Clinician System Protocol

 Step by step guide, Best Practices, and Guide Download

1. Identify Condyle
      
   Identify and mark the condyle's position using methods such as palpation, digital trackers, lateral cephalometry, or HV CBCT. While HV CBCT provides the most precise results, any of the other methods are suitable if an HV CBCT scanner is unavailable. Apply a small mark on the skin or use a radiographic marker.
   
   
2. Identifying and Capturing the Facial Midline
   

   Start by aligning the two fences of the occlusal bite plate with the patient’s facial midline. This allows us to capture any discrepancy between the facial and dental midlines.

   Apply a generous  amount of bite material to the occlusal plate, ensuring the incisal edges make full contact with the fences and create as many indentations as possible. The facial midline and occlusal fences should be properly aligned with each other.
   
   

3. Identify Baseline
   
   When Identifying the baseline we are basing off of the corner of the ear (Otobasion Superius) and corner of the eye (Exocanthion). It is important that the patient’s head position is at 0 degrees and you are eye level with the patient. If the patient has long hair, they pull it back or secure it with a hair tie so that the ear is not covered.
   
   
4. Choose the protocol
   For analog use the black cube and black components. For digital, use the white cube, and the white components.
   
   
5. Assemble the Onebite Evolution System
   

   Start by sliding the arch onto the cube’s ball joint connector. Press firmly to ensure the connector is fully secured. Next, slide the occlusal bite plate with the patient’s record, into the arch.

   
   

   Proceed to assemble in the following order:

   • Remove cube nut

   • Attach midline bar

   • Attach horizontal bar to the midline matching the pins

   • Secure the cube nut

   • Place Baseline bar onto midline

   • Secure Baseline trinity screw

6. Micro Adjustments
   
   
   
   Before placing the system back in the patient’s mouth, check that the ring is tightened enough to allow micro-adjustments. Use the screw attached to the ring for tension and turn it to the left to tighten. Keep the ring slightly tight so you can still make adjustments before fully securing the position.
   
   
7. Capture the Terminal hinge Values
   Align the baseline bar with the patient’s baseline, which runs from the corner of the eye to the corner of the ear. Make sure the patient’s head is positioned at 0 degrees. It's important to either be at eye level with the patient or have an assistant at eye level guiding you from the side.
   Verify that the midline bar is properly aligned with the patient’s facial midline.
   Ensure there is even spacing between the bars at the front and back, with consistent space between the patient’s head and the baseline bar.
   
   
8. Secure the Record
   
   Once everything is aligned, secure the system using the cube locking mechanism. There are two locking methods: the ring and the ring screw. Tighten the cube ring to the left, then lock the screw for extra security.
   
   
9. Record the Values
   Once the baseline bar has been locked in position we can record our terminal hinge baseline (Z) and midline (Y) values. Move the small rubber band to the number that aligns with the condyle and record the Z number. The number located on the midline above the baseline connector is the Y vlue, also record this.
   
   
10. Photograpy
    
    Now that we have our Z and Y values, we will take photography from the right side of the patient's face with the camera eye level with the baseline, along with a front-facing shot of the patient with the OneBite evolution system in place. Also, take a photo of the patient smiling for reference.
    
    Things to Note
    
    When capturing photographs, ensure you are aligned parallel to the baseline to prevent the bar behind from being visible. At the correct angle, it should appear as a single bar.
    
    
11. Remove the System
    Remove the system from the patient. Begin by unscrewing the OneBite nut, removing the horizontal bar, and then the midline bar from the cube. Take the record out of the patient’s mouth, and all record information will now be within the cube.
    Both the analog and digital protocols are the same up until the transfer process.