Help with Setting Individual Anterior Guidance Plate for Bioform 33 Degree Teeth

[TMNT120]

Hi everyone!

Been studying away for my second attempt at practical exams coming up soon.

Last year, I was using a Hanau-Mate average value articulator and I think that contributed to my inability to pass.

A generous denturist friend of mine has been kind enough to lend me a Stratos 300 with an individual anterior guidance plate to challenge the exam this time around.

The question that I have is how to set the guidance plate for Bioform 33 degree teeth?

I looked in the Arrangement manual from dentsply but all they provide is this:



The Guide plate looks like this:





I found this video:



but it doesn't really explain anything.

Do I set everything to 30 degrees? or do I set the angle to 30 degrees and 15 degrees for the two to correspond with the bennett angle? or leave it flat?

Thanks in advance!

 

[kcdt]

It very clear on the literature.
Condyles at 30.
Incisal table at 30.
Bennett shift at 12-15.

 

[kcdt]

Hi everyone!

Been studying away for my second attempt at practical exams coming up soon.

Last year, I was using a Hanau-Mate average value articulator and I think that contributed to my inability to pass.

A generous denturist friend of mine has been kind enough to lend me a Stratos 300 with an individual anterior guidance plate to challenge the exam this time around.

The question that I have is how to set the guidance plate for Bioform 33 degree teeth?

I looked in the Arrangement manual from dentsply but all they provide is this:

View attachment 30315

The Guide plate looks like this:

View attachment 30316

View attachment 30317

I found this video:



but it doesn't really explain anything.

Do I set everything to 30 degrees? or do I set the angle to 30 degrees and 15 degrees for the two to correspond with the bennett angle? or leave it flat?

Thanks in advance!

I see what you're getting at. Try this:
https://books.google.com/books?id=D...ngs on adjustable incisal guide table&f=false

 

[kcdt]

I see what you're getting at. Try this:
https://books.google.com/books?id=DLpEDwAAQBAJ&pg=PT234&lpg=PT234&dq=how+to+use+lateral+wings+on+adjustable+incisal+guide+table&source=bl&ots=4cEDQcQBo3&sig=z3SloX-lspfv6rJDUcLy7onaczw&hl=en&sa=X&ved=2ahUKEwii4sX8m6XcAhVBON8KHSsEDgIQ6AEwGHoECAAQAQ#v=onepage&q=how to use lateral wings on adjustable incisal guide table&f=false

I never messed with that for CDT.
You might be overthinking it.

 

[lcmlabforum]

This is in the FWIW department. After taking my share of exams, it is sometimes more important
to understand the concept to do well in future, but more important to give the examiners the standard
answers they expect, to pass and get through.
LCM

 

[TMNT120]

It very clear on the literature.
Condyles at 30.
Incisal table at 30.
Bennett shift at 12-15.

Yes, I saw that in the literature, and thanks for the link to the textbook,

I've set the anterio-posterior angle to 30, but for some reason, all my setups seem to only achieve working and balancing contact at a slope of 5 degrees for the lateral wings. Flat wings results in teeth knocking and 30 degrees results in no working or balancing contact.

Any ideas?

 

[kcdt]

Yes, I saw that in the literature, and thanks for the link to the textbook,

I've set the anterio-posterior angle to 30, but for some reason, all my setups seem to only achieve working and balancing contact at a slope of 5 degrees for the lateral wings. Flat wings results in teeth knocking and 30 degrees results in no working or balancing contact.

Any ideas?

My first one is wondering why with the wings at all. If you've got knocking, as you put it, the solution is find the offending tooth and correct it's position.
I've never needed the wings to get me there.

Let me just say this: figure out what areas contributed to your last exam's outcome. Focus on those.
A more complex gadget you don't fully comprehend isn't going solve that for you.

I don't mean to sound mean, but a lot of frustration comes from diving down a rabbit hole. Focus on what the examiner's remarks said were deficient.
You should not need a fully dialed in Stratos to achieve that setup.

 

[TMNT120]

My first one is wondering why with the wings at all. If you've got knocking, as you put it, the solution is find the offending tooth and correct it's position.
I've never needed the wings to get me there.

Let me just say this: figure out what areas contributed to your last exam's outcome. Focus on those.
A more complex gadget you don't fully comprehend isn't going solve that for you.

I don't mean to sound mean, but a lot of frustration comes from diving down a rabbit hole. Focus on what the examiner's remarks said were deficient.
You should not need a fully dialed in Stratos to achieve that setup.

Thank you for the suggestion! I really appreciate it, doesn't come off as mean at all. You're probably right that I'm diving a bit too deep into the rabbit hole and causing more frustration for myself. Unfortunately, there were no examiner remarks, just a mark sheet.

Working and balancing contacts was one of my weak spots last year, so that's why I'm focusing on that. The reason I'm getting frustrated is exactly what you're saying: the lateral wings SHOULDN'T be a factor in achieving contact, but I'm getting a bunch of different results when playing with them.

So my process is to set the upper teeth first according to the occlusal table: Buccal and lingual cusps on the premolars on the occlusal plane, distal cusps on molars raised 0.5mm etc, etc.

When I sock in the lowers to achieve the same occlusion as the IFU and I check the working and balancing contacts, the incisal pin will lift up off of the lateral wings prematurely, rather than being guided by it. My previous articulator had a 10 degree non-adjustable average-value slope for the wings and that would cause for no occlusion at all when checking function.

The exam does allow for *some* occlusal grinding of the denture teeth. Should I just set the wings flat, grind away at the cusps, and forget about playing with the wings to achieve balance?

 

[kcdt]

Thank you for the suggestion! I really appreciate it, doesn't come off as mean at all. You're probably right that I'm diving a bit too deep into the rabbit hole and causing more frustration for myself. Unfortunately, there were no examiner remarks, just a mark sheet.

Working and balancing contacts was one of my weak spots last year, so that's why I'm focusing on that. The reason I'm getting frustrated is exactly what you're saying: the lateral wings SHOULDN'T be a factor in achieving contact, but I'm getting a bunch of different results when playing with them.

So my process is to set the upper teeth first according to the occlusal table: Buccal and lingual cusps on the premolars on the occlusal plane, distal cusps on molars raised 0.5mm etc, etc.

When I sock in the lowers to achieve the same occlusion as the IFU and I check the working and balancing contacts, the incisal pin will lift up off of the lateral wings prematurely, rather than being guided by it. My previous articulator had a 10 degree non-adjustable average-value slope for the wings and that would cause for no occlusion at all when checking function.

The exam does allow for *some* occlusal grinding of the denture teeth. Should I just set the wings flat, grind away at the cusps, and forget about playing with the wings to achieve balance?

Ok, let's play devil's advocate. You say you can achieve balance w/wings at 5 degrees.
So. After its all set to the wing at 5, what occurs when you flatten them (the wings) out? Is balance still there or gone?

Secondly, what is your order for setting mandibular to your set up? Are doing a key tooth method, or what?

 

[TMNT120]

Ok, let's play devil's advocate. You say you can achieve balance w/wings at 5 degrees.
So. After its all set to the wing at 5, what occurs when you flatten them (the wings) out? Is balance still there or gone?

Secondly, what is your order for setting mandibular to your set up? Are doing a key tooth method, or what?

It is "balanced" but the incisal pin lifts off of the platform rather than being guided by it. I'm probably being pedantic, but I don't want to lose marks unnecessarily.

For the mandibular setup I start with the first molars on either side and work my way forward to the canines, set the lower centrals and work towards the canines, then set the 2nd molars last. Not familiar with the key tooth method.

 

[kcdt]

It is "balanced" but the incisal pin lifts off of the platform rather than being guided by it. I'm probably being pedantic, but I don't want to lose marks unnecessarily.

For the mandibular setup I start with the first molars on either side and work my way forward to the canines, set the lower centrals and work towards the canines, then set the 2nd molars last. Not familiar with the key tooth method.

You are being pedantic. We all are. The incisal table is a rabbit hole. If it works smoothly, it works.

Key tooth is an old term. You just described it.

Not to nit pick, but we fail in execution. Do you fell you did anything a little rushed? The time frame to task ratio is tight.
It's why almost half fail the first go.

I'm just probing a bit to keep you from focusing in the wrong place.

Let me illustrate: back when dinosaurs roamed I tested in Norfolk Natal base.
The guy next to me was attempting to fabricate an old school stabilized baseplate. Never done one before. Old geezer coworker told him it was da bomb. So he' s freaking out.
Never saw him finish his set up, but he was using soft red wax...

All I'm saying is figure out what to improve about the job you did there. Going advanced won't win you anything.
They're looking for task competency.
Don't over think that.

 

[Brandon Patrick]

The Hanau you used is a non adjustable articulator. Using that in itself costed you a few points right off the bat, then even more points when the examiners couldn't properly check for working, balancing, and protrusive contacts. Using a semi adjustable articulator isn't going to magically correct your issues (as you are finding out I'm sure). The denture teeth are designed to be set a specific way in order to achieve consistent results. Compensating curves (Spee and Wilson) are important when it comes to these contacts. Too much tilt straight or buccally over the ridge can create premature working contacts and zero balancing, while too much lingual tilt can create the opposite or even add anterior interference. With out proper curve of Spee you may notice working contact only on molars. You are correct about grinding on teeth to help get your contacts (an examiner told me this),but it can be done without. As encouragement know that you can easily pass and not have every one of these contacts.. if a few teeth aren't in working, balancing, or protrusive contact you'll lose a point per contact, but it won't be a make or break thing by itself. Remember to keep everything neat, even the preliminary work. Too many people come in with sloppy mountings and I assure you, even though nobody may openly admit it, this definitely affects their idea of the quality you produce. Take a piece of 400 or 600 grit sandpaper and smooth out those mountings under some running water. Clean wax off of teeth with a handpiece and bristle brush or use solvent. Even though the instructions don't go in to great detail on this.. create denture base anatomy. Interdental papilla, gingival rolls, and subtle root eminences go a long way. I recommend polishing the wax up when finished as well. A wet cotton ball over the surface or anything similar will do (I use a sponge wheel with the handpiece). As you may know, in this field presentation means just as much as function to most. Some I dare say would even choose aesthetics over function.

 

[TMNT120]

The Hanau you used is a non adjustable articulator. Using that in itself costed you a few points right off the bat, then even more points when the examiners couldn't properly check for working, balancing, and protrusive contacts. Using a semi adjustable articulator isn't going to magically correct your issues (as you are finding out I'm sure). The denture teeth are designed to be set a specific way in order to achieve consistent results. Compensating curves (Spee and Wilson) are important when it comes to these contacts. Too much tilt straight or buccally over the ridge can create premature working contacts and zero balancing, while too much lingual tilt can create the opposite or even add anterior interference. With out proper curve of Spee you may notice working contact only on molars. You are correct about grinding on teeth to help get your contacts (an examiner told me this),but it can be done without. As encouragement know that you can easily pass and not have every one of these contacts.. if a few teeth aren't in working, balancing, or protrusive contact you'll lose a point per contact, but it won't be a make or break thing by itself. Remember to keep everything neat, even the preliminary work. Too many people come in with sloppy mountings and I assure you, even though nobody may openly admit it, this definitely affects their idea of the quality you produce. Take a piece of 400 or 600 grit sandpaper and smooth out those mountings under some running water. Clean wax off of teeth with a handpiece and bristle brush or use solvent. Even though the instructions don't go in to great detail on this.. create denture base anatomy. Interdental papilla, gingival rolls, and subtle root eminences go a long way. I recommend polishing the wax up when finished as well. A wet cotton ball over the surface or anything similar will do (I use a sponge wheel with the handpiece). As you may know, in this field presentation means just as much as function to most. Some I dare say would even choose aesthetics over function.

I think you hit the nail right on the head. I probably focused a little *too* much on model work last year which cost me in time, but the marks did show for the neat work. I'll be sure to keep the lingual and buccal tilt in mind when setting the teeth!

 

[TMNT120]

Thanks again everyone for all of the feedback, really appreciate it!!

Exam is Monday so wish me luck!

 

[kcdt]

Thanks again everyone for all of the feedback, really appreciate it!!

Exam is Monday so wish me luck!

Break a leg!

 

[JMN]

[…]
Exam is Monday so wish me luck!

Pack everything in the car the day before and get to bed early.

Praying for you to have safe travels and steady hands.

 

[lcmlabforum]

Belated best wishes! Hope it all turned out well.
!
LCM

 

[denturist-student]

To me the incisal table just got in the way but the reality is you need to under4stand what your objectives are. Some techs like myself will not have any anterior contact during any excursion if so then very little. I learned that from Turbyfill.