Acrylic.....

JKraver

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As a dental tech you always look at the material and what you did wrong or how you could save the Drs a$$. Pt compliance generally never enters my mind, but your are probably right about the compliance thing.
 
kcdt

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Never said that. Of course it wouldn't fit. Might get close, but rare to get it to fit.
Dentures originally fit the original model after processing very well. Whats the point if they don't.
After a few weeks in the mouth they did not.
Only a couple of cases have been like this, the rest are fine.
Starting to think it was the patient leaving them out to dry as they were sore......
That would do it. Every textbook on dentures warns against allowing the resin to dry out.
 
lcmlabforum

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I have seen those who make remount casts dispense with the putty...They fill the deep parts of the intaglio with wet tissue paper and then just make a cast....YOu really only need the vestibular periphery to capture a remount cast....give it a try and save some putty for repairs.
Tell me about it!
Putty cost money like VPS impression material nowadays.
Tried the 'paper mache' block out, just not presentable and
typically do not have enough retention to actually adj occlusion
without denture dropping or shifting when going into excusions.
Thanks for point that out, though.
LCM
 
wojtek121

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You can ask the patient how he cleaned dentures, if he does it in boiling water it may not fit
 
denturist-student

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Tell me about it!
Putty cost money like VPS impression material nowadays.
Tried the 'paper mache' block out, just not presentable and
typically do not have enough retention to actually adj occlusion
without denture dropping or shifting when going into excusions.
Thanks for point that out, though.
LCM
If it lacks retention use sticky wax to keep it in place....Since you usually do the adjustments in the lab, the presentation is not that critical...Actually the dentist wil not even see it....Remember also that we make the remount casts using slurry water in the lab and then mount them using a saved facebow index. Once mounted then we will equilibrate on the articulator....If you don't have a facebow index it takes about five minuites of patients time.....but if you are a lab I understand about presentation to the dentist...I am speaking from the point of view as a denturist where our lab is right in the clinic or right in the baack of the office.....ergo we can do lots there.
 
lcmlabforum

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Sorry did not disclose: I am prosthodontist with OCD. The putty is only inside the ridge areas, and if necessary with flabby ridges,
after block out of the deepest undercuts. Paperclips will then be placed to secure it before pouring/inverting to a base of mounting stone.
The mounting stone preserves borders and the vertical stop. All complete dentures sets have a facebow preservation prior to separation
from the mounting and my lab will process for me after that. I do make occlusal adjustments in the lab after new records are made following
seat procedure to ensure the denture seats appropriately onto the arches, PIP, borders refined.
Many ways to skin a cat, just one here.
LCM
 
highscore

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Have you ever thought it might be your impression/casting and not the denture acrylic? Just one old guy's opinion. I have had similar issues with Lucitone 199. I don't use it any more. Make sure to leave your (assuming you are using heat cure) clamped casings stand for about a half hour under compression before dropping into the heat tank. Also one more thing to consider, is that if a patient has an impression taken at the end of the day the mucosa may be dehydrated and not at full shape. Have the patient come in first thing in the morning without wearing the dentures the night before, then take your impression. Use a good POLYETHER impresseion material like impregum. Polyvinyl siloxane doesn't cut it for me, and neither does a rubber base. Don't let anyone tell you otherwise. Impregum is better... (we had a meeting). Proper fit is all about compression. Compression of the tissue during impression, compression of the bite during occlusal registration, Compression during bite checks, and especially compression of the material in the flask. Another thing to consider is the patient's oral and general health. Are they taking Diuretic medication? Are they diabetic? Do they take any medications which effect blood pressure? These factors can greatly effect the day to day fit of a denture. If you put a denture in and it drops immediately. Don't panic. Let it settle into place for a while, sometimes it can take a few days for the muscles and tissues to settle and seal around the denture. Lastly, if that still doesn't work. Don't be afreaid to use a good chairside "reline filler" to capture detail such as Tokayama (not sure if thats how ya spell it) rebase. Excellent product. I also recommend Diamond D by Keystone. Fantastic acrylic to work with. Stay away from 20 minute curing of any kind. And be sure to bench cool and not shock cooling it in water after curing in heat. Remember basic chemistry... heat expands stuff, cooling constricts stuff. If you flash cool a flask full of hot acrylic, a thicker denture will shrink more within the flask because there is more acrylic to shrink. (duh').
 
M

Makes Dentures

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Thank you highscore--- you "get it". You have touched on many points that many techs (or dentists) have never even heard of before.
 
highscore

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Thank you highscore--- you "get it". You have touched on many points that many techs (or dentists) have never even heard of before.

Thanks Hombre... Perhaps I have been doing this too long
5652852.jpg
 
Doris A

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Have you ever thought it might be your impression/casting and not the denture acrylic? Just one old guy's opinion. I have had similar issues with Lucitone 199. I don't use it any more. Make sure to leave your (assuming you are using heat cure) clamped casings stand for about a half hour under compression before dropping into the heat tank. Also one more thing to consider, is that if a patient has an impression taken at the end of the day the mucosa may be dehydrated and not at full shape. Have the patient come in first thing in the morning without wearing the dentures the night before, then take your impression. Use a good POLYETHER impresseion material like impregum. Polyvinyl siloxane doesn't cut it for me, and neither does a rubber base. Don't let anyone tell you otherwise. Impregum is better... (we had a meeting). Proper fit is all about compression. Compression of the tissue during impression, compression of the bite during occlusal registration, Compression during bite checks, and especially compression of the material in the flask. Another thing to consider is the patient's oral and general health. Are they taking Diuretic medication? Are they diabetic? Do they take any medications which effect blood pressure? These factors can greatly effect the day to day fit of a denture. If you put a denture in and it drops immediately. Don't panic. Let it settle into place for a while, sometimes it can take a few days for the muscles and tissues to settle and seal around the denture. Lastly, if that still doesn't work. Don't be afreaid to use a good chairside "reline filler" to capture detail such as Tokayama (not sure if thats how ya spell it) rebase. Excellent product. I also recommend Diamond D by Keystone. Fantastic acrylic to work with. Stay away from 20 minute curing of any kind. And be sure to bench cool and not shock cooling it in water after curing in heat. Remember basic chemistry... heat expands stuff, cooling constricts stuff. If you flash cool a flask full of hot acrylic, a thicker denture will shrink more within the flask because there is more acrylic to shrink. (duh').
I agree with almost all of what you've said here except if the patient is taking meds for high blood pressure they should not have impressions taken in the morning because their tissues are swollen from retaining water overnight. their impressions should be taken midday. I just did a reline on a brand new Ivocap injected denture because the pt didn't take their water pill before going to the Dr for their final impression first thing in the morning. When the denture was delivered it was loose. The reline impression was taken around noon and now the denture fits perfectly.
 
JMN

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Another concern with Fibromyalgia increasing in prevalence is whether they are having a 'flare', spasms or have the taken muscle relaxers today. I've seen vast differences of range and found that the doc or pt didn't factor the muscle relaxer into the equation of what motions would be nominally reachable and those that were fine only when medicated.

The annoying part is how rarely anything on the Pt's medical history sheet is communicated to the lab.
 
highscore

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I agree with almost all of what you've said here except if the patient is taking meds for high blood pressure they should not have impressions taken in the morning because their tissues are swollen from retaining water overnight. their impressions should be taken midday. I just did a reline on a brand new Ivocap injected denture because the pt didn't take their water pill before going to the Dr for their final impression first thing in the morning. When the denture was delivered it was loose. The reline impression was taken around noon and now the denture fits perfectly.


If you re-read what I wrote, you will find within my statement:
" Also one more thing to consider, is that if a patient has an impression taken at the end of the day the mucosa may be dehydrated and not at full shape. Have the patient come in first thing in the morning without wearing the dentures the night before, then take your impression."

In fact we both agree on the same thing.

"Another thing to consider is the patient's oral and general health. Are they taking Diuretic medication? Are they diabetic? Do they take any medications which effect blood pressure? These factors can greatly effect the day to day fit of a denture."

If you used a chairside reline to "tighten up" the denture then of course it will fit. But there is a lot of time that passes when final impressions for a new denture are taken, and the final product were inserted. Plenty of time for tissue change in a patient with plasiatic tissue. Everything you did is in agreement with my previous statement. So... ya know...


neener.gif
 
G

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Is the ulcer from the bite or the fit or both.for the bite i vasoline the model before investing processing and dig it out without breaking it then mount to the baseplates which have relocation grooves etc.i then grind in the bite i have good and bad days so sometimes more effort than others.i then deflask the rest of the denture polish and so on if it doesnt have good retention check post dam etc but most ulcers are from bites and sharp bits shrinkage is always a problem the best results ive seen are from ivocap base thingy which is really good.i wouldnt worry about the stuff you are experiencing to much its fairly standard not reading the instructions never really stopped any of us having an opinion HAHAHAHAH
 
lcmlabforum

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I agree with almost all of what you've said here except if the patient is taking meds for high blood pressure they should not have impressions taken in the morning because their tissues are swollen from retaining water overnight. their impressions should be taken midday. I just did a reline on a brand new Ivocap injected denture because the pt didn't take their water pill before going to the Dr for their final impression first thing in the morning. When the denture was delivered it was loose. The reline impression was taken around noon and now the denture fits perfectly.
Good point, but just to clarify, not everyone on HPT meds are on a diuretic, which would cause the patient to loose water instead of water retention.
If they on a calcium channel blocker, that may not matter.
Converserly, if it fits perfectly when it was relined that way, what happens in the morning - would it not be too tight?
Just my 2 cents.
LCM
 
highscore

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Good point, but just to clarify, not everyone on HPT meds are on a diuretic, which would cause the patient to loose water instead of water retention.
If they on a calcium channel blocker, that may not matter.
Converserly, if it fits perfectly when it was relined that way, what happens in the morning - would it not be too tight?
Just my 2 cents.
LCM


It's a good point... but as we all find in practice. Every patient is different. I find that most patients that take out their hardware overnight find it takes a while in the AM for the denture to seat back into place. I suggest patients start Drinking heavily to keep patients from getting sore spots from their dentures.
 
Doris A

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Good point, but just to clarify, not everyone on HPT meds are on a diuretic, which would cause the patient to loose water instead of water retention.
If they on a calcium channel blocker, that may not matter.
Converserly, if it fits perfectly when it was relined that way, what happens in the morning - would it not be too tight?
Just my 2 cents.
LCM
That's a good question that I don't have an answer to other than the Dr said it fit perfectly after I did the Ivocap reline.
 
lcmlabforum

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It's a good point... but as we all find in practice. Every patient is different. I find that most patients that take out their hardware overnight find it takes a while in the AM for the denture to seat back into place. I suggest patients start Drinking heavily to keep patients from getting sore spots from their dentures.
I think I should start drinking heavily just to be healthier than I am now!
(*NOT* that type of drinking o_O alcoholism not a joking matter).
LCM
 

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