Video: How to Capture Open Bite Relation

Baron Grutter DDS, https://www.barongrutterdds.com/

How to Use a Leaf Gauge:

• The goal is to achieve 1.5-2mm  of clearance in the posterior teeth. Start with and insert 2/3's of the leaf gauge, have the patient bite down, tilt the leaf gauge forward and backwards and have them bite down again. Repeat this 5 times to loosen up the joint. Check that the posterior clearance is between 1.5-2mm. Once you have achieved the correct opening, have patient bite down and hold still, scan occlusion.

What If You Don't Have a Scanner?

The same theory applies, the leaf gauge should be used to create the desired bite opening and the opening should be captured using bite registration material.

Why Is Using A Leaf Gauge Important?

Splints prematurely contacting in the posterior is one of many ways that the bite can be off - but why does this happen? Traditionally, nightguards are mounted on an articulator in a closed bite and opened using the articulator's "average" dimensions (condylar/Bennett angles). In reality, the dimensions of the patients jaw are often drastically different from that of the articulator, resulting in the articulator’s open bite being completely different than the patients open bite. Using an articulator to open the bite can require extensive adjustment at the chairside to correct for the patient-articulator discrepancy.

The Solution

Scanning the open bite relation with a leaf gauge can be done in under a minute and allows us to completely avoid the patient-articulator discrepancy issue. By scanning the patients real open bite, the laboratory can make the appliance exactly to the open bite scan. The bite of the nightguard will reflect the exact open bite relationship of the patient - requiring no chairside adjusting.