In Friday’s post I discussed the use of an anterior only (Anterior Bite Plane) style occlusal appliance. Once you have completed an exam and made the decision that an anterior only appliance is the appropriate choice, the next step is to fabricate the appliance and deliver it. We have a variety of choices when it comes to this style of appliance. We can have the appliance fabricated by a laboratory, utilize a pre-fabricated shell that we reline to fit the patient, or make one for the patient in our offices. I keep Best Bite Discluder’s in my office that can be easily relined for the patient so I can send them home with an anterior bite plane when they present with an acute situation. Routinely my assistant’s make our anterior bite plane appliances in the office. The following video demonstrates the fabrication technique I utilize.
- Upper Alginate Impression
- Mach II Model, takes approximately 2 minutes to fabricate.
- 1.5 or 1.0 mm Biocryl, I use 1.5 for anterior only and 1.0 for full arch.
- Cut out anterior segment or entire arch. Full arch prevents posterior tooth super-eruption on covered arch.
- Trim & polish edges. Trim labial at 1.3 from gingiva and then shorten to reduce retention. Gingival just beyond gingival margins.
- Air abrade with 50 micron aluminum oxide
- Paint with dentin adhesive. Self etching does not seem to work.
- Apply composite platform. Flat from mesial to distal and anterior-posterior. Canine to canine is my preference. Cover all the biocryl on the lingual.
- Cure. With hand held light for composite or in an oven for lab composite, which requires returning to a model.