Dentaltown June 2024 - 46

CONTINUING EDUCATION
Fig. 29
Average length for a maxillary aesthetic wax rim at
the lateral incisors is approximately 20 to 22 mm.
22 mm
Fig. 30
Fig. 31
gauge and communicated to the laboratory.
If the dentist wants the denture teeth to be set
in a different relation to the ridge than found on
the old denture, measurements can be given to
the lab as vertically longer or a specific horizontal
position. If the patient's old dentures are
unacceptable or have been lost, the wax rim and
the teeth can be set in relation to the upper lip;
the papillameter measurement will help with
this. Also, other guidelines are available for
tooth position.
Another helpful measurement that can guide
the wax rim length is to have the incisal edge
location of the maxillary lateral incisor area of
the wax rim 20-22 mm below the peripheral
border of the denture in that area (Fig. 29). This
is often very aesthetic and close to the patient's
natural teeth locations.
At the consultation/examination appointment,
Communicate specific instructions about
rim contours to the laboratory: It is important
to request the aesthetic wax rim with a specific
vertical length and, specifically, how far labial
to the incisive papilla the incisal edge of the
wax rim in the central incisor area should be.
Rather than providing vague instructions like
" construct wax rim, " the dentist should give
precise guidance.
Benefits of delegating to the laboratory:
Delegating the task of contouring the wax rim
to the laboratory with clear instructions can
significantly reduce chairside time. This time
saved during clinical appointments can then
be devoted to refining the wax rim contours to
more accurately represent the positions of the
denture teeth.
Other guidelines for contours of the anterior
portion of the wax rim: The length of the
anterior portion of the wax rim and the horizontal
distance from the center of the incisive
papilla to the incisal edges of the central incisors
can often be determined from the patient's old
denture. This can be measured with the alma
these measurements and guidelines can also
be used to evaluate the patient's old denture to
determine if a new denture can have teeth set to
more aesthetic positions and match the patient's
desires and expectations.
Ensure retention and stability of the
maxillary baseplate with the wax rim: When
evaluating and contouring the wax rim, it is
important that the baseplate remains securely
in place intraorally. This ensures the patient can
comfortably and naturally move their mouth,
smile and speak without the baseplate becoming
dislodged from the maxillary ridge. Request the
dental laboratory to create a well-fitting retentive
maxillary baseplate. Additionally, consider
the option of digital fabrication using 3D printing
or milling to achieve an optimal fit and retention.
Request patient engagement: Encourage
patients to bring photos of themselves showing
their natural teeth while smiling before tooth
extractions. This provides a visual reference for
restoring their natural appearance and positioning
the denture teeth as close as practical to
the estimated position of the patient's natural
teeth. Additionally, ask patients to share pictures
from magazines or online of smiles they admire
JUNE 2024 | 46 | DENTALTOWN.COM
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Dentaltown June 2024

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