What should you check before inserting the try in?
- are the try in bases stable on the cast
- are the borders smooth, rounded with no sharp edges
- is the borer extension shaped to the width and depth of the sulcus
- are the centre lines correct
- is there proper contact with the pin on the table
- are the teeth set in the correct position eg over the ridge in the mandibular
- correct shade and mould
- has the post dam been cut
What should you check when you put in the try in?
- retention and stability
- base extensions
- LIMBO
- position of teeth
- vertical dimension and FWS
- even contacts
- speech
- aesthetics
How should you assess the try ins?
- assess individually then together
- allow time to settle
- moisten before inserting
- insert mandibular before maxillary
How do you assess retention and stability?
- manipulate soft tissues and ask patient to speak
- will not be as good as final denture (due to wax)
- ensure effective communication with patient regarding this
How do you assess base extension?
- hold the tissues away from denture, if it drops then likely underextended
- manipulate the tissues, if it drops then likely overextended
- if there is too much lip support then it will drop
How do you assess LIMBO?
- lip support
- incisal level
- midline
- buccal corridor
- occlusal planes (anterior/posterior)
How do you assess position of teeth?
- ensure teeth are in the neutral zone
- mandibular teeth should be set over the ridge
- maxillary teeth should be set just buccal to the ridge
How do you assess vertical dimension?
Ensure patients FWS has not changed dramatically from previous denture or from what is comfortable for them
How do you assess speech?
- ask patient to speak, ensuring all different sounds are checked including f, v, s, sh etc
- teeth should be slightly apart when speaking
How do you assess aesthetics?
- allow patient to look in the mirror, leave them alone to form their own appearance
- get specifics if there is an aspect they do not like
- reassure that try in gingiva is much redder than final
What are the options if something is wrong with the denture at try in?
- re-try appointment
- correct at chairside
- prescribe for the lab to make a change before finish
- correct at insertion appointment
How do you correct the teeth touching during speech?
- insufficient FWS
- OVD needs to be reduced
- re-reg jaws and lab will reset all teeth except the upper anteriors
How do you correct a whistling sound during the “s” sound?
- OVD may need to be increased or anterior tooth position changed
- re-reg jaws and lab will reset all teeth
How do you correct the incorrect mould or shade?
- choose again
- prescribe to lab to reset
How do you correct the incorrect midline?
- mark new midline
- prescribe to lab to reset with same teeth
How do you correct minor changes to tooth position?
- alter at chairside until patient is happy
- send to lab to finish
How do you correct major changes to tooth position?
- LIMBO problems
- re-reg jaw and prescribe to lab for re-try in
How do you correct minor overextension?
- modify wax
- mark on master cast max extent of flange
- prescribe lab with instructions for insertion
How do you correct major overextension?
Master impressions
How do you correct minor underextension?
- wash imp material and try in (closed mouth technique), prescribe to lab for casting/mounting for re-try
OR - proceed to insertion but do not insert, reline denture at this stage
How do you correct major underextension?
Master impressions
How do you correct an error in vertical dimension?
- always triggers re-try
- if OVD is too great, teeth removed from one denture and wax rim added
- if OVD is too small, wax rim can be added to teeth or teeth removed and replaced with larger wax rim
How do you correct major occlusal discrepancies?
- measure OVD and decide if correct or not
- if correct, some or all teeth removed and replaced with wax rim, re-reg, prescribe to lab for re-try
- if incorrect, remove all teeth from one denture and place wax rim to eliminate error, re-reg, prescribe to lab for re-try
How do you correct minor occlusal discrepancy?
- selective grinding at try in or insertion (use BULL)
- use articulating paper
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Reasons for rendering a patient edentulous21
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Treatment planning for complete dentures31
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Impressions for complete dentures22
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Replica dentures17
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Occlusion for conventional dentures23
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Conventional complete denture clinical laboratory interface12
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Retention and stability of complete dentures13
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Tooth selection for complete dentures16
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Denture try in25
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Denture insertion and review10
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Denture maintenance24
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Immediate dentures8
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Setting teeth24
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Practical Questions4
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DIAN - Denture Design20
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Pros Tutorials44
