How To Get Lip Support From Dentures
How To Get Lip Support From Dentures - This bulletin describes the step-by-step provision of implant-supported lower full metal dentures with three dental implants placed in the anterior mandible. The upper arch was restored with an upper tooth with a full metal base.
Mary had 3 implants placed in her front jaw 10 years earlier with brand new teeth. These were successful for a time. The dentures were replaced a few years later. Mary was never happy with her new lower dentures because the implants did not fit properly. This patient was referred to me from Ireland to my practice in Garstang, England.
How To Get Lip Support From Dentures
I put all metal teeth. The clinical condition and treatment process are shown in detail with the pictures below. I provided the clinical work and Rowan Garstang the technical work. The teeth took 5 visits - the patient flew from Ireland to Manchester. The patient had a revision after the dentures were placed.
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Pre-treatment - complete upper tooth lower - complete tooth protecting the implant The patient is not satisfied with the appearance of the dentures and the adjustment to the lower tooth
Pre-treatment - upper lower whole tooth - whole tooth protected by an implant. Non-engaging bonding attachments for lower tooth crowns. Optimally shaped restorations with poor tissue fit due to turning of the dentition. Smooth aesthetics
More muscle breaking on the left side compared to the right. Perhaps the dentist who took the impressions at work was right-handed. Poor prosthesis shape (extended below molar posteriors) probably from improperly extended personal tray
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The horn does not sit properly on the implants - damaging the Locator inserts. In the new houses I decided to remove the casings and temporarily improve the cold to improve Marys adaptation
Before cold curing the new attachments, I wanted to make sure the dentures fit snugly in the saddles.
PTFE washers are provided to place the cold cure acrylic on the placement piles. If these are not used, the denture will be locked in place - it must be drilled.
The new coverings are cold cured on the old tooth - a temporary measure while the new teeth are being made - this has made fitting the existing tooth supply more comfortable.
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Patient aged 8 years. This allowed the width of the upper central incisors to be calculated. 8.5 mm. Carol wanted to have teeth similar to her daughters beautiful natural teeth.
Treatment planning card with sequential treatment plan and budget. This is how I plan the treatments of all my patients
Lip extractions made from photographic retraction are very useful for placing the impression tray in the mouth.
The light body alginate syringe is placed in the hole by the hamular notch around the hamular notch. Heavy body alginate is shipped in a Schotlander Edentulous tray.
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Spray clear alginate in the retromylohyoid region around the lingual sulcus over the retromolar and around the buccal and labial sulcus. A frame cutting tray (available from Metrodent) is loaded with heavy body alginate.
Greensticks right and left buccal shelves from the canine to the second molar position - avoiding a retromolar cushion - are adapted to the patients mouth with the patient saying EEE and OOO with exaggerated cheek movements.
Greenstick right - right and left bilaterally from second molar to second molar - avoiding the retromolar - is adapted to the patients mouth by having the patient lick the upper lip from the right to left commissure, pushing the tongue against the lower.
Tray fitted - where the tray shows through the impression material is not an issue as the tray is made to fit the exact primary mould.
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Tray set - where the tray shows through the impression material is not an issue because the tray is made to fit the exact primary mold.
The usual top tray is divided into 2 layers of wax - 3mm alginate or silicone for impressions. This is 2 mm from the depth of the groove around the entire edges. In the area of the post dam the tray extends 1 mm beyond the fovea palatini.
Greenstick is crossed in the dog and post dam regions. This recreates the wax spacer used to produce the tray.
Greenstick is then applied to the edges of the tray from the 4s to the tuberosities; this improves absorption/retention. This is placed in the patients mouth to break the muscles and the patient is instructed to move their jaw from right to left.
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A very fine mixture of alginate is placed (so as not to overfill the tray) and glazed with water. The same cuts and movements as the Greenstick app are performed, with 1 second of firm suction. Keep the edges thin
Primary jaw register - used for assembly of working money, correct configuration of the central support apparatus - gothic arch tracking system
Central bearing device - Gothic arch tracking system - mounted on workbenches mounted using the main jaw roll.
Visit 3 registration steps - prescribing the position of the upper teeth and the correct vertical occlusal dimension
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Support lips Incisal plane - the level of the Occlusal plane IPD - the level of the ala-tragus corridors Buccal - according to the tooth image Midline - according to the tooth image OVD - if they see well - they are correct
These are the pictures the technician must have. Mary wanted her smile to be like her daughters. I have preserved the anonymity of Mary and her daughter in this slide but the technician will take full face photos.
Upper central incisor tooth size calculation formula - The following slides are a different person to preserve Marys anonymity
If a picture of the patients front teeth is available, Dr.s tooth size formula can be used. John Besford to estimate the size of the prosthetic teeth.
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Top center cuts 8.5mm wide - Scottlander Enigmalife teeth. To match the exact shape of her daughters teeth.
Appropriately trimmed margins are used to establish the patients vertical dimension during the 3rd visit. After the 2nd visit, the articulated working casts are used with the primary margins.
The central bearing apparatus is set in the same vertical occlusal dimension as the carved wax rims by opening or closing the screw in its lower part. This sets the vertical dimension of the central bearing apparatus in Marys OVD. Thus, Gothic and
Part 2 of visit 4 - Tracing Gothic arches - made to fit working molds correctly - using lightly cured tray making material. This allows accurate recording of the centric relation - much better than wax blocks
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Sequence of use - the patient is instructed to move the lower jaw back - this is a central relationship
The front of the triangle is the most reproducible position of the jaw in a patient-centered occlusal relationship.
The front of the triangle is the most reproducible site of the jaw in a well-educated patient. Sometimes I check with a tap point on the pronunciation paper if the tip of the triangle is not clear enough.
The central bearing apparatus fits into the mouth and the lower jaw fits into the hole in the upper plate.
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The central bearing apparatus is fitted together with Futar D bite registration material - locking the position of the jaws in a central relationship.
Visit 4. The bite fork is attached to the wax rim used to attach the upper working cast to the articulator
The biting fork is attached to the wax rim used to attach the upper working mold to the articulator
A facebow glued to the wax margin is used to place the upper working cast on the articulator
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At the end of the visit 3 Rowan restores the carved upper and lower edges, face bow transfer (used with the upper wax edge, the central bearing apparatus installed in the CR, together with the working molds supplied in previous).
The working casts are released from the bases that held the articulator using the main jaw roll. The upper working mold is attached to the articulator using a biting fork
The lower working mold is attached to the lower limb of the articulator using a central bearing assembly
Rowan then uses carved wax edges to set the teeth. Note the skeletal arrangement of class III
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Rowan then uses carved wax edges to set the teeth. - ready to test the teeth. - Pay attention to Class III skeletal arrangement
Rowan then uses carved wax edges to set the teeth. - ready to test the teeth. - Pay attention to the bilateral crossbite
Try checking the occlusion first. No occlusal defect is detected when using Gothic arch tracing
Mary watches her video (with the sound off) talking, smiling, and trying to communicate with her dental supplies.
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