The adventures of impossible man in antique dentistry land

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Toni Toscano

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Toni Toscano:
We are having an issue. The doctor and the lab both work side by side. For personal reasons for Dr this is a pro bono case. Pt is incoherent and is a poor choice for what the pt family wants. Long story short after relines and just short of securing it with implants (against family wishes) this upper with barely a ridge is not keeping the retention and falls out. As far as we know they have tried glue. The idea of using suction cup bur on the model before process has been talked about but not yet tried. Another idea brought to the table is pretty antique. Spring loaded dentures? I only just learn of theyre existence. I'm wondering about info on the those and if its still possible to use this technique as well as any other ideas you can come up with. Its such a hard situation.. Its one of those you tell the family the square block will not fit in the circle whole and they say well it needs to so make it happen

So in the chair btw everything fits. Dr is please in all aspects but once pt is back in the home with a relaxed jaw is when the denture falls. The family is saying he is loosing weight because of this. However I would be amazed if he was able to regain motor skills and eat normally with a full set of natural teeth. I totally get it. They want to save their family member. Its so sad. Dr is frustrated because of wasted man hours and materials. Lab is frustrated because the case becomes priority and average cases are halted. So even if you don't have a suggestion on how to fix the actual problem of getting the denture to stay in I am curious what the appropriate response is to this. Tell the family its just not gonna work? (😢) or just keep doing it over and over (with economy teeth at least) to appease them..

I'm open to suggestions
 
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CoolHandLuke

CoolHandLuke

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I am assuming whrn you say implants were placed that its micro implants or locator type housings on normal implants? And this still failed?
 
JMN

JMN

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Toni Toscano:
We are having an issue. The doctor and the lab both work side by side. For personal reasons for Dr this is a pro bono case. Pt is incoherent and is a poor choice for what the pt family wants. Long story short after relines and just short of securing it with implants (against family wishes) this upper with barely a ridge is not keeping the retention and falls out. As far as we know they have tried glue. The idea of using suction cup bur on the model before process has been talked about but not yet tried. Another idea brought to the table is pretty antique. Spring loaded dentures? I only just learn of theyre existence. I'm wondering about info on the those and if its still possible to use this technique as well as any other ideas you can come up with. Its such a hard situation.. Its one of those you tell the family the square block will not fit in the circle whole and they say well it needs to so make it happen

So in the chair btw everything fits. Dr is please in all aspects but once pt is back in the home with a relaxed jaw is when the denture falls. The family is saying he is loosing weight because of this. However I would be amazed if he was able to regain motor skills and eat normally with a full set of natural teeth. I totally get it. They want to save their family member. Its so sad. Dr is frustrated because of wasted man hours and materials. Lab is frustrated because the case becomes priority and average cases are halted. So even if you don't have a suggestion on how to fix the actual problem of getting the denture to stay in I am curious what the appropriate response is to this. Tell the family its just not gonna work? (😢) or just keep doing it over and over (with economy teeth at least) to appease them..

I'm open to suggestions
Magnet dentures used to be a thing. I dont know if the neodynium ones are approvedfor intraoral use, but professional body modifiers (yeah, that's a real job title) have been putting them in ppl for years to add a sense of magnatatism/magnetic fields.

So magnet dentures: put north to north with a magnet behind the molars. Pushes the away from each other.
 
rkm rdt

rkm rdt

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Magnet dentures used to be a thing. I dont know if the neodynium ones are approvedfor intraoral use, but professional body modifiers (yeah, that's a real job title) have been putting them in ppl for years to add a sense of magnatatism/magnetic fields.

So magnet dentures: put north to north with a magnet behind the molars. Pushes the away from each other.
Maybe he's bi polar?
 
T

Toni Toscano

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Magnet dentures used to be a thing. I dont know if the neodynium ones are approvedfor intraoral use, but professional body modifiers (yeah, that's a real job title) have been putting them in ppl for years to add a sense of magnatatism/magnetic fields.

So magnet dentures: put north to north with a magnet behind the molars. Pushes the away from each other.

I do really like this idea. I will have to research this further. Its the least invasive to serve the purpose that the family is wishing for. I spoke with a different not involved doctor about this. He's such a good guy. Any ways he brought up a good point. With pt's deteriorating Parkinson's = rarely closing his mouth =dry mouth with even less retention regardless of ridge. So I definitely don't think suction cup will work. (>Our idea was suction cup.. This is more a recap to my original thoughts in the post)

And about the implants. So heres the deal. Originally when he was lucid pt had four abutments placed for an upper anterior bridge. Remaining naturals in place. I don't know his history but I imagine he's been in a home for a while and I'm not sure how much daily dental care he recieved. So he lost the rest of his teeth. They removed the bridge and left the abutments as is. I'm strictly a removable tech so pardon my mistranslated
Terminology about this. So what he has aren't meant to be with dentures. Probably being left alone at this point because removal=ie surgery could be the cause of a worsened state (inevitable but for dental to be the cause would be an issue with Dr id presume) so the family won't have any adjustments made as far as being locators or screw retained. There may be more of an option. I've heard also maybe they will try cementing the denture to the bridge abutments.

I have no idea this is why I'm wondering...
Are there materials or things Parkinson's patients need to avoid? If we can find more out about the magnets.. I wonder if this would have any effect on his disease. Hmm
I digress

Thanks for everyones input.
Ill update with the success rate of different treatments
 
2000markpeters

2000markpeters

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If I understand correctly there are implant there for past crown and bridge, have dr remove existing abutments and replace with a locator type abutment. Patient should achieve excellent retention then.
 
JMN

JMN

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If I understand correctly there are implant there for past crown and bridge, have dr remove existing abutments and replace with a locator type abutment. Patient should achieve excellent retention then.
Angulation and location may be an issue. 40deg divergence with ext range only gets you so far.

Pls I worry that a pt woth parkinsons may give a real challengd to not dropping screws and pieces as they cannot hold still for seating or torwuing.
 
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CoolHandLuke

CoolHandLuke

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there has been talk of time-release cbd prosthetics for the treatment of many forms of disease and pain. no prototypes yet tho.
 
Contraluz

Contraluz

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Magnet dentures used to be a thing.
Used to do a few in a previous life, pre implant era! As far as I remembre, they worked pretty well. But as I mentioned, we used to do them over cut down natural teeth (endo treated, mostly)
 
rkm rdt

rkm rdt

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Used to do a few in a previous life, pre implant era! As far as I remembre, they worked pretty well. But as I mentioned, we used to do them over cut down natural teeth (endo treated, mostly)
I never saw the attraction to doing them.
 
Contraluz

Contraluz

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I never saw the attraction to doing them.
Well, as I said, this was in a different life, about 30 years ago... Where I see the advantage is in low maintenance. Especially for elderly Pt, I think this is suited. Also, it isn't as harsh on the root as a regular attachment.

It seems the system evolved over the years.
The magnets are different now, solid pieces, it seems. Back then, the magnet was inside a housing, which, at least on one occasion, started to leak...

But, if I remember correctly, the pt's acceptance was very high.
 
Contraluz

Contraluz

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@Contraluz This is a sticky subject, but what was the effective range for the effect?
The effective range for the effect? Not sure I understand...

If you referent to the +/- poles, it needs to be 'cheek to cheek'...
 
Sda36

Sda36

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The effective range for the effect? Not sure I understand...

If you referent to the +/- poles, it needs to be 'cheek to cheek'...
You could try Bosworth Tissue Conditioner, sets up in several hours and self bordrer molds. Would last for several months for sure, possibly 6 and need to be retreated but adhesion would be maximized. A very good product that your Dr. Could utilize well given the circumstances. Hope this helps...
 
JMN

JMN

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The effective range for the effect? Not sure I understand...

If you referent to the +/- poles, it needs to be 'cheek to cheek'...
I was meaning for them to be - to - or + to + with the poles to be repelling the dentures into place. Ignoring the implants altogether. Using magentic repulsion instead of springs as OP opined for the force separating the dentures.
 
T

Toni Toscano

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I love you guys and your dedication and helpfulness. I'm going to revise all these suggestions with the Dr

In the mean time this song reminded me a little of the situation. Its good regardless of relevance. Your welcome


Thanks again for all the input
 
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