Valplast Full Denture?

[denturist-student]

Exactly what I did... a silicone putty impression of the denture surface with a stone index of the intaglio surface. I then made wax molds of the dentures much like a duplicate denture. Then I mounted it on a Hanaumate arbitrary mount using the stone intaglio casts. I measured the old vertical with an outside caliper guage (picked up from Lee Valley) in three places (Tuberosities and incisive papilla). Confirmed on the mounted case using an inside guage..(Indellible pencil tranferred measurement points to models.)...

I incorporated the changes that should be made in the setup and did a setup at that vertical. I did a setup using stabilized light cure baseplates of and obtained an upper impression using silicon pvs. (dual viscosity technique)

Since the bite was quite close to the original via the caliper readings I inserted the processed lower and did a chairside Tokoyama Softliner M reline and that restored the original bite and made for a better lower impression. It was very close....Centric was taken from the old denture impressions and was very close.

My thinking was that the original denture setup had the upper incisors way outside anterior functional limits and posteriors setup on flat plane rather than compensating curve.

You were quite right that I should not change the bite at all so I did not change the vertical nor the class three protrusion. I merely reset the upper teeth back within functional limits and then tilted the lower incisors inward as my be-learned instructors taught me to do with class three's. First time I have ever done a two insertion denture...One for upper reline impression at try in and one for the lower chairside reline impression during insertion...... (Actually did a confirming insert of the lower for vertical and centric) Most of the concerns were functional and cosmetic. I also set the posteriors up on a curve rather than flat plane...I have remade about four or five of those already using a Dentsply 20 degree template...

Normally on a flat ridge I will do a Neutral Zone impression using an Ivolene baseplate with a wire cage and let the Hydrocast flow where it wants too...

End result is she gets a more functionally correct setup at her old bite and a soft liner as well....best I can do....

Thanks for your suggestions...
...Great minds think alike....

 

[Flipperlady]

What teeth did you go with? Flat, 20 deg., 10 deg, or a combo of 10 or 20 over flat? My first thought would be to go with the combo, but would have to see ridge before I would choose upper degree.

 

[denturist-student]

Extremely flat ridges both upper and lower. I chose zero degree Arctics to allow some flexibility in the centric laterally. I have done this many times. Patients who are on soft diets will accept this quite well. I just might try your suggestion as I have seen some patients with dangling tuberosities and reasonably good support. I may try a ten or twenty degree on top for shearing in a lingualized setup but am reluctant without some absolute centric to work with. Her existing teeth were zero on both upper and lower already....I just put them on a curve and verified excursive contact in the mouth which was very close...Broad flat upper ridges...I mean really flat...hard to get any suction at all but it stays in place. soft liner on bottom is very comfortable for the patient. She had an old molloplast before on under-extended base....The broad and flat upper ridges leaned me towards zero on both upper and lower. But the case is done now and no more sore spots along with esthetically pleasing results for both patient and family...Patient insisted she doesn't want that "Monkey mouth any more"...and asked "if my dentures would be comfortable"....which the Tokoyama M chairside reline did the trick. I did round the lower flanges out somewhat from the original to accommodate the Tokoyama reline....which requires 2 mm clearance before taking the impression. Worked out quite well actually. I do a lot of chair-side relines with that on the lower....that lasts about two or three years and then I cut it out and replace it....A lot up here are using Karlens Easysoft chairside or in lab which is about half the cost...but quite easy....and the Silicon relines don't have a bitter burning flavor that the tissue conditioners do.
Appreciate your suggestions as always though....Thanks so much.
Hard to find a tissue conditioner that doesn't taste like crap...Tempo is great stuff in the lab and gives good results but sometimes burns....Better success with Hydrocast but still bitter tasting....A dentist I met at a seminar suggested Ufigel by Voco for a soft reline material chairside.
Do you have any favorites for a chairside soft reline?

 

[Flipperlady]

I was reading that the Tokoyama is a good chairside. Astron makes a good light cure chairside reline but it doesn't hold up for more than a few months.
You're on the right track though, maybe just make sure they come in and have the chairside reline changed every few months.

 

[denturist-student]

My understanding is that Tokoyama M can last for two years....I have had some bonding problems with Easysoft...Tried to use Flexacryl by Lang, same people who make tempo but it tends to taste horrible and some say it burns. Same with Tempo TC. I will give Tokoyama a try and even may get some hydrocast to see itf it is tolerated better.

FYI I run a completely outpatient service....basement is full of lab equipment. So looks like the Tokoyama stuff is the cats meow....Someone suggested Ufigel too by Voco.
I will follow up with a pp how this all turns out after a few weeks post insert. Thanks again so much for all the advise.

 

[AJEL]

Dental student if you have managed to obtain impression and have setup you might think of using a hypoallergenic flexible denture material such as acrytone or Vynacron Vynapac. the acrytone is more flexible. accuracy pretty close when using their system. a Head pressure of 3 metric tons eliminates the old valplast palate space, it is a PMMA Vinyl material melted at 273*c 25 min. I am using material in flexipress and have technique worked out if you are interested. The myreson variflex can obtain head pressure in the 2.2 metric ton range, TCS about the same, lld screw units have head ressure depending on flask from 1-4 metric ton.
Acry-tone polishes super glass smooth and may assist insertion,note cleaning with only dishsoap & soft brush, have noted some loss of shine if patients use tooth paste with abrasive toothpaste contains.

 

[denturist-student]

Dental student if you have managed to obtain impression and have setup you might think of using a hypoallergenic flexible denture material such as acrytone or Vynacron Vynapac. the acrytone is more flexible. accuracy pretty close when using their system. a Head pressure of 3 metric tons eliminates the old valplast palate space, it is a PMMA Vinyl material melted at 273*c 25 min. I am using material in flexipress and have technique worked out if you are interested. The myreson variflex can obtain head pressure in the 2.2 metric ton range, TCS about the same, lld screw units have head ressure depending on flask from 1-4 metric ton.
Acry-tone polishes super glass smooth and may assist insertion,note cleaning with only dishsoap & soft brush, have noted some loss of shine if patients use tooth paste with abrasive toothpaste contains.

Only had an upper impression so went with tokoyams soft reliner. It cures well in the mouth in about five minutes.My denture is a tad bit smaller than the original one so with a mouth mirror which I left behind and some biotene lubricant it can be inserted and removed easily. I can think of a few cases though where your acrytone might come in handy...But not enough cases to make it profitable.
These situations come around once in a hundred if that. But this one has been a good learning experience. Patient is doing much better and complains of far fewer sores after placing the posterior sextants on a compensating curve and then shifting the teeth back into a functional limits.....Every now and then as flipper central suggests we get a case where we need to think outside the box. How true this really is.

 

[AJEL]

Good to hear you worked your way thru, sometimes it takes not wanting to give up. It helps to have someone to bounce ideas off of as well, this forum for one, I am in contact with 5 techs with the I-Pad to show & tell as well. They are C&B folk wanting to get into removable and discovering the complex nature of the removable end of this industry.

 

[Cheryl Thompson]

Question, why do some dental office call a flexable denture a Valplast, when they are really selling is a no label?

 

[Sp00n]

Why do you call a Post-it a Post-it?

 

[Sp00n]

Pretty sure post-it is the name of a 3M product. Theyre probably self-adhesive note pads or something

 

[Doris A]

Question, why do some dental office call a flexable denture a Valplast, when they are really selling is a no label?

Probably because Valplast is a name that people recognize. Who knows, the product that was used may be better than Valplast.

 

[denturist-student]

Exactly what I did. Went for a four week followup call and she was wearing my dentures very well without any complaints. They will be classed as transitional dentures and go through a series of applications of a tissue conditioner....Been using coe soft lately for that so patients do not gag with Tempo. Seems to get the job done but it is very sticky and gooey not unlike Tempo.
Tried some c hydrocast and it woks well only for final impressions.
So all is alright for now.

Take care and keep well. DJC

 

[CoolHandLuke]

Probably because Valplast is a name that people recognize. Who knows, the product that was used may be better than Valplast.

this was what i was first told about procera. zirconia crown is what it is, procera is its brand. but a lot of dentists were introduced to zirconia as procera so its still a procera to that core group.

like facial tissue; its a Kleenex. cause Kleenex is its brand and about the only one that stood up for such a long time.

 

[lcmlabforum]

Check out this: expensive but recommended by maxillofacial tech and what they use in the clinic, good bonding agent.
http://www.gcamerica.com/products/operatory/GC_Reline_Soft/index.php
LCM

 

[denturist-student]

Good to hear you worked your way thru, sometimes it takes not wanting to give up. It helps to have someone to bounce ideas off of as well, this forum for one, I am in contact with 5 techs with the I-Pad to show & tell as well. They are C&B folk wanting to get into removable and discovering the complex nature of the removable end of this industry.

One of the most difficult things to do is explain that a person needs to shell out an extra $545 for a molloplast soft lining on the lower denture after already having paid about 2700 for a complete standard acrylic denture.....Extremely frustrating when they still get sore spots because of thin tissues or sharp ridges. In those cases I will ususally try a Tokoyama first...or alternative such as coesoft. to confirm that thier problem is with hard acrylic and bone meeting when biting force is happening.....very typical situation over a boney or sharp ridge or kinfe edged ridge etc....

 

[JKraver]

Question, why do some dental office call a flexable denture a Valplast, when they are really selling is a no label?

Bruxzir as well. Drs ask for bruxzir they mean full contour zirconia, but bruxzir is glidewells trademarked name.

 

[denturist-student]

Solution to this problem...Thinking outside the box, I took full external an intaglio impressions of the existing denture Much like one would do for a copy denture. Then I made models using stone and mounted them on a base made of elite 85 and reinforced that with normal stone. I then made a full setup using custom lc baseplates and made changes I wanted to see in occlusion and anterior esthetics. I opted for some zero degree setup on curve for lower posterior teeth adn some Candulour uppers setup in lingualized form but as suggested kept the same vertical dimension from the former bite....Also replaced existing anterior farther back.........Went ahead and processed leaving a bit of room for tissue conditioner as Turbyfil suggests....Then I took those dentures down tot patient and loaded some COEsoft on lower and Coecomfort on upper and left in vivo for several days....Relined and reprocessed upper in acrylic and lower in valplast...NO complaints yet and it has been two years...