Pearly Whites Dental Lab

Thank you so much for taking the time to view our website! I am excited to see you are taking the time to read more. 
 

Why Pearly Whites Dental Lab? It's simple...consistent, successful results! A brief explanation as to why that is important. As an in-house lab technician, I had an operatory and ran a patient schedule along with a lab to do 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 denture technician and that's extremely important. Knowing how to make prosthetics is good but knowing how they function is so much better. There was no time for constant resets, remakes and repairs. The more time I spent chairside was less time in the lab to fabricate implant guides, long term functional provisional bridges for full mouth rehab cases, dentures and partials, just to name a few. My results had to be successful and consistent. That now benefits you and can save your chair time just as it saved mine.

 

 Since I am not an in-house for your office, I won't go in to the patient side of things. If you are interested in how your Assistant can further save your time, by doing many of the chairside steps you have to do, that is easier explained in person, or on the phone, so please feel free to call.

On to the lab procedures:

               Mounting:  All cases are mounted on a full sized, semi-adjustable Stratos articulator. This is very important as it allows for a more natural arc of closure than the smaller, hand held, "clop clop" type articulator. This alone 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. The reason for the Stratos vs the more common Deynar is the set-up guides which leads us to the set-ups below.

               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 is to protect 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. Speaking of the posterior teeth, they are all set to the anatomically natural curves of Spee and Wilson with the mandibular 2nd molars 2/3rds the height of the retromolar pads. 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. Sometimes the movement is not even noticable and others it is extreme. Either way, this movement 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! Also, how many times have you relined and relined and relined a denture that continues to split down the median palatine suture? Again, much of this is unnecessary and 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 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 can save or waste so much of your valuable chair time, in so many ways, and take away from the more profitable sides of your practice! Did I mention how important occlusion is for implants? To use a phrase common with today's youth, OMG! I have seen improper occlusion destroy implants; break them off at the gum line, bend the implants or torque them in all of the wrong ways to the point they get so loose that they simply come out.

               Acrylic/Base: The importance of the base is second only to occlusion. A quality base can still break, with improper occlusion, and proper occlusion can prevent an improper base from failing. Why have all of this quality workmanship only to then have a weak link at the end with a press packed or standard injection processed denture? As acrylic cures, it shrinks. This shrinkage will, not only cause sore spots, but will also alter the position of the teeth and the posterior contact. How many times have you delivered an appliance with occlusion different than what was provided at the try-in? This is most likely the reason why. No contact or heavy contact requiring extensive occlusal adjustments, again, wasting so much chair time! Since the law prevents me, the lab tech, from using a handpiece in the mouth, I had to have everything process exactly as it was in the wax-up. I didn't do my job properly if I had to then get the dentist to adjust heavy occlusion at delivery time. This is where the Ivocap injection system comes in! By design, it cures in the anterior region to the posterior region, all while under constant pressure. In short, this means as the acrylic shrinks, during final polymerization, the Ivocap compensates and adds more acrylic. There are no dimensional changes, teeth stay in their position and the denture base absolutely the most dense that can be achieved in acrylic. No porosities! Thinner palate for comfort while still providing strength! The more dense acrylic also means it is more stain and odor resistant! Injecting with the Ivocap also provides the best adaptation and fit, to the impression, achievable than any other processing technique available. With a quality impression, such as a Hydrocast functional impression, this gives the best fit with no sore spots.
              

               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.

               Chairside Delivery: I know you are tired of the "25 years of in-house experience" but during that time I have delivered denture after denture, partial after partial, brux guard after brux guard, all without any adjustments necessary! This is the consistency I keep talking about. Almost every case can be simply handed to the patient and let them walk away! The success of the cases are so great, I even implemented a 1 year follow up/cancer screening appointment since the patient wouldn't ever have to return for adjustments or repairs. This appointment is made after their delivery and a reminder is sent, just as recall reminders are sent for your hygiene appointments. I explain to the patient that oral cancer is a real and serious risk that often goes undiagnosed since they don't have teeth, therefore don't come in every 6 months for a cleaning. This 1 year appointment is quick, simple, billable and a great way to check the denture for any needed relines and wear.