How to Accurately Capture Open Bite
Video by Baron Grutter DDS, https://www.barongrutterdds.com/
How To: Capture Open Bite Relation (Leaf Gauge)
Step 1:
Ensure the patient is seated comfortably in a natural position with their head supported. Have the patient relax their jaw and then open their mouth naturally.
Step 2:
Start with and insert 2/3's of the leaf gauge, have the patient bite down.
Step 3:
Tilt the leaf gauge up and down and have them bite down again to loosen up the joint, repeat this 5 times.
Step 4:
Check that the posterior clearance is between 1.5-2mm (add or remove leaves as needed). Once you have achieved the correct opening, have patient bite down and hold still, scan occlusion.
Why is Using a Leaf Gauge Important?
Traditionally, to fabricate a nightguard, the models are mounted on an articulator in a closed bite and opened using an articulator’s "average" (condylar/Bennett) angle values. In reality, the angle values are unique to the patient and occasionally are drastically different from that of the articulator. Unfortunately, this means when we open the vertical dimension on the articulator, the occlusal surface of the splint will not contact the antagonist teeth properly, requiring chairside adjustment or a remake of the appliance.
Luckily we have the solution! Follow the Steps indicated above to capture the open bite relation of the patient with a leaf gauge. We can then fabricate the splint exactly to the patients vertical opening, and eliminate the need for chairside adjustment.
Leaf Gauge Sterilization Protocol:
Sterilization Protocol from the Huffman Leaf Gauge Website:
https://www.leafgauge.com/how-to-guide-for-the-leaf-gauge/