hello and welcome cheer sidelines I'm Megan strong and I'm Will Smith registered dental assistant
here at gladwell dental and this episode sure sounds nice my goodness but that's that's right
we are talking about the ever-important bite registration stage hidaka cheese going to talk
today about communication with his patient to make sure they bite properly we acquire the correct
data and the upper and lower arch meshes together yes right and in that he's addressing periodontal
ligament compression as well as managing local anesthetic that's a mouthful it is but I got it
out so let's go so now on to the bite registration you've captured the prep side the opposing
side how do we bring those models together and articulate it digitally so that we can accurately
establish our patient's occlusion so making sure that we go through the correct steps before
scanning the bite and then making sure you scan the bite at the right time and in the patient in
the correct centric position we'll ensure that you have an accurate fitting restoration and occlusion
if the bite is often anyway if the patient's bite is slightly open that would lead to a very high
restoration and certainly we want to avoid that because there would be a lot of adjusting when the
restorations back and tried in on our patient so let's review some steps and tips on how to ensure
that we can scan the patient's bite accurately for that precise fitting occlusion let's take a look
so you've captured the preparation area the prep quadrant the opposing now it's how do we bring
those together with an accurate bite registration so whenever we take a digital bite registration we
captured the buccal surfaces of the patient's teeth when they're biting together and then
the system will use that position to digitally articulate those digital models now we do want to
capture those accurately if the patient's slightly open during the scan that certainly will throw off
the accuracy of the restoration for that area so again if they're slightly open your restoration is
going to come out high which would lead to more adjustments on your end so we want to make sure
that we can design the restorations in the most accurate way by knowing what the true occlusion
is for your patient now we have our digital model so we first want to ensure that on the quadrant
model of the prep in this case it's the lower and the quadrant model of the opposing that you have
a lot of data of the adjacent teeth of most of the teeth that you're scanning or around the area that
you're working on so that the system can visualize and match those same data points during the bite
registration scan so what that means is you have a lot of buccal information you want to also have at
least the buccal or the gingival margins on the buccal side because that's what the software is
going to use to create that alignment to this model during the buccal scan so we have that
on the lower all the way to the canine and we try to establish the same thing on the opposing scan
so here we have the upper right scan we have all the way to the last tooth number two and I like
to scan the entire quadrant to the cuspids or canines in this case to number six forward on
the mesial so we have a lot of information for the system to use to create that alignment so
now for the patient whenever we take the scan or whenever we establish the bite we want to first
ensure that they understand how to bite correctly because a lot of times what happens is the patient
may bite down on just the incisal edges toward the front edge to edge bite and that would leave the
posterior open or they're just slightly open so we want to practice that beforehand before we take
the skin so asking the patient of close together perfect and then making sure that you do have that
accurate centric position for the patient open again and bite together and bite with a little
bit of pressure and of course that's easier when the patient is more dentate but if there
are more in dental is it certainly be a little more challenging so you want to practice that
with the patient beforehand ensure that you can accurately create that position during the scan
because especially if they're even anesthetized that could also impact their sensation on whether
or not they're biting together correctly so it's important that we guide the patient and we can't
capture the skin in that correct position all right so let's go to the bytes section so you
can see on this scanner with the eye tarot when you we select bite we have a visualization of
the upper quadrant scan the lower quadrant scan and for this scan what it's going to do
is just merge those together so usually when the patient's biting together we may not have access
to that area so we'll first ask the patient to open go ahead and open all the way perfect and
then we position the scanner against the cheek and now bite all the way down together like we
did earlier so we get them back into that same position that we practice with and now I'll take
it a step further and now bite down with pressure so we ask the patient to bite down and just kind
of clinch together and that just allows the PDL to compress it really insures that we have the
teeth in the most centric position once they're in that position and the cameras in position now
I'll activate the camera so I activate the camera here with activation on the eye Tyrael is on the
scanner itself activate the camera and begin capturing information on the buccal surfaces
on both the upper and lower you can see once the software recognizes enough data from the upper and
lower teeth it just brings those together and I'll take some additional rotations actually I want to
try to actually capture some of the upper occlusal surfaces around those Custis just to give the
system even more data points to lock those models together because I scan from the posterior or we
try to capture from the posterior most posterior tooth to the cuspid on both the upper and low
even if we're working if the restorative prep is the most posterior last tooth by having more
data toward the mesial during this buccal scan it will allow the system to accurately bring those
together it just has more data points to reference so that's how we establish an accurate bite and
that should hopefully lead to a successful and great fitting restoration with minimal occlusal
adjustments thank you so much for that dr. Jean and if you missed any of the episodes in this
exciting series you can of course go to Jersey live.com pop some popcorn and binge watch all the
episodes to get the full scoop well I'm all well been watching I love it but for today's episode
we're all wrapped up so thank you so much for watching we'll meet you right back here next time
you