Learn how to use the T-Scan® system to remove occlusal interferences that may lead to an abfraction issue.

 

Excessive occlusal forces have long been reported to be a significant factor in decreased longevity of dental restorations, including Abfractions. Therefore, after Adhesive Restorative Dentistry, successful treatment requires Occlusal Adjustment Therapy.

 

How to use the T-Scan Novus to remove occlusal interferences:

Simply have the patient bite down on the T-Scan III's thin, high density, disposable sensor. The resulting Force Movie shows where and for how long the abfracted tooth is not disengaging from its opposing tooth during excursions (Disclusion Time).

A Disclusion Time of < .4 seconds insures lateral stresses are removed.

 

1. Pre-Treatment of interferences in excursion

a. Take a T-Scan excursive force movie and locate lateral interference(s). Enhance patient communication and treatment planning.

 

 

 

 

 

 

 

 

 

 

 

 

 

a. Use Accufim™ to mark areas of force and adjust.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Post-Treatment of interferences in excursion

 

a. Record a new excursive force movie to verify interference is gone.

 

 

 

 

 

 

 

 

b. This stops cyclic compressions onto the CEJ, arresting the abfractive process.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Without the T-Scan® would you know this faint "ink smudge" is the CR prematurity, with higher force than the larger mark to the right?

 

Complete Occlusal Assessment

Progressive dentists worldwide are using the

T-Scan Novus Computerized Occlusal Analysis system as part of overall dental evaluations. The T-Scan collects occlusal contact time and force data you can combine with periodontal charting, full mouth radiographic exams, and clinical hard tissue exams to provide a complete assessment of your patient's oral health.

 

Only T-Scan graphically illustrates both occlusal force and time.

Use the T-Scan to get a recording of occlusal contact data.

Just look at what you can find out in minutes with the T-Scan:

 

1. Manipulated Centric Relation bite recording - check for CR prematurities

 

 

 

These before and after frames from the T-Scan "force movies" are CR bite recordings. This allows you to check for CR prematurities and adjust until CR=CO.

The resulting "force movie" shows tooth contacts (shown above in 3-D view), where forces are identified by bar height and color.

 

 

 

 

 

 

 

 

 

 

2. MIP / Centric Occlusion recording - check for prematurities & unbalanced bite

 

 

 

Here we record a habitual closure into IP (Intercuspated Position) before and after adjustments (in 2-D view).

Notice how T-Scan's red "Center of Force" (COF) icon pinpoints the balance of occlusal forces. The BEFORE frame shows premature loading on the anterior right and overall excessive forces on the right side.

Adjust until your patient's COF is in the center of the arch, showing bilateral simultaneous loading with a well-balanced left-to-right bite (AFTER).

 

 

 

 

 

3. Lateral Excursion recording - check for interferences

 

The T-Scan makes it easy to see interferences, their locations, and their force levels. This takes the guesswork out of adjusting. Record again to verify if and when proper anterior guidance has been achieved.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

General Occlusion

The green bar on tooth 12 at first contact represents significant centric relation prematurity.

 

Problematic MIP closure in 2-D = forces off-center to right

Patient at IP (intercuspal position)

Before

Before

Before

After

After

After

CR prematurity removed; blue bars widely distributed indicate simultaneous initial contact

 

Healthy MIP closure = forces centered; straight path of closure

Moments later tall bars on teeth 3, 7 & 15 appear indicating interferences in excursion

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After adjustment, patient at IP

Moments later, the tall red bar on tooth 11 indicates canine guidance

Implant Occlusion

Ensure that implant prostheses load after the natural teeth make contact with T-Scan® Bite Analysis

 

Implant Preservation with Occlusal Analysis

 

It has been reported that excessive occlusal forces applied to implant prostheses may result in bone loss, uncementation,screw loosening, and material failure. As there is no periodontal ligament surrounding implants, they have no cushioning shock absorber to dampen occlusal forces.

 

Occlusal forces are a potentially destructive factor to implant prostheses.

The T-Scan III quantifies occlusal forces and allows for corrective treatment.

Don't finish an implant case without the T-Scan!

 

1. "Center of Force" - ensure a balanced bite

 

These BEFORE and AFTER frames from T-Scan "force movies'' show a patient biting into IP (Intercuspated Position).

Notice how the T-Scan's red "Center of Force" (COF) icon shows the exact location of the balance of occlusal forces. Adjust until your patient's COF icon is in the center of the arch, indicating superior left/right occlusal balance (AFTER).

This prevents bone loss, uncementation, screw loosening, and material failure.

 

 

 

 

 

 

 

2. "Excursive Force Movies"- eliminate traumatic interferences

 

Here is a left lateral excursion, before and after adjustments.

The BEFORE force movie quickly and accurately displays traumatic and potentially costly interferences (force represented by bar color and height).

After adjustments, the AFTER force movie enables you to be sure all lateral stresses are removed and canine guidance is achieved.

This promotes implant longevity, saving you time and money.

 

 

 

 

 

 

 

 

 

3. "Time Delay"- load implants last to protect them

 

This force movie shows how sequential loading of implants after natural teeth can be achieved with the

T-Scan. This prevents unecessary forces from causing implant failure.

This is because natural teeth depress 26-110 microns into the periodontal ligament, where as implants can only depress 5-25 microns

 

Try that with ink smudges!

Locating Painful Teeth with

T-Scan®

Which tooth is causing the discomfort? Find occlusally activated painful teeth using the T-Scan® NovusTM Technology

 

Occlusal Trauma: Case Report

 

After almost one year post insertion of ceramic crowns on tooth #s 14 and 15 (Figure above), tooth #14 remained painful to chew on since the day of its delivery. Over the year, the practitioner attempted a number of times to adjust this crown but couldn't isolate the contact that was the problem. Inspection of the figure above shows five contacts present on tooth #14 represented by five paper markings; the actual problem contact could not be determined from the paper marks.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A T-Scan recording was made of the patient clenching and grinding (figures 2a and b) revealed that spiking occurred on the MB contact of tooth #14.

 

 

 

 

 

Note that tooth #s 2 and 15 are very forceful, before and during, the recorded grinding motion. But those teeth are not sore or painful to the patient. As pointed out earlier, often the tooth that is sore is less force than other teeth nearby.

 

Post adjustment, the new T-Scan III recording illustrates that there is no more spiking up of the MB contact area to the highest forces (Figures 3a and b).

 

Conclusion

 

The T-Scan III System can aid the clinician in the isolation of painful teeth that are occlusally activated. By employing a "Clenching and Bruxing" recording that elicits the pain, and locating the spiking of forces within the force movie playback, it becomes simple to identify which contact is the problem contact. After corrective adjustments are accomplished, follow up Clenching and Bruxing recordings will reveal a removal of the spiking of force and noticeable pain relief for the patient.

Removable Prosthetics

"Take the Mystery out of Removable Prosthetics."

 

Without the periodontal ligaments of their natural teeth, edentulous patients lack normal proprioception and cannot "feel" prematurities or imbalance of their dentures during function. When treating patients without periodontal ligaments, progressive dentists do not take the patient's word when determining first tooth contact and occlusal force balance. The T-Scan III obtains the actual occlusal contact time and force balance data you can rely on, not the edentulous patient's perception.

 

1. Centric Occlusion Recording - check for prematurities

 

Quite often a premature occlusal contact creates a "sore spot" on the alveolar ridge under the denture base. Deflective occlusal contacts often result in shifting the denture base causing the flange to "dig into" the patient's edentulous ridge.

 

 

 

 

 

 

 

 

2. MIP/Centric Occlusion Recording - check for unbalanced bite

 

Unequal force balance is a major cause of denture instability/rocking while edentulous patients are chewing and swallowing. Uneven occlusal forces, for edentulous patients, result in unstable, "loose" dentures that often cause trauma to the alveolar ridges. In some cases the cause of fractured denture bases is due to unbalanced, disproportionate occlusal forces.

 

 

 

 

3. Occlusal Force over Time - check for irregularities

 

Uneven occlusion can cause a patient to have unequal bite forces that limit the consistency of their bite force. Note how the black line is not a smooth, constant line. This indicates a fluctuating bite force characteristic of weak muscles; the patient is having difficulty "finding their bite".

 

Pathological muscle conditions, lack of optimal muscle function; unevenness or a jagged black line is an indicator of tongue bracing, that is a symptom of a lack of optimal vertical dimension.

 

Notice how before rehabilitation, the patient has difficulty holding their teeth together with consistent pressure. Notice how after rehabilitation, the patient can hold consistent pressure throughout the ip/co recording.