DentaltownUK May 2017 - 53

provisional wax-up provided by the laboratory (Fig. 11). After
temporization, the three reference locations should again be measured
with digital calipers to verify that the bite is at the correct VDO.

Translating the bite:
Fabricating definitive restorations
The final impressions are poured at the laboratory and model
work completed. The progressive bite, along with a facebow or stick
bite, is then used to articulate the models and to verify that the VDO
and horizontal and vertical ation are correct according to the three
previously determined reference points (Fig. 12).
The wax-up is then duplicated in stone models, and processing is
initiated for transforming the wax-up into pressed or milled lithium
disilicate restorations, using a product such as IPS e.max by Ivoclar
Vivadent. Aesthetic layering is performed to complete the restorations
(Fig. 13), after which the VDO is verified one final time.

Fig. 13. View of the definitive restorations on the model before
cementation.

Conclusion
Using the progressive bite matrix technique can result in a
final seating appointment that requires very few adjustments and
produces very high success. In fact, using the progressive bite matrix
technique helps to not only verify but also establish a necessary rate
of insertion that's reliably predictable. After trying the restorations
in the patient's mouth, the case can be cemented according to the
appropriate protocol and the measurements verified once again, with
the definitive treatment in the correct VDO that was established
before the wax-up. n
Dentistry provided by Stephen Dankworth, DDS.

References
1.
DiMatteo AM. Pounding on the occlusion pulpit-wherein lies all the controvery? Inside Dentistry.
2008 March; 4(3).
2.
Ackerman JL, Ackerman MB, Kean MR. A Philadelphia fable: how ideal occlusion became the
philosopher's stone of orthodontics. Angle Orthod. 2007; 77(1):192-194.
3.
Okeson JP. Occlusion, Condylar Position and TMD: Where is the controversy? Where is the
evidence. Lecture. 148th American Dental Association Annual Session; September 28, 2007: San
Francisco, CA.
4.
Rouse JS. Interocclusal registration. Inside Dentistry. September 2010;76-80.
5.
Wynne WPD. Considerations for establishing and maintaining proper occlusion in the aesthetic
zone. Dentistry Today. 2004 April;112-19.
6.
Alex G. Is occlusion and comprehensive dentistry really that important? Inside Dentistry. 2007
February;32-40.
7.
Hess LA. The relevance of occlusion in the golden age of esthetics. Inside Dentistry. 2008 February;36-44.

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Fig. 14. Postoperative view of the definitive restorations after
the cementation appointment, which went smoothly.

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Table of Contents for the Digital Edition of DentaltownUK May 2017