Dental Asia Sep/Oct 2018

Behind the Scenes DENTAL ASIA SEPTEMBER / OCTOBER 2018 54 Anterior aesthetic testing Before proceeding to mount the posterior teeth, we made a quick aesthetic test of the anterior group and a control that confirmed both the VDO and CR recorded previously (Figs. 34-37). of the Fox plane in the oral cavity. The palatal cusps of the molars and premolars were placed in contact with the plane while the vestibular ones were raised in ascending order from fourth to sixth by tilting the long axis of the teeth in a vestibule-Palatal way; we thus set the Spee and Wilson curve (Fig. 38). Completed mounting test At this stage, in addition to verifying aesthetics and phonetics, the patient had the opportunity to comment on the mounting of the teeth with her family. Static behaviour was also controlled by checking the autonomous stability of every single posterior element. From a clinical point of view we rechecked By Dr. Alessio Casucci and Mr. Rodolfo Colognesi Figs. 34-37: VDO and CR confirmed with aesthetic test Figs. 40-41: Trial Figs. 42-43: Silicone masks Fig. 39: Completed mounting of teeth Fig. 38: Mounting the posterior teeth Fig. 34 Fig. 35 Fig. 36 Fig. 37 The palatine cusps were positioned in contact with the occlusal plane; the vestibular cusps were lifted from the occlusal plane, setting the compensation curves. The horizontal discrepancy between the upper and lower alveolar ridge required a cross mounting on the left side and a tooth by two teeth mounting on the right (Fig. 39). The implants were then waxed with hard modelling wax taking care to set the thickness of the flange and modelling the prosthetic bodies with the final volumes. Fig. 40 Fig. 41 Fig. 42 Fig. 43 Mounting the posterior teeth The mounting of the posterior teeth was performed by taking as a reference the upper occlusal plane obtained through objective examination and with the help the repeatability of the centric relation. Altogether, there were no changes noted to bemade on themounting (Figs. 40-41). Evaluation of the spaces After checking again the occlusal contacts by compensating for some slight shifts that the teeth had suffered because of the dimensional variations of the waxes, we made two Platinum 95 Shore silicone masks (Zhermack) of the lower prosthesis, one on the vestibular side, the other on the lingual side (Figs. 42 - 43). The silicone masks showed a gap of about 13/15 mm from the mucosal profile in the crestal area and the incisal margin of the lower incisors; moreover, the use of the lingual mask showed a space of only