Lab Tips for Anterior Cases Involving Two or More Teeth

Before Numbing the Patient

• Take an impression for a pre-op full-arch study cast.
• Take full-face and close-up smile photos with lips unretracted and teeth slightly apart, to show the occlusal plane and incisal length in relation to the lips.
• Discuss the improvements to be made with the patient, and note the changes on the laboratory work order.
• Send a study model of the teeth as photographed.

Bite Registration

Send a centric occlusion bite registration for all cases (quadrant, full arch, or triple tray). Take the registration with a firm material over the preparations only — material placed over non-prepped teeth will hide your view of centric occlusion. We recommend a firm vinyl polysiloxane. Do not use wax or acrylic bite materials.

Impressioning

• Subgingival — Pack dual cord around all subgingival margins. The impression must capture tooth structure below the margin so margins can be identified on the stone cast. Cordless techniques are for supra-gingival margins only.
• Before impressioning, polish rough proximal contacts.
• Quadrants — Quadrant impressions should include anteriors to the midline.
• Inspect all impressions carefully under high magnification to confirm accuracy.

Shade Taking

Take the shade at the beginning of the appointment while teeth are fully hydrated. When photographing, position the shade tab so the incisal edge of the tab opposes the incisal edge of the tooth. See our companion post, Shade Accuracy Guidelines for Restoration, for more.

Photography

Provide photos for any restorations requiring color characterizations. Quality smartphone photos are acceptable.

Draw

Check for overhanging proximal teeth that prevent proper draw — especially in the lower arch where an excessive Curve of Spee may be present. Adjust contacts as necessary to facilitate the draw of the bridge or crown.

Veneers & Thin All-Ceramic Restorations

Take a prep shade so the ceramist can determine the level of porcelain opacity needed to achieve the finish shade. When selecting an all-ceramic crown, a material with adequate opacity is indicated to mask darker stump shades.

Implants & Simplicity for Your Practice

If you're unsure which abutments, healing abutments, or componentry to use, please call us. We stay abreast of the latest products and techniques from Nobel Biocare, Zimmer Biomet, Straumann, BioHorizons, Astra, and all manufacturers.

We're most helpful when included early in case planning with the restoring dentist, surgeon, and technician team. If that's not possible, provide an impression at the level of the implant fixture — we can loan you a torque driver for proper delivery of the custom abutment and restoration.