Vienna 2012 Program Abstract

7/22/2019 Vienna 2012 Program Abstract

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After Vienna 2006, Krems 2008, Nice 20104 th meeting of the

international Academy of AdvancedInterdisciplinary Dentistry

in association with Associazione Italia Gnatologia,iAAID Asia, Collge National dOcclusodontologie,

iAAID East European, iAAID North American

Official language : English [email protected] http://www.iaaidentistry.com

VIENNA 201230 th November (13h-18h)

1 st December (9H_18h)2 sd December (9h-13h)

Faculty of Dentistry Bernhard Gottlieb UniversittszahnklinikWien Sensengasse 2a A-1090 Vienna Austrian

Interdisciplinary approach of

THERAPEUTICPOSITIONIn oral rehabilitation

To a common language : R. Slavicek (Austria), JD. Orthlieb (France)Clinical implications of occlusal plane individuality in children : S. Naretto (Italy)

TMJ : From anatomy to function and dysfunction : P. Carpentier (France)Reproducibility of centric relation : E. ry (Hungary)

Condylar and disc position, a review : G. Slavicek (Germany)To choose the vertical dimension of occlusion : R. Slavicek (Austria), JD. Orthlieb (France)

Occlusal plane and articular paths reconstructing during prosthetic treatment : E. Roshchin (Russia)Perio-Orthodontic Case report, stability of therapeutic position : Xiaohui-Rausch-Fan (Austria)

Therapeutic position - decision making in dentistry : S. Kulmer (Austria)Condyle position in occlusal reconstruction :Xiao-Jiang Yang (China)

Transversal displacement of the condyles (Delta (Y): decision of therapeutic position :A. Landry (Canada)Transversal Delta (Y): procedure of repositioning treatment : M. Greven (Germany)

Esthetic full mouth rehabilitation of severe bruxism : a contemporary prosthetic approach : P. Simeone(Italy)Choice of therapeutic position, clinical cases discussion : N. Bassetti (Italy)

Our investigation of therapeutic position and transfer to occlusal rehabilitation : G. Reichardt (Germany)Correlation of MLT in symmetrical mandibular movements in condylography and MRI examination : S. Cid

Provisional restorations according to gnathological rules : R. Masnata (Italy)Full mouth prosthetic rehabilitation and rest position : F. Ravasini, N. Gondoni (Italy)

Therapeutic position: from occlusal splint to final rehabilitation : E. Tanteri (Italy)

Virtual articulator and simulation of therapeutic position : G. Duminil (France)Rehabilitation of patients with severe Bruxism using Full Ceramic Cad-Cam : A. Knaus (Austria)The Recent Approach to Craniomandibular Disorder by prosthodontic and orthodontic treatment : H. Yoshimi (Japan)

Orthodontic trt and therapeutic position following the centric relation of disco-condylar assembly : S. Sato (Japan)Forum : R. Slavicek (Austria), S. Sato (Japan),JD. Orthlieb (France), E. Tanteri (Italy)


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Interdisciplinary approach

of

mandibular

THERAPEUTIC POSITION

in oral rehabilitationEditorial

Editorial Vienna 2012

Occlusal functions and mandibular therapeutic position

A mandibular therapeutic position claims to allow a stable mandibular position during clenching andswallowing in a stable orthopaedic position of the temporomandibular joints, thus allowing a jointposition without overload and only maintained by simple muscular activities. It seems possible to

propose a probably better understanding of therapeutic position through atriptych of occlusalfunctions: stabilizing, centering and guiding.

Occlusal function: Stabylizing (no unstable ICP):Mandibular stability requires a long-term stability of every dental unit of the dental arches. The occlusalmorphology, the long axis inclination of each tooth, the three-dimensional dental arches arrangementwhich are responsible for long-term stability of the teeth and mandibular position in maximum

intercuspation (ICP). Occlusal stability in ICP is mandatory for a proper stability of a mandibulartherapeutical position.Occlusal function: Centering (no deflected ICP)ICP predicts the condylar position exposed to clenching. Optimization of temporomandibular joint

requires a stable disco-condylar position along the articular tubercle (orthopaedic situation) to be ableto absorb the muscular constraints without damage or nociceptive reactions. Stability of a mandibular

therapeutic position is probably impossible with a shiftedICP, specifically in transversal direction, whichexpose overloading of a small joint area (lateral pole of the condyle).

Occlusal function: Guiding (no interference)Functionnal guiding or control is an easy mandibular access to ICP accommodating order and freedom.

A therapeutical mandibular position established by a stable, non-deflected ICP, is not sufficient forefficient function if the access to this position is prevented or limited, by occlusal interferences. Onecannot expect to create a functionnal new ICP if the occlusal guiding functions are optimized by

eliminating any anterior anterior or posterior occlusal interferences, and providing an effective retrusionguidance especially in cases of mandibular anteposition (protuded position).Once defined the occlusal requirements for stabilizing and centering the mandibule, and defined a

appropriate guiding function, it is necessary to establish a set of indications in order to decide aninvasive treatment creating a new mandibular position called therapeutic position. This is what all this

meeting is about

Jean-Daniel Orthlieb

President of iAAID


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November, Friday 3012h30 registration

13h inaugural session

Chair : E. TANTERI (Italy)13h30 To a common language

R. Slavicek (Austria), JD. Orthlieb (France)

13h55 Clinical implications of occlusal plane individuality in childrenS. Naretto (Italy)

14h25 TMJ : From anatomy to function and dysfunctionP. Carpentier (France)

14h55 Reproducibility of centric relationE. ry (Hungary)

15h25 Break

15h55 Condylar and disc position, a reviewG. Slavicek (Germany)

16h25 To choose the vertical dimension of occlusionR. Slavicek (Austria), JD. Orthlieb (France)

17h10 Synthesis of the day

17h30 iAAID general assembly

December, Saturday 1 (morning)Chair : G. SLAVICEK (Germany)9H00 Occlusal plane and articular paths reconstructing during prosthetic

treatmentE. Roshchin, V. Panteleev, A. Roshchina (Russia)

9h20 Perio-Orthodontic Case report, stability of therapeutic positionXiaohui-Rausch-Fan (Austria)

9h50 Therapeutic position - decision making in dentistryS. Kulmer (Austria)

10h20 Break

10h50 Condyle position in occlusal reconstructionXiao-Jiang Yang (China)

11h20 Transversal displacement of the condyles (Delta (Y): decision oftherapeutic positionA. Landry (Canada)

11h50 Transversal Delta (Y): procedure of repositioning treatmentM. Greven (Germany)


12h40 Buffet


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December, Saturday 1 (afternoon)Chair : M. GREVEN (Germany)14h00 Esthetic full mouth rehabilitation of severe bruxism : a contemporary

minimally invasive prosthetic approachP. Simeone(Italy)

14h20 Choice of therapeutic position, clinical cases discussion

N. Bassetti (Italy)

14h50 Our investigation of therapeutic position and transfer to occlusalrehabilitationG. Reichardt(Germany)

15h20 Break

15h50 Correlation of Mandibular Lateral Translation (MLT) in symmetricalmandibular movements in condylography and MRI examinationS. Cid, C. Rijpstra, U. Labermeier, M. Vahlensieck, V. Kehl, S. Sato, A. Kolk,M. Geven (Germany, Japan)

16h10 Provisional restorations according to gnathological rulesR. Masnata (Italy)

16h40 Full mouth prosthetic rehabilitation and rest positionF. Ravasini, N. Gondoni (Italy)


19h00 Bus to Schoenbrunn castle20h00 Gala dinner (Gloriette)

December, Sunday 2Chair : S. NARETTO (Italy)

08h50 Therapeutic position: from occlusal splint to final rehabilitationE. Tanteri (Italy)

09h20 Virtual articulator and simulation of therapeutic positionG. Duminil (France)

09h50 Rehabilitation of patients with severe Bruxism using Full Ceramic Cad-CamA. Knaus (Austria)

10h20 Break

10h50 The Recent Approach to Craniomandibular Disorder by prosthodontic andorthodontic treatmentH. Yoshimi (Japan)

11h20 Orthodontic treatment and therapeutic position following the centricrelation of disco-condylar assemblyS. Sato (Japan)

12h10 Therapeutic position: why ? Where ? when ? How ?

Forum : R. Slavicek, (Austria), S. Sato (Japan), JD. Orthlieb (France),E. Tanteri (Italy)

12h40 General synthesis C. Weber, M. Greven, JD. Orthlieb


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Interdisciplinary approach of mandibularTHERAPEUTIC POSITION in oral rehabilitation

Prsident of the congres : JD.Orthlieb (Marseille - France)

Vice-Prsident : E.Tanteri (Torino - Italy)

President of the scientific committee : R.Slavicek (Vienna - Austria)

President of the organization committee : C.Weber (Vienna - Austria)

Scientific committeeRudolf Slavicek (Vienna - Austria)

Sadao Sato (kanagawa- Japan)Jean-Daniel Orthlieb (Marseille - France)

Marcus Greven (Bonn - Germany)Silvano Naretto (Torino - Italy)

Rory O'Neil (Boston - USA)

Gregor Slavicek (Stuttgart- Germany)Eva Piehslinger (Vienna - Austria)

Eugenio Tanteri (Torino - Italy)

Organization committeeChristiana Weber(Vienna - Austria)

Georg Reichenberg (Vienna - Austria)Satoshi Aoki (Tokyo - Japan) (iAAID asia representant)

Laurent Darmouni (Marseille - France)Armelle Maniere-Ezvan (Nice - France)

Barbara Gsellman (Vienna - Austria)Isabel Moreno (Madrid - Spain, Lexington USA)

Jean-Philippe R (Marseille - France)Mikhail Soikher (Moscow - Russia) (iAAID east-european representant)

http://www.iaaid.com/ IAAID (AIG)2012/ Friday 30 November (14h-18h)/ Saturday 1 December (9h-18h)/ Sunday 2 December (9h-13h)Place : Faculty of Dentistry / Bernhard Gottlieb / Universittszahnklinik Wien / Sensengasse 2a A-1090 Vienna- Austria


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To a common languageReference plane, reference position, therapeutical position,protrusion, anteposition, decompression, distraction

R. SLAVICEK (Austria)

JD. ORTHLIEB (France)

Proposition of definition about the following words should be presentedReference planeHorizontal reference planeOcclusal planeVertical reference plane and frontal aesthetic planeMandibular asymetry

Non alignement of incisal midline

Mandibular positionsReference positionMandibular reference positionMandibular therapeutic position

Condylar positionsCompression- decompressionRetropositionAnteposition (protrusion)

Rudolf SLAVICEK : Father of iAAID

Jean-Daniel ORTHLIEB received his doctorat in dentistery (DDS) in 1978 in Marseille,France. He was certified in Anthropology, in fixed prosthodontic and in Occlusodontology. Hereceived his "Doctorat d'Universit " PHD- in 1990. From 1993 he was , "Matre deconfrence des Universits", Chairman of the Occlusion and Dysfunction department ofFaculty of Dentistry of Marseille, University of Mediterranean. From 2007, he is Full Professorof University. From 2009, he is Vice dean of the faculty of Dentistry of Marseille in charge ofeducation. He was President of the French National College of Occlusodontology in 1995-96,.He is member of the European Academy of Craniomandibular Disorders (EACD), member ofthe eduction Committee of EACD, In 2008 is was named Visiting professor of DonauUniversity. From 2010, he is President of International Academy of Advanced Interdisciplinary

Dentistry (iAAID), He published 4 books and more than 110 scientific papers about occlusion,TMD and prosthodontic.


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Clinical implications of occlusal planeindividuality in children

S. NARETTO (Italy)1- Which occlusal plane definition which is the more pertinent?2- What are the relation between occlusal plane inclination and skeletal types?3- What is the incidence of the occlusal plane inclination on the therapeutic choice?

Basic studies and researches on cranio facial growth show that occlusal plane change his

position in space and time during the whole period of development and growth of the skull until

the attainment of the mature dentition stage. The final position is depending by several factors

related to the biomechanical behaviour during functions of the masticatory organ.

Cephalometric analysis is useful to simplify the complex concept of Occlusal Planes.

Observations of data indicate that the inclination is different between scheletal class I, class II

and Class III, being more steep in class II and more flat in class III. Variation between the

subclasses demonstrate the very high degree of individuality of

the inclination of the occlusal plane in subjects during mixed

dentition stage.

Silvano NARETTO

M.D., D.D.S., M.Sc.

Doctor of Medicine

Doctor of Dental SurgeryPostgraduate in Oral SurgeryPostgraduate in OrthodonticMaster of Science in Dental Science


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TMJ : From anatomy to function anddysfunction

P. CARPENTIER (France)1- Which are the weak elements of TMJ?2- What means TMJ compression, overloading ?3- Is the lateral pterygoid muscle involved in the mechanism of disc displacement?

The temporomandibular joints are undoubtedly one of the mostsophisticated joints of the human body. Althought they havebeen designed to fulfill specifications of masticatory function,some of their anatomical aspects still remain difficult to elucidate.This presentation will emphasise the phylogenetic, ontogeneticand biomechanical TMJ specificities to underline why are they so

different from the others synovial joints. These elements areessential to understand the uniqueness of their cartilage, theirlinks to the middle ear, and their various masticatory musclesrelationships. Anatomical and electromyographic data will becompiled to show that the lateral pterygoid muscle must definitelybe considered as a three-dimensional complicated muscularentity.We will then focus on the anatomical asymmetry of thedisc-condyle complex in order to explain the mechanisms of discdisplacement.

Pierre Carpentier is Professor of orofacial anatomy in thedepartment of basic dental sciences at the university of Paris 7Denis- Diderot.He is clinically involved in the treatment of Orofacial Pain atRothschild hospital of Assistance Publique de Paris.His research interests are concerned with salivary glands,functional anatomy and imaging of the TMJ and with surgicalanatomy of the oral cavity. Dr Carpentier has publishedinternational and national articles in this research fields.

He is a member of the Acadmie Nationale de ChirurgieDentaire and of several societies


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Reproducibility of centric relationE. ry (Hungary)

1- Definition, and recording of a mandibular reference position is it a key question ?2- Reproducibility of centric relation is it a myth?3- How to manage an unstable centric relation in initial phases of treatment?

Clinical diagnostic and reconstructive procedures require a proper 3D inter-maxillaryrelationship. This starting point should be a reproducible, neuromuscularly stable position.Description of the spatial position, the CENTRIC is often confusing, techniques andprocedures to define it are waste and have controversial results. The aim of this lecture is topresent two techniques which are useful in most of the clinical situations and have excellentreproducibility. Efforts to find and capture the starting point (the where we are) makespossible to define the therapeutic position (the where we go) where our reconstruction shouldbe finished.

El!d RY Date and place of birth:1967, Reghin1996 Centrocc gnathology course, Budapest1996 Centrocc gnathology course, Budapest1996 Maxillofacial specialist degree1997 University degree in dentistry Semmelweis University of

Medicine, Budapest1998 Brnemark surgery / prothetics course, Rgen2000 Reality aesthetic dentistry course, London2000 Centrocc gnathology course, Budapest2002 Brnemark Clinical Training Course, Gteborg2004 Condylographie Typologie und Deutung, Rheinbach2005 Advanced Replace Select Training Course, Sopron2005 Funktionen und Dysfunktionen des Kauorgans, (Donau Uni,Krems)2006 Die Therapie des Funktionsgestrten Kauorgans (Donau Uni,

Krems)

2007 Master of Science in Dental Sciences (MSC)


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Condylar and disc position, a reviewG. Slavicek (Germany)

1- Which are the prevalence in different condyle-disk relations?2- What are the pathogenic incidence of condyle-disk desunions?3- How to analyse the condyle-disk relation?

The position of the condyle and the disc are often the focus of various interpretations andhazardous speculations. A physiologic condyle disk relation is basic and ambitious goal notonly in restorative-prosthodontic dentistry, but also in many other dental disciplines.The function of the disc, and from that aspectalso the position of the disc, is strongly relatedto the anatomical incongruence between thecondyle and the articular eminence. Twoconvex osseous structures are stabilized andequalized by a fibrous, annular structure.

Additionally, this function of the disc-condylerelation is not only a static one; in fact thedynamic components of mandibular movementshave to be considered as well.Three questions will be highlighted in thislecture:1) Are there different condyle-disc relations andif yes, how often these different relations arefound (prevalence)?2) What is the incidence rate forpathogenic condyle-disc relations?

3) Which methods to be used foranalyzing the condyle-discrelation?

Dr. G. Slavicek graduated 1984 from the University ofVienna and continued his education at the Dental SchoolVienna. He certified as specialist in Dentistry (Facharzt frZahn-, Mund- und Kieferheilkunde) in 1986. He graduateda postgraduate training program in Orthodontics at the

Royal Dental College in Aarhus, Denmark.In 1991 he joins the Department of Maxillofacial Surgery atthe Landeskrankenhaus St. Plten. In 1994 he wasappointed as lecturer at the Department for Prosthodontics,University of Vienna, School of Dentistry. From 2006 to2008 he was Head of Clinical Trials, Cancer ResearchCenter, 1stmedical Department, Wilhelminenspital Vienna,Center for Oncology and Hematology. Since 2008 he isHead of Steinbeis Transfer Institute BiotechnologyInterdisciplinary Dentistry.

His main interest and research activities focus on diagnostic and treatment ofcraniomandibular disorders of the stomatognathic system. He took part on the development ofcomputer aided diagnostic systems for jaw joint recording and analyzing lateral cephalograms.


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To choose the vertical dimension of occlusionR. SLAVICEK (Austria)

JD. ORTHLIEB (France)

1- What are the physiopathogenic incidences of vertical dimension variations?2- In case of extended rehabilitation, what are the key determinants to choose theVertical Dimension of Occlusion?3- What are the interests and methods of cephalometric analysis to choose the VerticalDimension of Occlusion?

During an extensive prosthetic reconstruction, the choice of the vertical dimension of occlusion(VDO) is frequently presented as the main point to obtain a successful treatment. Probably, itis a sensible opinion to think that there is an optimal adaptative space concerning the verticaldimension (VD) rather than a magic point. The practitioner may play with the VD, if a strictrotation around the hinge axis is used, if the facial type is not worsened, and if lip closure iskept in a natural position. The decision making will be described in relation two key factors,such occlusal anterior relation and prosthetic space. Mandibular morphology, sagittal maxillaryposition, facial aesthetic, skelettal skeletal type are also factors to take in count. A decisionmaking table will be proposed to visualize the trend of this different factors.


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Occlusal plane and articular pathsreconstructing during prosthetic treatment

E. ROSHCHIN, V. PANTELEEV, A. ROSHCHINA(Russia)

Aim: to determine individual radiological parameters of orientation of occlusal plane;individualization of prosthetic treatment using electronic axiography.Purpose:1. determine orientation of occlusion plane with cephalometric analysis during restoration ofposterior teeth defects;2. reconstruct condular movement in final prosthetic treatment.Materials and methods:One hundred and ten volunteers,age range 18-30years with naturaldentition were selected for this study. All the volunteers had a CT (dental tomography I-Cat,USA) end electronic axiography (Arcus Digma II, KaVo, Germany). Using obtained data weanalyzed sagittal (right and left) orientation of occlusal plane, condylar position and anatomy ofarticular eminence. During clinical examination we made articular analysis for individualprogramming the articulator (Protar 9, KaVo, Germany) and functional analysis for evaluationcondylar and incisal paths.Results:analysis of TMJ on CT revealed condylar displacement (28 volunteers). Analysis ofsagittal CT showed up angle 1 (tangent to eminence and occlusal plane angle) and angleSNASNP-GoGn dependency. By analyzing the difference between the two angles wediscovered constant "C" which depends on ArGoMe angle.

Angle size

(Ar-Go-Me)

(group 1)

110-115

(group 2)

115-120

(group 3)

120-125

(group 4)

125-130Constant " 1013 1033 1043 1043

With radiological analysis, individual anatomy of condylar eminence was discovered, that ledto restriction of use of articulator Protar because of invariable structure of articular mechanismwhich are standard and not in all cases conform anatomically. We have developed electronicarticulator which can reconstruct condylar and incisal paths recorded by electronic axiographArcus Digma II without manual intervention.Conclusions:-with the help of cephalometric analysis we worked out radiological orientation of occlusalplane

-individuality of lower jaw articulation were identified in recorded articular paths in the group ofvolunteers with condylar displacement.


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Perio-Orthodontic case report, stability oftherapeutic position

X. RAUSCH-FAN (Austria)1. How to understand the role of occlusal trauma in pathogenesis of periodontal

disease?2. What is benefit or risk of orthodontic treatment for periodontally compromisedcases?3. Which therapeutic occlusion is suggested to be benefit for maintaining teeth stabilityin periodontium?The malocclusion has been discussed to influence the pathogenesis and progression ofperiodontal disease. Occlusal adjustment and correction is considered to be an importantadjuvant therapy for periodontally affected teeth. A combined orthodontic, periodontic andother interdisciplinary therapy often offers the best option for resolving complex clinicalproblem and achieving a predictable outcome. However, orthodontic tooth movement couldalso accelerate occasionally periodontal destruction, in particular, under condition ofperiodontal inflammation. To minimize the risk and achieve the optimum treatment result, acombined periodontal-orthodontic treatment concept is required to be established. Theeffective non-surgical and surgical periodontal treatment provides opportunities for gainingnew attachment and improved the pre-orthodontic condition for moving teeth. In other hand,orthodontic correcting malpositioned teeth can change of topography of bone tissue andfurther improve the results of periodontal regenerative therapy. Moreover, orthodonticapproaches in treatment of periodontally compromised teeth, by mainly focusing on diagnosisand therapy for occlusal trauma and establishing functional occlusion, can obtain the outcomeof long term of periodontal stability.

Prof. DDr. Xiaohui RAUSCH-FAN MD, DDs, Ph.D.Professor in division of orthodontics, head of periodontal researchlaboratory, Bernhard Gottlieb University Clinic of Dentistry, MedicalUniversity of Vienna, Austria

Xiaohui [email protected] and career history1987 Master degree of medicine, Norman Bethune University,Changchun, China1992 PhD at Nippon medical University, Tokyo, Japan.1993 Research associate in dental school and institute forexperimental pathophysiology, Vienna University, Austria

1998 Medical Doctor (MD) in Vienna University, Austria.1999 Intership for specialized in general dentistry, ViennaUniversity, Austria2002- Assistant, department of periodontology, dental school,

Vienna University, Austria2004- Orthodontic training under supervision of Prof. S Sato at department for interdisciplinarydentistry and technology, Denube University, Krems, Austria2005- Professor, senior resident, department of periodontology, Bernhard Gottlieb UniversityClinic of Dentistry, Medical University Vienna, Austria2007- Specialist in orthodontics awarded from Denube-University Krems, private orthodonticpraxis in Vienna, Austria

2012- Professor in division of orthodontics and Head of periodontal research laboratoryClinic field:periodontics and orthodonticsResearch field: pathogenese of periodonttal diseases, periodontal tissue regeneration,biocompatibility of dental implant surface.


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Therapeutic position decision making indentistry

S. KULMER (Austria)1- Therapeutic position, is it a key question for the stability of the rehabilitation, thehealth of the stomatognathic system and the wellbeeing of the patient?2- What do you need to decide?3- What are the criteria of decision making?

It is the duty of dentistry to give the patient astomatognathic system, that has the bestprerequisites for longterm stability and goodfunction. It shall give the patient wellbeeing andkeep him pain free.Diagnosis and treatment plan are based on the

therapeutic position. Research and longtermfollowup studies have shown, that the patientpositions the condyle-disc complex, when closingactively by himself, in an anterior-superiorposition. This proves right in a healthy joint, in aloose lower compartment of the TMJ and evenwhen a disc displacement has occured. Longtermfollowup studies will show, that such a"Myostabilized centric relation", together with good parameters of function, can be stable overdecades.

Univ.-Prof. DDr. Siegfried KULMER1964: Promotion to Dr.med.univ. ( MD )

Karl-Franzens-University - Graz1964/66: Education to medical specialist for oral medicine anddentistry Leopold-Franzens-University - Innsbruck1967/68: Assistant at the Department of Jaw and FaceSurgery -Regional Hospital Salzburg1969: University Assistant at the University Hospital forOral Medicine and Dentistry - Innsbruck1972: Head of the Department of Preventive and

Restorative Dentistry / InnsbruckScientific studies in the USA and Switzerland

1977: University Assistant Professor (PhD)Austrian Stomatology Award

1981: University-Professor1981/85: Vice President of the Austrian Society of Prosthodontics and Gnathology1982: Austrian Stomatology Award1986/93: President of the Austrian Society of Prosthodontics and Gnathology1987: Member of the International College of Prosthodontists

Lectures and seminars in Europe, Japan and USA2001 2005: Head of the University Clinic of Oral Medicine and Dentistry (Innsbruck)

2001 - 2006: President of the Association for Dental Health in TyrolSince 2005: In private office in InnsnbruckSince 2005: President of the Tyrolean Dental SocietySince 2006: Charter member IAAID


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Condyle position in occlusal reconstructionX.-J. YANG (China)

1- Condyle position : Is it a key question about the stability of the rehabilitation, thehealth of stomatognathic system?2- How to control the condyle position along the treatment?3- What is the prognosis of condyle position in long term after treatment?

Many restorations may lead to patients feel uncomfortable in occlusion, masticator musclesand temporomandibular joint (TMJ). These symptoms may not only due to the high point ofthe occlusion but also the unstalbe of the condyle position. However, how to evaluate condyleposition during the treatment is still an open question.3D-ultrasonic mandibular trace testing instrument (ARCUS Digma system) was use to detectthe position of condyle during occlusion reconstructing since 2003 in our department. It wasfound that condyle position may still shift unbalance on two sides of TMJ after regular grindingof the restorations by guided with articulating paper. After grinding with the guidance of T-Scan

and ARCUS Digma, the condyle could be shown in a relative stable position. Application ofthis technique in splint (186 cases), implant (259 cases) and fixed denture (122 cases) werediscussed in this report. It indicated that grind the restorations with help of T-Scan III system,and the 3D-ultrasonic mandibular trace testing instrument (ARCUSdigrna system) explored aconsiderable accurate method to obtain the changes of condyle position during occlusionreconstruction treatment.

Xiaojiang Yang is the head of the 2nd Oral & MaxillofacialSurgery Department, Beijing Stomatological Hospital CapitalMedical University in China. Get his PhD in Oulu University ofFinland; DDS in West China Medical University in China. He isnow the Vice President of Chinese National OcclusionAcademy; Board Member of Chinese National TMJ Academy;Member of International Dental Collage (IDC); Member ofInternational Association of Dentalmaxillofacial Radiology(IADR); Member of International Association of American DentalAssociation (ADA); American Implant Dentistry Association(AAID). His main research is TMJ, occlusion and dental implant.


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Transversal displacement of the condyles(Delta Y) : decision of therapeutic position

A. LANDRY (Canada)1- How to diagnose transversal mandibular position disorders (Deranged ReferencePosition and unphysiologic ICP)?2- Why Deranged Reference Position and/or unphysiologic ICP present a TMD riskfactor?3- What are the criteria of decision making to change transversely the mandibularposition?

Physiology of the masticatory system implies that the structures (CMS, NMS and Occlusion)work in harmony to perform normal functions under the supervision of the CNS.On dysfunctional patients, normal functions can be altered by overload (somatic or psychic)which may bring, with time, alterations to the structures of the masticatory system.

Most of us have a good understanding of what may happen to the functions of an alteredmasticatory system on the sagittal plane. But what about the transversal plane?If we have to plan an oral rehabilitation, it is logical to consider the three planes of space, i.e.the sagittal plane (X and Z axis) and the transversal plane (Yaxis). So, if the patientsmasticatory system need to be reconstructed in a therapeutic position, it is a must to alsoconsider the transversal plane.

Alain Landry : Graduated from Laval University, Qubec,Canada, general practice from 1976 to 1989.From 1990 to these days, his practice is oriented exclusivelytowards the treatment of Cranio-Mandibular Disorders (C.M.D.),

Orthodontics and Prosthodontics.In 1994, he developed the Controlled Mandibular Repositioningmethod to maximize the concept of Therapeutic Position.In 2005, he obtained the degree of Master of Science in DentalSciences (M.Sc.), from Donau University, Krems, Austria.From 2005 to 2009, he offered, in cooperation with DonauUniversity, a Masters program, under the supervision of ProfessorRudolf Slavicek.The achievement of an important breakthrough in the field ofC.M.D. brought him to present theresults of his work in North America and Europe.


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Transversal Delta (Y) : procedure ofrepositioning treatment

M. GREVEN (Germany)1- How to simulate on articulator the corrected mandibular position?2- How to control with temporaries the position transfert from the articulator to thepatient?3- How to maintain the therapeutic position during the treatment?

The respect of condylar position in any oral rehabilitation plays a major role in dentistry. Thechoice of condylar therapeutic position has been discussed controversially for many year andstill remains a topic with many open questions.Main focus in the last couple of years was mainly given to anterior-posterior (X-axis) andcranio-caudal (Z-axis) direction of condylar control.This presentation is trying to show the significance of transversal position of the mandible andwants to discuss the procedures necessary to perform transversal control of the condyles inclinical treatment.

Markus Greven : Undergraduate at Dental School, MedicalUniversity of Aachen/GermanyDDS Degree University of Aachen - Dr.med.dent.Post Graduate Education/Dental School University of Vienna -Department of Prosthodontics/Prof.Slavicek

Since 1996: Private Office/Bonn/GermanyPost Gradaute in Periodontology Prof.Dragoo/Study Group/Karl-Hupl-Institute/German Board of Dentistry/Division NordrheinPost Graduate in Function/Dysfunction of Masticatory Organ and Therapy of the functionally disturbed Masticatory OrganDanube-University Krems/Prof.Slavicek (MSc)Post Graduate in Orthodontics - Kanagawa DentalCollege/Yokusuka/Japan; Dept.Craniofacial Growth andDevelopment Dentistry; Prof.SatoPhD - Education/Scientific Visiting Researcher Kanagawa Dental

College/Yokusuka/Japan; Dept.Craniofacial Growth and Development Dentistry; Prof.Sato

Visiting Researcher - LIFE&BRAIN-Insitute /Dept.Neurology- Med.Faculty - MedicalUniversity, Bonn/Germany (Chair: Prof.Elger; Prof.Weber)Asigned e.o.Professorship at Medical University of Vienna


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Esthetic full mouth rehabilitation of severebruxism: a contemporary minimally invasiveprosthetic approach

P.SIMEONE (Italy)

Restorative treatment of severely worn dentition is typically indicated to replace deficient toothstructure, limit the advancement of tooth destruction, improve oral function, and enhance theappearance of the teeth. Minimizing removal of additional tooth structure while also fulfillingthe desire of patients to have higly esthetic restorations can present a prosthetic challengewhen the existing tooth structure is already diminished, especially in the bruxers patients. Inthis particolar cases the restorations provide for a new masticatory pattern, according to thearticular path and the muscolar activity, by using condylography, cephalometry andelectromyography tools. This article presents the clinical and laboratory steps of acomprehensive minimally invasive prosthetic treatment approach, using a lithium disilicate all-ceramic material for the esthetic full mouth rehabilition of a severly worn dentition in patientsdiagnosed with bruxism.


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Choice of therapeutic position, clinical casesdiscussion N. BASSETTI (Italy)1- What is needed in order to decide to change the intercuspal position (ICP)?2- What are the correct criteria to use in complex rehabilitation therapy involvingmandibular repositioning?3- What do you think are the main points to consider in achieving and stabilizing thecorrect therapeutic position?

The plan for the treatment of complex dysfunctional and non dysfunctional cases requires aninterdisciplinary approach that involves the most common branches of dentistry and anorthodontic, prosthetic approach respecting a functional-occlusal concept according to thephilosophy of Professor Slavicek.Pre-therapy with bite or with temporary is usually required for those patients to solve thesymptom of pain generally associated with the dysfunctions of the masticatory organ.Implant terapy will allow you to have the back support, the control of the vertical dimension,and

to guide the mandibule in a sagittal and traversal reposition.Proceed and verify the therapeuticposition by reassembling the temporary crowns in the articulator and valuate the R.P.(reference position) and any corrections to be made on the resin so as to reach thetherapeutic position(TRP). We can say that the position of the implant, the consequent bonetissue management and the subsequent prosthetic reconstructions are gnathologically guided.

The final aim of the therapy is to rebuild anocclusion able to give back to the masticatoryorgan the function which allows it to carry out itstask with the least energetic requirement and thecontrol of the parafunctions.This type of approach is shown important for thelong term stability of the therapeutic position in the

complex rehabilitations.

Nazzareno BASSETTI1982 Dental technician diploma CDT1988 Degree in dentistry and dental prosthetics with high honorsuniversity of Sapienza in Rome Italy2002 Postgraduate University course Therapies for thefunctionally disturbed craniofacial ans masticatory system Prof.R. Slavicek Prof S. Sato and Noshir R. Mehta, DonauUniversity Krems Austria2004-2007 Master course Orthodontics in craniofacial

dysfunction Prof S. Sato, Donau University Krems Austria2007 Title of academic expert in orthodontics, Prof S. Sato,Donau University Krems Austria


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Our investigation of therapeutic position andtransfer to occlusal rehabilitation

G. REICHARDT (Germany)1- How to validate the mandibular therapeutic position obtained by splint?2- How to transfert a mandibular therapeutic position from splint to fixed restorations?3- When to decide to change mandibular position by invasive permanentreconstruction?

The definition of a spatial mandibular position serving as therapeutic position (TRP) for thesuccessful occlusal rehabilitation remains unclear and controversial.We observed the mandibular response to the elimination of occlusal influences by using a flatanterior and lateral guidance splint (FGS).The insertion of an FGS led to a change in the topographical condyle-fossa relationship with atendency toward forward and downward movement and is likely to create an unloading

condition for the temporomandibular joint (TMJ).The masticatory organ appears to self-regulate and rebalance by providing a new muscularlystabilized mandibular position which may be more physiological and we labeled as occlusionrelief position (ORP).As a consequence, we present the incorporation of sequential guidance to occlusalrehabilitation using ORP as TRP.

Gerd Reichardt

Year of Birth: 1965Dental School: University of Tuebingen/GermanyPrivate Dental Clinic in Stuttgart/Germany since 1993Postgraduate Function und Dysfunction of Masticatory Organ- Prof.Slavicek/University of Vienna and Danube-University KremsPostgraduate Orthodontics- Prof. Sato/Kanagawa DentalUniversity/JapanPhD Program - Prof. Sato/Kanagawa Dental College/JapanScientific/Research Member Research Institute of OcclusionMedicine and Brain Research Center- Dept. of Craniofacial Growth

and Development Dentistry/Kanagawa Dental College/Japan (Chair:Prof. S. Sato)


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Correlation of mandibular lateral translation(MLT) in symmetrical mandibular movements incondylography and MRI examination

S. CID, C. RIJPSTRA, U. LABERMEIER,M. VAHLENSIECK, V. KEHL, S. SATO,

A. KOLK, M. GREVEN (Germany, Japan)

Hypothesis. The occurrence of Mandibular Lateral Translation (delta YMLT) in symmetricalmandibular movements is an (early-) indicator of an Internal Derangement of the TMJ.Aim(s) of the study. a) The aim of the study is to find evidence that the occurance ofMandibular Lateraler Translation (deltaY MLT) in symmetrical mandibular movments (sym. =Open/Close; Protrusion/ Retrusion) during 3 dimensional condylographic TMJ tracing is an

indicator fr an Internal Derangement in the TMJ and b) the definition of a threshold value ofdelta-Y condylar deviation as an indicator for a pathological intra-articular finding.Material and method. A patient group of 112 TMJs (56 patients) were examined bystandardized interview (anamnesis), clinical functional examination, true hinge axiscondylography (incl.delta-y) and Magnetic Resonance Imaging (MRI) of the TMJ. 12volunteers (24 TMJs) served as a control group.Results. The patients sample all showed pathological displacements oft he TMJ(s) (Internalderangement) according to Kobs classification (SHIP 2003). According to this classification thewhole control group showed no pathological findings in the MRI tracings. There was asignificant difference between the patients group and the control group in the evaluation of thecondylographic tracings in terms of a Mandibular Lateral Translation (MLT / delta-Y) in

symmetrical mandibular movements. The patients group uniformly displayed an average MLTvalue 0,91mm in open/close-movements and an average MLT value of 0,77mm inprotrusion/retrusion-movements, whereas the control group showed significantly lower meandeviation values on Y-axis (open/close-movement: 0,51mm; protrusion/retrusion-movement:0,49mm). This resulted in a receiver operating characteristics (ROC) curve for theopen/close-movement of ROC=0,671mm and for the protrusion/retrusion-movement ofROC=0,702mm.Conclusion(s). The occurance of transversal, condylar displacement in symmetricalmandibular movements (O/C and (P/R) is a strong indicator of temporo-mandibular disorder(TMD) by the definition of articular "Internal Derangement". At minimum a loosening of thecapsular and condylar ligaments is existing. The deviation of condylar movement in a quantityof 0,6 - 0,75 mm indicates limitation of the functional joint space and an InternalDerangement of the TMJ(s) and is in concordance with the values found in the recentlittrature.


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Provisional restorations according tognathological rules

R. MASNATA (Italy)1- What are the rules which dictate the wax-up modeling?2- How to transfert, without distorsions, wax morphology to acrylic restorations inmouth?3- Provisionals are a main step, for how many time may you maintain provisionalreconstruction in mouth?

In dysfunctional patients, the transition from pretherapy to theprosthetic restoration is always very critical and delicate.In fact, even if the pretherapy has been successful, it must beensured that the jaw maintains the correct therapeuticposition

To make use of a gnathological provisional restoration, itoffers the possibility of simulating the final state, with theadvantage of being able to intervene again in case of need.The electronic instrumentation allows us to build a bio-dynamic occlusion with immediate disclusion, and sequential

canine dominance with great precision.Such a provisional restoration allows us to verify that the prosthetic approach fits theserequirements, offers the possibility of some corrections and guarantees greater security to re-establish a normal function at the end of the final restoration.

Roberto MASNATA : Born in Milan the 10/15/47, he took a

degree in Medicine and Surgery at Pavia University (Italy) in 1974.He specialized in Prosthetic Dentistry with first class honours atthe same University in 1979.He has been an active member of the International Academy ofGnathology since 1989.He is a founder member of the Italian Association of Gnathology(A.I.G.), established in 1989. He has been the secretary and vice-president of this society since 1990.Qualified lectured at the center of Interdisciplinary Dentistry,Donau University Krems, since 2003.He practises as a free professional doctor in Stradella (Pv, Italy),

devoting himself especially to complex rehabilitations andgnathological problems.


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Virtual articulator and simulation of therapeuticposition

G. DUMINIL (France)1- What is the state of the art about virtual articulator?2- Is it possible to use non occlusal reference position?3- Is it possible to simulate different therapeutic position to aid decision making?

In the early 80's, Franois Duret hasintroduced new concepts in dentistry andsince then, the trend for dentistry is to movemore and more digital.Actually more than 30% of dental labs alreadyuse cad/cam equipments, and most dentistsprofit of these advances probably without even

knowing it. The primary goal of thesetechnologies is to mill prosthetic crown andbridge frameworks. The cosmetic (and thusthe occlusion) is being elaborated by classicalmultilayering ceramic procedures.Today, can occlusion also go digital?The purpose of this lecture is to describe the means by which occlusion can be recorded andreproduced using electronic articulators.The questions are :If using an intraoral scanner, how can one record and reproduce proper occlusal contacts?If using a laboratory scanner, how can the dental technician properly set the functionnal

parameters of the patient in the cad/camsoftware ?And finally, how accurate is the combined useof cone beam imagery and intra oral scanningof the dental arches ?Most Cad/Cam softwares actually include a socalled "digital articulator". Is it worth the timeand cost ? What are the real benefits for thepatient and the dentist ?We will compare classical versus digitaltechnics and discuss the present and the future

of occlusal practice.

Grard Duminil : Gratuated from marseille dentaluniversity DDS in 1975, ; DSO, 1980Certificates in Prio , Fixed ProthodonticsDU Occluso, Implantology, Biophysics and computerizd dentistry.Private Practice in Nice since 1976National and International lecturer in Occlusion, and implantologyCNO and IAAID Member

Guest lecturer in the dental faculty of Nice


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Rehabilitation of patients with severe bruxismusing Full Ceramic Cad-Cam

A. KNAUS (Austria)1- What are the advantages avec CAD-CAM technique in this type of reconstruction?2- In severe bruxism, which type of occlusal concept is recommended: canine guidanceor group guidance?3- In this type of cases are there some specific protocols about splint, temporaries, oradditional treatments?

At the prosthodontic department of the Dental School inVienna, a standarised diagnostic pathway, we call it:

diagnostic package, is used for all patients with severe

occlusal relationships. This diagnostic package will beintroduced very briefly in my presentation as well asthe necessity to create the treatment plan for eachpatient.The relationship between bruxism andpsychopathological symptoms were evaluated andintroduced.Biofeedback therapy is helpful to control the bite force.Based on a patient case a step by step implementationof the treatment plan will be demonstrated.The advantages of the Cad-Cam techniques will be

discussed.


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The recent approach to craniomandibulardisorder by prosthodontic and orthodontictreatment

H. YOSHIMI (Japan)1- Can we reconstruct the occlusion according to TRP accurately?2- Can we eliminate the molar interferences in protrusion, laterotrusion, mediotrusion?3- Can we control the mandible retrusive movement during Sleep Bruxism?

Patients with temporomandibular disorder are frequently accompanied problems with thevertical growth of craniomandible . Mandibular position is adapted , under the influence ofdirection of occlusal plane, the activity of the orbicularis oris muscle ,maxillary growth, thepotential of mandibular ramus growth. These elements are easily to lack of coordination andbalance.We can find out the originally acquired mandibular position(TRP) through theexaminations of Axiograph, models which are mounted to the articulator based on axis-orbitalplane and RP point, and lateral cephalographic X-rays . The mandibular position can beadapted to TRP accurately through the prosthodontic Metal Overlays.The three dimensional position from Metal Overlays can be transferred to other teeth withorthodontic technique. Retrusive movement might be remained during Sleep Bruxism. Weshould eliminate the interferences in molars. The retrusive interferences in molar are excludedthrough controlling the inclination of retrusive guiding area and the molar occlusal plane. Iwould like to show that craniomandibular disfunction clinical case who was recovered throughthis way and has good prognosis.

Hidehiro YoshimiDate/Place of Birth:01.03.1961 in Tokyo/Japan1986 Nihon University School of Dentistry at Matsudo1987-1990 Institute of Maxillo-FacialImplant/Urawa/Saitama/Japan1992-1996 Institute of Kasumigaseki Post GraduateCenter/Tokyo/Japan2000-2007 Institute of Craniomandibular Function/Asahikawa/Hokkaido/Japan2003-2009 Kanagawa Dental College Post-Graduate School,Department of Craniofacial Growth and Development

Dentistry/Yokosuka/kanagawa/Japan2009 Award of Kawamura as Best Thesis of the Year ,TheBulletin of Kanagawa Dental College Vol.36No2,63-68Since1996 Private Office/Tokyo/Japan


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Orthodontic treatment and therapeutic positionfollowing the centric relation of disco-condylarassembly

S.Sato (Japan)1- Can we have a stable centric relation with a disc-condyle disunion total andpermanent?2- What are the tecision criteria for changing the mandibular position in orthodontictreatment?3- How to establish a retrusive guidance in orthodontic treatment?

The objective therapeutic goal for the position of the mandible in orthodontic treatment iscentric relation (CR) of the disco-condyle assembly. The definition of CR is normalphysiological and functional relationship of the condyle and articular disc.Decision criteria for changing the mandibular position in orthodontic treatment are as follows:

1) Existence of one or more pathological conditions of the temporomandibular joint: noise,pain, difficulty of mouth opening, delta-Y shift of the condyles, and others.

2) Existence of symptoms of the

craniomandibular system (CMS): poor retralstability of the condyle, muscles of masticationproblems and others.

3) Class II during the growing period4) Adult Class II with functional disturbances

Strategies to achieve repositioning of the mandible:1) Control the occlusal plane

2) Control vertical dimension3) Establish coordination of the upper and lower

dental arches4) Establish retrusive guidance with adaptation

and articular compensation of the condyles

Sadao Sato,Academic Dean, Professor

1971 Assistant, Department of Orthodontics, KanagawaDental College1979 Assistant Professor, Department of

Orthodontics, Kanagawa Dental College1988 Associate Professor, Department ofOrthodontics, Kanagawa Dental College1991 President, Japanese MEAW Technic andResearch Foundation1992 Active member of EH Angle Society ofOrthodontists1996 Professor, Department of Orthodontics,Kanagawa Dental College2002 Visiting Professor, Donau University at Krems, Austria2010 Academic Dean, Kanagawa Dental University (College),

and Shonan Junior College


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POSTER1- Relation between legs lenght discrepancy (fLLD) and condylar position.

Giorgio DeLuca di Pietralata

Department of Interdisciplinary Dentistry and Technologyat the University of Continuing Education / Danube-University KremsAdvisor: Univ.-Prof. MR Dr. Rudolf Slavicek.

Adress: Via Antiochia 8/7 16129 Genoa, ITALYtel/fax 0039 010 588295 0039 3474231781

email: [email protected]

A) functional LLD, Fukuda test, condylar position, Reference position, postural screening.B) Are fLLD and Fukuda test, two postural findings, related to condylar position measured from ICP toRP on casts mounted in Reference SL articolator? Can they be used for diagnostic purpose of occlusaltherapeutic position?

C) 20 patients tested for fLLD and Fukuda test in ICP and with an occlusal appliance made in RP, in

order to observe their modifications between the two examinations.Condylar Position Measurement (CPM) were checked in articolator Reference SL Ghirbach to observeif the change of mandibolar posture induced by the appliance can be related to a particular pattern of

direction of condyle from ICP to RP.Inclusion criteria: functional legs lenght discrepancy.

Exclusion criteria: anatomic legs discrepancy, acute pain, dental and physical treatment, legs surgeryor trauma. T-student test performed.D) 90% of fLLD changed with RP appliance, 50% completely, 40% partial change. Fukuda Test changewas 80%. T-student test significative in both. 60% of omolateral condyle go to cranial position, but T-

student test no significative.E) Both fLLD and Fukuda test are strongly related to mandibolar posture and can be used as screening

tests for correlation between occlusion and posture during diagnostic and therapeutic procedures, but

matched with clinical findings. Not possible to use them as indicators of condylar therapeutic directions.Correlation between occlusion and posture in literature is at the moment at a poor level.

2- Symetry of external auditive meatus - Pilot study on human skulls

Simona Mizgiryte 1, Julius Vaitelis 1, Arunas Barkus 2, Linas Zaleckas 3,Rolandas Pletkus 2, Adomas Auskalnis 4.

1Institute of Odontology, Faculty of Medicine, Vilnius University, Lithuania2Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University,

Lithuania3Department of Oral and Maxilofacial Surgery, Institute of Odontology, Faculty of Medicine, Vilnius

University4Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian Univeristy of Health Sciences

Simona Mizgiryte

Address: Zalgirio 117, Vilnius, 08217Cell phone: +370 656 03714

E-mail: [email protected]

Objectives: To evaluate the perpendicularity of the line connecting external auditive meatus to themidsagital plane and the palatal suture as a midsagittal symmetry reference line.

Methods: 26 female and 36 male skulls of adult individuals were used for photography taking (Nikon40 D and 50 mm Nikkor lens) from basal, frontobasal and frontal views. Images were analysed withAdobe Photoshop CS5 (Adobe). The first line was drawn over a region of petrous part of temporal boneconnecting the frontal points of both external auditive meatus and the angle to the midsagittal planewas measured. The second line extending from sutura palatina mediana in frontal and distal directions


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was evaluated in compare to the midsagittal plane. Statistical analysis included descriptive statistics,

Kolmogorov Smirnov test, t-test and ANOVA (SPSS 17, IBM).

Results: The mean value for the angles of the line between the external auditive meatus and themidsagittal plane in basal views was 90,12 (SD=1,48) and in frontobasal 90,36 (SD=2,25). Nostatistically significant differences were found between age groups and genders. The inter-rater

agreement for evaluation of the adequacy of sutura palatina mediana with the midsagital plane washigh (Cohen's Kappa 0,702 (p


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especially to avoid posterior interference in our reconstruction therapies. A virtual environment was

created in order to observe the effects of some factors on posterior disocclusion: Sagittal condylar inclination (SCI) Anterior guidance (AG), retrusive guidance (RG), canine guidance (CG) Occlusal plane (OP)

Methods: a virtual model was created scanning two plaster models of Slavicek sequential wax-up witha laser scanner (Dental Wings 3D Series 5); they were positioned in a virtual articulator with the samerules: hinge axis, axio-orbital plane, reference position, overlapping of condylar tracing. The virtual

environment was created with the software Rhinoceros and then different situations were simulatedmatching SCI (30, 45, 60) with different OP (-5, 0, 8, 20 and 30) and guidance inclination. Withthe animation module Bongo we tried to simulate some ideal movements with different

guidances and Bennet angles.

Results: the study shows how easy it is, in this virtual environment, to change the above parametersand see the consequences immediately. Other parameters, like curve of Spee and Wilson, could beintroduced. Furthermore it is possible to put all the individual parameters (scanning individual models

and positioning them in the individual space position, with the appropriate tracing) of real cases in thevirtual articulator to help us to better comprehend the situation of clinical cases, without any limitationsof the mechanical articulator (e.g. retrusion)

Conclusions: the virtual environment can be very helpful to the dentist and the technician for theinstrumental analysis, the diagnostic and therapy. Moreover it seems to be interesting from aneducational point of view and it could have some relevant developments like implementation with cone-

beam x-ray images, muscular vectors investigations, virtual wax-up. Further interesting developmentsare expected with the use of the Rhinoceros parametric plug-in Grasshopper that we are going tointroduce. Bongo does not seem suitable for the asymmetric movements that we need to simulate.


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Vienna 2012 Program Abstract

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