I utilize stick bites very often in my practice, as an additional piece of information for the lab. Along with my facebow transfer, bite records, and photos the stick bite is sent to the lab for both wax-ups and fabrication of the final restorations. The stick bite serves several functions. First it references the incisal edge to the horizon. This is a key piece of information for the technician, They can now create the final incisal edge position and know that it is level to the horizon, and how it relates to the rest of the occlusal plane and the patients eyes and face. The stick bite also serves as a verification for the facebow mounting. It is not uncommon for the facebow transfer to get altered during transport of the records to the lab. I also have patients whose ears are not level, or we take an inaccurate record, the stick bite let’s the technician detect these aberrations.
Taking a stick bite is quick and easy, and the time it saves preventing inaccurate wax-ups and final restorations is amazing.
- Find or create a reference to the horizon. You can use tape on the back of a door that has been put up with a level, or verticals over a window.
- Have the patient stand in front of the reference to horizontal.
- Inject bite registration paste over their lower anteriors.
- Have them close.
- Add more bite silicone to cover the labial 1/3 of both upper and lower incisors.
- Place a cotton tip applicator or bend a brush into the silicone and level to the reference.
- Cover the stick with extra bite silicone for stability.
- Take a full face photo.
- Remove from the mouth and send to the lab.
Hi Dr. Lee,
What if the horizon is not parallel to the intercommissural line of the face? In that case, if the lab makes the incisal edge position parallel to the horizon and when it’s tried in the mouth since it’s not parallel to intercommissural line, won’t it result in one side showing more teeth and gum than the other? Shouldn’t we always level the stick bite to the closest anatomical landmark?
Many thanks
I always start with horizon, as so many patients have asymmetric faces, and when the incisal edges cant or tip, patients rarely like it. Commissural plane may be canted, and also not have any relationship to upper lip position in a high smile. A mock-up or the provisionals are the best way to see what the proposal looks like itn eh face., I never go from Wax to ceramics, as this and many other features of smile design are our first best guess.