CLEAR CLONE CONCEPT DENTURE (3C)
Enter the Clear Clone Denture Technique
This will be a 2-3 part series on the use of clear duplicate dentures for treating edentulous patients.
Denture patients come in many shapes and sizes. The patients are as varied as fish in the sea. Some are old, some young and many in between. Some have large ridges that help with denture stability, some, not so much. There are times when the patient’s existing dentures can be a valuable reference for use in fabrication of new appliances. This may be as simple as recreating an identical esthetic composition to making major changes to satisfy proper clinical parameters. As dentistry continues to include implant solutions for patients, we often need a way to start these cases utilizing the information contained within the patient’s old dentures. Don’t reinvent the wheel if it already exists!
As with most restorative cases, getting into the articulator with accurately mounted models is our initial goal. It is pointless to continue laboratory procedures if the mounted case is not a facsimile of what resides in the patients mouth and head. When patients are dentate, this can be accomplished with a simple blue bite registration. With edentulous patients these same bite records can be a daunting task. Traditional bite rims are still a gold standard, however, it can be tedious to confidently gain a recording of bite relationship.
Most edentulous patients have at least one set of dentures (some may have a sack full!) These dentures can serve as a valuable proving ground for the new appliances you intend to fabricate.
Dental offices are always looking for an efficient means to deliver treatment. The beauty of the Clear Clone Technique is the reduction of patient visits necessary to get to a delivery appointment. Any dental assistant can perform the initial duplication procedures. The materials are inexpensive and the procedure is relatively fast. While the dentist is performing examination and consultation, the assistant can go ahead with duplication procedures in the office lab. This eliminates the need for alginate preliminary impressions and potentially another impression to start the process. Once the C3 dentures are returned, final impressions and jaw relations can be accomplished during the same appointment.
The following are a few circumstances where existing dentures can be valuable:
I hope you have never suffered the ignominy of making a brand new set of dentures for an elderly patient only to have them refuse to wear them. Well meaning family members want to “get new teeth for Mama”. Seems like a good idea since the old ones are really old. Here’s the rub (no humor intended). “Mama” knows the old teeth as a part of her. The borders are short, the intaglio only touches in a few areas and the occlusion is many millimeters in front of Centric Relation.
So you go ahead and follow the dental school 5 appointment technique. Overextended alginate impressions, custom trays, bite rims, tryin, delivery AND THEN 10 POSTOP APPOINTMENTS. And, oh by the way, she will never be happy.
There has to be another way……..
A new patient has a great set of dentures. Esthetics are good and occlusion is spot on. This patient has decided to make the transition from traditional dentures to implant supported/retained dentures. It would be great to have a predictable method of transferring all this valuable data to an articulator. Its extremely important to be able to evaluate prosthetic space available prior to implant placement. Depending on the type of implant restoration you are planning, the prosthetic space can vary significantly. (Locators, Bar Overdenture, All On Four Hybrid, etc)
If all the esthetic and functional parameters are recorded in the articulator, it becomes much easier to recreate an implant supported/retained solution.
You have a new denture patient with existing dentures that wants a new set but with some changes. Upon examination, you find that the borders are short in some areas and that the teeth are worn in such fashion that additional incisal edge length would improve esthetics.
Scenario 4 (similar to Scenario 2)
The laboratory often gets impressions of existing dentures along with bite rims that were fashioned in the patient’s mouth. The prescription will ask for the new setup to be “just like” the patient’s existing dentures. Please understand, there is no way to relate the solid models of the patient’s existing dentures to the casts mounted with the bite rims. Technicians often can get close, but there is no truly accurate way to coordinate these two.
There will certainly be other scenarios to consider as you learn to utilize duplicate dentures for treatment planning. The next couple of blog entries will show how to develop the duplication flasks and then the clinical steps necessary to utilize the C3 denture technique.
How do you handle similar work flows today?
Till next time……….
Larry R. Holt, DDS, FICD