Apr 122015
 
DSC_8350

The shrink wrap technique for veneer provisionals has become my favorite. Over the years I have tried direct and indirect techniques, both of which require a great deal of time, are technique sensitive and result in provisionals that come loose, break and are a management nightmare until the ceramics is ready to seat. The shrink wrap technique allows me to produce stable beautiful provisionals quickly and easily. There are some key points to this technique as well:

  •  Fabrication of a Bead Line silicone matrix is CRITICAL
  • Spot Etch Preps, NO dentin Adhesive
  • Capture all lab records prior to making provisionals

In this video I fabricate a set of shrink wrap provisionals for 3 anterior teeth.

 

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Feb 242015
 
Equilibration Refinement Web

I’ll admit that for a portion of my professional career I didn’t think twice about occlusion. Today occlusion is as well integrated into my thought process as caries, perio or restorative considerations. What role does occlusion play in your practice? Is it part of your routine diagnostics? Is it fully integrated with your esthetic and restorative treatment planning? Or do you only wonder about it when a patient breaks something or you are concerned about moving forward with a severe wear case?

Early in my career occlusion would show up as a frustration. One example is when I would prepare a second molar being very careful about creating adequate occlusal clearance, using both depth cutting burs and checking the result with bite registration, just to have my assistant come and tell me she didn’t have enough clearance to make the provisional. It was a relief years later in my first CE course with a focus on occlusion to learn this was not rapid super-eruption, or a mistake on my part, but muscle release due to removal of a key occlusal contact and I could predict this before i prepped the tooth. How about the patient who would come into my office for a hygiene visit or a buccal pit restoration with no joint sounds and call the next day concerned that their jaw had been clicking ever since they left the office the day before. What a relief when I learned these patients had an underlying risk for disc displacement called ligament laxity and I could diagnose it quickly at an exam appointment. Continue reading »

Feb 172015
 
Futar On teeth-Resized

Capturing an accurate centric relation bite record can be challenging and sometimes frustrating. Simplifying this process, and doing it with confidence has been about two components in my practice. First having techniques at hand to deprogram the muscles and separate the teeth temporarily, which are the two things that make this unpredictable. Secondly I use multiple techniques to capture the record, depending on which one the patient responds best to ( muscles stay relaxed) and what I will be doing with the models and how this vertical corresponds to the vertical the record is captured at.  The last post demonstrated a great tool and technique for deprogramming muscles using a QuickSplint. In this video Dr. Michael Smith, one of faculty for Clinical Mastery, demonstrates capturing a centric relation bite record Using a QuickSplint to deprogram the muscles and composite to create an anterior stop. Continue reading »

Quicksplint

 Occlusion/TMD, Videos  Comments Off
Feb 142015
 
quicksplint-try-300x144

Now that I have Quicksplint’s in the office I am not sure how I practiced before them.  A QuickSplint is a plastic shell designed by Dr. Brad Eli, that fits over the anterior teeth from canine to canine and is customized using heavy body tray impression material to create an instant temporary anterior only appliance. My first thought was to use them for acute pain patient’s who get some relief on a lucia jig. I could send them home with an Quicksplint appliance immediately without the need to take an impression, and without the worry of giving them something lacking in retention that they could swallow or aspirate., as they are highly retentive.  As I began using them I found more and more clinical applications. One is as an easy inexpensive way to help patients experience that they grind or clench, and the value of an occlusal appliance, immediately after endo therapy to avoid having to cut down the occlusion on the tooth or crown, to deprogram the masticatory muscles and take accurate centric relation records, and many more. In our Ultimate Occlusion One Program at Clinical Mastery we teach fabricating a Quicksplint and using it for deprogramming.

In this short video I will demonstrate how to make a Quicksplint. Continue reading »

Dec 152014
 
Kois Web

Accurately transferring a maxillary model in three planes of space to an articulator is essential for predictability and accuracy whether we are using the models for diagnostic or restorative purposes. If we work with mounted models where the radius of the arc of rotation, or the position of the maxilla are different then the clinical reality all of the tooth contacts other then intercuspal will be different int he mouth than what we see on the bench top. Additionally we are looking to transfer esthetic information, incisal plane compared to the horizon, which can not be accomplished if the upper model is hand mounted. The Kois Dentofacial Analyzer is a quick, simple and predictable way to mount the maxillary model to ensure functional and esthetic predictability. This video demonstrates capturing the record. Continue reading »