42
The following protocol was developed
by a panel of experts in occlusal treat-
ment on the philosophy that a dentist
seeking good laboratory support will
give the technician complete specifica-
tions for fabrication of the occlusal
aspects of the restoration.
Recognizing that the position of maxi-
mum intercuspation is of paramount
importance, it is the responsibility of the
dentist who takes the centric relation or
centric occlusion interocclusal record to
mount the mandibular cast. Complete
specifications furnished by the dentist
to his laboratory for fabrication of the
occlusal aspects of restorations include:
1. Full arch master casts mounted in
an instrument with trimmed dies or
dies with margins that are easily
identifiable.
2. Instructions for adjusting articula-
tor condylar controls (if adjustable)
when the restoration is fabricated
plus records for adjustment of the
incisal table.
3. Specifications as to which teeth
are to bear the load in eccentric
bruxing movements.
4. Specifications for the class of
occlusal anatomy desired and the
character of the position of maxi-
mum intercuspation as described
below.
DISCUSSION
Mounted Casts with Trimmed Dies
To specify that it is the responsibility of
the dentist to mount the mandibular
cast does not mean that he cannot del-
egate this procedure to a dental auxil-
iary. For example, in limited restorative
procedures in which there are sufficient
unprepared teeth to accurately index full
arch casts in the position of maximum
intercuspation, the mounting procedure
could certainly be delegated to a dental
auxiliary. However, as the restoration
becomes more extensive, if the dentist
delegates the mounting of the casts to a
dental auxiliary and an error is intro-
duced, the dentist should still assume
full responsibility for the mounting error.
Instructions for Adjustment of
Condylar Controls
To specify that the dentist should pro-
vide instructions for adjusting condylar
controls does not mean that the restora-
tion is to be constructed on a fully
adjustable articulator. An example of
instructions for adjustment of the
condylar controls could be: “Lock the
instrument in centric relation throughout
the laboratory procedure”. It is the
responsibility of the dentist to specify to
his technician if he wants consideration
given to eccentric factors of occlusion
in the laboratory, and if so, to what
extent.
Dentist
__
Laboratory Relations
Currently, most dentists send unmount-
ed casts to the laboratory for fabrication
of prosthetic restorations. Restorations
are returned to the dentist on unmount-
ed casts. If the occlusion is found to be
in error when the restoration is inserted
in the patient’s mouth, who made the
error
__
dentist or technician? This condi-
tion can result in strained dentist-labo-
ratory relations.
It is the responsibility of the dentist who
takes the centric relation record to
mount the mandibular cast. When the
restoration is returned to the dentist on
full arch mounted casts the dentist has a
basis for accurate communication with
his laboratory. If the laboratory services
APPENDIX B
DÉNAR SYSTEM PROTOCOL FOR DENTIST-LABORATORY RELATIONS
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