The Kois Dento-Facial Analyzer
Dental labs like Burbank Dental Lab rely on the records that the clinician collects and sends to us. Our technicians can replicate the function and esthetics of natural dentition, but we can be limited by the information communicated to us through the patient records.
Whether you are creating a beautiful smile make-over with IPS e.max, or restoring a patient’s whole mouth, you will want to communicate essential information to the lab. There are four essential elements that the lab requires to deliver the most predictable restorations:
- Photos: full-face smile, smile close-up, and lip at rest
- Pre-Op models
- Bite records
- A Face-Bow record
This article will focus on the face-bow record, specifically, the Kois Dento-Facial Analyzer. The advantage of a face-bow mounting is to place the dentition in a 3-D relationship to the articulator’s condyle. However, too often the esthetics of the smile line is lost. One advantage of the Kois Dento-Facial Analyzer is that it facilitates both functional and esthetic objectives.
First let me say, use of a face-bow is not required for every case. There are, however, three scenarios that need the additional information that a face-bow provides.
- The distal terminal abutment, especially a bridge.
- Full arch rehabilitation.
- Smile makeover cases.
Note: Full arch impressions are assumed for the above cases and any use of a face-bow.
What Makes the Kois Bow Different?
Simplified bow design & procedures
The Kois Dento-Facial Analyzer is an elegantly simple instrument. Unlike other face-bows, there is no ear bow, movable joints, or tightening screws. “Kois has developed a unique face-bow transfer that corresponds to the facial midline and horizontal plane to the 100-mm distance of the conditional hinge position. This technique simplifies the process of the face-bow transfer and ensures the occlusal plane of the teeth is evaluated and fabricated correctly.” Ref. 1 (Figures 1-3)
The basic clinical steps to using the Kois Dento-Facial Analyzer are as follows:
- With the posterior portion of bow out of occlusion, set the incisal edge of maxillary incisors to the ledge on Index Tray. The incisal ledge is designed to position the incisors based on an average 100mm distance from the condyle and the central incisor edge.
- Align Vertical Indicator Rod to patient’s facial midline to register the dental midline of the teeth.
- While maintaining incisal contact with the Index Tray and vertical rod alignment to the facial midline, rotate Analyzer Bow up in the posterior until the lateral wings are level to the horizon. There is no need to take a stick-bite. The Kois Dento-Facial Analyzer captures the horizontal smile line, but it also places it into a relationship to the condyle. (Figures 4 & 5)
- With the patient standing upright, confirm that the bow maintains proper position.
- The central incisors are in contact with the incisal ledge on the Index Tray.
- Ensure the horizontal plane of the bow is parallel to the horizon. (This can be assisted if you have patient stand next to a door jam and reference the vertical line of the door frame, keeping the bow perpendicular to this reference.)
- Check the vertical rod in relation to the facial midline.
- Have the lateral wings extend parallel to the horizon.
You have now captured the steepness and tilts of the occlusal plane in the registration material on the horizontally aligned Index Tray. Remove Index Tray from Analyzer Bow and send to the lab for mounting of study casts. This disposable Index Tray now becomes a permanent bite fork registration record.(Figure 6)
Error-Free lab procedure to transfer face-bow recordings to the articulator
Eliminating potential error in the transfer of the face-bow orientation is one of the strengths of the Kois bow.
The lab procedure is four simple steps.
- Place the magnetic adjustable mounting platform onto the Panadent articulator’s lower mounting plate, then snap the face-bow transfer index tray on the adjustable platform. (Figure 7)
- Set the mounting platform to zero.
- Affix the maxillary model onto the index.
- Set anterior pin to zero and mount upper model to the articulator.
You are not sacrificing accuracy for ease of use.
- The evidence supports the accuracy of the Kois Face-Bow. “The Kois Dento-Facial Analyzer articulates the maxillary cast in a position that is not statistically different to the Pana-Mount face-bow when comparing the incisal edge position and occlusal plane angle relative to Frankfort Horizontal.” Ref. 2
- "The Kois Dento-Facial Analyzer is a quick, simple, and predictable way to mount the maxillary model to ensure functional and esthetic predictability." Ref. 3
- There is no risk of your face-bow transfer jig shifting in transporting it to the lab. With the Kois system, you do not send a jig, you send the Index Tray only.
- The lab transfer process is 100% predictable. There is no complicated transfer apparatus. The lab has a straightforward procedure of snapping the Index Tray onto the magnetic mounting table, affixing the model to the Index Tray and mounting.
Why you should adopt it into your tool belt.
- Simplicity - both the clinical and lab procedures are simple and reduce errors.
- Face-bow records taken with the Kois Dento-Facial Analyzer are duplicatable if there is a need to retake a second face-bow record.
- There are no movable parts in the transfer of the Index Tray.
- Combines the function of a face-bow transfer and a stick-bite in the same record.
- The Kois Bow establishes the midline of the smile.
In the final analysis, using the Kois Dento-Facial Analyzer in conjunction with Burbank Dental Lab will enhance your predictability and level of occlusal accuracy, while at the same time increasing your esthetic results.
- Kois Dento-Facial Analyzer System, Panadent Corp., Grand Terrace, CA. http://www.panadent.com
- Lux, Laura H., "A Comparison of Two Methods to Articulate a Maxillary Cast with Lateral Cephalometry" (2014).Master's Theses (2009 -). Paper 252. http://epublications.marquette.edu/theses_open/252
- KOIS DENTOFACIAL ANALYZER: HOW TO VIDEO, By Lee Ann Brady on 12.15.14 https://leeannbrady.com/occlusion-tmd/kois-dentofacial-analyzer-how-to-video