Dr. Faraj Edher
Prosthodontist, Vancouver BC
Every dentist who has ever fitted a crown will identify with the scenario: You have just placed a crown. The crown is cemented, the shade is perfect, and the contour is fantastic. And then the patient tells you something is not quite right. The bite feels funny.
In this episode of CDA Oasis Live, Dr. John O’Keefe invites Dr. Faraj Edher to discuss the finer details of checking for occlusion when placing a crown. Dr. Edher, a prosthodontist from Vancouver BC, assesses the reliability (or not) of the three common occlusal indicators, and gives a step-by-step visual presentation of his own crown insertion sequence, the result of three years of research in testing occlusal virtually.
He also shares practical tips on complex insertions involving multiple crowns, making adjustments, and what type of bur to use and when…
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team
Dr. O’Keefe,
Good topic for discussion. Loved your comment about having cemented a nice looking crown only to have the patient sit up and say “feels a bit high”. Technological advances in dental materials and methods have pretty much eliminated such outcomes – if recommended procedures are followed. How much of the short and long term success of a crown relies on proper occlusion cannot be overstated. So, I really appreciated Dr. Edher’s comments re shimstock and occlusion check for implants. All great information especially for the dentists’ wanting to develop or hone their prosthodontic skills. Very helpful pdf summary as well. I know due to time constraints the checks and adjustments listed below are implied. Perhaps Dr. Edher can do another session and/or comment on:
2a Place crown and first check proximal contacts followed by check of margin fit.
2c Once it appears that crown seating is achieved, if possible confirm with a wash.
3b After contralateral occlusion confirmed, check centric occlusion on teeth mesial and distal to the crown (ipsilateral side)
3c finally check crown occlusion in centric, working, protrusive and non working.
3e Polish crown (Very important especially with ceramic crowns)
3f Patient approval.”
Thank you.
Occlusal balancing doesn’t end after cementation. With disparate materials in the mouth, amalgam, resin, porcelain, gold, Zirconia, rebalancing occlusion may be necessary otherwise teeth end up in hyper occlusion and end up experiencing occlusal trauma
My question: what do you think of waxes to check occlusion?