BEHIND THE SCENES

remature contact in restorative

and prosthodontic work is
a critical concern for every
dentist. Single crowns
(regardless of material), bridge
restorations and implant structure
present the highest prevalence of
premature contacts during trial fitting.
This cannot be fully attributed to the
patients perception as this is a subjective
assessment: The use of occlusion test
materials, which demonstrates reliable
objective evidence, is essential to address
this concern. Ill-fitting prosthesis means
numerous laboratory interventions,

Protocol (Figure 2: http://www.

bausch.fm/bauschweb/dwnld/
ShimstockProtokoll.pdf) before starting
the preparation and as a supplement to
the occlusion test. In this respect, it is
important that the test be made when the
patient is in maximum intercuspation.
According to the definition of the
DGZMK, maximum intercuspation is
solely determined by the occlusion in
largely preserved supporting areas and
stable intercuspation. In maximum
intercuspation, the position of the
mandible is defined in relation to the
upper jaw in all three dimensions.

It is recommended to use identical

occlusion test materials in the dental
practice and laboratory, as this will lead
to better results.

Using S h i m s t o c k F i l m
for Achieving Precise Occlusion
by Meltem Inanmisik, dentist

which could include several requests for

modification or grinding in the patients
mouth. In turn, this lengthens the
duration of the treatment and greatly
affects the occlusal surface contouring
of the initial prosthetic work. Imperfect
handling in the clinic or laboratory can
result to additional inaccuracies, thereby
delaying the installation of the final
restoration.

Fig. 1

The occlusion protocol and the Shimstock

protocol recorded by the dentist
will be forwarded to the laboratory
(Figure 4). These protocols form the basis
for the lab to check occlusal contacts after
articulation.

1.
2.
3.
4.
5.

66

The recorded Shimstock Protocol

(Figure 3) and the dental chart including
the occlusal contact points are precise,
diagnostic tools for prosthodontics.
Fig. 4

Causes of very high

indirect restorations
(premature contacts)
No occlusion test prior to preparation
Insufficient vertical preparation
Deficient impression taking
Incorrect impression storage
Patient not in an upright sitting
position It is a MUST that the
patient sits upright.
6. Defective or missing jaw relation
7. Change of tooth position during
temporary restorations
8. Incorrect mixing ratio of impression
material
9. Incorrect model construction
10. Other faulty materials
11. Defective opposing jaw model
because of suboptimal impression/
storage/model construction
In this context, it would be advisable
for the dentist to create a Shimstock

Fig. 3

Fig. 5: Bausch Arti-Fol metallic,

Shimstock-Film BK 38 (12 uncoated)
Fig. 2

Handling of Arti-Fol
metallic (BK38) Shimstock
film
At habitual bite, it should be possible to
pull the foil through (Figure 1).

A Shimstock Protocol can be created

using the Bausch Arti-Fol metallic BK
38 (Figure 5) or Arti-Fol metallic BK
35 (Figure 6). The base material of
these films is a metallised polyester film
DENTAL ASIA
NOVEMBER / DECEMBER 2015

BEHIND THE SCENES

(Shimstock-Film) of only 12 thickness

and 8mm width, which is extremely
tear-resistant.

Fig. 6: Bausch Arti-Fol metallic,

Shimstock-Film BK 35 (12 red/one-sided)

Application of Shimstock
film in manual functional
diagnosis of TMJ
According to Gerber (1971), the
resilience test is an analytical
procedure in dentistry and orthodontics
to record dysfunctions of the TMJ
(temporomandibular joint).

Contralateral to the joint to be

examined, a tin foil shall be placed
(0.3mm thick, about 7mm wide and
6cm long), slightly blocking the bite.

Ipsilateral, preferably dorsal

between the molars, a Shimstock

The unique combination of a high-tech

metal foil (Shimstock foil 12) and a
one-sided colour coating has crucial
advantages for some usage. As Arti-Fol
metallic BK 35 is extremely tear-resistant
and has excellent colour transfer and
minimal thickness, it is ideal for checking
approximal contact points when fixing
bridges and crowns.

film (BK35) fixed in forceps must

be placed between the dental rows.
In healthy, non-compressed TMJs
during jaw clenching, the Shimstock
film should be held between the
dental rows.
The tin foil should be folded for
double thickness.
Re-examination.
Threefold tinfoil (0.9mm thickness).
If the Shimstock film is being held
at threefold tinfoil thickness, the
resiliency is pathologically elevated
(mandibular distraction). DA

Thickness of tinfoil (mm)

Held

Not held

0.3

OK

Compression

0.6

OK

Compression

0.9

Distraction

OK

Scope of application of the

foil

References
1.

2.
3.

Utz KH, Schmitter M, Freesmeyer WB, Morneburg T, Hugger A, Trp JC, Rammelsberg P,
DGZMK (German Association for Oral-Maxillofacial Surgery), http://www.dgzmk.de/uploads/
tx_szdgzmkdocuments/wiss_Mitteilung_DGPro_Kieferrelation_09_2010.pdf.
Thieme Publishing, https://www.thieme.de/de/zahnmedizin/resilienztest-52490.htm.
Strub JR, Trp JC, Witkowski S, Hrzeler MB, Kern M. Curriculum Prothetik Band I. Quintessenz
Publishing.

About the Author

Dentist Meltem Inanmisik graduated from the Faculty
of Dentistry, Heinrich Heine University in Dsseldorf,
Germany in 2009. She subsequently practiced in Dsseldorf,
Cologne and Mnchengladbach. Her areas of interest are
periodontology and holistic dentistry. She is specialising
in periodontology and is a member of APW (Akademie
Praxis und Wissenschaft), DGParo (German Association
for Periodontology) and DGZMK (German Association for
Dental, Oral and Maxillofacial Medicine). Since this year,
Ms. Inanmisik is working as a dental advisor for the use of
occlusion materials for Dr. Jean Bausch GmbH & Co. KG.

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DENTAL ASIA
NOVEMBER / DECEMBER 2015