By Global Dental Science LLC
Clinical Instructions
AvaDent™ Clinical Instructions Welcome to the new standard of care in removable prosthetics, AvaDent™ Digital Dentures. Developed by an international team of leaders in the digital dentistry field, AvaDent’s breakthrough technology brings the precision, aesthetics, speed and profitability of CAD/CAM process automation to removable dentistry. AvaDent™ Digital Dentures, whose name is derived from Ava meaning rebirth and Dent meaning dentition, make it possible for you to offer your patients a precise fitting, aesthetic denture in as little as two appointments. Additionally, AvaDent™ allows you to offer the digital denture using standard clinical procedures, with no computer skills or capital investment required. Increase your profitability and patient satisfaction with the one removable prosthetic that is virtually changing dentures forever ... AvaDent™.
AvaDent™ Materials 1. Thermoplastic Trays 2. AvaDent Border Molding Material 3. AvaDent putty 4. AvaDent Anatomical Measuring Device (AMD) a. Upper Tray with vertical height pin and lip support b. Vertical height pin extension c. Lower “Y” Tray d. Lower Tracing Tray 5. AvaDent Thermometer 6. AvaDent Hex Key 7. Aesthetic tooth guide transparency 8. AvaDent Caliper 9. AvaDent bite registration material 10. Impression Material 11. Bite plane 12. AvaDent prescription sheet 13. Plastic case bags 14. AvaDent Cup 15. AvaDent Adhesive 16. AvaDent Case Shipping Box
Impression Procedure: Edentulous patient with dentures 1. Remove dentures from the patient’s mouth. Mix the two part AvaDent putty in equal parts. Press the putty into the ridge of the denture to create a denture mold as shown in the picture. Do this for both the upper and lower denture.
2. Once the putty is hard, select the appropriate sized thermoplastic tray by measuring the crest of the ridge on the mold with the enclosed caliper.
3. The tray is then placed in warm water for 60 seconds. Water temperature should be a minimum of 160 degrees Fahrenheit.
4. Once the tray is malleable, mold it to the denture mold with particular care given to forming the tray against the pallet and sides of the ridges. You may need to trim the putty mold so that the tray fits accurately. You can also trim the tray if necessary to accommodate the ridge.
5. Repeat the process for the lower denture. When there are undercuts in the lingual posterior ridge, take care to expand the lower tray in the Retromylohyoid space or Mylohyoid Ridge to allow for impression material. Proceed to Step #6
Edentulous patient without dentures 1. Select the appropriate sized thermoplastic tray by measuring the crest of the patient’s ridge with the enclosed caliper.
2. The tray is placed in warm water for 60 seconds. Water temperature should not exceed 170 degrees Fahrenheit and needs be a minimum of 160 degrees Fahrenheit.
3. Once the tray is malleable, place it in the patient’s mouth. The upper tray should be molded to the patient’s ridge with particular care given to pushing the tray to the pallet. Then mold the sides.
4. If the tray needs to be adjusted it can be placed back in the water and reformed.
5. Repeat the process for the lower denture. When there are undercuts in the lingual posterior ridge, take care to expand the lower tray in the Retromylohyoid space or Mylohyoid Ridge to allow for impression material. Proceed to Step #6
6. Once the tray is molded, express a line of AvaDent border molding impression material around the edge of the tray. Start by forming a rope of material on the inside of the tray lip and then follow with more material on the top edge of the tray. This will prevent the material from slumping into the tray. Include running the material across the post dam.
7. Insert tray into the patient’s mouth and have the patient execute a series of movements to form accurate border and muscular molding. This creates an “immediate custom tray”.
8. Repeat the process for the lower arch.
9. The “immediate custom trays” are then filled with light or medium body impression material and final impressions are taken.
AvaDent™ Anatomical Measurement Device (AMD) Procedure: 1. Choose the correct size AMD using the caliper to measure the widest part of the ridge. If the ridge is between AMD sizes, choose the smaller AMD size.
2. With the current dentures in the mouth place a dot on the patient’s maxillary and mandibular facial features to establish the desired vertical height (VH). Have the patient seated in an upright and relaxed position with their head unsupported. (Ask the patient to verbalize the letter “M” while taking the vertical measurement. This will help the patient assume their resting position.) Measure the vertical height with caliper and put it aside. 3. Coat the AMD upper tray with adhesive and then fill the upper AMD tray with AvaDent Bite Registration material and place it in the mouth.
4. With the upper tray in the mouth, put the lower “Y” tray in the mouth and insert the ball of the vertical height pin into the slot on the top of the “Y” tray. The slot is designed to accommodate class 1,2 &3 bites. Have the patient slowly bite down until stopped by the pin and the three ends of the “Y” tray are lying on the mandibular arch.
5. Gently manipulate the mandible into CR and check the vertical height using the external landmarks and the caliper. (If you would like to confirm Centric Relation, see CR Tracing Option)
6. Adjust the vertical to the desired height by using the AvaDent Hex Key to turn the hex fitting. This will move the pin up and down. Check for desired VH using the caliper.
7. Have the patient open slightly and inject bite registration material onto the lower ridge, under the “Y” tray. Make sure that the entire ridge is covered. Manipulate the mandible back into the CR position once again and have the patient bite down to the “hard stop” vertical height.
8. Reconfirm VH again and adjust with AvaDent Hex Key when necessary.
9. Using the same Hex Key, adjust the lip support in or out to the desired position using the slot in the front of the AMD.
10. Insert the bite plane into the holes in the lip support and adjust the outer gauge parallel to the inter-pupillary line at a right angle to the long axis of the patients’ face and record the angle number from the bite plane onto the prescription. Then remove the bite plane.
11. Mark the midline, central incisal plane and smile-line on the AMD lip support as shown.
12. Put a small amount of light cure composite on the back of the plastic aesthetic tooth guide and position it to the desired position using your incisal and midline marks. Once you are happy with the position tack it with a curing light.
13. Stabilize the AMD by liberally injecting bite registration material into the area between the upper and lower AMD trays.
14. Your final AMD should look like this.
15. Choose the tooth mold and color with the patient as you normally would and record selection on the prescription. 16. Disinfect, pack and ship the impressions, AMD and prescription to Global Dental Science for processing.
CR Tracing Option: If you would like to confirm CR, use the tracing lower tray instead of the “Y” tray. (A) • Put impression material on the lower tracing tray.(B) • (Option) Take the tray out of the mouth and coat the lingual plane with occlusal spray. • Place both trays in the mouth so that the impressions conform to the ridges and adjust the vertical height as before. (C) • As the patient bites down, guide the patients’ mandible back and trace lateral plus anterior and posterior excursions with the pin to find the CR point. (D) • Remove the lower tray from the mouth and drill a divot into the tray at the tip of the tracing. (E,F)
A
B
C
D
E
F
• Place the tray back into the mouth, place the tip of the VH pin into the divot and continue with the step #8. (G)
G
By Global Dental Science LLC
AvaDent™ Digital Denture Global Dental Science LLC 15730 North 83rd Way Suite 101 Scottsdale, AZ 85260 480-275-2736 Toll Free 855-AVADENT (282-3368) info@globaldentalscience.com ©Global Dental Science LLC 2011, AvaDent™ Digital Denture is a Trademark of Global Dental Science. All Right Reserved