Blog | Finlay Sutton - Denture Education

The importance of spare dentures

It is an advantage having a spare denture. I regularly make spares as part of the treatment process if the patient is happy to invest. I encourage the patient to alternate the dentures on a daily basis, so that when one fractures and requires repair, they are completely used to the other....

Importantly, however hard we try; we cannot make identical dentures. It is likely that the patient will have a favourite (set) and it is important the patient still alternates.

The spare set are conventionally handmade in the same way as the definitive set. If not, they would be made using 3D printing/milling. With current technology 3D printing/milling, does not look as good as the handmade.

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My 10 most important technical factors in producing complete dentures with superb aesthetics and function

1. Know what a great technical denture should look like (in terms of fit). Appearance is the patient’s prerogative.

2. Making accurate impressions

3. Finding and recording centric relation

4. Carving the wax rims to mimic the patient’s dentate appearance if that’s what the patient wants - for correct lip support, tooth positioning and face shape - including maintaining ultra-thin denture flange margin beneath base of the nose to form natural lip support which is generated by the crowns and roots of the teeth - COPY NATURE - “If the OVD looks right it is right”

5. Photometric calculation for tooth size selection

6. Be REALLY brave with tooth positioning – throw away the rule book

7. Video and photographic rehearsal of the try in to allow the patient a true aesthetic representation

8. Composite rest seats for supporting partial dentures

9. The Scandinavian hygienic design principles for partial dentures

10. The gums mimicking nature – shape, texture and colour

Plus 2 more important factors

11. Metal reinforcement for complete dentures – plates and cages – longer lasting dentures

12. Molloplast B lining for poor denture supporting tissues

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Do my complete denture patients need implants?

Interestingly, in the last 15 years I have not had a single patient require dental implants to stabilise a lower complete denture I have fitted. I am sure this will happen at some stage in the future, though. I believe the most important factor in delivering successful dentures is the patient’s education and understanding of their role – i.e. understanding the need for neuromuscular control through adaptation. Technical factors are extremely important but are not the most important factor in delivering successful dentures. I liken successful dentures to well-engineered lumps of plastic made within the patients’ adaptive capacities. They learn how to use them.

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Alginate impression material for metal-based dentures

IIIMaxilla

I love alginate for definitive impressions for metal-based dentures, probably because it is hydrophilic, producing a great soft tissue impression of the edentulous denture bearing mucosa. Additionally, having worked with this material for many years, I have a good feel for it. I get better fitting RPDs with alginates compared to silicones. I very rarely need to remake the metal- frames owing to poor fit.

My advice, however, is to use whichever material you get the best results with, be it alginates, silicones or polyether.

It’s not easy

Removable prosthodontics is not easy and takes effort and graft to get good at it.

Like anything in life that is worth doing – it’s not easy, but it’s worth the effort.

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Ring rests and gold clasps

I use ring rests regularly on posterior teeth which are lone standing. They provide excellent support and stability, allowing the clasp element to work optimally. It is a design I have used for the past 7 years and is based on Scandinavian teachings. I particularly like gold I bars and gingivally approaching clasps? on premolars and canines as they are more flexible and more fatigue-resistant than cobalt chromium allowing deeper engagement of undercuts resulting in improved retention and less visibility.

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We are “life savers”

Lynn said to me:

“You are a life saver. I don’t know what I would have done without finding you. I wouldn’t be able to eat!”

We made complete dentures for this patient. The lower had a Molloplast B soft lining. I made 4 sets of dentures to get a successful outcome. See this step by step on YouTube.

This patient bruxes on the dentures in situ.

We do a really important job which can have a dramatic effect on our patients’ quality of lives. I quite often forget this!

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Lowering the possibility of unhappy denture patients

I say to the patient that "your new dentures will be well engineered lumps of plastic. They look like teeth but don’t work like teeth - like a prosthetic hand/leg, they will not work like natural teeth. I will make them to the very best technical standard; however, I am heavily reliant on you getting used to them. Just like learning to drive a car or learning a new skill (like golf, football, golf, violin, chess etc) it takes time to get used to them. You will need to work with them rather than against them”.