How does everyone else do it?

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Denture Dude

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This is going to be full upper and lower immediate. I was taught in school and trained at the bench in the early days to set teeth for the try in in their final position. Then after a few yrs I realized that this doesn’t work. Teeth almost always end up having to be moved around after removing what’s left of the natural teeth and getting it set up for finish. Like in the case in the picture here. Clearly the posterior teeth I set will need to be heavily ground in. They won’t be suitable to set the lower to. So my protocol is this now, well, for the last ten yrs. I sacrifice a card of teeth for the try in. Grind the hell out of em. Just to get a proper bite reg back from doc. Once I get it mounted and go to finalize the set up I throw the old teeth away and start from scratch w new teeth. I use economy teeth on immediates, and I tack a little onto the price for this. Just interested to see if anyone else does it like this.
 
2thm8kr

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Interested. First post I've clicked to watch in years
 
JMN

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This is going to be full upper and lower immediate. I was taught in school and trained at the bench in the early days to set teeth for the try in in their final position. Then after a few yrs I realized that this doesn’t work. Teeth almost always end up having to be moved around after removing what’s left of the natural teeth and getting it set up for finish. Like in the case in the picture here. Clearly the posterior teeth I set will need to be heavily ground in. They won’t be suitable to set the lower to. So my protocol is this now, well, for the last ten yrs. I sacrifice a card of teeth for the try in. Grind the hell out of em. Just to get a proper bite reg back from doc. Once I get it mounted and go to finalize the set up I throw the old teeth away and start from scratch w new teeth. I use economy teeth on immediates, and I tack a little onto the price for this. Just interested to see if anyone else does it like this.
I would push back against a try in when everything you're trying in against will be gooooone. It's like checking to see if new pants are the right length before getting a prosthetic foot the next day. Silly.
 
Rtyrelw

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When a Dr asked us to do something along those lines we call and let them Know that we will have to charge for the teeth used. But if we just fabricate an immediate that won't have that charge, one or two take the charge, all others consent, just like what jmn said.
I would push back against a try in when everything you're trying in against will be gooooone. It's like checking to see if new pants are the right length before getting a prosthetic foot the next day. Silly.
 
Chalky

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if there is severe corrections to the occlusal plane that would in fact cost a set of throw away teeth for the try in, I would set as many as possible without compromising too much of the acrylic tooth integrity (so they are still functional for the finished denture). then I would wax up wax blocks in these posterior areas to 'check bite position' - indicate the issue on the lab slip and idealise the plane in the final work up prior to processing. sometimes its impossible to set all the required teeth. in this case pictured, id personally set the first 2 premolars, with wax blocks posterior to that for bite confirmation (obviously you'd wax the blocks to oppose what exists so the bite isn't open for the try in).
 
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kytoothdude

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I set what I can with no major cutting. Generally i've got broken sets for repairs that i'll use if something needs a lot of cutting to fit. A lot of these are pretty much bite checks with maybe some anteriors.
 
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Isn’t it it easier for doc to get a more accurate bite relation with a teeth on baseplate? I’d rather not have the extra step for sure but these docs I work with need all the help they can get. Be nice if I could convince them to cut this step out. Save the patient an appointment. I’m in-house btw, 5 docs. Appreciate the feedback as always
 
mshiss

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I don't grind in the teeth until final set. Just try and get the ant/post in an ideal arrangement so patient and see what if will likely look like and check bite, etc
 
esamuelr

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If you had no upper anteriors to start you setup is good so far. At that point I remove one quadrant of the lowers, add the 2 sheets thickness which is ideal for an immediate and develop a new occlusion plane for the posterior. Afte that I will switch to the adjacent arch posterior and do the same.lastly comes the final set of the anteriors both upper and lower.
On the case you show. There is a lot of room on the posterior once those teeth are removed. It just looks close due to the super eruption of 19. This should be a straight forward case.
I would ask my setup techs to reduce the overjet you have on the uppers so far. Immediate are going to slide as the tissue starts to settle so you should be aiming for a maximum 1/2 mm overjet almost end to end.
Any more than that will end up pushing the lips way out even with chairside relines before final dentures are made.
Just my 2 cents.
 
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I get a good roundhouse bite reg. Mount it, set it up and send for Dr/pt approval and SIGN OFF BY PT. Process and finish.
 
Chalky

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I've also done what we would call a splint try-in in certain cases if the situation allowed.... set the missing teeth in wax as you normally would and 'exo' the teeth to be extracted on the model and wax direct to the dry model so they stay in place. This way bite and shade can be checked, as well as the overall final result on the articulator for pt to see and approve (or not!). then its a simple case of wax down and process
 
nvarras

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I do this wherever possible. Doctors love it and it usually means fewer adjustments for me before processing.
I've also done what we would call a splint try-in in certain cases if the situation allowed.... set the missing teeth in wax as you normally would and 'exo' the teeth to be extracted on the model and wax direct to the dry model so they stay in place. This way bite and shade can be checked, as well as the overall final result on the articulator for pt to see and approve (or not!). then its a simple case of wax down and process
 
Chalky

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I've also done what we would call a splint try-in in certain cases if the situation allowed.... set the missing teeth in wax as you normally would and 'exo' the teeth to be extracted on the model and wax direct to the dry model so they stay in place. This way bite and shade can be checked, as well as the overall final result on the articulator for pt to see and approve (or not!). then its a simple case of wax down and process
[/QUOTE]
EDIT... SPLIT try-in... not splint!
 
Doris A

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I've also done what we would call a splint try-in in certain cases if the situation allowed.... set the missing teeth in wax as you normally would and 'exo' the teeth to be extracted on the model and wax direct to the dry model so they stay in place. This way bite and shade can be checked, as well as the overall final result on the articulator for pt to see and approve (or not!). then its a simple case of wax down and process
EDIT... SPLIT try-in... not splint!
[/QUOTE]
We used to call those look see - try in.
 
kimba

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as a couple have said , I set what anteriors I can with no major cutting. and bite rims on posterior for bite check.
I like the idea of the split try in if the case could allow it, but I imagine it wouldnt work in all cases.
 
nvarras

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Here is one of those cases where the split tryin worked very well. After the try in you are essentially sticking everything down, closing the seam and processing.
 

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Inna-Hurry

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Here is one of those cases where the split tryin worked very well. After the try in you are essentially sticking everything down, closing the seam and processing.
.... unless the bite is off....This turns into a potential shiit show if the bite is off. 'Ya dun removed ur hard landmark teeth..... watcha' gunna do for the remount to re-establish ur teeth? (Make a dupe and start over with it...) what a royal pita. Just leave those ants. alone for the post. try-in. Whatever you do for them is going to make an improvement over what they have now.
 
TheLabGuy

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Here is one of those cases where the split tryin worked very well. After the try in you are essentially sticking everything down, closing the seam and processing.
That's how we do it as well.... however, in that case I would dropped a bicuspid and kept the laterals.
 
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