Wax up of the week

[CoolHandLuke]

From wax up, to finish. Here are some photos of a previous case of a very young female patient.
Somewhat difficult due to the high lip etc. Great communication with the doctor!

 

[DentureDude]

Really?
I don't find that to be true, but I'm just offering the information.

im sure your right.
still have allot to learn.

 

[kcdt]

im sure your right.
still have allot to learn.

Incisal guidance is a function of Hanau's quint. Failure to achieve balance means the other elements of the quint weren't addressed.
For the curious, these elements would be:
incisal guidance, condylar guidance, cusp height, plane of occlusion, and compensating curve.

Christensen's phenomenon describes how a gap occurs between the posterior occlusal contacts because of translation of the mandible downward and forward in protrusive. In complete denture construction balance is introduced by building in compensating curves utilizing the appropriate cusp height for the occlusal scheme.

 

[denturist-student]

Incisal guidance is a function of Hanau's quint. Failure to achieve balance means the other elements of the quint weren't addressed.
For the curious, these elements would be:
incisal guidance, condylar guidance, cusp height, plane of occlusion, and compensating curve.

Christensen's phenomenon describes how a gap occurs between the posterior occlusal contacts because of translation of the mandible downward and forward in protrusive. In complete denture construction balance is introduced by building in compensating curves utilizing the appropriate cusp height for the occlusal scheme.

Not really sure how to apply it....incisal guidance and condylar guidance are on the top of the formula and the rest are on the bottom....Any change in a top formula element must be compensated by either reducing the other top element or increasing the bottom elements.....Occlusal plane is considered a constant once it is determined....compensating curves are usually determined by the standard Dentsply 20 degree curve template....So any change needed to correct either the incisal guidance or condylar guidance is done with a tilt of the posterior teeth. ie cusp angle....When I set up I only use the incisal guidance for the start.....When finishing the setup I take it right off the incisal plate and tweek the teeth into balance. I only use the incisal pin thereafter to maintain the freeway space. In school also we were taught to setup for balancing and grind in for working....that is to elevate the working ( later known as lingualised) during setup slightly......If someone really wants to emulate christensen's phenomenon I use balancing ramps......but they risk pinching the cheeks....I usually finish off by adjusting the incisal edges in the mouth after leaving them slightly long during processing. I also tilt the necks of the lower incisors lingually in case the labial flange needs reduction later on....I never leave any anterior contact during occlusion.....Only during protrusive....In severe class II I will use balancing ramps...Last class II I had retruded six mm.....(which I established by the pin tracings) she needed that much lip support to fill the vermillion border....But as we all know most severe class II's have dual bites anyway..One for speaking, close to the resting position, and one for chewing....That was a dramatic change for that patient and she will need to get used to the crowded tongue during chewing because she had been setup as a class I for twenty years in a protruded position.....The esthetic results were dramatic as well....but she will have to go easy for a while.....I may even need to make her a transitional lower denture half way back for the interim.

 

[kcdt]

Not really sure how to apply it....incisal guidance and condylar guidance are on the top of the formula and the rest are on the bottom....Any change in a top formula element must be compensated by either reducing the other top element or increasing the bottom elements.....Occlusal plane is considered a constant once it is determined....compensating curves are usually determined by the standard Dentsply 20 degree curve template....So any change needed to correct either the incisal guidance or condylar guidance is done with a tilt of the posterior teeth. ie cusp angle....When I set up I only use the incisal guidance for the start.....When finishing the setup I take it right off the incisal plate and tweek the teeth into balance. I only use the incisal pin thereafter to maintain the freeway space. In school also we were taught to setup for balancing and grind in for working....that is to elevate the working ( later known as lingualised) during setup slightly......If someone really wants to emulate christensen's phenomenon I use balancing ramps......but they risk pinching the cheeks....I usually finish off by adjusting the incisal edges in the mouth after leaving them slightly long during processing. I also tilt the necks of the lower incisors lingually in case the labial flange needs reduction later on....I never leave any anterior contact during occlusion.....Only during protrusive....In severe class II I will use balancing ramps...Last class II I had retruded six mm.....(which I established by the pin tracings) she needed that much lip support to fill the vermillion border....But as we all know most severe class II's have dual bites anyway..One for speaking, close to the resting position, and one for chewing....That was a dramatic change for that patient and she will need to get used to the crowded tongue during chewing because she had been setup as a class I for twenty years in a protruded position.....The esthetic results were dramatic as well....but she will have to go easy for a while.....I may even need to make her a transitional lower denture half way back for the interim.

"Any change in a top formula element must be compensated by either reducing the other top element or increasing the bottom elements"
Exactly.

 

[Darby Hawkes]

Being I finished this case today. Thought I would post the final prosthesis to compare the case to the wax up. Most all cases here are characterized with tissue tint
during the processing stage. It is important to have the case waxed to proper thickness, anatomy, etc. to avoid grinding away the tint. If done correctly, only
the peripheral borders is where minimal flash is removed using the Ivocap injection.

View attachment 4267 View attachment 4266
View attachment 4266 View attachment 4267

I am a crown and bridge guy, but this looks incredible. If I ever end up in dentures Im requesting you!

 

[droberts]

I am a crown and bridge guy, but this looks incredible. If I ever end up in dentures Im requesting you!

Thank you Darby Hawkes.

 

[JohnWilson]

This will be a f2 hybrid ti/resin case that I set/waxed today, it was a great case to work on as the ridges were leveled perfectly and the bases will convex easily.

 

[Thedentureman]

Ha John nice work. What stone is that? A lot of people just talking, it is great to see someone work.

 

[JohnWilson]

Ha John nice work. What stone is that? A lot of people just talking, it is great to see someone work.

We use Fuji rock for all implant cases, very low expansion and strong. I am looking forward to designing the bars this next week. Thanks for the compliment

 

[Thedentureman]

Here it is the first wax-up in the new lab.

 

[TomZ]

One of the first cases of 2015. Not every case is ideal in treatment, but every case is treated in the same because there is a human attached.

 

[TomZ]

thanks Wade, bummer about Tony

 

[cdtwade]

I wonder if there was anybody that didn't know Tony. I presume you mean Tony Hicks. I didn't know how many people knew him until after he passed. He definitely marched to the beat of his own drum!!

 

[Doris A]

One of the first cases of 2015. Not every case is ideal in treatment, but every case is treated in the same because there is a human attached.

At a lab where we USED to work, the boss would say "it's only for Dr so and so". NO it's only the Patient!!!

 

[TomZ]

Loved the guy. He had contacted me through Facebook about 2 years ago and we reconnected, exchanged ideas he even sent me some of his hand roasted coffee. Theres alot of characters in dental technology.

 

[TomZ]

Some "hump day" denture porn to keep the thread throbbing..

 

[JeffreyDugré]

First anatomical waxup of 2015

 

[JeffreyDugré]

Closer one !

 

[Thedentureman]

Boys play nice. Here's my bench, and yes I use an iron. I also use it to just set the teeth like John.