BitReg DIR®

Quick and easy digital production of DIR® registrations

This is what BitReg DIR® makes possible!

This software is the digital solution for producing DIR® registrations.

The workflow in the laboratory and the laboratory structure are also taken into account here. This is because it is helpful for time- and labor-saving production if the design software is not too complex so that it can be operated as intuitively as possible.

The special software tailored to this enables design directly in the plastics department. This means that no CAD design workstations or CAD technicians are required. Production is carried out by the same personnel who were already responsible in advance.

The simple design is supported by logical wizard steps and specific software functions tailored to the area of application.

Digitization must always support the entire work process in a meaningful way… and this is what we offer you with BitReg DIR®!!!

The advantages of the digital solution at a glance:

“Easy to use” order management
Wizard-guided process, so no computer experience necessary
Simultaneous modeling OK/UK
Total and fully edged
Create median level
Subsequent bite wall correction possible
Automatic bite blocking in the software
Fully automatic DIR® support pin and DIR® sensor positioning calculation
show Situ or pre-bite scan

BitReg DIR® is available exclusively from DIR® KG!

You also have the option of upgrading to the BitReg full version (creation of bite templates, set-up and functional bases and bite forks) via our cooperation partner r2.

Talk to us – Mr. Beltermann will be happy to inform you on 0201_2 79 06 09 40!

Order now

The DIR system in research and science

For determining the position of the lower jaw in centric relation with the DIR® system

A. ^Dietzel1 A. ^Zöllner2
1Dentistry practice, Essen
2Departmentof Dental Prosthetics, Witten/Herdecke University
Publication: Deutscher Ärzte Verlag, DZZ, Deutsche Zahnärztliche Zeitschrift, 2012; 67 (2)

The influence of different registration techniques on condylar position and electromyographic surface activity in stomatognathic healthy subjects

S. Linsen, A. Samai, H. Stark, M. Klitschmüller
Polyclinic for Dental Prosthodontics, Propaedeutics and Materials Science, Rheinische Friedrich-Wilhelms-Universität Bonn
Publication: The Journal of Prosthetic Dentistry, Issue: Vol. 107 No 1, January 2012, p. 1-72

Evaluation of the condylar position depending on different registration positions and different jaw closing forces

I. Salas Ruiz de Arbulo, H. Stark, S. Linsen
Polyclinic for Dental Prosthetics, Propaedeutics and Materials Science, Rheinische Friedrich-Wilhelms-Universität Bonn

Repositioning osteotomy in patients with craniomandibular dysfunctions –
Renaissance of temporomandibular joint fixation in conjunction with DIR® diagnostics

Philipp ^Scherer1, Farina ^Blattner2
¹ Department of Oral and Maxillofacial Surgery, Klinik am Ring, Hohenstaufenring 28, 50674 Cologne
² Practice Dr. Blattner, Gertenbachstr. 30, 42899 Remscheid

The effect of occlusal splint therapy for CMD on the cerebral control of occlusal bite block movement

M. ^Lotze1, R. Lickteig1^,2, E. Weinert1^,2 B. ^Kordaß2 1FunctionalImaging, Diagnostic Radiology, University of Greifswald Department of CAD/CAM and CMD Treatment, University Medicine Greifswald

Clinical-radiologic study to evaluate the physiologic condylar position in MRI

UKB University Hospital Bonn, Rheinische Friedrich-Wilhelms-University Bonn, Practice Dr. Blattner

Excellent reproducibility of the DIR® system in subjects with CMD

L. ^{Passin-Arnold1}, F. ^Saha2, J.^Poth3, R. ^Jordan4

^{1Witten/Herdecke University}, Faculty of Health – ^{2Department of}Internal Medicine V, Naturopathy and Integrative Medicine, Essen-Mitte Clinics
3Dentist in private practice, Essen – ^4Departmentof Conservative and Preventive Dentistry, Witten/Herdecke University, Witten

Randomized, controlled pilot study on the effects of a bite splint according to the DIR system on headaches in patients with craniomandibular dysfunction Study Dr. Saha

Felix Joyonto ^Saha1, MDa, Almut ^Pullaa1, Thomas Ostermann, ^PhDb2, Theresa ^Millera1, Gustav Dobos, ^MDa1,
Holger Cramer, PhD, ^MSc1
1Department of Inernal and integrative Medicine, Klinikum Essen Mitte, Faculty of Medicine University of Duisburg-Essen –

^2Departmentof Psychology, Faculty of Health, University of Witten-Herdecke

The DIR® rail

Centric position as target bite

After the DIR® measurement has been carried out in the dental practice, it is transferred to the articulator in a DIR® authorized dental laboratory.

In the following model analysis, an occlusion analysis is performed, whereby the deviation of the habitual occlusion or the current ACTUAL state from the centric occlusion or the TARGET bite is documented.

DIR® splint therapy

The corresponding DIR® splint therapy is planned on the basis of this result.

There are three different types of biomechanical DIR® splints.

The adjusted splint according to DIR® takes both condyles out of compression.

With the relief or relaxation splint according to DIR®, the two condyles are moved anteriorly or retrally by a small amount (1 to 2 mm).

With the DIR® reprogramming splint, the right or left condyle is rotated slightly and the contralateral condyle is rotated back.

The “Clinical-radiological study to evaluate the physiological condylar position in MRI” provided evidence of a centric position of the temporomandibular joint during DIR® splint therapy.

Wearing time of the DIR® splint

The respective DIR® splint is worn for at least six months with a follow-up measurement after three months.

The prerequisite for the implementation of the final prosthetic restoration, with continuous monitoring by the treating dentist, is that the patient is completely free of symptoms and that the lower jaw position has been successfully reprogrammed in the patient’s occlusal memory, as well as objective confirmation by means of a further control measurement.

Instrumental dental functional analysis and jaw relation determination

Reliable DIR® diagnostics: Tracking down the functional disorder through intraoral
measurement!

If a functional disorder is suspected – especially after a clinical functional analysis – dentists obtain definitive clarity about the individual situation of the craniomandibular system through further instrumental analysis. The centric condylar position, which is considered ideal for smooth functioning of the temporomandibular joint, is also determined.

Definition of centric condylar position

The cranioventral, not laterally displaced position of both condyles with physiologic condyle-discus relation and physiologic loading of the involved tissue structures (DGZMK and DGFDT)

“In the centric condylar position, both condyles are not laterally displaced in the cranioventral section of the eminentia if the vertical dimension of the mandible to the maxilla is correct. In this circumscribed area, the tissues involved are not subjected to excessive pressure or tension.
There is freedom of movement in all three spatial directions. The centric condylar position can be controlled and maintained neuromuscularly with minimal energetic effort.”

DIR® (DYNAMIC INTRAORAL REGISTRATION)

An intraoral measurement of the patient with the DIR® system enables the function of the craniomandibular system to be assessed.

A support pin register is used here, whereby the recording of the lower jaw movements is transferred to a medical PC in real time at any time via the DIR® System software and the dentist can observe the movements of the lower jaw. Recording and bite encoding take place under a defined chewing force. (ACTUAL POSITION)

The DIR® System software supports the dentist in converting the ACTUAL to TARGET position.

The physiological condyle position is the focus of the bite adjustment.

After evaluating the results, misalignments can be corrected and secured as part of the DIR® treatment concept, using the DIR® splint, among other things. It also serves to retrain the masticatory muscles. Only after correction and freedom from pain should dental treatment be continued and the TARGET POSITION reconstructed (e.g. with dentures).

Instrumental functional analysis with the DIR® system is used for

Suspicion of CMD
Setting the physiologically optimal bite position
Fabrication of new dentures
Orthodontic treatment
Patients who were not treated according to the DIR® concept (e.g. with dentures) and now have complaints
Bruxism, abrasive dentition, joint noises and other complaints

The high quality and safety of DIR® diagnostics is also guaranteed by regular training courses (refresher seminars, acquisition of current DIR® quality seals).

The manual clinical functional analysis

The manual clinical functional analysis is used to record the functional findings in the craniomandibular system, as functional disorders are often not correctly recognized without a professional analysis.

This makes it all the more important to have a basis for safe and rapid functional diagnostics in the dental practice, which should be used as a matter of course for every patient before restorative and/or orthodontic treatment planning and to differentiate between unclear jaw and facial pain and/or orofacial dysfunctions.

What does a practical method look like?

Since different causes of the complaints require different treatment approaches, a targeted and thorough diagnosis is of the utmost importance before starting treatment.

1. which diagnostic concept will get me to the desired goal?

2. what does professional functional prophylaxis look like in the practice?

3. do I need further diagnostic measures?

4 Which examinations will give me a clear and unambiguous diagnosis?

5 How can I bill for functional diagnostics?

What the dental practice needs is a basis for safe and fast functional prophylaxis that can be used as a matter of course for every patient.

It should not only consist of a subjective medical history, but must also include a clinical functional status. This is the only way to make a reliable diagnosis that includes all important clues. This would then fulfill the dentist’s obligation to perform a clinical functional analysis as a basic examination. Such an analysis could serve as a well-documented decision-making basis for a possible course of treatment.

The basic examination is always in the foreground.

During CMD screening (basic CMD diagnostics), the patient undergoes a general dental anamnesis with an individually completed digital questionnaire and brief dental findings. If there is no suspicion of a functional disorder, the functional analysis can be completed with this.

If there are indications of a functional disorder, such as

-Tension headaches, migraines, tension in the back and neck muscles, pain in the jaw joints, tinnitus, dizziness, etc.

the dental check is deepened.

The manual clinical functional analysis is used to differentiate between pain, restrictions, disorders of the stomatognathic system, joint noises and different disc displacements. It provides comprehensive results that are documented and evaluated in order to make an initial diagnosis and plan the further course of treatment.

Even if private reimbursement agencies like to refuse to cover the analogous CMD screening service or do not readily recognize the medical necessity of the service, it should not be dispensed with in view of the current case law on dental liability.

The OLG Munich (Ref.: 3 U 5039/13) of 18.01.2017 states that screening to clarify whether a hidden CMD is present or not is standard medical practice prior to prosthetic treatment.

In its ruling (5 U 64/16) of April 8, 2020, the Higher Regional Court of Cologne also came to the conclusion that a functional analysis would have been mandatory prior to the restoration. The omission of the required screening before the start of the prosthetic restoration is considered a diagnostic error.

These questions and requirements have prompted dentists with their own practices and specialist consultants, together with the Society for Functional Diagnostics, to develop the functional prophylaxis procedure for all dentists in a practical and professional manner. The result is the easy-to-use FunktioCheck Pro® software.

The FunktioCheck Pro® software enables you to carry out a quick and uncomplicated manual anamnesis and to make a reliable diagnosis based on the structured entries.

Further information

The DIR® concept

A really good concept as a supporting framework for a strong partner network is the result of years of development work. Good and coherent, a
concept that makes it possible to use the DIR® system as a therapeutic link between dentistry and dental technology as well as complete planning
from the first impression to the finished restoration (planning reliability).

The range of indications for the DIR® concept includes both the prosthetic restoration of patients with CMD syndrome and the fabrication of new dentures for functionally healthy patients.

Diagnostics

As part of the DIR® concept, the FunktioCheck Pro® software documents the preliminary dental findings.

The type of complaints and previous visits to the dentist from other specialist disciplines are recorded as part of the functional dental history. In the brief dental findings, missing canine guidance, non-age-appropriate abrasion of the teeth in the sense of grinding facets and abrasions or The brief dental findings record missing canine guidance in the sense of grinding facets and abrasions or wedge-shaped incisions, tooth loosening, tilting and migration, gingival recessions with Still-man clefts and McCall’s garlands, pain during muscle palpation, temporomandibular joint noises as well as restrictions and asymmetrical mouth opening movements, resulting in a three-grade probability statement for the presence of a functional disorder and a recommendation for further findings.

Axis 2 diagnostics

The special functional analysis carried out in the case of a high probability of CMD, the so-called Axis 2 diagnostics, is highly relevant for the success of the subsequent therapy and is objectively assessed using a Graded Chronic Pain Scale and a pain perception scale, whereby an evaluation of the patient’s degree of psychological stress is possible in an evaluation form.

Manual-clinical diagnostics

The subsequent manual-clinical diagnostics allow an assessment of a manifest arthropathy with examination of the temporomandibular joint function to exclude or confirm the presence of a disc perforation or a disc displacement, condylar osteoarthrosis, hypermobility, capsulitis or inflammation of the bilaminar zone. The morphological or structural remodeling processes in the hard tissues should of course be confirmed radiologically (MRI). Manifest myopathy is assessed by performing standardized masticatory muscle examinations using the isometric tension test and muscle palpation.

Instrumental functional analysis

The manual functional analysis is followed by the instrumental functional analysis with the DIR® system, which is also carried out on functionally healthy patients as part of prosthetic planning. The electronic measuring method is based on the arrow angle or support pin registration according to Gerber with recording of the marginal movements of the mandible under physiological masticatory pressure and without reference to occlusion.

Centric position as target bite

Once the DIR® measurement has been completed, the centric position determined is encoded in the patient’s mouth as a so-called target bite by guiding the support pin into a fixation plate under defined chewing pressure. This is followed by transfer to the articulator. In the following model analysis, an occlusion analysis is performed, whereby the deviation of the habitual occlusion or the current actual state from the centric occlusion or the target bite is documented.

The appropriate therapy is planned on the basis of these results.

The DIR® concept for the treatment of functional disorders (CMD) is scientifically validated and follows a closed anamnesis and therapy principle.

FunktioCheck Pro®

Professional digital functional prophylaxis for every dental practice

The app that no dental practice should be without

Functional disorders are often not properly recognized without professional analysis. This makes it all the more important to have a basis for safe and rapid functional diagnostics in the dental practice, which should be used as a matter of course for every patient.

FunktioCheck Pro® is software that enables you to integrate professional and scientifically based functional analysis into your practice immediately and easily.

The software guides you through a targeted anamnesis with brief dental findings in the simplest possible way.

Stay flexible

Once downloaded, you can use the FunktioCheck Pro® app individually on your devices. Whether IOS, iMac, Android or within the browser of your practice PC.

The safe investment in the future of your practice:

Easier and safer handling
Immediate and uncomplicated integration into your practice
Precise initial diagnosis
Based on scientifically sound functional diagnostics
Forensic and legal security
For satisfied patients and safe dentistry
Amortizes within a very short time and is highly profitable

Further details