sidesh0wb0b
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This case was super fun for us, we loved the challenge and the uniqueness of the solution. And of course the overwhelming positive reaction from the patient and Dr makes it all priceless. This is truly why we do what we do. I think I posted some of this before but here goes anyway!
LMT really condensed everything we did down to a very very small half page write up, so here is a much more lengthy version with the details they left out.... be picky folks, i dont mind! we ALL learn from this stuff!
(denture #1) The patient presented with an existing maxillary denture showing evidence of multiple cracks, breaks, and repairs. She wanted a more permanent solution, so six root form implants were placed for placement of a final locator denture. After the fixtures healed, (denture #2) an open palate locator denture was fabricated with a cast strengthener bar to help keep the denture from breaking. Over the next two years the patient kept returning for multiple repairs as the denture continued to break and fracture. (denture #3) A new denture was made with more cast metal mesh as a strengthener and thicker acrylic to help avoid future issues. Again, the patient kept returning with more fractures and breaks in the new denture. (denture #4) A new plan was made to fabricate a denture that did not use posterior denture teeth with the idea that the added thickness of acrylic would prevent the denture from fracturing. Posterior occlusion was developed by using monolithic denture base acrylic. Sadly, the patient returned a short time later with more fractures in her denture. She was frustrated, and so was the Dr. All this took place leading up to Harmony Dental Creations being involved.
We got a call from Dr. Thomas Brown to work through a unique treatment plan and see if there was a prosthetic we could develop to create a long-lasting denture that would not fracture for this patient. After listening to the concerns and frustrations of Dr. Brown, he sent us articulated models with a denture setup that had been tried in and approved by the patient. My lead denture technician, Chris Brooks, and I sat down to treatment plan and after lengthy discussion back and forth, we decided upon a cast metal substructure that kept all the posterior occlusion in metal. In essence; posterior metal occlusions, except on a removable appliance retained by 6 locators. We contacted our good friend and fellow lab owner, Justin Gerard at Colonial Dental Lab in Virginia, to discuss our ideas and evaluate the plan we had discussed with the Dr. We further discussed our treatment plan and he agreed to help with the fabrication of the cast frame portion of this prosthetic. All the posteriors were to have metal occlusion, but we really wanted to maintain some cosmetics, so we settled on denture tooth facings instead of all-cast facials for the posteriors. We also wanted to ensure the locator housings were picked up in acrylic so that they could be replaced should the need arise in the future.
We set up the denture on the Panadent PSH articulator with the confirmed bite and approved setup taken by Dr. Brown, replaced the denture teeth with our premium cards for added strength, marked the design for occlusal coverage on the denture teeth, and sent it over to Colonial Dental for framework manufacturing. Justin worked his magic by meticulously and carefully trimming the denture teeth, designing digitally, and hand casting a horse-shoe style work of art for us to use as the frame.
When it returned to us, we transferred the approved tooth setup and the posterior denture tooth facings. We reviewed the setup and waxing thicknesses and sent images to Dr. Brown for approval prior to injecting with acrylic. We invested and injected the denture with the Snow Rock injection system and GC’s Nature-Cryl Super High Impact denture base resin. From there we poured a second model for verification and locator stability, finished the denture, and shipped it back to Dr. Brown.
A few days later, the Dr called to offer his and the patients' thanks for a successful denture delivery. A week or two later we got a call at the laboratory that the patient called in to the practice in (happy) tears and wanted to thank everyone again. She was able to eat an apple for the first time in 7 years! She has since been back for follow up appointments and as you can see by the smiling pictures, she is thrilled to have an appliance that allows her to smile once again!
Major thanks to Dr. Brown and his staff for being amazing and patient through the entire process, Justin Gerard and his team at Colonial Dental Lab for the hard work and out-of-the-box thinking to make this magic happen, and to Chris Brooks and my entire staff at Harmony Dental Creations for dedicating long hours to this and each unique case we have coming through the door. This case would not have been possible without this incredible team going above and beyond.
The end results speak volumes to the skill, dedication, and love we all have for this industry and for giving people a reason to smile again!
LMT really condensed everything we did down to a very very small half page write up, so here is a much more lengthy version with the details they left out.... be picky folks, i dont mind! we ALL learn from this stuff!
(denture #1) The patient presented with an existing maxillary denture showing evidence of multiple cracks, breaks, and repairs. She wanted a more permanent solution, so six root form implants were placed for placement of a final locator denture. After the fixtures healed, (denture #2) an open palate locator denture was fabricated with a cast strengthener bar to help keep the denture from breaking. Over the next two years the patient kept returning for multiple repairs as the denture continued to break and fracture. (denture #3) A new denture was made with more cast metal mesh as a strengthener and thicker acrylic to help avoid future issues. Again, the patient kept returning with more fractures and breaks in the new denture. (denture #4) A new plan was made to fabricate a denture that did not use posterior denture teeth with the idea that the added thickness of acrylic would prevent the denture from fracturing. Posterior occlusion was developed by using monolithic denture base acrylic. Sadly, the patient returned a short time later with more fractures in her denture. She was frustrated, and so was the Dr. All this took place leading up to Harmony Dental Creations being involved.
We got a call from Dr. Thomas Brown to work through a unique treatment plan and see if there was a prosthetic we could develop to create a long-lasting denture that would not fracture for this patient. After listening to the concerns and frustrations of Dr. Brown, he sent us articulated models with a denture setup that had been tried in and approved by the patient. My lead denture technician, Chris Brooks, and I sat down to treatment plan and after lengthy discussion back and forth, we decided upon a cast metal substructure that kept all the posterior occlusion in metal. In essence; posterior metal occlusions, except on a removable appliance retained by 6 locators. We contacted our good friend and fellow lab owner, Justin Gerard at Colonial Dental Lab in Virginia, to discuss our ideas and evaluate the plan we had discussed with the Dr. We further discussed our treatment plan and he agreed to help with the fabrication of the cast frame portion of this prosthetic. All the posteriors were to have metal occlusion, but we really wanted to maintain some cosmetics, so we settled on denture tooth facings instead of all-cast facials for the posteriors. We also wanted to ensure the locator housings were picked up in acrylic so that they could be replaced should the need arise in the future.
We set up the denture on the Panadent PSH articulator with the confirmed bite and approved setup taken by Dr. Brown, replaced the denture teeth with our premium cards for added strength, marked the design for occlusal coverage on the denture teeth, and sent it over to Colonial Dental for framework manufacturing. Justin worked his magic by meticulously and carefully trimming the denture teeth, designing digitally, and hand casting a horse-shoe style work of art for us to use as the frame.
When it returned to us, we transferred the approved tooth setup and the posterior denture tooth facings. We reviewed the setup and waxing thicknesses and sent images to Dr. Brown for approval prior to injecting with acrylic. We invested and injected the denture with the Snow Rock injection system and GC’s Nature-Cryl Super High Impact denture base resin. From there we poured a second model for verification and locator stability, finished the denture, and shipped it back to Dr. Brown.
A few days later, the Dr called to offer his and the patients' thanks for a successful denture delivery. A week or two later we got a call at the laboratory that the patient called in to the practice in (happy) tears and wanted to thank everyone again. She was able to eat an apple for the first time in 7 years! She has since been back for follow up appointments and as you can see by the smiling pictures, she is thrilled to have an appliance that allows her to smile once again!
Major thanks to Dr. Brown and his staff for being amazing and patient through the entire process, Justin Gerard and his team at Colonial Dental Lab for the hard work and out-of-the-box thinking to make this magic happen, and to Chris Brooks and my entire staff at Harmony Dental Creations for dedicating long hours to this and each unique case we have coming through the door. This case would not have been possible without this incredible team going above and beyond.
The end results speak volumes to the skill, dedication, and love we all have for this industry and for giving people a reason to smile again!
