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14 | cerecdoctors.com | quarter 4 | 2013
the teeth should contact, but have no
penetration
• Accurate articulation of the upper and
lower jaws
• Jaw boundaries provided by average
articulation values (Fig. 1)
• Accurate occlusal plane
There has been ample research and
literature supporting the notion that the
smaller the vertical dimensionatwhichan
interocclusal record is taken, the smaller
the error in the relationship between
the two arches. When doing traditional
dentistry, thiswas always a concern.What
material and method would produce the
i have been on my cad/cam journey
withCEREC for just over 10 years. During
that time, there have been some extremely
exciting and groundbreaking innova-
tions.We have beenwitness tonewdesign
capabilities, new software interfaces, new
milling units, a couple new cameras and
even the elimination of powder with the
revolutionary Omnicam.
While these are all features that truly
changed the face of CAD/CAMdentistry,
two years really stand out for me: 2003
and 2009. In 2003 came the introduc-
tion of the 3-D software. This allowed
the user to create three-dimensional
images of teeth and made the design
process more intuitive than ever before.
In 2009 came the introduction of
the buccal bite. Prior to that time,
creating and identifying a static rela-
tionship between the teeth in MIP
(maximum intercuspation) was done
by the method of scanning bite registra-
tion. Having the ability to scan the MIP
relationship directly in the mouth
created a real framework to create excel-
lent occlusion. Both of these features also
laid the groundwork for the introduction
of Virtual Articulation in CEREC V4.2.
Articulators can be generalized into
three categories: average value articu-
lators, semi-adjustable articulators,
and fully adjustable articulators. When
trying to digitally reconstruct dynamic
occlusion, average value articulation
will make the most sense and create the
most predictable results. To accomplish
this we need a few things:
• Sufficientremainingtooth
structure on both the
upper and lower arches;
Virtual Articulation
With CEREC V4.2
The Next Level of Designing Restoration Occlusion
c a s e s t u d y | | | b y M i k e S k r a m s ta d , D . D . S .
most accurate, repeatable record? With
the advent of the buccal bite digital regis-
tration, these concerns are now reduced
substantially, and it is possible to take the
bite record in MIP (the lowest possible
vertical dimension [Fig. 2]).
This, inturn, allowsus toaccuratelyvisu-
alize the contact points between teeth in a
static position (Fig. 3). When the software
has accurate tooth contacts, mathematical
algorithms can be created to automate
functionally generated paths (FGP). That
is, the softwarewill be able to reproduce all
the different ranges of contactmovements.
Another critical aspect of creating an
average value articulator is establishing
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