ITO's revised mandibular movement theory formula, brush, analog and digital strategic information processing, strategic information means and strategic program

Abstract

To provide CAD, CAM, CAE and CAT software for simulating a patient's jaw movement, making optimal diagnostic planning, cooperating with software relating to an oral hygiene management device, etc. and AI transformation.SOLUTION: A method includes: using functions of a Twin Hobby Articulator, an improved Zero Hobby Articulator, and an ITO Articulator to reproduce a virtual articulator of each individual using a three-dimensional image of tooth rows of a patient; projecting a treatment plan for determining whether the patient's tooth rows occlude correctly with respect to the past, present and future, into a computer to perform AI transformation; reading three-dimensional data including a part to be designed, by STL and PLY; and associating a revised version of Ito's mandibular movement theory formula with software that can be linked to equipment, to install it in an oral cavity without adjustment.SELECTED DRAWING: Figure 4

Description

[Technical field]

[0001] The digi-ARTI module (ITO Virtual Software, Yasunaga Computer Co., Ltd., Fukui, Japan) software is a software system that does not have a dental diagnosis planning program. The present invention relates to a technology for simulating the jaw movement of a patient, and in particular, as a diagnostic device that can be a scientific basis for a comprehensively planned device, method, and program, optimal diagnosis planning is possible, and the technology of analog and digital CAD.CAM.CAE devices, 3D printers, oral hygiene management devices, etc., all over the world. Conventional interdental brushes are painful, so patients tend to refrain from using them, but in Figure 48, there is no pain, and if discomfort occurs, the symptoms deviate from the standard values ​​in Table 1 due to occlusion. Furthermore, in order to correct the tip of the brush brush, which spreads with repeated use, a cap is inserted from the base to improve the difficulty of inserting, and at the same time, various subjective and objective patient phenomena history, etc., as shown in Figure 28, can be added to various symptoms by using a dedicated brush brush, and it is a CAD.CAM.CAE.CAT software that can be AI-ized. Figures 1 to 4 show a structure in which software development to establish diagnosis will be disseminated from the dental medical diagnosis process, multidimensional definitions, and process charts of multidimensional diagnosis, thereby improving the skills and experience of dentists and dental medical professionals, providing optimal treatment without failure, and not relying on experience or intuition. At the same time, dental clinics (dental medical technicians) will become one of a kind, and patients in any region will be able to receive the same treatment. A web support center service will also be launched. [Background technology]

[0002] The reality of the current state of dentistry is that it is still dependent on the skills and countermeasures of the dentist, as well as the experience and craftsmanship of the patient's own oral environment. Figure 5 The problem dentists face in prosthetic treatment remains the same as it was in the past: the repeated adjustments to the oral cavity after the completed prosthesis is placed in the oral cavity cause discomfort to the patient, leading to them transferring to another clinic. Despite the recent development of large CAD / CAM / 3D printer equipment and cloud computing, the same adjustments to the oral cavity are still being made, and although the accuracy has improved, not everyone is able to achieve the same results.

[0003] In recent years, check bites, gothic arches, and pantographs are used to obtain data for each individual across the entire dental treatment, and CAD software is developed from intraoral information (algorithms for more than 1,000 to 2,000 cases) of patients, which vary from one another. There are CAD / CAM devices with built-in virtual articulators that determine the condylar path angle and incisal path angle of the articulator and process and manufacture prosthetics, corrections, dentures, etc. Although technology has improved in data collection related to the methods and programs of the equipment, the overview items have not yet moved away from the ideas of Gysi's complete denture or McCollum et al. in the early 1900s around the world. However, with quantitative and qualitative confirmation from Takayama's mandibular movement theory formula (Quintessence Publishing, Occlusion, p563-p583 and ORAL REHABILITATION Clinical Determination of Occlusion, p.143-163), as well as revision of the data analysis of each eccentric movement amount of 3 mm of analog articulator condylar path length and the amount of molar dislocation in the oral cavity, the revised Ito's mandibular movement planning theory formula has been reproduced as being extremely good over a clinical course of over 40 years.

[0004] By using Takaaki Kawazoe's (Clinical Evidence and Dental Prosthodontics: Prosthodontics 46: 476-478, 2002) evidence-based clinical concept in dental treatment (Journal of the Japanese Prosthodontic Society) and the new multi-dimensional planning movement theory formula that is scientifically successful, it has become possible to create a final prosthesis that fits well and feels natural for proper clinical diagnosis and treatment planning by utilizing Yasunaga's ITO virtual software, ITO articulator, Twin Hobby articulator, and the revised Zero Hobby semi-adjustable articulator with angle-changing trough-shaped table. Dental treatment as a medical treatment has begun to arrive at the establishment of evidence-based dentistry.

[0005] There are systems that use a computer system to determine the orthodontic treatment policy when correcting a patient's teeth. For example, a three-dimensional image of the patient's teeth can be used to predict the teeth after orthodontic treatment is completed. Specifically, the teeth can be moved and constructed in various ways in the three-dimensional image of the teeth. In addition, based on the predicted teeth, the dentist has a program that can determine the policy of all dental treatments, conservative, periodontal, prosthetic, internal jaw disorders, and orthodontic treatment. Various clinical trials have been reported for the incisal path and condylar path angles. In general, it has been reported that the numerical values ​​of the incisal path and condylar path angles change depending on the difference in the angle of the occlusal plane in the horizontal plane. Ito et al. used the same method to evaluate preadjusted appliances in orthodontic treatment using data accumulated over 10 years, and were able to roughly determine the numerical value of U1-L1·FH. In recent years, reports by Costa, Slavicek, Sato et al. have also come close to these results. However, Ito reported that the incisal path angle in the sagittal plane is not affected by the occlusal plane, and that based on 30 years of clinical results using the theoretical formula for mandibular movement in the axial plane, there is no sensory discomfort at certain standard values. Furthermore, the theoretical formula and clinical results have shown extremely good results. As stated in a doctoral dissertation from Oshu University based on Class 1 crowding cases of extraction and non-extraction, the following describes how the 47° U1-L1 angle with respect to the Frankfurt plane actually relates to the following: Fig. 6 In the sagittal plane, when the axis is flattened, no matter how many millimeters it moves within the trough table, it is guided along the 120 mm on the condylar path. If the axis plane and the Frankfurt plane are said to be about 7.37°, this is a drawing that calculates the angle value on a semi-adjustable zero hobby articulator when the difference in the vertical distance moves approximately 10 mm. The basic angle values ​​in FIG. 7 have been calculated. Figure 8 shows the values ​​of the overjet and overbite in the incisor region. The anterior reference point of the Denar articulator and the Twin Hobby and Zero Hobby revised articulators, which are widely used Hobby series, is determined to be approximately 2.07°, or approximately 2°, based on the calculation of the angle when the interfacial distance is set to 43 mm in the Willis method (70 mm) (Figures 6 to 8). In other words, the positional relationship of the incisal pole and trough-shaped table of the Twin Hobby articulator is reproduced 40 mm forward from the mandibular incisor and 20 mm vertically downward, and the anterior distance of the perpendicular line from the center of the condylar path is 120 mm. In Takayama's mandibular movement theory, the interfacial distance is set to 80 mm, so the middle of 40 mm needs to be reproduced in the articulator. If the height of the upper and lower arches of the actual Twin Hobby Articulator is 80 mm, the twin stage method, which divides the model for the procedure of dividing the anterior and molar parts into two, does not allow the height of the upper and lower teeth division by pindex to be insufficient, so the nurse slides the upper arch frame of the articulator 20 mm upward, but there is no problem in the calculation of the movement theory formula. In other words, the articulator is manufactured as a standard with the position of the condylar path center point standardized to 80 mm from the incisal path. Next, the front reference point of 43 mm reproduces the incisal edge of the maxillary right central incisor, so the maxillary occlusal plane is reproduced 2.15° downward as shown in Figure 8. However, since the occlusal plane is generally based on the mandibular dental arch, it is necessary to consider the angle difference of overbite and overjet, which is an average of 3 mm. When the upper central incisor is 3 mm forward of the lower central incisor (corresponding to the theoretical condylar path movement distance of 3 mm), the angle at 83 mm is 2.07°. The angle at the lower central incisor, which is reproduced as the original occlusal plane in front, is 2.15°, so there is a difference of approximately 2.2° = (2°). In other words, the angle at the incisal path is calculated as 7.37-2.07(2.15)=5.3°(5.22°) of the virtual occlusal plane. If this value is the virtual occlusal plane, the value of each horizontal reference plane and the value of approximately 2° will be important points for the results described later (see Figures 6-8). In the Ext group in the previous section, the incisal path angle relative to the Frankfurt plane is in the range of 46.85° = 47°. The difference of 2° in front is on the incisal path, and the result of 47° on the Frankfurt plane is not affected by the occlusal plane, so the value of 45°, which is 2° less, becomes the angle on the virtual occlusal plane, based on the results of the paper on crowding in Angle Class I. Looking at the angles in the above table, it seems contradictory, but the data from Angle Class I shows that the actual incisal path angle is not affected by the occlusal plane, so although there is no error in the arithmetic angle of the articulator, it is judged that there is no basis for any calculation based on Takayama's theoretical formula on the axis plane. Furthermore, even if the model of the articulator changes, the deviation of the upper arch frame of the articulator is close to zero (shown in Figures 6 and 7). The difference of 5° between the condylar path angle and the incisal path angle proposed by MacAuleys in his paper is probably why it is said to be clinically natural. It can be said that the values ​​of various occlusal planes all produce the same results as the values ​​of the axis plane. Next, the difference between the trough and condylar path angle is 120 mm, and the virtual movement of about 10 mm from the calculation of the deviation angle of the upper arch articulator itself is approximately 10 mm. The angle between the Frankfurt plane and the axis plane (7.35°) is moved by 10 mm on the condylar path angle of the upper arch frame (40°), as shown in Figure 6, and it moves almost parallel. In other words, we decided to calculate the occlusal plane reproduced as another standard. Similarly, the commonly used standard occlusal plane (see Table 8-5 on Occlusion Science, p. 194) has almost no effect on the incisal path angle. The angle 3 mm below the anterior reference point of Takayama's mandibular movement theory formula is about 2°, and the angle with respect to the Frankfurt plane from the calculation of the virtual occlusal plane is not affected by the occlusal plane, so if the incisal path angle is 47°, it can be reproduced as 45°, which is 2° less. Similarly, in the condylar path angle inclination, the trough-shaped and articulator arches are reversed by 180° and guided, so if the incisal path angle is slid to the trough-shaped angle and moved the same distance 120 mm on the condylar path, the difference between the condylar path angle of 40° and the trough-shaped angle of 45° is 5° (McAulis reported that a difference of 5° between the condylar path angle and the incisal path angle is clinically comfortable occlusal position). Even if the angles relative to all reference planes are traced on a Twin Hobby or Zero Hobby articulator, they are reproduced without any influence from the occlusal plane. In addition, a similar virtual movement of 5.3° in front will produce the same result. Furthermore, in general clinical practice, the guidance range of the articulator exceeds 10 mm, and the entire arch of the jaw is adjusted while guiding the teeth (Figures 6 and 7). Moreover, because the incisal path angle is not affected by the occlusal plane, it can be reevaluated as the incisal path angle in the Frankfurt plane by subtracting approximately 2° from the above 2.1°. In other words, the angle 3 mm below the anterior reference point in Takayama's mandibular movement theory formula is approximately 2°, and the angle relative to the Frankfurt plane is not affected by the occlusal plane from the calculation of the virtual occlusal plane, so if the incisal path angle is 47°, it can be reproduced as 45°, a value obtained by subtracting 2°. Takayama's mandibular movement theory formula does not clearly state that the incisal path angle is 45°. In other words, the calculated values ​​of each standard value in the sagittal plane from the mandibular movement theory formula are the trough-shaped incisal path angle of 46°, and the incisal path angle of 44° (44° + 2° = 46°) ⇒ approximately 2° is added to correct it downward to approximately 45°. Also, the condylar path angle is 40.05° (40°) (the result of calculation from the Quintessence Publisher's appendix on occlusion, and the number in parentheses is the number on the articulator). In calculations from Takayama's mandibular movement theory head and neck basic formula, the incisal path angle is 45° when the upper anterior teeth move 3 mm on the trough-shaped table, and the incisal path angle is 43° when the condylar path angle is 40°, but the articulator is set so that it is regulated to 45° by correcting 3 mm of the anterior reference point of 43 mm. In addition, the late Dr. Takayama stated that a difference of about 1° is fuzzy and ambiguous in physics. In other words, this is the angle reproduced on the Twin Hobby Articulator, and by using the Twin Hobby Articulator, which was introduced based on the author's mandibular movement theory formula of over 30 years, even if the incisal path angle is specified as 45°, good clinical results are achieved. Because of this, the incisal path angle was calculated based on Takayama's mandibular movement theory formula, and was not influenced by each reference occlusal plane relative to the horizontal plane. Treatment with a preadjusted appliance for Class I crowding showed no change in the skeletal system, regardless of whether the four premolars were extracted or not. However, in the extraction group, the inclination of the upper and lower central incisors was inclined lingually after treatment. In a report by Miyake et al., no change was observed in the axis of the upper and lower central incisors in either the extraction or non-extraction groups after dynamic treatment. The U1 to FH of the extraction group of Miyake et al. was smaller than that of the extraction group in this study (116.77°) (111.7° before treatment). The mandibular central incisor was 94.61° before treatment, but decreased by 4.58° to 90.03°, and the condylar incisal angle was close to 90°. According to Mc Horris, the condylar incisal angle is most stable functionally at 90°. Although the maxillary and mandibular anterior tooth axes decreased, the U1-L1 to FH (incisal path angle) did not change with treatment. However, during the retention period, it increased by 4.5° compared to the average value before treatment, reaching 46.9°. As Mc Horris states, this is thought to have been a constant value due to functional factors. The difference between the condylar path angle and the incisal path angle of 5° brings about a correlation between the incisal path angle and each reference occlusal plane, and we have come across results that are determined to be clinically consistent with Mc Horris' data (see Ito's diagnostic method using the Twin Hobby Articulator). Slavicek states that the condylar path angle of the incisal path angle is 9°. In a study of Japanese people, Takei et al. reported that the sagittal condylar path angle during forward movement (5mm) in different molar occlusion relationships was 50.2° in Class I, 50.3° in Class II, and 48.2° in Class III, and that the average inclination of the sagittal condylar path angle was 50° at 3mm and 5mm forward, with Class III having a gentler inclination compared to Classes I and II. The incisal path angle was 57°, which was 7° steeper than the condylar path angle of 50°. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] JP 2010-506692 A [Patent Document 2] JP 2007-37687 A [Patent Document 3] Korean version 2013-7006047 [Patent Document 4] Patent Publication No. 2022-105741 Trademark Registration 1 Trademark Application No. 2023-067830 Non-patent Documents

[0007] [Non-Patent Document 1] [Table 1] Reference materials (1 to 49 items) [Table 2] Reference materials (1 to 20 items). Summary of the Invention Even in this digital age, treatment plans for the same treatment vary from region to region, and treatment can be based on experience. More than 30 years have passed since the diagnosis and planning theory was revised to provide the same treatment to people of all ages, genders, and dexterity, and the brush is fitted without any discomfort to the patient, and if there is any discomfort with the trademarked brush, it creates an opportunity to go to the dentist, and it is a software that can utilize average values ​​that are scientific and can be used by anyone, and can be linked to existing large CAD, CAM, and 3D printers. [Problem to be solved by the invention]

[0008] The present invention is capable of optimal diagnostic planning, and can be linked with software related to analog and digital CAD, CAM, CAE equipment, 3D printers, oral hygiene management equipment, and other technology around the world, and can be AI-enabled. However, the digi-ARTI module (ITO Virtual Software, Yasunaga Computer Co., Ltd., Fukui, Japan) This software is a software system that does not have a dental diagnosis planning program.

[0009] This invention relates to technology that simulates a patient's jaw movement, and in particular to CAD.CAM.CAE.CAT software that can be used as a diagnostic device that can be the scientific basis for comprehensively planned devices, methods, and programs, and that can plan optimal diagnoses, can be linked with software related to analog and digital CAD.CAM.CAE devices, 3D printers, oral hygiene management devices, and other technology around the world, and can be AI-enabled; however, such software does not currently exist.

[0010] When using the improved brush pen brush, which has been trademarked (Trademark Application 2023-067830), to clean gaps in the crowns and around implants, the patient may experience a sensory discomfort that suggests some kind of symptom. Ordinary brush tips are used as brushes for cleaning and treating the tooth surface after the formation of vital teeth. When brushing around the crowns with a conventional interdental brush, interdental space brush, floss, or toothbrush, pain and bleeding occur, so patients tend to avoid it and stop cleaning, which leads to plaque deposition and inflammation. We would like to make it possible for the brush brush that corresponds to the above basic condition values ​​to be an improved brush brush that can also be computer-processed and AI-based for past guesses, current situations, and predictions for treatment. Means for the invention to solve the problem

[0011] Oral hygiene management has become common knowledge, but we tend to tolerate it unless it hurts. This brush brush can be used for cleaning without pain, so if you feel it, it can be a trigger to go to the dentist. And the technology to determine the policy of dental treatment plan by focusing on not only the alignment of teeth but also the bite, for example, according to the technology described in the patent document of Ito, can be realized by using the functions of Twin Hobby Articulator, Zero Hobby Improved Articulator, and ITO Articulator in a computer system (it can also be used for other virtual articulators), and each individual's virtual articulator can be reproduced using a three-dimensional image of the patient's dentition, and it is possible to judge whether the patient's dentition is correctly occluded in the past, present, and future, and there is no means to project it into a computer and make it into AI, so it is the present invention.

[0012] 1. Load intraoral STL and PLY data. 2. Load the 3D data of the part (prosthesis) you want to design. (There is a base, and the base design screen is created based on the XYZ axis data of each part of the base.) From here on, I will explain the thinking behind this order and calculation formula, although this is purely my imagination. 3. Figure 9 shows the limit movement when pinpointing each tooth in the sagittal and frontal planes starting from both condylar heads based on Takayama's theoretical formula for mandibular movement. In other words, it is a basic drawing that can be used as the basic limit movement when the tooth shape is created in sequence from the curved surface explained above according to the theoretical formula. 4. When determining the outline of the crown, even if you refer to Patent No. 5676325, Information Processing Device, Information Processing Method, and Program (0040, 0100-0107), it is not decisive. The tooth shape explained below must be considered by converting the cusp path into a fine mesh and determining the outline of the crown from the mandibular movement theory formula. However, the cusp path inclination of the tooth can be calculated from the measured values ​​of the condylar path and incisal path. It can also be calculated from the adjustment values ​​of the condylar path and incisal guide plate. In order to analyze the relationship between mandibular movement and occlusion from both theoretical and experimental perspectives, when the measured values ​​of the movement paths of the left and right condyles and the incisal path, which are the three vertices of the mandibular triangle, are given, a formula is required to calculate the movement path of the molar cusp tips from those values. The inclination of this movement path is the cusp path inclination, and the inclination angle relative to the axis plane is the cusp path inclination angle (Quintessence Publishing's Occlusion: Chapter 15, Figure 15-1c: p. 378). (Quintessence Publishing's Occlusion: Chapter 15, Figure 15-1a, b), as well as the reference point for measuring the occlusal surface of the molar (Kanazawa et al., 1983). The condylar path and the movement distance of the upper and lower teeth are the distance from the intercuspal position to the cantour, and correspond to the cusp path inclination, marginal ridge (ridge), and the above eight factors of the teeth. The gap between the contact guidance is considered to correspond to the groove. In other words, the effective cusp inclination angle of each tooth, which is the extremely effective angle of the tooth, can be calculated from the mandibular movement theory formula (Quintessence Publishing's Occlusion: Chapter 15, Table 15-5). Within these countless guide paths, a fine mesh is drawn, and the measurement values ​​are calculated on a computer to create moire patterns that appear like contour lines, and a three-dimensional tooth shape is constructed with an accuracy of 4 microns using laser irradiation. Next, the maximum values ​​of length, width and height (calculation formula, for example, calculation from the opposing tooth and remaining teeth on both sides, the numerical value of the starting point where the slope is induced with the axis plane, which is the occlusal plane, as well as the cusp path inclination angle are determined for each condition, so the distance to each trajectory can be calculated from trigonometric functions). Using existing large CAD / CAM / 3D printer equipment, these calculations are compared with the reference points of the mandibular movement theory formula to form the slope of the cusp path, and the shape of the occlusal surface is modeled through data processing in STL and PLY. 5. The position of the cusp tip is determined by Quintessence Publishing's Occlusion: pp. 130-146. The cusp tip is roughly equivalent to the occlusal plane (Journal of the Japanese Prosthodontic Society: 14(4): 351-356 2022). Furthermore, in Takayama's mandibular movement theory, the distal buccal cusp tip of the mandibular first molar is calculated to be at a position equivalent to one-quarter of the intercondylar distance. Anatomical support is required to determine the cusp tip of each tooth. 6. The position of the fissures is determined according to 5 above using the anatomical morphological information of each tooth. (Calculated using Euler's theorem from data on the opposing teeth, it is thought that the position of the fissure from the point where it fits with the cusp tip of the opposing tooth can be calculated using trigonometric functions.) 7. The inclination angle and distance from the fissure to each cusp tip are determined in accordance with 4 above (calculation is possible using Euler's theorem). 8. Italian physicist Tullio Regge discovered a groundbreaking method for calculating the general theory of relativity in the 1960s. This method divides space-time into triangles and calculates the curvature of space-time, and is currently used to calculate gravity using supercomputers. Points are appropriately determined for the shape of a sphere or tooth. The points are connected to divide the plane into triangles. All points are numbered. For each point, the surrounding triangles are extracted and placed flat on the plane. Since the plane is divided from the beginning, nothing changes, but if you calculate the angle of the gap between the triangles, the angle is zero because there is no gap. Next, divide the whole image of the sphere and tooth into triangles by connecting the similar points. When the points are numbered, all the angles are calculated to be 4π, and the surface area of ​​the sphere is 4πR. 2 4π represents the degree of curvature of each plane and sphere. This idea can be extended to three dimensions. In the case of three-dimensional space, a triangle is expanded and divided into a pyramid, i.e., a tetrahedron, and this time, instead of a point, a tetrahedron is cut out around a line segment. The sum of the angles of the gaps when placed in a flat space represents the curvature of the space, and the sum of the angles of the gaps multiplied by the length of the line segment represents the curvature. Furthermore, the four-dimensional space is divided into figures called simplexes, which are generalized tetrahedrons expanded to four dimensions, and since it is a rotational movement, it is also related to Euler's theorem. As mentioned above, the sum of the angles of the gaps represents the time and space (the moved position) and the degree of curvature of the rotation. This is related to the derivation of the curved form of the dental crown. In general, the degree of curvature is the left side, and the right side is related to matter, energy, and the force of the occlusion. In other words, Einstein's matter and energy are the Einstein equations for the oblique axes of the Minkowski diagram and the general orthogonal case. The contents of programming the computer system are added by multiplying the occlusion guidance, mandibular movement planning theoretical formula, and four basic condition values ​​with the polyhedron (Tomonaga Shinichiro, Iwanami Shoten; What is physics?, see Vol. 1 and 2), curved display, STL, PLY, which are related to the previous description instruction manual creation number. In other words, the curvature, curve, angle adjustment, and shape of the eight factors of the tooth shape ([from claim 2]) become the measurement data. Next, when we normally consider the shape of the occlusal surface of a tooth as an object, the surface of the differential structural calculation, which is a method of constructing by changing the surface, is a two-dimensional surface, but by attaching x and y coordinates onto a sphere, we can imagine a fine mesh that can specify any position. For example, it is the same as attaching the coordinates of latitude and longitude on a globe as a mesh. And the circumference is a one-dimensional surface, and just like there are stations on the Yamanote Line, the angle is determined from the condylar path, incisal path, and trough-shaped table, and the cusp path slope inclination is determined from the station you want to get on the cusp path family tree. At the same time, it is an exotic sphere in each dimension of mathematician Milner. If we select two of the eight morphological factors for each tooth, the movement from the meshed surface (coordinate system) of the occlusal surface 1 to another spherical surface 2 becomes a mapping, which, if we call it h, becomes a function. h is differentiable, and -1 If h is also differentiable, then h becomes a diffeomorphism, and if a diffeomorphism h exists for surface 1 and surface 2, then it is called a diffeomorphism. Differentiability means that the surface display is smooth. Conversely, if the image of STL.PLY drawn on surface 1 cannot be distinguished on the image of surface 2, then h is determined not to be differentiable. Effects of the invention

[0013] The set angles of the condylar path inclination and the trough-shaped incisal path inclination at each condition value (in the axis plane) Four standard values ​​for the condylar path inclination and the trough-shaped incisal path inclination setting angles (on the axis plane) for each condition value of formula 1. These are the condylar path angle, Bennett angle, trough-shaped table incisal path angle, and lateral wing angle of the basic condition values ​​1 to 4 revised by Takayama and Ito, and at the same time, the angles of the articulator relative to various occlusal planes refer to formulas 2 and 3. Four standard values ​​for the condylar path inclination and the trough-shaped incisal path inclination setting angles (on the axis plane) for each condition value of formula 1 TIFF2025066022000055.tif207141TIFF2025066022000056.tif73117The mandibular movement theory of nurse Takayama has been proven to be effective for over 30 years by the author, and has been proven to be effective for anyone with no discomfort, by obtaining the average value from the patient's consent and scientifically based numerical values ​​from both in vitro and in vivo comparisons of articulators and the oral cavity. However, if the anterior guidance of the anterior teeth is set to 45° and 20° upward, and at the same time there is no contact with the rearmost tooth on the opposite non-working side, the posterior teeth are loaded, resulting in severe periodontitis. This idea describes the history of the occlusal pattern of eccentric movement. 1. Balanced occlusion (GPT-6 balanced articulation) distributes lateral occlusal force and stress evenly to each tooth and temporomandibular joint, and as a result, the lateral occlusal pressure is reduced to a range that can be physiologically shared by the teeth and temporomandibular joint (Granger 1962). It is based on the theory that chewing movement occurs horizontally, not vertically. It has also been established as Bonwill's triangle (1859) and the theory of three-point contact, the curve of Spee (1984), and Monson's spherical theory (1920). The so-called balanced occlusion is an occlusion in which all teeth are in contact at the same time during the intercuspal position and the entire process of mandibular movement. Lucia (1961) performed oral rehabilitation with balanced occlusion for 12 years, and for the next 20 years, the majority of patients had a comfortable occlusion, the condition of the periodontal tissue improved, the temporomandibular joints were healed, and oral rehabilitation was considered successful. A few cases were good for 5 to 10 years after surgery, but abnormalities occurred, excessive wear appeared between the centric position and the intercuspal position, and disharmony occurred as occlusal trauma. As a result, Lucia recognized it as a failure. However, although it is effective in stabilizing complete dentures, it has been pointed out that it can cause occlusal trauma in dentate jaws, and therefore is harmful (Ramfjord et al. 1966, Posselt 1968). Before D'Amico proposed the origin of canine guidance in 1958, Nagao (1919) 2)(1969) and his detailed study of the curve of Spee in mammals, which showed that the mandibular path during protrusive movement challenged Spee's view and consequently criticized balanced occlusion. The concept of canine guidance was inspired by the work of Nagao and was supported by the extensive work of D'Amico. Figure 10 shows CTB: cross tooth balance and CAB: cross arch balance in canine guidance. 2. Schuler (1959, 1961, 1963), who had doubts about D'Amico's canine guidance, proposed a group function (GPT-6.1994 group function) 22) By applying lateral pressure only to one canine tooth, This was supported by Lauritzen (1954), Pankey and Mann (1960), Posselt (1968), Ramf jord and Ash (1966). Lateral pressure is distributed across the entire tooth on the working side. Figure 11 shows group function, and Schuler (1959, 1961, 1963) rejected CAB (cross-arch balance), a pattern in which the buccal side of the molars on the working side are in contact, the lingual side is in disarticulation, and the non-working side is all in disarticulation. 3. Mutual protective occlusion has been defined as the long centric theory, the sharing of lateral pressure by all teeth on the working side during lateral movement, and the prevention of induced contact of teeth on the non-working side during lateral movement. Figure 12 shows how all teeth separate during canine guidance. 4. When the anterior guidance of the anterior teeth is set at 45° and 20° upward, and at the same time there is no contact with the rearmost tooth on the opposite non-working side, the posterior teeth are loaded, resulting in severe periodontitis over the past 25 years. In other words, this is different from the indications of Schuyler, who contraindicated cross-arch balance on the non-working side. Mutually Protective Occlusion, which is evaluated as a gnathological occlusion pattern. 21)This also has a bearing on the definition of the occlusion pattern. It is often said that a four-legged desk is prone to wobbling, and that a three-legged desk is more stable, but is this really the case? Even in animals, the chairs and tables we use in our daily lives must have four legs more frequently. The gnathologists and Schuler mentioned above say that a three-legged desk that opens the non-working side is stable, but the numerical values ​​of the ITO mandibular theoretical formula this time are an occlusion pattern that is contrary to Schuyler's point out and the gnathological occlusion pattern. And, the left and right bilateral condyles, anterior guidance, and posterior guidance 26,32) If the jaw is supported on four legs, it will be stabilized based on the virtual occlusal plane, and this has been suggested as a medical measure for predicting and preventing periodontitis, caries, and various other conditions. 5. A case in which there was space between the upper and lower parts of the right non-working side during working side movement of the left canine equivalent. The case was observed 20 years ago with the basic condition values ​​for the molar area and the anterior area of ​​the posterior movement, and the periodontal pocket on the right side had resorbed up to the apex. Figure 13 shows the periodontal pocket values, especially the distal root pocket, which has resorbed bone to the extent of mixing, 9mm to 6mm. Figure 14 shows the guide articulator image of the left working side canine. Figure 15 shows the articulator image of the right most posterior molar area in Figure 14. Figures 16 and 17 show the contact area of ​​the right canine and the left non-working side, which has no protruding points. In the case of cross arch balance, the standard values ​​1, 2, and 3 from the new mandibular movement theory formula have brought about clinically very good results, and the regeneration by bone resorption is also going well. Figure 18 shows a tendency to improve on May 20, 2014 and December 20, 2018. The condition value of cross arch balance is the lateral wing angle of condition 2 of forward movement, which is the same value as the angle of the posterior molar area on the opposite side. Figure 19 is an X-ray image after periodontal regeneration.

[0014] 1. If the sagittal incisal angle is less than 44°, it will be impossible to bite through with the anterior teeth. Even if the nerve is removed during root canal treatment and the covering relationship is considered normal, there are cases where objects are caught between the teeth, caries, caries repair treatment, plaque, tartar deposits, tooth chips, and all kinds of prosthetic treatments are performed on the lower anterior teeth. When the permanent teeth are said to have completed eruption from the baby teeth to the upper grades of junior high school, if the incisal movement of the anterior teeth is less than 45 degrees, symptoms such as caries, periodontitis, not being able to chew with the anterior teeth, tooth fractures due to trauma, and dislocation will appear. If it is more than 45 degrees, the front teeth will have fracture lines, chipping, and as the patient ages, the teeth will become discolored. In the areas where chewing is not possible, acid erosion depressions will appear on the incisal edges and the inclined surfaces on the tongue side. Figure 20 shows that when the anterior guidance of the upper right central incisor is smaller than the reference value, This leads to the expansion of caries and tea stains tend to adhere to the teeth. 2. If the side wing angles of the trough-shaped table are, for example, 21° on the right side and 20° on the other side, the patient will chew at 21° even though 20° is the normal value according to the theoretical value for mandibular movement. 3. If the side wing angle of the trough table is 20° on both sides and the sagittal incisal path angle is 45°, The facial distortion has improved. 4. If the anterior guidance of the anterior teeth is set at 45° or 20° upward and at the same time does not come into contact with the highest posterior tooth on the opposite side, stress will be placed on the posterior tooth on the opposite side, causing severe periodontitis (5 in

[0012] of the main text). 5. Although it is an exception, if there is a right posterior tooth, or if the left posterior tooth has collapsed, the angle of the side wing of the trough-shaped table of the right canine equivalent will exceed 20° and 30°, so the molar area needs to be properly treated. Common sense would seem to affirm the tendency to have a biting habit, but facial distortions appear due to the involvement of the bite. The corners of the mouth, the swelling of the cheeks, the curvature of the nose, the height of the eyebrows, and facial distortion tend to improve if there is no facial trauma (traffic accident, etc.) and the cause is the upper and lower teeth. Figures 22 and 23 show that the lower left 5, 6 and 7 areas match the ideal values ​​of condition 1, but the lower left second molar 7 is protruding. However, during backward movement, the buccal mesial of the maxillary left first molar 6 and mandibular second molar 7 slides and cannot protrude any further, and the canine of the right anterior tooth on the opposite side of condition 2 is set at the same angle as the lateral wing angle that reproduces the molar area, which is the beginning of the factors that determine chewing habits, and the incisal pole is floating. You will bite with the side that is floating at a larger angle. Now, the height and angle of the teeth that have been extruded and moved will stop at the point where they meet the reference value of condition 3 so as to hold the jaw in place. This will also match the information in the patient's mouth if it is actually attached to an articulator. This is a theoretical formula for planned movement that can be understood by performing this series of operations. Adjustment and attachment of the stent is necessary as a treatment prosthesis to improve any discomfort felt at the initial consultation, and the Ito revised mandibular movement planning theory formula allows the patient to take their time (Figures 24-27). 6. When moving from dynamic to retention in orthodontic treatment, the numerical angle of the anterior guidance is widely used as a resettable value, and appears to be both aesthetic and functional. Figure 28 shows an example of an occlusion diagnostic item, along with an explanation of the diagnostic process and results communicated to the patient using ITO Virtual Software and a semi-adjustable articulator with a trough table. 7. Regarding anterior guidance, despite the existence of opinions, the current situation is that no solution has yet been reached (see number 3 above). The inclination angle of the anterior guidance is set at an extremely stable angle for all occlusal planes, and in the axis plane according to Guichet, it was possible to bite down on both sides without any sensory discomfort from a condylar path angle of 40°, a sagittal incisal path angle of 45° on the trough table, and a lateral wing angle of 20° on the trough table. In Figures 29 to 34, check the movement of the left and right working sides, and the side wing angle of the trough-shaped table is 20°. Although the incisal pole is in contact, due to the space in the canine area, the patient cannot cut the thread at all, and the functionality and aesthetics of the front teeth are affected by the short teeth and facial appearance. In the cases of Figures 29 and 30, if there is a space above and below the upper and lower front teeth during forward movement, the patient cannot bite and eats using his tongue. You can judge this by eating, for example, by trying to cut glass noodles or your own hair with the incisal edge of your teeth. 8. If there is not enough From Figure 35, when special laminate is utilized, hybrid type hard resin (Ceramage Up, Matsukaze, Kyoto, Japan) is used. As shown in Figures 36 and 37, the final treatment will be to create the front teeth out of ceramic. Figures 38 to 40 show cases in which orthodontic treatment was performed and discomfort in the molar area occurred immediately before dynamic treatment. Figures 41 to 45 show examples of the prosthetic process and final dental treatment, from mandibular attachment.

[0015] The set angle of the anterior guidance is a strategically essential value while responding to various clinical findings such as implant prosthesis, orthodontic treatment, chewing function that allows easy biting, periodontitis, caries, etc. In the unlikely event that pain occurs, emergency treatment is performed, and if not, on the day, the upper and lower full jaw models are attached to the articulator, and although it takes about 3 hours, the standard angle evaluation is performed, and a stent for occlusion adjustment is decided, and as a result of the treatment on the day, the pain disappears on the spot, and I have experienced many cases. Since discomfort due to the occlusion often causes severe pain, it is important to properly obtain a full jaw dental model and attach it to an articulator with a trough-shaped table angle changeable. Clinical results over the past 30 years have shown that prosthetic devices can be fitted without any sensory discomfort and without occlusal adjustment. However, in 2018, Kulzer, based on numerous cases and algorithmic ideas that are important for computer analysis, has been working hard to reduce the time required for large-scale equipment and technical production. The same results have been seen with CAD / CAM / 3D printers (Table 1, Reference 44) sold worldwide. Although we live in a digital age where precision can be improved with precision, unfortunately, it is difficult to say that these devices are fitted without adjustment. If CAD software that can be fitted without adjustment is completed, it would be great if it becomes a miracle cure for dental treatment. Of course, diagnostic evidence for the dental world, including the medical field, is an important strategic issue in any industry. See the reference materials (1 to 52 items) in Table 1 below. References 1) Gysi A.The problem of articulation.Dent Cosmo 1910;52(3):1-19,148-169,68-283,403-418. 2) Nagao M.Comparative Studies on the Curve of Spee in Mammals,with a discussion of Its Relation to the Form of the fossa Mandibularis.JD Res.1919;1:159-202. 3) Monson, GSOcclusion as Applied to Crown and Bridgework, JN Dent Assoc.1920;7:399-413. 4) Monson GS.Applied mechanics to the theory of mandibular movements.Dent Cosmos 1932;74:1039-1053. 5) McLean, DW The Physiology of Mastication, JADA27:226-231, 1940. 6) Schuyler,C.H.Correction of Occlusal Disharmony of the Natural Dentition,New York J.Den.1947;13:445-462. 7) Schuyler,C.H.Factors of Occlusion Applicable to Restorative Dentistry,J.Pros.Den.3:781,1953. 8) McCollum BB,Stuart CE.A Research Report.South Pasadena Calif:Scientific Press;1955. 9) D’Amico,A.Canine Teeth-Normal Functional Relation of the Natural Teeth of Man,J.South California D.A.1958;26:6-23,49-60,127-142,175-182,194-208,239-241. 10)Schuyler,C.H.Evaluation of incisal guidance and its influence in restorative dentistry.J Pros Den 1959 May;9:374. 11)Schuyler,C.H.Factors Contributing to Traumatic Occlusion,J.Pros.Den.11:708,708-717,1961. 12)Stallard,H.,and Stuart,C.E.Eliminating Tooth Guidance in Natural Dentitions.J.Pros.Den.1961;11:474-479. 13)Bregstein,S.J.Diagnosis and Treatment Planning.A Philosophy,Ann.Den.1962;21:37-39. 14)Schuyler CH.The function and importance of incisal guidance in oral rehabilitation.J Prosthet Dent 1963;Nov-Dec 13(6):1011,1011-1029. 15)Takayama H.Kinematical and Experimental Analyses of the Mandibular Movement in Man for Clinical Application,PhD thesis:University of Tokyo Japan 1989;8,203:278-282. 16)Takayama H,Hobo S.Kinematical and experimental analysis of the mandibular movement in man for clinical application.Precision Machinery 1989;2:229-304. 17)Hobo S,Takayama H.A new system for measuring condylar path and computing anterior guidance:Part I.Measuring principle.Int J Prosthodont 1988;1:99-106. 18)Hobo S,Ito H.Gnathologic reconstruction for osseointegrated implants.J Gnathol 1990;9:49-64. 19)Hobo S. Twin-tables technique for occlusal rehabilitation:Part I Mechanism of anterior guidance .J Prosthet Dent 1991a;September 66(3):299-303. 20)Hobo S. Twin-tables technique for occlusal rehabilitation:Part II Clinical procedures .J Prosthet Dent1991 b;October 66(4):471-477. 21)Ito H,Takayama H.Diagnostic method of occlusion,utilizing the twin-stage procedure.J Aca gnath Occ 2004;(24)1:81-93. 22)Hobo S Supervised by,Haga M,Takayama H.Science of occlusion.Tokyo:Quintessence;1995:12-19,86-128.250-252,255,256,253-255,257-262,564-583. 23)Hobo S,Itou H,Takayama H.Atlas Twin Hobby actual clinical studies occlusal articulator.Tokyo:Quintessence;1995:64-84,38-134.135-139. 24)Hobo S,Takayama H.Oral Rehabilitation Clinical determination of occlusion.Tokyo:Quintessence;1997:64-84,135-139,143-163. 25)Kar AK,Parkash H,Jain V. Full-mouth rehabilitation of a case of generalized enamel hypoplasia using a twin-stage procedure .Contemp Clin Dent 2010;1(2):98-102. 26)Itou H.A dental practice support method and system(the 2010 patent acquisition). 27)McHorris WH.Occlusion with particular emphasis on the functional and parafunctional role of anterior teeth,Part 1.J Clin Orthod 1979 a;13:606-620. 28)McHorris WH.Occlusion with particular emphasis on the functional and parafunctional role of anterior teeth,Part 2.J Clin Orthod 1979 b;13:684-701. 29)McHorris WH.Focus on anterior guidance,Introduction.J Gnathol1979 c;8:3-13. 30)Itou H,Oue K,Ryu T,Himuro T.Anterior tooth movement and stability of Class I crowding treated with a preadjusted appliance.Ohu University thesis presentation:2012. 31)Itou H.Anterior tooth movement and stability in class 1 crowding patients treated with preadjusted appliances.Ohu Univ dent j 2013;40,(3):129-137. 32)H.N.Costa,R.Slavicek,S.Sato.A three-dimensional computerized tomography study,into the morphological interrelationship between anterior and posterior guidance and the occlusal scheme in human Caucasian skulls . International Journal of Stomatology and.Occ.Med.2011;vol.no.4,10-19. 33)Zoghby AE,Re JP,Perez C. Functional harmony between the sagittal condylar path inclination and the anterior guidance inclination .J Stomatology Occ Med 2009;2:131-136. 34)Kar AK,Parkash H,Jain V.Full-mouth rehabilitation of a case of generalized enamel hypoplasia using a twin-stage procedure .C Ontemp Clinic nt2010;1(2):98-102. 35)G Rani,A Gambhir.Twin-stage technique for occlusal rehabilitation of a mutilated dentition.2010;m.lakotalakes.com 36)Naresh HG Shetty,Manoj Shetty,Krishna Prasad D.ESTHETIC AND FUNCTIONAL REHABILITATION OF THE PATIENT WITH SEVERELY WORN DENTITION USING TWIN STAGE PROCEDURE:A CASE REPORT. IJCRR IJCRR 2012 February;04,03,:93-99. 37)Ravindra M.Chavdal,Rupal J.Shah,Hiren Vanza.A generalized attrition case-full mouth rehabilitation using Hobo Twin-stage procedure.Int J Res Med.2013;2(4);108-111. 38)Anulekha Avinash CK,Chittaranjan B,Sudheer Charry N,Ramu Reddy,and Aditya Sai Jagini.Restoring the Lost Functional Harmony in a Mutilated Dentition using Hobo’s Twin Stage Concept of Full Mouth Rehabilitation.J Clin Diagn Res.2014 Sep;8(9):21-23. 39)Huzaifa Ezzy,Amit Gaikwad,Sabita Ram,Naisargi Shah,Jyoti Nadgere,Janani Iyer.Full-mouth Rehabilitation of Worn Dentition by Hobo Twin-stage Philosophy:A Case Series.Journal of Contemporary Dentistry 2019 January-April;9,1:17-24. 40) Anjana Maharjan , Sarita Joshi , Anand Verma ,and Ujjwal Rimal . Rehabilitation of Severely Attrited Teeth with Hobo Twin Stage Technique:A Case Report. JNMA J Nepal Med Assoc. 2019 Nov-Dec;57(220):453-456. 41)Huzaifa E,Amit G,Sabita R,Naisargi S,Jyoti N,Janani I.Full-mouth Rehabilitation of Worn dentition by Hobo Twin-stage Philisophy:a Case Series.J of Contemporary Dentistry(January-April2019;9,1:17-23. 42)Kobayashi K,Kobayashi K,Harakawa R.Occlusal contact at eccentric position and it’s historical changes.Tokyo:Quintessence;2019;38,4:44-67. 43)Chatterjee N,Ghosh A. Oral rehabilitation by twin stage technique in a case of Amelogenesis Imperfecta. Clinical Dentistry.2020;14,3:18-24. 44)Uchida T,Yoshida T,Ito K.Improvement of Tooth Appearance and Function after Reconstruction of the Maxillary Anterior Interproximal Dental Papilla by an Interdisciplinary Approach.J jpn Periodontal 2003;45:142-149. 45)Abe S.Esthedc Relationbetween the Upper and Lower Anterior Teeth and the Face.Kyushu dental society 1988;S42(6):887-v902. 46)Mutobe Y.A Case of Interdental Papillae Growth by Application of Maxillary Anterior Crowns.J Jpn Prosthodont Soc 2005;49:306-309. 47)Tanaka S.Esthetic Restoration of Upper Anterior Teeth Using Castable Ceramics Crowns.J Jpn Prosthodont Soc 2003;47:383-384. 48)Tatiki T,Matumura E,Muramatu E,Nsii Y,Nezu T,Nojima K,Takaki T,Sueisi K.Long-term Outcome in a Patient with Discrepancy between Dental and Mandible Midlines.Jan J Jaw Deform;2012,22,3:228-237. 49)Ogawa T, Ikawa T, Kihara T, Ito T, Shigemoto S.Current status and future perspective of virtual articulators.Ann Jpn Prosthodont Soc 2021;13:5-12. 50) Yasuhiro Tanimoto, PhD, Shunsuke Nabata, DDS, PhD and Yukako Kato, DDS.Current status and future perspectives of dental materials for CAD / CAM system in prosthodontics.Ann Jpn Prothodont Soc 15:458-466,2023. 51)Akikazu Shinya,DDS,PhD.Relationship between analog and technology Current status and future prospects of prothetic fabrication using digital technology.Ann Jpn Prothodont Soc 15:467-473,2023. 52)Kumar KH, Gopika KK, Shari SR.Restoring esthetics and functional harmony in a patient with attrited dentition using Hobo twin-stage technique.J Interdiscip Dentistry 13:109-14,2023.

[0016] Condition 4: Reproduction of the posterior region of the backward movement. Figure 46 This time, the evaluation was performed under condition 4 using the ITO articulator, which is a semi-adjustable articulator with a trough-shaped table. Since the amount of movement in condition 4 is extremely delicate, the full-arch dentition model was scanned using the semi-adjustable articulator with a trough-shaped table, and intraoral scanning was performed to process the STL data. Next, while linking and enlarging with the ITO virtual articulator made by Yasunaga Computer Co., Ltd., the reproduction of condition 4 is judged by the ITO virtual occlusion. In other words, since it is a very delicate movement to reproduce with the analog semi-adjustable articulator shown in Figure 47, we have no choice but to rely on digital equipment. The full-arch dental model is attached to a semi-adjustable articulator with a trough-shaped table, and the intraoral scan is performed to process the STL data, so that the details of each case can be judged in conjunction with the ITO virtual articulator.

[0017] In general practice, experienced dental professionals seem to be able to overcome patients' concerns by talking about their own experiences. It seems that serious troubles between patients can be difficult to resolve even if they go to court. Since there is no evidence-based dentistry for dental treatment based on occlusion, how many years has it been said that evidence-based dentistry, which is a diagnosis based on proper scientific evidence, does not exist? At the Japanese Society of Orthodontics held in Tokyo on October 10, 1998, a professor who was an academic committee member at the time announced that general clinicians and university professors of basic and clinical sciences would set a goal of establishing a diagnosis for treatment based on occlusion within 10 years. Unfortunately, no conclusion has been reached yet. The authors generally find that by utilizing criteria values ​​of 1 to 3, patients experience no discomfort and achieve good results. The ITO Virtual Software developed by Yasunaga Computer Co., Ltd. was created to reproduce jaw movement in the ITO Virtual Software by storing data converted to STL and PLY from opposing teeth such as 3D cephalometric CT scans and upper and lower jaw models on a CD-RUM flash disk. However, it is not possible to diagnose, and furthermore, [Patent Document 2] may be necessary. The basic concept is to use the four basic condition values ​​of the new mandibular movement theory formula to reproduce the mandibular movement of all kinds of articulators, and to reproduce it as a computer simulator that creates an ideal occlusion. Unfortunately, dental professionals, who are under pressure every day, do not incorporate a diagnostic planning basis for dental treatment. The current situation is that treatment is haphazard and temporary, and it is not possible to obtain the consent of all patients. However, the effects of this system are as described above.

[0018] In the science of the human act of eating, various interpretations arise depending on the experimental design and evaluation of the results. Figure 48 shows an improved and existing brush. The use of the crown cleaning brush being developed by Ito et al., which can be used as a cleaning brush for the oral cavity, can be a bridge to the opportunity for patients to visit a dental clinic due to the discomfort that may occur in the area being cleaned. In addition, existing cleaning tools for interdental spaces, etc., are currently used for cleaning the current state, but they are no longer used because they are painful. In addition, a sleeve cap that returns the tip to its original shape is inserted from the base of the improved brush brush, which is inserted around the crown of the tooth. In general, a tapered brush brush tends to be difficult to insert because the cap is inserted from the tip of the brush.

[0019] Now, the shape of a tooth is a molecular machine that is controlled very precisely at the molecular level of an organism, and the tooth shape information programmed in the AGTC genetic code made of DNA in each and every tooth cell at the molecular level of an individual is evaluated by an algorithm, and we are now in an era of dental CAD / CAM / 3D printers. It is said that there are millions of differences between the standard human genome and an individual's genome. However, since each person's genome is 99.9% the same, with only slight differences, it is natural that tooth shapes are different if we consider it as a difference in individuality. Now, by analyzing the tooth morphology of 99.9% of individuals, the tooth morphology is formed from the design of Takayama's mandibular movement theory formula (Figure 9), and as a result of the experiment as a basis, in order to reevaluate the upper and lower molar morphology, the averaged cusp path inclination angle, which is important for creating the tooth morphology, is derived from the case of Kanazawa et al.'s comparison and examination of the upper and lower first molar morphology. Furthermore, in order to scientifically evaluate, the molar dislocation amount, anterior guidance, etc. are combined to create a formula as two standard values ​​as a comparative examination plan, and clinical evaluation has been carried out for over 30 years. The author has a history of clinical practice in which two standard values ​​as a design for clinical evaluation are evaluated from the results of the patient's condition. In a case of prosthetic treatment for the posterior teeth, due to the occurrence of internal jaw disorders, a reevaluation was carried out, which resulted in the quantification of what is commonly referred to as posterior guidance, and in order to reproduce posterior movement, two reference values ​​were added, making four reference values, and at the same time, errors in Takayama's theoretical formula were evaluated and revised. These clinical results over the past 30 years have been evaluated by patients as good results that do not cause any sensory discomfort (Numbers 1, 3).

[0020] Takayama's process of manifestation of internal jaw derangement in the kinematic basis of the new prosthetic clinical technique, when internal jaw derangement occurs due to dental causes and gives rise to vague symptoms, is as follows: 1. Measure the interfacial distance to determine whether there is an infraocclusion. 2. Calculate the splint thickness and elevation. 3. After taking a full jaw upper and lower dental model or scanning the oral cavity, attach it to a semi-adjustable articulator with a trough-shaped table. 4. How to make and adjust splints. 5. After completing the adjustments, reattach it to the articulator and begin final treatment using the standard condition values ​​of the mandibular movement theory formula. 6. The final treatment involves replacing the occlusal surface of the splint with metal or other material in accordance with the basic condition values, or creating a removable splint out of hard resin or other material. 7.6 In principle, full mouth treatment to reconstruct the entire dentition is the final solution. The progress has been good by proceeding with treatment based on Takayama's description of internal jaw derangement, the mandibular movement theory formula, and commonly used standards for interfacial distance and occlusion registration.

[0021] Next, referring to Takayama's sagittal diagram of the process of internal jaw derangement, we will proceed with treatment in the following steps. Figure 49 shows that when the posterior second molar area is raised about 1.5 mm in the sagittal plane, the condyle is guided downward by about 3.0 mm from the vector force. Detailed guided dimension values ​​are summarized in Figures 49 to 51. 1. The basis for making a splint is to make a Michigan-type splint in cases where the difference between the interfacial distance and the amount of resting space indicates a definite low occlusion. The standard for raising the occlusion is the Viral method from Figure 50. If the height of the face is low, there is a risk of misalignment in the interocclusion position if the incisal pole is simply raised on the articulator. The interfacial distance is measured to determine whether there is a low occlusion. The interfacial distance from the Viral method seems to be about 60mm to 80mm, and is judged from the difference in the distance from the chin to the underside of the nose and the height from the corner of the mouth to the pupil. According to the Willis method, the height of the interfacial distance fluctuates within the range of BD = 5 mm to 10 mm. The thickness and elevation of the splint are calculated by taking the front as + on the X-axis and the bottom as + on the Z-axis. Note that the Y-axis is determined by taking the right side as +. Regarding the induction of the mandibular body by molars, the table numbers are quoted from Hobo S, Takayama H. ​​Oral Rehabilitation Clinical determination of Occlusion. Qint Pub Co, In; 1997: 143-163. Figure 51 Position of the last molar M⇒M' by hinge rotation (Θ rotation) around the condyle C The change in the height of the teeth when the teeth are rotated around the molars M' and M'' to return them to their original height. These are displacement of the condyle position (C'⇒C'') and change in incisor position (I'⇒I''). 2.Nomalized Kinematic formula for lateral movement:(ORAL REHABILITATION Clinical Determination of Occlusion:Table 6 (p151) ΔX=B×Λ cl ×cosΩ cl ÷L c -C×Θ hl ΔY=(C×tanΩcl+A+L c ×tanβ e )×Λ cl ×cosΩ cl ÷L c ΔZ=B×sinΩ cl ×Λ cl ÷L c +A×Θ hl ΔZ is h z : Molar displacement on the Z axis in mm. 3. Calculate the rotation angle θ of the rotation centered on the molar. The distance from the molar to the incisor (I'M') is 40mm, so it is as follows (quoted from Takayama's standard values ​​for mandibular movement related elements). The rotation angle is set so that the lower incisor is returned to its original height around the displaced upper second molar. θ=sin -1 (h z / 40). 4. The position (X', Z') after rotation of any point (X, Z) on the mandible with the second molar as the origin can be calculated using a rotation matrix as follows. If the displaced maxillary second molar is taken as M: origin (0, 0), the mandibular head position C(X, Z) before the displacement is posterior, so X=-40, Z=-40, and the mandibular head position C'(X', Z') after the displacement is X'=Xcosθ-Zsinθ, Z'=-Xsinθ+Zcosθ+h z mm. On the Z axis, h z mm will be added. The formula for the displacement of the molar position due to hinge rotation (Θ rotation) around the mandibular condyle (Table 13, cited from the appendix of the overseas edition, p.157) Non-working side: h=(L c / 2+b m )×δ l tan Ω cl +40×Θ t hl Working side: h=(L c / 2-b m )×δ l tan Ω cl +40×Θ t hl It becomes. In other words, "δ l =(Λ cl / L c )×cosΩ c " is the horizontal side turning angle, so h=(L c / 2+b m )×δ l tan Ω cl +40×Θ t hl ⇒ΔZ h = B × sinΩ cl ×Λ cl ÷L c +A×Θ hl [B=(L c / 2+b m ), A=40]. 5. The displacement of the mandibular condyle, ΔX' and ΔZ', are ΔX'=X'-X and ΔZ'=Z'-Z. Displacement of the condyle C. (-40,-40) for each condition 1, 2, 3, and 4 by the mandibular molar center M (0,0) during forward movement (number 4). Condition 1 is the molar area, condition 2 is the anterior area, condition 3 is the anterior area of ​​backward movement, and condition 4 is the posterior area of ​​backward movement (See the original paper, "A method for diagnosing occlusion using the twin stage method: The Science of Occlusion," Vol. 24, No. 1: 81-93, 2004). TIFF2025066022000057.tif133129 Displacement of the condyle C (-40, -40) for each condition 1, 2, 3, and 4 based on the mandibular molar center M (0, 0) during forward movement. Condition 1 is the molar area, condition 2 is the anterior area, condition 3 is the anterior region of retraction, and condition 4 is the posterior region of retraction. (Method of diagnosing occlusion using the twin-stage method: The Science of Occlusion, Vol. 24, No. 1: 81-93, 2004, original article) Remarks 1 Protrusive movement ΔX=B×Λ cp ×cosΩ cp ÷L c -C×Θ hp ΔY=(C×tanΩ cp +A+L c ×tanβ e )×Λ cp ×cosΩ cp ÷L c ΔZ=B×sinΩ cp ×Λ cp ÷L c +A×Θ hp Note 2 ΔX h =B×Λ cp ×cosΩ cp ÷L c -C×Θ hp ΔZ h = B × sinΩ cp ×Λ cp ÷L c +A×Θ hp Front hinge rotation angle (Θ t hp ) was set with the molar M(0,0) as the origin. The X and Z coordinates of the incisors are: (Ai=40. Bi=110. Ci=40). On the X-axis, the front is +, on the Z-axis, the bottom is +, and on the Y-axis, the right side is +, so we will add that the coordinate axes are determined by this. For example, if the condylar path length is Δ cp= 3mm, to move the condylar path length backward by the same distance of -3.0mm on the Z axis, the value on the Z axis is 3×sin40=1.928mm ≒ 2.0mm upward adjustment if the condylar path angle is 40°. On the X axis, it moves backward by 3×cos40=2.298mm ≒ 2.3mm. This is the same result as moving -1.0mm upward on the Z axis at M(40, 40), resulting in a lower occlusion. This value is also considered to be comparable to the vector force value of Takayama's internal jaw derangement. In other words, since the incisal path I, the incisal edge of the mandibular anterior teeth, is -2.3 mm posterior on the X-axis, it moves upward, that is, -2.0 mm, on the Z-axis in the condylar path C. Conversely, if M(40, 40) is raised by 1.0 mm, it will be guided in the opposite direction to that described above. Now, from the calculated value of the displacement of the mandibular head, when the mandibular molar part is the center during forward movement, the displacement amount of the condyle C (-40, -40) of each condition value by M (0, 0) is condition 2, which is the condition value of the anterior part. On the X axis, it is 1.974 mm ≒ 2.0 mm, and on the Z axis, it is 0.047 mm. Even if the displacement of the mandibular head is arithmetically calculated, if it moves forward about 2.0 mm on the X axis, the same distance is 2.0 mm at the incisal path point in the sagittal plane, so it becomes 1.0 mm higher at the molar part. In other words, the same distance is also corrected downward by 2.0 mm on the Z axis at the condylar path part. However, since the displacement of the mandibular head is 2.3 mm on the X axis, it is necessary to assume that the condyle is displaced by approximately 2.3 times. If the overbite and overjet in a normal dentition is approximately 3.0 mm, then the overjet of 3.0 mm will have been moved forward by 3.0 mm at the incisal point in the sagittal plane. In other words, the height at the molar area M (40, 40) will be raised by 1.5 mm, and the dentition on the Z-axis from the condylar path will be 3 mm higher. However, the condylar path will be corrected downward by about 3 mm. This calculated value will be taken into consideration as the amount of displacement of the mandibular condyle. Now, if the posterior teeth are lowered by 1.5 mm, the angular difference in the sagittal plane is 2.15°. According to condition 2 in Table 1, the displacement on the X-axis is 0.112 mm, and on the Z-axis at the bone body below the occlusal plane of the dentition at the condylar path is 3.0 + 0.047 = 3.047 mm. This 3.047 mm ≒ 3.0 mm value on the Z-axis is an estimate of Takayama's internal jaw disorder in Figure 1. This value seems to correspond to the difference of about 10 mm, which is the maximum value of the interfacial distance in the Viral method. Therefore, in order to make a splint, the interfacial distance and the space of the resting space must also be measured. (Mandibular Kinesiograph K7, Morita Co., Ltd., Tokyo, Japan) Even when using electromyography, the amount of resting space is determined from the occlusal vertical dimension when the facial muscle spasm is the smallest, and it is generally said to be about 0.8 to 1.2 mm for K7. It is an arithmetic calculation, but for example, when the interfacial distance is about 10 mm, the condylar displacement in upward movement is about three times larger, so the thickness of the splint is approximately (10-1.2)÷3=2.9mm≒3.0mm. Considering this, examples of this would be clicking, crepitation, or discomfort in the jaw caused by the inability to withstand the changes in the situation within the articular tissue of the condylar path. If the resting space is about 1.0 mm, the value from upward movement is (10-1.2)÷3.0=2.9mm, which is the thickness of the splint for the amount of elevation of the posterior teeth. Generally, the interfacial distance for low occlusion in the Viral method seems to be in the range of a maximum of 10 mm to 5 mm. When there is a difference of 5 mm, the specified splint thickness is made as (5-1)÷3.0=1.33≒1.3 mm. In the case of an analog articulator, if we calculate it as about 3 mm, a space of 3 to 1.0 mm will be secured and a Michigan-type splint will be prepared for fabrication. By measuring the inter-face distance, the thickness of the splint for treating low occlusion and internal jaw derangement can be calculated. The amount of splint displacement in this study was evaluated when the mandibular condyle moved forward. However, since the actual displacement must be induced by the splint simultaneously on both the working and non-working sides of the mandibular condyle, the displacement is added as a table. It should be noted that the posterior stop and guidance are important because the mandibular condyle may be displaced on the X and Z axes under the two conditions of Takayama's mandibular movement theory formula calculated using this method. In the case of full mouth reconstruction treatment, many papers on the Hobo Twin Stage method have been submitted overseas over the past 10 years (Table 2, 1-3, 5, 6, 8-17, 34-52), and have been published in many overseas journals in 2023. In Patent Document 1, JP 2010-506692 A, the calculation formula for mandibular movement has been corrected one after another. Old (Error) and New (Correct) are written. Regarding the displacement of the mandibular condyle on the working side with the last molar as the origin, (L c / 2-b m ):Rearmost molar Y axis dimensional values ​​from condylar head.L c :Distance between condylar heads:110mm,b m :27.5mm were set as approximately 1 / 4 of axis between condylar heads in rearmost molar position(axis plane),δ l tan Ω cl :0.0209 radian horizontal lateral turning angle,δ l =Λ cl ×cosΩ cl (Λ cl :lateral condyle path length:3mm,Ω clsagittal lateral condyle path inclination angle 40°)(Lc / 2-bm): Y-axis dimension of the last molar from the condyle, Lc: intercondyle distance: 110mm, bm: 27.5mm is set as approximately 1 / 4 of the intercondyle axis at the last posterior molar position (on the intercondyle distance). Λcl: lateral condyle path length: 3mm, Ωcl: sagittal lateral condyle path inclination angle 40°) TIFF2025066022000058.tif196158TIFF2025066022000059.tif114161From the above, the displacement of the condylar path for each condition on the working side is corrected backward on the X axis to -0.905 mm in condition 1, and the trough value is -0.543 mm. However, from the numerical values ​​of the anterior and posterior regions of the backward movement in conditions 3 and 4, in condition 4, the condyle is shifted infinitely to zero on the X and Z axes. TIFF2025066022000060.tif91431.173mm). Condylar displacement on the non-working side with the posterior molar as the origin TIFF2025066022000061.tif100162TIFF2025066022000062.tif190163(L c / 2+b m ):Y axis dimensional values ​​from condylar head to rearmost molar.L c :Distance between condylar heads was 110 mm and bm:27.5 mm was the rearmost molar position.Axis between condylar heads was set as approximately 1 / 4(axis plane).δ l tan Ω cl :Rotation angle on the frontal plane(radian). δ l :0.0209 radian.Horizontal lateral turning angle,δ l =Λ cl ×cosΩcl (Λ cl :lateral condylar path length of 3 mm and Ω cl :sagittal lateral condylar path inclination of 40°). (Lc / 2+bm): The dimension value of the Y axis from the condyle to the last molar. Lc: The intercondylar distance was 110 mm, and bm: 27.5 mm was the position of the last molar. The Y axis of the intercondylar distance was set to approximately 1 / 4 (Y axis plane. δl: tan at lateral condylar path length 3 mm Ωcl: Frontal plane rotation angle (radian), δl: 0.0209 radian is the horizontal rotation angle. Ωcl: Sagittal lateral condylar path inclination angle is 40°. From the above numbers (4 to 6), the condyle is shifted posteriorly and inferiorly on the X-axis and Z-axis. The movement of the mandibular body can be broadly divided into two categories: forward movement of the anterior region and lateral movement, and is classified into a total of four categories: movement of the anterior region from the proper central position and movement of the posterior region. The thickness of the articulating paper for the Michigan splint in Figure 52 is approximately 40 microns. The articulating paper is placed on both sides of the face while tapping adjustment is performed, and the left and right facial distance and the discomfort and stiffness of the stylohyoid muscles are eliminated and reduced. No eccentric movements are performed, and a single convergence point that does not feel uncomfortable is determined. At the same time, the normal facial distance is balanced on both sides, and the aforementioned

[0015] and condition 2 for reproducing the molar area are reproduced in full balance on both sides, so it can be a preliminary step to being able to eat anything, anywhere, and deliciously, unconsciously, on both sides. Regarding the displacement of the mandibular condyle on the non-working side, with the posterior molar as the origin, it moves downward on the Z axis and is guided backward on the X axis. The current mainstream in the world follows either Gysi's complete denture or McCollum's gnathology. Gysi's geometric construction is a three-dimensional construction made by combining three two-dimensional constructions, but it is kinematically correct within the range of first-order approximation. The reason why Gysi and McCollum did not reach the level of widespread use in daily clinical practice is simply because they did not have the tools of scientific theoretical formulas. In 1987, Takayama experimentally analyzed human mandibular movement on an articulator for clinical application, and derived a theoretical formula for mandibular movement that integrated the cusp inclination angle of the molar part and the condylar path angle from the molar disarticulation amount and the cusp path inclination angle from the anterior guidance of the anterior teeth. Takayama's analytical occlusion theory, which consists of thousands of sheets, was built based on the traditional occlusion studies accumulated by his predecessors, and was constructed using the Twin Stage Procedure, which is a completely new method of separately manufacturing the molar part and the anterior teeth part, adding physical thinking and new experimental facts. The basic concept can be introduced from Takayama's theoretical formula for mandibular movement. Takayama's theoretical formula for mandibular movement shows extremely good values ​​for the molar disarticulation amount at a condylar path length of 3 mm measured on an articulator, at the standard values ​​set for conditions 1 and 2 from in vivo and in vitro clinical trials, and the prosthesis is fitted without any discomfort. In addition, after the production of the teeth for the forward movement in the rearmost molar part in condition 1, a symptom called internal jaw disorder appeared. By re-evaluating the theoretical formula, a flaw in the equation associated with the turning angle was identified. For this reason, it has been reaffirmed as an omission in the above three tables. The creation equipment using CAD, CAM, and 3D printers based on this theoretical formula is likely to cause major problems unless the errors in the design equipment of the analysis software CAD are corrected. The amount of displacement of the mandibular head with the molar area as the fulcrum is a value that makes the condyle feel compressed in condition 1. In condition 4, with the same amount of displacement on the working side, it was evaluated that the condylar path would shift to a nearly constant position. If the values ​​in the table are considered to be movements caused by the articulator, it is thought that the trough-shaped values ​​(the trough-shaped table is the CAD of the articulator) should be taken into consideration. The newly revised theoretical formula was calculated by reevaluating Takayama's theoretical formula and reproducing the area of ​​retraction and the displacement of the mandibular condyle. As a result, the displacement of the mandibular condyle was confirmed. To develop a full-scale CAD / CAM system based on this theoretical formula, a mathematical model of mandibular movement is necessary. By combining the analysis software (design device) with sophisticated CAD / CAM equipment and a 3D printer (production device), adjustment-free prosthetics can be produced, marking the beginning of the latest comprehensive dental diagnostic planning. This invention will enable new dental treatment plans to be made possible for anyone, anywhere, and it is believed that this will be evaluated as a beneficial effect for patients.

[0022] After taking a full-arch upper and lower dentition model or scanning the oral cavity, it is attached to a semi-adjustable articulator with a trough-shaped table. Sheet wax is layered on the upper dentition, and the splint is made by adding just under 3 mm overall. It is suggested that splints can be made from the Zero Hobby articulator described in the book Implant Occlusion sold by Quintessence Publishing, but this is only one idea, and if the original correct jaw position is not reproduced, even if the condylar path bearing screw is converted with the articulator, it will not lead to the reproduction of the final prosthesis. The improved Michigan-type splint will be fine-tuned properly in the oral cavity. Previously, the Zero Hobby articulator was made by incorporating a face bow of the face analyzer that is parallel to both pupil lines to correct distortion from the anterior part, and an adjustable screw that lifts the left and right condyles for splint production. However, I reported to the nursery teacher that this lifting could not be used this time because it requires fine adjustment in three axes. However, if it can be manufactured using CAD, CAM, and a 3D printer, it is possible to utilize the software that converts the calculated values ​​of the displacement of the condyle and trough into CAD, which is currently being submitted for publication, if the idea is to use the thickness of the sheet wax. It would be great if we could manipulate the final fitting state without manufacturing a splint. Regarding how to make and adjust splints, if you experience discomfort such as jaw pain, try cutting a few pieces of leaf gauge into small pieces and gently placing them on your molars for about 10 minutes. If you press the mandibular angle where the digastric muscles meet, you can determine whether the treatment is successful or not by whether the tenderness goes away, so this can be one of the factors in the examination by palpation. In other words, as a method of palpation to see if internal jaw disorder is occurring, please purchase 0.1 mm vinyl acetate sheets and make a leaf gauge like the one by 3M, which is no longer on sale. By improving the Michigan-type splint, the thickness of the articulating paper (Figure 52) is set at 40-odd microns so that the patient can find a central point of interdigitation that feels extremely comfortable to them. While maintaining the height of the posterior tooth, the height to the premolar is reduced by reducing the interdigitation spot (Figures 52 and 55), and the splint is adjusted every 1.5 to 3 months. The so-called splint is adjusted by inserting a wedge like jacking up a car to repair a flat tire, but the condyles are pulled down on three axes, leading to a situation where the sensation is not uncomfortable. The adjustment is not made in the anterior teeth, but rather by adjusting each point from the premolar to the posterior molars, changing the size of the circular points while observing the facial features on both sides. As a facial finding using the Willis method, which is used to obtain the occlusion required for complete dentures, etc., we recommend that you determine the length of the splint for the anterior teeth by determining the dry / wet line of the lower lip and the position of the corners of the mouth, etc. (Figure 57). In Figures 52 and 57, it is important to layer articulating paper to a thickness of approximately 48 microns and determine the patient's single convergence point, and no adjustment of eccentric movement is made. The splint adjustment period is about three months when the inter-face distance measured by the Viral method is 10 mm, and when it is 5 mm, the appropriate position is determined in about 1.5 months. The length of the anterior teeth is determined from the long diameter of the splint covering the anterior teeth on the articulator. The so-called anterior guidance can be determined. This allows a functional and aesthetic positional relationship to be reproduced. However, in order to find the displacement of the mandible during the paper submission, as well as the individual points of each tooth by splint adjustment as mentioned above, if eccentric movement is reproduced in the oral cavity, it tends to be inaccurate as to where the teeth should occlude, resulting in a misalignment of the occlusion, so it is important to reproduce it in a vertical occlusion position. This will be improved with the Michigan splint, which is an improved type for orthopedic stabilization. However, for example, splints that are easily manufactured using hard and soft materials are said to be for occlusal stabilization, but it can be said that caution is required. By raising the posterior teeth and grinding the inner surface of the mandibular anterior teeth of the splint attached to the maxilla, the condyle head is moved to an appropriate position that is considered normal, and adjustments can be made while being visually observed. In other words, the splint is adjusted so that a wedge is attached to the occlusal contact area of ​​the splint body. The center of the masseter muscle and medial pterygoid muscle is the fulcrum of the first mandibular molar on the occlusal plane, and like a shiiso, the area equivalent to the first molar is the center, and the teeth behind it are slightly higher than the 4th and 5th premolars and the 6th molar, so this is an occlusal adjustment method guided by the mandibular body. Even when adjusting the occlusion by tapping alone, which is commonly used in clinical practice, it goes without saying that it is important to adjust the occlusion while taking into account the balance of the left and right faces, but the splint used for this adjustment is worn when sleeping. If the patient wakes up in the morning and finds that the splint has come off, even one point of the lower front teeth will be in contact with the front part of the splint during interdigitation, causing discomfort and leading to the patient unconsciously removing the splint from the mouth. The discomfort will quickly disappear if the patient returns to the clinic for fine adjustments. After a 5-10 minute rest, fine adjustments are repeated to ensure that the front teeth do not come into contact. Furthermore, the shape of the anterior teeth corresponding to the anterior guidance is inclined at about 45° to the occlusal plane, becoming like a continental shelf on the seashore, and the state in which the mandibular body is moving can be understood. It can also be seen that the canine equivalent is being ground down while the patient is asleep when it is worn in the mouth. Over the years, scratches have appeared on the inner surface of the anterior slope splint while the patient is asleep, and the length of this guide is assumed to be the protrusion amount of the maxillary anterior teeth, that is, the cantour of the teeth, Toyotaka, and is comparable to the artificial tooth arrangement of a general complete denture. If we assume that displacement such as clicking occurs when the articular disc of the jaw is pressed upward and displaced, it tends to produce a sound. The movement of the condyle, which is called the centric position and changes in various positions, is pulled back to a state that does not feel strange to the senses. Celenza 4) It seems that the position called the anterior lower medial position is reported to be extremely good. However, in order to find the displacement of the mandible during the paper submission, as well as each individual tooth as mentioned above, the usual splint adjustment method will cause misalignment if the eccentric movement is reproduced in the oral cavity, so it is important in clinical practice to reproduce it in the vertical interdigital position (tapping). This technique improves on the author's Michigan-type splint by considering the displacement of the condyle and the anterior incisal point, which is the body of the mandible, and the displacement of the condyle from a reverse perspective. As the basis for this, we decided to quantify the process of internal jaw derangement as shown in the publication by Takayama. Final treatment begins by utilizing the condition values, which are the standard values ​​of the mandibular movement theory formula. By determining the length of the anterior teeth on the articulator while referring to the above, the major axis of the teeth in the anterior teeth is determined, and the anterior guidance can be determined. This allows a functional and aesthetic positional relationship to be reproduced. The condition values ​​in the molar area are also changed to grasp the final situation. Please refer to the displacement of the X and Z axes of the various condition values ​​above, which will be the point where the posterior stop and posterior guidance are reproduced and internal jaw disorder does not occur. In other words, based on the above, we decided to make splints for all upper and lower teeth after adjusting the splint. The patient felt solid and stable. There was no discomfort and she felt lighter. As another example, Figure 53 shows the preoperative state before splint adjustment, and Figure 54 shows the completed prosthetic treatment after splint adjustment. 1-20) Please refer to Table 2 below. References Table 2 References “1)~20)”. 1) Hobo S, Itou H, Takayama H. ​​Atlas Twin Hobby actual clinical studies occlusal articulator.Tokyo: Quintessence;1995:64-84. 2) Hobo S, Takayama H. ​​Oral rehabilitation clinical determination of occlusion.Tokyo: Quintessence;1997:64-84,143-163. 3) Ito H, Takayama H.Diagnostic method of occlusion,utilizing the twin-stage procedure.J Aca gnath Occ 2004;(24)1:81-93. 4) Celenza F V.The centric position:Replacement and character.1973;J.Prosthet.Dent,30:591-598. 5) Hobo S Supervised by, Haga M, Takayama H.Science of occlusion.Tokyo: Quintessence;1995:86-128. 6) Kar AK,Parkash H,Jain V.Full-mouth rehabilitation of a case of generalized enamel hypoplasia using a twin-stage procedure.Contemp Clin Dent 2010;1(2):98-102. 7) Itou H.A dental practice support method and system(the 2010 patent acquisition). 8) Kar AK,Parkash H,Jain V.Full-mouth rehabilitation of a case of generalized enamel hypoplasia using a twin-stage procedure.Contemp Clin Dent2010;1(2):98-102. 9) G Rani,A Gambhir.Twin-stage technique for occlusal rehabilitation of a mutilated dentition.2010;m.lakotalakes.com 10)Naresh HG Shetty,Manoj Shetty,Krishna Prasad D.ESTHETIC AND FUNCTIONAL REHABILITATION OF THE PATIENT WITH SEVERELY WORN DENTITION USING TWIN STAGE PROCEDURE: A CASE REPORT. IJCRR IJCRR 2012 February;04,03,:93-99. 11)Ravindra M.Chavda1,Rupal J.Shah,Hiren Vanza.A generalized attrition case-full mouth rehabilitation using Hobo Twin-stage procedure. Int J Res Med.2013;2(4);108-111. 12)Anulekha Avinash CK,Chittaranjan B,Sudheer Charry N,Ramu Reddy,and Aditya Sai Jagini.J Clin Diagn Res.2014 Sep;8(9):21-23. 13)Huzaifa Ezzy,Amit Gaikwad,Sabita Ram,Naisargi Shah,Jyoti Nadgere,Janani Iyer.Full-Mouth Rehabilitation of Worn Dentition by Hobo Twin-Stage Philosophy:A Case Series. 14) Anjana Maharjan, Sarita Joshi, Anand Verma, and Ujjwal Rimal. Rehabilitation of Severely Attrited Teeth with Hobo Twin Stage Technique:A Case Report.JNMA J Nepal Med Assoc.2019 Nov-Dec;57(220):453-456. 15)Huzaifa E,Amit G,Sabita R,Naisargi S,Jyoti N,Janani I.Full-mouth Rehabilitation of Worn Dentition by Hobo Twin-stage Philosophy:a Case Series.J of Contemporary Dentistry(January-April2019;9,1:17-2 16)Kobayashi K, Kobayashi K, Harakawa R.Occlusal contact at eccentric position and it,s historical changes.Tokyo:Quintessence;2019;38,4:44-67. 17)Chatterjee N, Ghosh A.Oral rehabilitation by twin stage technique in a case of Amelogenesis Imperfecta.Clinical Dentistry.2020;14,3:18-24. 18) Kyoji Yamaguchi.Improvements in Occlusion and the Mastication System and Changes in Constitutional Symptoms.Journal of Japanese Society for Mastication Science 1993;3,1:57-63. 19)Funakoshi Masaya.The Physiology of Temporomandibular Joint Dysfunction.J Aca gnath 1984;1·2:11~15. 20)Yatani Hirofumi.Historical Transition of Prosthodontic Treatments for Temporomandibular Disorders with Special Reference to Splint Therapy,Occlusal Adjustments,and Occlusal Reconstruction.Ann Jpn Prosthodont Soc 2012;4:229-245. The Clinical Color Atlas of Occlusion published by Quintessence 1) , English version of full mouth treatment 2)The bite registration in the book has been changed to the classical centric bite and published. In the current dental situation at the time, the late Hobo Sumiya, former president of Ou University, said that it was too early to introduce Ito's new technique to the world, and that it would completely change the foundations of dentistry, so they had to give up on it. After that, Takayama and I only introduced it partially as an improved Michigan-type splint for bite registration. 3) . Over the past 10 years, many academic papers on the Hobo Twin Stage Method (two standard values) have been published overseas. Unfortunately, no scientific evidence on the basis of the bite elevation has been mentioned in any of these papers. 1-3,5,6,8-17) So I'm worried that there will be problems in the future. The development process of Takayama's internal jaw disorder, the mandibular movement theory, the interfacial distance, and the occlusal vertical dimension have been quantified, so I hope that they will be useful in future clinical practice. At the same time, I believe that the production of prostheses based on these two standard values ​​will require careful observation of the prognosis in the future. Dr. Takayama's diagram of the developmental process of internal jaw disorders, and Kosten syndrome, which has been said to be involved in otolaryngology and dentistry 18-20) There is a wealth of clinical research and a history of changes in etiology regarding how treatment for temporomandibular joint disorder (TMD), particularly conservative treatment in the field of prosthetic dentistry, has changed over the course of history (see Table 2). Nowadays, 1. TMD is a comprehensive term that encompasses several pathological conditions with similar clinical symptoms. 2. Treatment and long-term management of each condition must be carried out within the framework of the biopsychosocial model. 3. TMD is a comprehensive term that encompasses several conditions with similar clinical symptoms, and each condition is said to be a self-limiting disease in which symptoms can be expected to disappear naturally. 4. It is a multifactorial pathology whose onset mechanism is based on the biopsychosocial model. 5. Treatment and long-term management of each condition needs to be carried out within the framework of the biopsychosocial model. 6. Each condition is said to be a self-limiting disease in which symptoms can be expected to disappear naturally. Medical professionals have long had clinical experience in finding that vague symptoms are caused by dental issues, hormone imbalances, neurological disorders such as brain diseases, etc. In recent years, when a patient is diagnosed with temporomandibular joint disorder, a certain academic society has recommended that dental treatment not be started and that it be discontinued, with drug therapy being recommended. If the occlusion of the rear teeth causes a localized low bite, the front teeth will not come into contact and the mandibular body will move backwards, so left-right balance is important. In extreme cases, a tendency to bite is considered undesirable because it tends to cause left-right facial displacement. The author improved the Michigan-type splint, setting the thickness of the articulating paper at 40-odd microns so that the patient could find a central point of intercuspation that felt extremely comfortable to them, and adjusting the splint every 1.5 to 3 months. The adjustment method is to adjust each point from the premolar to the posterior molar area one by one without intercuspating the anterior teeth, while changing the size of the circular points and observing the facial features on both sides. Occlusal reconstruction generally consists of the work of aligning the intercuspal position with the proper occlusion position (previously the centric position) by guiding the jaw position with the splint, and providing molar disocclusion during eccentric movement. In other words, the process of development of intra-jaw disease ⇒ induction by splint ⇒ quad stage method The final clinical trial will be carried out by utilizing these four conditions (see Figure 65). By predicting this from the calculated displacement of the condyles and troughs, and by creating CAD software for TMD, we can avoid the need for splints to prevent internal jaw disorders and ultimately improve occlusal disharmony, so we can hope that this will become a strategy that serves as evidence in dental care. Table 2 lists references (1 to 20). When making the final prosthesis from the actual splint, the process of making a removable hybrid hard resin before placing the upper and lower jaws is performed by taking the bite registration according to

[0019] and

[0020] above, and then mounting it on an articulator with a groove. In the upper and lower jaw models, the thickness of the Michigan splint and the major axis of the upper anterior teeth are usually aligned with the dry lip line of the lower lip. As an alternative method, the pound method, which is performed while pronouncing sounds, can be difficult, but there is also a method of arranging from the lower anterior teeth, which is the same as the work of arranging artificial teeth such as normal complete dentures. At the same time, the splint is converted to a metal-zirconia hybrid resin while adapting it to the basic condition values ​​after adjustment, and the following splint can be removable (see Figures 57 to 64). Ideally, after splint therapy, a bite registration is performed in the oral cavity for one-point convergence, the mandibular dentition model is removed from the ring, remounted in the final state, and a split splint is attached to the oral cavity. Then, a normal formation impression is taken and the final prosthesis is made. 1-3,5,6,8-17) Since the device was manufactured with only two teeth, the anterior and posterior, which are Takayama's basic requirements, it cannot be said with certainty that clinical symptoms will not occur in the future (Table 2) is a reference (1 to 20). [Brief description of the drawings]

[0023] [Figure 1] Dental medical diagnostic system process overview [Diagram 2] Dental diagnostic support: A multidimensional definition [Diagram 3] Dental diagnostic strategy planning materials [Figure 4] Software transmission outline for establishing diagnosis [Diagram 5] Dental treatment skills and countermeasures [Figure 6] ~ [Figure 8] Dimensions and angles in the sagittal plane relative to the axis and Frankfurt planes [Figure 9] Based on Takayama's mandibular movement theory, this is a basic diagram of the limit movement, pinpointing each tooth in the sagittal and frontal planes starting from both condyles. [Figure 10] Balanced Occlusion Ground Point Diagram [Figure 11] Group Function Proposed by Schuler [Figure 12] Mutual occlusion advocated by gnathologists [Figure 13] Pocket measurements of the upper and lower molars on the right side, values ​​of the lower second molar in the case of Schuler's group function [Figure 14] Condition of the left guide of the trough-shaped table [Figure 15] This is a case where, after more than 20 years, there was a space between the upper and lower molars on the right side of the mandible on the non-working side in response to movement of the working side on the opposite side (Figure 14). [Figure 17] Guide for the right canine equivalent and contact cross-arch balance for the contralateral left posterior second molar. [Figure 18] Periodontal pocket condition from May 20, 2014 to December 20, 2018. [Figure 19] X-ray of the right posterior second molar area after periodontal regenerative surgery. [Figure 21] If the standard anterior guidance angle is less than 45°, caries and staining are likely to occur. [Figure 22] General examination of the basic condition value of 1 for the molar area: The judgment will be made after guiding the upper and lower molars up to the very edge of the cantour. [Figure 23] In condition 2, the canine and in condition 3, the protruding tooth slide over the proximal area of ​​the left maxillary first molar and the left mandibular second molar during posterior movement, and no longer protrudes. [Figure 26] An example of a stent for occlusal adjustment when the induction of the basic value is greater than the basic value. [Figure 27] An example of pasting. [Figure 28] Examples of diagnostic items. [Figure 29] ~ [Diagram 33] Anterior guidance, condition 2 condylar path angle of the anterior teeth, lateral wing angle from the trough table 20°. [Diagram 34] When the food is moved forward due to condition value 1, the upper and lower front teeth are not able to fully bite down, and the patient ends up using the tongue to eat. [Diagram 35] As shown in Figure 34, if the tooth cannot be bitten off, a special laminate veneer is made from a hybrid hard resin (Ceramage Up, Matsukaze, Kyoto, Japan). [Figure 37] When performing final treatment on the front teeth, it is preferable to use ceramics or other materials. [Figure 38] ~ [Diagram 45] Preoperative image of a case in which discomfort developed just before dynamic treatment despite orthodontic treatment [Figures 38-40], attachment of the mandibular dentition [Figure 41], waxing up the areas to be treated in the upper and lower jaws for the treatment process [Figures 42, 43], and fitting of the final prosthesis [Figures 44, 45]. [Figure 46] ITO Articulator: A semi-adjustable articulator that is capable of reproducing conditions 1 to 4. [Figure 47] Improved Zero Hobby Articulator, a semi-adjustable articulator capable of reproducing the range of the anterior region of the posterior movement condition 3. [Figure 48] Existing brushes, watercolor pen brush and improved brush brush [Figure 49] Sagittal plane drawing of Takayama's jaw derangement process. [Figure 50] The standard measurement of the facial golden section ratio, which measures interfacial distance as an important factor for dental treatment. [Figure 51] The change in the position of the most posterior molars M⇒M' due to a hinge rotation movement (Θ rotation) around the condyle C is the displacement of the condyle position (C'⇒C'') and the change in incisor position (I'⇒I``) when rotation is performed around M', M'' to return them to their original height. [Figure 52] The articulation paper of the Michigan-type splint and the point contact of the splint are the process of Takayama's internal jaw derangement ([Figure 49]). 1 [Figure 53] For preoperative and anterior interplanar work procedures before splint adjustment, see [Figures 55-64]. [Figure 54] Postoperative anterior interfacial. [Figure 55]After one-point convergence is completed using the Michigan splint, the position of the labial and buccal contours and the corners of the mouth are clearly indicated on the splint. [Figure 56] ~ [Figure 64] A technical work process in which the angle setting values ​​of the articulator are adjusted to match the basic condition values. [Figure 65] Intraoral photographs of full-mouth treatment using an improved Michigan splint, at the initial visit, and current status 15 and 30 years later.

Claims

1. In constructing CAE software required for CAD in the computerized digital calculation process leading to software development by calculating Bennett angles, condylar path angles, cutting path angles, etc. with respect to various horizontal reference planes from the ITO mandibular motion theoretical formula, equipment CAD.CAM.3D printers available all over the world, four reference digitizations that are attached without adjustment and do not feel strange in the oral cavity with an articulator with an analog trough-shaped table are equipped with an acquisition means for acquiring a three-dimensional model representing the upper and lower jaws on the patient's skull, and a derivation means for deriving eccentric movement to the front and rear, and the derivation means derives the contact sliding movement with the three-dimensional model representing the upper jaw when the three-dimensional model representing the lower jaw is behind the intercuspal position as the eccentric movement, and the lateral eccentric movement when the three-dimensional model representing the lower jaw is behind the intercuspal position can be a four-dimensional model of the jaw movement that has been determined. Since the theoretical formula is an approximation formula using one infinitesimal term, it is possible to obtain a 10 －１ The value is considered reliable up to mm, and the second-order small term is set to 10 －３ The range can be extended to third-order infinitesimals up to mm, and it can be a higher-order infinitesimal term, and can be an integrated planning mandibular movement theory formula for an instrument that digitally reproduces analog results from the ITO mandibular movement theory formula. The one-jaw model is manually installed in the extremely complicated oral cavity by the technician and adjusted by the dentist, and is then trimmed down, causing discomfort. For this reason, the calculation of the Bennett angle, condylar path angle, incision path angle, etc. for each horizontal reference plane from the ITO mandibular movement theoretical formula based on the axis plane of the above items in the CAD. CAM. CAE software that achieves the harmony of analog and digital to the full jaw dentition is a theoretical formula for the CAD. CAM. CAE software that plans treatment for the final diagnosis, from a combination of four condition values ​​as a planning theoretical formula that maintains cooperation with technicians and medical professionals, to a non-adjusted installation that does not feel uncomfortable in the oral cavity of each patient, and is a CAD. CAM. CAE for the program of strategic information processing device, strategic information processing numerical value, strategic information processing method, and strategic information processing means. The CAT software, ITO Integrated Planning Mandibular Movement Theory Formula, is generally used by dentists to check for caries, periodontal disease, orthodontics, etc., through computer processing using X-rays, scanners, and Invisalign, and to check for substantial defects through oral examination, and to match the standard values ​​for optimal dental treatment of partial dentures and complete dentures, and can also be software for a strategic information processing device and strategic information processing method using algorithms to calculate and promote AI by handling computer calculation processing from the number of cases related to past predictions, current analysis, and future prediction design.

2. The software developed by Yasunagasha cannot reproduce Takayama's mandibular movement theory formula due to an error, and even though there is a revised Ito mandibular movement theory formula after correction, it does not use the theory formula in the information simulation based only on the opposing teeth and CT photography. The ITO planned mandibular movement theory formula creates the occlusal surface of the prosthesis based on the occlusal surface of the opposing teeth, and calculates the 8 elements of one tooth's cusp apex, marginal ridge, central ridge, triangular ridge, developmental groove, minor groove, minor ridge, and cavity, the cavity after formation, abutment, entire jaw dentition, posterior movement distance, face bow, etc., and outputs the calculation results as 3D. The history of periodontal disease is judged from the cross arch balance guide of the working side canine equivalent part and the non-working side posterior molar part from the basic condition value of the anterior guidance, and the basic numerical value from the four basic condition values ​​can be important for the rearmost molar part on the non-working side. In addition, in the case of Denar, when the inter-face distance is set to 70 mm and the inter-face distance is set to 43 mm, the inter-face distance is set to 60 mm to 80 mm, but the inter-face distance is set to 60 mm to 80 mm, and the inter-face distance is set to 500 cases or more. When attached to an analog articulator, the anterior reference point is set differently depending on the manufacturer for the height of the articulator, and the upper and lower jaw dentition model is a mechanism assumed in the middle part of the articulator for all articulators. From the above, ITO virtual software can be a strategic information processing device that incorporates the functionality of chewing movement by importing the data of the upper and lower jaw models and bites by a scanner into the software of this system without a method of CT photography and a CAD, CAM, CAE, CAT software for strategic information processing method. In addition, by cleaning between the teeth with a trademarked brush pen brush, the patient's unique sensory discomfort can be computerized to AI, including past guesses corresponding to the basic condition values, the current situation, and predictions for treatment, and can be CAD, CAM, CAE, and CAT software for strategic information processing devices, strategic information processing methods, and strategic programs.

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