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Dentures
   
   

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.

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