Improving interocclusal records for crowns and fixed prostheses.

JADA Middle East vol 2 No 4 Jul-Aug 2011 JADA 142(4) http://jada.ada.org April 2011 441 Fixed prosthodontics is one of the major components of clinical activity for U.S. dentists. It has been estimated that in 2010, about 36 million units of fixed prostheses were placed in the United States (R. Braswell, coexecutive director, National Association of Dental Laboratories, oral communication, Jan. 7, 2011). Assuming that there are about 140,000 active general dentists and prosthodontists in the United States, that means that the average general dentist or prosthodontist placed about 257 units during the year, or about 21 units per month. Multiplying this number by the average revenue produced for a crown in the United States (about $900) indicates that gross revenue from crowns was about $231,000 per dentist for the year. That number is about 30 percent of the average overall annual gross revenue of the approximately $780,000 reported for a general dentist by the American Dental Association (ADA). In other words, it obviously is important that dental students, and subsequently dentists, are competent in fixed prosthodontics. However, there are questions about whether this has been achieved. I routinely hear reports from dental laboratory technicians about challenges with the tooth preparations, impressions and interocclusal records they receive from their dentist clients. In my opinion, all three of those topics need immediate and in-depth attention from instructors in dental schools and dental continuing education settings. In this article, I will discuss one of those topics: methods by which dentists can make more adequate interocclusal records that are based on scientific evidence, on my observations of crowns and fixed prostheses that have been accomplished in laboratories in this country, and on opinions held by me and by the laboratory technicians at CR Foundation in the course of nearly 50 years. THE CHALLENGE WITH INTEROCCLUSAL RECORDS