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1.9

Major VersionM

by Patrick Tessier

  1. For 300 years, since the first dentures were built for George Washington, clinicians have struggled with obtaining impressions and models to accurately build fixed and removable  prosthetics that fit the patient. From beeswax to alginate to PVS, analog impressions have improved dramatically. Full arch impressions for sleep devices are the most difficult to obtain.  You must capture the distal surface of the most posterior lower teeth.  With a gagging patient and a ton of impression material
    • For 300 years, since the first dentures were built for George Washington, clinicians have struggled with obtaining impressions and models to accurately build fixed and removable prosthetics that fit the patient.

    • From beeswax to alginate to PVS, analog impressions have improved dramatically.

    • Full arch impressions for sleep devices are the most difficult to obtain. You must capture the distal surface of the most posterior lower teeth. With a gagging patient and a ton of impression material

    • New digital impression devices are awesome, but again, the full arch including imaging the lower, most posterior distal surface is hard!

    • Because the full arch requires a lot of "Stitching" to get the full picture, the algorithm in the software sometimes must interpolate surfaces. This leads to inaccurate impressions for the DSM Device.

    • One more issue to mess things up: Between the impression and delivery of the appliance - teeth often move

    • Bottom Line: Even today with our highly technical materials and tools, we still have to deal with poor fit due to impressions and models.

  2. AMI has offered 2 tray systems for many years.  The TL and ThermAcryl  lined trays.  AccuTherm is the evolutionary next step. ThermAcryl Lined trays  >4 mm thick Build Specs:  We start with a temporary spacer of 1.0 mm EVA, then add a 1.0 mm PET-G Polycarbonate shell.  Once this is formed on the model, we remove the 1.0 mm EVA and hand load the ThermAcryl.  Then it is formed over the model again.  Finally, we add the hardware and mold the top layer using a 1.5 mm PET-G polycarbonate disc.   Total >4.0 mm
    • AMI has offered 2 tray systems for many years. The TL and ThermAcryl lined trays. AccuTherm is the evolutionary next step.

    • ThermAcryl Lined trays >4 mm thick

    • Build Specs: We start with a temporary spacer of 1.0 mm EVA, then add a 1.0 mm PET-G Polycarbonate shell. Once this is formed on the model, we remove the 1.0 mm EVA and hand load the ThermAcryl. Then it is formed over the model again. Finally, we add the hardware and mold the top layer using a 1.5 mm PET-G polycarbonate disc. Total >4.0 mm

    • TL Trays - 3.8 mm Thick

    • Build Specs: We start with a 1.8 mm Durasoft disc. This is a duo-laminate with 1.0 mm PET-G polycarbonate shell and 0.8 mm Urethane liner. Finally, we add the hardware and mold the top layer using a 2.0 mm PET-G polycarbonate disc. Total 3.8 mm

    • AccuTherm Trays - 3.1 mm thick

    • Build Specs: We start with a 1.6 mm duo-laminate disc of 1.0 mm PET-G with 0.6 mm of ThermAcryl. This disc is manufactured in the plastics factory. Finally, we add the hardware and moldl the top layer using a 1.5 mm PET-G polycarbonate disc. Total 3.1 mm

  3. Before Fitting:    Before fitting the custom TAP appliance with AccuTherm trays, wash and rinse thoroughly. Step 1:   Place the upper tray over the upper teeth.  If the tray does not fit comfortably or with proper retention, proceed with adjusting the trays.
    • Before Fitting: Before fitting the custom TAP appliance with AccuTherm trays, wash and rinse thoroughly.

    • Step 1: Place the upper tray over the upper teeth. If the tray does not fit comfortably or with proper retention, proceed with adjusting the trays.

    • Step 2: Place the tray in hot water until the AccuTherm tray turns mostly clear. You can submerge the whole tray or just the portion that needed to be adjusted.

    • DO NOT leave the tray unattended. The tray should be removed AS SOON as it turns clear, which can happen very quickly. Leaving the tray in hot water can cause it to warp.

    • Step 3: Place the softened tray over the teeth

    • Step 4: Push the appliance over the teeth with even pressure. Do not rock the appliance over the teeth.

    • Step 5: Remove the tray from the patients mouth and place into or run under cool water to speed the cooling process.

    • Step 6: Repeat steps 1-5 with the lower tray.

    • Here's what you DON'T need to worry about:

    • Buying expensive new equipment/materials. Or learning new technical procedures or software. Use what you already have with your tried and true protocols for impressions.

    • Wasting chairtime and the embarrassment of grinding out an appliance in front of your patient.

    • Sending remakes to the lab for poor fit. Making another impression appointment for another try for a good fit.

    • Here's what you can look forward to:

    • Every case will fit, every time. Excellent retention - Snap fir PET-G shell with custom fit ThermAcryl liner "sticks" the seating. A long lasting device based on the successful trays from AMI (double thick PET-G)

    • New Crowns - no problem. Heat and seat will allow the ThermAcryl to form to the new restorations.

    • A more productive DSM practice. Allow you to spend more face time with your patients. A more confident staff - knowing how every seating is going to be easy and great. Happy patients - getting the best fitting, most comfortable device on the market.

    • Too Tight

    • Heat and Seat. Let the material flow and create a new equalibirum

    • Too Loose

    • Add a little ThermAcryl to the appliance where it's lifting off.

Finish Line

Patrick Tessier

Member since: 08/09/2017

51 Guides authored

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51 Guides authored

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