Occlusal refinement of mounted casts before crown fabrication to decrease clinical time required to adjust occlusion

An inordinate amount of time is often required to adjust the occlusion of a newly fabricated crown.

This study determined whether the procedure of "cast adjustment" significantly decreases the time necessary to clinically adjust the occlusion of a newly fabricated crown.

Thirty-eight crowns were fabricated by a commercial dental laboratory for patients of senior dental students at the University of the Pacific School of Dentistry. After master casts were returned from the laboratory and then mounted on semiadjustable articulators by the students, the cases were divided randomly into 2 groups: (1) the control group, for which no further work was performed before fabrication of the restoration; and (2) the experimental group, in which casts were occlusally adjusted by a certified laboratory technician until there was at least 1 cusp tip to flat surface centric contact on each posterior tooth in maximum intercuspation position. After the crowns were delivered, the students filled out a survey. One question on the survey asked the student for the time required to adjust the occlusion on the crown.

Of the 19 crowns in the control group, 6 crowns required more than 1 hour for occlusal adjustment. Of the 19 crowns in the experimental group, 1 crown required more than 1 hour for occlusal adjustment.

Performing a "cast adjustment" before fabricating a single unit casting can significantly decrease the chance of a lengthy clinical occlusal adjustment.