Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C19/00—Dental auxiliary appliances
  • A61C19/04—Measuring instruments specially adapted for dentistry
  • A61C19/045—Measuring instruments specially adapted for dentistry for recording mandibular movement, e.g. face bows
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C11/00—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings
  • A61C11/003—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings with height adjustments thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C11/00—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings
  • A61C11/006—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings with an occlusal plate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C11/00—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings
  • A61C11/02—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings characterised by the arrangement, location or type of the hinge means ; Articulators with pivots
  • A61C11/022—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings characterised by the arrangement, location or type of the hinge means ; Articulators with pivots with two adjustable pivoting points, e.g. Argon-type articulators
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C11/00—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings
  • A61C11/06—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings with incisal guide
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C11/00—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings
  • A61C11/08—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings with means to secure dental casts to articulator
  • A61C11/087—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings with means to secure dental casts to articulator using magnets

Definitions

• the present invention relates to a system and a method for recording biometric data on the position of the maxilla in the skull for cases of skeletal symmetry and asymmetry.
• a face bow (1 ) commonly used is fixed in ear canals using ear canal holders (1 .3', 1 .3"), and on a nose, using a nasal shaft (1.1 ).
• Such face bow (1 ) has a pivot joint (1 .2) for mounting an occlusal fork (2).
• a conventional occlusal fork (2) comprises a register holder (2.1 ) and a holder (2.2) for mounting the register holder in the pivot joint (1.2) of the face bow (1 ).
• Such face bow is shown in Figure 1 .
• Positions of a patient's temporomandibular joints may be asymmetric with respect to the sagittal plane (SP).
• SP sagittal plane
• None of the statistical planes (KP, OP, FH, EP) correspond to x, y, z axes / planes as shown in Figure 3: the xy plane is a transversal plane (TP); the z plane is a sagittal plane (SP) and the yz plane is a frontal plane (FP).
• the conventional method of measurement using a face-mounted face bow (1 ) is not suitable for evaluating / measuring asymmetry of the ear canals and / or rotational axis.
• Digital articulators (4') are replicas of mechanical articulators in digital space. Branches (1.4', 1.4") of the face bow, being at different positions (e.g. at different heights) on the head relative to the sagittal plane (SP), are horizontally and vertically aligned during transfer to the articulator (4). This discrepancy results in distorted biometrics because the genetic reference points are horizon, vertical, and depth, i.e. xy, xz, and yz planes (TP, SP, FP). The discrepancy is illustrated in Figures 5a and 5b.
• VZM maxilla model
• a specialist working with jaw models so positioned may be misled because the geometry of a conventional articulator implies a different illusion of the position of the models in space than it is actually the case.
• a method for measuring odontological biometric data, a face bow, an occlusal fork, and an articulator are disclosed in U.S. Patent No. 5090901.
• the face bow, the articulator, the occlusal fork, and the method for measuring include the above shortcomings of the conventional face-mounted face bow, occlusal fork, articulator, and the method for measuring.
• Modern digital data transfer systems operate on the principle of direct information transfer: the position and relationship of the jaw models in a conventional laboratory articulator is scanned and transferred to a virtual space.
• scanned models are manually (by using a computer mouse and a computer screen) positioned in a virtual articulator according to conventional planes (e.g. occlusal, Bonwill or Balkwill triangle planes).
• planes e.g. occlusal, Bonwill or Balkwill triangle planes.
• virtual tools and their working principal remain the same as in manual systems.
• Virtual articulators are merely simulations of a real articulator on a computer screen, without the ability to change the position of the pivot joints with respect to the sagittal plane and to each other individually. Therefore, in modern systems, creating an individual asymmetry of the ends of the rotational axis is not possible.
• the invention simplifies the recording and transfer of patient’s biometric data, such as the position of the mandible with respect to the rotational axis of the temporomandibular joints, to the articulator ensuring proper data quality for diagnostics and restoration of the patient's chewing apparatus in cases of skeletal symmetry and asymmetry.
• the invention discloses a method for recording the maxilla position with respect to the vertical rotational axes of heads of temporomandibular joints, a system for recording and tools for recording and transferring biometric data to a laboratory articulator and / or digital chewing simulator with customizable positions of ends of rotational axis with respect to the sagittal plane.
• the system comprises a dedicated clinical occlusal fork for measuring facial biometric parameters, such as maxilla position in the head.
• the clinical occlusal fork includes a register holder, face center ruler and face sides’ rulers.
• the system also comprises a laboratory occlusal fork for transferring facial biometric data, such as maxilla position to the laboratory articulator, both in normal and virtual environments.
• the laboratory occlusal fork comprises a register holder and side rulers in holders, the interposition of which substantially corresponds to those of the clinical occlusal fork register holder and the side rulers’ holders.
• a conventional or modified articulator is used.
• the modified articulator that is used in the case of skeletal asymmetry comprises an interchangeable individual connection between the lower part of the articulator and one of the articulator branches with a pivot joint.
• the method for recording involves the use of said occlusal forks in cases of skeletal symmetry and skeletal asymmetry.
• Figure 1 depicts a head-mounted, ear canal-mounted and face-mounted face bow and an occlusal fork for recording odontological biometry data known from prior art.
• Figure 2a depicts planes in a human head model.
• Figure 2b depicts the planes in a human skull.
• Figure 3 depicts the xy, yz, xz planes.
• Figure 4 depicts a known system for recording facial biometric data corresponding state of the art.
• Figure 5a depicts a system for recording facial biometric data and an occlusal fork attached horizontally to the patient's maxillary teeth (front view) known from prior art: due to skeletal asymmetry, the transfer of face-mounted face bow with occlusal fork to the articulator causes the transverse tilt of the latter and results in horizontal deviation.
• Figure 5b depicts the transverse and horizontal tilt of the jaw model resulting from skeletal asymmetry after transferring the face bow with the occlusal fork to the articulator.
• Figure 6 depicts normal individual positions of patient's maxilla model with respect to the rotational axis: if the position is incorrect, the angle of occlusal load is incorrect.
• the Special Line (OP3) is the most popular reference for positioning the maxilla model when working without any face bow and positioning the model in a normal way.
• the optimum angle of the trajectory of motion of the mandible to the occlusal surface of the maxilla is 90 degrees.
• Figure 7 depicts an example of a clinical occlusion fork for recording facial biometric data according to the invention, which is mounted to the maxilla and positioned horizontally.
• Figure 8 depicts an example of a laboratory occlusal fork for positioning in the articulator according to the invention.
• Figure 9 depicts a comparison of a clinical occlusion fork for recording facial biometric data and a laboratory occlusal fork for positioning in the articulator.
• Figure 10 depicts an example of an articulator table for positioning a laboratory occlusal fork for positioning in an articulator, according to the invention: a) side view; b) front view; c) top view.
• Figure 11 depicts an example of a system for recording facial biometric data according to the invention with an articulator table and a laboratory occlusal fork with a silicone register.
• Figure 12 depicts the possible position of the maxilla with respect to the rotational axis of temporomandibular joints and the positioning points of the occlusal fork.
• Figures 13a and 13b illustrate an example of a system for recording facial biometric data according to the invention and reference points for positioning a laboratory occlusal fork for positioning on the articulator with a maxilla model.
• Figure 14 depicts directions for changing position of virtual pivot joints with respect to the sagittal plane (XZ plane).
• Figure 15 depicts position of rotational axis of a mandible with respect to the parasagittal (PSP', PSP") and sagittal (SP) planes at: (a) skeletal symmetry; (b) vertical skeletal asymmetry in which the joints of the mandible and the ends of their rotational axis (RA), respectively, are at different heights (with respect to the sagittal plane (SP)); (c) horizontal skeletal asymmetry in which the joints of the mandible and the ends of their rotational axis (RA), respectively, are at different depths (distally or medially with respect to the sagittal plane (SP)); (d) horizontal and vertical skeletal asymmetry in which the joints of the mandible and the ends of their rotational axis (RA), respectively, are at different depths and in height (with respect to the sagittal plane (SP)).
• Figure 16 depicts lower part of a standard articulator with symmetrical branches.
• Figure 17 depicts lower part of the articulator according to one embodiment of the invention with a pivot part: a) rear view; b) side view.
• Figure 18 depicts the lower part of the articulator according to one embodiment of the invention with asymmetrical branches and interchangeable individual connection: a) rear view; (b) side view; c) lateral cross-section of the connection.
• Figures 19a to 19c illustrate a replaceable individual connection according to an exemplary embodiment of the invention: assembled and cross-sectional view.
• Figure 20 depicts a three-dimensional matrix of a virtual articulator: a) with the location of position of the register holder; (b) mandible and maxilla models.
• Tragus (T) an anatomical structure in an outer ear used as one of the reference points for identifying the plane of a head and the rotational point (RT) of the mandible.
• Sagital Plane (SP) - divides a body into a symmetrical left and right side through a center: used as a reference plane for positioning a clinical occlusal fork (7) and identifying skeletal asymmetries in the skull and chewing apparatus.
• Frankfurt Horizontal (FH) - passes through the center of the tragus (T) and the orbital point (OT).
• Camper's Plane (KP) - passes through the center of the tragus (T) and the sub-nasal point (PT).
• Occlusal plane (OP) - passes through the occlusal surface of the dental arch.
• Conventional Laboratory Articulator (4) - laboratory simulator of chewing apparatus can be digitally embedded in odontological image editing programs (such as 3shape, exocad), usually comprising at least the upper part that imitates the maxilla with joint sockets and the lower part that imitates the mandible, symmetrical pivot connections with the head of the mandible joint and the surfaces that imitate the slope of the joint socket, vertical shaft (4.3) adjusting the ratio by height of the upper part and the lower part.
• odontological image editing programs such as 3shape, exocad
• Clinical occlusal fork (7) is a tool for measuring facial biometric parameters, such as maxilla in a head, a measuring tool with register holder (7.4), face center ruler (7.9), and face sides rulers (7.1 ', 7.1").
• Silicone register (3) is an individual register made from odontological basic silicone or other material used to register the occlusion.
• the odontological biometric data recording system for recording biometric data when the mandibular joints are symmetrical with respect to the sagittal plane (SP) and the ends of their rotational axis (RA) are symmetrical with respect to the sagittal plane (SP).
• the system comprises a clinical occlusal fork (7) with a face center ruler (7.9) and two face sides rulers (7.1 ', 7.1"); a conventional laboratory articulator (4) comprising a frame (12.3), a rotational axis (RA), an articulator shaft (4.3), a maxilla model holder (11.1 ), a laboratory occlusal fork (8) for mounting in the articulator (4), and a height- adjustable table (10) for positioning the laboratory occlusal fork (8) in the articulator with two face sides rulers (8.1 ', 8.1").
• a conventional laboratory articulator (4) comprising a frame (12.3), a rotational axis (RA), an articulator shaft (4.3), a maxilla model holder (11.1 ), a laboratory occlusal fork (8) for mounting in the articulator (4), and a height- adjustable table (10) for positioning the laboratory occlusal fork (8) in the articulator with two face sides rulers (8.1
• Figure 7 depicts an example of an embodiment of a clinical occlusal fork (7) according to the invention for measuring facial biometric parameters.
• the clinical occlusal fork (7) comprises a frame (7.5) that includes a register holder (7.4) whose position, when measured, coincides with the occlusal plane (OP) of the maxilla, on one side of which the recording material (3) is placed; a face center ruler (7.9) extending along and within the sagittal plane (SP), which is intended to prevent deviation from the sagittal plane (SP) when applying a clinical occlusal fork (7) in the mouth; a facial left side ruler (7.1 ') and a facial right side ruler (7.1”) for recording biometric parameters of left side of the face and the right side of the face respectively.
• SP sagittal plane
• the clinical occlusal fork (7) may further comprise a level (5) for ensuring horizontal positioning of the register holder (7.4) and the occlusal plane (OP) in the patient's mouth.
• the facial left side ruler (7.1 ') is inserted into the lateral ruler locking member (7.2'), which is located on the left branch (7.5') of the frame (7.5) of clinical occlusal fork (7).
• the facial right side ruler (7.1") is inserted into the lateral ruler locking member (7.2"), which is located on the right branch (7.5") of the frame (7.5) of clinical occlusal fork (7).
• Said locking elements (7.2', 7.2") of the left and right rulers (7.1 ', 7.1") prevent spontaneous movements of the left and right rulers (7.1 ', 7.1 ") during the measurement of facial biometric parameters.
• Said left and right branches (7.5', 7.5") are formed so that they are substantially in the same plane as the register holder (7.4), and the ruler locking elements (7.2', 7.2") therein are offset from the face center ruler (7.9) and its locking element (7.2'") to the left and right, respectively, so that the left and right rulers (7.1 ', 7.1") after locking thereof are at the left and right side tragus points (T), respectively.
• the side rulers can be of any shape that ensures that the rulers can be brought to the tragus points (T) on the left and right side of the face.
• a shape may include a first part (7.6', 7.6") that engages in a locking member (7.2', 7.2") and slides along its axis (7.7', 7.7"), and a second part (7.8', 7.8"), which, when sliding the first part along its said axis (7.7', 7.7"), could be brought to tragus points (T).
• Such a shape may include a first part (7.6', 7.6") that engages in a locking member (7.2', 7.2"), slides along its axis (7.7', 7.7") and would be perpendicular to the register holder (7,4), and a second part (7.8', 7.8") that, when sliding the first part along its said axis (7.7', 7.7"), could be brought to the tragus point (T) and is perpendicular to the first part (7.6', 7.6").
• the clinical occlusal fork frame (7.5) also includes a locking member (7.2"') of the face center ruler (7.9) that functions in the same way as the locking members (7.2', 7.2") of the side rulers (7.1 ', 7.1") and is in the sagittal plane during the measurement of the facial biometric parameters.
• the locking member (7.2'") of the center ruler (7.9) is preferably in line (7.10) with the locking members of side rulers and / or in the same plane with the said locking members of side rulers.
• Figure 8 depicts a laboratory occlusal fork (8) for transferring biometric data to the register.
• the laboratory occlusal fork (8) comprises a frame (8.14) comprising a register holder (8.7) that, at the time of data transfer, is in the same plane as the occlusal plane; and sagittal edges (8.3', 8.3"), which are intended to position the laboratory occlusal fork (8) on the adjustable table (10) of the articulator (4) so that said edges are in parallel with the corresponding edges (10.1 ', 10.1") on the adjustable table for guiding the movement of the laboratory occlusal fork and parallel to them.
• the laboratory occlusal fork (8) also comprises a left branch (8.4') and a right branch (8.4") for fixing the left ruler (8.1 ') and the right ruler (8.1"), respectively, using the locking members (8.6', 8.6") which operate on the same or a similar principle as the ruler locking members (7.2', 7.2") of the clinical occlusal fork (7).
• Said branches (8.4', 8.4") extend from the register holder (8.7) so that there is a gap (8.5) between the first parts (8.8', 8.8") of said branches.
• Said first parts (8.8', 8.8" extend from the register holder (8.7) to the second parts (8.9', 8.9") that extend in opposite directions.
• Said left and right branches (8.4', 8.4") are formed so that they are substantially in the same plane as the occlusal plane (8.2), and the ruler locking elements (8.6', 8.6") therein are offset from the center line (8.10) of the register holder to the left and right, respectively, so that after locking the left and right rulers (8.1 ', 8.1") they are, during the measurement, at the left and right side ends (RA) of rotational axis (RA) of the articulator (4).
• the side rulers can be of any shape that ensures that the rulers can be brought to the left and right ends of rotational axis (RA) of the articulator.
• Such a shape may include a first part (8.11 ', 8.11 ”) that engages in a locking member (8.6', 8.6") and slides along its axis (8.13', 8.13"), and a second part (8.12', 8.12"), which, when sliding the first part along its said axis (8.13', 8.13"), could be brought to rotational axis (RA).
• Such a shape may comprise a first part (8.11 ', 8.11") that engages in a locking member (8.6', 8.6") and is slideable along its axis (8.13', 8.13") and would be perpendicular to the occlusal plane (8.2), and a second part (8.12', 8.12") which, when sliding the first part along its axis, could be brought to the rotational axis (RA) and is perpendicular to the first part (8.11 ', 8.11 ").
• Figure 9 illustrates how in one embodiment of the invention in case of the laboratory occlusal fork (8), as described above, and the clinical occlusal fork (7), as described above, the positions of the register holders (8.7, 7.4) and the locking means (7.2', 7.2"; 8.6', 8.6") of the side rulers, located on the frames of laboratory and clinical occlusal forks, match each other in the structure of the laboratory and the clinical occlusal forks, with the laboratory and clinical occlusal forks positioned in parallel and symmetrically above each other.
• width between the rulers (8.1 ', 8.1") of laboratory occlusal fork (8) is 185 mm, which should coincide with the width of the clinical occlusal fork (7) between the rulers (7.1 ', 7.1"), the latter should have sufficient space between the rulers (7.1 ', 7.1") to accommodate the patient's head between them.
• the space of movement of the laboratory occlusal fork (8) should be at least 40 m deep / long. This is the maximum amplitude space of movement of the laboratory fork (8) on the laboratory table (10) without interference with front corners of the table.
• the width of the central space should be 20 m so as not to interfere with the central shaft of the articulator.
• the table width can be 70 m . This is the optimum width needed to accommodate a laboratory occlusal fork (8) with a silicone register.
• the table should be approximately 80 m in length or such as to allow sliding of the laboratory occlusal fork (8) in a buccal-distal direction without loss of stability.
• FIGS 10a, 10b and 10c illustrate an adjustable table (10) for positioning the laboratory occlusal fork (8) of the articulator (4) in the articulator (4).
• the adjustable table comprises a base (10.2) for connection to the holder (4.2') of the articulator (4); a table top (10.3) for positioning the laboratory occlusal fork on and between its sagittal edges (10.1 ', 10.1"); a lifting mechanism (KM) for the table top (10.3), which comprises pantographs (R', P") symmetrically arranged on the left (KR) and right (DS) sides of the table (10), each comprising associated supports (10.4', 10.4", 10.4'", 10.4""), wherein two upper supports (10.4', 10.4"") are pivotally attached at the first end to the base of the table top (10.6) and pivotally attached at the second end to the ends of the other two supports (10.4", 10.4'"), wherein the second ends of the other two supports are pivotally attached to the base (10.5) of
• a longitudinal cylindrical member (10.7) is passed through both of said cylindrical members (10.6, 10.8), one end of which has an outer thread that interacts with the inner thread of the cylindrical member (10.6) and the other end is passed through the cylindrical member (10.8) having no thread in which the longitudinal movement of the longitudinal cylindrical member (10.7) is restricted and it can only rotate around its central axis (10.9).
• the cylindrical member (10.6) having an internal thread interacts with the outer thread of the longitudinal cylindrical member (10.7) and, depending on the direction of rotation of the cylindrical longitudinal member (10.7) the interconnected ends (10.10') of associated supports (10.4‘”, 10.4““) relatively approach or move away with respect to the interconnected ends (10.10") of other associated supports (10.4', 10.4").
• the table top (10.3) descends and, as they approach, it rises.
• Figure 11 depicts the position of the laboratory occlusal fork (8) on the adjustable table (10) of the articulator.
• the space (8.5) between the left branch (8.4') and the right branch (8.4") of the laboratory occlusal fork (8) is configured so that the laboratory occlusal fork (8) can be relatively moved with respect to the articulator shaft (4.3) with the help of articulator table (10) in all directions of table adjustment.
• the laboratory fork additionally includes one blank area (8.5') on the other side of the first part (8.8') of the left branch (8.4'), relative to the space (8.5) designed for the articulator shaft, and one blank area (8.5") on the other side of the first part (8.8") of the right branch (8.4"), relative to the space (8.5) designed) for the articulator shaft.
• the articulator table can be secured to the lower part of the articulator by means of a magnetic coupling: with the help of a magnet present in the table base (10.2) that secures the table to the lower part of the articulator holder (4.2'), which is made of a material that interacts with a magnet, such as iron.
• the holder (7.4) of the register (3) of the clinical occlusal fork (7) is applied horizontally in the patient's mouth, where it is attached to the upper jaw (VZ), for example, by using basic silicone, horizontally with respect to X, Y, Z axes.
• the position of the face center ruler (7.9) coincides with the patient's sagittal plane (SP).
• the lateral rulers (7.1 ', 7.1 ") are then inserted so as to coincide with the tragus (T) or externally measured statistical locations (RT) of rotational axes, which are about 12 mm medially away and about 4 mm vertically down from the center of the tragus.
• the data from the scales of the rulers (7.1 7.1 ”) are then recorded: the distance between the first point (13.1 ', 13.1") and the second point (13.2', 13.2") of the side rulers (7.1 ', 7.1") is measured according to horizontal scales of the side rulers (7.1 ', 7.1").
• the first point (13.1 ', 13.1") is recorded on both side rulers (7.1 ', 7.1") at tragus (T) point on both sides of the face where the said side rulers are positioned, or externally measured statistical locations (RT) of rotational axes that are about 12 mm medially away and about 4 mm vertically down from the center of the tragus.
• the second point (13.2', 13.2") with respect to both side rulers, lies at connection of the first part (7.6', 7.6") and the second part (7.8', 7.8") of each side ruler (7.1 ', 7.1"). Then, the distance from the second point (13.2', 13.2") to the third point (13.3', 13.3") is measured according to the scale of the side rulers (7.1 ', 7.1 ") in horizontal position of the ruler according to the readings of the level (5).
• the third point (13.3', 13.3") coincides with the upper surface of the side ruler holders (7.2', 7.2") of the clinical occlusal fork (7), i.e. the surface through which the side rulers are inserted in the holders. For both side rulers, the measurements are made individually.
• the silicone register (3) obtained from the patient's mouth is attached to the register holder (8.7) of the laboratory occlusal fork (8) as shown in Figures 13a and 13b.
• the laboratory occlusal fork (8) is placed on the articulator table (10) so that the articulator shaft (4.3) is located between the first parts (8.8‘, 8.8") of the side branches (8.4', 8.4") of the laboratory occlusal fork (8).
• the laboratory occlusal fork (8) is positioned in the articulator (4) by setting on both lateral rulers (8.1 ', 8.1") of the laboratory occlusal fork (8) the position of the first (13.1 '", 13.1""), the second (13.2'", 13.2"") and the third (13.3'", 13.3"") points with respect to corresponding branches (8.4', 8.4") and each other according to the measured values from the first point (13.1 ', 13.1") to the second point (13.2', 13.2") horizontally and from the second point (13.2', 13.2") to the third point (13.3', 13.3") vertically by using the clinical occlusal fork (7).
• the side rulers of the laboratory occlusal fork (8) and the clinical occlusal fork (7) are of the same shape and dimension to accurately reproduce the measurements of the clinical occlusal fork (7) on the laboratory occlusal fork (8).
• a maxilla model (VZM) is placed on the silicone register (3) of laboratory occlusal fork (8).
• the scales of the side rulers (8.1 ', 8.1") must reproduce the measured height of the clinical occlusal fork (7).
• the side rulers (8.1 ', 8.1") are positioned at the height of the rotational axis (RA) of articulator by raising or lowering the articulation table (10) if the recording according to the individual rotational axis (RT) took place at the clinic.
• the ruler should be 4 mm higher.
• the scale of the side ruler (8.1 '; 8.1") should be 12 mm distally to the rotational axis (RA).
• the vertical shaft (4.3) of the articulator (4) is adjusted at a height of 0 mm.
• the maxilla model (VZM) is fixed, by means of articulating plaster, to the magnetic pad (12.4) of the articulator.
• the mandibular model is attached to the maxilla model.
• the construction of the virtual articulator (4') is substantially consistent with that of the physical articulator (4) as described above.
• the digital patient’s model with the virtual ruler is a reference point for spatially positioning the rotational axis of the temporomandibular joints.
• the articulator can be set individually (by changing the positions of the virtual pivot joints relative to the x, y, z axes) as shown in Figure 14: the vertical and horizontal asymmetries of the temporomandibular joints are customized by changing the positions of the pivot joints (4.1 ', 4.1") of the virtual articulator (4') a) vertically (z) /vertically (z) asymmetrically, b) horizontally (x) /horizontally (x) asymmetrically, c) vertically (z) and horizontally (x) /vertically (z) and horizontally (x) asymmetrically.
• Modern systems operate on the principle of direct information transfer, when the position and relationship of jaw models in the laboratory articulator is scanned and transferred to a virtual space.
• scanned jaw models are manually (by using a computer mouse and computer screen) positioned in the virtual articulator along conventional planes (e.g., occlusal, Bonwill, or Balkwill triangular planes).
• planes e.g., occlusal, Bonwill, or Balkwill triangular planes.
• virtual tools and their working principal remains the same as in manual systems (as described above).
• Virtual articulators are merely simulations of a real articulator on a computer screen, without the ability to change the position of the pivot joints with respect to the sagittal plane and to each other individually. Therefore, in modern systems, creating an individual asymmetry of the ends of the rotational axis is not possible. This requires a new articulator matrix with facial ruler data entry and ability to change automatic adjustment of pivot joints position in space.
• Each patient's maxillary model has an individual position with respect to his mandibular rotational axis (RT): if the position of the jaw model in the articulator (4, 4') is incorrect, the angles (b2, b3, b4) of the occlusal load are incorrect, as shown in Figure 6.
• the scale of the side ruler (8.1 ', 8.1") defines where the maxilla model should be attached in the articulator (4, 4’) with respect to the individual rotational axis of patient’s mandible.
• the biometric recording is performed in case of skull skeletal asymmetry.
• skull skeletal asymmetry the positions of the temporomandibular joints and their rotational axis (RT) with respect to the sagittal plane are asymmetrical vertically and / or horizontally (vertical, horizontal or vertical and horizontal asymmetries).
• the clinical occlusive fork (7) is used for the measurements. Measurements are made as described in the previous example. In case of vertical asymmetry, during the measurement of patient’s biometric data it appears that the corresponding side rulers (7.1 ', 7.1 ") of the clinical occlusal fork (7) make different distances, i.e. the distance from the second point (13.2') to the third point (13.3') measured by one side ruler (7.1 ') is not equal to the distance from the second point (13.2") to the third point (13.3") measured by the other side ruler (7.1”), as shown in Figure 15b.
• the corresponding side rulers (7.1 ', 7.1 ") of the clinical occlusal fork (7) make different distances, i.e. the distance from the first point (13.1 ') to the second point (13.2') measured by one side ruler (7.1 ') is not equal to the distance from the first point (13.1 ") to the second point (13.2") measured by the other side ruler (7.1 "), as shown in Figure 15c.
• the corresponding side rulers (7.1 ', 7.1") of the clinical occlusal fork (7) make different distances in both directions, i.e.
• both the distance from second point (13.2') to the third point (13.3') measured by one side ruler (7.1 ') is not equal to the distance from the second point (13.2") to the third point (13.3") measured by the other side ruler (7.1") and the distance from first point (13.1 ') to the second point (13.2') measured by one side ruler is not equal to the distance from the first point (13.1") to the second point (13.2") measured by the other side ruler, as shown in Figure 15d.
• one branch (16") of the laboratory articulator (17) is disconnected from the lower part (17.3) of the articulator while the other branch (16') remains connected.
• the disconnected part (16") is the pivot part (17.1 ) and it is disconnected from the lower portion (17.3) as shown in Figure 17a.
• the pivot part (17.1 ) and the lower part (17.3) are connected by a replaceable individual connection (18), as shown in Figures 18 and 19.
• Figure 19 shows an example of a replaceable individual connection (18).
• the replaceable individual connection (18) comprises a connection filling (18.3) for interaction with the locks (17.2) of the pivot joint (17.1 ) and the lower part (17.3) of the articulator (17) for their fixed connection, and a frame (18.1 ) for holding the filling part (18.3) and preventing movement with respect to the pivot part (17.1 ) and the lower portion (17.3) and also restricting movement of the pivot part (17.1 ) and the lower part (17.3) relative to each other.
• the method of manufacturing the replaceable individual connection (18) of the articulator (17) comprises scanning the silicone register (3) attached to the scanning table that is part of a laboratory scanner to which a subject has to be rigidly attached.
• the register scanning also includes scanning of gypsum models of the upper and the lower jaws, or making upload of an intraoral camera scanning data of the jaws and their relationship (occlusion) to the digital matrix.
• the biometric data obtained with the clinical occlusion fork (7) are entered into the computer program input fields: face sides’ rulers (7.1 ', 7.1 ”) data, such as distances from the first points (13.1 ', 13.1”) to the second points (13.2', 13.2 ”) and to the third points (13.3', 13.3") of the face sides rulers (7.1 ', 7.1 ").
• the matrix of the articulator (4') has the same engineering parameters and construction as the physical articulator (17), i.e. the construction of the virtual articulator (4') is substantially consistent with that of the physical articulator (17) as described above.
• the part (17.3) imitating the mandible is detached from the branch (16") having pivot joint.
• the ends of the latter have locks (17.2), by means of which the individual connection (18) is firmly fixed to the ends of the pivot part (17.1 ) and the lower part (17.3) that includes locks (17.2).
• the vertical gap between the ends with the locks (17.2) must be at least 25 mm with respect to the lower part (17.3) of the articulator so that the branch (16") with the pivot joint (17.1 ) can descend down with respect to the sagittal plane and the opposite branch (16').
• the spatial position of the virtual articulator is fixed. Its center corresponds to the sagittal plane (divides it in half lengthwise) and divides the articulator to the left and right sides, where the ends of the rotational axis are equidistant from the center at 60 mm and are located in parallel parasagittal planes.
• the end of the rotary axis of one side e.g., left
• the position of the other is variable in the parasagittal plane in all directions. It varies in case of asymmetric biometric measurement data.
• the virtual matrix of the articulator operates on basis of three vertical planes, one perpendicular to the latter and divided in half.
• the horizontal plane corresponds to the plane of the register holder.
• the biometric data of the clinical occlusal fork (7) are transmitted to the parasagittal planes on both sides of the articulator, binding to a fixed end / point of the rotational axis corresponding to the first point (13.1 ') of the clinical occlusal fork and the point of rotational axis (4'.1 ) of the articulator (17).
• the algorithm After input of measurement data of the clinical occlusal fork (7) into the virtual matrix of the articulator, the algorithm automatically calculates the asymmetry of pivot axis horizontally and / or vertically with respect to the sagittal plane and changes the position of the pivot part (17.1 ) with respect to the lower part of the articulator (17.3) accordingly. In the resulting gap between the pieces, a drawing of the individual connection (18) is automatically generated for printing with 3D printer. In this way, by joining the lower part of the articulator (17.3) with the individual connection (18) to the pivot part (17.1 ), the standard articulator becomes individual, since the change in length of the branches (16', 16") of its lower part (17.3) results in corresponding change of the position of rotational axis (RA).
• the position of the rotational axis calculated by the algorithm is fixed in a three-dimensional matrix and a digital maxilla model is bound to it in an individual / unique position relative to the sagittal plane and the ends of rotational axis as described above.
• the mandibular model is then attached to the maxilla model, according to the occlusion register data.
• the matrix data can be displayed on the operator's monitor as an articulator with maxilla and mandibular models, or simply as a jaw models with a coordinate system.

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  • 2019-11-15 LT LT2019528A patent/LT6828B/lt unknown
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  • 2020-02-11 WO PCT/IB2020/051063 patent/WO2021094837A1/en active Application Filing

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