Articulating Paper is Lying To Us – Measuring the Occlusion Digitally with Force and Time – PDP109

Articulating paper has been around for over a hundred years, and it's still the most common way we evaluate the way our patients' teeth touch or occlude. But there's so much we cannot tell by looking at those marks! We cannot tell which ones are higher force or low force, and we definitely cannot tell anything about the timing of contacts. In this episode with Dr. Robert Kerstein will enlighten you about the T-Scan! https://youtu.be/YsxjGGitJr8 Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: Classically on glazed ceramic, articulating paper marks will be difficult to show up. A little hack to overcome this is to get a tiny smear of vaseline on a micro-brush, paint the articulating paper and get the patient to bite together because the Vaseline has an effect on the articulating paper which allows it to stain or ink the teeth more effectively. In this episode Dr. Rob and I discussed: Traditional way of using articulating paper and its disadvantages 14:55T-scan in terms of occlusal adjustment 19:34T-scan in terms of differences in adaptive capacity 24:53Importance of patient’s feedback 28:58Treating patients with TMD through occlusal equilibration 35:45Dentists’ concern about the thickness of the T-scan 41:20Level of precision in diagnosing patients 46:50Why does T-scan seldom meantion on occlusal courses 54:18 All of the Protruserati clan get £200 OFF the T-Scan™ from Clark Dental with the code ‘protrusive‘! As promised in the episode, if you would like to read some studies/evidence base for the T Scan click here. Click here to email Dr. Rob Kerstein If you enjoyed this episode, check out Philosophy of Functional Occlusion with Riaz Yar Click below for full episode transcript: Opening Snippet: Articulating paper marks are lying to you. Now just think about it for a second, right? When you stick some articulating paper in, and you get the patient to bite together, you often get false positives. So you get these red or blue marks in areas where the teeth aren't actually touching. And you also get false negatives, areas of teeth which actually touching and you don't see a mark and I'll tell you in my Protrusive Pearl later on how to overcome that when it comes to ceramic, glazed ceramic sometimes doesn't pick up the articulating paper ink, and therefore I'll share with you a little tip on how to make it appear... Jaz's Introduction:I just want to just elaborate on this point a little bit. When we see articulating paper marks, we see small dots we see big dots. We kind of have different beliefs if you ask different dentists some will say oh, it's the bigger marks that mean that there's more force, whereas other people think No no smaller marks because pressure is force over area therefore, a smaller mark often means higher pressure. The reality of it is, is that this has been studied, and we cannot tell by looking at articulating paper marks, which ones are higher force or low force, and we definitely cannot tell which teeth are hitting first before they eventually, more or less come together. We don't know anything about the timing of those contacts, which is what this episode is all about. Hello, Protruserati I'm Jaz Gulati. Now, let me elaborate on that a little bit more still. When we're dealing with single tooth dentistry, this really isn't so important because you're just working on one tooth. And how important is that one tooth-like to be in the grand scheme of the entire occlusion of the patient. In most patients, you can get away with a lot, you know, our patients are great at adapting. But when you have an arch of temporaries, or multiple units, let's say five or six units, and you want to be able to make sure that the patient's occlusion is comfortable, and that no one restoration is taking too much load. We're relying on this articulating paper ink, but you don't know where to adjust.