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THE ARTICULATOR
The idea for the Electronic Anatomo-Physiological
fully adjustable articulator (SEM Limites Ltda., Sao
Paulo, Brazil) occurred when the question of the possibility of a radical simplification of procedures and of
the existing fully adjustable articulators showed that
prosthodontic aims could easily be reached and that
other aspects, such as the precision of patient records,
would be clearly understood, seen, and repeated on a
new articulator, used in both the clinic and laboratory.1,2 The handling of this new articulator, the records
of the mandibular positions and movements, and all the
clinical and laboratory procedures follow a simple
sequence.
The creation of the articulator (Fig. 1) and the
development of procedures into a system (Fig. 2) were
based on research3,4 regarding existing and imaginary
performances of articulators that respected authors
considered ideal.5-9 Posselt9 stated that the drawing,
construction and practical use of articulators would be
dictated by factors such as: 1) Knowledge of the jaws
movements and functional anatomy of the temporomandibular joint. 2) Specification of the particular
aPrivate
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Practice.
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Fig. 1. Schematic drawing of Electronic Anatomo-Physiological articulator and its components. A, Lateral view; B, posterior view.
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Fig. 2. Recording mechanism including digital display box: A, Lower recording plate with 5 temporary
crowns and electrical lead attached, showing pattern made by 3 scribing points in recording medium.
Upper recording plate with 3 scribing points and central electronic contact point (central bearing point)
with 4 temporary crowns and electrical lead attached. Digital display box (top) to which electrical leads
attach. Signal on face of box indicates that contact points are not in proper position. B, Drawing of upper
recording plate (top) with temporary crowns and recording points superimposed over lower recording
plate with crowns attached, showing tracing through clear plastic plate. Digital display box showing lighted CO on its face indicating that recording points are in contact with lower recording plate in centric
occlusion position. C, Drawing with mouth open to show position of recording plates in mouth. D, Articulator with casts, recording assembly, and digital display.
378 THE JOURNAL OF PROSTHETIC DENTISTRY
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Fig. 4. Schematic draws of contact paths from centric occlusion to protrusive and right and
left lateral movements. A, Paths on all maxillary incisors made by contact of mandibular
incisors in CO and gliding contact movements. B, Schematic drawing showing paths made
by maxillary recording pins on mandibular recording plate.
Fig. 5. Representative scheme of arbitrary abutment preparation, in laboratory, on diagnostic cast to obtain patients provisional crown and temporary crowns used in this system. 1,
Section of diagnostic cast showing one maxillary abutment.
2, Arbitrary preparation of abutment on diagnostic cast. 3,
Two sets of resin crowns to be made on each preparation.
One for patient to wear as provisionals; other as temporary
crowns to be used with recording plates. 4, Plastic crowns
made to full contour.
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Fig. 6. Intraoral examples of some specific system procedures. A, When all natural teeth are
prepared except 2 or more opposing teeth, opposing teeth may be used to preserve vertical
dimension (arrow). B, Plastic crown being adjusted to CO and VDO. C, Maxillary recording
plate before insertion of recording styli with temporary crowns attached to it with acrylic
resin; 1, temporary plastic crowns fastened to maxillary recording plate with autopolymerizing acrylic resin; 2, clear, 2-mm thick plastic recording plate shows contoured edged to fit
lingual surfaces of plastic crowns and natural teeth crowns with resin crowns attached.
Fig. 7. Schematic drawing of elements needed for each abutment preparation used with individual Anatomo-Physiological system. Top, acrylic resin crown. Coping must be adjusted to fit die accurately; crown must fit precisely over the
coping and also must be in ideal articulation with opposing
teeth in centric occlusion. Middle, thin plastic coping. Bottom, section of master cast showing die of abutment preparation made in mouth.
individual system of the patient, artificial restorations created must be in strict harmony with the
natural components of the stomatognathic elements of that patient. There is no scientific means
at this time to exactly determine the VDO. However, with the skill, knowledge, and experience of
the dentist, it should be easily established and
recorded within the physiologic limits of the
patient.
9. After preparing the first abutment, try-in the
respective provisional crown, rebase it, and adjust
the occlusion to establish the selected vertical
dimension (Fig. 6, B). Complete the procedure for
the remaining abutments using the first set of
crowns called provisional crowns in step 6.
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Fig. 8. Recording plate preparations. A, Plate for arches with abutment preparations; 1, sheet
of clear plastic cut to approximate shape of arch; 2, sheet trimmed with bur to fit lingual profile of abutment crowns and other teeth; 3, holes cut for insertion of scribing points and electrical contact points; 4, inserting scribing points and electrical contact point with lead
attached; 5, modified master cast with plastic copings in place on abutment dies. B, Recording plate for arches with few or no abutment preparations; 1, upper splint-type acrylic resin
appliance surrounds teeth but must not cover occlusal surface; 2 (left) recording plate in one
piece and (right) separated and attached to lingual surface of splint; 3, electrical contact point
(button) may be placed wherever it is convenient but maxillary and mandibular electrical
contacts must be opposite each other; 5, tracings made by scribing points in recording medium recording plate. C, 4, screws to clamp splint on teeth. Alternately it may be fastened to
the teeth with temporary cement, wire, or a combination of these. D, Possibility of placing
scribing point and recording material at the line of alveolar ridges, in addition to 2 other
recordings, performing three points which define plane.
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Fifth appointment
37. Remove the provisional restorations and place the
definitive restoration in the patients mouth. Usually it is not necessary to adjust the completed
restoration in the patients mouth; however, it
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DISCUSSION
The recording made in the mouth incorporates all
the guidance given to the mandible by the muscles,
joints, ligaments soft tissues, and various soft and hard
tissue surfaces and contours. When these records are
transferred to the articulator through the recording
assembly and are established in the condyle and incisal
receptacles in autopolymerizing acrylic resin, it seems
reasonable to assume that the condylar balls will be
positioned on the articulator in the same relative relationship as the patients condyles are in the patients
glenoid fossae.24,28 Therefore any prosthesis made on
that programmed articulator will be positioned in the
appropriate 3-dimensional space when placed in the
patients mouth and will function properly and
smoothly.28
With the individual Anatomo-Physiological system,
it is easy to look at the digital display and see whether
the records made in the mouth have been transferred
properly to the articulator. Information incorporated in
the registration consists of CO, CR, extension and limit
of the contact movements, the influence of the intercondylar distance, the influence of the lingual surfaces
of the maxillary teeth, and any influence of the occlusal
determinants.
SUMMARY
The individual Anatomo-Physiological system
enables the dentist to record intraoral positions and
mandibular movements stereographically or by interocclusal records and personalized anterior guidance. This
system provides a means whereby the information can
be transferred to the articulator. Every step can be
checked by mechanical or electrical apparatus, so accumulated mistakes can be avoided. Each dentist has the
opportunity to check the success or failure of each step
in the clinic or laboratory. This system does not intend
to oppose any school of thought or philosophy but is
only a means to reach the stated goals in an easier and
more precise manner.
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