Complete Dentures on Hinge Articulators

[Inna-Hurry]

.... this is gonna be a great show....

 

[Affinity]

Maybe I should clarify my statement with the setup of the tooth not the price per se. The gerber technique requires a certain articulator, as determined by someone smarter than me. The condylator is a nice simple articulator, it’s the technique I chose to study. There are many paths to follow but Candulor has a lot figured out when it comes to biomimetics, occlusion, materials.. so I guess what I’m getting at is, there is a difference or Gerber would’ve used an articulator with no pin. Take it up with him not me.


CHL I understand what you mean but show me you’re not speaking hypothetically.. who is doing functional CBCT removable dentures? Commercially, as it relates to this thread. Does avadent use a CBCT bite? What patient is going to dole out money for a CT scan when a Dr can simply determine the condylar angle and midline with a face bow in 5 minutes? A Gothic arch determines your excursions also in minutes, in real time. We’re not sending these things to Mars, but ultimately it comes down to the effort and skill that goes into it not necessarily the technique. Otherwise KCDT is wasting his time explaining Massad technique, which would be a shame.

Drs out of school don’t know how to do dentures or take a facebow record, use an alameter,or Gothic arch.. they rely on us whether they admit it or not. Most refer them out. There is a difference in the way a denture is made just like there is a difference between what McDonalds and a steak house do to a cow.. but in the end they’re all just plastic teeth..

 

[Inna-Hurry]

Maybe I should clarify my statement with the setup of the tooth not the price per se. The gerber technique requires a certain articulator, as determined by someone smarter than me. The condylator is a nice simple articulator, it’s the technique I chose to study. There are many paths to follow but Candulor has a lot figured out when it comes to biomimetics, occlusion, materials.. so I guess what I’m getting at is, there is a difference or Gerber would’ve used an articulator with no pin. Take it up with him not me.


CHL I understand what you mean but show me you’re not speaking hypothetically.. who is doing functional CBCT removable dentures? Commercially, as it relates to this thread. Does avadent use a CBCT bite? What patient is going to dole out money for a CT scan when a Dr can simply determine the condylar angle and midline with a face bow in 5 minutes? A Gothic arch determines your excursions also in minutes, in real time. We’re not sending these things to Mars, but ultimately it comes down to the effort and skill that goes into it not necessarily the technique. Otherwise KCDT is wasting his time explaining Massad technique, which would be a shame.

Drs out of school don’t know how to do dentures or take a facebow record, use an alameter,or Gothic arch.. they rely on us whether they admit it or not. Most refer them out. There is a difference in the way a denture is made just like there is a difference between what McDonalds and a steak house do to a cow.. but in the end they’re all just plastic teeth..

I am very curious on the Gerber Technique". I have attended two Turbyfill clinics in my lifetime and I am still looking for that technique that will give the Dr's.-that want to be great at dentures- tools to use as a foundation. Gonna look that up. Thanks!

 

[Affinity]

Also called the Swiss denture concept. Ivoclar must have thought it was special enough to ‘acquire’ candulor.. I’ve got a great pdf that explains it maybe I can post it.

 

[kcdt]

I am very curious on the Gerber Technique". I have attended two Turbyfill clinics in my lifetime and I am still looking for that technique that will give the Dr's.-that want to be great at dentures- tools to use as a foundation. Gonna look that up. Thanks!

I'm sure I'm oversimplifying, but it boils down to mandibular over crest of ridge with the lowest point mapped out and the first molar religiously put there; if the ridge deviates more than (I think) ~2° towards the pad, the second molar is dispensed with. Lingualized occlusal is favored, though swissdent flipped the arches.
IIRC, Artigal hold courses that cover some of these ideas.
I'm sure my answer glosses over a lot; I just relate what I think is the functional emphasis in a nutshell

 

[CoolHandLuke]

just gonna put this out there: in order to get anything out of Avadent you have to have a CBCT, according to what i know. their process is not yet 100% digital but it is getting close. the facebow method is often fraught with the same user error as the user that takes algenates for finals and puts drags all over the place and bottoms out trays because he's too cheap for custom ones and inept as to probably bottom out those trays too if you have them for free.

for reasons related to development here i can't speak to specifics. its no secret that fully digital is the end game though. and i do mean fully.

 

[Lanny]

Are you a lab tech at Creighton Lanny? I have an acct that graduated from there a couple years ago.

Yeah, I came to the school about 3 yrs ago.

 

[Flipperlady]

Good impressions,good bite (they don't whistle or look overclosed),making sure a close friend or family member is there to say the try-in looks great, following a setup philosophy (there are many),making sure your bite isn't locked in that they can protrude and bite without dislodging, taking away the old denture "to clean" for a couple of weeks. If you can accomplish this, doesn't matter what kind of articulator.

 

[Affinity]

If the end game is fully digital, and its taken decades to perfect the analog technique, and you can still say its not perfect, but Im not sure digitizing the patient is going to necessarily be better. Better bites from a computer, better fit, and esthetics? We could be talking about even more decades to perfect that.

Also, avadent does not require ct scans, in fact, they ask for polyvinyl impressions with a bite record.. not to mention you have little control as a lab tech, over what they do with the bite/setup/esthetics. You basically oversee what someone else, who knows how skilled, sets up.

 

[CoolHandLuke]

from the invention of the silicon chip to the Apple LC2 was 20 years. it was an ever accelerating game after that, with growth in the field doubling in power and intelligence every 12-18 months.

where do you think digital denturism is on this scale right now, given the companies like Avadent, Baltic and Evolve and conventions such as DLOAC (now entering the 14th year) bringing digital bits and pieces of the process to anyone with an interest? have we arrived at the equivalent of Windows 95 ? has it become a system everyone can use? is it still DOS, reserved for the ultra nerds still operating tactile-ly at the keyboard?

dismissing it as nonexistant, i don't know how to react to that. dismissing it as though it might exist but it is operated by simpletons, i think we don't have much to talk about then.

 

[Affinity]

Your analogy holds up, its probably past Windows 95 , but Im not sure what the advantage is yet.. unless it helps the patient. Just because its faster, cheaper? and easier for the dentist or lab doesnt mean it provides the pt a better denture. I heard a well known prostho give a lecture a few months ago about all the digital denture options and his conclusion is that they are promising but not there yet.

 

[JMN]

Your analogy holds up, its probably past Windows 95 , but Im not sure what the advantage is yet.. unless it helps the patient. Just because its faster, cheaper? and easier for the dentist or lab doesnt mean it provides the pt a better denture. I heard a well known prostho give a lecture a few months ago about all the digital denture options and his conclusion is that they are promising but not there yet.

The advantage will be the automation providing a more assembly line approach and commensurate fee schedule as the technology matures.

Eyeglasses were once made by hand, then man/machine, now primarily by machine. Even field adjustable ones are made for impoverished areas.
Imagine a small box van in Sub Saharan Africa with a generator, water, 500lbs of alginate, a scanner and a data link. Scan a village or small town, come back next month with all of them to deliver and drive away.
The US will see little need for this step until it is precise and completely digital. How many bushwackers are out there vs proper labs... The under served US communities will not be the market, the guy with a few extra thousand will be. But after it is more 'there', not until.

 

[CoolHandLuke]

"Better" is a quantitative term. we can prove something is objectively better than something else.

its going to be a hard pill to swallow then, if it can be proven that the digital production is quantifiably better. when digital can produce implants for example that have a better longevity record. better passive fit.

"aesthetics" is a subjective term. what you like is different from what i like, and different still from what the patient likes.

so the solution will need to take information about what the patient likes, generate a quantifiably better more accurate fit, and all be done without a hand laying a finger on it. id est nicht ein soluzione Avadent or Evolve. no sockets. no flat teeth. no superglue. no trimming.

 

[Lanny]

In the end isn't it really as good as the human dictating everything?

 

[CoolHandLuke]

play the cards right and there won't be a human, just a set of mathematical principles, a carefully constructed and elaborately automated process, and a big green button to start it up and retire.

 

[rkm rdt]

play the cards right and there won't be a human, just a set of mathematical principles, a carefully constructed and elaborately automated process, and a big green button to start it up and retire.

That's what she said

 

[XxJamesAxX]

What do you think your actual success rate is when you you fabricate dentures using hinge articulators? 50% at best? why waste your time with a beautiful wax up and custom staining etc. when the odds are that its no better that a basic denture? Just curious. Are people just feeding their egos?

Thanks

Tell me what your measurement of success is and I’ll tell you my success rate.

Success can be very different.


Sent from my iPhone using Tapatalk

 

[droberts]

Success rate? The articulator is a tool for setting teeth. The impression has more of a percentage to do with the case being successful.
Have set many cases up in my early years with a simple hinge. Now, would not consider it. I have become attached to a system and
it works well with my clients. The Stratos from Ivoclar with the occlusal mounting plate. My clients give me information of the mid-line,
occlusal plane, lip support, high smile etc. This is transferred utilizing the occlusal mounting table, and all the info is used as a reference.
Then only the set-up / casts utilizing the magnetic mounts are sent to the doctor. Most all of my clients have a Stratos in their office.
This allows the doctor to view it, also showing the patient as well.

Lanny, to answer your actual question. My success rate with a standard hinge was very high as it is now with my technique described above.
IMO, its analyzing the impression has more to do with success.

 

[kcdt]

Yes we can figure out how to make a flawed or inadequate tool perform.
But how much more attention to detail and just productions numbers could be improved if you didn't have to devote so much to making the flawed work?

 

[kcdt]

Success rate? The articulator is a tool for setting teeth. The impression has more of a percentage to do with the case being successful.
Have set many cases up in my early years with a simple hinge. Now, would not consider it. I have become attached to a system and
it works well with my clients. The Stratos from Ivoclar with the occlusal mounting plate. My clients give me information of the mid-line,
occlusal plane, lip support, high smile etc. This is transferred utilizing the occlusal mounting table, and all the info is used as a reference.
Then only the set-up / casts utilizing the magnetic mounts are sent to the doctor. Most all of my clients have a Stratos in their office.
This allows the doctor to view it, also showing the patient as well.

Lanny, to answer your actual question. My success rate with a standard hinge was very high as it is now with my technique described above.
IMO, its analyzing the impression has more to do with success.

I would add bite to that. I've seen plenty of nice master casts with meaningless bite registrations.