This article includes a step-by-step appointment guide for the scanning appointments for an overdenture case involving wax rims.
Wax Bite Rim Overdenture Workflow
The following implant supported locator overdenture workflow is applicable for patients with no existing dentition or appliance (partial or full denture) to establish their VDO and / or bite and requires a chairside pickup.
To be used for the following clinical scenarios:
√ Patient lost or broke their implant supported overdenture and is unable to establish VDO.
√ Immediate-load of an implant Supported Overdenture post surgery
Appointment 1
Take Upper and Lower Intraoral Scans
√ Select the arch(es) that need a full denture fabricated. On the scanner order form select: "Removables" > "Full Dentures" > "Printed/Milled."
√ If facing difficulty scanning (in particular an edentulous lower arch) doctors may take a standard impression and scan either the impression or the 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, guide the wax bite rim into the patient's mouth to get an accurate bite impression.
√ Apply light body wash to the wax bite rim for border molding and accuracy.
√ Clearly mark the wax bite rim with the patient's smile lines, canine lines and midlines
√ Add blue mousse to register bite.
√ 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).
Setting Up Case and Scan the Denture
√ Select the arch(es) that need a full denture to be fabricated. On the scanner order form select "Removables" > "Full Dentures" > "Printed/Milled."
√ 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 single arch wax bite rim, scan with wax bite rim in mouth (from molar to midline) with blue mousse.
- If dual arch wax bite rim(s), scan both arches in occlusion outside of mouth (full arch from molar to molar) with blue mousse.
Appointment 3
Before Chairside Pickup
√ Remove implant healing caps and place locator abutments; Verify abutments are above the tissue.
√ Apply blockout spacers to abutments.
√ Seat denture housings with black nylons onto each abutment to confirm passive fit of the prosthesis over the housing
√ Verify reliefs by test fitting denture (using pip paste and a bur, reduce material if needed).
√ Check the occlusion against the opposing arch.
√ Dry and clean denture thoroughly before adding material for chairside pickup to ensure material bonds properly.
Chairside Pickup
√ Place Chairside auto-polymerizing material inside denture reliefs.
√ Guide denture in mouth, being sure to seat the denture all the way down. Have patient close into bite.
√ Remove once auto-polymerization is complete (follow manufacturer's instructions).
√ If there are voids around the abutments, place additional material carefully so as to not get any inside the abutments.
√ Using a carbide bur, clean up any excess material on the intaglio and / or lingual areas.
√ Polish as needed for a smooth finish.
Suggestions
√ Drill lingual exhaust vents for excess material connecting into relief holes.
√ When placing auto-polymerizing material inside denture reliefs, set a timer or put some on your glove to test for polymerization.
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