How do I get a parital to fit perfectly when the dentist seats it

[troutsnoggle]

I am duplicating my models with hydrocolloid and I block out the necessary undercuts and I get good feedback from the dentists. But can anyone suggest some ideas on how to make a partial (flexible or rigid) fit perfectly in the patients mouth without the need for the dentist to reduce tight spots and still have perfect retention? Ex survying methods, best material to duplicate models etc.
Thanks

 

[Flipperlady]

There is usually a week or more between steps to finish out a partial denture,so you are a good three to four weeks out before seating.
During this time teeth can shift making any well thought out plan pretty much useless. I've always thought the way to go would be a temp that holds the teeth in place until partial is finished.

 

[rkm rdt]

If the teeth are that mobile ,then a metal frame may not be the best option.

 

[Flipperlady]

They don't need to be very mobile to move just enough to throw a metal partial off and if pt. has had extrations in the last 6 months all bets are off.

 

[rkm rdt]

Exactly my point.

Lower free end frames act as crowbars on bicuspids

 

[rkm rdt]

In the old days , clasps were wrought wire or gold.

Imo, cast clasps are the problem.

 

[Flipperlady]

Well that's a different subject but yes given the right circumstances you are right. I'm talking about extractions from other causes. I dread making a framework on an immediate case and even offer to make a temp for free just because I know the framework will probably not fit right otherwise.

 

[rkm rdt]

I think your approach is the best considering you are speaking from experience.

In order to be compensated for your efforts, changing the name "temp" to " provisional" or " interm" would allow you to offer everything in a complete package.

Immediates usually need to be relined, so when there is a frame involved, all fabrication steps should be charged for.

I would dupe my models with silicone just to see if the fit is improved.

 

[Flipperlady]

In the old days , clasps were wrought wire or gold.

Imo, cast clasps are the problem.

This I agree with you on, gold is king. If I ever need a partial it'll be gold. I would have all gold fillings too but dentists now days don't like to use gold as much.

 

[Flipperlady]

This subject given the fact in a few years everything will be digitalized and milled/printed kind of makes me smile. The image taken will be only a snapshot of any given moment in time, the same issues will be there in years to come.

 

[rkm rdt]

There's more to it than just the scan. Keep in mind that al excursions will be recorded and better materials will be created as well.

I think digital denture will be huge.

 

[Flipperlady]

Again different subject, the dentures won't be any better than they are now, complete with same problems, just quicker turn around and cheaper..... Well probably not because they'll still be a pain.

 

[troutsnoggle]

Those are really great points. I can definitely try silicone for duping and turn the work around quicker. If they let me do provisionals or at least seat the work asap than I think that would be really good thing. Thanks!

 

[Dentex]

You must make a duplicate stone model...So you can seat it to point where it "snaps-on" to the model. That will greatly reduce the chair-side adjustments.

 

[XxJamesAxX]

I have found that properly blocking out models make for alot better products in the end. I use to hardly block out anything and just "grind" it in. Now basically everything that gets duped gets some amount of block out. I use to think it was a waste of time, now I think it's a waste of time not to.... it's funny how things change.

 

[AJEL]

I use my surveyor every day & change the marker pretty regular, I have noted that a worn marker puts the survey at a new location. I have had PM's telling me the survey can often be done by eye when you get enough experience. I'm still waiting for the experience to kick in, I have tried by eye and then checked with survey, strange how shadows can be so false. An improperly designed cast frame (or digitally printed then cast frame) can easily become an orthodontic or tooth extractor.
If I have that gut feeling that something might move I have sent a provisional brux appliance for use during construction (strangely they seem to continue treating themselves with them). My DDS's have come to respect my judgment and take my hints from time to time, I even get them to pay for the treatment brux, having the teeth not move and having the brux for the patient to use when the partial is being cleaned or the mouth is resting at night is not all that bad either.
If a tooth is at any question don't clasp or combo clasp with wrought wire soldering or welding the round flexible clasp in place. Reducing the I beam from extracting all so soon, just another ideas or two too chew on.

 

[jimi]

heavy polishing inside aprons, guideplanes, and especially guideplanes under the rest areas.