Function meets aesthetics

WHEN IT COMES TO HEALING … ... only the best is good enough. For this reason, we decided to work with my long-time colleague, Udo Plaster, MDT, in the realm of patient and model analysis. His PlaneSystem® is a transfer method that respects and recognises the patient as a person. Whether we choose the digital or the traditional route in the preparation of dental restorations, the accurate recording of patient data by the PlaneSystem® will pave the way for the pursuit of complete health. Our company’s software developers have integrated the PlaneSystem® into the Zirkonzahn CAD/CAM workflow. We...

PORUS ACUSTICUS EXTERNUS SULCUS ALARIS

FUNCTION MEETS AESTHETICS OCCLUSAL PLANE AND MIDLINE Dental technicians need very precise data about The precise position of the human maxilla, which each patient’s individual situation to develop forms an integral part of the skull, varies from restorations in a virtual environment. The individual to individual, depending on skeletal more precise the data, the better the achievable growth types, and the orientation of the occlusal function and aesthetics of design (Fig. 1). In plane is dictated by the growth pattern of the some situations, however, the technician will maxilla and mandible. For...

these natural or induced asymmetries cause the organism to compensate, giving rise to asymmetric loads that may affect the whole body. Excessive loading may result in pain or damage to the body parts affected. Dental restorations may also be a cause of asymmetric loads inside the body. These may be avoided, however, if the clinician succeeds in identifying the position of the maxilla within the skull and determining how any asymmetries that may be present relate to this position. But what options are there available for the clinician to achieve this goal? Fig. 3: The occlusal plane of this individual...

about the position of the maxilla are essential to identify the patient’s midline and occlusal plane for consideration in fabricating the dental restoration. The technician needs both of these parameters to appropriately position the dental reconstruction inside the jawbone, thus closely imitating the natural ideal situation and avoiding the development of asymmetric loads inside the body. THE PLANESYSTEM® This system offers an alternative to conven- Fig. 6: The PlanePositioner ® features a transparent plate used to position the maxillary cast inside the articulator and to individually reflect...

will intuitively be in balance with the body position Recording the position of the maxilla and and the sight axis parallel to the horizon. measuring the occlusal plane starts out by placing the PlaneFinder ® on a level surface and aligning This position is almost identically reproducible its upper arm horizontally. The extension of the at all times, offering a stable frame of reference arm thus provides a zero-degree reference plane, for the PlaneSystem to record the position of horizontally hemisecting the face at a zero-degree each patient’s maxilla in the skull and to measure his or her occlusal...

An independent reference value of this type could not be ensured by using a conventional facebow, which would involve application of a symmetrical measuring instrument to the asymmetric skull these asymmetries. To record the position of the maxilla in the NHP, the maxilla is placed by the patient upon a bite tray connected to the PlaneFinder®, followed by indexing of this position with bite registration material (Fig. 10). The fact that the patient will always be able to return to this position in Fig. 10: Recording of the position of the maxilla in the Natural Head Position which the reference...

Fig. 12: ... may have an ascending, horizontal or descending inclination

its angle is measured on both sides of the face. TRANSFER TO THE ARTICULATOR The next step is to insert the maxillary cast into the silicone index, followed by placing the index onto the (horizontally oriented) PlanePositioner ® and positioning inside the PS1 articulator, effectively “copying” the situation recorded directly from the patient to the articulator can be removed and the inclination of the occlusal Fig. 13: Aligning the maxillary cast orientation based on the silicone index plane can now be replicated by adjusting the PlanePositioner® inside the articulator to the angle ® (Fig. 14)....

Fig. 16: Scan of the mounted cast Fig. 15: Ideal setup for repeatedly checking the occlusal plane through different stages during the development of the case Fig. 18: The occlusal plane of this patient’s existing dental restoration deviates markedly from his natural occlusal plane Fig. 19: For maximum realism during the design process ... POSSIBILITIES IN THE SOFTWARE In the Zirkonzahn.Scan software environment, the occlusal plane (Fig. 18), tooth proportions a project is created using the CAD-PlaneTool as well as various 2D/3D photographic images PS1-3D, followed by digitisation of the mounted...

Fig. 22: Positioning of the dental restoration based on the natural occlusal plane Fig. 21: The position of the occlusal plane (grey) and of the maxilla are recorded separately using the same reference plane, which permits to reproduce the current situation of the patient in the software be depicted in those photographs from different dental restoration can now be related to the angles and with varying facial expressions (like natural occlusal plane also in the digital domain serious or laughing or smiling). Fig. 23: The position of the absolute midline and of the maxilla are recorded separately...

Thanks to a fluid and smart workflow, all The occlusal plane of the restoration can be measurements, records and the articulation repeatedly checked, as needed, for agreement carried out by means of the PlaneSystem can be with the natural occlusal plane, both in the used in further steps of the case realisation. The digital domain using the software and in the PlaneSystem®’s hardware and software elements physical domain using the PS1 articulator. This used in this process are designed to include both function and aesthetics in the realisation of dental even subsequent adjustments to restorations...