Bite Registration for Complete Dentures, How to guide for Denture Bite Registrations, Technical Guide - Part 3 of 3
Now that you have obtained all of that information from the patient clinically , do you know what the dental laboratories do to turn your beautiful bite registrations into functional try-in?
Step 1 - Patient Details, Assessment of the bite registration, Articulation
The prescription is checked for patient details, age, sex, shade and any special instructions. Then the bite registration is checked for the aesthetic parameters, accuracy of the jaw relationship and base plate to the cast. Once checked the bite registration is then articulated with low expansion articulating stone with the guide pin set on 0mm and centric relation locked together during articulation
Step 2 - Transferring the patient information from the bite registration
Once articulated, lab putty is placed underneath the upper bite rim to transfer the frontal plane & occlusal plane onto the lab putty as a guide once. The putty is placed at the same level as the bite rim anteriorly for tissue support and determines the anterior tooth positioning. The aesthetical parameters is transferred onto the lab putty and on the cast above the bite rim. The excess lab putty is trimmed to the same level as the bite rim.
This will ensure every aspect of the bite registration is transferred, the frontal plane, occulsal plane, aesthetical features with the smile features are scribed above the cast for cross checking.
Step 3- Setting up Dentures, Tooth positioning & Dentogenics
Now that information has been utilised we determine the anterior tooth moulds from the parameters & shade. Once we have found the correct moulds, the centrals are positioned in line with centre line, low lip line, frontal plane & tissue support set via the parameters of the upper bite rim on the putty plate. The rest of the anterior teeth are positioned in line with the centrals and the canines with the canine line. The posterior teeth are positioned on the lab putty to follow the occlusal plane set via the upper bite rim on the putty plate. Once the upper denture has been set the lower denture is constructed to the upper denture. By setting up the denture in this technique you have successfully utilised the centre line, canine line, smile features, high / low lip line, frontal & occlusal plane whilst maintaining the OVD via the articulator. This makes the technique bullet proof as you have not guessed any of the try-in, the try-in has been constructed exclusively and exactly from the bite rims provided.
Step 4 - Waxing up, contouring
Once everything has been checked, the try-in is waxed up with the smile features taken into consideration when determining the height of the necks. The wax up is then complete and then re-checked back onto the articulator.
Hopefully this guide has provided more of an insight on how important a bite registration is . I have trained many technicians and they always say to me that i am too quick at setting up and waxing etc, my reply back is simple, its not about being the fastest, its about being the most productive, accurate and consistent. You can be the quickest technician in the world, without understanding, quality, accuracy and consistency, you ain’t going no where.
When i set up, i do not do it quickly, i do it productively, accurately, precisely and consistently. I make sure all of the information is utilised, the patient information, anatomical features, peripheral areas, aesthetical parameters, smile features, orientation, OVD and all of the teeth are set up accordingly with the correct axis’s per tooth .
I do however, get this comment from time to time "if i had the time to do that, then i could do exactly the same" they are right and wrong , any one can do that but ill be honest i do not have the luxury of spending a huge amount of time per job as i would like (See image below, feel sorry for the technician who has the wax them up.... for the morning).
(Timing Record for the above job Set up: 12 mins upper, 8 mins lower, Wax up Privately: 21 mins )
Private Dental Laboratory in London
About the author:
Kash Qureshi is a Clinical Dental Technician (Denturist) in the U.K who oversees and quality controls over 3000+ fixed and removable prosthesis including implant cases from a clinical and technical aspect monthly at Bremadent Dental Laboratory & Swissedent Denture Clinic in London.
www.swissedent.co.uk www.bremadent.co.uk firstname.lastname@example.org