Summary

The success of a dental prosthesis pivots on its harmony with the jaw movements. Dentists strive to create a prosthesis that seamlessly blends with the chewing patterns, adjacent teeth/gums and the tongue. Digital bite registration devices are one such tool used in restorative dentistry that reduces chairside time, minimizes corrections during trials, and guarantees a happy patient. Bite registration devices have undergone a paradigm shift over the past decade. With digital technology in place, registering jaw movements is more precise today than ever before.

Dental Bite Registration Devices-A Knowhow

Oral and maxillofacial prosthetic rehabilitation includes replacing form, function and aesthetics, in harmony with the hard and soft tissues of the jaws. A series of steps are involved in this process; impression making (measurements), maxillofacial records (recording the bite), laboratory procedures, trials, final prosthesis placement and chairside adjustments.

Though the dental technicians do the heavy lifting, the success of the prosthesis depends on the accuracy of the bite registration.

Occlusion (the relationship of the upper and lower jaws) includes both static and dynamic aspects. The occlusal form of a prosthesis depends on morphology of the antagonist teeth, adjacent teeth, and the centric and eccentric movements of the jaws. It is important to make these records correctly before transferring them to the laboratory for manufacturing.

Traditional methods used to record the maxillomandibular relationship in centric positions included graphical methods, functional recordings, cephalometric techniques, direct interocclusal records, Lucia jig, leaf gage technique, and the Kois deprogrammer (KD) method. (1) However, digital methods have helped us record maxillomandibular relationship in both, the static and dynamic forms. This allows us to visualise the jaw movements in 3D. It ensures accuracy, an assessment of the real-time functioning of the prosthesis and comfortable jaw movements.

The result?

“ A final prosthetic trial without any occlusal adjustments  – a dream come true.”

The Uses of Digital Bite Registration Devices

Bite registration devices together with digital devices have introduced the concept of ‘digital occlusion analysis’.

Digital occlusion analysis helps construct the bite record on a virtual articulator (the device used to establish the relationship between upper and lower jaws), read quantifiable data about the occlusal forces – timing, pattern and distribution of forces and make occlusal adjustments in real-time as required.

Treatment planning.

Bite analysis is used to proactively plan the treatment. This will avoid unnecessary complications, prolonged appointments, multiple repetitions, and uncomfortable prostheses.

Patient orientation and satisfaction

Visual data from the digital scans helps the dentist to explain to the patients about their present issues with the bite, the reason for jaw pains, unhealthy chewing patterns and more. It ensures that the patient understands his oral status, the urgency of the treatment and co-operates at all stages. There are different methods to acquire the data digitally from the bite registration device and transfer it accurately to the manufacturing units (CAD-CAM units).

These include :

• Intraoral scanners (IOSs)

• Jaw movement tracking devices

• Occlusal analysis systems.2

Let us go through some of the digital bite registration devices that have been a game changer for Prosthodontics in the dental industry.

Intraoral scanners for recording bite

Intraoral scanners use light to obtain the data and hence optical properties of the surrounding environment play an important role. Popularly used intraoral scanners that help in recording digital bite along with impressions include Trios Health3 shape, Medit i500 and PrimaScan, Dentsply Sirona. These scanners register the static bite with teeth in occlusion. Usually, two bite records are made (right & left) and the software helps in generating an automatic bite record of the whole jaw. In cases of severe malalignment, missing posterior teeth, very few teeth contact points, etc. manual alignment is required.

Jaw tracking devices:

Motion tracking devices are useful in registering the dynamics of the jaw. Integrating this data with digital scans and the CAD software, allows a real time understanding of the jaw movements. Ultrasonic devices, like Jaw Motion Analyzer (JMA) by Zebris Company, ARCUSdigma II by KaVo, or Axioquick Recorder by SAM Präzisionstechnik, employ ultrasonic sensors to track jaw movements in 3D, providing real-time data on jaw positioning. Another prominent name in the industry is the Bite Finder.

Modjaw allows 4D analysis, capturing dynamic sequences of jaw movements, with optical sensors and advanced algorithms of dental AI.

Cyclops is another fairly newer device based on photometric data collection. 3

Occlusal analysis systems:

T Scan by Tekscantwo, has been a famous player of the bite registration market since 1984. It highlights the precise location of biting forces, its pattern and timing. T-scan has been upgraded and modified over the years to make it more user friendly and digitally adaptable. The two latest software updates are – T Scan Novus and T Scan Novus core, which are efficient in identifying premature interferences, heavy forces, discrepancies in bite etc.

From a Prosthodontists point of view, T scans have made life quite easy specially while correcting bites in eccentric movements. It’s critical to be able to visually demonstrate to the patients the problems with their bites and correct it at same time.

Integration of these three aspects can help achieve maximum accuracy  without any subjective evaluations and guesswork. These systems can be streamlined with CAD CAM technology to become a part of routine dentistry.

Applications of Bite Registration Devices in Other Fields of Dentistry

• Digital occlusion analysis enables orthodontists to assess occlusion pre and post procedures, with accuracy. It helps track tooth movements over time and allows precise adjustments of orthodontic appliances.
• Crucial for diagnosing dental conditions such as: Malocclusion (improper teeth alignment), Bruxism (teeth grinding), Temporomandibular Joint Dysfunction (TMJD) and facilitates early detection of occlusion-related issues.

Takeaway

Occlusion has always been a complicated part of dental treatment planning and introducing devices that can help visualise it in real time can be a game changer. It reduces chairside time, and frequency of appointments and trials and offers long-lasting and compatible restorations.

Digital advancements in bite registration devices have transformed the face of accurate and efficient dentistry. However, dentists often find it hard to learn, adapt and adopt these devices into their practices.  Moreover, there is always a cost factor and comfort level associated with embracing new dental devices.

This highlights the role of dental device manufacturers and researchers in integrating the practical needs of dentists while conceptualizing a ‘bite recording device’.

Awareness and training in this field should be the starting points of the dental device industry; companies must also strive to make digital devices more accessible to every dentist by orienting them to the long-term benefits. Explore the Different Digital Applications in Prosthetic Dentistry with the NamNR Pro – Global Dentists’ Pool comprised of experienced dental specialists who contribute to the development, marketing, and training of digital tools and advanced biomaterials used in prosthetic dentistry.

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For dentists –

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References:

1.Revilla-León M, Fernández-Estevan L, Barmak AB, et al. Accuracy of the maxillomandibular relationship at centric relation position recorded by using 3 different intraoral scanners with or without an optical jaw tracking system: an in vivo pilot study. J Dent. 2023;104478.

2. Revilla-León M, Kois DE, Zeitler JM, Att W, Kois JC. An overview of the digital occlusion technologies: Intraoral scanners, jaw tracking systems, and computerized occlusal analysis devices. J Esthet Restor Dent. 2023 Jul;35(5):735-744. 3. Valenti, C., Massironi, D., Truffarelli, T., Grande, F., Catapano, S., Eramo, S., Tribbiani, G., & Pagano, S. (2024). Accuracy of a new photometric jaw tracking system in the frontal plane at different recording distances: an in-vitro study. Journal of Dentistry, 105245.

Disclaimers

The opinions expressed in this article are the author’s own and are not necessarily shared by NamNR Pro.

Author’s Profile:

Dr Alpa Newaskar

Dr Alpa Newaskar is a practicing oral and maxillofacial prosthodontist and implantologist; she is a celebrated aesthetic dentist specializing in TMJ management. Her captivating paper & poster presentations at global dental conferences have been instrumental in shaping her profile as a dental clinician and educator. As a dental education enthusiast, she offers her clinical experiences and ideas to train professionals in dental companies, helping them drive innovation in this healthcare niche.