occlusal reduction guide

[kev]

I received a case and the doc wants me to do a full waxup on the upper arch and needs a occlusal reduction guide using siltech.
Waxup is no problem but I never made a reduction guide before, how do you do it??

 

[doug]

Read through this article and look at the pictures. This should help get you started

Inside Dentistry May 2009

 

[Marcusthegladiator CDT]

I would supply the doctor with an additive/reductive model and diagnostic waxup. Including several putty indexes that the doctor can use to guide her when she preps the teeth. But the additive reductive model is most usefull when prepping veneers and not so much of a help if the doctors prepping for full crowns. Either way an index or two of the diagnostic waxup will help significantly. You can also supply her an un trimmed index from your diagnostic waxup ready for her to inject temp material into.

 

[Dentalmike]

It's probably to late now but may help later. First, I think you should ask them specifically what they want. There are many ways to create a matrix. For full arch I'll do a putty adaptation that also captures palate and let the doctor slice as they prep however they want. Also I like for them to have a clear vaccuform that has holes for measuring reduction with an explorer. I use 020 clear, on a stone duplicate of waxup, and take a round or whatever in a highspeed to make holes, then use scalpel to clean it up. This allows for the doc to have reference from fitting to the palate when all the teeth are gone. They can measure and see through the clear material. Hopefully they would use as they go along and not wait untill all tooth reference is gone.

 

[sidesh0wb0b]

there are a few ways to make these reduction guides. it depends upon how many teeth are being prepared, anterior or posterior, type of coverage desired, etc.
the article doug posted is a good one. like marcus said, reduction models are a good help too. i usually include a matrix for temps as well....giving the doctor the proper temps for the diagnostic and letting the patient "try out" the wax up for comfort and look.
then when you get the prepared impression, you can use the temp matrix (or another) to compare and be sure the doctor has proper reduction. and i always tell them up front that i will be doing this. that way its not a surprise if i call and tell them they should reprep here and there due to design/clearance/etc.

 

[JohnWilson]

We had the oddest request this last week on a full mouth case. Patient loved the Diagnostic wax up we did on this case, Dr made temps from the siltec matrix we provided. Dr sends in case with this request on the lab slip.

Pour models articulate with face bow, and send case in bisque for evaluations. Also include a copy of the case in plastic for the patient to evaluate . WTH? Didn't we just do that with the Diag???

Anyhow I made a fast CAD copy of the Bisque with just a few clicks of the mouse and actually made the case splinted. Was super fast and actually looked amazing with the Wieland PMMA.

Mo Money for more laziness. all I could fathom is that the Dr did not make very good temps and didn't want to have to remake them at the bisque appointment, OH and maybe this lady may say the case needs to be tweaked or something.

We shall see next week when the case returns wether she likes them or not.

 

[sidesh0wb0b]

wow, that is redundancy at its best!

 

[kev]

Thanks guys for the help!