T-Scan as a Patient Education Tool

The T-Scan is an effective patient education tool for illustrating existing occlusal pathology. It presents complex occlusal information in a visual format that is easily understood. The T-Scan applies to all stages of the teaching/learning process because its recorded data forms the framework upon which a doctor/patient discussion can begin regarding the patient's occlusal disease manifestations, the potential benefit of treatments, and the risks of not undergoing corrective treatment. When used as part of an educational strategy, the T-Scan can lead the patient to accept procedures that would benefit their long-term dental health. This chapter outlines the four stages of creating optimum dental health, the steps required to perform effective teaching and learning, the differing styles of teaching and learning utilized in educational forums, and how to best employ the technique of Feature, Function, and Benefit. A case study illustrates how T-Scan data can educate a patient about their own occlusal problems.

Centric Relation Records and T-Scan Occlusal Analysis of Centric Relation Prematurities

Occlusal analysis is the examination and diagnosis of the forces generated by the contacting surfaces of teeth. The clinician can use both mounted diagnostic casts and the T-Scan Occlusal Analysis system to understand the role of adverse forces in a patient's dentition. These casts should be mounted in Centric Relation so that they replicate the patient's hinge axis maxillomandibular relationship, absent of tooth contact. Diagnostic casts can demonstrate the mandibular slide into maximum intercuspation, as well as illustrate the excursive contacts. The T-Scan not only records the location of tooth contacts present in Centric Relation, maximum intercuspation, and lateral excursions, but also detects the timing and relative force of all contacts. The rapid display of recorded tooth contact data in the 2- and 3-Dimensional ForceViews makes it practical for intraoral operative use. These modalities can be used separately or in concert depending on the clinical situation. This chapter discusses the clinical technique, advantages, and rationale for identifying Centric Relation prematurities with mounted diagnostic casts and the T-Scan.

Orthodontic T-Scan Applications

This chapter reviews T-Scan use in Orthodontics, defines normal T-Scan recordings for orthodontically treated subjects versus untreated subjects, and explains T-Scan use in the case-finishing process. After orthodontic appliance removal changes in the occlusion result from “settling,” because teeth can move freely within the periodontium. Despite a post treatment, visually “perfect” Angle's Class I relationship, ideal occlusal contacts often do not result solely from tooth movement. Creating simultaneous and equal contacts following fixed appliance removal can be accomplished using T-Scan data to optimize the end-result occlusal contact pattern. The software's force distribution and timing indicators (the 2 and 3-Dimensional ForceViews, force percentage per tooth and arch half, the Center of Force, and the Occlusion and Disclusion Times) aid in obtaining an ideal occlusal force distribution during case-finishing. Several case reports highlight combining lingual orthodontic treatment with Orthognathic surgery, where each presented case utilized T-Scan data during active treatment and retention.

The Management of Advanced Tooth Wear Using the T-Scan/BioEMG Synchronization Module

Tooth wear is considered a normal, age dependent, physiological process that leads to the loss of enamel and dentine. However, in some cases the process is so progressive that it may be pathologic. The focus of this chapter is to present the consequences of advanced tooth wear resultant from parafunction, excessive masticatory forces, imbalanced occlusal contacts, and hyperactive masticatory muscles. This chapter also outlines preventative strategies that can predictably reduce the progression of pathologic wear, which employ the T-Scan 8/BioEMG synchronization module. These two objective companion technologies assess the occlusion before, during, and after dental treatment, as well as predictably control the long-term stability of newly installed fixed, implant-supported, or removable prostheses. Their synchronization correlates muscle activity level information directly to occlusal contact force and time-sequencing information, which when applied together in the wear patient can be instrumental in tempering and eliminating pathologic occlusal wear.

Detecting and Quantifying Cervical Dentin Hypersensitivity Using Air Indexing Combined with the T-Scan System

This chapter introduces the Air Indexing method for detecting and quantifying cervical dentin hypersensitivity as a companion to the T-Scan Occlusal Analysis System, which evaluates occlusal force and timing values of contacting teeth. The chapter discusses detection, diagnosis, and treatment of clinical signs and/or symptoms of Cervical Dentin Hypersensitivity (CDH). A 17-year-long retrospective study conducted between 1979 and 1996 is presented that illustrates the correlation between Cervical Dentin Hypersensitivity and its resolution following occlusal adjustment. Resulting stress from occlusal contact force is etiologic for non-carious cervical lesion formation and root degradation. This chapter details how biocorrosion and lost protective glycoproteins hasten the effects of applied force, creating CDH symptoms and cervical abfractions. Lastly, the Air Indexing method of CDH diagnosis is melded with T-Scan occlusal analysis to diagnose and treat CDH symptoms. Together, these two methods yield more CDH/occlusal insight than either method can alone.

Occlusal Considerations in the Hypersensitive Dentition

In the literature, Dentinal Hypersensitivity (DH) is considered to arise from exposed dentin and patent dentinal tubules. However, clinical observation of recurrent DH sensitivity indicates it can occur in the presence or absence of exposed dentin. Quantified occlusal contact force and timing parameters have been ignored in studies assessing hypersensitive teeth. This chapter introduces a novel occlusal concept: Frictional Dental Hypersensitivity (FDH). Clinical evidence from combining computerized occlusal analysis and electromyography is presented linking opposing posterior tooth friction and muscular hyperactivity to Dentin Hypersensitivity. This chapter proffers how occlusion, muscular TMD symptoms, and frictional Dentin Hypersensitivity are all related. Lastly, a Pilot Study is presented that used a Visual Numerical Analog scale to quantify Dentin Hypersensitivity resolution observed in symptomatic patients who underwent the Immediate Complete Anterior Guidance Development (ICAGD) coronoplasty. This computer-guided occlusal adjustment eliminated pretreatment FDH symptomatology, further supporting that Dentinal Hypersensitivity has an occlusally-based, frictional etiology.

Force Finishing in Dental Medicine

This chapter introduces the Force Finishing concept that is based upon the T-Scan technology. During case finishing, the aesthetic components are clinically visible and guided by the subjective analyses of the patient and the clinician. Alternatively, the case occlusal force components are invisible and do not become apparent until their adverse effects become chronic. When the force components are not properly addressed, clinicians may encounter Occlusal Force Disorder (OFD) symptomatology. Often, clinicians focus on the aesthetic finishing while placing a low priority on the occlusal Force Finishing by relying on subjective articulating paper mark interpretation and the patient's subjective “feel” with which to guide occlusal adjustments. Because articulating paper is a poor indicator of occlusal force and timing, the T-Scan technology can greatly improve the occlusal case finishing. This chapter details how to integrate the Force Finishing concept into conventional case finishing to simplify achieving occlusal force harmony in every case.

T-Scan Case Finishing Applications in Aesthetic Dentistry Assisted by the iTero Digital Impression System

This chapter introduces the iTero digital impression system as a companion to the T-Scan Occlusal Analysis System. Occlusion as a component of aesthetic dentistry is discussed, and how the aesthetic case is aided by T-Scan force control at insertion. The chapter explains that brittle adhesive restorations cannot be evaluated occlusally prior to bonding. Combined with the spatial errors inherent with impression material setting and stone cast articulation, obtaining reliable interocclusal spatial relationships with adhesive restorations can be compromised. Alternatively, the iTero system accurately captures preparation shapes and the opposing interocclusal relationships, which eliminate typical, non-digital cast articulation errors. These clinical realities are illustrated in a10-unit porcelain veneer Case Report, where the iTero system and the T-Scan system are employed together. Finally, recommendations are made that Dental Medicine move towards digital impression making and accept the importance of the T-Scan system in occlusion to improve the standard of patient care.

T-Scan 8 Recording Dynamics, System Features, and Clinician User Skills

The newly designed T-Scan 8 Computerized Occlusal Analysis system represents the state-of-the-art in occlusal diagnosis. The reliability of the system's high definition recording sensors, the many occlusal analysis timing and force software features, and the modern-day computer hardware electronics that record occlusal function in 0.003 second real-time increments affords a clinician unparalleled occlusal contact timing and force information with which to predictably diagnose and treat many occlusal abnormalities. T-Scan 8 represents the culmination of 30 years of T-Scan technology innovation and development with revised desktop graphics and less toolbar buttons for simpler graphical display designed to shorten the T-Scan learning curve. The chapter also discusses five useful diagnostic occlusal recordings employed when treating commonly observed occlusal problems. Lastly, the chapter outlines the three Learning Levels of T-Scan mastery that must be accomplished for a clinician to become an effective and competent T-Scan user.

Digital Occlusal Force Distribution Patterns (DOFDPs)

This chapter describes the many clinical applications of Digital Occlusal Force Distribution Patterns (DOFDPs) recorded with the T-Scan Computerized Occlusal Analysis system. Movements made by the Center of Force trajectory as force travels around the dental arches during the occlusion and disocclusion creates these patterns. The repetitive occlusal contact data points locate the force distribution received when teeth occlude against each other. These force distribution patterns correlate to intraoral compromised dental anatomy found in radiographs, photographs, and during the clinical examination of teeth and their supporting tissues. Moreover, they directly influence the envelope of motion, the envelope of function, and head and neck posture. This chapter illustrates with clinical examples the correlation between Stomatognathic System structural damage and repeating patterns of abnormal occlusal force distribution. The T-Scan technology isolates these damaging regions of excess microtraumatic occlusal force, absent of clinician subjectivity, thereby helping clinicians make an accurate, organized, and documented occlusal diagnosis.