Manuals_files/CD Manual 12.pdf - Removable Prosthodontics

Wax Try-in - 63
4. Excursive contacts
If the canine relationship is not acceptable, and will be changed, excursive contacts will
change as well. Nonetheless, the presence of working and balancing contacts should be
evaluated both visually and with articulating paper intraorally, and then compared to the
contacts on the articulator, to verify the accuracy of the articulator settings. If the
contacts appear noticeably different (check the amount of space between posterior teeth
in excursions) or the markings are different between the intraoral and articulator
situations, the protrusive record should be remade, and the condylar inclination reset.
5. Esthetics
Check the amount of the incisal display, the harmony of the maxillary teeth with the
smile line, the accuracy of the midline, and the cant of the occlusal plane. Check for
proper soft tissue profile, contours, lip support, display of the vermilion border, and
correct nasolabial angle. Ask the patient for their opinion of the appearance, prior to
voicing your opinion so that you avoid biasing the patient. It can be helpful to have a
family member or friend attend the wax try-in to provide a third opinion on appearance.
If you or the patient have reservations about the appearance, the problem should be
clearly resolved prior to final processing. Never attempt to persuade a patient out of a
concern they may have – the problem will be yours later if the patient still does not like
the appearance. It is helpful to the technician if the dentist can make changes, but major
changes can be delegated to the lab, if necessary.
6. Phonetics
Phonetics can be assessed more readily at the try-in stage since denture teeth have
replaced the relatively bulky occlusion rims. Patients will normally find speaking more
comfortable at this appointment. Watch for lisping. It can be caused by non-uniform
overjet of the anterior teeth, diastemas between teeth or faulty palatal contours.
Sometimes a crowded tongue space can adversely affect phonetics. If the initial wax tryin
has a diastema between anterior and posterior teeth due to canine malrelationship, this
can allow for the escape of air, and produce altered phonetics. In most instances
phonetics can not be corrected until the final wax tryin, when the diastemas should be
eliminated. If patients have not worn dentures for an extended period, or if the new
denture will have dramatic changes in contour, tooth position and/or vertical dimension,
the patient should be allowed to read a passage from a magazine out loud for 5 minutes to
allow them time to assess phonetics and comfort.