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6) CRITICAL FACTOR: COMPARING THE OPTIONS
Keep in mind that you CANNOT use a hinge articulator to alter the vertical dimension. It’s the wrong arc of closure, and you’ll never have the molar anatomy correct. If you base your provisionals on a diagnostic wax-up created on models mounted on a hinge articulator, the occlusion will be wrong.
Option No. 1: Evaluate the patient at the point of initial contact. Then, if possible, rebuild the new vertical dimension with the models mounted at the point of initial contact via CR mounting. Option No. 2: If a patient has an extremely vertical posterior anatomy, you can build the new vertical dimension to a point that is less than the initial point of contact in order to provide extra space without increasing the contracted length of the elevator muscles. Option No. 3: If a patient has really flat and worn out posterior teeth, you’ll have to build their vertical dimension beyond the point of initial contact. While the previous six factors are necessary steps to take when altering vertical dimension, there is no fixed formula you can use for every case. Vertical dimension is a highly adaptable position, and there is a range that will work for most patients. But if you follow the necessary steps, you’ll be able to determine which option will work best for each individual patient. You can listen as Dr. Phelan puts these seven critical factors in action when treating three of his patients by listening to his webinar. To access it, go to InsidersCircle.com SITE MAP AUDIO/VIDEO PROGRAMS GEMS INSIDERS’ CIRCLE WEBINARS 076 Phelan 7 Critical Factors You Must Consider When Altering Vertical Dimension. 7) CRITICAL FACTOR: DON’T RELY ON A FORMULA
4) CRITICAL FACTOR: BEST TECHNIQUE
While there are several techniques that have been used in the past, the one that Dr. Phelan stands by is Restorative Generated Occlusion Vertical Dimension. Expanded from a procedure he learned in Dr. Dawson’s book “Functional Occlusion: TMJ to Smile Design,” Dr. Phelan’s technique relies on using the geometry of the jaw and the space created by seating the condyle into CR, and then using this space to your advantage. The key concept here is seating the condyle into CR, which is helpful because it increases the vertical dimension of the anterior segment without increasing the contracted length of the elevator muscles. There are currently two schools of thought regarding the stability of vertical dimensions, and while there is ample literature exploring this topic, all you really need to know is that stability won’t be a concern unless you are working with a patient who has a mixture of both implants and teeth. What Dr. Phelan recommends in those cases is for you to open the vertical dimension and leave it in provisionals for the amount of time it typically takes for it to close. 5) CRITICAL FACTOR: WHEN TO WORRY ABOUT STABILITY
FALL GEMS FAMILY RETREAT, BOSTON FINAL SAVINGS END 7/31/19
(menu bar, top left of homepage). If you have questions, please contact your Personal Gems Concierge or call 1-888-880-GEMS (4367). 90-MINUTE GG12 TEAM TRAINING WEBINARS: GG12 Team Training Toolkit Dental Practice Transformation members, please block out this monthly program on your calendar. These occur just once each month, but they could easily be the most important 90 minutes you and your entire team will invest. GG12 OFFICE HOURS: Twice each month, my office door is open for your visits. This is an opportunity for GG12 Doctors and team members to reach me directly with questions about dental practice management. GEMS INSIDERS’ CIRCLE™ QUARTERLY Q&A WEBINARS: Four times each year, I’m available in the evening for up to 90 minutes to answer your questions about any topic of your choice regarding dental practice management.
GG12 AND INSIDERS’ CIRCLE™MEMBERS’ FALL RETREAT: Doctors and team members often tell us they have never experienced anything like our retreats in all their years attending dental continuing education. Experience it for yourself and form a lifelong bond with other GG12 and GIC family members. If you’re ready to experience a transformative time for your practice and your life, head on over to InsidersCircle.com and click the retreat banner in the top left corner. Register now! June 5; 10 a.m. to 11 a.m. EDT — GG12 Office Hours June 18; 8:30 p.m. to 10 p.m. EDT — Gems Insiders' Circle™ Webinar June 19; 11 a.m. to 12:30 p.m. EDT — 90-Minute GG12 Team Training Webinars June 21; 12 p.m. to 1 p.m. EDT — GG12 Office Hours
For the latest up-to-date information about what’s happening on Planet Gems, go to InsidersCircle.com and click on “Calendar”
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