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Dentures

Dentures

Dentures in one form or another have been around for many years. The earliest recorded use of dentures was more than 2000 years ago. A denture is an appliance, which is worn to replace lost or missing teeth to enable you to enjoy a healthy diet and smile with confidence. A complete or full denture is one, which replaces all of the natural teeth in either the upper or lower jaw. A partial denture fills in the spaces created by lost or missing teeth and can be attached to your natural teeth with metal clasps or devices called precision attachments. Dentures can be made to closely resemble your natural teeth so that little change in appearance will be noticeable. A well-designed and made denture can have a fantastic effect on your appearance.

Modern dentures are most often fabricated in a commercial dental laboratory or denturist using a combination of a tissue shaded powder polymethylmethacrylate acrylic (PMMA) for the tissue shaded aspect. These acrylics are available in both Heat Cured and Cold Cured types. Commercially produced acrylic teeth are widely available in hundreds of shapes and tooth colors.

The process of fabricating a denture

usually begins with a dental impression or initial impression of the maxillary & mandibular ridges. Standard impression materials are used during the initial impression process. The initial impression is used to create a simple stone model that represents the maxillary and mandibular arches of the patients’ mouth – this is not considered a detailed impression at this stage. Once the initial impression is taken, the stone model will be used to create a Custom Impression Tray which will be used to take a second and much more detailed and accurate impression of the patients maxillary and mandibular ridges.

Polyvinylsiloxane impression material is one of several very accurate impression materials used when the final impression is taken of the maxillary & mandibular ridges. A wax rim is fabricated to assist the dentist or denturist with establishing the vertical dimension of occlusion. After this a bite registration is created to marry the position of one arch to the other.
Once the relative position of each arch to the other is known, the wax rim can be used as a base to place the selected denture teeth in correct position. This arrangement of teeth is tried in the mouth so that adjustments can be made to the Occlusion.

After the occlusion has been verified by the Dentist or Denturist with the patient, and all phonetic requirements are met, the denture is processed.
Processing a denture is usually performed in a lost-wax process whereby the form of the final denture, including the acrylic denture teeth, is invested in stone.
This investment is then heated, and the wax is removed through a sprue when it melts. The remaining cavity is then either filled by forced injection or pouring of the uncured denture acrylic which is either a Heat Cured or Cold-Cured type of denture acrylic. During the processing period, Heat Cured acrylics – also called Permanent Denture Acrylics, go through a process called Polymerization causing the acrylic materials to bond very tightly-and taking several hours to complete.

The end result is a denture which looks much more natural, is much stronger & durable than a Cold Cured Temporary Denture, resists stains and odors and will last for many years. Cold Cured or Cold Pour Dentures-also known as Temporary Dentures, do not look very natural, are not very durable, tend to contain a high percentage of porosity and are only considered Temporary until a more permanent solution is found.

These types of dentures are inferior and tend to cost much less due to their quick turn around time (usually minutes)& low cost materials and teeth. It is not suggested that a patient wear a Cold Cured denture for a long period of time, for they are prone to cracks and can break rather easily. After a curing period, the stone investment is removed, the acrylic is polished, and the denture is complete.

Problems with dentures

include the fact that patients are not used to having something in their mouth that is not food. The brain senses this appliance as “food” and sends messages to the salivary glands to produce more saliva and to secrete it at a higher rate. This will only happen in the first 12 to 24 hours, after which the salivary glands return to their normal output. New dentures can also be the cause of sore spots as they compress the soft tissues mucosa (denture bearing soft tissue).

A few denture adjustments for the days following insertion of the dentures can take care of this issue. Gagging is another problem encountered by a minority of patients. At times, this may be due to a denture that is too loose, too thick or extended too far posteriorly onto the soft palate. At times, gagging may also be attributed to psychological denial of the denture. (Psychological gagging is the most difficult to treat since it is out of the dentist’s control. In such cases, an implant supported palateless denture may have to be constructed).

Sometimes there could be a gingivitis under the full dentures, which is caused by accumulation of dental plaque. One of the most common problems for new full upper denture wearers is the loss of taste.