Dental Excellence Video 5: Equilibration For The Porcelain Veneer Patient.

This is the fifth video from my new Dental Excellence video series. In this video I share with you my thoughts about Equilibration For The Porcelain Veneer Patient.

Watch the video below to find out when I would equilibrate a patient before placing porcelain veneers.

Remember. You can do this kind of dentistry and that beautiful dentistry with precise fit and occlusion is not just for the gurus!

Comments

  1. karim awadallah says:

    very illustrative video dr phelan. but may i ask how can i confirm the point of initial contact and what type and thickness of articulating papers should i use to record them?

  2. Mandla Simelane says:

    Marvelous videos! Hoping to be joining your occlusion seminars soon! Though at twilights in practice of dentistry, I am eager to change the way I practice dentistry and get more involved with “ Rehabilitation Dentistry’”

  3. hesham ahmed says:

    thank you so much for this great video

  4. DR Mohd Shajir KP says:

    Hello doctor….
    Thank you for sharing the case and it is very helpful in clinical condition…….
    Waiting for more clinical programme…

  5. Ahmad fawad says:

    Thanks so much for sharing the case…. And, you remind us to have a balance occlusion before starting the treatment… Excelent

  6. Steven Foxn DDS, FACD says:

    Nice photographs of the teeth and nice explanation. I learned Occlusion and Equilibration from my late father, Dr. Clifford W. Fox. We both actually gave a course years ago at the University of Toronto, probably late 90’s early 2000’s, maybe you attended it in the early years.

    Photographs show very well the hit and slide from the initial point of contact at centric relation into maximum intercuspation. But most patients I have seen in my 41 years of dentistry do not initially close in centric relation, but close directly into maximum intercuspation due to muscle memory patterns. Closing on an interference then sliding, should cause trauma to the tooth and possibly pain, so patients will avoid that contact . So my question is how do we determine if the patient has a true slide from CR to MICP.

    My second question is how do we know the interference on the biscupid it the etiology of the worn teeth. In the photographs it does not seem possible for the anterior slide to cause the severe attrition on the incisal edges, this would take a protrusive movement. Just want to know what you think.

    Have just found you on Facebook, I look forward to looking at all your other videos. Thanks for the nice video and the opportunity to have this discussion with you. Thanks, Steven Fox

    • I agree with your comments because this idea that we function from a place of “ cr” then slide into Mip is not what I observe in my patients either, perhaps an articulator but in the human it’s more of an outside in “ coming home” when occluding than it is Cr to Mip sliding forward. muscle engrams dictate this. Even if this slide forward concept were true in this case (and it could be) the bigger question is ..could that be the cause of all that attrition on all of those anterior teeth? I would be highly suspicious of some type of sleep related breathing disorder. habitual posturing forward to maintain a patent airway is more likely a cause of this broad pattern across the anterior segment.a clinical exam & medical history and perhaps a sleep study could be another consideration & potentially if discovered have a more profound effect on the patients overall health & wellness.

  7. Sonia shitole says:

    Helllo sir ….as m new to ur video series ….I have limited idea about hot to check for first point of contact …..so want to knw how do u do that …..if u have any video in basic occlusion pls do share
    Thanks
    Regard Sonia shitole

  8. Dr. Abrar says:

    That’s great…. awesome.., your approach is real awesome!!! Thanks a lot….sir, Dr phelan , would like to show n share few of my patients having occlusal issues not only disturbing thier bite but frequent headaches..too,.,my gut says correction of occlusion will help them,what do you think

  9. Dr. Robert Tinnin says:

    Your right on target with this informative video. This is a great way to reinforce good technique! Thanks for shareing.
    Dr. Tinnin

  10. Jonna D Lopez says:

    Thank you for sharing your knowledge. Very informative video. Looking forward for more of your videos.

  11. I am new to your your seminar series,joined yesterday ,enrolled by neighbour dentist at a Spear seminar that strongly recommended your course series,that is why I missed live webinar.
    I watched your recorded webinar last night.I really Iike your style of teaching and do appreciate all knowledge you accumulated.I am very excited to be part of your community.
    This is absolutely perfect timing,talking about fractured veneers.Things go well…. and then vertical fracture on an upper left central along distal line angle and mesial 3/4 plus of veneer is debonded,distal part still in place.
    About six months agoI replaced 6 anterior 20plus years old unesthetic veneers with Monolithic Emax veneers.,placed direct composite veneers on all bicuspids.As I was not changing occlusion models were hand mounted on articulator.
    I used laser (ErbiumYag Light walker) to remove old veneers and they popped easily,existing preps were into dentin.
    I was thinking what were these veneers bonded with,so they lasted for such a long time.
    I am still in Scottsdale and don’t remember if the one veneer that just fractured is on the same tooth that I needed to repair due to debonding.

    So definitely I will be in communication with you,
    There are couple of worn dentition cases waiting for me, my 2 staff members.
    Thank you very much

  12. Joshua Day DDS says:

    This approach makes perfect sense. I’ve started Dawson Academy training and they also talk about this. The key is getting an accurate CR record. I started doing this about four months ago and it’s amazing what you find! I’m having to revisit some cases where there’s significant wear that I didn’t CR mount. I previously recommended crown lengthening prior to crown and bridge and now I see a significant CR-MI slide and don’t need to do crown lengthening or open VDO. Equilibration usually shifts the occlusion distally on posterior teeth and lingually on anterior teeth and creates more space in the esthetic zone. Good informative tutorial to get the wheels turning!!!

  13. I’ve recently seen your videos, and I’m so happy that I can be part of your community!! You teach very well, I’m still a student, but I want to learn more and understand more, so THANK YOU!
    I have a question about the video. So, practically, you changed a long centric into a point centric? Or just reduced the slide to something less significant?

    • Joshua Day DDS says:

      Sorry to interject but I saw this and wanted to comment on this. With equilibration you’re eliminating the slide from CR-MI so the teeth ultimately contact harmoniously in a hinge position where the condyles are fully seated superiorly against the articular eminence. With planning restorations you should always check for long centric and accommodate for it. Long centric is a change in occlusion that occurs from moving from a supine position to an upright position. Equilibration doesn’t eliminate long centric.

  14. Thanks for sharing your knowledge. I admire your dedication and I am a fan.

  15. Dr. Abdallah Abdalgawad Ali Mohamed says:

    Thank you very much for helping & teaching excellent dentsits for excellent practice.
    Ver nice for your simple video,,simple way for teaching.

    I really appreciate your efforts to much

    ThanKs again

  16. Safrida hoesin says:

    Thanks so much for sharing the case…. And, you remind us to have a balance occlusion before starting the treatment… Excelent

  17. Dead Dr
    I would like firstly thank you so much that you are so eager to giving your students every useful points
    My inquiry is about your your tube .i really do desperate to have your explanations practically and theoretically .Please try to send me workshop videoes like sinus lifting , immediate implant , preparation tooth for porcelain crown,loading some implants for denture ,and finally prefacing for full denture
    Sincerely
    Husee

  18. Sharon Goodwin says:

    Stephen nice cases!! Do you equilibrate as you are doing the wax up? In the full mouth case hwere you had to lengthen teeth did you equilibrate as you designed your wax up around the anterior tooth length and corresponding increase in VDO? Thank you!!!

  19. Thank you for sharing your experience with the dental population. You are truly a giving person.

  20. Would you expect stability with occlusal adjustment or would you evaluate the muscles as well?
    After equilibration over a 20 year span and continual grinding I was left with 50% of my lower incisors. If there had been a way to stop the action sooner I would have much more enamel in my mouth. Erosion was not an issue.

    I appreciate your presentations very much!

  21. Simply Awesome

    Your passion for doing good work is infectious

    We are interested to join your Occlusion Seminar

    Kindly keep me posted

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