Managing Multiple Anterior Restorations Part 3: The Vacuform Stent and Temporaries
In Part 2 of this series, I showed how to prepare the teeth fast and predictably to get 90% of the preparations done in minimal time. Now we need to transfer the wax up to the patient to verify the esthetics, mid line and function. For this we use a vacuform stent made from duplicate stone model of the wax up.
The vacuform stent is filled with a self curing bisacryl material and then seated on the preparations.
The excess around the gingival margins is removed with a micro brush. The vacuform stent is trimmed to gingival margin of the wax-up. This way once the excess is cleaned there will be less need for trimming around the mock up.
The mock up is then trimmed with finishing burs to accentuate the embrasures and line angles. Once this is done, it is time to start imaging each individual unit and finalizing the preparations of each tooth.
The incisal embrasures are not as important since we will be refining them once we have prepared the tooth for the final restoration and we are ready to image.
For this initial temp, do you make it removable, or do you refine it, image, and then cut off when you start your final tooth prep?
Michael, I'm not sure what Darin did, but I like to bond them on and make all the adjustments. I then take the pre op images. I will use depth cutters from there on the temps, since I would bio copy this, and just make sure I have enough reduction from the biocopy. this allows you to be as conservative as possible on the prep without over reducing.
Michael,
It depends on if I am doing all the restorations that day. If am I am I let the resin set completely so it is locked on. I then just image one tooth and cut off the temp and finalize the prep(great now I have spoiled part 4) If I am doing the case in two sessions, either off of models or designing and milling while the patient is away, then I will remove the temporaries, refine all of the preps and reline the temporaries.
