in the centric positions is desired.desired. www.indiandentalacademy.com
  15. 15.  A definite cusp fossa or cusp tip to tip incline relation isA definite cusp fossa or cusp tip to tip incline relation is desired.desired.  When interocclusal check records are used forWhen interocclusal check records are used for verification of jaw positions.verification of jaw positions.  When the occlusal vertical dimension is subjected toWhen the occlusal vertical dimension is subjected to change, and alterations of tooth occlusal surfaces arechange, and alterations of tooth occlusal surfaces are necessary to accommodate the change.necessary to accommodate the change.  To diagnose existing occlusion in patients mouthTo diagnose existing occlusion in patients mouth www.indiandentalacademy.com
  16. 16. CONTRA INDICATIONSCONTRA INDICATIONS  When monoplane teeth are arranged on a planeWhen monoplane teeth are arranged on a plane in occlusal balance and the mandible is in mostin occlusal balance and the mandible is in most retruded relation to the maxilla at an acceptableretruded relation to the maxilla at an acceptable vertical dimension of jaw separation.vertical dimension of jaw separation.  When no alterations of the occluding …When no alterations of the occluding … necessitate change in the vertical dimension.necessitate change in the vertical dimension.  No inter occlusal check recordsNo inter occlusal check records  When articulators that are not designed to accept aWhen articulators that are not designed to accept a facebow transferfacebow transfer www.indiandentalacademy.com
  17. 17. PARTSPARTS  Basically it isBasically it is constructed in 3 bars,constructed in 3 bars, 1 anterior, 2 lateral.1 anterior, 2 lateral.  Face bow frame.Face bow frame.  Ear rods.Ear rods.  Orbital pointer.Orbital pointer.  Caliper.Caliper.  Bite fork.Bite fork. www.indiandentalacademy.com
  18. 18. ClassificationClassification Face bow Arbitrary Kinematic Fascia type Ear piece type With orbital indicator With nasal relator www.indiandentalacademy.com
  19. 19. FACE BOWS ARE GROUPED ASFACE BOWS ARE GROUPED AS FOLLOWSFOLLOWS Arbitrary face bow :Arbitrary face bow :  Uses arbitrary or approximate points on the face as theUses arbitrary or approximate points on the face as the posterior points and condylar rods are positioned onposterior points and condylar rods are positioned on these point.these point.  They are widely used type of face bow and areThey are widely used type of face bow and are sufficient for fabrication of most complete denture,sufficient for fabrication of most complete denture, fixed partial and removable partial denture.fixed partial and removable partial denture. www.indiandentalacademy.com
  20. 20. Facial typeFacial type  The facial type of faceThe facial type of face bow utilizes approximatebow utilizes approximate points on the skin over thepoints on the skin over the temporomandibular region astemporomandibular region as the posterior reference points.the posterior reference points. These points are located byThese points are located by measuring from certainmeasuring from certain anatomical landmarks on theanatomical landmarks on the face.face. www.indiandentalacademy.com
  21. 21. Ear piece typeEar piece type  First described by Dabley in 1914. However it was onlyFirst described by Dabley in 1914. However it was only during the early 1960: that it gained the popularity.during the early 1960: that it gained the popularity.  It uses the external auditory meatus as an arbitraryIt uses the external auditory meatus as an arbitrary reference point which is aligned with ear pieces similarreference point which is aligned with ear pieces similar to those on a stethoscope.to those on a stethoscope.  accurate relationship for most diagnostic andaccurate relationship for most diagnostic and restorative procedures.restorative procedures. www.indiandentalacademy.com
  22. 22. AdvantagesAdvantages  Simple to use.Simple to use.  Do not require measurements or works on theDo not require measurements or works on the face.face.  As accurate as other face bows.As accurate as other face bows.  It provides an average anatomic dimensionIt provides an average anatomic dimension between the external auditory meatus andbetween the external auditory meatus and horizontal axis of mandiblehorizontal axis of mandible www.indiandentalacademy.com
  23. 23. DisadvantagesDisadvantages  Regardless of which arbitrary position isRegardless of which arbitrary position is chosen a minimum error of 5mm from the axischosen a minimum error of 5mm from the axis can be expected.can be expected.  When coupled with the use of a thickWhen coupled with the use of a thick interocclusal record made at an increased verticalinterocclusal record made at an increased vertical dimension. This factor can lead to considerabledimension. This factor can lead to considerable inaccuracyinaccuracy www.indiandentalacademy.com
  24. 24.  Spring bowSpring bow ::  It is an earpiece faceIt is an earpiece face bow made of spring steel andbow made of spring steel and simply springs open andsimply springs open and close to various head widths.close to various head widths.  This instrument isThis instrument is designed to orient thedesigned to orient the occlusal plane to theocclusal plane to the Frankfort horizontal plane byFrankfort horizontal plane by means for a third point ofmeans for a third point of referencereference www.indiandentalacademy.com
  25. 25.  Advantages :Advantages :  The one piece design of bow eliminates the movingThe one piece design of bow eliminates the moving parts and maintenance problems encountered withparts and maintenance problems encountered with other models.other models.  Easy and efficient to use.Easy and efficient to use.  Sterilazable parts.Sterilazable parts.  Adaptability to other articulation.Adaptability to other articulation.  Direct/indirect mounting capability.Direct/indirect mounting capability.  Disadvantage :Disadvantage :  Inability to measure intercondylar distanceInability to measure intercondylar distance www.indiandentalacademy.com
  26. 26. KINEMATIC FACE BOW:KINEMATIC FACE BOW: ACTUAL VALUE/ HINGE AXISACTUAL VALUE/ HINGE AXIS  It is used to determine and locate the exact hinge axisIt is used to determine and locate the exact hinge axis points. Though hinge axis of the mandible can bepoints. Though hinge axis of the mandible can be determined by a clutch i.e., a segmented impression traydetermined by a clutch i.e., a segmented impression tray like device attached onto the mandibular teeth with alike device attached onto the mandibular teeth with a suitable rigid material such as impression plaster.suitable rigid material such as impression plaster. www.indiandentalacademy.com
  27. 27.  Indication :Indication :  When it is critical to precisely reproduce the exactWhen it is critical to precisely reproduce the exact opening and closing movement of the patient to theopening and closing movement of the patient to the articulatorarticulator  Draw backs :Draw backs :  Extensive chairside.Extensive chairside.  ExpensiveExpensive  Rarely indicated for routine articulators withRarely indicated for routine articulators with prosthodontic procedures.prosthodontic procedures. www.indiandentalacademy.com
  28. 28. Hinge AxisHinge Axis  Definition: an imaginary line around which theDefinition: an imaginary line around which the mandible may rotate within the saggital plane.mandible may rotate within the saggital plane.  HistoryHistory  Craddock & Symmons (1952)Craddock & Symmons (1952) Method of palpation to locate hinge axis - SatisfactoryMethod of palpation to locate hinge axis - Satisfactory  Trapozzano and LazzariTrapozzano and Lazzari more than one condylar hinge-axis pointmore than one condylar hinge-axis point questioned the accuracy and validity of hinge-axis locationquestioned the accuracy and validity of hinge-axis location  Granger (1952)Granger (1952) Only position where HA is common to both - CROnly position where HA is common to both - CR www.indiandentalacademy.com
  29. 29. Lucia (1953)Lucia (1953) -- Importance of the hinge-axisImportance of the hinge-axis  To diagnose an occlusal problemTo diagnose an occlusal problem  A centric relation record verificationA centric relation record verification  To reproduce jaw movementsTo reproduce jaw movements Schallohorn (1957)Schallohorn (1957)  An arbitrary location 13 mm anterior to the tragusAn arbitrary location 13 mm anterior to the tragus  95% of subjects within a radius of 5 mm from the arbitrary95% of subjects within a radius of 5 mm from the arbitrary centrecentre www.indiandentalacademy.com
  30. 30. Trapozzano (1957)Trapozzano (1957) disagreed the split hinge axis theory.disagreed the split hinge axis theory. The mandible would have to bend or the continuity ofThe mandible would have to bend or the continuity of the mandible would have to be broken.the mandible would have to be broken.  Joyce F. Palik, Donald R. Nelson, and James T. White  Accuracy of the ear bow  Significant discrepancy in the antero posterior direction but not in  the superior-inferior direction  Anterior to the terminal hinge axis 92% of the time  It was not statistically repeatable www.indiandentalacademy.com
  31. 31. Thomas R Morneburg and Peter A. ProschelThomas R Morneburg and Peter A. Proschel (2002)(2002) • Estimated the frequency of occlusal error-Estimated the frequency of occlusal error- arbitrary axesarbitrary axes • 2 and 4 mm changes of vertical dimensions2 and 4 mm changes of vertical dimensions • Found occlusal errors of less than 300Found occlusal errors of less than 300 µµm in them in the second molar area in 87% of patients with a 2second molar area in 87% of patients with a 2 mm change of vertical dimensionmm change of vertical dimension www.indiandentalacademy.com
  32. 32. Value of true hinge axisValue of true hinge axis  Allows the centric relation record in dentulousAllows the centric relation record in dentulous situations to be accurately mounted on articulator withsituations to be accurately mounted on articulator with the use of interocclusal centric record.the use of interocclusal centric record.  Further it is impossible to check the accuracy of centricFurther it is impossible to check the accuracy of centric interocclusal record without a hinge axis transfer. Hingeinterocclusal record without a hinge axis transfer. Hinge axis recording is required to check the accuracy of twoaxis recording is required to check the accuracy of two centric records.centric records.  It is the starting point of lateral movements.It is the starting point of lateral movements. www.indiandentalacademy.com
  33. 33.  Permits vertical dimension to be changed in thePermits vertical dimension to be changed in the articulator.articulator.  Allows the transfer of the opening axis to theAllows the transfer of the opening axis to the articulator so that occlusion would be on thearticulator so that occlusion would be on the same arc of closure as the lower jaw.same arc of closure as the lower jaw.  Opening and closing movements of theOpening and closing movements of the mandible are reproducedmandible are reproduced  BenefitBenefit :: It helps in diagnosis / treatmentIt helps in diagnosis / treatment planning of mounted study casts.planning of mounted study casts. www.indiandentalacademy.com
  34. 34. Facebow record is used….Facebow record is used….  Balanced occlusion in CDBalanced occlusion in CD  Class I & II casesClass I & II cases  Open anterior bite or end to end relationshipOpen anterior bite or end to end relationship  Single restoration on II molar not for premolar and I molarSingle restoration on II molar not for premolar and I molar  Segmental restorationSegmental restoration  Anterior restoration – primary guidance factor in excursive movementAnterior restoration – primary guidance factor in excursive movement  Restoration of entire quadrantRestoration of entire quadrant True hinge axis recordingTrue hinge axis recording  Kinematic facebowKinematic facebow  Trial & error method- McCollum(1921)Trial & error method- McCollum(1921)  Indications - To precisely reproduce the exact opening & closingIndications - To precisely reproduce the exact opening & closing  Drawback - Rarely indicatedDrawback - Rarely indicated To sum upTo sum up www.indiandentalacademy.com
  35. 35. ProcedureProcedure  Kinematic face bow styli positionedKinematic face bow styli positioned  A clutch attached on to mand teethA clutch attached on to mand teeth  Transverse component & adjustable side armTransverse component & adjustable side arm  Mandible manipulated Terminal hingeMandible manipulated Terminal hinge movementmovement Movement of the styliMovement of the styli Stationary One of the arcsStationary One of the arcs Actual axis Adjusted withActual axis Adjusted with of rotation thumb screwsof rotation thumb screws  Hinge Axis markedHinge Axis marked www.indiandentalacademy.com
  36. 36. Kinematic face bow transferKinematic face bow transfer  Impression on face bow forkImpression on face bow fork  Face Bow attached to the forkFace Bow attached to the fork  Styli aligned with Hinge AxisStyli aligned with Hinge Axis markmark  Pt in same positionPt in same position  Pointer devicePointer device  Face bow transfer to articulatorFace bow transfer to articulator www.indiandentalacademy.com
  37. 37. Plane of orientationPlane of orientation The spatial plane formed by joiningThe spatial plane formed by joining the anterior and posterior referencethe anterior and posterior reference pointspoints Posterior reference pointsPosterior reference points Arbitrary hinge axis points Accuracy % Investigator Beyron point 13 mm form posterior margin of tragus to canthus 98.0 Schallhorn, beyron, Beck 13 mm in front of anterior margin of meatus 40.0 Beck, lauritzen and bodner 13 mm from foot of tragus to canthus 33.0 Teteruck and lundeen Bergstrom point 10 mm anterior to center of external auditory meatus and 7 mm below Frankfurt plane 83.3 Beck Ear axis 75.5 Teteruck and Lundeen www.indiandentalacademy.com
  38. 38. Anterior reference points :Anterior reference points : 1.1. Orbitale (B) Located byOrbitale (B) Located by Hanau facebow with helpHanau facebow with help of orbital pointer.of orbital pointer. 2.2. Orbitale minus 7 mm. (C)Orbitale minus 7 mm. (C) This plane representsThis plane represents Frankfort plane.Frankfort plane. 3.3. Nasion (A) Used with quickNasion (A) Used with quick mount facebow (Whip mix)mount facebow (Whip mix) 4.4. Ala of nose (D) This planeAla of nose (D) This plane represents campers planerepresents campers plane 5.5. 43 mm superior from lower43 mm superior from lower border of upper lip (Denarborder of upper lip (Denar reference plane locator –reference plane locator – Denar facebow uses thisDenar facebow uses this reference point)reference point) www.indiandentalacademy.com
  39. 39. PLANE OF ORIENTATIONPLANE OF ORIENTATION The spatial plane formed by joiningThe spatial plane formed by joining anterior and posterior reference points isanterior and posterior reference points is called plane of orientationcalled plane of orientation Posterior reference pointsPosterior reference points It is located by arbitrary method/It is located by arbitrary method/ kinematic methodkinematic method Arbitrary method :Arbitrary method : By measurement:BERGSROM POINTBy measurement:BERGSROM POINT BEYRON POINTBEYRON POINT ““Beck’’-Bergstrom point closest to hingeBeck’’-Bergstrom point closest to hinge axisaxis Beyron point next most accurate pointBeyron point next most accurate pointwww.indiandentalacademy.com
  40. 40. The following steps apply for all facebow procedures : • Preparation of bite fork • Orientation of face bow to bite fork and reference points • Orientation of face bow to articulator. • Attachment of maxillary cast to articulator. When using a Hanau Face Bow • Infraorbital notch serves as a anterior point of reference. • Plane established by the external auditory opening & infraorbital notch • Face bow is used to record the position of the maxillary arch. • The spatial information is transferred to the articulator. www.indiandentalacademy.com
  41. 41. PROCEDURE Modeling plastic is heated – 600 Adapted to the bite fork Position over the maxillary teeth It is removed when cooled Chilled in water and trimmed Well adapted record base www.indiandentalacademy.com
  42. 42. To verify accurate fit and stability Bite fork position face bow is guided onto the stem of the bite fork Earpiece into the external auditory openings Orbital pointer positioned Thumbscrews tightened to maintain the spatial relationships between face bow and bite fork www.indiandentalacademy.com
  43. 43. • Maxillary rim attached to the bite fork. • Bite fork position • Ear-piece inserted • Clamp holding the bite fork locked • Fully assembled face bow and ear-piece clamps are loosened • Bow is centered in the articulator www.indiandentalacademy.com
  44. 44. WHIP MIX QUICK MOUNT FACEBOW TECHNIQUE Armamentarium Wax added to mandibular incisor portion Bite fork to maxillary teeth Thinning the posterior wax Nasion relator positioned Knobs tightened www.indiandentalacademy.com
  45. 45. DENAR EAR & MEASUREMENT TYPE FACE BOW Denar ear face-bow transfer Spatial adapting on the incisal table Denar measurement type assembled face-bow Oriented to the articulator Maxillary cast oriented in all spacial relationship as present in patientwww.indiandentalacademy.com
  46. 46. ConclusionConclusion www.indiandentalacademy.com
  47. 47. List of referencesList of references  Contemporary fixed prosthodontics, Stephen F. Rosenstiel, 3rdContemporary fixed prosthodontics, Stephen F. Rosenstiel, 3rd edition.edition.  Fundamentals of fixed prosthodontics, Herbet t. Shilling burg thirdFundamentals of fixed prosthodontics, Herbet t. Shilling burg third edition.edition.  Complete denture prosthodontics – Dr. John Joy Manapalli.Complete denture prosthodontics – Dr. John Joy Manapalli.  Stewart’z clinical removal partial prosthodontics, third editionStewart’z clinical removal partial prosthodontics, third edition  Essentials of complete denture prosthodontics, Sheldon Winkler,Essentials of complete denture prosthodontics, Sheldon Winkler, second edition.second edition.  McCracken’s removable partial prosthodontics, eleventh editionMcCracken’s removable partial prosthodontics, eleventh edition  Prosthodontic treatment for edentulous patients, George A ZarbProsthodontic treatment for edentulous patients, George A Zarb twelfth edition.twelfth edition. www.indiandentalacademy.com
  48. 48.  J Of Oral Rehabilitation 1985; 12: 135-159.J Of Oral Rehabilitation 1985; 12: 135-159.  Int J Prosthodont 2002; 15:358-364.Int J Prosthodont 2002; 15:358-364.  J Prosthet Dent 2001;85:236-45.J Prosthet Dent 2001;85:236-45.  J Prosthet Dent 1985;53(6):800-804.J Prosthet Dent 1985;53(6):800-804.  J of oral rehabilitation 1999;26:661-665.J of oral rehabilitation 1999;26:661-665.  J of Prosthet Dent 1986;56(5):606-616.J of Prosthet Dent 1986;56(5):606-616.  J of Prosthet Dent 1979;41(6):605-613.J of Prosthet Dent 1979;41(6):605-613. www.indiandentalacademy.com
  49. 49. Thank UThank U www.indiandentalacademy.com
  50. 50. Next journal club byNext journal club by Dr. Kesava ReddyDr. Kesava Reddy on Saturday, 15/07/06on Saturday, 15/07/06 www.indiandentalacademy.com

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