Christmas Denture Story by Dr. Russell Schafer
Christmas Denture Case Story
by Dr. Russell Schafer
Over the holidays, one of my friends asked me for some help with her case. She is a dental student and her patient wanted some dentures in time for Christmas. I agreed to help her make some if she and the patient were ok with me getting documentation. This case turned out to be great for showing processing and delivery as you can see the errors we got along the way.
We decided to make 3 different types of printed dentures: monolithic, printed base and printed teeth, and printed base and nobilium teeth. We used NextDent Denture Base resin printed on my Moonray and C&B MFH resin printed on my NextDent 5100. She provided me with excellent impressions and they were mounted and scanned and I designed the dentures. The patient gets to keep whichever one he likes the best.
The patient had his teeth removed a few months prior and you can see that he is still healing. I set the anteriors by looking where the bone was in the past and trying to imagine the roots of the teeth coming out of the bone and into the crowns. After I set the anteriors, I set the posterior by using the retromolar pad.
The first denture we processed was the monolithic. These are my go to as they are the easiest to make. Print it out, clean it up in some isopropyl alcohol (IPA), cure it, and then polish it back. The material is a bear to polish as it is much stronger than the red denture base. It is difficult to get the beauty that you want in them as well unless you want to color the gums. I personally opt not to color the gums on them simply because it adds to the cost and processing time. You can see when the denture is delivered that everything lines up like we want it to, but the esthetics are lacking.
The second denture was the printed base and printed teeth. These are tricky only because of how we print out the teeth. Because the teeth are printed out so that the cusps are used for support which changes the occlusion. However, we get a satisfying path of insertion with them as we can literally just snap the teeth in one piece into the bases. For this one my process is print them out, clean in IPA, place a bit of red denture base in the sockets and place the teeth, tack cure, and then place in curing oven. Finally polish up making sure that the supports are removed from the cusp tips. You can see in the final picture from delivery that we didn't remove all the supports so the patient has an anterior open bite. The final denture was the printed teeth and nobilium teeth. We have to print out two different denture bases for these with one base being used to cut back the nobilium teeth. After printing out the bases, clean them in IPA and then modify the teeth. We snap the teeth into the coping base with the cut outs and then just grind out the part that snaps through. I find that you really want to grind a tad more than you think you should so that you get a good. I like the make sure that each tooth fits well into the actual denture base before moving on. When we have all the teeth ground in and placed in the base, use a little of the red resin and tack cure each of them into place, then place in the curing oven. Polish them and you are done. When this one is placed in the mouth, you can see the midline is slightly off, but their is no anterior open bite due to better occlusion from using denture teeth.
Of the three dentures, the patient choose the one with the nobilium denture teeth. He left happy, my friend had two more dentures to show for presentations, and I got some good photos as well as a chance to document things step by step a bit. If you want to learn how to do these cases, they are really easy and this is what I'll be teaching at my next class in March.
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Dentures: Fit, Bite, and Smile Metairie, LA | March 6-7, 2020 | Dr. Russell Schafer More Info
BlueSkyPlan® is a dental planning software that can be downloaded free. The software can be used to fabricate Surgical Guides, Ortho Aligners, Dentures, Crowns and more.
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