Finishing dentures on overextended casts.

Denturepropgh

Denturepropgh

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Does everyone's doctors utilize the muscle trimming technique for better establishing the borders of a denture? To clarify, My dentist has all the assistants taking impressions pretty much except for washes and relines. They just put the alginate loaded trays in the mouth and let the borders go where they want to go, doing no manipulation of the lips/cheeks whatsoever. They don't do final impressions, as they don't think they are profittable. :mad: I can see just fine on a proper cast from a border-moulded final impression. I just had upper and lower relines yesterday, went to deliver and I had to reduce the periphery on both by 4mm. Dr. told patient to just use fixodent. The doctor took those impressions. That outcome upset me, not because of the extra work but that relines should fit pretty much right off the jig. But what did it even more was the Dr. coming in at the end of the day and saying they "don't know how many dentures I have finished but they want to get somebody in to help me. Not that I'm saying you don't know what you are doing.....Every lab tech we've had here has had a tough time knowing where to finish to", No, that's EXACTLY what you are saying. I know what I'm doing just fine. So I am going to have a talk with my corporate boss, because either I need to get good at defining borders on crap models, or they need to take proper impressions. But this daily adjustment of every single denture is exhausting insanity that makes me reeeeeally sad.

Thanks for letting me vent. I'm a little heated.
 
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Doris A

Doris A

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Does everyone's doctors utilize the muscle trimming technique for better establishing the borders of a denture? To clarify, My dentist has all the assistants taking impressions pretty much except for washes and relines. They just put the alginate loaded trays in the mouth and let the borders go where they want to go, doing no manipulation of the lips/cheeks whatsoever. They don't do final impressions, as they don't think they are profittable. :mad: I can see just fine on a properly border-moulded cast. I just had upper and lower relines yesterday, went to deliver and I had to reduce the periphery by 4mm. Dr. told patient to just use fixodent. The doctor took those impressions. That outcome upset me, but what did it even more was the Dr. coming in at the end of the day and saying they "don't know how many dentures I have finished but they want to get somebody in to help me. Not that I'm saying you don't know what you are doing.....Every lab tech we've had here has had a tough time knowing where to finish to", No, that's EXACTLY what you are saying. I know what I'm doing just fine. So I am going to have a talk with my corporate boss, because either I need to get good at defining borders on crap models, or they need to take proper impressions. But this daily adjustment of every single denture is exhausting insanity that makes me reeeeeally sad.
The writing is on the wall, time to move on.
 
bigj1972

bigj1972

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Does everyone's doctors utilize the muscle trimming technique for better establishing the borders of a denture? To clarify, My dentist has all the assistants taking impressions pretty much except for washes and relines. They just put the alginate loaded trays in the mouth and let the borders go where they want to go, doing no manipulation of the lips/cheeks whatsoever. They don't do final impressions, as they don't think they are profittable. :mad: I can see just fine on a proper cast from a border-moulded final impression. I just had upper and lower relines yesterday, went to deliver and I had to reduce the periphery on both by 4mm. Dr. told patient to just use fixodent. The doctor took those impressions. That outcome upset me, not because of the extra work but that relines should fit pretty much right off the jig. But what did it even more was the Dr. coming in at the end of the day and saying they "don't know how many dentures I have finished but they want to get somebody in to help me. Not that I'm saying you don't know what you are doing.....Every lab tech we've had here has had a tough time knowing where to finish to", No, that's EXACTLY what you are saying. I know what I'm doing just fine. So I am going to have a talk with my corporate boss, because either I need to get good at defining borders on crap models, or they need to take proper impressions. But this daily adjustment of every single denture is exhausting insanity that makes me reeeeeally sad.

Thanks for letting me vent. I'm a little heated.
Give the cast, mark his own "margin". Lets see how smart he is.
 
bigj1972

bigj1972

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Does everyone's doctors utilize the muscle trimming technique for better establishing the borders of a denture? To clarify, My dentist has all the assistants taking impressions pretty much except for washes and relines. They just put the alginate loaded trays in the mouth and let the borders go where they want to go, doing no manipulation of the lips/cheeks whatsoever. They don't do final impressions, as they don't think they are profittable. :mad: I can see just fine on a proper cast from a border-moulded final impression. I just had upper and lower relines yesterday, went to deliver and I had to reduce the periphery on both by 4mm. Dr. told patient to just use fixodent. The doctor took those impressions. That outcome upset me, not because of the extra work but that relines should fit pretty much right off the jig. But what did it even more was the Dr. coming in at the end of the day and saying they "don't know how many dentures I have finished but they want to get somebody in to help me. Not that I'm saying you don't know what you are doing.....Every lab tech we've had here has had a tough time knowing where to finish to", No, that's EXACTLY what you are saying. I know what I'm doing just fine. So I am going to have a talk with my corporate boss, because either I need to get good at defining borders on crap models, or they need to take proper impressions. But this daily adjustment of every single denture is exhausting insanity that makes me reeeeeally sad.

Thanks for letting me vent. I'm a little heated.
It is difficult to learn/ teach that line until it finally clicks.
1) its shorter than most think
2) if reline is over extended and not adjusted prior to impression, then the post denture will be overextended as well.
Because it is essentially a custom tray, if its bad to start, it won't magically get better.
Because it is a tray, it will blur that line vs original alginate impression.,
 
JKraver

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Does everyone's doctors utilize the muscle trimming technique for better establishing the borders of a denture? To clarify, My dentist has all the assistants taking impressions pretty much except for washes and relines. They just put the alginate loaded trays in the mouth and let the borders go where they want to go, doing no manipulation of the lips/cheeks whatsoever. They don't do final impressions, as they don't think they are profittable. :mad: I can see just fine on a proper cast from a border-moulded final impression. I just had upper and lower relines yesterday, went to deliver and I had to reduce the periphery on both by 4mm. Dr. told patient to just use fixodent. The doctor took those impressions. That outcome upset me, not because of the extra work but that relines should fit pretty much right off the jig. But what did it even more was the Dr. coming in at the end of the day and saying they "don't know how many dentures I have finished but they want to get somebody in to help me. Not that I'm saying you don't know what you are doing.....Every lab tech we've had here has had a tough time knowing where to finish to", No, that's EXACTLY what you are saying. I know what I'm doing just fine. So I am going to have a talk with my corporate boss, because either I need to get good at defining borders on crap models, or they need to take proper impressions. But this daily adjustment of every single denture is exhausting insanity that makes me reeeeeally sad.

Thanks for letting me vent. I'm a little heated.
Well the panel of DLN judges says.... Stick it out and try to make it work or leave.
 
D

Denture Dude

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Does everyone's doctors utilize the muscle trimming technique for better establishing the borders of a denture? To clarify, My dentist has all the assistants taking impressions pretty much except for washes and relines. They just put the alginate loaded trays in the mouth and let the borders go where they want to go, doing no manipulation of the lips/cheeks whatsoever. They don't do final impressions, as they don't think they are profittable. :mad: I can see just fine on a proper cast from a border-moulded final impression. I just had upper and lower relines yesterday, went to deliver and I had to reduce the periphery on both by 4mm. Dr. told patient to just use fixodent. The doctor took those impressions. That outcome upset me, not because of the extra work but that relines should fit pretty much right off the jig. But what did it even more was the Dr. coming in at the end of the day and saying they "don't know how many dentures I have finished but they want to get somebody in to help me. Not that I'm saying you don't know what you are doing.....Every lab tech we've had here has had a tough time knowing where to finish to", No, that's EXACTLY what you are saying. I know what I'm doing just fine. So I am going to have a talk with my corporate boss, because either I need to get good at defining borders on crap models, or they need to take proper impressions. But this daily adjustment of every single denture is exhausting insanity that makes me reeeeeally sad.

Thanks for letting me vent. I'm a little heated.
I’m in your boat buddy. Although not quite as tense from the sound of it, but close. Personally, I’d slash every border down to next nothing. Call it good. What in the h$ll else could a guy be expected to do. This is the norm today. It just is.
 
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Denture Dude

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‘Corporate boss’. All you really need to hear. Don’t expect much of what you say to get in. Hate to say it.
 
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nickate

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So you can open/close the bite on a hinge articulator if needed and it works just fine in the mouth? I think my problem is that they are taking too much wax off of the biteblocks, and pt's vdo is overclosed. Every one that comes into the lab hardly ever has a vdo of 38-40mm vestibule to vestibule. It's always like 30mm sometimes even less. After they get done melting down the wax rims, it literally gives me 4mm of room in the max anterior, and I have to open the bite to give me at least 9mm to set a tooth. I'm like, you guys know that teeth aren't 2 mm tall, right? I like to see at least 16-20 mm interarch space for setting teeth. There are the oddballs, but not every single one.
THIS has zero to do with the articulator type. A semi or fully adj. zillion dolla art. STILL has a hinge in the back..... unless I'm missing something?
 
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nickate

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So I just started working as an in-house technician again because I got kind of drained in the production setting. In the clinic, they take alginate impressions with stock trays lined with ropes of utility wax. I've been making dentures for 20 years, but have not experienced all these adjustments of border length from the clinic. They just use wax for their baseplates, don't want to do custom trays, and mount everything on a metal hinge-type articulator. I know that I just made some heads explode. But the metal articulator thing; I'm going to try to persuade the doctors to use semi-adjustable. Sometimes I might need to open/close the bite some during setting of teeth and I think it translates differently since we use the crappy hinge-type, and in the mouth the bite seems slightly off. It would be nice if we were given perfectly contoured wax rims with all the markings, but that's not reality right now. Everything that would make a prosthodontist scoff is happening right now, and it bites!

Would having the assistants practice muscle trimming their alginate impressions solve the overextension issue? This is driving me nuts, and definitely knocked me down a few rungs and humbled me a bit. I just feel weird coming in here and changing the way they do things. I always feel like people take me as being condescending but I really just want us all to do less work.

And to anyone who has finished dentures to an overextended cast, please explain your thought process in how long/thick to leave your flanges. Because if you take them to the border, they'll need cut back what seems to be at least 3-4mm. Thank you for your insight!
This is an easy one- especially for you as you have experience finishing dentures. . Look at your casts. Grab a pencil and draw a line around them precisely where the model starts to flare outward. Carve post dam now as well. Take and scribe your line lightly into the cast. Now- when finishing- even a monkey can finish to the correct length- just follow the line. BAM
 
bigj1972

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THIS has zero to do with the articulator type. A semi or fully adj. zillion dolla art. STILL has a hinge in the back..... unless I'm missing something?

Jack Nicholson Lol GIF
 
Flipperlady

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I've already commented on my thoughts on this earlier, but in my opinion Dr. Massad has/had one of the best denture impression and tray /bite procedures out there. He may be retired now but still great system for analogue dentures. The cow patty shaped models that I would have to trim back would be an extra model charge...
 
Doris A

Doris A

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This is an easy one- especially for you as you have experience finishing dentures. . Look at your casts. Grab a pencil and draw a line around them precisely where the model starts to flare outward. Carve post dam now as well. Take and scribe your line lightly into the cast. Now- when finishing- even a monkey can finish to the correct length- just follow the line. BAM
You can also take a processed denture, place it tooth side down in the palm of your hand, run a pencil around the highest point of the border. This is your height of contour. Trim the border just past the pencil line.
 

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