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  4. Accuracy of Cast Articulation: A Literature Review

In addition, an interested person can complete an apprenticeship program that lasts for five years. After the apprenticeship or associate degree has been finished, the person will need to pass an exam that is administered by the National Board for Certification in Dental Laboratory Technology. CDTs can retain certification if they apply to the NBC every year for renewal and prove they have complied with the local laws governing their work and undergone continuing technical education.

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They are also required to pay a renewal fee. It is in NADL best interests to protect the patients' health and assure their restorations are safe for use. To fulfill this objective, NADL has supported federal and state regulations since and has worked close with the U. It has also developed regulatory guidelines aimed to be a basic standard of regulation. Although its main objective is to benefit the general public it is also intended to be effective for the dental technicians and the dental industry. In this sense, the Association intends that the source of dental devices be disclosed to the patient.

Creating Individual-Looking Teeth On A Full-Arch Bridge - Dental Lab Learning

NADL has expressed its support to establish mandatory certification and continuing education for dental technicians dedicated to restoration manufacture; mandatory registration of all dental laboratories with the competent authority; mandatory documentation of those materials used in any restoration and their point of origin; as well as mandatory documentation of the mentioned items in the patient's dental records.

In their Guidelines for Establishing Statutory Regulation, NADL has noted that certification is a way to recognize individuals who have met established qualifications, therefore, they should be the only ones legally acknowledged to use the designated title. The GDC is an organisation which regulates all dentists and dental care professionals, they set and maintain standards in UK dentistry. The GDC ensures that dental professionals have the necessary qualifications and are trained to the necessary levels. Dental technicians must prove their knowledge is up-to-date by taking part in Continuing Professional Development CPD.

From Wikipedia, the free encyclopedia. The examples and perspective in this article deal primarily with the United States and do not represent a worldwide view of the subject. You may improve this article , discuss the issue on the talk page , or create a new article , as appropriate. Zirconia, conventional porcelain-to-metal, and traditional gold and other all-metal crowns block x-ray radiation, disallowing evaluation over time.

Crowns and bridges require an extremely precise fit on tooth abutments or stumps. Some systems are designed to attain higher standards of accuracy than others and some users are more skilled than others. It is estimated that 20 new systems are expected to become available in the next five years. From Wikipedia, the free encyclopedia.

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Cochrane Database of Systematic Reviews. Archived from the original on September 29, Retrieved March 20, May British Dental Journal. January Dent Mater Journal. May 29, Several different experiments have found that all tested recording materials have one or more major shortcomings that may affect the accuracy of registration. Fattore et al. Freilich et al. However, it has been reported that plaster is difficult to handle in the mouth and the final interocclusal record is brittle.

Differences in the interocclusal record materials studied and the study designs lead to difficulty in directly comparing the dimensional accuracy and stability between the materials.

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Thus, depending on the clinical situation, the knowledgeable practitioner can compensate for many of shortcomings while taking advantage of the more desirable characteristics to accomplish highly accurate outcome. In a trial carried out by Breeding et al. It was found that the use of the addition silicone generated significantly fewer mounting errors than those generated by the acrylic resins and thermoplastic resins. The findings of this study were supported by several studies conducted in the past few decades. Different materials have been suggested to be used in various clinical scenarios.

Elastomeric materials such as vinyl polysiloxanes and polyethers are well suited for making interocclusal records where only horizontal stability is needed as they allow the patient to be guided into maximum intercuspation at the existing vertical dimension of occlusion VDO without mandibular deflection. The authors highlighted that unlike records made from elastomeric materials, records made from rigid materials such as waxes, resins, pastes, and plasters should not be placed between teeth that have opposing tooth contacts because this could easily result in the inadvertent increase of the VDO or lateral displacement of the mandible.

Additionally, many of these materials are fragile in thin section and may break when handled. It has been suggested that when a rigid material is used to make an existing tripod record, space for the record should be available between prepared teeth and their antagonists or between teeth without interocclusal contacts. Techniques: Interocclusal record material is not the only factor that influences the accuracy of bite registration.

Several investigations have also found that recording technique is another primary cause of errors. Even though studies done in this field have not agreed upon one method to be used in all clinical scenarios, it is generally accepted that hand articulation of casts with stable interocclusal contacts has been considered more accurate than the use of a recording medium during mounting of working casts.

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While registering the bite in dentate cases, the interocclusal separation should be kept as small as possible. This is because, otherwise, the bite will be registered at increased vertical dimension. Many other skills have been described in the literature to improve the accuracy while registering the bite. According to Freilich et al. Also, it allows the practitioner to visualize the extent to which the casts seat into the record. Taken together, all investigations carried out in bite registration revealed that there is neither one ideal method nor material.

The most important part in this vital step is what Steele et al.


According to this study, the fundamental requirement is to obtain enough detail in a dimensionally stable recording material to enable casts to be confidently located in the laboratory whilst not recording so much detail that it stops the casts seating. Models pouring: Pouring accurate dental casts is a critical phase to be considered by the dental team when a perfect outcome is desired. Christensen [ 5 ] has shown that it is likely that pouring models with dental stone instead of plaster is a key role to achieve an accurate cast as dental stone provides strength and high wear resistance.

Facebow: Facebow orientation errors are common in many dental clinics. Accurate location of the hinge axis helps to orientate the maxillary cast on the articulator. Clark et al. Literature has reported some factors that are possibly the source of incorrect maxillary cast alignment.

According to Ferrario et al. Non-adjustable articulator: Literature has revealed that nonadjustable articulator can only duplicate maximum intercuspation position with acceptable amount of accuracy and reproducibility.

Accuracy of Cast Articulation: A Literature Review

Semi-adjustable articulator: Using semi-adjustable articulator is beneficial when fabricating multiple restorations that need appropriate guidance, increasing vertical dimension of occlusion, controlled occlusal contacts, or removing the interferences. This potentially helps to reduce the chair-side time and the total cost involved. Fully adjustable articulator: Fully adjustable articulator has been suggested to be used when clinician works on full mouth rehabilitation case that needs dental prosthesis with highly predictable outcomes.

Conflicting opinions have been written in the literature on what kind of dental articulator the dentist should use in different cases scenario.

Semi-adjustable articulator is probably the most appropriate type of dental articulators that could suit most of the daily restorative cases. On the other hand, even though there are studies have not suggested using non-adjustable hinge articulator to fabricate accurate restorations, [ 28 , 30 ] some other researchers have found that this kind of articulators might be used but with caution as many major limitations are associated with using such articulators.

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  5. This could be appropriate if single crown is needed to be fabricated for a patient who has a stable occlusion. Many advantages have been described in the literature for using the articulators that are claimed to be interchangeable. However, some studies have shown that the clinician should understand that no two articulators are exactly the same and that it may be wise to use only one articulator. Hatzi et al.