The purpose of illustrating this case is to provide you with information on how to communicate your expectations with your lab technician. The more you communicate with your technician, the end result wil be more satisfying to you and more importantly the patient.
Our case begins with a 68 year old patient who’s cheif complaint was that her upper partial was breaking. Upon further evaluation, the patient had the following:
1. fixed splinted crowns from teeth 1.3 to 2.3 (#6 to #11)
2. removable partial denture with precision attachments to teeth 1.3 and 2.3 (#6, and #11) that were worn out.
3. Lower partial denture replacing posterior teeth on both sides.
4. Decay present under her existing upper crowns.
5. Plane of occlusion had a “step” and did not follow her smile line.
Our challenge here was not only to provide our patient with a solution, but we had to make it look good also. She was accepting of what she was wearing for many years, and was open to making her smile appear more natural. After diagnostic records ( impressions, facebow transfer, Centric bite record and digital photography) were taken, it was determined that the plane of occlusion needed to be changed for both function and esthetics. In addition, her existing upper anterior crowns were too long incically. The treatment plan consisted of removing the remaining upper teeth and replacing it with an immediate denture, along with setting teeth on her lower partial to complement the new occlusal plane. This plan was accepted by our patient.
Using the mounted models, and our digital photography, it was determined that the insical edge position needed to be shortened and moved lingually. In this case we comminicated to our lab technician by resetting and reshaping one on the central incisors in both a vertical and horrizontal position. By completing this on the models, the technician now has the exact insisal edge position, and now can use the photography and create a new occlusal plane.
The case was completed with much success and predictability, and most importantly our patient was extremely pleased with the results.
Thank you for reading, and please post any questions or comments. I will be attaching more photos of this case shortly.
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