CLINICAL ASPECTS

THE OPTIMIZATION OF INTERMAXILLARY RELATIONS AT

THE MAXIMUM INTERCUSPATION WITH THE HELP OF THE
GERBER SET NO. 105

MIHAELA CERNUȘCĂ-MIŢARIU1, ALINA CRISTIAN2, CRISTINA DAHM TĂTARU3

1,2,3
“Lucian Blaga” University of Sibiu

Keywords: occlusion, Abstract: The consequences of those intermaxillary relations generating functional changes must be
intermaxillary treated in accordance with the rest position and the maximal intercuspal relation. Based on data
relations, dental collected from a total of 127 patients, the results of our study indicate that the intra-oral graphic
contact, occlusal recordings of intermaxilary relation offer a better accuracy and precision of the measurements.
equilibration Moreover, the use of intra-oral graphic recording methods for centric relation registration along with
the teeth mounting following the principles of bilateral balanced occlusion (using articulators) proved to
be essential steps in achieving correct and functional dentures In most of our cases, where the
measurements were made by the means of set Gerber teeth fitting errors were found. Therefore, these
were corrected by occlusal equilibration inside articulator or by teeth replacement.

Cuvinte cheie: ocluzie, Rezumat: Consecinţele relaţiilor intermaxilare generatoare de modificări funcţionale, trebuiesc
relații intermaxilare, apreciate în funcţie de poziţia de repaus şi relaţia de intercuspidare maximă. Pornind de la date
contact dentar, colectate de la un total de 127 de pacienţi, rezultatele studiului de față indică faptul că sistemele grafice
echilibrare ocluzală de înregistrare intraorală a relaţiei intermaxilare oferă o mai mare acurateţe şi precizie a
determinărilor. Mai mult, utilizarea sistemelor grafice intraorale pentru înregistrarea R.C. precum şi
montarea dinţilor pe baza principiilor ocluziei bilateral balansate (utilizând articulatorul) reprezintă
etape esenţiale în realizarea unor proteze totale corecte şi funcţionale. În majoritatea cazurilor în care
determinările au fost efectuate cu setul Gerber, s-au descoperit erori de montare a dinţilor. Acestea au
putut fi corectate prin echilibrare ocluzală în articulator sau prin remontarea anumitor dinţi.

INTRODUCTION OBJECTIVE
The paradigm underpinning this study is the principles The overall objective of this study is to capture the
of functional occlusion by the total prosthetics and mandibular- state of occlusal balance among the people with total edentulous
cranial fundamental relations. “C.R. is independent of dental through Gerber’s method no.105.
contact and is determined by the jaw manipulation through a The operational objective of the study is to highlight
purely rotational movement about the transverse axis”.(1) the advantages of using the Gerber Set Nr. 105 as a safe and
A detailed theoretical analysis of the occlusal comfortable method for both the physician and the patient for
principles and the mandibular-cranial relationship is not the analysis and correction of the intermaxillary relations at total
main subject of this paper, but we mention these concepts that edentulous.
underlie the case studies discussed.
Occlusal concepts in balancing total prosthesis include METHODS
the concept of bilaterally balanced occlusion, the concept of Sample: the data was collected from a total of 127
lingualized occlusion, the concept of linear occlusion and the patients of both sexes, mostly senior/elderly patients. 87 of these
concept of neutrocentric occlusion. have full-arch prosthetics and most of the required an
Regarding the false intermaxillary relationship in our optimization of the intermaxillary relations.
study we aim to detect false causes of intermaxillary relations The collection and selection method of the examined
and its impact on the dental apparatus, and identify an effective patients, included in addition to a clinical examination a
and ergonomic method of remedy. research-type, semi-structured questionnaire with open and
The optimization of the intermaxillary relations closed questions requesting socio-demographic data and both
involves analyzing and optimizing the artificial arches and the subjective (details about efficiency: of mastication, of
analysis and correction of the occlusal relationship at the closing swallowing, of phonation, of respiration, about the patients
movement of the articulator during the propulsional and lateral satisfaction regarding the above mentioned functions, and about
movement. During the optimization of prosthetics special the maintenance degree of oral hygiene) and objective
attention should be given also to the vertically over - or (examination of the mounting of the teeth using the required
undersized prosthesis. principles, and the examination of the occlusal relations)
information.

1
Corresponding author: Mihaela Cernuscă-Miţariu, Str. Ştefan cel Mare, Nr. 6, Sibiu, România, E-mail: confortmitariu@yahoo.com, Tel: +40269
212751
Article received on 05.03.2013 and accepted for publication on 29.04.2013
ACTA MEDICA TRANSILVANICA June 2013;2(2):278-280

AMT, v. II, no. 2, 2013, p. 278

 CLINICAL ASPECTS

Figure no. 1. Instruments for the use of the Gerber Set No. We noticed that an important reason leading to
105 prosthetic dysfunction in time is that prosthetic teeth were
mounted in contravention with the general principles.

Figure no. 5. Objective intraoral analysis of totally

edentulous patients

Figure no. 2. Registration plates

The most common unsatisfactory reason for patients

with prosthesis is an overall masticatory inefficiency.

Figure no. 6. Subjective evaluation of the masticatory

efficiency by totally edentulous patients

RESULTS
From 127 investigated patients, 87 patients (69%)
have prosthetic rehabilitation, and 40 patients (31%) do not have
prosthetic rehabilitation, which shows an interest in
functionality and the appearance of the buccal cavity.

Figure no. 3. The frequency of prosthetic rehabilitation at

totally edentulous patients

Assessment of the need and subsequently the

prosthetic rehabilitation, taking into account the level of
masticatory, phonation and physiognomic function obtained.

Figure no. 7. The need of occlusal adjustment after the

optimization of the prosthesis with the Gerber set

We can notice a high percentage of patients who

require, for various reasons, occlusal adjustment.

Figure no. 4. The need of occlusal adjustments by the totally

edentulous patients

These goals were met in a significantly higher

percentage of the patients with full prosthesis whose
intermaxillary optimization was performed using the Gerber Set.

CONCLUSIONS
Following the clinical-statistical study performed, we
can summarize the following conclusions:
Our study addressed a group of 127 patients of both
sexes, of which 69% respectively 78% had prosthetic
rehabilitation, which suggests addressability of the dental office
and thus interest in oral functionality and appearance.
AMT, v. II, no. 2, 2013, p. 279
 CLINICAL ASPECTS

From the examined patients with full prosthesis, we

found that 54.02% of them required occlusal adjustment.
We encountered modifications in intermaxillary
relations and thus prosthesis requiring optimization, more
frequently by patients wearing full prosthesis over a long period
of time.
The consequences of intermaxillary relations that
generate functional changes, must be judged according to the
rest position and the maximum intercuspation relations.
Graphic recording systems of intraoral intermaxillary
relationship provide a greater accuracy and precision of
measurements.
By respecting the tripod principle of balance and
avoiding dento-dental contacts the stability and masticatory
efficiency of the optimized prosthesis improved considerably,
which led to a higher degree of satisfaction at patients wearing
prosthetic parts.
In most cases where the Gerber Set was used to make
measurements, we found fitting errors of the teeth. This could be
corrected by occlusal equilibration in the articulator or replacing
some teeth.
The use of graphics and mounting models in the
articulator during all of the clinical and technical stages of total
edentulous prosthetic avoids a large number of errors and leads
to a functional prosthesis from the start up.
If the case of new prosthesis where the measurement
of the intermaxillary relations was made only with occlusal
templates is indicated reassessment with the help of the Gerber
Set and the immediate equilibration in the articulator to increase
the patients comfort in the early stages of the prosthesis process.
The use of intraoral graphical systems for recording
RC and mounting teeth using the principles of bilaterally
balanced occlusion (using articulators) are essential steps in
achieving accurate and functional dentures.

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