Reconstruction of full ach can be challenging for clinical procedures. As increasing number of patients live longer, retaining their teeth become challenging. Typically, clinicians will be called upon to deliver dental. Success esthetic and functional dentistry depend on technician, and clinicians understanding of tooth morphology. This study discusses the proper bite registration for fixed and removable prosthesis. The study discusses important point in ensuring that an accurate fabrication of relationships is obtained to deliver the best results. Fixed prosthodontics is a specialized branch dentistry designed to replace missing teeth using cast prosthesis to replace lost teeth. On the other hand, removable prosthodontics involves replacing missing teeth using a removable prosthesis. The paper identifies different materials necessary for both fixed and removable prosthesis. The modeling wax and Ramite are part of materials used bite registration to achieve accurate results.
Bite registration is the strategy of capturing accurate lower and upper teeth representation of patients in order to restore patients' dental case. Capturing an accurate representation of patients' bite is very critical in the restoration of patients' dental case. An impression of patient's bite is the first step in setting up a proper articulation of dental model in order to diagnose movement related to patient's problem. The strategy is to ensure that accurate bite registration is obtained for the fabrication of prosthesis in order to avoid adjustment upon cementations. Specialized materials for bite registration are very critical to deliver rigid bite impressions that will be used to capture the bite. Different viscosities and set times are available, however, it is very critical to find a bite registration materials that deliver easy work and accurate results.
Objective of this study is to discuss the proper bite registration for fixed and removable prosthesis. The study discusses important point in ensuring that an accurate fabrication of relationships is obtained to deliver the best results.
Proper Bite Registration for Fixed Prosthodontics
The use of good material is very critical for tooth preparation. When preparing tooth for fixed restoration, it is very essential to have appropriate amount of occlusal reduction to achieve a long-term success in teeth restorations. Fixed prosthodontics is a specialized branch of dentistry that is involved in the replacement of missing teeth using cast prosthesis and permanently cemented to replace lost teeth. (Elsevier Science, 2003). Typically, fixed prosthetics covers:
Crown as well as temporary crown,
Bridges as well as temporary bridges,
To achieve an effective accurate bite registration for fixed prosthodontics, the following indication and contraindication must be fulfilled.
Indications of accurate bite registration for a Fixed Prosthodontic
One or two adjacent patient's teeth are missing within the same arch.
The supportive tissues of patients are healthy.
Suitable abutment teeth of patients are present.
The patient should be in good health and needs to have his or prosthesis placed.
The patient has the motivation and skills to maintain a good oral hygiene. (Joshi, Shetty, Prasad, 2013).
However, fixed prosthodontics cannot be applicable for patients under the following conditions.
Contraindications of an accurate bite registration for a Fixed Prosthodontic
Necessary supportive tissues of patients are missing or diseased.
Suitable abutment teeth of patients are not present.
The patient is not well and in poor health.
The patient lacks motivation to have the prosthesis placed.
The patient lacks oral hygiene habits.
The patient is unable to afford the treatment.
Procedure for a Fixed Prosthodontic
The following step should be followed for the bit preparation of fixed prosthesis.
Materials for the bite registration of fixed prosthesis
Modeling wax such as Hindustan modeling wax)
Ramite that include 3M ESPE and Polyether Bite Registration Material.
Wax gauge such as Essago SBC German stainless,
Metal gauge such as Essago SBC German stainless.
A shade guide should be followed to match the natural color of the teeth.
Moisture should be achieved to enhance a more accurate match.
Using natural sunlight.
Essentially, there is a need to record patient's chart using the laboratory prescription.
The tooth should be prepared using the cast restorations that can slide into place, which will be able to withstand to the occlusion forces.
Rotary instruments should be used to reduce the contour and height of the tooth.
Rotary and hand cutting instruments to prepare the gingival margins.
It is very critical for a dentist to provide additional support for a patient's crown if the teeth are extensively decayed, endodontically treated or fracture. The additional retention aids include:
Post and core, and Core buildup.
Tissue Management and Gingival Retraction
Cord is used to temporarily displace the gingival tissue as well as widening gingival sulcus to assist free flow of impression material for the preparation with:
Nonimpregnated, and Impregnated.
Elastomeric impression materials should be used to create extremely accurate impressions. The following strategy should e used to accurate impression.
Mix and apply a light-bodied material around the patient's prepared tooth.
Mix and load tray using a heavy bodied material and placed onto the arch or quadrant.
A step in bite registration of fixed prosthodontic is to provide a laboratory technician the reproduction of a patient's teeth model to design the anatomy structure of patient fixed prosthetic of:
The provisional coverage is used to keep patients comfortable from the time of tooth preparation to the final cementation of patients fixed prosthetic. The following procedures for provisional coverage are as follows:
Reduces discomfort and sensitivity.
Maintains the esthetics and function.
Protects the teeth margins.
The laboratory prescription should include a precise and detailed order from a dentist directed to a laboratory technician with a description of teeth restoration model to be fabricated.
When the dentist accepts the casting, the dentist cements the casting to the patient's tooth using:
Home Care Instructions
This section discuses the home care instruction for a patient having a fixed prosthesis. Good home care is very critical to fixed prosthesis maintenance. The following fixed prosthesis should be followed:
The patient must brush his or her supporting tissues of fixed prosthesis carefully daily.
Removable prosthodontics is a specialized branch of dentistry involved in replacing missing teeth using a removable prosthesis. Removable partial denture is referred to a partial replacement of one or more teeth within the same arch. However, removable full denture is the replacement of the teeth in one arch. Removable prosthesis covers:
Immediate replacement denture.
Factors Influencing Removable Prosthesis option
Components of a Removable Partial Denture
The framework is the cast metal skeleton is used to provide support for the remaining components of the removable prosthesis.
The connector should be used to join various parts of the teeth together using major and minor connector.
Retainer should be used for clasping as well as proving stability to the partial denture to partially circling a patient abutment tooth.
Rest should be used and designed with a metal projection to control the seating of the removable prosthesis.
Artificial teeth should be constructed using either porcelain or acrylic.
Appointment for Sequencing of a Partial Denture
Updated dental and health history.
Appointment for Preparation
Prepare the teeth.
Take the patient's final impression.
Take patient's occlusal registration.
Selecting the mold and shade of the teeth.
Prepare the patient's laboratory prescription.
Appointment for Try-in
Evaluating the comfort, function and fit of the appliance.
Evaluate the mold, arrangement and shade of the teeth.
Taking a new occlusal registration.
Appointment for Delivery.
Place patient's partial denture,
Detect any of the pressure points.
Check the retainers for any tension on the natural abutment teeth.
Polish partial denture.
Home Care Instruction
Patients should store prosthesis in a moist airtight container or water when not in use.
Patients should not adjust partial denture.
Rinse retainers after eating.
The following procedure should be used for the full removable denture.
Components of Full Dentures
Suction seal for the retention of maxillary dentures,
Artificial teeth to be fabricated from porcelain or acrylic.
Appointment for Records
Updating dental and health history.
Appointment for Final impression
Essentials final impression for full dentures include
Produce landmarks of the dental arches accurately.
Maxillary must include the tuberosities, hamular notches, frenum attachments and post dam.
Mandibular must include the oblique ridge, outline of the mylohyoid ridge and retromolar pads. The genial tubercles, plus the buccal frena, lingual, and labial.
Laboratory prescription. (Tousignant, 2010).
Appointment for the Try in of the baseplate of occlusal rim
Occlusal rim records
Evaluation of vertical dimensions,
Selecting artificial teeth.
Measurements Occlusal registration
Full Denture is evaluated for stability fit, and comfort.
Verification of full denture that includes mold, shade, and teeth alignment.