Transition Toward Digital Dentures: Clinical Workflows – Wax Rim Bite

Subscribe to our YouTube Channel

Rewritten Transcript

Clinical workflows. The big question is: what do I have to do differently? Do I need to learn new techniques, new materials, and so on? Initially, when digital dentures first emerged, there were various workarounds required to adopt these new workflows. But essentially, no, clinically your materials and techniques see very little, if any, change initially.

I’ll focus on four particular workflows, starting with what I refer to as the traditional wax rim bite workflow. Reflecting on our traditional workflow taught in dental schools – taking preliminary impressions, custom trays, final impressions, back and forth over typically five appointments leading to insertion – we can follow the same process, but stop after taking the wax rim bite registration if that’s your comfort level at this stage. This can serve as our entry point into the digital denture process.

Looking at the traditional wax rim bite, what is it? It should be your prescription and guide for setting the teeth. When delivering a wax rim bite to the lab, they view it as indicating the midline, incisal edge length of upper and lower teeth, occlusal plane, and centric occlusion vertical dimension. This information is captured in the wax rim bite.

So we start with our traditional impressions and wax rim bite, scan them, and now have virtual models mounted according to that bite registration, including the wax rim we can utilize as a guide for initially setting the occlusal plane. By translating this information, we establish the midline, its inclination, the occlusal plane relative to pupillary line, and maxillary incisal edge length. Many details are captured from this wax rim bite.

We can ghostview the wax rim at any point while positioning teeth and make corrections accordingly. The assumption is the wax rim represents where you want the teeth positioned initially. Sometimes adjustments are needed – I may call a colleague who took a wax bite and say “I’m not sure I want to set the teeth as far forward as this rim indicates.” But it provides an easy reference point for communication.

We then proceed to a resin try-in, which we’ll discuss in more detail, followed by the final dentures. So this wax rim bite workflow is very familiar – nothing really changes except the try-in being resin rather than wax, which introduces a new concept we’ll cover.

A couple tips: Use a rim former, an inexpensive but wonderful tool for adjusting wax rims clinically or in the lab. It has a handle and fence to guide trimming if you want to shorten the rim, which is typically made slightly longer initially.

Another useful tool is a fox plane or “bite plane” which helps amplify and verify the rim reflects the patient’s bi-pupillary line, as this information guides how the lab will set the teeth. You can test this intraorally at this stage using these handy devices.

Upcoming Events

ROE Dental Laboratory, 7165 E Pleasant Valley Rd
Independence, OH 44131 United States
+ Google Map
ZimVie Institute, 1900 Aston Ave
Carlsbad, CA 92008
+ Google Map
Tags: Workflows

Related Posts