2. Appliance Fabrication
Step One – Design Ideal Denture or modify existing
You may use the patient’s existing denture if the criteria below can be met. If not, duplicate the denture in clear acrylic and adjust as necessary.
- Teeth are proper size, shape & length
- Occlusion and vertical dimension are properly established
- No metal components
- Sufficient thickness (2.5 – 3mm)
- Buccal flanges of sufficient length for scan markers / support anchor pins
- Excellent fit to soft tissue
- Hard reline only‐no soft reline
- No radio-opaque components or coating (no barium sulfate)
Step Two – Fully Edentulous
Order SureMarks (www.suremark.com) or add gutta percha markers
- 6 gutta percha markers
- Place half lingual and half buccal
- Place on varying horizontal planes
- Place on flange, below gingival plane of the teeth
- Use a #6 or #8 round bur to a depth of 1mm. Keep markers spherical in shape, no larger than illustrated.
- Fill flush with gutta percha
Step Two – Partially Edentulous
Order SureMarks (www.suremark.com) or add gutta percha markers. If the patient is missing many teeth, has metal‐based restorations on most of the teeth, or the bite is being opened more than 2mm, order a Scan Appliance.
- Send models and a bite to ROE with instructions on implant placement and future restorations
- Doctor receives scan appliance, seats and adjusts if there is a rock or ill fit (must fit with NO rock)
- Perform dual scan protocol
Patient CBCT Scan Instructions—Dual Scan Protocol
1st scan appliance in the mouth 2nd scan appliance alone
- Seat appliance(s) and ensure fit with no rocking—if there is a rock, hard reline or adjust until good seating (NO soft relines ever)
- Fully Edentulous scan appliance—important to bite IN OCCLUSION with No space between the opposing! No bite material, no cotton rolls.
- Partially Edentulous scan appliance—important to place bilateral cotton rolls and capture the CT
- Bite with medium pressure and do not move
- Scan appliance by itself sitting on any type of foam or scan table that is NOT plastic. Must sit above plastic scan table!