What the best and accurate the bite registration technique?

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mr-b

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this how we do it
1-upper bite hight, anterior 22mm and posterior 18(or 6mm) from the
Tiberosity
2-Lowe bite hight is 18mm
3-check each of them in the patient mouth
If you are not using Facebow
4- mark two points, tip of the nose and chin
5-measure the distance between two points, while the patient is relaxed(for example 40mm)
6- orientation grooves placed on either maxillary or mandibular one
7-after placing both upper and lower bite block in the patient mouth, make sure the hight of them in the patient mouth more than (40mm)

8-guide the patient to the most retrided position and let the patient close until the distance is 38mm

9-check that the bite is correct, at least two times 10 minutes apart.
 
JKraver

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Take the bite before the crown prep please.
 
highscore

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Use the densply kit and get it over with. Re-useable Stainless steel plates instead of "sloppy" plastic pin-housings.
 
denturist-student

denturist-student

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I have been using Massad pin tracers for a few cases now....Each one comes with enough plates or pins to tackle almost anything...But I do try and take pin tracings and facebows in as many cases as possible. The extra $14.00 for the pin tracer is peanuts when you consider a remake or reset for free. The pin tracer if nothing else ensures that the baseplates are having even pressure all around the arch provided pin placement is optimal....I don't worry so much as obtaining the correct vertical dimension but I do make necessary adjustments for the try in on the articulator.....I have worked with some really bad bite registrations due to patient intolerance or lack of strength to close with bite reg in place....or lack of muscular control....and take a check bite at try in.....most of my patients are extreme elderly or Parkinson's or MS or Stroke cases so it is really challenging getting a bite they functionally use.
 
JKraver

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I find that yelling at the patient while putting them in a headlock works best
Can I have your email? My lawyer needs to talk to you about the royalties on my patented technique.
 
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Can I have your email? My lawyer needs to talk to you about the royalties on my patented technique.

Haha. This is the most complete explanation on this thread. Also to relax the patient "acci-dentally" elbow them in temple as you spin to pick up occlusal rims. Nothing more relaxed than a semi conscious patient. ;)

On a serious note, any technique can be accurate. It's the application of the technique that makes it successfully or not. Also some patient cases are better served by a certain technique over another technique. The clinician should evaluate each case individually, have the knowledge and the skills of the possible techniques, understand their advantages and limitations, then choose the best one for the case.

I personally have my main technique and supplement that with three semi main alternatives. I have even used sub-modifications of those techniques. It all depends on what I'm working with and how I'm going to get the best result for that patient. Sometimes I might start with one technique then change to another if I feel it isn't working. Flexibility is important.

RVD is a variable that can change with VDO, or not. It is wrong to approach each case with fixed dimensions or ideas on where it should be. What is the current VDO? How long ave they been like that? How old is the patient? What's their medical condition? Etc etc etc. That's why we are clinicians with extensive training in understanding of all the variables, that we then use to make a decision so we can get the best outcome for our patient. Simple! Not.




Sent from my iPhone using Tapatalk
 
kcdt

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Haha. This is the most complete explanation on this thread. Also to relax the patient "acci-dentally" elbow them in temple as you spin to pick up occlusal rims. Nothing more relaxed than a semi conscious patient. ;)

On a serious note, any technique can be accurate. It's the application of the technique that makes it successfully or not. Also some patient cases are better served by a certain technique over another technique. The clinician should evaluate each case individually, have the knowledge and the skills of the possible techniques, understand their advantages and limitations, then choose the best one for the case.

I personally have my main technique and supplement that with three semi main alternatives. I have even used sub-modifications of those techniques. It all depends on what I'm working with and how I'm going to get the best result for that patient. Sometimes I might start with one technique then change to another if I feel it isn't working. Flexibility is important.

RVD is a variable that can change with VDO, or not. It is wrong to approach each case with fixed dimensions or ideas on where it should be. What is the current VDO? How long ave they been like that? How old is the patient? What's their medical condition? Etc etc etc. That's why we are clinicians with extensive training in understanding of all the variables, that we then use to make a decision so we can get the best outcome for our patient. Simple! Not.




Sent from my iPhone using Tapatalk
Excellent and thoughtful.
When diagnosis is glossed over, so is the patient as the person. There's so much to be gained by stepping back to see the situation.
 
kcdt

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Densply gothic arch/intra oral pintracer is fine and reusable. 99 bucks for disposable pin tracers? (See my avatar for appropriate reaction). That being said I rarely use them, mostly because you can get a decent bite if you are patient.
Over my years I have encountered many a plate dimpled by dentists handpiece, so there's that.
Besides, those disposables at $99 have enough parts to assemble about eight of them, if I recall correctly.

I do agree that for most intents and purposes, capturing CR isn' required to achieve a functional bite that repeats.
CR is a restorative convenience, and usually needs deprograming time in an orthotic to make it repeat habitually.
Most clinics don't have time or expertise to treat on that level. But if you are branching...

PS just saw previous price 14/99.
 
Flippercentral

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Excellent and thoughtful.
When diagnosis is glossed over, so is the patient as the person. There's so much to be gained by stepping back to see the situation.

Would the dentist that sent me 8 (four upper/4 lower) models of various states of completion, two more still in the alginate (full extractions complete with lots of blood),two more models upper and lower with teeth still on. I call him and say, "whah?", to which he says this is a medicaid case for an upper and lower immediate denture do the best i can. Would that count as glossing over the diagnosis?
 
kcdt

kcdt

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Would the dentist that sent me 8 (four upper/4 lower) models of various states of completion, two more still in the alginate (full extractions complete with lots of blood),two more models upper and lower with teeth still on. I call him and say, "whah?", to which he says this is a medicaid case for an upper and lower immediate denture do the best i can. Would that count as glossing over the diagnosis?
No, just inadequate grasp of treatment.
Curious:
How did you work it out?
 
Flippercentral

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No, just inadequate grasp of treatment.
Curious:
How did you work it out?

I'll preface this to say he is a general dentist that in his bio states that he is also a major dental college professor, so I take it that he knows the steps for an immediate denture. His tone on this and several cases showed his distaste for medicaid cases, like we shouldn't do our best on these. He also had sent me a case where all that was written was max metal partial framework, in which i sent out to be fabricated and the fit was good with the usual clasps. He called me to his office and yelled (face turning red) at me for ten minutes about how he had wanted wire clasps soldered on and how didn't I know that ;-p Anyway, first i soaked the bloody models on the immediate case in full strength bleach (you never get the smell out),made wax rims with the max centrals on and sent back saying we need a bite or I can't make these. He sends back the rims with soft liner (more blood ;-p I setup teeth process and send back. A month later I get another case, that i can tell he had another tantrum because he sent the lab slip that looked like he had wadded up my lab slips and thrown them in the trash, pulled it out and sent to me. After a year or two of this, I started my usual , "sorry but I can't get this back for 4 weeks". And that was that.
 
Doris A

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I'll preface this to say he is a general dentist that in his bio states that he is also a major dental college professor, so I take it that he knows the steps for an immediate denture. His tone on this and several cases showed his distaste for medicaid cases, like we shouldn't do our best on these. He also had sent me a case where all that was written was max metal partial framework, in which i sent out to be fabricated and the fit was good with the usual clasps. He called me to his office and yelled (face turning red) at me for ten minutes about how he had wanted wire clasps soldered on and how didn't I know that ;-p Anyway, first i soaked the bloody models on the immediate case in full strength bleach (you never get the smell out),made wax rims with the max centrals on and sent back saying we need a bite or I can't make these. He sends back the rims with soft liner (more blood ;-p I setup teeth process and send back. A month later I get another case, that i can tell he had another tantrum because he sent the lab slip that looked like he had wadded up my lab slips and thrown them in the trash, pulled it out and sent to me. After a year or two of this, I started my usual , "sorry but I can't get this back for 4 weeks". And that was that.
Wow, you've got more patience than I do. The minute he turned red in the face yelling at me, I would have turned around and walked out, gone back to the lab, packed up every case of his and sent them back.
We don't need the work that bad to take that kind of BS from anyone!!!
 
Flippercentral

Flippercentral

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Wow, you've got more patience than I do. The minute he turned red in the face yelling at me, I would have turned around and walked out, gone back to the lab, packed up every case of his and sent them back.
We don't need the work that bad to take that kind of BS from anyone!!!

I don't put up with it exactly, I have worked with a lot of primadonnas ( they are the exception most are great). I have a high tolerance but the patient is my first priority. If i think it will hurt the patient, I will refuse or try to direct the work to the proper procedure. Denture techs don't start out sarcastic and opinionated, they are made that way , lol.
 
kcdt

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I'll preface this to say he is a general dentist that in his bio states that he is also a major dental college professor, so I take it that he knows the steps for an immediate denture. His tone on this and several cases showed his distaste for medicaid cases, like we shouldn't do our best on these. He also had sent me a case where all that was written was max metal partial framework, in which i sent out to be fabricated and the fit was good with the usual clasps. He called me to his office and yelled (face turning red) at me for ten minutes about how he had wanted wire clasps soldered on and how didn't I know that ;-p Anyway, first i soaked the bloody models on the immediate case in full strength bleach (you never get the smell out),made wax rims with the max centrals on and sent back saying we need a bite or I can't make these. He sends back the rims with soft liner (more blood ;-p I setup teeth process and send back. A month later I get another case, that i can tell he had another tantrum because he sent the lab slip that looked like he had wadded up my lab slips and thrown them in the trash, pulled it out and sent to me. After a year or two of this, I started my usual , "sorry but I can't get this back for 4 weeks". And that was that.
You had me at "his distaste for..."
Speaks volumes right there
 
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I used to do wax rims and would have resets constantly. It’s very difficult to get the wax touching just right between both arches and not have a slight prematurity on one side that causes an unnoticeable shift.
I do nothing but mush bites now and very very rarely have resets/remounts. When I do, it’s almost always because I had the patient over close.
I’ve actually got an idea for something to fix a lot of issues without making a long drawn out convoluted process and I’m learning fusion360 and fdm printing to try and make it. Without saying too much, it involves click stops and bending tabs and uses side to side excursions to slowly break supports and bend tabs to close down the patient bite into vdo and would record their jaw motion and angle of closure in the process. When it’s ready, I’m gonna use the money to retire.
Or spend it on hookers and blow and keep making dentures cuz I like it. 🤷🏼‍♂️
 

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