FROM SCAN TO SPLINT – 100 % DIGITAL A dynamic approach and accurate analogue preparation are the keys to digital success

INTERDISCIPLINARY SOLUTIONS FOR OPTIMAL JAW STABILITY Modern dental technology faces the challenge of precisely analysing complex functional and structural disorders of the masticatory system and sustainably improving them using innovative treatment methods. An essential part of this work is the interdisciplinary collaboration between dentist, dental technician and physiotherapist, which leads to the development of the optimal solution for restoring oral functionality and structural jaw stability. Digitisation has provided new possibilities in dental technology to accurately capture jaw relations:...

MIDLINE, HEIGHT, AND HORIZONTAL POSITION IN RELATION TO THE SKULL (ANALOGUE) CREATING PHYSICAL MODELS FROM VIRTUAL DESIGNS USING 3D PRINTING (DIGITAL/ANALOGUE) PATIENT HISTORY (ANALOGUE) CAPTURING NHP AND OTHER INFORMATION USING THE HEAD TRACKER (DIGITAL) SPLINT PRODUCTION IN ZIRKONZAHN.MODIFIER (DIGITAL) TRANSFER OF ALL ACQUIRED DATA (DIGITAL) 3D POSITIONING IN THE VIRTUAL ARTICULATOR (DIGITAL)

PATIENT HISTORY PATIENT HISTORY A 27-year-old professional cyclist, presented to the dental practice with persistent complaints. Despite intensive physiotherapy, the patient continued to suffer from muscular imbalances, particularly in the neck and back muscles, as well as from an unstable posture during physical activities. This instability manifested in poor movement patterns and limited control during jumps, significantly affecting his athletic performance. A thorough examination revealed that the patient had previously lost a tooth in the upper left jaw: tooth 26 was missing, leading to an...

ANALYSIS AND PHYSICAL DIAGNOSTICSFOR PATIENT TREATMENT, THE FOLLOWING DATA IS ESSENTIAL: - Intraoral scans of the upper and lower jaw, of the impression — including the Tray Sensor Support of the Head Tracker — as well as of starting and final position of the lower jaw - 3D positioning in the virtual articulator (sagittal, frontal, and occlusal) - Various software solutions Bite registration Impression on the Bite Tray (incl. Tray Sensor Support)

ANALYSIS AND PHYSICAL DIAGNOSTICS Matching/Data verification Natural Head Position (NHP) and preparation of the dental work < Head Tracking Results j? Head ROLL-1.2“ PITCH. Position

Step 1 Data collection TO EFFICIENTLY SOLVE THE PATIENT CASE, THE FOLLOWING STEPS ARE CARRIED OUT, ALLOWING THE COMBINATION OF BOTH ANALOGUE AND DIGITAL METHODS AT ANY STAGE: Facial and model analysis Dental history Which vertical dimension should be used? Physical diagnostics Starting position of the lower jaw Physical diagnostics

ANALYSIS AND PHYSICAL DIAGNOSTICS Step 2 Acquisition: analogue and digital Step 3 Creation of a dental splint

DIGITAL IMPLEMENTATION DURING TREATMENT Once the patient data has been acquired, it is organised in the Zirkonzahn.Archiv software. Models are then verified in Zirkonzahn.Scan or Zirkonzahn.Modifier software. During this process, the quality of the intraoral scans is checked, as well as whether the scans have been correctly matched (different bite positions). The digital registration of the upper jaw position is carried out using the PlaneFinder ® and the Head Tracker: innovative measuring instruments which enable an accurate transfer of the upper jaw position into the software. The patient’s...

ANALYSIS AND PHYSICAL DIAGNOSTICS Display of jaw position and models: on the left File QR code Matching Starting position/Bite registration side, the measurement of the Natural Head Position (NHP) and its result are displayed. The models of the upper and lower jaw, the Tray Sensor Support of the Head Tracker, and the bite registration, which represent the starting position, are also shown. On the right side, the Image Viewer displays the detected jaw and bite situation. In Zirkonzahn. Archiv, all data and models are clearly organised and accessible. 11

INTERDISCIPLINARY COLLABORATION Patient data is carefully collected in order to consider all relevant information, such as orthodontic treatments or accidents. A detailed physical diagnostics records the starting position of the lower jaw, using both analogue and digital methods. Step 1 Data collection Step 2 Acquisition: analogue and digital Interview Facial and model analysis Dental history Which vertical dimension should be used? Physical diagnostics Starting position of the lower jaw Physical diagnostics Step 3 Creation of a dental splint

ANALYSIS AND PHYSICAL DIAGNOSTICS Successful dental technology is based on close interdisciplinary collaboration between dentist and physiotherapist to precisely determine the ideal skull position in relation to height, midline and horizontal plane. Medical history Is there a disorder in the TMJ mechanics? Dental analysis Dental findings Is it an ascending or descending chain? Diagnostics Clinical functional analysis Are there muscular imbalances? Realisation Treatment plan Compression side/Disc displacement side ... Are there premature contacts? Does the patient need height? Planned splint therapy/dental...

In the case described, it was found that the patient, a professional cyclist in his spare time, exhibits physical instability during jumps. 14 Watch the video: the patient performs jumps with spins, perfect balance, and lightning-fast reactions.

The physiotherapist was able to determine that the patient’s occlusion plays a crucial role in the physical instability, which goes beyond the ascending component. In cases of ascending rotational chain, shoulder girdle, neck joints, and temporomandibular joints compensate for dysfunctions in the lower body, such as an injury in the foot area. A descending chain, on the other hand, is characterised by dysfunctions in neck and temporomandibular joints, as seen in conditions like TMD (temporomandibular dysfunction). Instability due to occlusion and ascending chain.

The body is perceived as a cybernetic system consisting of structure, chemistry, and psyche. First, the structure – body/muscles – is examined for blockages. If the system remains unstable, chemical factors such as dental issues or hormonal influences are included in the analysis. Stress, often caused by occlusion problems, also affects the body’s structure and chemical processes. All three factors are closely linked – a disorder in one area impacts the others. The human organism is the largest cybernetic system Chemistry: a balanced diet, digestion, and a functioning metabolism. Structure: a...