Aim: There is an ongoing debate about the benefits of the facebow and individual articulator settings in prosthodontics when compared to simpler methods. This study aims to determine whether the implementation of novel algorithmic articulator concepts may be an alternative to avoid dynamic interference contacts during the design process of fixed posterior restorations and to which extent the occlusal morphology of the restoration is affected.
Materials and methods: From a chairside CAD database, a total of 50 clinical patient cases documenting 61 planned fixed restorations in the posterior tooth region were selected. A common CAD software was used for the automated knowledge-based design process. When designing the restorations, functional concepts including the pure static occlusion, average articulation, 3 different articulator settings as a control, and a combination of a broad range of articulation parameters (full range dynamic articulation) were applied. The resulting dynamic contact points were both compared visually and metrically with a monitoring software.
Results: There is a highly significant difference in avoiding dynamic interference contacts when applying the full range dynamic articulation in comparison to the pure static occlusion (p<0.001) and the average articulation (p<0.001). Furthermore, the superimposition revealed that the surface of the restorations showed nearly no visual morphologic changes after virtually grinding-in the interpenetrating contact points.
Conclusion: The full range dynamic articulation can be used for the design of small fixed posterior restorations to avoid most dynamic interference contacts, without the need for determining individual parameters for each patient.
Schlagwörter: average articulation, CAD/CAM, facebow, full range dynamic articulation, virtual articulation, virtual FGP