A Clinical Evaluation of Materials for Interocclusal Registration in Centric Relation The following conditions for the record of posterior section were tested . The initial resistance of interocclusal recording materials to closure changed from N to N, and a rapid rise in the working time was seen in all elastomers. Statement of Problem: Interocclusal recording materials should have good dimensional stability for precise articulation. Purpose:The aim of this in vitro study.
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Clinical evaluation of interocclusal recording materials in bilateral free end cases. Five combinations of materials commonly used for intermaxillary records in cases of bilateral free end saddle inetrocclusal evaluated: The materials were evaluated by measuring the vertical distance between pairs of reference points located on the bases of the upper and lower interocclhsal casts.
The measurements obtained by manual articulation of the casts were used as the standards to which the measurements obtained with the recording materials were compared.
Comparison of five interocclusal recording materials.
Based on the findings of this study, the following scale of fidelity can be settled from best to worst: Com base nos achados deste estudo, a seguinte escala de reprodutibilidade pode ser estabelecida, do melhor para o pior: Oral rehabilitation involves a sequence of steps that must be followed in a highly judicious manner. The success of any prosthetic rehabilitating treatment depends on several aspects related to the precise mounting of casts in the articulator.
When maximum intercuspation is considered, in cases in which the number of teeth present is satisfactory and will provide cast stability, the casts can be mounted by manual articulation On the other hand, when large edentulous spaces are present, specifically in posterior free end cases, cast mounting is considerably more complex 7.
There is a higher risk of distortion due to interference by the soft tissues of the margins, which can be compressed and may give origin to errors on cast mounting, if special attention is not taken during impression. Furthermore, the lack of teeth that articulate with their antagonists poses an additional difficulty to recording and increases the need for accurate transfer of the interocclusal relationship and vertical dimension 8.
These parameters are usually fulfilled by using registration bases fitted into wide edentulous spaces or free ends. The recording base should provide adequate fitting as well as rigidity and stability. The purpose of this study was to evaluate 5 combinations of materials used in daily clinical practice to obtain intermaxillary records for bilateral free end cases.
Five patients with complete upper dentition and bilateral lower edentulousness were enrolled as volunteers for this study. As an inclusion criterion, only individuals who had some teeth remaining in the mandibular arch up to premolars were selected, in order to allow manual articulation of the casts by the presence of tripod support and horizontal stability.
Five cast pairs upper and lower arches were obtained for each patient, in such a way that each tested combination of materials would be represented by a pair of casts with their own standard measurements for evaluation.
The following combinations of materials were compared for interocclusal records: The cannulas’ entrances allowed adaptation of the tips of a handheld digital caliper Mitutoyo Digimatic Caliper, model ; Mitutoyo Corp, Tokyo, Japan used to measure the vertical distance between the predetermined upper and lower perforations Fig. Thus, 6 pairs of reference points were established to perform the vertical measurements Fig.
The pair of casts of each patient was first articulated manually in maximum intercuspation and fixed with rigid wooden rods and compound.
Vertical distances between the pairs of reference points were measured and used as comparative standard for the measurements obtained with interposition of the registrations. Retentive areas of the lower casts were relieved for preparation of five self-polymerized acrylic resin bases.
Cylinders of 7 wax were softened with a heated spatula and set in place during the clinical procedures. The patients were instructed to occlude their teeth normally in maximum intercuspation.
Excess wax was removed and the procedure was repeated. After interoxclusal spray cooling, the records were removed and kept in a humidifier until for reading.
In a second stage, the records were interposed between the casts and fixed with wooden rods and compound, so that the measurements could be made.
Comparison of five interocclusal recording materials.
For the records made with condensation silicone, the material was divided into two equal parts placed in the right and left edentulous regions of the lower arch and the patients were instructed to occlude normally in maximum intercuspation Fig.
After setting of the material, the records were removed and stored in sealed plastic bags with no humidity until reading 9. Five self-polymerized acrylic resin plates were prepared to obtain interocclusal records with irreversible hydrocolloid.
Rolls of 7 wax of uniform thickness were placed on the alveolar margin crest to create space for the alginate under the plate. Perforations were made in materiaos resin with a 5 spherical bur to retain the material Fig.
Small portions of alginate were placed above and below the resin plate. After the material jelled, the records were removed Fig. Special care was taken not to change the vertical dimension of occlusion at the moment of interoccusal recording. Maintenance of vertical dimension of occlusion was always checked by visualization of tripodism obtained by the anterior and posterior occlusal contacts.
Data were analyzed statistically by analysis of variance and Tukey’s test for individual comparisons. Square root transformation was done to allow the use of parametric statistical tests. Analysis of variance showed significant differences in vertical distance among the combinations of materials under study. However, statistically significant differences were not observed matrials the other materials.
Figure 6 illustrates the differences between the measurements obtained with the interocclusal records and the standard measurements.
In all cases of prosthetic rehabilitation, accurate diagnosis, proper planning and correct execution of clinical and laboratory procedures are mandatory for high-quality results. Moreover, successful treatment is highly dependent on precise mounting of the casts in the articulator. Thus, intermaxillary recording plays an extremely important role in final results. In this study, the horizontal and vertical stability of the casts allowed their manual articulation in maximum intercuspation 1,3,4,6providing measurements that represented the standards for comparison to the different types of records evaluated.
Therefore, the method permits the transposition of the results obtained to edentulous cases that require intermaxillary records for mounting in maximum intercuspation when the stability factors are not present, or in centric relation.
Condensation fecording is extensively used for interocclusal records interoccusal In this study, however, silicone presented the highest mean value of vertical separation between casts, although it did not differ significantly from the combinations of materials under study except for acrylic resin base plus wax.
Figure 6 shows that condensation silicone presented the greatest differences compared to the standards.
These results are consistent with those reported by other authors, who stated that elastomers may suffer distortion at the time of cast joining, due to the compressive force generally exercised to maintain the casts in position 5,11, Duralay acrylic resin is a material with great dimensional stability, rigidity, precision in the reproduction of details, ease of handling and favorable degree of hardness during the setting process, which does not offer resistance to mandibular closure 13, Figure 6 shows that the differences obtained with this combination of materials were more marked at the reference points 3, 4, 5 and 6.
Despite its favorable properties, ZOE is a brittle material that strongly adheres to the dental surface due to contractions and, in the presence of excesses, it may suffer rupture and distortion and cause vertical displacement 9,17, In cases of edentulous areas, the ZOE paste in combination with the register base tends to dislocate the underlying mucosa, resulting in articulator mounting with a slight vertical opening The use of wax as a interocclusal recording material has been debated because it reportedly causes mandibular deflection, resistance to closure and distortions with changes in temperature 3,9,14, Notwithstanding the criticisms, this is still the most often used material in daily clinical practice because of its ease of handling, clinical versatility and low cost 3, In this study, the combination of acrylic resin and wax presented the lowest mean value of vertical separation between casts.
In conclusion, the combination of acrylic resin base and wax for interocclusal record yielded the least differences in comparison to the measurements obtained by manual articulation of the casts, i. Intermaxillary record with condensation silicone putty produced the greatest differences compared to manual articulation of the casts.
From the combination of materials investigated in this study, the following scale of fidelity can be settled from best to worst result: Principles, concepts and practice in prosthodontics. J Prosthet Mateeials ; Interocclusal registration at the vertical dimension of occlusion using acrylic resin copings.
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Accepted September 21, All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution Materiale. Services on Demand Journal.
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