Whether using composite or porcelain, veneer artistry is critical to the form and function of a patient’s bite. While articulating paper can only show the location of bite contact, T-Scan allows dentists to see timing and levels of force across their dentition, helping them reduce fracture potential.
In this case study, authored by Dr. Robert Kerstein (DMD), T-Scan was used in tandem with articulating paper to measure high force contacts during a veneer patient’s bite sequence. As the results showed, T-Scan was able to capture potentially damaging forces that were missed by articulating paper.
Patient Overview
This case details a 25-year-old female patient, who, three years prior to these photographs, had six maxillary anterior veneers placed. Unfortunately, over the three years of intraoral service, she experienced mid-facial cracking on two of the original six veneers. This patient was obviously unhappy with the quality degradation of her original veneers and wanted to replace all six. Subsequent to the consultation visit, they were removed, new provisional veneers were fabricated, and then six final new veneers were seated after they were returned from the lab. As the coloring and esthetic shape were both correct, the six new veneers were bonded into place. The excess cement was removed, and the veneers were highly polished lingually where they met the tooth structure, and facially at the gingival margin. Following veneer placement, it is essential to assess the occlusal function with the T-Scan, especially in protrusion. Veneers often require protrusive force control, as their incisal edges are brittle, and too much occlusal pressure applied to the incisal edges can lead to both incisal edge failure and mid-veneer cracking, as was the case for this patient.
Click here to read the Case Study PDF
About the Author: Dr. Robert Kerstein DMD
Dr. Robert B. Kerstein received his D.M.D. degree in 1983, and his Prosthodontic certificate in 1985, both from Tufts University School of Dental Medicine. From 1985 - 1998, he maintained an active appointment at Tufts as a clinical professor teaching fixed and removable Prosthodontics in the department of Restorative Dentistry. In 1984, Dr. Kerstein began studying the original T Scan I technology, and has since that time, also studied the T-Scan II, the T-Scan III, T-Scan 8, T-Scan 9, and now the T-Scan 10 technology. Dr. Kerstein has conducted original research regarding the role that occlusion and lengthy Disclusion Time plays in the etiology of Chronic Myofascial Pain Dysfunction Syndrome. His now 35 years of research with all versions of the T Scan Digital Occlusal Analysis System, has led to his becoming a leading author and researcher in the field of Computerized Occlusal Analysis. Dr. Kerstein has been published in the Journal of Prosthetic Dentistry, the Journal of Craniomandibular and Sleep Practice, Quintessence International, Practical Periodontics and Aesthetic Dentistry, the Journal of Computerized Dentistry, the Compendium of Continuing Education, the Journal of Implant Advanced Clinical Dentistry, Cosmetic Dentistry, the Journal of Oral and Maxillofacial Implants, and Advanced Dental Technologies & Techniques. Additionally, Dr. Kerstein has published a 2-volume research handbook about the T-Scan computerized occlusal analysis technology. For many years now, Dr. Kerstein has lectured both nationally and internationally, about Prosthodontics, Implant Prosthodontics, Digital Occlusal Analysis, and treating muscular Temporomandibular Dysfunction with Disclusion Time Reduction Therapy. Visit his website at www.drrobertkerstein.com
