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Denturist
characterized dentures
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<blockquote data-quote="denturist-student" data-source="post: 126607" data-attributes="member: 5492"><p>I build a stabilized baseplate on the lower ridge or rather bowl....I insert a wire frame where I think the teeth usually are placed. Then I build up with Tempo tissue conditioner until it forms a ridge around the wire frame. While I am building it up I will get the patient to say different sounds like oooo ahhh and eee and go through a series of tongue and cheek movements....This will form a functional impression which I will use as a guide in placing the lower teeth. It is like forming the buccal surfaces to adapt to the muscles in a range of patterns....Normally in these types of super resorbed ridges I will prescribe 0 degree teeth. this si because they are usually not that adept at replicating centric anyways.....I will do a facebow and vertical registration....Then I will transfer to articulator....I will make a silicon index of the surface of the finished impression and use that to finish the acrylic too....Patients will often wonder what the heck is going on....But when I try them in they are quite pleased because there are no musclular forces dislodging the denture at all and they do seem to stay in place....The posterior teeth inevitably fall in Pounds Triangle somewhere but the anterior teeth are placed using the silicon key of the original impression.....I will use the functional neutral zone impression to contour and set the lower teeth....Can also do this for the upper as well once the amount of facial support has been determined. Result is a convex buccal surface rather than a convex buccal surface we normally shape. Since there is not that much contacting bone I will polish most of the intaglio surface on the lower. Result is that the patient keeps them in place even when chewing and when speaking....I guess that is why they call them neutral zone....hope this helps....there are a few books on it but it seems to be a long lost art but I do a lot of rest home patients who cannot be prescribed implants....while they are not implants they do tend to be more comfortable and to me that is important in the geriatric wings.....</p></blockquote><p></p>
[QUOTE="denturist-student, post: 126607, member: 5492"] I build a stabilized baseplate on the lower ridge or rather bowl....I insert a wire frame where I think the teeth usually are placed. Then I build up with Tempo tissue conditioner until it forms a ridge around the wire frame. While I am building it up I will get the patient to say different sounds like oooo ahhh and eee and go through a series of tongue and cheek movements....This will form a functional impression which I will use as a guide in placing the lower teeth. It is like forming the buccal surfaces to adapt to the muscles in a range of patterns....Normally in these types of super resorbed ridges I will prescribe 0 degree teeth. this si because they are usually not that adept at replicating centric anyways.....I will do a facebow and vertical registration....Then I will transfer to articulator....I will make a silicon index of the surface of the finished impression and use that to finish the acrylic too....Patients will often wonder what the heck is going on....But when I try them in they are quite pleased because there are no musclular forces dislodging the denture at all and they do seem to stay in place....The posterior teeth inevitably fall in Pounds Triangle somewhere but the anterior teeth are placed using the silicon key of the original impression.....I will use the functional neutral zone impression to contour and set the lower teeth....Can also do this for the upper as well once the amount of facial support has been determined. Result is a convex buccal surface rather than a convex buccal surface we normally shape. Since there is not that much contacting bone I will polish most of the intaglio surface on the lower. Result is that the patient keeps them in place even when chewing and when speaking....I guess that is why they call them neutral zone....hope this helps....there are a few books on it but it seems to be a long lost art but I do a lot of rest home patients who cannot be prescribed implants....while they are not implants they do tend to be more comfortable and to me that is important in the geriatric wings..... [/QUOTE]
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