DuraTemps:

Ensuring Case Success

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

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Successful cases are a direct result of proper case planning.  When a patient’s expectations are met and the process is effective, patient satisfaction is established.

Patients tend to use review sites and referrals to make decisions as to what dental practice to choose. Therefore managing online reputations in growing a practice is critical now more than ever. Ensuring the patients’ experience within the practice is a positive one will help create a possible referral source and fan of the practice while managing the patient experience from diagnosis to final treatment.

With over 40 years in the dental field, Burbank Dental Lab has invested in technology and systems that support clinicians throughout the treatment, from the clinicians’ vision to the final prosthesis.

The key to case success lies in the plan. This includes starting with the end result in mind and working through the case to ensure the patients’ needs are met.

The Smiles By Design® team at Burbank Dental Lab works with the clinician to systematically work through a case plan to ensure the expectations are achievable and accepted.

The first steps in the process include: 

  1. Analyze study models to note any functional or occlusal issues.
  2. Review photos
  3. Evaluate case for material selection
  4. Create a diagnostic wax-up to incorporate the plan on a model
  5. Use the wax-up to create provisionals that the patient can wear and evaluate before the final restorations are fabricated.
Digital vs Traditional Impressions

This process can be done using either conventional impression methods or using digital impression methods. If utilizing a traditional method, you should provide the following to the dental lab:

  1. Detailed prescription form with case goals
  2. Study models
  3. Photos
  4. Mouth at rest
  5. Full face
  6. Close-up with smile
  7. Pictures with the desired shade tab
  8. Impressions
  9. Bite registration, including a record of the horizontal using a facebow or Kois Dento Facial Analyzer), see image below.

The use of technology has created a new dimension to dentistry, often creating faster, more accurate treatments. The use of intraoral scanners greatly improves the patient experience by eliminating the often unpleasant aspects associated with taking conventional impressions and bites. Often, scanned cases can reveal enhanced details that are better shared with patients on a screen to inform them of their specific treatment plans.

These scans can be sent immediately to Burbank Dental Lab, where they can be uploaded in real-time and discussed if needed. This is especially critical if any changes need to be made to the preparation design. These changes can be made while the patient is still in the operatory.  The benefits of digital scanning methods include:

  • Chair time is reduced since digital scans are faster than conventional scans.
  • There is no need to use impression material.
  • The accuracy of the final restoration is improved, reducing insertion time and remakes.
  • Patients find digital impressions more tolerable than conventional methods.

To ensure digital scans are accurate, all of the same issues apply as with conventional impression methods. The margins and gums must be handled correctly, and the preparation must be adequate for the desired material choice. In addition, please consider the following to improve the accuracy of digital scans:

  • Provide a scan of the area to be treated, the opposing and the bite.
  • The submarginal line must be clear for the scanner to pick up the image; this means for preparations, the tissue must be retracted.
  • Slowly take the scan to ensure the necessary tooth structures are captured.
  • Rotate the scanner to capture 4-5mm of the patient’s soft tissue.
Diagnostic Wax-up

Whether the case is done through conventional or digital methods, the most critical factor is to begin with a diagnostic wax-up or digital diagnostic rendition.

It is through the wax-up stage that the desires of the patient and clinician can be implemented. This allows for an evaluation of what has been prescribed, but it also allows for determining what may not be possible. For example, issues regarding function can be examined through a wax-up, and plans such as opening the bite may need to be reevaluated and reworked.

Once the wax-up is completed, and all of the desired case plans have been implemented, provisionals should be fabricated from the wax-up.  This will provide the patient with the ability to try-out the restorations before the final restorations are fabricated.

By allowing the patient some time to evaluate the provisional case, any changes can be made prior to the final. Provisionals are one of the most critical steps in ensuring patient satisfaction. It takes any surprise away from the patient's expectations and creates a smooth process from start to finish.

All On "X" Success Guide Coming Soon
DuraTemp Provisionals
DuraTemps Provisionals
DuraTemp Provisionals by Burbank Dental Lab

When working on cases that are more complex, lab fabricated provisionals offer an ideal solution. DuraTemp Provisionals, a proprietary product from Burbank Dental Lab, have been used in thousands of cases to help patients evaluate their restorations.

DuraTemp Provisionals provide the following benefits:

  • Provide accurate occlusal schemes
  • Joints and muscles remain comfortable
  • The patient can accurately assess the case design
  • Assessment of the proportions, positions, length, and midline can be determined
  • Evaluation of phonetics
  • Tissue is protected
  • The vertical dimension of occlusion is tested
  • Approximation of shade
  • Chair-time is saved since DuraTemps are designed and finished in the lab.
  • If approved, DuraTemps become the template for the final restorations.
Seating DuraTemps Chairside
  1. Pack cord and control bleeding
  2. Try-in the DuraTemps to evaluate the path of insertion and make sure there is enough reduction.
  3. Brush monomer on the inside of the temps.

    Brush monomer on the inside of temps

  4. Brush petroleum jelly off the exterior to prevent reline material from sticking to the surface.
  5. Fill ¾ full with acrylic and wait until the acrylic has a dull gloss before seating.

    Fill with Acrylic and wait for a dull gloss before seating

  6. Acrylic should be stiff and rubbery.  Move the temps off of the preps during curing.
  7. Clean flash and finish margins and glaze.

    Clean flash and finish margins and glaze

  8. Use temporary cement to insert.
  9. It can be re-glazed with a light-cured glaze.

    Re-glazed with a light-cured glaze - DuraTemps

DuraTemps offer a long-wearing provisional solution. These dental prototypes are an excellent way to ensure patients are clear on the final outcome from the start.  They allow the patient to be involved in the planning and help to work out any diagnostic issue that a particular case may face.

This allows for communication and planning to reach an outcome that manages patient expectations and leaves patients satisfied. The ability to manage online reputations starts with ensuring patients are raving fans of the practice. Planning and prototyping are the keys to successful complex cases.

Call or chat with us. We are ready to help answer any questions regarding case planning services.

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