Darin O'Bryan, D.D.S. With buccal bite we are able to reproduce the patients existing occlusion with incredible accuracy. But when should you take the buccal bite? You will get varying opinions. I prefer to take the buccal bite before I start preparing the teeth. There are few reasons for this.
First if I take the bite after I have prepared the teeth. The patient has been open most likely for over 10 minutes. Figure with preparing the teeth, retraction, hemostasis and imaging at least 10 minutes will have passed. Since I use and isolite on every case the patient has not closed down for this 10 minutes. This is long enough for the proprioceptors to get deprogrammed ergo the patient may not bite down in their “normal” bite any longer. By taking the bite before hand the patient will be able to bite down in their normal maximum intercuspal position.
The second reason to do it before hand is the patient is not anesthetized yet. Again their proprioception is normal. While anesthesia does not affect the proprioceptors patients certainly think that it does and acts accordingly. How often do we get a patient numb and then they say “ I can’t tell if I am biting down I am to numb”. This is avoided by taking the images before the anesthesia is given or sets in. This is especially true when giving an inferior alveolar or any quadrant anesthesia.
Lastly it gives either my assistant something to do before I get in the room or for me to do while I am waiting for anesthesia to set in. With the omnicam I am more likely to have my assistant go ahead and take the buccal bite, otherwise I give anesthesia and before it can set in I take the buccal bite. I then place my isolite and take my opposing. Since I use 4% articaine with a buffering solution on everyone by the time I am done with this they are ready to start prepping.
By taking the buccal bite before the procedure you have a better chance of capturing the patients preferred intercuspal position and also save your self a little bit of time.
