AvaDent Clinical protocol ati v 3 sm

By Global Dental Science LLC

Clinical Protocol for AvaDent™ Advanced Try-In (ATI)

The AvaDent Advanced Try-In (ATI) allows the clinician the opportunity to fine-tune the aesthetic and functional components of an AvaDent Digital Denture. The ATI is not a standard wax try-in, but rather an acrylic milled base with precision sockets which has been fabricated using the information taken from the initial impressions and Anatomical Measurement Device (AMD). The teeth are then set in a rim of wax that has been applied to the ridge giving the clinician the advantage of an advanced try-in with a precise base plate and occlusal scheme that is accurate and true to the records supplied. This short guide is intended to provide the clinician with the quickest way to a final prosthesis that meets even the most demanding requirements.

ATI Capabilities: •• Movement of the anterior teeth •• Movement of the posterior teeth •• Equilibration of the teeth •• Buccal corridor adjustment •• Re-lining of the base •• Seating adjustment (adjust an undercut, etc.) •• Flange/extension adjustment

Step 1: Seating Adjustment A. Without Undercuts: Using Pressure Indicating Paste (PIP/Try-in Paste), seat the AvaDent until there is a uniform distribution of the paste throughout the intaglio surface. This step can be adjusted and repeated as often as necessary to achieve the desired result. B. With Undercuts: Undercuts may be relieved as necessary to seat the AvaDent. If the ATI is trimmed beyond the optimal fit, perform a light wash using AvaDent Impression Material.

Step 2: Occlusion Adjustment A. Minor Equilibration: With the AvaDent(s) properly seated, the occlusion can be verified and equilibrated until optimal occlusion is achieved. B. More Substantial: If the occlusion is “off” substantially, remove the tooth (teeth) and establish a new bite by adjusting the tooth and setting it back in the ATI. Then refine the occlusion. Note: If this procedure requires the removal of too much of the tooth’s anatomy, the AvaDent base can be adjusted. It is preferable to grind on the base of the tooth to avoid penetrating the AvaDent base which could result in the necessity to re-design and re-mill the base. Following this step, the AvaDent software will reset your occlusion to the new occlusal preference.

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C. Alternative to grinding base of the tooth: Remove all of the posterior teeth by using a heat source to soften the wax. Establish the proper OVD by placing external wax to build the appropriate height and send the teeth back for final placement.

Step 3: Adjust Aesthetics A. Minor Aesthetic Changes: Without changing the position of the teeth, indicate the amount of change and the direction in millimeters (mm) on the prescription (i.e., mid-line shift, over-jet/ over-lap, medial/lateral movement of teeth over ridge, etc.) B. Small Customization Movements: The smile design can be customized by making slight movements to the teeth. Use a heating instrument to soften up the wax and then move the teeth to their desired position. C. Larger Customization Movements: For larger customization, remove the teeth or tooth from the base plate by popping it out of the socket. The base or the tooth should be ground slightly. With a heating instrument soften the wax and place the teeth in the desired position. This can be repeated with as many teeth in the anterior as desired and as many times as necessary to achieve the desired aesthetic outcome.

Step 4: Buccal Corridor Adjustment •

To add or subtract from any buccal flange contour, grind the base material away or add wax and contouring to create the desired aesthetic shape and function.

Step 5: Reline Base •

If the ATI fit is not optimal either before or after your PIP adjustment, reline the AvaDent ATI with a light wash using AvaDent Impression Material. The final AvaDent will be milled precisely using the information from the new impression.

Step 6: Flange Adjustment •

Flange/extensions can be adjusted by trimming it to the appropriate length or adding to it with wax (or any other stable material) and contouring it to the desired shape.

Step 7: Bite Registration •

Once the AvaDent fit, occlusion, contours and aesthetics have been optimized, and clinical tests performed, a full bite registration should be taken. If it is a Full Over Full case, lute the two dentures together with bite registration material.

Step 8: Return the Case to the Laboratory for Final Fabrication.

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