February 29, 2016
A well done diagnostic waxup is what separates the excellent dentists from the average ones when it comes to delivering a new smile. While ANY dentist can give “A” new smile, without proper steps the final result is a gamble, or an expensive game of chance. Also, without proper planning, the dentist may irreversibly remove more tooth structure than needed which results in a weaker tooth or teeth.
Step number one is taking impressions. Traditionally this is done with trays and “goopy” material that sets after a few minutes. This leads to stone models of the teeth that can be evaluated and a smile design can be created. NOW, Dr Timmerman uses a digital scanner to electronically record the teeth and can virtually plan or 3D print models for the evaluation. This means NO gagging and saves DAYS of lab time, so treatment can begin QUICKLY.
The BEST part of a diagnostic waxup is the transfer. Impressions of the WAXUP can be taken, and your smile design PROTOTYPE (your temporary smile) can be worn after your teeth are shaped for the veneers (if needed). Now you can SEE the new shape of your smile BEFORE it is done! Sometimes the waxup looks great on a model but not what you expected in your mouth. Whatever changes you desire can be worked out with Dr Timmerman and then communicated to the lab.
An alternative to the lab fabricated diagnostic waxup is to have Dr Timmerman design your smile right in your mouth. This MAY be all you need to see, but has SOME draw backs. Impressions of the intra oral mock up may dislodge it, so the prototype may be a challenge to create and may not look as nice as using a lab. So, YES, you can save a couple days (and we really are saying 2 days and not a week or two since the digital scanner is used) but having the lab participate from the start may be a more comfortable experience.
November 25, 2014
Lance Timmerman DMD is known for many different services, but it is his customer SERVICE that sets him apart. Any dentist can offer dental care, but it is not common to offer no gag dental impressions when dental impressions are needed. Many patients have a heightened gag response, so even the most basic dental treatment can be a challenge.
When reproducing the shape of the teeth, models to study or fabricate restorations, trays filled with soft and gooey material (historically alginate but more common today is polyvinyl siloxane) are inserted in the mouth and removed after setting. Plaster can then be poured into these impressions and after fully set a perfect reproduction is created. It is during the GOOEY stage that exists the problem. The more “runny” the material, the more detail is captured; however, gravity tends to allow this material to run down the throat and induce a gag or tendency to vomit. This leads to an unpleasant dental experience.
The more advanced and modern dental practices use digital impressions. Dr Timmerman uses the iTero machine, a device that stitches together several images, or pictures, of the teeth and allows this file to be sent to a lab for fabrication of the dental models. These “impressions” are both more easily tolerated by patients AND more accurate than the tray method. There is no downside.
The most accurate impression is one that does not distort in any way. However, the “perfect” material would then be impossible to remove from the mouth, so dental materials have a certain “give” to them, making them soft. This allows the trays to be removed and the material returns to the shape of the tooth. This “give” has a bit of distortion and is compensated when poured up in stone. A little expansion on one end, a little contraction on the other. The hope is when added together, the result is “zero” or neutral.
Since a digital impression does not need to worry about expansion or contraction, the iTero model can be fabricated to the EXACT dimensions desired. This allows the dental restorations to fit PRECISELY. Dental restorations that FIT require no adjustments, which means the cement used works better, the bite is more comfortable and the restoration lasts longer.