It is just taking the old teeth off and putting new teeth on an old base.

[denturist-student]

I think the neat thing about our profession is the variety and methods of overcoming scenarios like this one occur every now and then for whatever the reason. I think the doc wanted to effect the most economical method for his patient....Nothing wrong with that. However they are clinicians and have little experience with labwork. The doc knows that relines must be honed out before taking the reline impression. Have to have some flow and egress for the impression material. It may have worked out much better to just crazy glue the denture back together and taken a reline impression with that. Once you receive the reline impression is is just a matter of doing a closed flask reline....We do that by making a silicon impression with the old denture restoring the bite. Once that is accomplished it can be sent to a lab for processing....The lab makes a model of the reline impression and leaves it intact on the denture base....It is then trimmed back and invested in a flask using a silicone insulation on the outside of the denture base but not on the tooth surfaces.....Then it is pulled apart. Either the model will separate from the impression or the denture base will ease out of the silicon matrix. The rest can be done after the denture is pulled from the new model base.....After the impression denture is separated from the new model imbedded in the flask, it is then ground out substantially and refit into the silicon index of the top half of the flask.....The rest can then be press packed and processed normally and there will be very little occlusal change....After recovery and polishing it can be sent back to the dentist and walla the lady is happy...dentist is happy and you have made a few sheckles for a reline/repair at the same time.....So it can be done sort of.....But it cannot be done the method the dentist suggested....They likely just took an alginate impression in a stock tray and poured up a model on that....Cannot be done successfully that way. The denture impression has to remain on the poured model until after it is fully invested. Even cannot pull the silicon impression off the denture and expect to reseat it before it is fully flasked and ready for processing.....
But what gets my goat is that the dentist did not send an intact PVS impression that you could have processed using the closed flask technique....and accomplished both the repair and reline in one single shot.....
Take care and keep well

 

[AJEL]

You have described a rebase, next day no problem.
What Dr G wants is to use the old base and put 14 new teeth on it. This requires a model in the denture, then an articulation , removal of current teeth placement of new teeth (probably a try-in) then flasking & processing of a thin pink around the new teeth on the old base. Have I done this yes has the base warped in the past yes. The fit is not retained when boiling off & reprocessing on an old denture base. She does not want a reline or a rebase. I guess she does not want me changing the taste she has worked into the old.

I believe youj were taking idea from deamonwaxa's story account, not same case.

 

[rkm rdt]

.... I've said this a zillion times... The patient doesn't know how long it takes to do ANY PROCEDURE we do.

So? That's not the patients fault , it's yours!

 

[droberts]

AJEL,

No one else other than you can handle this situation with your client. Its all about having good communication and working together as a team.
When that part fails, its time to move on. As for a warped base during processing. Here, I do not process to any base, old or new.
All are pulled before injecting. Eliminates any possible separations. Have a great day!

 

[dmonwaxa]

So? That's not the patients fault , it's yours!

rkm, are'nt you supposed to be on vacation on a lake somewhere?

 

[Inna-Hurry]

Here is where so much of our problem in the lab lies..... This guy cannot even comprehend the OP's vent! (New teeth--- not new base scooter)..... Boy would his account be surprised when they received a rebased denture that afternoon!!!!!
(I realize he may be a denturist)
READ THE TICKET.
I

I think the neat thing about our profession is the variety and methods of overcoming scenarios like this one occur every now and then for whatever the reason. I think the doc wanted to effect the most economical method for his patient....Nothing wrong with that. However they are clinicians and have little experience with labwork. The doc knows that relines must be honed out before taking the reline impression. Have to have some flow and egress for the impression material. It may have worked out much better to just crazy glue the denture back together and taken a reline impression with that. Once you receive the reline impression is is just a matter of doing a closed flask reline....We do that by making a silicon impression with the old denture restoring the bite. Once that is accomplished it can be sent to a lab for processing....The lab makes a model of the reline impression and leaves it intact on the denture base....It is then trimmed back and invested in a flask using a silicone insulation on the outside of the denture base but not on the tooth surfaces.....Then it is pulled apart. Either the model will separate from the impression or the denture base will ease out of the silicon matrix. The rest can be done after the denture is pulled from the new model base.....After the impression denture is separated from the new model imbedded in the flask, it is then ground out substantially and refit into the silicon index of the top half of the flask.....The rest can then be press packed and processed normally and there will be very little occlusal change....After recovery and polishing it can be sent back to the dentist and walla the lady is happy...dentist is happy and you have made a few sheckles for a reline/repair at the same time.....So it can be done sort of.....But it cannot be done the method the dentist suggested....They likely just took an alginate impression in a stock tray and poured up a model on that....Cannot be done successfully that way. The denture impression has to remain on the poured model until after it is fully invested. Even cannot pull the silicon impression off the denture and expect to reseat it before it is fully flasked and ready for processing.....
But what gets my goat is that the dentist did not send an intact PVS impression that you could have processed using the closed flask technique....and accomplished both the repair and reline in one single shot.....
Take care and keep well

 

[rkm rdt]

rkm, are'nt you supposed to be on vacation on a lake somewhere?

Waiting for a patient to show up for a custom shade then I'm outta here!

 

[denturist-student]

You have described a rebase, next day no problem.
What Dr G wants is to use the old base and put 14 new teeth on it. This requires a model in the denture, then an articulation , removal of current teeth placement of new teeth (probably a try-in) then flasking & processing of a thin pink around the new teeth on the old base. Have I done this yes has the base warped in the past yes. The fit is not retained when boiling off & reprocessing on an old denture base. She does not want a reline or a rebase. I guess she does not want me changing the taste she has worked into the old.

I believe youj were taking idea from deamonwaxa's story account, not same case.

Yes I was following deamonwaxa's story......

Seeing and rereading your story well it just cannot be done properly nor ethically without going through the whole process again....I agree with you there...
Yes you are right when you say the new denture base would be compromised during processing....
You might be able to use the old baseplate and form a matrix of the old teeth...place some new teeth in there wax. Then you could invest the old baseplate with the new teeth on it......but the likelihood of getting the exact same mold from any tooth company is remote.....It would also likely require a reline anyway......You might be able to make a matrix of the old denture teeth and do a wax up and reset with new teeth. But that would be a long shot.....Still far better just to make a new denture....Sounds like the doc is looking for an easy fix with minimal chairtime....

 

[denturist-student]

So little prosthodontics is still taught in dental schools now. Its all endodontics, periodontics, orthodontics, surgery, and single tooth repair....Almost all of the prosthodontics is removed from dental school curriculum's now...Prostho work is more and more being considered as an extracurricular thing....So while its easy to become frustrated with the dentists, its not entirely their fault either....One cannot become competent in anything if the training is vague and scant.... And no three day course on dentures and removeables will create any level of competence.

 

[Flipperlady]

I charge by the tooth $200 (made up#) for the first tooth and $15 (made up #) after that. It ends up full denture cost when you add full set of teeth. No way would I be able to do that same day, you need at least 3 days.

 

[dmonwaxa]

Waiting for a patient to show up for a custom shade then I'm outta here!

Lets hope that its not due tomorrow. .........hahaha

 

[araucaria]

Going through with this is an irreversible journey the family jewels will be at stake! The current denture would make a perfect 'spare' - I cant believe they want to put you under so much time-pressure with this type of job too. Could you offer the doc the use of your lab? after all he's sure it's so simple! I occasionaly get asked to change teeth on a chrome, but still get all the time needed to do it effectively. Doing it to a resin denture is a strangely rare request imo usually involves restoring occlusion..

 

[Tom Moore]

The hardest thing for a technician to learn is the word NO. That is not what anyone wants to here when they ask you to do something and most of us do not like disappointing the person that pays us.

The patient and dentist are under the impression that the are just getting a new set of tires on their old car...but they are not.

 

[AJEL]

The process changing teeth

I got this as a rush case Monday PM

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I started the model work, I used silicone putty and put spatula "piers for lab stone to hold steady and to use less expensive silicone. I have made base that will index & place a galvanized washer for a magnet in the articulator.

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I then articulated the cast of the old denture then the silicone/stone base with old denture & a magnet for remounting & ease of working with ( my standard)

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I removed the old teeth and set new teeth and the case went out for a try-in Tuesday am.

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The patient liked so I opted for a new batch of hydrocoloid & invested for processing, when I made the base I intentionally made sure I had lots of land area and the base was in pyramid shape to ease going into a hydrocoloid flask. The Denplus material is a heat activated acrylic with pourability, 10mg monomer 40 mg polomoner at 3 bar @ 60*c. for 1 hour.

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The case is remounted on pin articulator with my magnet system checked for occlusal adjustments.

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This is sent back to DDS on Wensday Am for patiennt delivery, luckily the denture base fit, and if she breakes the denture I could use the silicone stone model to repair it on.

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For any newbies this is posted thru photo bucket, clicking on thumbnails will give you a larger image (if you are interested)

 

[grabo]

Dentist to a technician: I can do this job with my eyes shut so stop telling me what to do !!!
Technician : Next time please open just one of your eyes slightly and we may get a better job!

 

[denturist-student]

Do you folks make remount casts for all of your patients? Up here it is mandatory if prescribing a fully equilibrated denture...That and a remount facebow index....Bravo on working with the dentist and accomplishing the almost impossible. While at first it may appear to be a loss for you I am almost certain that the goodwill involved will precipitate more business down the road....Try and get service like that from an Overseas Lab....

 

[AJEL]

Do you folks make remount casts for all of your patients? Up here it is mandatory if prescribing a fully equilibrated denture...That and a remount facebow index....Bravo on working with the dentist and accomplishing the almost impossible. While at first it may appear to be a loss for you I am almost certain that the goodwill involved will precipitate more business down the road....Try and get service like that from an Overseas Lab....

My magnet system allows me to remount from the flask, to return to what ever the try-in is. I have 2 out of 30 accounts that will sometimes do a facebow. I would venture many denture and most none C&B even know how to use a face bow. The average over the shoulder tech may not see such equipment, except if they stumble across one at a convention. Most of what I have seen here the DDS has to adjust as almost nothing goes back on the articulator, I make blocked out dupe models for my flippers just to ensure the case will fit, but that is really not the norm. I have seen dentures done on non pin articulators, & for C&B everything seems to be triple trayfail.
As for respect from this DDS not expected, he did complain about the charges though.

 

[Tom Moore]

What we have here is a failure to communicate.

I hate calling about prescriptions that don't match what I was sent but its part of the business.

I get in trouble around here because I think the people that need to know have the information I have. Mark this up to I should have called and bust your hump to make it work for them. Discussing procedures and time factors after the fact is a road to a vendor customer break.

If I'm not sure what to do how will the lab on the other side of the world know what to do. Making teeth is hard but communicating with those involved was a harder to learn skill set for me that I paid for by losings money and accounts.

Get the dentists cell and text the question. Easier than dealing with all the people on phones between you and your destination. It also leaves a written trail.

 

[dmonwaxa]

My magnet system allows me to remount from the flask, to return to what ever the try-in is. I have 2 out of 30 accounts that will sometimes do a facebow. I would venture many denture and most none C&B even know how to use a face bow. The average over the shoulder tech may not see such equipment, except if they stumble across one at a convention. Most of what I have seen here the DDS has to adjust as almost nothing goes back on the articulator, I make blocked out dupe models for my flippers just to ensure the case will fit, but that is really not the norm. I have seen dentures done on non pin articulators, & for C&B everything seems to be triple trayfail.
As for respect from this DDS not expected, he did complain about the charges though.

Ajel, great job, really like you technique with magnets; I'll need to give that a try sometime. Nice job on the acrylic, did you end up re-basing with new acrylic or did you process new over the old base? cant tell from the picture, looks brand new.

 

[AJEL]

I have at the DDS a list and time expectations for most procedures. This is not a regular procedure but I rush charged for each step. A denture has a :model, custom tray, baseplate, articulation, setup, sometimes a re articulation then another set-up then processing, with time expectations for each step and transport. I have sheets for relines, repairs, brux appliances, flexables, cosmetic bite openers, ect, as I don't expect the girl scheduling to have a clue. Many of my accounts had removable in College but it has been so long they forget and the new guys often don't get it, they stop at a C&B lab and see a little time and it's done, if they stop by me they see all the steps and if they still don't get it, theres more of them than me.
Tom I only put the first page for illustration there are three pages of phone notes on this case & a prescription per stage, one start, one approval set-up & process. one page phone notes.
Tom I just had an "off shore" case to reline Wensday, I wound up rebasing as the material was funky pink crumbled when ground on had some strange brown dotty blobs and when I tested a spot with some cross link monomer it went soggy. Do you know a trick to relining this stuff. One of my accounts is going corporate dentistry and will only use me for repairs. (I cannot & will not make a denture for under $99. as they want.) I charges more to rebase it than I think they purchased it for.