Pearly Whites Dental Lab

 Why Pearly Whites Dental Lab? It's simple...consistent and successful results! A brief explanation as to why that is important. As an in-house lab technician, I had an operatory with patient scheduling as well as operating the lab and doing the lab work. The patient schedule was demanding and was filled with impressions, try-ins, deliveries, adjustments, repairs, picking up attachments etc... all that I was to do as the in-house lab tech. Obviously more than the usual bench denture technician. Knowing how to make prosthetics is good but knowing how they function is superior. There was no time for constant resets, remakes and repairs. The more time I spent chairside, the less time in the lab. My results had to be successful and consistent. 

               Mounting:  All cases are mounted on a full sized, semi-adjustable Stratos articulator*. This allows for a more natural arc of closure than the smaller, hand held, "clop clop" type articulator. This style articulator eliminates many of the posterior interferences found in try-ins, requiring you to remove the 2nd molars from the set-up, for the patient to even close.

               Set-ups: Using the Stratos, and it's accessories, your midline mark is exactly where the midline is on the set-up. There won't be any rollercoaster smiles either. The anterior teeth are set and characterized according to the patients sex and age. A youthful female will have slightly longer centrals with the laterals raised about 1mm and the mesial edges slightly set labial to the centrals, using a softer mold.  An older male will have the centrals and laterals the same length with the lateral mesial slightly tucked in to the centrals using a more square type mold. The cuspids are a little flared and raised to meet the posterior teeth. When possible, there will NEVER be any contact on the anterior teeth, unless necessary or instructed by you to do so. This protects the fragile premaxilla to prevent a "flabby" denture that moves with every closure since the 3rd point of support has been lost. Additionally, this same set-up will greatly reduce the amount of movement, if the patient has already lost the support of their premaxilla, as the contact is on the posterior teeth. The posterior teeth are all set to the anatomically natural curves of Spee and Wilson. The maxillary posterior teeth are then set in lingualized occlusion. If I had to choose any ONE important thing in all of the steps, techniques and materials, this would be that one most important thing. Many adjustments, requiring your chair time, are improperly required because the denture was set with the posterior teeth landing on inclines. This causes the denture to move with every closure as the teeth land on these inclines. Oftentimes the movement is so minimal, it goes unnoticed. This movement then causes soreness in the same way that an Indian Burn would cause soreness on the arms of our friends when we were kids. Stop the movement, stop the sore spots! Additionally, how many times have you relined a denture that continues to split down the median palatine suture? Many midline fractures can be avoided with proper lingualized occlusion. When the patient closes with lingualized occlusion, the pressure and force of the closure is up and down, supported by the ridge. When typical denture occlusion is set, the forces can push the teeth in opposing directions, causing the split. The right and left side each get forced out (or inward) and the base then breaks under the pressure. Even if lingualized cannot be utilized, posterior occlusion will always be on centric stops and never on any inclines. As indicated, proper occlusion is EXTREMELY important and is taken very seriously at Pearly Whites! This single lab technique is one of the cornerstones of our business. Occlusion is also beyond important when dealing with implants. Improper occlusion can physically break the implant or cause it to become loose. 

              

                Acrylic/Base: The importance of the base is second only to occlusion. With incorrect occlusion, even the best base will break. There is no amount of metal framework that is stronger than the power of the bite. Conversely, proper occlusion can preserve the integrity of even the weakest of bases. At Pearly Whites, we inject our premium acrylic with the Ivocap system from Ivoclar. The Ivocap injects under constant pressure and cures the anterior region first. As acrylic cures, it shrinks. Being under constant injection pressure, while curing from the anterior first, allows for virtually zero dimensional changes. This tremendously reduces sore spots, eliminates porosities, ensures teeth stay in their proper position and provides for the most dense base possible, allowing it to be much thinner than traditional press packed bases. The more dense acrylic also means it is more stain and odor resistant.
             

               Delivery: Delivery is more of a chairside technique but there is a lab side to its chairside success. Remounts! Production labs don't take the time to remount the case after processing. At Pearly Whites, every case is remounted to fine tune occlusion. Even with the Ivocap, there are new variables that allow for occlusion to be fine tuned. We remount at every step, if possible, but definitely after processing, before delivery to your office.

 *Some pictures will be shown with the hinge articulators. While cases are set and worked on in the lab, on Stratos articulators, they are then mounted on hinge articulators to be sent to the office.