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The Perfect Bite Registration & Impression
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<blockquote data-quote="denturist-student" data-source="post: 309784" data-attributes="member: 5492"><p>Prelims using zhermack trays and hydrogum 5....finals using custom trays and then virtual....Bite rims on a pin tracer using plastogum for an index....upper bite rim uses the existing denture as a guide with any corrections I might want to see....Then it goes either digital or analog but digital is okay for replicating the existing dentition...Analog if we are starting from scratch...although if digital we wil do a lower final impression in the existing bite rim....If analogue then we will drop the final impression and use a tissue conditioner Bosworth Softone on the lower to work out the kinks and then a followup reline. If digital we print the teeth and usually have few adjustments but then when patient is satisfied we redo the lower base and upper base and insert stock off shelf teeth currently tribos or meyersons......That way the patient gets a spare set almost identical to the one they have ended up with and both are using the same bases making for a far superior spare set...I dont let them use the old set as a spare......If changes need to be made then we redo with changes and reprint......takes 40 min for bases using Nextdent 5100 and then 1.5 hours for teeth if printed using the Phrozen shuffles. Analog dentures are using typically pressed for the uppers and ivobase for lowers....Ivobase more accurate and the uppers are fine pressed and if not pressed then Ivobased. those with implants or special needs will get a fully formed neutral zone on the bottom using ivolene base and wire cage and then with Tempo TC to register the neutral zone.. The whole base gets replicated in wax using a putty matrix....doing it that way results in an extremely stable base....No final equillibration is done in the mouth...They all get remounted using blue bite as a matrix.....and a facebow is used to record the jaw distances forming Pounds triangles.BPS protocol is used for all of the cases to be fitted with implant abutments....usually two on lower...If any needed on upper I send to a buddy who does a lot of them.....Currently using Exocad for dentures design becasue we can place stock teeth in later and the replication of the impression intaglio is true...We using Ivory for all immediate denture caseworks with an Exocad remake at 6 months after gums have stabilized. So we still using Ivory and Exocad... For denture duplication Pala design studio has good one for that.....For single uppers we do up an |Ivory single denture and use that as a try in by leaving the anteriors out and just using that as a bite rim with stock uppers...We are currently using Vita Synoforms for most of our analog work expecially where no facebow is used...Short story is we have many different methods...and we use all of them because no single method or protocol will satisfy every patient who comes in the door. For patients with really worn out dentures we will make a copy of their old set and use that as a sort of pattern..Then I make one set for use with all of the necessary changes and then a transitional set incorporating many of the original elements because some patients cannot tolerate a lot of change all at once..Most of our sets run about 2750 but seniors insurance grade are done for 2350. The BPS are done for 3400.....so we usually have a healthy budget to work with. We can be quite flexible.Take care and keep well. Partials are almost exclusively Duraflex. People hate the metal clasp standards.</p></blockquote><p></p>
[QUOTE="denturist-student, post: 309784, member: 5492"] Prelims using zhermack trays and hydrogum 5....finals using custom trays and then virtual....Bite rims on a pin tracer using plastogum for an index....upper bite rim uses the existing denture as a guide with any corrections I might want to see....Then it goes either digital or analog but digital is okay for replicating the existing dentition...Analog if we are starting from scratch...although if digital we wil do a lower final impression in the existing bite rim....If analogue then we will drop the final impression and use a tissue conditioner Bosworth Softone on the lower to work out the kinks and then a followup reline. If digital we print the teeth and usually have few adjustments but then when patient is satisfied we redo the lower base and upper base and insert stock off shelf teeth currently tribos or meyersons......That way the patient gets a spare set almost identical to the one they have ended up with and both are using the same bases making for a far superior spare set...I dont let them use the old set as a spare......If changes need to be made then we redo with changes and reprint......takes 40 min for bases using Nextdent 5100 and then 1.5 hours for teeth if printed using the Phrozen shuffles. Analog dentures are using typically pressed for the uppers and ivobase for lowers....Ivobase more accurate and the uppers are fine pressed and if not pressed then Ivobased. those with implants or special needs will get a fully formed neutral zone on the bottom using ivolene base and wire cage and then with Tempo TC to register the neutral zone.. The whole base gets replicated in wax using a putty matrix....doing it that way results in an extremely stable base....No final equillibration is done in the mouth...They all get remounted using blue bite as a matrix.....and a facebow is used to record the jaw distances forming Pounds triangles.BPS protocol is used for all of the cases to be fitted with implant abutments....usually two on lower...If any needed on upper I send to a buddy who does a lot of them.....Currently using Exocad for dentures design becasue we can place stock teeth in later and the replication of the impression intaglio is true...We using Ivory for all immediate denture caseworks with an Exocad remake at 6 months after gums have stabilized. So we still using Ivory and Exocad... For denture duplication Pala design studio has good one for that.....For single uppers we do up an |Ivory single denture and use that as a try in by leaving the anteriors out and just using that as a bite rim with stock uppers...We are currently using Vita Synoforms for most of our analog work expecially where no facebow is used...Short story is we have many different methods...and we use all of them because no single method or protocol will satisfy every patient who comes in the door. For patients with really worn out dentures we will make a copy of their old set and use that as a sort of pattern..Then I make one set for use with all of the necessary changes and then a transitional set incorporating many of the original elements because some patients cannot tolerate a lot of change all at once..Most of our sets run about 2750 but seniors insurance grade are done for 2350. The BPS are done for 3400.....so we usually have a healthy budget to work with. We can be quite flexible.Take care and keep well. Partials are almost exclusively Duraflex. People hate the metal clasp standards. [/QUOTE]
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