maxillary tori

[twaite]

I have a patient with a large maxillary Tori. We are planning on leaving it intact. She needs extractions and an upper immediate denture then a final denture. Here is my plan so far. Please advise.

set the teeth
wax up
at processing block out the tori with pink rubber sep
deliver with hydrocast
after she heals from the the extractions
I'll make her final denture the question is how do I do it
without hurting her and getting retention.
She has full lower dentition
I'll try to get some pictures up

 

[Doris A]

How about some locators and a horseshoe palate?

 

[Marcusthegladiator CDT]

 

[twaite]

How about some locators and a horseshoe palate?

That's the plan if she can't tolerate the immediate denture. But not everyone can do implants and bar retained dentures.

T

 

[Doris A]

That's the plan if she can't tolerate the immediate denture. But not everyone can do implants and bar retained dentures.

T

From the picture it looks like there is room for a small post dam on either side of the torus, and then maybe add a soft liner over JUST the torus
for comfort. I have multiple lingual tori on the lower, some food irritate them, I can only imagine what a denture would feel like.

 

[AJEL]

Doris do you have nylon injector available? If so shoot a Duraflex horseshoe as your permanent or the new snowrock vinyl try to keep 2mm away from that bundle of nerves.
Otherwise use your Diamond D with either a Protech soft cover or CMP IMPAK like you would do a palatal obturator . The Vynacron Microfit VR might be a good choice it has a little flex, is hypoallergenic & can be made thinner than PMMA. It can be press packed or you can put it into an old cartridge & inject it. It is also easy to repair and if youdouble model you could put a protech soft reline around the tori. Either way use tin foil and burnish it to get an even space, I would use the .003. during yor processing (if you have to cover the tori, the old rule was either cover it with a space or keep 1/8" away s there are capillary veins feeding it around the base.)

 

[ottawa]

The dentist will most likely place a temp softliner the day after the extractions, so you don't have to worry about denture pushing/pinching the tori. Just make sure there are no sharp edges around the tori.

 

[Bobby Orr ceramics]

This patient really needs to be evaluated for OSA(Obstructive Apnea). Tori are a major flag for OSA. Designing proper teeth for daytime use looking good as mentioned; however, special planning required for airway management thru the night could save a life.

 

[twaite]

The dentist will most likely place a temp softliner the day after the extractions, so you don't have to worry about denture pushing/pinching the tori. Just make sure there are no sharp edges around the tori.

Have you ever made a final denture for a patient with a large upper tori? If so how did you make it work?

 

[ottawa]

That tori isn't very large. You can put a space when packing acrylic and pop it out when finished. You could also use molloplast-b around the area or molloplast-b liner inside the whole denture. I would just put a spacer around the tori.

Ask the dentist if he would like an all acrylic denture or molloplast-b inside. Also it looks like the bite is open in quadrant 2, the molars aren't in contact.

 

[Sp00n]

Implants and some sort of attachments. If they need a graft, bone can be taken out from the torus i dont think a full upper denture will work because there wont be enough soft tissue compression. Soft lining JUST over the torus miight help but it still needs to be blocked out sightly... otherwise it will act as a pivot

Sent from my GT-I9305 using Tapatalk

 

[rmcmanus]

I my opinion this case will be a disaster. There is a reason they recommend max tori removal and the dentist just doesn't want to do it or to refer the patient to have it done. I have covered many flat raised tori but nothing has large and ugly as the tori here. After the extractions the ridge shrinks and the relief around the tori is just going to be an additional reason for a lack of stability. How to make this type denture is not up to you but rather the dentist's responsibility, get the tori removed, or tell the patient she will have no retention and have to rely on adhesives until the tori is removed.