Pour and mount for implant overdentures?

[JonnyLathe]

I have a patient that loves his old bite with a conventional upper denture and lower overdenture with 4 locator abutments, but he needs a new set and I want to nail these as close to his old set as possible (he's VERY finicky). Is there any way for me to take an accurate wash impression pour and mount in the lower overdenture without altering it in any way?

 

[Denture Dude]

Following. I’d be interested to hear ideas.

 

[JonnyLathe]

So I just got off the phone with a prosthodontist colleague of mine. She suggested duplicating the dentures to use as the pour and mount custom trays and bite. So putty matrix flask the original dentures, process with clear acrylic, grind out the locator housing areas and lower posterior teeth (to compensate for the possible VDO change with the wash) and apply impression adhesive. Put locator impression copings on patients abutments and take wash impressions and bite like normal but in the duplicates. I'm going to try it Tuesday with the patient and report back.

She said the alternate way to do it without using impression copings is picking up the housings chairside at delivery.

 

[TheLabGuy]

This is where I like the digital workflow...scan it and duplicate it exactly. Very simple with ivotions integrated software.

 

[mightymouse]

This is where I like the digital workflow...scan it and duplicate it exactly. Very simple with ivotions integrated software.

Do you mind going into to detail? It would be a great resource for us all, if you don’t mind.

 

[TheLabGuy]

Do you mind going into to detail? It would be a great resource for us all, if you don’t mind.

Sure,
-scan the entire overdenture, including intaglio surface. I set up case in exocad, invert intaglio, import bite and opposing scans.
-Then send over to 3shape ivotion software. For the ones that don't know, 3shape has a denture software, but ivoclars ivotion is a separate software that integrates with 3shape. Uses phonares moulds and allows the case to be setup using the monolithic ivotion pucks (where the pink and teeth are all in same puck...no gluing teeth into pink).
-then duplicate it (learning the software and moving stuff around takes a little bit, but ivoclar has been pretty good with any technical questions),then mill it. Now you have a duplicate that is stronger than the original...have Doc pick up locator housings chairside. Very quick process once you learn all the tedious tricks that 3shape likes to throw at you. Although, I hear exocad is supposed to integrate with ivotion soon...then the process would be faster...at least for me.

 

[mightymouse]

Thank you. Have yet to do one digitally and appreciate you sharing.

 

[bigj1972]

OR Just use a whipmix or denar. Take reline impressions in denture, mount said dentures, set pin and take measurements, then duplicate dentures and cross mount. Then you will have the correct bite and a duplicate.of existing denture bite and vertical. Then you can go back.and forth matching plane or arch.

 

[JonnyLathe]

OR Just use a whipmix or denar. Take reline impressions in denture, mount said dentures, set pin and take measurements, then duplicate dentures and cross mount. Then you will have the correct bite and a duplicate.of existing denture bite and vertical. Then you can go back.and forth matching plane or arch.

Seems like a solid method as well. How do you go about the locator impression copings for the final impression on the lower overdenture? Pick up housings chairside at delivery?

 

[Doris A]

OR Just use a whipmix or denar. Take reline impressions in denture, mount said dentures, set pin and take measurements, then duplicate dentures and cross mount. Then you will have the correct bite and a duplicate.of existing denture bite and vertical. Then you can go back.and forth matching plane or arch.

That's how we do it, except they needed the dentures back that day so we can't go back and forth. It's not a problem though since it's going for try in.

 

[Doris A]

Seems like a solid method as well. How do you go about the locator impression copings for the final impression on the lower overdenture? Pick up housings chairside at delivery?

You don't need impression copings this way. Just put analogs in the locator housings before you pour the model in the existing denture.

 

[JohnWilson]

Or you could make your own library for cad, take the locator analog digitize it, take the locator attachment housing digitize it align everything make a library with the parts you just digitized, Snap the analogs in the denture do a 360 scan of each denture with the analogs now make your library see the analogs as scan locators and reverse out the intaglio and you now have both internal and external and you can replicate exactly with the ability to incorporate the attachments.
OH yeah no one trusts digital, and god knows its so easy to pick it up in the mouth so maybe make your client work a little Or be like me and find a way to upcharge and make the paper your knowledge deserves.

 

[bigj1972]

Seems like a solid method as well. How do you go about the locator impression copings for the final impression on the lower overdenture? Pick up housings chairside at delivery?

Yes..... If you will charge for placing attachments, they will learn to do it themselves. Manufacture recommended

 

[zero_zero]

Or be like me and find a way to upcharge and make the paper your knowledge deserves.

I wonder what is your strategy to upcharge ? I am doing everything I could think of.... got no competition, patients lined up for months ahead, got dentists on payroll, in-house, lean manufacture, digital and whatnot ... but I feel there's always room to improve, no ?

 

[bigj1972]

I wonder what is your strategy to upcharge ? I am doing everything I could think of.... got no competition, patients lined up for months ahead, got dentists on payroll, in-house, lean manufacture, digital and whatnot ... but I feel there's always room to improve, no ?

I bill $50 additional labor 1st attachment with $25 each additional. So having to analog, process, post process a 2 locator overdenture is $75 additional labor only. 4 attachments denture would be $125.

If they're gonna be lazy, they pay for the privilege. I personally prefer they pick up chairside. So that when divergent angles come into play, it's their problem.

 

[JKraver]

I prefer them to pick up chairside then when they are in and verified to work we reline them into the denture with ivobase. Sometimes there are issues but rarely.

 

[zero_zero]

If they're gonna be lazy, they pay for the privilege. I personally prefer they pick up chairside. So that when divergent angles come into play, it's their problem.

In my case, since I pay for the chairtime.... there's no room for laziness or monkeying around, I got the whole crew lined up (me included) to get things done the most efficient way.