When creating digital dentures, it’s important to choose the right case when using Avadent lab.
The ideal case is for someone who already has a set of complete upper and complete lower dentures. You can use those dentures to make the process of making the new denture easier. You can also create complete dentures for patients without an existing denture, but you cannot create partial dentures with this digital technique.
3 Different techniques for making a digital denture
There are 3 of techniques for making a digital denture.
1. Reference Denture
The first technique is a three-step technique called the reference denture technique.
It takes three visits and it’s best for patients that already have an existing denture.
During the first visit, you will capture the impression and the vertical occlusion and the bite. Basically, this is done by using the existing denture as a custom tray and to determine the vertical and bite.
A light body PVS material is placed inside of the denture and the denture is used as a custom tray to take a new impression of the gums.
Then the upper and the lower denture is used to establish the vertical and to do the bite registration. Same as you would use a wax block.
So the first visit, you capture the impression by using the existing denture, and then you capture the occlusion by doing the bite registration. Next you scan all of this.
You will scan:
- the bite registration with the upper and the lower denture to get the occlusion.
- each denture on the tooth surface side.
- the underside of the denture, the intaglio side of the denture that touches the teeth.
Once you finish scanning, you remove the PVS material, and give the patient back their set of dentures the same day. They never have to be without their dentures, and then you send all the scanned information electronically. There’s nothing to mail. We just send the scanned STL images to the AvaDent lab.
That’s the first visit.
The second visit is the try-in of the newly designed denture, and the lab can mail you a printed denture. Avadent sends a tryin denture that’s all white. It won’t be white and pink. It’ll be all white. Or if you have a 3D printer, Avadent can send the STL file and you can print the denture yourself.
So again, nothing in the mail.
If you print the denture yourself, they can design the try-in denture and send you the STL file. And then you print the denture and then try it in chairside with the patient.
You can make adjustments to this try-in denture at the try-in appointment. If you need to adjust the occlusion, you can adjust the teeth on the printed denture with a bur.
If you want to make arrangements to the tooth setup, for example if you need to move the midline to the left or right, you can use a sharpie and draw on the printed denture how you want to move the midline to the left, to the right, you can mark on the denture.
And then if you make major changes to the occlusion, then scan the dentures so that you can send that new information to the lab so that they can see the adjustments you made to the inclusion.
If you are moving the midline, you can take photos of the denture and send it to the lab so they can see which direction to move the midline and by how much.
Again all of this information is sent electronically with nothing to mail.
Then the third visit will be the only time something really has to come in the mail.
The AvaDent lab will mail the milled denture to the office. This milled denture is made from the same material that a traditionally made denture would be. It has the pink resin, but they pour the white tooth material and the pink resin in a block to let it harden.
So it’s called a monoblock, because there are not two material glued together. It’s a singled, unified material.
They don’t print the white tooth material and print the pink resin separately and glue them together. The white and the pink are all fused together in a block.
Then the cad cam mills the denture, knowing where that line is between the white and the pink, it finds that interface, and mills a denture that has the pink gums, the white teeth. It’s all a single unified structure.
Then they mail the denture to the office, and then the office delivers it to the patient.
So that’s a three step technique for using an existing denture to create a digital denture.
2. Wagner Try-In
For a digital denture, there’s a second technique called the Wagner Try-In technique, which can also be three visits.
If you don’t have an existing denture, on the first visit, you take the intraoral impression using premade custom trays that can be trimmed and shaped with warm water. A papilameter guide is used to estimate the vertical evaluating the resting and smiling lip position, and a tooth shape is chosen.
The vertical and bite are confirmed on the second visit using a printed denture the the anterior teeth in wax that can be adjusted. Once the final position of the anterior teeth re determined and a bite registration is made – the scanned images of the tryin denture are sent back to Avadent
The third visit is when you do the final fitting and the delivery.
For the Wagner technique, you’re going to need the Wagner premade custom trays for the impression and a papilameter to measure the resting and smiling lip positions.
Wagner EZ Protocol
3. Record-based
The third technique is the traditional record-based technique, which will take four visits, but you can still make an AvaDent complete denture.
For the traditional record-based technique, take an intraoral impression to make your custom tray and wax block.
On the second visit, record the bite and vertical using a wax base with wax rims.
Then the third visit, you can do the printed try-in that we talked about earlier. And in the fourth visit, you can deliver the denture.
The main difference between the traditional record-based technique and the Wagner technique is using the Wagner tray for the impression and the papalimeter for the vertical. Then also using the tryin denture with the anterior teeth in wax.
Why is the AvaDent process unique and simple?
It’s streamlined using your scanner. It can save visits, and you don’t have cases going in the mail back and forth as much using the digital scans. And you have the accuracy of the digital scans.
There is efficiency in potentially fewer visits and there seems to be less adjustments using the digital technology. And you’ve got good patient satisfaction, you’ve got these final files saved. It’s easier to create a replacement denture if you need it.
Using AvaDent Lab to create digital dentures
This AvaDent technique can be a fast, easy way to create a high quality digital dentures.
It can get good results.
You can use the reference denture technique if they have an existing denture.
You can use the Wagner technique to create a denture in three visits if they don’t have a denture. And it just is a way to create dentures with less hassle and more patient satisfaction.