The Dawson Academy Blog

Dental Articles on Occlusion, Centric Relation, Restorative Dentistry & More

Return to Blog Index

Assessing Provisionals

It’s important to keep in mind, when assessing prototypes for final restorations, we are in the third step of treatment.  At this stage we have a complete exam, a diagnosis and treatment plan, and a full contour wax up.

process complete dentistry

Only after that should we then put provisionals into the mouth.  In order to assure a predictable outcome we now need to follow a 10 Step Provisional Checklist which consists of the following:

1. Refine and verify lower incisal edge position

2. Establish centric holding stops

3. Lip support in line with alveolar contour

4. Check for lip closure path

5. Determine incisal edge length, using smile, rest lip position

6. Verify incisal position using ‘f’ and ‘v’ sounds

7. Adjust for long centric

8. Establish lingual contours

9. Evaluate ‘s’ sounds

10. Evaluate cingulum contours using ‘t’ and ‘d’ sounds

provisional checklist 

provisionals

After completing the 10 Step Provisional Checklist the patient is sent home to “test drive” the prototypes for function and esthetics. After a few days the patient is brought back and we are able to make any necessary changes to insure everything is functioning properly and that we have 100% patient approval.

Once we have patient sign-off we can then take impressions as well as a complete set of photographs to send to the lab. From this information the lab can “copy” the prototypes for incisal edge position, as well as facial and lingual shapes of the teeth. This information is crucial to insure that there is no guesswork being done by the lab.

KEY POINT: Proper assessment of your prototypes allows the lab to fabricate predictable final restorations.

By following this systematic approach you will insure that your finals are going to work when they come back from the lab. Remember, garbage in is garbage out. Make sure you give your lab exactly what you expect to get back. That’s one of the reasons we call it predictable dentistry.

Dr. J. Stephen Hoard attended the University of North Carolina-Chapel Hill, for both undergraduate and graduate dental studies. He is a sustaining member of the American Academy of Cosmetic Dentistry, the American Dental Association, and the North Carolina Dental Society. He also is a charter member of the New Bern chapter of the Seattle Study club for dentists. In Dr. Hoard’s spare time, he enjoys boating, golfing, and spending time with his wife Tina and two daughters, Lake and Nicole.