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    Bite rim/custom tray in one?

    Discussion in 'Removable' started by Denture Dude, Jul 7, 2017.

    1. Denture Dude

      Denture Dude Member Full Member

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      Has anyone seen this done. Someone was telling me they've had good results using a light cure base/wax rim as a custom tray. Kill 2 birds with one stone? Get a final impression while you take the bite? Any thoughts?
       
    2. denturist-student

      denturist-student Active Member Full Member

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      I have done this quite often with elderly infirm as part of minimally invasive procedures...Then refine the bite with a check bite later on....But only when centric is not really important such as using monoplane lowers with lingualized uppers..It is far better to use a custom tray and obtain the definitive final impression. I don't like doing it because there is a risk involved in that the heals might interfere thereby preventing full coverage of the retro molar pad area and also compromising the bite....Let me clarify this by saying I NEVER REALLY DO THIS unless I am going on to do a pin tracing and I only use this method where the definitive bite will be finalized with a pin tracing and facebow mount. When a functional impression is to be ustilized then I will also do this knowing that the bite will be finalized with the functional impression to a certain extent. All of my relines are using functional impressions because the tissue conditioners also aid in reestablishing the better condition of the mucosa...
       
    3. JMN
      Curious

      JMN Christian Member Donator Full Member

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      I actually lost a client for refusing to do it. But he wanted it for a case that had 2 teeth remaining and was to be an immed c/... Some people's kids.

      If you are in a place that is less concerned about accuracy and final product and more concerned about speed, you might see it. But it's a shortcut with issues. Adjusting the wax rim to the patient is rarely done well even if it is a standalone item. After putting Imp material in it, It will change the orientation, however slightly, of the rim to the opposing arch.
       
    4. denturist-student

      denturist-student Active Member Full Member

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      If the suction from the impression is good and usually is then it may be a good idea but care must be taken when doing the bite registration to ensure that the bite rim doesn't poke through the bite reg material..Because when that happens there is a chanse that one of the dentures is no longer seated....We usually hold the lower in place and let the upper suction do its thing.....but yes there are shortcomings this method for sure.....But that can be said for any procedure.....For me it is something I can recover from with a pin tracer....
       
    5. JMN
      Curious

      JMN Christian Member Donator Full Member

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      You are a very different animal than the average dentist doing dentures. In my neighborhood 3 resets are not uncommon. Getting more than midline marked without specifically requesting it is unusual. Only one that I know of does tracing.
       
    6. Denture Dude

      Denture Dude Member Full Member

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      In a perfect world, dentures would cost a grand (to doc) and all steps and propers would be done, we know that most pts can't afford tho
       
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    7. Denture Dude

      Denture Dude Member Full Member

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      I asked originally because my new doc wants these done this way. I'd heard of it but never don't this way. I figure at least the guy is trying, I've made a ton of dentures, 99.99999% with no custom tray or rim contouring.
       
    8. Denture Dude

      Denture Dude Member Full Member

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      And the ones that I have set to the docs 'contoured' rims had to be reset. Lol. Of course the response was 'you must not have set to my rim.'
       
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    9. BobCDT

      BobCDT Well-Known Member Full Member

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      It takes a very good clinician to get this right. It has been attempted for decades but never became mainstream due to the difficulty in achieving adequate accuracy
       
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    10. keroassidy

      keroassidy Member Full Member

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      I have a Dr that does this on all full denture cases. He uses that blue acrylic tray material for impression. He locks in paper clips for retention when making tray on outside. after impression he warms wax and forms rim over exposed paper clips. Looks funky but me and him have almost zero retrails. Looks crazy but I dont fix what aint broke.
       
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    11. denturist-student

      denturist-student Active Member Full Member

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      I usually mark midline, high and low smile lines and canine lines. But not before contouring for fullness.
       
    12. JKraver
      Tired

      JKraver Well-Known Member Full Member

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      This can be done with only a good clinician. If you get something back that isn't marked for midline, high/low, ect. It is not a good sign.
       
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    13. Old School Dentures

      Old School Dentures New Member Full Member

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      I always push for a custom Tray. If they don't use one no biggie ...i put all full upper/lower bites on hard light cured bases and then use those same bases for setting up. If you think the impression is **** or the doc says the base doesn't fit have them do a reline type wash inside the base AFTER the tryin and make sure everything looks the same...center line ,occlusion etc when they have said wash in the base and in the mouth. Get it???
       
    14. Old School Dentures

      Old School Dentures New Member Full Member

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      When you cut corners in this business you run around in ****ing circles.
       
    15. JMN
      Curious

      JMN Christian Member Donator Full Member

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      One of my really good docs got a custom tray, border molded, stabilized wobbly teeth, and impressed.

      Then used the cust tray impression for the baseplate and rim. The pt had gotten so nervous and mouth so dry by the time the impression was made that it captured less detail and peripheral roll.

      Can't always win, can always try.
       
    16. JKraver
      Tired

      JKraver Well-Known Member Full Member

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      All he had to do was allow the patient one minute with their mouth closed and a swish of water.
       
    17. JMN
      Curious

      JMN Christian Member Donator Full Member

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      Probably. She also had gotten a bit nauseous and trepidation had set in after going through the border moulding, smelling the border molding material, rubber base, etc. Some pt's just don't have 'chair stamina' and managing that is a real learning curve for the licensee.
       
    18. Chalky
      Relaxed

      Chalky Member Full Member

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      I will always do what they ask... I just outline to pitfalls of the(often poor) technique they are attempting. if they choose to cut a corner and it fails I will charge them - as I previously warn them. if they think it will cost extra when it fails, they sometimes see sense. As previously said, some can pull it off and get it right... but when it goes wrong who pays for the mistake?
       
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    19. kcdt

      kcdt Well-Known Member Full Member

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      Only point I would add is if clinician does this, make a new baseplate on the new model and set up on that.
       
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    20. gallagerdental

      gallagerdental Active Member Full Member

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