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UPPLANDS VÄSBY, Sweden: Occlusal adjustment is usually a time-consuming process and a very critical phase in restorative dentistry. However, most dentists do not dedicate adequate attention to this process. A recent study showed that around 95% of occlusal readings are incorrect. Misreading results in the dentist removing structure from different occlusal areas, possibly leading to occlusal disturbance.
In crown delivery, any undetected high occlusal point can have a range of negative consequences, such as minor cracks in the crown, temporomandibular joint pain and sometimes failure of the implant in a case of a crown seated on an implant. In some situations, minor errors may self-adjust, but this is not always the case.
Despite the introduction of computerised occlusal analysis devices, articulating paper remains the most common means of checking occlusion. The sensitivity and reliability of the techniques applied for occlusal analysis when using articulating paper depend on its thickness, composition, ink substrate and plastic deformation. The oral environment—characterised by saliva and humidity—also plays an important role. Another factor that affects readings when using articulating paper is the restorative material used. Conventionally, the material used in fixed and removable prosthodontics is metal, composite, porcelain fused to metal, veneered zirconia or acrylic resin, and full-contour zirconia, either polished manually or glazed in a furnace, is a recent introduction. This material can affect the interpretation of the articulating paper marks.
To meet these challenges, the Swedish occlusion foil TrollFoil is the best ally of any dentist. This extremely precise double-sided articulation foil can be used in a wide variety of clinical situations, including wet or dry teeth, limited opening, limited vestibular space, patients with an excessive gag reflex, and restorations in any material, even those with highly polished surfaces such as zirconia and IPS e.max (Ivoclar Vivadent). TrollFoil is mounted on a rigid plastic frame that keeps it stretched and straight, enabling the operator to hold it without the help of forceps.
Older studies published in the Journal of Prosthetic Dentistry and Bio-Medical Materials and Engineering showed that the thinner the articulating paper, the more precise are the marks obtained. Thick articulating paper generates a less uniform and larger contact area than the occlusal area marked with thin articulating foil. This is why TrollFoil measures only 8 μ and is now also available in a new 4.5 μ version—the thinnest foil available. It proves especially useful when checking the occlusion on implants that have a very smooth and shiny surface.
More information can be found here. TrollDental is part of DirectaDentalGroup.