Additive Subtractive Method
The Tooth Studio Dental lab has been a member of the American Academy of Cosmetic Dentistry since 2004. Though our sustaining membership is an accomplishment in itself, we are on our way to becoming accredited member.
The AACD allows us the opportunity to interact with dentists wanting to achieve the best dentistry possible that is in complete alignment with the goals and mission of The Tooth Studio dental laboratory. It has been an outstanding forum for learning and sharing of ideas, techniques and procedures.
The AACD has come up with a set of guidelines in restoring anterior and posterior teeth that brings back the natural form function and esthetics. The guidelines closely mimic the principles of The Biomimetic Approach of Pascal Magne, which we were introduced to at the Integra Institute in Metairie Louisiana. We have a checklist of soft and hard tissue attributes that we use to restore a case, and then
The Additive Subtractive Method is applied to show the patient and doctor what is possible without orthodontal movements. A duplicated model of the arch we are restoring is taken and analyzed to show what we can do with dental prosthetics. Teeth are labeled on what type of movement or reduction is needed to achieve desired results, i.e. moving mesial distally, or reduce adjacent teeth to make room for ideal tooth width, etc… First the teeth that are out of arch alignment are subtractively ground away from the model. Marked in blue or black, which shows the reduction of all the teeth being restored before any crown preparation is started. A bulk reduction guide is made, then wax is added to the teeth to make ideal taking in all of the esthetic requirements of the AACD and the biomimetic approach that are treatable within the global diagnosis for this patient. Then a duplicate is made and a suck down reduction guide is made. The reduction can be done visually by the restoring dentist, or physically through holes in the cervical middle and incisal thirds for probing depth. The Additive/ Subtractive method can be used for all types of dental restorations it is a precise tool in developing a treatment plan to all the way through the final restorations. The wax model is used to make a poly vinyl matrix to make temps chairside or custom Ivoclar Telio temps can be fabricated precisely through the new Nobel Procera Scanner.
If you as the doctor “buys” into this system completely and for every case you will improve case acceptance, increase predictability and esthetics and guarantee results. If you want to take esthetics to a new level, let us show you how.
While performing the additive subtractive method of reducing and adding to the model, we adhere to the principles of; and evaluate for all of the esthetic requirements in doing an AACD accredited case.
Which includes:Inclination of the teeth, gingival contours, and zenith height of soft and hard tissues.
To ensure patient acceptance, all embrasures of each tooth are designed and measured for optimal esthetics creating the most correct smile line.
For example: If we determine that a crown lengthening is going to be needed as apart of the global diagnosis, we would need you to measure the biological width and determine what type of crest is present on each of the teeth.
For posteriors we adhere to the Pankey philosophy of function, form and fit. With all of this information and our technique we believe it gives you the dentist and the patient all the necessary information to make a final decision that fulfills all expectations for superior restorations.
Add/Sub Method stages on lower jaw dentition
Original Dentition mandibularAdditive wax up mandibular
Final wax up mandibularFinal results in IPS e.max mandibular
