Orientation Sonal

8/9/2019 Orientation Sonal

1/85

ORIENTATIONJAW

RELATION

O Presented by : Dr Sonal BatraMds IInd year

Department of prostodont!"s #"ro$nand br!d%e


2/85

&ontent :INTROD'&TIONDE(INITION

TERMINOLO)IES

T*EORIES O( *IN)E A+ISImportan"e Of Or!entat!on Ja$ Relat!on

(A&E BOW

RE,IEW O( (A&E BOW

&LASSI(I&ATION O( (A&E BOW


3/85

O ANTERIOR RE(EREN&E POINT

O POSTERIOR RE(EREN&E POINTO (A&E BOW TRANS(ER

O &ON&L'SION

O RE(EREN&ES


4/85

Or!entat!on -a$ relat!onOTo or!ent to lo"ate

O It !s te -a$ relat!on $en te mand!ble

!s .ept !n !ts most poster!or pos!t!on # !t"an rotate !n te sa%!ttal plane aro/ndan !ma%!nary trans0erse a1!s pass!n%tro/% or near te "ondyles23)PT 45

OTe pos!t!on of te ma1!lla or mand!ble

!n te s./ll !s re"orded /s!n% an!nstr/ment "alled te fa"e bo$2


5/85

OTe open!n% mo0ement

to br!n% te -a$ fromo""l/sal to rest pos!t!on!s almost a p/re !n%emo0ement2

O *ere te mand!blemo0es on an ar" of a"!r"le $!t a de6n!terad!/s from te TM J

OT!s pat of te "ondyle!s determ!ned by te"/r0at/re of te"ondylar ead and te

"/r0at/re of %leno!d


6/85

O S!n"e te rad!/s !s not"onstant for all te

pat!ents !t as to bedeterm!ned for e0ery!nd!0!d/al pat!ent2

O Relat!on of ma1!lla to te

open!n% and "los!n% a1!sas to be determ!ned

O Open!n% and "los!n% a1!s"an be lo"ated $en temand!ble !s !n !ts mostposter!or pos!t!on bymeans of a FACE BOW


7/85

Term!nolo%!esO *!n%e a1!s : A""ord!n% to Bo/"er 7An

!ma%!nary l!ne tro/% te t$omand!b/lar "ondyles 8 aro/nd $!" temand!ble may rotate $!to/t translatory

mo0ement2OTe open!n% a1!s :It !s an !ma%!nary l!ne

aro/nd $!" te "ondyles may rotated/r!n% open!n% 8 "los!n% mo0ements ofte mand!ble2

OTerm!nal !n%e pos!t!on :It !s te mostretr/ded !n%e pos!t!on2 In t!s "ondylesare !n de6n!te pos!t!on !n fossae2


8/85

*!n%e a1!s !s a or!9ontal a1!s

aro/nd $!" te "ondyles rotated/r!n% open!n% and "los!n% mo0ement/p to te ran%e of ; mm2


9/85

*!n%e a1!s po!ntsTe left and r!%t "enters $ere

"ondyle e1!b!ts p/re rotat!on !s

.no$n as !n%e a1!s po!nts2


10/85

*!n%e a1!s also "alled *or!9ontal a1!s #Inter"ondylara1!s# Term!nal !n%e a1!s#Trans0erse or!9ontal a1!s 2

Terminal hinge axis

S!n"e rotat!on of "ondyles o""/r $en mand!ble !s!n !ts term!nal retr/ded "entr!" relat!on pos!t!on# !t $as.no$n as term!nal !n%e a1!s2

Transverse horizontal axis

Today $!t te "an%!n% "on"ept of &R# 0!9 antero mm !nfer!or to te l!ne e1tend!n%from te s/per!or border of tra%/s to o/ter"ant/s of te eye2

6.auritzen and *odner

O mm anter!or to "enter of e1ternal a/d!torymeat/s and mm !nfer!or to por!on "ant/s l!ne

3.*randnu7 and 8ognsen

O mm anter!or to most prom!nent po!nt ofposter!or border of tra%/s on l!ne from !t too/ter "ant/s of te eye2


32/85

. Teteru9 andundeen;s 7oint:

lo"ated = mm anter!orto te tra%/s on a l!ne fromte base of te tra%/s tote o/ter "ant/s of te eye2

appro1!mately at le0el of most prom!nentpo!nt of poster!or border of tra%/s2

!.Prothero:On l!ne from s/per!or mar%!n of EAM to O&E

!nterse"t!n% $!t l!ne =mm anter!or toanter!or ed e of EAM2


33/85

F2 *ergstrom 7oint

;mm anter!or to te "enter

of te sper!"al !nsert forte e1ternal a/d!torymeat/s and Fmm belo$ te(ran.fort or!9ontal plane2

42 *eyron;s 7oint

=mm anter!or to teposter!or mar%!n of te

tra%/s of te ear on a l!nefrom te "enter of tra%/se1tend!n% to te "orner ofte eye2


34/85

". %ysi 7ointlo"ated =mm !n front of

te most /pper part of tee1ternal a/d!tory meat/s ona l!ne pass!n% to te o/ter"ant/s of te eye2 T!smetod $as proposed by

)ys!# *ana/# Sno$ and)!lmer and !s te most"ommon po!nt /sed today

1>.4ein?erg;s Point

A po!nt


35/85

Anter!or Po!nt of

Referen"eOTe sele"t!on of te anter!or po!nt ofte tr!an%/lar spat!al plane determ!nes$!" plane !n te ead $!ll be"ome

te plane of referen"e $en teprostes!s !s be!n% fabr!"ated2


36/85

Reasons for sele"t!n% an

Anter!or po!nt of referen"eO Wen tree po!nts are /sed# te pos!t!on

"an be repeated# so tat d!Cerent ma1!llary"asts of te same pat!ent "an be pos!t!oned

!n te art!"/lator !n te same relat!0epos!t!on to te end "ontroll!n% %/!dan"es2

O A planned "o!"e of an anter!or referen"epo!nt $!ll allo$ te dent!sts and a/1!l!ar!esto 0!s/al!9e te anter!or teet and te

o""l/s!on !n te art!"/lator !n te sameframe of referen"e tat $o/ld be /sed$en loo.!n% at te pat!ent2


37/85

Sele"t!on:

O ,ar!o/s Anter!or Referen"e Po!nts tatmay be /sed are as follo$s:

5 'r?itale:

OIn te s./ll# orb!tale !s te lo$est po!ntof te !nfraorb!tal mar%!n2 On a pat!ent !t"an be palpated tro/% te o0erly!n%t!ss/e and s.!n2 One orb!tale and t$oposter!or po!nts tat determ!ne te

or!9ontal a1!s of rotat!on $!ll de6ne tea1!s


38/85

6@ $mm ?elo8 'r?itale:

OTe (ran.fort or!9ontal plane passestro/% bot por!on and one orb!tal po!nt2Be"a/se por!on !s a s./ll land mar.# S!"erre"ommends /s!n% te m!dpo!nt of te /pperborder of e1ternal a"o/st!" meat/s as te

poster!or "ran!al landmar. on te pat!ent2O)o9ale9 po!nted o/t tat t!s poster!ort!ss/e landmar. on te a0era%e l!es Fmms/per!or to or!9ontal a1!s2

Te re"ommended "ompensat!on for t!sd!s"repan"y !s to mar. te anter!or po!nt ofreferen"e F mm belo$ orb!tale on te pat!ent2


39/85

3@ 63mm ?elo8 asion

O A""ord!n% to S!"er# anoter s./lllandmar.# te nas!on "an beappro1!mately lo"ated !n te ead as tedeepest part of te m!dl!ne depress!on

-/st belo$ te le0el of eye bro$s2

O Te nas!on %/!de# or pos!t!oner of G/!".Mo/nt fa"e bo$ $!" !s des!%ned to be

/sed $!t te $!p m!1 art!"/lator 6ts!nto t!s depress!on


40/85

O @ Alae of the nose: A part of many "ompletedent/re te"n!/es !s to ma.e tentat!0e or te

a"t/al o""l/sal plane parallel $!t te or!9ontalplane2

OT!s "an be a"!e0ed !n t$o $ays:

35 A l!ne from te ala of te nose to te "enter of

te a/d!tory meat/s des"r!bes &amperHs l!ne235A se"ond metod of establ!s!n% t!s

relat!ons!p !s to ma.e a $a1 o""l/s!on r!mparallel to &amperHs l!ne on te fa"e2 Te des!redlo"at!on for te ma1!llary !n"!sal ed%e so/ld bemar.ed on te $a1 o""l/s!on r!m as an !n!t!alstep !n determ!nat!on of te o""l/sal plane2


41/85


42/85

Cinemati9 method

O Most a""/rate metod forre"ord!n% te "orre"t

or!9ontal a1!s !s by a

Tr!al and error metod

de0eloped by M"&oll/m

!n K /s!n% a .!nd of

.!nemat!" de0!"e2

OTe te"n!/e of lo"at!n% te term!nal !n%ea1!s pos!t!on !s essent!ally te same fordent/lo/s and edent/lo/s pat!ents# b/t temetods of atta"!n% te "l/t" to temand!ble are /!te d!Cerent2


43/85

(a"e bo$O

It !s a "al!per l!.e de0!"e tat !s /sed to re"ordte relat!ons!p of te -a$s to te open!n% a1!s

of te -a$ 8 to or!ent te "asts !n t!s same

relat!ons!p to te open!n% a1!s of te art!"/lator2

O P'RPOSE:

Is to or!ent te ma1!llary "ast to te art!"/lator !n

te same relat!ons!p to te open!n% 8 "los!n%

a1!s of te art!"/lator as e1!sts bet$een te

ma1!lla 8 te open!n% and "los!n% a1!s !n te

TMJ2


44/85

Ad0anta%es for /s!n% a

fa"e bo$:Perm!ts more a""/rate /se of lateral rotat!on po!nts

for te arran%ement of teet2

5Its a!d !n se"/r!n% an anteroposter!or "ast pos!t!on

$!t relat!on to te "ondyles of te mand!ble2

=5It re%!sters te or!9ontal relat!ons!p of te "asts

/!te a""/rately# and t!s ass!sts !n "orre"tly

lo"at!n% te !n"!sal plane2


45/85

5It !s an a!d !n te 0ert!"al pos!t!on of te "ast

on te art!"/lator2

>5Te fa"e bo$ transfer $!ll be e1a"t !n te

pos!t!onal relat!on of te "asts2

5Te fa"e bo$ transfer allo$s a more

a""/rate ar" of "los/re on te art!"/lator $en

te !ntero""l/sal re"ords are remo0ed and te

art!"/lator !s "losed2


46/85

Re0!e$ of te fa"e bo$


47/85

BONWILL34;5

OTe d!stan"e from te"enter of ea" "ondyleto te med!an !n"!salpo!nt of te lo$er teet

!s ; "m 2

OTe "ast $as mo/nted$!t o""l/sal plane !n aor!9ontal pos!t!on

m!d$ay bet$een te/pper and lo$er part ofte art!"/lator 2


48/85

BALWILL345

O *e made a apparat/s tomeas/re te an%lebet$een te o""l/salplane and te planepass!n% tro/% te l!nes

e1tend!n% from te"ondyles to te !n"!sal l!neof te lo$er teet 2

O An%le ;


49/85

O In 44; *AES /sed a ton% l!.e de0!"e

$!" e "alled "al!per2

O )SI de0eloped an !nstr/ment s!m!lar to a

fa"e bo$ pr!mar!ly to re"ord te pats of

te "ondyles2

O At te same t!me !n 4KK SNOW

!ntrod/"ed te sno$ fa"e bo$


50/85

O In K;># &AMPION made %rap!" re"ords ofmo0ements of te mand!ble of a l!0!n% s/b-e"t2

*e e1pressed te !mportan"e of lo"at!n% te!n%e a1!s2 *e empas!9ed tat ma1!llary "astso/ld be at te same or!entat!on on teart!"/lator as te pat!ents ma1!llae !s to te

TMJ2

O In K# M"&OLL'M# ST'ART and otersreported te d!s"o0ery of te 6rst pos!t!0emetod of lo"at!n% te a1!s2

O In KF# M"&OLL'M WIT* ROBERT *ARLAN

!ntrod/"ed a metod of re"ord!n% te !n%e a1!sand de0eloped te 6rst !n%e a1!s fa"e bo$2


51/85

O In K=4 T*IELEMAN !ntrod/"ed anter!orreferen"e po!nt orb!tale2

O In K> SLOANE stated tat te mand!b/lara1!s !s not a teoret!"al ass/mpt!on# b/t ade6nately demonstrable b!ome"an!"al fa"t2It !s te a1!s /pon $!" te mand!ble rotates!n an open!n% and "los!n% f/n"t!on $en"omfortably# not for"!bly retr/ded2

O K>> M&&OLL'M AND ST'ART de0elopedpanto%rap2

O In K> SI&*ER sa!d tat te !n%e pos!t!on

or te term!nal !n%e pos!t!on !s tat pos!t!onof te mand!ble from $!" or !n $!" p/re!n%e mo0ement of a $!de ran%e !s poss!ble2


52/85

O In K># L'&IA "on"l/ded tat te "enters !n

te term!nal !n%e pos!t!on pro0!de a de6n!testart!n% pos!t!on relat!on of te mand!ble to tema1!llae or te!r d/pl!"ates on an art!"/lator2

OTe anter!oposter!or relat!on of mand!ble tote ma1!llae at te term!nal !n%e pos!t!on !ste same as &R2 It !s a repeatable borderpos!t!on2 Terefore# !t !s a po!nt of ret/rn2

O L!.e &R# !n%e a1!s !s stable# reprod/"!ble andrepeatable2 Terefore# !t !s /sed as an!mportant referen"e !n mo/nt!n% "asts !nart!"/lator# so tat te open!n% a1!s of te

art!"/lator "o!n"!des $!t te term!nal !n%ea1!s2


53/85

O In K LA'RITEN AND WOL(ORDdemonstrated te 0ary!n% de%rees of a""/ra"y!n lo"at!n% te trans0erse !n%e a1!s amon%

s.!lled operators !n te ran%e of ;2> to mm2O In KF O*NO termed te or!9ontal a1!s

"onne"t!n% te left and r!%t rotat!onal "entersas !nemat!" a1!s2

O In K>F 8 K4 S&*ALL*ORN AND &O*EN )reported tat an arb!tary a1!s re"ord!n%te"n!/e $!ll l!e $!t!n >mm of te .!nemat!"a1!s !n 442K4Q of a pat!ent pop/lat!on2

O In K; BROTMAN )eometr!" s!%n!6"an"e of

trans0erse a1!s2O In K WEINBER) An e0al/at!on of fa"e bo$

mo/nt!n%2


54/85

O In K4 '&ERMAN )eometry of arb!tary

!n%e a1!s as !t !s related to te o""l/s!on2Demonstrated te !mportan"e of te a1!stro/% matemat!"al models of o""l/salerrors tat $o/ld res/lt $!t de0!at!ons fromte trans0erse !n%e a1!s of te pat!ent2

O In KFK WILIE Te ant


55/85

Types of fa"e bo$ :

Ar?itrary fa9e ?o8

O(a"!a type

OEar p!e"e type

O*ana/ fa"e bo$ 3 spr!n% bo$ 5

OSl!demat!" 3 denar 5

OW!pm!1

OT$!rl bo$

Cinemati9 fa9e ?o8


56/85

KINEMATIC

'7ening axis is lo9ated

7hysiologi9ally

&otational 7oints lo9ated ?yatta9hing to mandi?le as

7atient o7ens 9loses hismouth . A 7ointer is adusted

until axis of rotation is lo9ated

(sed in /.P.D full mouthreha?ilitation

&eFuires ela?orate eFui7ment is time 9onsuming

o9ates the true hinge axis 8ith

ex9e7tional a99ura9y

ARBITRARY

Axis is lo9ated using anatomi9

landmars

-enters of rotation arelo9ated 13mm anterior to

EA= on lines to8ards outer9anthus of eye

(sed in fa?ri9ation of 9om7letedentures

ot as 9om7li9ated as inemati9

o9ates the rods 8ithin


57/85

arious 9ommer9ially availa?le fa9e ?o8s andtheir a77li9ations

40)P =)

DEA&

+)DE=AT)-

0AA(+P&)% *'4


58/85

W*IPMI+ (A&EBOW

O It !s a earp!e"e type of fa"ebo$2

O It as a Nas!on Relator $!" !s pos!t!oneda%a!nst te br!d%e of nose2

O It as !nter"ondylar s"ale !n front offa"ebo$2

OTe fa"ebo$ !s "onne"ted to p!ns on te"ondylar o/s!n% of art!"/lator2

OTese p!ns are lo"ated be!nd te !n%ea1!s 8terefore a/tomat!"ally "ompensatefor poster!or lo"at!on of te e1ternal ear2


59/85


60/85

DENAR SLIDEMATI&

(A&EBOWO It !s a earp!e"e type fa"ebo$2

O A Denar referen"e plane lo"ator !s /sed to

lo"ate te anter!or referen"e plane 2O It also as Transfer J!% $!" allo$s te

mo/nt!n% of ma1!llary "ast to te art!"/lator$!to/t atta"!n% te fa"ebo$ 2


61/85


62/85

0anau fa9e ?o8

Ear 7ie9e ty7e /as9ia ty7e Cinemati9 ty7e

*ana/ >= ser!es

*ana/ spr!n% bo$

*ana/ t$!rl bo$ K

=K m!n/tes to !ns/re ades!on ofplaster to stone2

O Se"/re te !n"!sal %/!de p!n $!t !ts top/s $!t te top of ma1!llary member ofte art!"/lator2 Open te ma1!llary

member of te art!"/lator and apply a"reamy m!1 of dental plaster to te topof te art!"/lator /nt!l te !n"!sal %/!dep!n !s stopped on te %/!de table and te

mo/nt!n% plate !s embedded !n teplaster2


79/85

O &aref/lly remo0e te e1"ess plaster2 Allo$

te plaster to arden before remo0!n% tefa"e bo$ assembly2 Te ma1!llary "ast !srelated to te open!n% a1!s !n teart!"/lator !n te same anteroposter!orand or!9ontal pos!t!on as te ma1!lla !nte s./ll are related to te open!n% a1!s !nte TMJ

O (rom ere f/rter re"ords "an be madestart!n% $!t a tentat!0e "enter relat!on

re"ord2


80/85


81/85

&ON&L'SION

O (a!l/re to /se te fa"ebo$ leads to error!n o""l/s!on2

O *!n%e a1!s !s a "omponent of e0ery

mast!"atory mo0ement of te mand!bleand terefore "annot be d!sre%ardedand t!s !n%e a1!s so/ld bea""/rately "apt/red and transferred tote art!"/lator2 So !t be"omes a 6ne

representat!0e of te pat!ent andb!olo%!"ally a""eptable restorat!on !sposs!ble


82/85

Referen"es

O &arles m2 eart$ell # art/r o2 ran 7syllab/s of "omplete dent/re 7 ted!t!on2

O )eor%e a2 9arb # "arles l2 bolender 7bo/"er s prostodont!" treatment foredent/lo/s pat!ents 7 ;t 8 ted!t!on2

O Seldon $!n.ler 7 essent!als of "ompletedent/re prostodont!"s 7 nd ed!t!on2


83/85

O Syllab/s of "omplete dent/res U &arles M*eart$ell# tEd!t!on

O S"alorn# R2 )2 A st/dy of te arb!trary "enterand .!nemat!" "enter of rotat!on for fa"ebo$mo/nt!n%2 J Prostet Dent F: F2

O )ran%er# E2 R2 &l!n!"al S!%n!6"an"e of te *!n%e

A1!s Mo/nt!n%2 D&NA# Mar K>K:;>


84/85

O Preston# J2 D2 A reassessment of temand!b/lar trans0erse or!9ontal a1!s teory2 J

Prostet Dent : ;>>=>K# K44


85/85

T*AN O'

Orientation Sonal

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