Second denture visit – Wax rims to find VDO and CR
The second denture visit.
May be able to get CR and VDO with Ivoclar Centric in first visit
Try in wax rims 2 weeks after initial visit to determine vertical dimension of occlusion (VDO). This visit can last anywhere from 10-30 minutes. If there exists significant issues with the denture this appointment will be re-scheduled and sent back to lab and this step repeated.
Check fit framework with Occlude green spray
- Rests just hitting in bottom not sides
- Guide planes hitting
Check esthetics of maxilla
- Try in wax rims
- Adjust length to proper esthetics on upper from facial in both repose and smile. Repose means slightly open with lips at rest but separated.
- Measure central show at rest and smile
- Check for cant
- Confirm enough lip support
- Confirm buccal corridor filled
- Fox plane in and photo check Campers line (ala-tragus parallel) Use wax rim former
- Kois facebow
Measure and set wax rims VDO
- Tape on nose and chin with black marker dot
- Wet lips and relax
- Count to ten, swallow hard, and relax
- Hum “Mmmmmm” and relax
- Take measurement
- Repeat x2
- This is vertical rest position (VRP)
- Final centric position is VRP minus 2-3 mm (Class I 3-5 mm, Class II > 5 mm,Class III < 3 mm)
Confirmation of proper VDO
- Check lower lip slightly touching central incisors when “f” “v” sounds (count fifties)
- Check 2-4mm speaking space when ‘s’ sounds (count the sixties)
Impression and data transfer to lab
- After all adjustments made make V notches in rims
- Mark mid-line and high smile line
- Bite impression material on wax rims
- Pick shade and Mould (Facial Meter)
Obtaining CR with separate base plates with recorder mounted to it
Candulor Registration Set 10,15,20 and Vertical Centric Recorder
Y&M Intraoral Tracer Edmonds Dental Lab
Intra-Oral Establisher Massad
Tip of tongue to roof mouth or Coble Balancer
Gothic Arch with magic slate July 12
Coble Balancers are good gothic arch tracing would be better to use at your wax relations visit.
Protrusive record for horizontal and lateral condylar indications?
Teeth set in balanced, lingualized occlusal scheme
Can use Massad and Dawson techniques to check for neutral zone. This will balance the muscles and allow for better seating of denture. Massad cameo technique for upper can be seen here.
For more information you can check out our denture page as well.