WHY MY DENTURES (DON'T) SUCK


Part 1
Edentulous Anatomy & What’s Important to Capture  
by Drake's on-staff Dentist - Larry R. Holt, DDS, FICD

Have you ever suffered that sinking feeling when you deliver an upper denture and instead of making a satisfying suction sound, it just follows your hand back out of the mouth?     

Well, you're not alone.
It happens to everyone.
And I plan to write in our blog until I have shared 
every.
last.
drop.
of information that I know on how to make good dentures and avoid those headaches.


It’s always best to start at the beginning.  Do a thorough intraoral exam of the patient and eliminate any possible pathology.  Once that’s out of the way, take a look at their existing dentures.  How are the borders?  Are they short?  Does the patient have decent suction with their current denture?  How much adhesive have they become addicted to?  First things first, if a patient is totally addicted to denture adhesives, don’t paint yourself into a corner by creating unrealistic expectations.  The best handiwork you can possibly do will still not equal a quart of adhesive!

Be sure to understand the critical anatomy associated with denture fabrication.  We see a lot of final impressions that miss this anatomy, resulting in less than stellar results.  On upper impressions you want to be able to clearly see the Hamular Notches and Fovia.  On lower impressions, you want to see the Retromolar Pads.  These are the most often missed details for denture impressions.  Obviously you want to capture all the anatomical details shown in these graphics and images of an ideal denture cast.

^Figure 1 note the difference in arch length when hamular notches have been captured.  The denture did not have any suction due to inadequate coverage of hamular notches.  

                   
Go ahead and familiarize yourself with critical anatomic structures of the edentulous mouth.  Compare to the models and see how they are a fair representation of the patient’s denture bearing anatomy.  This will be your goal for all denture impressions. 
Next entry, we will discuss what impression trays to use for impression taking.  There are many options, some good and some not so good...



............................................................................

'till then!
-Larry

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