A denture design dilemma successfully resolved

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  Posted by: The Probe      2nd June 2018

John Stoodley is a partner and Clinical Dental Technician (CDT) at Wessex Dental Laboratory in Dorset. He is a member of the British Association of Clinical Dental Technicians (BACDT) and is dedicated to the provision of private denture care. With a dental laboratory, three state-of-the-art surgeries and a wide range of materials and systems, John and the highly qualified team have helped to improve the appearance, daily function and confidence of many patients. Recently, John used Ultaire™ AKP to resolve a denture design dilemma and here he details the case:

A gentleman in his 60s presented at the surgery wearing a very old

partial upper chrome-cobalt denture. He explained that the UR3 was continually being knocked off the denture and I could also see that three teeth; the UL4, 5 and 6 were very worn down through occlusal forces. Understandably, the gentleman wanted to renew his denture, but he also needed a solution that would also prevent the UR3 from breaking off. The patient’s tight bite and over closure meant that the tooth was coming away very frequently and it was affecting his confidence considerably, so his main criteria was to prevent this from happening. 

I had a treatment plan to provide an upper partial denture, but it was particularly important to go through all the options with the patient and find a suitable material to ensure the best possible outcome. I advised against an acrylic RPD as this as this this would cover more tissue surface area as well being thicker once processed. The UltaireAKP frame would not only add the strength required without adding more material, but also the aesthetics of hidden retention clasping. I also explained that achieving retention with a new chrome frame was likely to be difficult due to the tightness of the bite and, there was every possibility that the teeth would again keep getting knocked off. To this end, I suggested a removable partial denture (RPD) framemade from UltaireAKP, which is a strong, yet compliant metal-free material. The patient agreed and we decided to design an Ultaire RPD frame so that the UL3and UR4 & 5had a backing, which we could then bond with composite veneers to the front.

First impressions were taken as well as special tray impressions. As the bite was over closed I opened this up a bit to allow for the increased vertical dimension. I also had to ensure that the lower dentition all occluded exactly with the Ultaireframe so that when the veneers were bonded on, there would be no knocking of the teeth in lateral excursions. I then did a try in to make sure the position, shade and aesthetics were all correct before the frame was milled in-house. I should also point out that the Ultaireframe was designed in close cooperation with clinician and design team. The whole process from scan, design and mill took less than 3 hours. It was specifically designed so that it could be sandblasted, making it possible to bond the composite facings on, which were all custom made by our laboratory team.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

There were no issues with the production of the RPD, UltaireAKP is very efficient to work with and the design was a success. The setting was no problem, the aesthetics were good and my patient was delighted.

The gentleman has since returned to the surgery for a review and everything was good apart from a small clasp on the UR4, which was visible if you looked at him from an angle. Face on there was no problem but just a very small part of the Ultairematerial was showing from an angle and this concerned the patient. All I had to do was trim the material back a little bit and increase my composite tooth slightly. I took the colour out the Ultairecompletely and now the clasp cannot be seen at all. Other than this, the patient had not experienced any issues in the two months since the final fitting. In terms of comfort, retention and aesthetics it is a successful result and most importantly, no teeth have broken off.

I am delighted to report that the patient has regained his confidence. He is now able to go out, eat and socialise without the fear of a tooth breaking off from his denture. The patient also finds the UltaireAKP frame a lot lighter and more comfortable than the metal framework and feels that the denture is much more secure in his mouth. He said…

“For many years I have had a metal plate in various forms that take a long time to get comfortable with. I’ve also suffered from teeth breaking off numerous times. The new partial was comfortable from day one, it fits very closely, I have no problems eating, it looks very good and it has solved my long term problems.”

Once again, John and the team at Wessex Dental Laboratory were pleased to offer exemplary denture care and help this patient to recover assurance and improve his quality of life.

 

 

For more information about Solvay Dental 360™, Ultaire™ AKP and Dentivera™ milling discs, please visit www.solvaydental360.com

 

 


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