This article will be the first in a series that discusses what your laboratory needs to know in order to produce the best outcome for your patients.
Obviously, the items requested will vary from lab to lab, but the following are my recommendations in order to enable effective communication with your lab team or technician, facilitate predictable outcomes, and avoid the technician having to “interpret” the information sent.
The one essential prerequisite for all cases is a fully completed lab prescription. The law in most states dictates this requirement and the technician must fabricate only what is prescribed. This serves as protection not only for you, but also for the lab. The following will describe the basic information that should be included with each case.
Triple Tray Impressions:
- 1. Impressions
- A firm triple tray which will not distort when the patient closes.
- Inject syringe material on prep as well as occlusals of adjacent and opposing teeth.
- Adequate material on both arches to impress teeth and soft tissue.
- The impression should be distortion free.
- A clearly defined preparation finish line.
- You should have a tooth in contact mesial and distal to the prepared tooth or teeth. A confirmed bite into impression material. (Check occlusal contacts on contralateral side.)
- 2. Bite Registration
- On prepared tooth or teeth only.
- After trimming, confirm bite.
- It is helpful to take the bite before the impression because you can use a thickness caliper to measure the bite material at the central groove and opposing functional cusps. This will confirm adequate room for the required thickness of the restorative material.
- 3. The requested shade.
- 4. The shade of the prepared tooth.
- The shade (discoloration) of the prepared tooth will influence the esthetics of all ceramic restorative material.
Sending the following items will be of added value to the laboratory:
- A photograph of the requested shade tab next to the natural teeth.
- A photograph of the prepared tooth/teeth with a shade tab.
Hopefully following this checklist will help your technical team to produce a restoration with the appropriate fit, form, function and esthetic outcome.