ЭКСПЕРИМЕНТАЛЬНО-МАТЕМАТИЧЕСКОЕ ОБОСНОВАНИЕ ПРИМЕНЕНИЯ ЦИФРОВЫХ ТЕХНОЛОГИЙ ДЛЯ РЕГИСТРАЦИИ ПОЛОЖЕНИЯ НИЖНЕЙ ЧЕЛЮСТИ ПРИ ТОТАЛЬНОМ ПРОТЕЗИРОВАНИИ С ИСПОЛЬЗОВАНИЕМ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ

Abstract

Subject. When prosthetics of toothless jaws are performed, the physiological position of the lower jaw must be determined before the final structures are made. In some cases, the use of temporary prostheses for several weeks may be useful to check for a new occlusion in a centric relationship. When the correct ratio is achieved, it is difficult to transfer them from the preliminary prostheses to the final ones. This article presents a case and a technique used to communicate information about the position of the lower jaw using a digital workflow.
 To determine the optimal position of the lower jaw, a computer tomogram of the temporomandibular joint was used to mathematically measure the correct position of the head of the lower jaw.
 Purpose. To describe a technique designed to transfer the inter-occlusal relations of the upper and lower jaws, using digital technologies in the prosthetics of full adentia using dental implants.
 Methodology. On the example of a clinical case of rehabilitation of a patient, total removal of failed teeth was performed, followed by prosthetics of complete adentia with the installation of six implants on the upper and lower jaws. After the completion of the integration period, a cone-beam computed tomography was performed with the capture of the temporomandibular joint, and a scan of plaster models with installed gum shapers was performed. The obtained data were compared in a specialized program for mathematical calculation of the optimal position of the lower jaw. This information was used to produce registration templates for the manufacture of fixed structures supported by implants in the resulting central jaw ratio.
 Results. A digital protocol for determining the central ratio of the jaws allowed us to transfer the information obtained in a virtual model of the temporomandibular joint to a permanent restoration based on implants.
 Conclusion. The approach described in this article predictably conveys information about the optimal position of the lower jaw during prosthetics and allows you to perform the final restoration on implants with optimal occlusal ratios, based on a mathematical calculation performed in specialized programs.