Fabricating An Anatomic Appliance-Creating The Occlusion

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The last step in creating an anatomic appliance is to create the occlusal design prior to polishing the appliance for delivery. Anatomic appliances are designed to capture an actual occlusal scheme that can be created on the patient’s teeth onto an artificial acrylic surface. Alterations from the existing occlusion to the acrylic are designed to eliminate signs and symptoms of occlusal disease and stabilize joints and muscles. The anterior guidance can be designed as either a canine guidance or a group function, and normally mimics the existing interincisal angle or is more shallow. The combination of anterior guidance on the appliance and the angle of the eminence create posterior disclusion. This disclusion is created by clearing out the posterior acrylic int he pathways of the maxillary tooth cusps, or a crow’s foot pattern. In the attached video Dr. Mark Kleive explains and demonstrates the crow’s foot pattern created during excursive and protrusive movements of the mandible. Understanding this pattern is integral in adjusting the occlusion on an anatomic appliance.

End To End

The first step is creating even posterior tooth contacts in ICP. Once this has been accomplished unlock the articulator and mark the excursives. Using an e-cutter begin to design int he guidance and remove the posterior interferences. Crossover is accomplished by a hand off from the canine to the incisal edge of the central incisors. Once the occlusion has been adjusted in polish the appliance with flour of pumice and polishing paste on a lathe before delivery.

To contact Dr, Mark Kleive:  www.blackmountaindentist.com