Dentaltown June 2021 - 54

up, you can move to the first molars; in a
very unstable patient, I do this one tooth
at a time and measure, measure, measure
(Figs. 17-22, p. 52).
Then I build up the bite the same way I
did on the articulator-by adding some resin
to a buccal cusp (on the lower) or lingual
cusp (on the upper), having the patient close
into the resin-don't forget the Vaseline on
opposing teeth-curing for a few seconds
while they're biting down, asking them to
open and fully finishing curing.
Knowing which tooth/teeth to start
with is important here, because you want
to hold the vertical on both sides at all
times. So before you do this, place the
sectioned TENS bite in the mouth and
have the patient close down and check
your measurements.
I am constantly checking and rechecking
measurements for vertical height changes.
At each step, check the measurement from
cervical to cervical of opposing teeth. I often
Fig. 23
do one posterior measurement on right, one
on left, and one in the anterior. So, cervical
of first molar on upper to opposing lower on
each side, and cervical of one upper central
incisor to opposing lower. If something
changes along the way, you know you lost
or increased your vertical, so always keep
checking to make sure you are keeping the
vertical where it should be.
Once you build up the resin on both
sides, make sure to check with articulating
paper-initially to get rid of any
interferences and flash, smooth everything
out and polish-and then go back with
Shimstock to refine and create even posterior
contacts. You want this bite to feel even
and comfortable to your patient, so if
something is too heavy or too light, you
need to adjust before they leave.
After using articulating paper and
Shimstock, I often check the bite again
with TekScan to confirm balance and find
any small interferences (Fig. 23).
Fig. 24
Fig. 25
54 JUNE 2021 // dentaltown.com
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Dentaltown June 2021

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