This article includes a step-by-step appointment guide for the scanning appointments for a complete denture case involving wax rims.
Wax Bite Rim Workflow
To be used for the following clinical scenarios:
√ Patient has no dentition or full or partial denture to establish VDO and/or bite.
Chairside
Appointment 1
√On your Chairside Home screen press “Start” and enter the patient's name. (If they are new please fill out gender and birthday)
√Select “Dentures””Denture””A New Denture”
√You will then be asked if your patient has an existing denture to which we will answer “No” and press “Next”
√Then you will indicate whether the appliance is to be implant supported, answer “Yes” or “No” and press “Next’”
√Indicate which arch(es) we will be creating a full denture for, press “Add to Order” and “Start Scanning”
√Take upper and lower Intraoral scans, capturing all necessary landmarks. I.E. Depth of buccal and lingual vestibules, frena, hamular notches, retromolar pads, full palate including some extension into the soft palate.
Note: If facing difficulty scanning (in particular an edentulous lower arch) doctors may take a standard impression and scan the impressions intaglio surface and borders. (no 360 needed) Patient must be fully edentulous to direct scan impressions, if patient still has existing teeth pour stone model and scan model.
Appointment 2
Register Bite via Wax Bite Rim and Take 360 Extraoral Scan of Wax Rim
√ After receiving the wax bite rim from Dandy, evaluate the fit and dimensions of the wax rim in the patient's mouth and adjust accordingly.
√Border mold the periphery of the wax rim using compound, wax or heavy body PVS material, having patients perform functional movements. (It is recommended to use PVS tray adhesive.)
√Apply light body wash, have patients repeat functional movements.
√Trim excess impression material that may be covering the occlusal or facial portion of the wax rim.
√Adjust wax rim to achieve proper VDO, bite and lip support.
√Evaluate “F”,”V” and “S” sounds to verify dimensions of the wax rim.
√Clearly mark the wax bite rim with the patient’s smile lines, canine lines, and midlines.
√Also cut notches in the occlusal and mark up the rest of the unmarked wax rim to break up the monotony of the flat wax. This will greatly assist in capturing the 360 scan.
√Capture bite registration, trim excess material away from the buccal and facial sides of the wax rim.
√Navigate to the patient's case and select “Continue Order”, it will be displayed in a green banner. This will prompt you to scan with scan pages labeled accordingly.
√ Perform 360 extraoral scan of the wax bite rim(s).
√ To obtain bite registration:
- If a single arch wax bite rim, scan with wax bite rim in mouth (from molar to midline on both left and right sides) with blue mousse.
- If dual arch wax bite rim(s),you have the option of either scanning both arches in occlusion outside of mouth (full arch from molar to molar) with blue mousse or scanning inside the mouth molar to midline on both sides..
√ Take photos of the patient [highly recommended]:
- Head-on photo with the patient smiling naturally (with wax bite rim in place).
- 2 profile pictures (1 from each side) with the patient smiling naturally (with wax bite rim in place).
- [If possible] A head-on photo of the patient with cheek retractors in place (with wax bite rim in place).
3Shape Unite
Appointment 1
√Select the patient's record or create a new patient record.
√Select “New Case” “Dandy Labs” “Removables” “Full Dentures”
√Select one tooth per arch on which we will be fabricating a full denture press “Save” and “Next”
√Select “Intraoral” and take upper and lower Intraoral scans, capturing all necessary landmarks. I.E. Depth of buccal and lingual vestibules, frena, hamular notches, retromolar pads, full palate including some extension into the soft palate.
√Capture “dummy scan” for the bite scan and proceed to fill out lab rx.
Note: If facing difficulty scanning (in particular an edentulous lower arch) doctors may take a standard impression and scan the impressions intaglio surface and borders. (no 360 needed) Patient must be fully edentulous to direct scan impressions, if patient still has existing teeth pour stone model and scan model.
Appointment 2
Register Bite via Wax Bite Rim and Take 360 Extraoral Scan of Wax Rim
√ After receiving the wax bite rim from Dandy, evaluate the fit and dimensions of the wax rim in the patient's mouth and adjust accordingly.
√Border mold the periphery of the wax rim using compound, wax or heavy body PVS material, having patients perform functional movements. (It is recommended to use PVS tray adhesive.)
√Apply light body wash, have patients repeat functional movements.
√Trim excess material on the occlusal or facial portion of the wax rim.
√ Adjust bite to achieve proper VDO, bite and lip support,
√Evaluate “F”,”V” and “S” sounds to verify dimensions of the wax rim.
√Clearly mark the wax bite rim with the patient’s smile lines, canine lines, and midlines.
√Also cut notches in the occlusal and mark up the rest of the unmarked wax rim to break up the monotony of the flat wax. This will greatly assist in capturing the 360 scan.
√Capture bite registration, trim excess material away from the buccal and facial sides of the wax rim.
Set Up Case and Scan the Denture
√ If the original case was scanned through 3Shape Unite: Search patient's name and select them, select “New Case” “Dandy Labs” “Removables” “Full Dentures”
√ When scanning arch(es) with wax bite rim(s) select “Denture” from pop-up.
√ Perform 360 extraoral scan of the wax bite rim(s).
√ To obtain bite registration:
- If a single arch wax bite rim, scan with wax bite rim in mouth (from molar to midline on both left and right sides) with blue mousse.
- If dual arch wax bite rim(s),you have the option of either scanning both arches in occlusion outside of mouth (full arch from molar to molar) with blue mousse or scanning inside the mouth molar to midline on both sides..
√ Take photos of the patient [highly recommended]:
- Head-on photo with the patient smiling naturally (with wax bite rim in place).
- 2 profile pictures (1 from each side) with the patient smiling naturally (with wax bite rim in place).
- [If possible] A head-on photo of the patient with cheek retractors in place (with wax bite rim in place).
√When submitting the order select “Wax Rim Continuation” to be taken to the lab rx for full dentures.
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