Freedom in Centric Protocols
Reduce set-up time, resets, and adjustments
Freedom in centric—the ability to hold natural teeth together with freedom of movement—is a vital concept that is often overlooked in today's mainstream denture fabrication. Freedom in centric allows for compensation in the mouth, which leads to a better fitting denture, increased patient satisfaction, and greater profitability with decreased set-up time, resets, and adjustments.
One common cause of both resets and adjustments can be traced back to errors that occur during the denture tooth set-up process. During set-up, a laboratory technician must spend considerable time to identify and set the relationship between teeth and their opposing antagonists, ensuring there is centric contact without interference. Denture teeth without occlusal/centric landmarks to guide this relationship have a higher probability of error during set-up. If this relationship is not correct, the issue is exacerbated in the dentist's chair, resulting in the need to reset with additional patient appointments as well as further denture adjustments post-insertion. The average adjustment appointment takes approximately 30 minutes and costs roughly $200 (based on an hourly rate of $400 per hour for a dentist or denturist). The typical denture patient returns two to five times for adjustments, costing a minimum of $400 per patient and impacting the overall profitability of the practice.
Starting with the correct denture teeth is imperative to successful outcomes. Most denture teeth on the market do not have the freedom-in-centric concept built into them. VITA premium denture teeth like VITAPAN EXCELL® and VITAPAN LINGOFORM® feature unique pre-abraded facets in the teeth to self-occlude. These interconnecting geometries and interproximal characteristics enable the teeth to glide into place for easy set-up with less chance of error. In addition, the maxillary lingual cusp tip doesn't lock into the opposing fossa, which is the basis for the freedom-in-centric concept. The maxillary buccal cusps are out of contact, creating freedom, and only the lingual cusp of the upper tooth is in centric contact with the central fossa of the lower. Combined with lingualized occlusion, these features result in a better fitting denture with less chance of interference and greater stability during mastication.
The benefits of freedom in centric are significant, including faster, easier set-up with less chance of errors, fewer resets and adjustments, and less denture/implant component damage, resulting in reduced chairtime and higher profitability. The improved function and greater comfort means more satisfied patients and opportunity for referrals.
› The Clix attachment system uses a 2.25-mm ball compatible with most major implant systems
› The audible click and strong retention help patients feel secure and confident
› Clix is also easier to keep clean compared to other attachments with "cup" abutments that may harbor food and calculus
Disclaimer: The statements and opinions contained in the preceding material are not of the editors, publisher, or the Editorial Board of Inside Dental Technology.
About the Author
Marc Wagenseil, CDT, DD
Heritage Dental Laboratory/Heritage Denture Centre