[Canines as abutments--basic principles].
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Biomedical subjects
Publications and source records attributed to W Gernet.
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On the basis of clinical and roentgenologic examinations of progenia patients which were planned according to our occlusal concept and monitored postoperatively, we established that the condylar displacement in the roentgenogram offers an exact parameter for the extent of operative displacement of the condyles. Nevertheless, a direct conclusion concerning the clinical symptoms or freedom of complaints cannot be established on the basis of this roentgenographic analysis. The roentgenogram also showed considerable condylar alterations in patients with temporomandibular joint symptoms; greater displacement of the condyles was frequently demonstrable with temporomandibular joint complaints.
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The relationship between periodontal disease and dysfunction of the stomatognathic system was examined with the usual analysis of function in the context of a clinical study. In addition to neuromuscular incoordination, premature centric contacts deflect the mandible from a muscularly stable contact position and traumatize the periodontium mechanically. After suitable treatment, the causes of functional damage to the tooth attachment apparatus may be demonstrated in connection with an exact clinical registration of the findings by a simple instrumental analysis of function. This analysis may be adequately carried out with a semiadjustable articulator together with a rapidly transmitted curve.
Operative planning for progenia is carried out using prosthetic principles. Correction of a malpositioned mandible, modelling of incongruent dental arches, functional distribution of piers, and a favorable interalveolar connecting line form the basis for stable occlusion and articulation. The fitting of a prosthesis later is simplified by such intensive interdisciplinary cooperation.
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The exactitude of transferring castings was tested in two currently used methods of casting. Results showed that alginate casting from a remontage matrix and simple casting with IMPREGUM are sufficiently exact for clinical purposes. When the mixing relations between the casting substances is exactly maintained a transfer exactitude of +/- 0.11 is achieved by the methods tested. When there is a change in the relationship of the mixtures deviations of up to 0.20 mm occur.
Investigations of the articular mechanics of the tempero-mandibular joint are an important element in gnathology. Graphically recorded movements of the condylus obtained by extra-oral mechanical aids, only give information about the projections of the articulatory pathways. Only roentgencinematography allows a profound study of the articular mechanics. The movements of the condylus can be analysed directly without interference. Studies on condylar pathways evaluated by roentgencinematography from waerers of full dentures who received two sets of dentures which fitted after different jaw relation determinations, confirmed that the movement of the condylus is controlled by neuromuscular mechanisms. The condylar pathway changes after removal of the dentures. The fitting of different dentures in a healthy stomatognatic system had no effect on the course of the pathway. In neuromuscular disorders the fitting of a full denture which can be made corresponding to the functional anatomical concept reflecting a suitable jaw relation determination according to Gerber, allows the articulation pathway to be altered. A therapeutic re-orientation of the pathological reflexes makes the improvement of the discomfort possible.
Six edentulous patients were each provided with two complete dentures and the relation of the jaws to each other was determined by means of both the conventional checkbite and a combined Gerber arrow-angle registration. Cineradiographic evaluation of the temporomanidibular joint movements did not confirm a bony or ligamental guidance, but showed that the condyle path is characterized by neuromuscular coordination. In four patients there was no characteristic difference in the form of condyle path when using the two dentures. But the condyle paths differed strikingly in those patients who had temporo-mandibular complaints or neuromuscular disharmonies. The paths were clearly steeper with Gerber dentures than dentures made after the conventional check-bite. In laterotrusion the "active" condyle moves on a straight line towards the from and downward, while the relatively "resting" condyle describes a shortened path corresponding to the initial part of an opening movement.