If you follow The Dawson Academy protocols, altering the vertical dimension is going to be the exception rather than the rule. We can work with the vast majority of patients’ vertical dimension and still fulfill the five requirements for occlusal stability and get a beautiful esthetic result.
Sometimes it’s hard to get patients to understand and accept the need for treatment.
The first thing to understand when it comes to patient acceptance is that patients won’t accept any course of treatment if they don’t understand that they have a problem. Particularly with equilibration it is important during the context of the examination that you first have a basic discussion about what optimum health is.
Over the years I have heard many objections to doing a complete exam like we teach in our courses. Dentists say they don’t have enough time, patients won’t agree to it, it costs too much and so on. What I tell those dentists and what I’m about to tell you is that you can’t afford NOT to do a complete exam.
Following proper diagnosis and treatment planning, occlusal equilibration can provide selected patients with the most conservative, predictable and safest treatment possible.
Occlusal equilibration can often help avoid the need for more complex treatments. Dentists who have developed proficiency in equilibration universally agree it is one of the most practical skills they use routinely in practice.
When you are still going through the Dawson curriculum, do you wait to treat or do you try anything immediately?
This is an important question for anyone still learning occlusion and smile design. When you look at the totality of what we're training you to do, there are still a lot of patients who need preliminary mouth preparation to get healthy. There’s still periodontal and biological work to be done, like fillings and build ups. There are also going to be patients that don't have tremendous functional problems.
When we talk about utilizing bimanual manipulation as a way to get centric relation, one of the biggest misunderstandings we see is the tendency for dentists to think CR is achieved by forcing the jaw back to seat the condyles. When we are in a situation where we have a ‘tight’ patient, or patients that are resisting, the worst thing we can do is force it.
Bimanual manipulation provides verification of:
The correctness of the physiologic position
The alignment of the condyle-disk assembly
The integrity of the articular surfaces
In this webinar, Dr. Cranham discusses the elements involved in perfecting an occlusion to insure predictability in restorations.
- Insuring a Perfected Occlusion with centric stops
- What to do when back teeth rub
- Anterior Guidance
- Tooth Preparation (under and over)
- Proper coping design
by Dr. John Cranham
As time has gone by, the general population has continued to put pressure on the profession to create lifelike dental restorations that have enough longevity to justify the cost. While several materials have hit the market in the last few years, evidence suggests that lithium disilicate has the strength, durability and esthetics to make it the logical replacement to the time tested porcelain fused to metal crown.