Complete dentures provide a viable solution for edentulous patients, even though today’s practitioners have access to many implant-supported treatment options. To serve the population who cannot receive implant-supported prostheses due to financial or anatomical restraints, it is helpful for clinicians to maintain their ability to deliver complete dentures. A predictable outcome can be achieved when the clinician has a full understanding of the desired result, accurately captures the stabilizing areas, and successfully communicates the anatomical information — such as tooth characteristics, vertical dimension and interocclusal space — to the dental laboratory.
In the case that follows I will outline my straightforward clinical protocol for replacing an ill-fitting existing denture in a fully edentulous patient. The patient in this case is Daniel, a CAD/CAM mill technician who has worked in the Fixed department at Glidewell Laboratories for 10 years. Daniel operates the milling machines that are used in the production of many of the restorative materials delivered to dentists around the world, including BruxZir® Solid Zirconia and Obsidian® lithium silicate ceramic (Glidewell Laboratories; Newport Beach, Calif.).
Complete dentures provide a viable solution for edentulous patients.
Custom trays ... better capture the denture-bearing surfaces and tissues.
The bite rims serve as a record to communicate to the laboratory the esthetic and functional aspects of the complete dentures.
Figure 14: The preliminary setup try-in features the six anterior teeth on both the maxillary and mandibular arches. The try-ins are seated, and I evaluate the vertical and horizontal positioning, occlusal relationship, masticatory and speech function, and esthetics. Any changes are communicated to the lab. If a reset is not necessary and the tooth positioning for the anterior try-in is acceptable, the lab will then set the remainder of the teeth and fabricate a complete setup try-in.
Conventional complete dentures continue to serve as a viable option to rehabilitate patients and restore everyday oral functions and esthetics.
Conventional complete dentures continue to serve as a viable option to rehabilitate patients and restore everyday oral functions and esthetics. What we often fail to recognize, however, is the value of complete dentures for diagnostic purposes when planning cases for patients receiving implant-supported prosthetic solutions. A well-made set of complete dentures for the edentulous patient can act as a prototype for the implant-supported prosthesis prior to implant placement, providing information such as tooth position, tooth shape, vertical dimension, interocclusal space, esthetics and phonetics. The ability to deliver conventional complete dentures should still be regarded as a necessary skill set for practitioners as it serves edentulous patients across the economic spectrum.