Starcke EN The history of articulators: ‘scribing’ articulators: those with functionally generated custom guide controls, part I. J Prosthodont. 2004; 13:118-28 https://doi.org/10.1111/j.1532-849x.2004.04018.x
Starcke EN The history of articulators: ‘scribing’ articulators – those with functionally generated custom guide controls, part II. J Prosthodont. 2005; 14:57-70 https://doi.org/10.1111/j.1532-849x.2004.04045.x
Basudan TA, Alghaythi KS, Abuhabshah AA Iatrogenic damage in restorative tooth preparation and management. Int J Community Med Public Health. 2021; 8:3708-3712 https://doi.org/10.18203/2394-6040.ijcmph20212632
Shah YR, Shiraguppi VL, Deosarkar BA, Shelke UR Long-term survival and reasons for failure in direct anterior composite restorations: a systematic review. J Conserv Dent. 2021; 24:415-420 https://doi.org/10.4103/jcd.jcd_527_21
Wang X, Huyang G, Palagummi SV High performance dental resin composites with hydrolytically stable monomers. Dent Mater. 2018; 34:228-237 https://doi.org/10.1016/j.dental.2017.10.007
Eltahlah D, Lynch CD, Chadwick BL An update on the reasons for placement and replacement of direct restorations. J Dent. 2018; 72:1-7 https://doi.org/10.1016/j.jdent.2018.03.001
Caplin RL Dentistry – art or science? Has the clinical freedom of the dental professional been undermined by guidelines, authoritative guidance and expert opinion?. Br Dent J. 2021; 230:337-343 https://doi.org/10.1038/s41415-021-2726-4
Saunders WP, Saunders EM Prevalence of periradicular periodontitis associated with crowned teeth in an adult Scottish subpopulation. Br Dent J. 1998; 185:137-140 https://doi.org/10.1038/sj.bdj.4809750
Alharby A, Alzayer H, Almahlawi A Parafunctional behaviors and its effect on dental bridges. J Clin Med Res. 2018; 10:73-76 https://doi.org/10.14740/jocmr3304w
Pereira FJ, Lundh H, Westesson PL Morphologic changes in the temporomandibular joint in different age groups. An autopsy investigation. Oral Surg Oral Med Oral Pathol. 1994; 78:279-287 https://doi.org/10.1016/0030-4220(94)90055-8
Sutin AR, Terracciano A, Ferrucci L, Costa PT Teeth grinding: is emotional stability related to bruxism?. J Res Pers. 2010; 44:402-405 https://doi.org/10.1016/j.jrp.2010.03.006
Ohkawa S, Okane H, Nagasawa T, Tsuru H Changes in retention of various telescope crown assemblies over long-term use. J Prosthet Dent. 1990; 64:153-158
Hernigou P, Queinnec S, Flouzat Lachaniette CH One hundred and fifty years of history of the Morse taper: from Stephen A. Morse in 1864 to complications related to modularity in hip arthroplasty. Int Orthop. 2013; 37:2081-2088 https://doi.org/10.1007/s00264-013-1927-0
de Souza Costa CA, Hebling J, Randall RC Human pulp response to resin cements used to bond inlay restorations. Dent Mater. 2006; 22:954-962 https://doi.org/10.1016/j.dental.2005.10.007
Tan K, Ibbetson R The effect of cement volume on crown seating. Int J Prosthodont. 1996; 9:445-451
Nemane V, Akulwar RS, Meshram S The effect of various finish line configurations on the marginal seal and occlusal discrepancy of cast full crowns after cementation – an in-vitro study. J Clin Diagn Res. 2015; 9 https://doi.org/10.7860/jcdr/2015/12574.6283
de Freitas Oliveira J, Ishikiriama A, Vieira DF, Mondelli J Influence of pressure and vibration during cementation. J Prosthet Dent. 1979; 41:173-177 https://doi.org/10.7860/jcdr/2015/12574.6283
Carrotte PV, Johnson A, Winstanley RB The influence of the impression tray on the accuracy of impressions for crown and bridge work–an investigation and review. Br Dent J. 1998; 185:580-585 https://doi.org/10.1038/sj.bdj.4809870
Breitman JB, Nakamura S, Freedman AL, Yalisove IL Telescopic retainers: an old or new solution? A second chance to have normal dental function. J Prosthodont. 2012; 21:79-83 https://doi.org/10.1111/j.1532-849x.2011.00797.x
Niederman R, Badinovac R Is it philosophy of care or evidence-based dentistry?. Evidence-based Dent. 1998; 1:3-4
Anterior aesthetics without dysfunction: a case report. Part 2: the prosthodontic conversion Raj Raja Rayan Aesthetic Update 2025 2:1, 29-33.
Authors
Raj RajaRayan
OBE, MA (ClinEd), MSc, FDSRCS(Ed), FFGDP(UK), MRDRCS(Eng), MGDSRCS(Eng), DRDRCS(Ed), BDS, LDSRCS(Eng), Former Dean, FGDP(UK), RCS (Eng), Former Associate Dean, London Deanery; Recently, Professor and Head of Restorative Dentistry, College of Medicine and Dentistry; Former restorative referral-only practice in Harley Street; Honorary Colonel of The Commonwealth of Kentucky. Now retired
Marketing cosmetic dentistry is financially fashionable. Anterior aesthetic reconstructions are an art form showcasing the dental technician's skill. There is a perceived concern that anterior reconstructions that do not consider the functional features of the mutually protected occlusion may, in susceptible patients, lead to dysfunction with its possible consequences. Part 1 described a case in which severe anterior tooth wear was restored using compomers for the palatal surfaces, and composites anteriorly to provide acceptable aesthetics. The compomers were used so the patient could relatively easily fashion this ‘softer’ material during parafunction. This provided a pattern of anterior guidance within the patient's ability to adapt. Once adequate time was allowed to ensure the guidance was not dysfunctional, it was copied and replicated onto an incisal guidance table for future use. This article deals with the conversion of the guidance to fixed prosthodontic work.
CPD/Clinical Relevance: Transfer of anterior guidance; telescopic crowns and planning for failure.
Article
In the previous article, severe anterior tooth wear was restored using compomers (the material of choice of its time 30 years ago) for the palatal surfaces and composites anteriorly to provide acceptable aesthetics.1 The compomers were used so the patient could relatively easily fashion this ‘softer’ material during parafunction. This provided a pattern of anterior guidance within the patient's ability to adapt. Once adequate time was allowed to ensure the guidance was not dysfunctional, it was copied (Figures 1–3) and replicated onto an incisal guidance table (Figure 4) for future use. This article deals with the conversion of the guidance to fixed prosthodontic work.
The provisional composite work had no signs or symptoms for over 3 months, and the occlusion was stable with posterior stability and anterior disclusion. Once stability was established, and the anterior guidance was within the patient's adaptive capacity, study casts were taken. These were mounted onto an articulator, and the anterior guidance of the provisional aesthetic restorations was transferred to an incisal guidance table.2 This was constructed by sliding articulated upper against lower casts, the envelope of motion of the incisal pin engraving the tooth guidance onto an acrylic mould block placed on the incisal table.3,4 The ensuing photographic illustrations (not the patient being discussed) are of a full mouth reconstruction where the impressions of the final provisional crowns are mounted on a SAM articulator (SAM Präzisionstechnik GmbH, Germany). Because the vertical dimension was changed and the SAM articulator has a straight incisal pin, the incisal pin must be mounted on the mandibular bow and the incisal table on the maxillary bow (upside down in contrast to manufacturer illustrations). If the pin is straight, when the vertical dimension is changed, the centric point of the pin in the acrylic will no longer be centred owing to the closing arc. Hence, it will not be centred in the guidance table. This is not a problem with the Denar articulator (Denar Mark II articulator, WhipMix, KY, USA), where the pin is curved to compensate for the change in height during the closing arc, thus keeping the centre point centred. Hence, in the Denar, the incisal pin remains on the maxillary bow when the vertical dimension changes.
Register now to continue reading
Thank you for visiting Aesthetic Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits: