Complete dentures are fabricated when the patient
has all of his or her teeth missing. It generally takes 4 or
sometimes more appointments to make a set of standard
dentures.
The first appointment consists of an oral examination,
sometimes X-Rays, and a set of impressions of the upper and
lower edentulous (toothless) ridges (gums). These
impressions are poured with plaster to form accurate models
of the shape of the edentulous ridges.
These first set of impressions are then used to make custom
fitting impression trays for a second, more accurate
impression at the second appointment.
The third appointment is called the "wax try-in". This is
basically a trial stage where the teeth are placed in wax
and look like real denture.
This gives us the opportunity to see how the denture looks.
If required any changes can be made for better results. If
the teeth look too long, or the patient clicks when talking,
or the midline is wrong, we can send the denture back to the
lab where a technician can melt the wax and reset the teeth
to specification.
At the fourth and final appointment the denture made in
acrylic is delivered to the patient with proper
instructions.
Immediate dentures
Immediate dentures
(sometimes called temporary dentures) are actually
made BEFORE the natural teeth are extracted. The patient
walks into the office with natural teeth, and walks out with
false teeth. The teeth are extracted, and a prefabricated
denture is inserted directly over the bleeding sockets. The
patient is still numb from the extractions, and nothing
hurts until he gets home. Generally, most patients do not
complain of much pain after their teeth are extracted and
the immediate denture is inserted. The denture acts like a
band aid and reduces pain.
The construction of an immediate denture
requires only one or two preliminary appointments before the
insertion date, depending on how many natural teeth the
patient has left. They usually work out reasonably well.
When the patient leaves, he looks much better than when he
walked into the office. The bone that supported the
original teeth is still intact, and the gum tissue is firm.
For the first week or so, the denture remains stable and
reasonably retained.
At the end of 4 to 6 months, the immediate
denture must be relined with the same acrylic that the
denture base was made from originally. The longer you
wait, (no more than 6 months), the longer you can expect the
denture to remain tight before another reline is needed.
Implant retained dentures
Implants are placed at strategic locations by
a surgical process. Implants are basically titanium
cylinders which are drilled into the bone. After 4-6 months,
once they have osteointegrated with the bone they are able
to support complete dentures .
A minimum of 2 implants need to be placed to
support a lower denture which would not otherwise be
tolerated by that patient. Implant retained lower dentures
have special significance for people who cannot wear lower
dentures. The addition of two implants in the front of the
lower jaw can make it possible to retain a lower denture
which would otherwise be impossible for the patient to
tolerate. The image on the left below shows a pair of ball
attachments on implants, and the denture that fits over them
is shown in the image on the right.
For more information and case studies
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