Blog | Finlay Sutton - Denture Education

Universal Scandinavian partial denture designs

Please find my updated universal Scandinavian partial denture designs for most patterns of missing teeth. Please note there are two types of design.

1. Remaining teeth have good prognosis

2. Remaining teeth have poor prognosis - meaning the RPDs can be added to as teeth fail.

Dentures work in a similar way to a prosthetic hand

When consenting new patients and at the fitting of new dentures I emphasise to the patient that the new dentures will require considerable amount of practice and adaptation for them to be a success.

I show them a prosthetic hand and ask them to imagine how it would feel to have an artificial hand. I say “a prosthetic hand would operate in a completely different way to a natural hand and this is no different with dentures v natural teeth. Dentures chew, bite and work in a totally different way to natural teeth and as such require considerable adaption. They are essentially well- engineered blocks of plastic”

In addition, I say “The new dentures have been made to the highest possible standards using all of our skills and knowledge, giving you the best possible chance of being able to wear them comfortably. We are, however, reliant on your adaptation to the denture and it will require considerable practice and effort on your behalf to make it work. A similar analogy is learning how to use chopsticks instead of a knife and fork.”

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The magic of a heat cured soft lining for lower complete dentures

I find that patients who develop constant soreness under a lower denture benefit greatly from a heat cured soft silicone lining (such as Molloplast B or Permaliner) which is processed in the dental laboratory.

The transformation in their quality of life cannot be overestimated.

It is crucial in these circumstances that the rest of the denture is made well with optimal:

1. Extension of the denture base

2. Polished surfaces

3. Tooth positioning and occlusion

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Photographs of the patient smiling with the shaped wax rims in situ – send to the technician

Photographs of the patient smiling and at rest with the shaped wax rims in place are extremely helpful for the technician. I take the following 10 photographs with the patient smiling and at rest:

1. The right and left profile

2. The right and left three quarter view

3. Portrait view

Along with dentate photographs of the patient, if these are available, the above photographs are of great assistance for setting the teeth. Corrections to the prescribed tooth positions of the wax rim can be made by the dental technician with reference to these photographs, adding another check in the system.

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Appointments for making acrylic based RPDs – after the consultation visit(s)

In general, these are the visits required to make acrylic based removable partial dentures satisfactorily. I regard acrylic based RPDs as temporary and metal based RPDs as definitive appliances.

To provide a quotation a basic design is performed from photographs taken at the initial consultation. The initial consultation is a crucial part of the process for establishing rapport, trust and generating the all-important wish list.

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Appointments for making cobalt chromium based partial dentures

In general, these are the timings I require to complete each stage for a set of cobalt chromium based partial dentures satisfactorily.

To provide a quotation a basic design is performed from photographs taken at the initial consultation.

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Post dam position for maxillary complete dentures – the fovea palatini getting a good posterior seal

The posterior border of a maxillary complete denture is positioned at or around the position of the fovea palatini, by cutting a “cupids bow shaped” groove onto the master cast. The post dam groove extends from the right to the left hamular notches and beyond just into the buccal sulcus, enclosing the tuberosities and passing across the midline of the palate within 1 mm of the fovea palatini.

If the patient cannot tolerate this extension, the post dam position is brought forward (away from the soft palate) in the centre by cutting a new post dam on the definitive cast. It is important to maintain coverage of the tuberosities past the hamular notches into the buccal sulcus.

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Well engineered lumps of plastic

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 reliant heavily on you getting used to them. Just like learning to drive a car or learning a difficult new skill (like golf, football, using chopsticks (if they don’t use them)….. the analogies vary for patient to patient ) it takes time to get used to them.” The role of neuromuscular control cannot be over emphasised. The adaptability of humans is incredible.

Managing expectations is 50% of the job with dentures. 50% is technical.

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