Try In & Wax Up Flashcards
Trial Denture visit number?
Lab step after?
Trial Denture is patient visit number 4
Then do processing and lab remount
What do you confirm in trial denture visit?
because just because we selected and recorded (we did all this in intermaxillary records) it does not mean we got it right
- Occlusal Plane
- Vertical Dimension
- Facebow Registration (PRESERVATION)
- Centric Relation
- Phonetics
- Esthetics
Intermaxillary records vs trial denture
Recording —-> confirming
trial denture check list
VDO? CR? Phonetics? Esthetics? Patient Approval Signature (EDR)
VDO Evaluation
General and what you consider (4 main ones)
Freeway Space –> M sound
Closest Speaking Space
Space of Donders
Inter-ridge space
Freeway space importance in trial denture visit
Helps in verifying VDO
place dots again, swallow, rest, approximate this position and record the VDR and VDO should be 2/3 mm from there
Closest Speaking Space importance in trial denture visit
VDO Evaluation “S”
small space during sibilant sounds
NO CONTACT IN TEETH
adjust B and D
Space of Donders importance in trial denture visit
VDO Evaluation
this is the space that is between the tongue and palate at REST
what happens when VDO is too much or too little in regards to the space of donders
increase in VDO (teeth too tall) —> increases the space of donders
decrease in VDO , decreases space and teeth too narrow or denture base is too thick – patient will have trouble swallowing and not enough room for the tongue
Interridge space importance in trial denture visit
when natural teeth are in occlusion – ridge crests are a MINIMUM OF 12MM apart
what appearance does increased VDO cause?
decreased VDO?
Increased – stretched appearance
Decreased – overclosed appearance
VDO confirmation?
Swallow
estehtics
phonetics
Step by step corrections to decrease VDO with GOOD ESTHETICS AND GOOD RMP
include what areas you do not touch
problem 1a
not A and not C (occlusal plane)
so you need to warm and intrude areas B and D
- raise pin by the amount that you need to raise vertical (C+D now holding vertical)
- warm wax area D and close the articulator
- intrude area B, one side at a time
if esthetics are good what area is okay?
A
if good rmp what areas are okay?
C
what happens when D moves up when trying to decrease vertical
pin begins to touch and A and B may begin to overlap
if overlap? and dont want it? – intrude B until this does not happen
Step by step corrections to decrease VDO (have excess) with GOOD ESTHETICS BUT RMP TOO HIGH
include what areas you do not touch
Problem 1b
Do the same thing but instead of intruding area D you will work with area C
*warm and intrude area B and C
- Check RMP and raise Pin
- Warm wax area C and close articulator
- Intrude area B one side at a time if there is overlap and you do not want this
leave area D alone
DONT TOUCH A
if overlap – will produce incisal guidance and will have to intrude area B one side at a time (so dont loose esthetics)
Step by step corrections to decrease VDO with POOR ESTHETICS AND
include what areas you do not touch
problem 2
make all adjustments in the anterior first ( A and then B)
Then follow up with intruding C or D as needed, depending on whether RMP is OK
- Select the arch and select the side
- Warm wax and intrude area A (or B) ONE SIDE AT A TIME. – so have a reference
- chech posterior – check RMP and if it is not good - adjust C - if okay and D is okay you can RAISE THE PIN
- warm wax , close articulator, intrude C or D and lower
Step by step corrections with insufficient VDO (have to increase) with POOR ESTHETICS OR PHONETICS
include what areas you do not touch
intra oral or extra oral adjustments?
problem 3
IN PATIENT MOUTH
Add to POSTERIOR FIRST to establish VDO then position anteriors as needed
- place wax on occlusal surfaces until at correct vertical
- if RMP is right – placing on D
- check RMP add wax to C or D
- Remove and reset area A – one side at a time
- check RMP, raise pin, warm wax, close articulator, intrude C or D
Why do we make dentures in CR?
Independent of Tooth contact
Clinically discernible
Clinically REPRODUCIBLE
if CR does not match up what do you do first?
take CR on patient again because you dont know if this was exact – so try again
Initial CR?
Confirmed?
Comparison?
Initial = taken with Auluwax without rims touching
Confirmed= INTRA-ORAL check bite with auluwax– teeth must not touch
Comparison –> made with articulator (so bring wax to articulator and make sure it locks in same as on patient intra-orally
if CR does not match up on articulator?
have to REMOUNT – but check on pt. first a few times - rehearse it before re mount
If there is a discrepancy between the CR on articulator and patients mouth?
have to correct it
take a new bite (CR check bite) and remount lower
