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The Dawson Academy's T-Scan® Protocol

T-Scan RecordDr. Dawson said in a recent article, "Occlusion is the foundation for everything a dentist does that involves teeth. A thorough knowledge of occlusion is the basis for understanding why teeth get loose, why they wear excessively, break cusps, fracture restorations, or shift position."

There are many tools we use in order to perfect an occlusion. The T-Scan® is one of those tools. It can help us precisely diagnose malocclusions, adjust a splint, equilibrate and more. Studies have shown that occlusion marking paper is not as accurate as T-Scan®. T-Scan® helps us achieve a better result for our patients.

The following is The Dawson Academy T-Scan Protocol for various procedures.

Initial Exams/Complete Exams

Using a T-Scan® record during your complete exams can not only help you initially diagnose malocclusions, but it can help us better communicate with our patients. The visual representation of bite forces and timing of forces can help the patients better understand their problems and increase case acceptance. Seeing this Occlusal disharmony is extremely beneficial to the patient’s understanding. In addition, it serves as a baseline record for comparison after any treatment is completed.

The following is how to incorporate the T-Scan into your complete exam:

Take a T-Scan® record of the patient closing, squeezing, sliding right, left and forward. This is 
done with the patient manipulated into CR and the dentist guiding each movement.

Splint therapy

Fine-tuning a splint with T-Scan® can increase accuracy and decrease the number of appointments needed 
for therapy. Additionally, it can increase patient comfort from the initial delivery 
appointment. 

The following is how to use the T-Scan®  with splint therapy:

  • The splint is tried in and the occlusion is idealized using articulating ribbon
  • Next use T-Scan® to further perfect the occlusion. Start with CR and then progress to eccentric movements one at a time: right and left lateral excursions as well as protrusive. This makes the adjustments easier.
  • Look for equal intensity and simultaneous contacts in closure.
  • Look for good anterior guidance free of balancing or working interferences.


Equilibrations

Equilibrations are an extremely important skill for any dentist practicing Complete Dentistry. The T-Scan® is an additional resource for performing equilibrations successfully. It can help identify any forceful contacts that might cause future problems. Fine-tuning the equilibrated dentition using the T-Scan® can also increase patient comfort from 
the first appointment. 


The following is how to use T-Scan® in your equilibration apointments:

  • Use the T-Scan® at the beginning of an equilibration and to finish the equilibration.
  • Use articulating paper to create ideal CR contacts. Once achieved, use the T-Scan® to perfect the CR contacts
  • Compare T-Scan® recording to paper marks and make necessary adjustments.
  • Once CR equilibration is completed, proceed in a similar manner to eccentric movements, perfecting one movement at a time, first with articulating paper and then using the T-Scan®.
  • Use T-Scan® during limited or full equilibrations to check for problem contacts.
  • When the entire equilibration is complete, create a T-Scan® record similar to the complete examination T-Scan® record. This serves as a great post-treatment record and also for “before and after” comparison.

Restorative Treatment

T-Scan® can be used after delivery and adjustment of definitive restorations, especially those involving anterior restorations. This helps ensure even CR stops and anterior guidance with non- interfering posterior teeth. The procedures mirror those of the equilibration.

Implants

T-Scan® is used to verify ideal occlusion with implants. Implants are frequently overloaded by occlusal forces, which may lead to implant failure. T-Scan® will identify this overload easily. 
In addition, it is extremely important that in closing, the implant is not first in contact. The T-Scan® will identify time and force of contacts, which will help verify implant time of contact.   

The following is how to utilize your T-Scan® with implants: 

When placing a single implant, T-Scan® is used 
to make sure it is not the 1st point of contact.

As with the other procedures, verify in all movements starting with CR and then proceeding to eccentric movements.

Follow-up to Restorative cases

On larger cases that are checked at regular intervals, the T-Scan® can help verify that the occlusion is still stable and allows comparison to the previous scan for verification. This helps ensure long-term predictability of the restorations. Take a periodic T-Scan® record as done in the complete examination and compare it to previous scans. Make any adjustments that are needed 

You can also use T-Scan® to determine if further adjustments will be needed for patients with unhealthy TMJ's who present a higher functional risk.

Once the use of T-Scan® is incorporated into your daily routine, it will become an invaluable resource to help you create and verify a healthy occlusal foundation for your patients. 

For additional resources on using the T-Scan®, visit their youtube channel

Note:  T-Scan® is a registered trademark of Tekscan, Inc.

dental occlusion stability whitepaper

Dr. Cobb was born and raised in the Washington DC area and graduated from Georgetown University School of Dentistry in 1984. He joined the practice of his father, Dr. Everett Cobb, and maintains a private practice in the District of Columbia focusing on restorative and esthetic dentistry. Dr. Cobb is involved with a number of dental organizations including the American Academy of Cosmetic Dentistry, the American Equilibration Society and is a Fellow in the International College of Dentists. In addition to maintaining his practice, Dr. Cobb volunteers extensively both nationally and internationally. He volunteers routinely with local dental clinics for the underserved in the DC area, the AACD “Give Back a Smile” program and Somos Amigos Medical Mission in the Dominican Republic. Dr. Cobb has been on numerous trips with Somos Amigos and is the dental coordinator for the mission. He has been recognized with numerous awards for his philanthropic efforts.