Articulating Papers in Dentistry

Articulating Papers in Dentistry

Articulating papers are available
in a wide variety of thicknesses. This is because different
companies offer articulating papers in
different thicknesses. And although choices are
often a good thing in life, sometimes too many
choices can only land up leaving us more confused. So friends, with that in mind
in this particular video, I shall be sharing
with you firstly, a personalized classification with respect to the thickness
of articulating papers; but more importantly, I shall share with you
what is my perspective with respect to choosing
different articulating papers that are available
in the market. So let’s start with the
classification part. I personally like to cluster articulating
papers into four different groups. And I’d like to call
these ultra-thick, thick, thin and ultra-thin. Let’s look at all of
these individually. Ultra-thick articulating
papers generally lie in the cluster of 200
microns and above. Sharing with you a couple of examples
of these articulating papers that are available
in the market. Now if you were to ask me, where will I use a 200 micron
or thicker articulating paper, my answer is very simple
– ABSOLUTELY NEVER! In my understanding, there is no justifiable reason to using an articulating
paper this thick. So ultra-thick 200 plus
micron articulating papers personally I do not use
in practice at all. Let’s look at the next cluster which
is thick articulating papers. Now thick articulating
papers in general, I like to cluster them as being
41 to 100 microns in thickness. Here again a couple of examples
that I am sharing with you. These are a 100 micron which is
called as progress 100 from Bausch and then you have from
Hanel, an 80 micron. This is in a horseshoe form. Now where do I prefer to
use articulating papers that lie in this cluster? So in general, thick articulating
papers in my practice, I prefer to use them for all forms of
removable prosthodontics that I perform. These could be
complete dentures, these could be cast
partial dentures, these could be regular acrylic
flipper kind of dentures. These require thicker papers and that’s why a 100
micron or an 80 micron is generally what I prefer here. The second aspect that you see
is glazed or metal prosthesis which is where I use
these thicker papers. I’m sure we all have had
this clinical situation where we get either a
metal crown from the lab or a glazed porcelain crown; because of the extremely
smooth surface, these don’t tend to record or register
articulating paper marks easily. In such situations, what I prefer
to do is a two-step procedure. The first step of this is the use
of a larger or a thicker paper which is classically progress
100 which is from Bausch. This tends to leave the
surface with a large mark and leaves it slightly sticky because of the
adhesive ‘Tranculase’ that is available in that paper. Because the surface is sticky, a thinner articulating paper
now begins to register marks even on extremely
smooth surfaces. To help you guys
understand this, I am going to put up a link of one
of the videos from my channel. This is a video courtesy Bausch. It will help you understand
the two-step procedure that I use for glazed
or metal prosthesis. Let’s look at the next
cluster which is thin. In general according to me, thin lies between
19 to 40 microns. Now this is a thickness that I
very commonly use in my practice. Where do I use this? Just giving you a couple
of examples of these. What you see on the extreme
left is from Whip Mix, it’s called Ardent and that is
about a 19 micron thick paper. What you see in the
bottom is from Bausch. This is called Arti-Check and
this is 40 microns in thickness. These articulating papers
I regularly use them whenever I want to check
occlusion on natural dentition. This could be
directly on a tooth if I am checking
for interferences or this could be at the
bisque trial phase if I were to be testing
a crown or a bridge that has come back
from the laboratory. It’s important to understand
that this is for natural teeth because in natural teeth, a
periodontal ligament is present and it allows for a certain amount
of micro-movement within a tooth. Now let’s look at the ultra-thin which is the thinnest or the
finest articulating papers that are available in the market and I usually prefer to cluster
them between 8 to 12 microns. These are extremely thin and these are usually
foils and not papers because papers in
such thin dimensions would tend to tear very easily and that’s where
a foil comes in. What you see in pictures on
the left is a metallic foil which is called as a Shimstock. Again, I will be putting up a
link of what a Shimstock is and how do I prefer
to use the Shimstock. – – – So where do I use the 8 or the 12
micron thick articulating paper? Classically whenever I want
to do implant prostheses. Like I mentioned, a natural tooth
has a periodontal ligament. So I can use a slightly
thicker paper. However if I am working on implant
prosthesis that is fixed, I would most definitely want
to use something that’s thin because I do not want to play
with the occlusion there at all. At the same time, a 12
micron foil is used to check presence or tightness
of proximal contacts between your prosthesis
and the adjacent tooth. At the same time I often use a
12 micron articulating foil also to check for friction on the
intaglio surfaces of crowns. I’m sure a clinical situation that we all dentists are
faced with in practice is, a crown comes back from the lab, it’s fitting the cast perfectly
but it’s not fitting the mouth. It could be tight
on the contacts or there could be some friction on
the internal or the intaglio surface which does not allow the prosthesis
to seat down to the margin. In such a situation
a 12 micron foil is what I personally
prefer to use. The last point that you see
which is gauge occlusal stops, is where a Shimstock is used. A Shimstock is not an
articulating paper because it is metallic. It’s not something
that transfers marks but it definitely helps you gauge
if contacts are present or not. If you wish to, I’m putting up the link of one of my
videos on YouTube from my channel. You can go and watch that and then
come back to this video again. So this in general friends,
is a broad understanding of what are the different papers
that are available in the market and how do I personally decide what thickness to use where. At this point, when I come
to a close of this session, I’d like to share with
all of you all friends, that regardless of which phase
of practice do we lie in – are we a beginner in dentistry or we have an
established practice, it is our moral obligation, it’s our duty to make sure that patient care is at its utmost
priority to us at every phase in life. With respect to
articulating papers, because there are various options
available in the market, what I would like to say to
all of you all friends is, “CHOOSE THEM WISELY AND MAKE SURE YOU

Author: Kevin Mason

11 thoughts on “Articulating Papers in Dentistry

  1. We talk of the importance of occlusion, but how many of us truly know about the adjusters of this occlusion?! Great talk!

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