頜位關(guān)系的轉(zhuǎn)移教材課件

轉(zhuǎn)移頜位關(guān)系的內(nèi)容（一）牙合架（二）面弓（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度（五）確定側(cè)方髁導(dǎo)斜度（六）確定切導(dǎo)斜度轉(zhuǎn)移頜位關(guān)系的內(nèi)容（一）牙合架（二）面弓（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度（五）確定側(cè)方髁導(dǎo)斜度（六）確定切導(dǎo)斜度牙合架的定義Articulator:amechanicalinstrumentthatrepresentsthetemporomandibularjointsandjaws,towhichmaxillaryandmandibularcastsmaybeattachedtosimulatesomeorallmandibularmovements——GlossaryofProsthodonticTerms,8thedition牙合架的分類（1）簡單牙合架（simplearticulator）（2）平均值牙合架（average-valuearticulator）（3）半可調(diào)牙合架（semi-adjustablearticulator)（4）全可調(diào)牙合架（fully-adjustablearticulator）（1）簡單牙合架（simplearticulator）

僅能保持上下模型的位置，并以穿釘為軸作上下開閉運動。asimpleholdinginstrumentcapableofacceptingasinglestaticregistration;verticalmotionispossible.——

nonadjustablearticulator,ClassI（1）簡單牙合架（simplearticulator）PlanelineorSimpleHingearticulator（2）平均值牙合架（average-valuearticulator)

將平均值作為髁導(dǎo)斜度，可一定程度模擬下頜前伸和側(cè)方運動。

aninstrumentthat

permitshorizontalaswellasverticalmotionbutdoesnotorient

themotiontothe

temporo-mandibularjoints.——ClassIIArticulator（四）確定前伸髁導(dǎo)斜度確定前伸髁導(dǎo)斜度的注意事項調(diào)拌石膏固定上頜模型于上架環(huán)能較為逼真的模擬下頜運動；arbitraryfacebow（四）確定前伸髁導(dǎo)斜度（三）轉(zhuǎn)移頜位關(guān)系的方法將面弓及牙合托從口內(nèi)取出aninstrumentthatwillacceptthreedimensionaldynamicregistrations;theseinstrumentsallowfororientationofthecaststothetemporomandibularjointsandsimulationofmandibularmovements.（4）全可調(diào)牙合架（fully-adjustablearticulator)Acaliper-likeinstrumentusedtorecordthespatialrelationshipofthemaxillaryarchtosomeanatomicreferencepointorpointsandthentransferthisrelationshiptoanarticulator;Aninstrumentthatindexestotheexternalauditorymeatusandregisterstherelationofthemaxillarydentalarchtotheexternalauditorymeatusandahorizontalreferenceplane.arbitraryfacebow（2）平均值牙合架（average-valuearticulator）Acaliper-likeinstrumentusedtorecordthespatialrelationshipofthemaxillaryarchtosomeanatomicreferencepointorpointsandthentransferthisrelationshiptoanarticulator;（三）轉(zhuǎn)移頜位關(guān)系的方法arbitraryfacebow（3）半可調(diào)牙合架（semi-adjustablearticulator)（1）簡單牙合架（simplearticulator）arbitraryfacebow（3）半可調(diào)牙合架（semi-adjustablearticulator)

可調(diào)節(jié)前伸髁導(dǎo)斜度、側(cè)方髁導(dǎo)斜度。能在很大程度上模擬患者的下頜前伸及側(cè)方運動。需用面弓轉(zhuǎn)移患者上頜對顳下頜關(guān)節(jié)的固有位置關(guān)系。（3）半可調(diào)牙合架（semi-adjustablearticulator)——ClassIIIArticulator

aninstrumentthatsimulatescondylarpathwaysbyusingaveragesormechanicalequivalentsforallorpartofthemotion;theseinstrumentsallowfororientationofthecastsrelativetothejoints.（3）半可調(diào)牙合架（semi-adjustablearticulator)簡單牙合架半可調(diào)牙合架（3）半可調(diào)牙合架（semi-adjustablearticulator)HanauH2型半可調(diào)牙合架（3）半可調(diào)牙合架（semi-adjustablearticulator)上頜體

上頜骨

下頜體

下頜骨

側(cè)柱

下頜升支

髁球、髁槽

髁突、關(guān)節(jié)凹

髁桿

左右髁突間的假想聯(lián)線

髁桿外端

與髁突相應(yīng)的面部皮膚表面

髁導(dǎo)(髁球在髁槽內(nèi)滑動的路線)髁道(髁突在關(guān)節(jié)內(nèi)運動的路線)髁導(dǎo)斜度(髁槽與水平面間的角度)髁道斜度(髁道與眶耳平面間的角度)切導(dǎo)(切導(dǎo)針在切導(dǎo)盤內(nèi)滑行的路線)切道(下領(lǐng)前伸側(cè)向運動時，下切牙切緣運動的路線)

切導(dǎo)斜度(切導(dǎo)盤與水平面間的夾角)切道斜度(切道與眶耳平面間的交角)（3）半可調(diào)牙合架（semi-adjustablearticulator)B.簡單牙合架A.半可調(diào)牙合架（3）半可調(diào)牙合架（semi-adjustablearticulator)arconarticulatornon-arconarticulatorarticulatorcondylearconusedtodescribeanarticulatorcontainingthecondylarpathelementswithinitsuppermemberandthecondylarelementswithinthelowermember.——GPT,8theditionArcon型牙合架(ArtexAP)Non-Arcon型牙合架(ArtexTK)（3）半可調(diào)牙合架（semi-adjustablearticulator)（3）半可調(diào)牙合架（semi-adjustablearticulator)Hanau"Teledyne"Articulator,1975（3）半可調(diào)牙合架（semi-adjustablearticulator)Hanau"Teledyne"Articulator,1975（3）半可調(diào)牙合架（semi-adjustablearticulator)Hanau"Teledyne"Articulator,1975（3）半可調(diào)牙合架（semi-adjustablearticulator)Hanau"Teledyne"Articulator,1975（3）半可調(diào)牙合架（semi-adjustablearticulator)arconarticulator（3）半可調(diào)牙合架（semi-adjustablearticulator)non-arconarticulator（4）全可調(diào)牙合架（fully-adjustablearticulator)Acaliper-likeinstrumentusedtorecordthespatialrelationshipofthemaxillaryarchtosomeanatomicreferencepointorpointsandthentransferthisrelationshiptoanarticulator;arbitraryfacebowNEYArticulator，19644、固定面弓于人體上kinematicfacebowfacebow，又叫hingebow，一種將患者上頜對顳下頜關(guān)節(jié)的位置關(guān)系轉(zhuǎn)移至牙合架上的工具。與之相關(guān)的切導(dǎo)斜度多由醫(yī)師確定，其范圍為0-15°（五）確定側(cè)方髁導(dǎo)斜度調(diào)拌石膏固定上頜模型于上架環(huán)Non-Arcon型牙合架(ArtexTK)（四）確定前伸髁導(dǎo)斜度離牙合平面平面約2mm（五）確定側(cè)方髁導(dǎo)斜度（3）半可調(diào)牙合架（semi-adjustablearticulator)確定前伸髁導(dǎo)斜度依據(jù)

Christensen’sphenomenonaninstrumentthatwillacceptthreedimensionaldynamicregistrations;theseinstrumentsallowfororientationofthecaststothetemporomandibularjointsandsimulationofmandibularmovements.（4）全可調(diào)牙合架（fully-adjustablearticulator)asimpleholdinginstrumentcapableofacceptingasinglestaticregistration;verticalmotionispossible.能較為逼真的模擬下頜運動；Arcon型牙合架(ArtexAP)（4）全可調(diào)牙合架（fully-adjustablearticulator)可將患者所有的頜位參數(shù)轉(zhuǎn)移到牙合架；能較為逼真的模擬下頜運動；適用于全口咬合重建和科研。

aninstrumentthatwillacceptthreedimensionaldynamicregistrations;theseinstrumentsallowfororientationofthecaststothetemporomandibularjointsandsimulationofmandibularmovements.——ClassIV（4）全可調(diào)牙合架（fully-adjustablearticulator)Arcon型牙合架(ArtexAR)Non-Arcon型牙合架(ArtexTR)（4）全可調(diào)牙合架（fully-adjustablearticulator)NEYArticulator，1964NEYArticulator，1964（4）全可調(diào)牙合架（fully-adjustablearticulator)（4）全可調(diào)牙合架（fully-adjustablearticulator)NEYArticulator，1964NEYArticulator，1964（4）全可調(diào)牙合架（fully-adjustablearticulator)其他一些牙合架（*&#$@!articulators)（4）全可調(diào)牙合架（fully-adjustablearticulator)（1）簡單牙合架（simplearticulator）（三）轉(zhuǎn)移頜位關(guān)系的方法切導(dǎo)(切導(dǎo)針在切導(dǎo)盤內(nèi)滑行的路線)（五）確定側(cè)方髁導(dǎo)斜度（4）全可調(diào)牙合架（fully-adjustablearticulator)aninstrumentthatwillacceptthreedimensionaldynamicregistrations;theseinstrumentsallowfororientationofthecaststothetemporomandibularjointsandsimulationofmandibularmovements.——ChristensenC.調(diào)拌石膏固定上頜模型于上架環(huán)asimpleholdinginstrumentcapableofacceptingasinglestaticregistration;verticalmotionispossible.側(cè)方髁導(dǎo)斜度定于15度能較為逼真的模擬下頜運動；（五）確定側(cè)方髁導(dǎo)斜度asimpleholdinginstrumentcapableofacceptingasinglestaticregistration;verticalmotionispossible.Acaliper-likeinstrumentusedtorecordthespatialrelationshipofthemaxillaryarchtosomeanatomicreferencepointorpointsandthentransferthisrelationshiptoanarticulator;asimpleholdinginstrumentcapableofacceptingasinglestaticregistration;verticalmotionispossible.可將患者所有的頜位參數(shù)轉(zhuǎn)移到牙合架；Aninstrumentthatindexestotheexternalauditorymeatusandregisterstherelationofthemaxillarydentalarchtotheexternalauditorymeatusandahorizontalreferenceplane.左右髁突間的假想聯(lián)線Non-Arcon型牙合架(ArtexTK)轉(zhuǎn)移頜位關(guān)系的內(nèi)容（一）牙合架（二）面弓（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度（五）確定側(cè)方髁導(dǎo)斜度（六）確定切導(dǎo)斜度面弓facebow

facebow，又叫hingebow，一種將患者上頜對顳下頜關(guān)節(jié)的位置關(guān)系轉(zhuǎn)移至牙合架上的工具。面弓facebowAcaliper-likeinstrumentusedtorecordthespatialrelationshipofthemaxillaryarchtosomeanatomicreferencepointorpointsandthentransferthisrelationshiptoanarticulator;面弓facebowItorientsthedentalcastinthesamerelationshiptotheopeningaxisofthearticulator.面弓facebowCustomarilytheanatomicreferencesarethemandibularcondylestransversehorizontalaxisandoneotherselectedanteriorpoint.面弓facebowarbitraryfacebowkinematicfacebow（3）半可調(diào)牙合架（semi-adjustablearticulator)5、固定面弓于牙合架上前伸約6mm，不能太多可調(diào)節(jié)前伸髁導(dǎo)斜度、側(cè)方髁導(dǎo)斜度。離牙合平面平面約2mm（3）半可調(diào)牙合架（semi-adjustablearticulator)（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度切導(dǎo)(切導(dǎo)針在切導(dǎo)盤內(nèi)滑行的路線)（四）確定前伸髁導(dǎo)斜度僅能保持上下模型的位置，并以穿釘為軸作上下開閉運動。能較為逼真的模擬下頜運動；kinematicfacebow（五）確定側(cè)方髁導(dǎo)斜度Aninstrumentthatindexestotheexternalauditorymeatusandregisterstherelationofthemaxillarydentalarchtotheexternalauditorymeatusandahorizontalreferenceplane.（四）確定前伸髁導(dǎo)斜度（三）轉(zhuǎn)移頜位關(guān)系的方法arbitraryfacebow（4）全可調(diào)牙合架（fully-adjustablearticulator)asimpleholdinginstrumentcapableofacceptingasinglestaticregistration;verticalmotionispossible.arbitraryfacebowAninstrumentthatindexestotheexternalauditorymeatusandregisterstherelationofthemaxillarydentalarchtotheexternalauditorymeatusandahorizontalreferenceplane.arbitraryfacebowsimplefacebow,earpiecefacebow,earbow…arbitraryfacebow外耳道至髁突中心的平均距離為10-13mmarbitraryfacebowarbitraryfacebowarbitraryfacebowarbitraryfacebowarbitraryfacebowarbitraryfacebowarbitraryfacebowarbitraryfacebow（三）轉(zhuǎn)移頜位關(guān)系的方法僅能保持上下模型的位置，并以穿釘為軸作上下開閉運動。eponymforthespacethatoccursbetweenopposingocclusalsurfacesduringmandibularprotrusionDentalCosmos,1905;47:1184-95.調(diào)拌石膏固定上頜模型于上架環(huán)——ClassIIIArticulator可調(diào)節(jié)前伸髁導(dǎo)斜度、側(cè)方髁導(dǎo)斜度。Non-Arcon型牙合架(ArtexTK)（三）轉(zhuǎn)移頜位關(guān)系的方法NEYArticulator，1964切導(dǎo)斜度(切導(dǎo)盤與水平面間的夾角)（3）半可調(diào)牙合架（semi-adjustablearticulator)（1）簡單牙合架（simplearticulator）（2）平均值牙合架（average-valuearticulator）Outerarmisattachedtomandibularteetharbitraryfacebowkinematicfacebowarbitraryfacebow切導(dǎo)(切導(dǎo)針在切導(dǎo)盤內(nèi)滑行的路線)arbitraryfacebowkinematicfacebowAninstrumentthatindexestotheexternalauditorymeatusandregisterstherelationofthemaxillarydentalarchtotheexternalauditorymeatusandahorizontalreferenceplane.kinematicfacebowOuterarmisattachedtomandibularteethkinematicfacebowOnceterminalhingeaxisisfound,markismadeontheskin轉(zhuǎn)移頜位關(guān)系的內(nèi)容（一）牙合架（二）面弓（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度（五）確定側(cè)方髁導(dǎo)斜度（六）確定切導(dǎo)斜度轉(zhuǎn)移頜位關(guān)系的方法1、調(diào)整好牙合架

2、標(biāo)記髁突點

3、固定牙合叉

4、固定面弓于人體上

5、固定面弓于牙合架上

6、固定上頜模型

7、固定下頜模型

8、完成頜位關(guān)系轉(zhuǎn)移1、調(diào)整好牙合架

切導(dǎo)針上刻線與上頜體上緣平切導(dǎo)盤面為水平位固定兩側(cè)前伸髁導(dǎo)斜度螺絲髁球緊貼髁槽前壁扭緊固定正中鎖側(cè)方髁導(dǎo)斜度定于15度2、標(biāo)記髁突點髁突點位于耳屏向外毗方向13mm3、固定牙合叉加熱后插入上牙合堤離牙合平面平面約2mm內(nèi)叉起輔助固位作用，只需插入牙合堤少許牙合叉平面與牙合平面平行牙合叉柄上的刻溝對準(zhǔn)中線3、固定牙合叉加熱后插入上牙合堤離牙合平面平面約2mm內(nèi)叉起輔助固位作用，只需插入牙合堤少許牙合叉平面與牙合平面平行牙合叉柄上的刻溝對準(zhǔn)中線4、固定面弓于人體上

5、固定面弓于牙合架上將面弓及牙合托從口內(nèi)取出兩側(cè)髁梁分別套在牙合架的髁桿的梁上調(diào)節(jié)面弓高度5、固定面弓于牙合架上將面弓及牙合托從口內(nèi)取出兩側(cè)髁梁分別套在牙合架的髁桿的梁上調(diào)節(jié)面弓高度5、固定面弓于牙合架上將面弓及牙合托從口內(nèi)取出兩側(cè)髁梁分別套在牙合架的髁桿的梁上調(diào)節(jié)面弓高度6、固定上頜模型將濕潤的上頜模型就位于牙合托調(diào)拌石膏固定上頜模型于上架環(huán)6、固定上頜模型將濕潤的上頜模型就位于牙合托調(diào)拌石膏固定上頜模型于上架環(huán)7、固定下頜模型翻轉(zhuǎn)牙合架石膏固定捆綁固定牙合架7、固定下頜模型翻轉(zhuǎn)牙合架石膏固定捆綁固定牙合架（四）確定前伸髁導(dǎo)斜度需用面弓轉(zhuǎn)移患者上頜對顳下頜關(guān)節(jié)的固有位置關(guān)系。arbitraryfacebownon-arconarticulatorDentalCosmos,1905;47:1184-95.（五）確定側(cè)方髁導(dǎo)斜度Arcon型牙合架(ArtexAP)可將患者所有的頜位參數(shù)轉(zhuǎn)移到牙合架；（3）半可調(diào)牙合架（semi-adjustablearticulator)——ClassIV（1）簡單牙合架（simplearticulator）Aninstrumentthatindexestotheexternalauditorymeatusandregisterstherelationofthemaxillarydentalarchtotheexternalauditorymeatusandahorizontalreferenceplane.（四）確定前伸髁導(dǎo)斜度（3）半可調(diào)牙合架（semi-adjustablearticulator)調(diào)拌石膏固定上頜模型于上架環(huán)將濕潤的上頜模型就位于牙合托調(diào)拌石膏固定上頜模型于上架環(huán)aninstrumentthatwillacceptthreedimensionaldynamicregistrations;theseinstrumentsallowfororientationofthecaststothetemporomandibularjointsandsimulationofmandibularmovements.（4）全可調(diào)牙合架（fully-adjustablearticulator)（3）半可調(diào)牙合架（semi-adjustablearticulator)arbitraryfacebow7、固定下頜模型翻轉(zhuǎn)牙合架石膏固定捆綁固定牙合架8、完成頜位關(guān)系轉(zhuǎn)移（1）去除面弓（2）取出牙合叉（3）完成8、完成頜位關(guān)系轉(zhuǎn)移（1）去除面弓（2）取出牙合叉（3）完成（1）去處面弓（2）取出牙合叉（3）完成8、完成頜位關(guān)系轉(zhuǎn)移轉(zhuǎn)移頜位關(guān)系的內(nèi)容（一）牙合架（二）面弓（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度（五）確定側(cè)方髁導(dǎo)斜度（六）確定切導(dǎo)斜度確定前伸髁導(dǎo)斜度即髁槽與水平面的夾角，是從人體的前伸髁道斜度轉(zhuǎn)移到牙合架上而成的確定前伸髁導(dǎo)斜度依據(jù)

Christensen’sphenomenoneponymforthespacethatoccursbetweenopposingocclusalsurfacesduringmandibularprotrusion——ChristensenC.Theproblemofthebite.DentalCosmos,1905;47:1184-95.Christensen’sphenomenon確定前伸髁導(dǎo)斜度的注意事項蠟片厚度適合，一般3層蠟片下頜直向前伸，不能偏移前伸約6mm，不能太多重復(fù)2－3次protrusiverecord轉(zhuǎn)移頜位關(guān)系的內(nèi)容（一）牙合架（二）面弓（三）轉(zhuǎn)移頜位關(guān)系的方法（四）確定前伸髁導(dǎo)斜度（五）確定側(cè)方髁導(dǎo)斜度（六）確定切導(dǎo)斜度確定側(cè)方髁導(dǎo)斜度Hanau公式計算得出側(cè)方髁導(dǎo)斜度（L）＝前伸髁導(dǎo)斜度（H）/8+12轉(zhuǎn)移頜位關(guān)系