Finlay's Implant Overdenture Case Presentation

Welcome to my October 2021 Newsletter Case Presentation

This newsletter describes in step by step detail the provision of a lower implant supported metal based complete denture with three dental implants positioned in the anterior mandible. The upper arch was restored with a metal based complete upper denture.

This 72 year old woman (Mary) was referred to me from her general dental practitioner from Ireland.

Dental History and Concerns

Mary had 3 dental implants placed in the anterior mandible 10 years previously with new complete dentures. These were successful for a time. The dentures were replaced a few years later. Mary was never pleased with the new lower denture as they did not fit the implants properly. This patient was referred to me from Ireland, to my practice in Garstang, England.

Medical History

Nil

Dental wish list

"That new dentures would be secure in my mouth."

"An improvment in appearance would also be appreciated."

Diagnoses of the complete dentures

  1. Locator attachments not engaging the housings in the lower denture.
  2. Suboptimally shaped dentures with poor tissue fit resulting in rocking of the dentures.
  3. Bland aesthetics.

I provided new metal based complete dentures. The clinical situation and treatment process is shown in detail below with photographs. I provided the clinical work and Rowan Garstang provided the technical work. The dentures took 5 visits to make - with the patient travelling by plane from Ireland to Manchester. The patient had one review after the dentures were fitting.

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Pre-treatment - upper complete denture lower - implant supported complete denture Patient unhappy with denture appearance and fit of the lower denture
Pre-treatment - upper complete denture lower - implant supported complete denture Patient unhappy with denture appearance and fit of the lower denture
Pre-treatment - upper complete denture lower - implant supported complete denture Patient unhappy with denture appearance and fit of the lower denture
Pre-treatment - upper complete denture lower - implant supported complete denture Patient unhappy with denture appearance and fit of the lower denture
Pre-treatment - upper complete denture lower - implant supported complete denture. Locator attachments not engaging the housings in the lower denture. Sub-optimally shaped dentures with poor tissue fit resulting in rocking of the dentures. Bland aesthetic
Pre-treatment - upper complete denture lower - implant supported complete denture. Locator attachments not engaging the housings in the lower denture. Sub-optimally shaped dentures with poor tissue fit resulting in rocking of the dentures. Bland aesthetic
Old denture - clear palate - thick flange under base of nose - poor aesthetics
Old denture - clear palate - thick flange under base of nose - poor aesthetics
Pre-treatment. Locator abutments on dental implants. Calculus present. Scaling and oral hygiene instruction given.
Pre-treatment. Locator abutments on dental implants. Calculus present. Scaling and oral hygiene instruction given.
Following scaling and oral hygiene instruction
Following scaling and oral hygiene instruction
More “muscle trimming” on the left side compared to the right side. Dentist who took the working impressions may have been right handed. Poor denture shape (under extended in retro molar pads) probably from incorrectly extended custom tray and inadequate
More “muscle trimming” on the left side compared to the right side. Dentist who took the working impressions may have been right handed. Poor denture shape (under extended in retro molar pads) probably from incorrectly extended custom tray and inadequate
Denture not seating properly on the implants - damaging the Locator inserts
Denture not seating properly on the implants - damaging the Locator inserts
Denture not seating properly on the implants - damaging the Locator inserts. I decided to remove the housings and cold cure in new housings to improve the fit for Mary temporarily
Denture not seating properly on the implants - damaging the Locator inserts. I decided to remove the housings and cold cure in new housings to improve the fit for Mary temporarily
Prior to cold curing in the new attachments I wanted to make sure that the denture was seating properly on the saddles
Prior to cold curing in the new attachments I wanted to make sure that the denture was seating properly on the saddles
New Locator housings tried in - ensuring they fit properly
New Locator housings tried in - ensuring they fit properly
PTFE washers placed to prevent the cold cure acrylic from setting onto the locator abutments. If these are not used the denture will lock in place - needing drilling out.
PTFE washers placed to prevent the cold cure acrylic from setting onto the locator abutments. If these are not used the denture will lock in place - needing drilling out.
New housings cold cured into old denture - temporary measure whilst new dentures made - this made the fit of the existing denture more comfortable
New housings cold cured into old denture - temporary measure whilst new dentures made - this made the fit of the existing denture more comfortable
The patient at the age of 8. This enabled calculation of the width of the upper central incisors. 8.5mm. Carol wanted to have teeth similar to her daughter’s beautiful natural dentition.
The patient at the age of 8. This enabled calculation of the width of the upper central incisors. 8.5mm. Carol wanted to have teeth similar to her daughter’s beautiful natural dentition.
Treatment planning card containing sequenced treatment plan and quotation. This is how I plan all of my patients treatments
Treatment planning card containing sequenced treatment plan and quotation. This is how I plan all of my patients treatments
Downloadable examples of patient treatment plan letters for all types of removable dentures at finlaysutton.co.uk/resources
Downloadable examples of patient treatment plan letters for all types of removable dentures at finlaysutton.co.uk/resources
Mary’s appointments - to make the dentures
Mary’s appointments - to make the dentures
Upper tray - selected. Medium size - Schottlander tray
Upper tray - selected. Medium size - Schottlander tray
Lip retractors fashioned from photographic retractors are very useful for correct position of the impression tray in the mouth
Lip retractors fashioned from photographic retractors are very useful for correct position of the impression tray in the mouth
Lip retractors fashioned from photographic retractors are very useful for correct position of the impression tray in the mouth
Lip retractors fashioned from photographic retractors are very useful for correct position of the impression tray in the mouth
Syringe light bodied alginate into the sulcus from hamular notch round to hamular notch. The heavy bodied alginate is carried in a Schottlander Edentulous tray.
Syringe light bodied alginate into the sulcus from hamular notch round to hamular notch. The heavy bodied alginate is carried in a Schottlander Edentulous tray.
Syringe light bodied alginate into the sulcus from hamular notch round to hamular notch. The heavy bodied alginate is carried in a Schottlander Edentulous tray.
Syringe light bodied alginate into the sulcus from hamular notch round to hamular notch. The heavy bodied alginate is carried in a Schottlander Edentulous tray.
Primary cast
Primary cast
A “frame cut back tray” is loaded with heavy bodied alginate
A “frame cut back tray” is loaded with heavy bodied alginate
FCB tray - checking for size - large selected - lingual extension fits into retromylohyoid space
FCB tray - checking for size - large selected - lingual extension fits into retromylohyoid space
Syringe the light bodied alginate from the retromylohyoid region around the lingual sulcus over the retromolar pad and around the buccal and labial sulcus. A “frame cut back tray” (available from Metrodent) is loaded with heavy bodied alginate.
Syringe the light bodied alginate from the retromylohyoid region around the lingual sulcus over the retromolar pad and around the buccal and labial sulcus. A “frame cut back tray” (available from Metrodent) is loaded with heavy bodied alginate.
Syringe the light bodied alginate from the retromylohyoid region around the lingual sulcus over the retromolar pad and around the buccal and labial sulcus. A “frame cut back tray” (available from Metrodent) is loaded with heavy bodied alginate.
Syringe the light bodied alginate from the retromylohyoid region around the lingual sulcus over the retromolar pad and around the buccal and labial sulcus. A “frame cut back tray” (available from Metrodent) is loaded with heavy bodied alginate.
Primary cast
Primary cast
Technical work provided by Rowan for treatment visit 2
Technical work provided by Rowan for treatment visit 2
Lower custom tray with Locator impression pick ups
Lower custom tray with Locator impression pick ups
Locator impression pick ups - carefully fitted
Locator impression pick ups - carefully fitted
Greenstick right and left buccal shelves from canine to second molar position – avoid the retromolar pad – this is moulded in the patients mouth by the patient saying “EEE” and “OOO” with exaggerated cheek movements.
Greenstick right and left buccal shelves from canine to second molar position – avoid the retromolar pad – this is moulded in the patients mouth by the patient saying “EEE” and “OOO” with exaggerated cheek movements.
Greenstick right and left buccal shelves from canine to second molar position – avoid the retromolar pad – this is moulded in the patients mouth by the patient saying “EEE” and “OOO” with exaggerated cheek movements.
Greenstick right and left buccal shelves from canine to second molar position – avoid the retromolar pad – this is moulded in the patients mouth by the patient saying “EEE” and “OOO” with exaggerated cheek movements.
Greenstick right and left buccal shelves from canine to second molar position – avoid the retromolar pad – this is moulded in the patients mouth by the patient saying “EEE” and “OOO” with exaggerated cheek movements.
Greenstick right and left buccal shelves from canine to second molar position – avoid the retromolar pad – this is moulded in the patients mouth by the patient saying “EEE” and “OOO” with exaggerated cheek movements.
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Greenstick right - right and left lingually from second molar to second molar – avoiding the retromolar pad - this is moulded in the patients mouth by the patient licking the upper lip from right to left commissures, pushing the tongue against the lower
Impregum adhesive applied to fitting surface
Impregum adhesive applied to fitting surface
Impregum adhesive applied to labial, lingual and buccal surfaces
Impregum adhesive applied to labial, lingual and buccal surfaces
Tray loaded with Impregum. The patient performs all 5 movements twice.
Tray loaded with Impregum. The patient performs all 5 movements twice.
The borders are moulded by the 5 movements the patient makes.
The borders are moulded by the 5 movements the patient makes.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray hs been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray hs been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray has been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray has been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray has been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray has been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray has been made to fit the accurate primary cast.
Close fitting tray - where the tray shows through the impression material is not a problem because the tray has been made to fit the accurate primary cast.
Top surface of working impression - showing developed polished surfaces to be preserved in the denture
Top surface of working impression - showing developed polished surfaces to be preserved in the denture
The upper custom tray is spaced by 2 layers of wax – 3mm for alginate or silicone impressions. This is short of the depth of the sulcus all the way round the periphery by 2 mm. In the post dam region the tray is extended 1mm beyond the fovea palatini.
The upper custom tray is spaced by 2 layers of wax – 3mm for alginate or silicone impressions. This is short of the depth of the sulcus all the way round the periphery by 2 mm. In the post dam region the tray is extended 1mm beyond the fovea palatini.
Greenstick is placed in the canine regions and along the post dam. This recreates the wax spacer used to produce the tray.
Greenstick is placed in the canine regions and along the post dam. This recreates the wax spacer used to produce the tray.
Greenstick is then applied to the borders of the tray from the 4s back to the tuberosities - this enhances suction/retention. This is placed in the patient’s mouth with muscle trimming and the patient is instructed to move the jaws from right to left “wa
Greenstick is then applied to the borders of the tray from the 4s back to the tuberosities - this enhances suction/retention. This is placed in the patient’s mouth with muscle trimming and the patient is instructed to move the jaws from right to left “wa
Greenstick - thinned after border moulding to functional width of the sulcus
Greenstick - thinned after border moulding to functional width of the sulcus
A very thin mix of alginate (avoiding over filling the tray) is applied and glazed with water. The same trimming and movements are performed as with greenstick application, with the addition of sucking firmly for 1 second. Keep the periphery thin in the
A very thin mix of alginate (avoiding over filling the tray) is applied and glazed with water. The same trimming and movements are performed as with greenstick application, with the addition of sucking firmly for 1 second. Keep the periphery thin in the
Working impression
Working impression
Working impression
Working impression
Working impression
Working impression
This is trimmed to the occlusal vertical dimension. When the patient looks right they are right.
This is trimmed to the occlusal vertical dimension. When the patient looks right they are right.
Rims trimmed to occlusal vertical dimension. When the patient looks right they are right.
Rims trimmed to occlusal vertical dimension. When the patient looks right they are right.
Primary jaw registration - fixed together with futar D
Primary jaw registration - fixed together with futar D
Primary jaw registration - used to mount the work casts to allow correct setting up of the central bearing apparatus - gothic arch tracing system
Primary jaw registration - used to mount the work casts to allow correct setting up of the central bearing apparatus - gothic arch tracing system
Primary jaw registration - used to mount the work casts to allow correct setting up of the central bearing apparatus - gothic arch tracing system
Primary jaw registration - used to mount the work casts to allow correct setting up of the central bearing apparatus - gothic arch tracing system
Central bearing apparatus - gothic arch tracing system - set up on the working casts which have mounted using the primary jaw registration
Central bearing apparatus - gothic arch tracing system - set up on the working casts which have mounted using the primary jaw registration
Technical work provided by Rowan for treatment visit 3
Technical work provided by Rowan for treatment visit 3
Lower pivot/rim which attaches to the implants for treatment visit 3
Lower pivot/rim which attaches to the implants for treatment visit 3
Lower pivot/rim which attaches to the implants for treatment visit 3
Lower pivot/rim which attaches to the implants for treatment visit 3
Visit 3 registration stage - prescribing the position of the upper teeth and the correct occlusal vertical dimension
Visit 3 registration stage - prescribing the position of the upper teeth and the correct occlusal vertical dimension
Visit 3 registration stage - prescribing the position of the upper teeth and the correct occlusal vertical dimension
Visit 3 registration stage - prescribing the position of the upper teeth and the correct occlusal vertical dimension
The rim carving recipe
The rim carving recipe
Visit 3 registration stage - prescribing the position of the upper teeth and the correct occlusal vertical dimension
Visit 3 registration stage - prescribing the position of the upper teeth and the correct occlusal vertical dimension
Lip Support Incisal plane - level with IPD Occlusal plane - level with ala-tragus Buccal corridors - as per dentate picture Centre line - as per dentate picture OVD - if they look right - they are right
Lip Support Incisal plane - level with IPD Occlusal plane - level with ala-tragus Buccal corridors - as per dentate picture Centre line - as per dentate picture OVD - if they look right - they are right
The rim carving recipe
The rim carving recipe
These are the must have photographs for the technician. Mary wanted her smile to be similar to her daughters. I have preserved Mary’s and her daughter’s anonymity in this slide but the technician will get full face photos.
These are the must have photographs for the technician. Mary wanted her smile to be similar to her daughters. I have preserved Mary’s and her daughter’s anonymity in this slide but the technician will get full face photos.
Upper central incisor tooth size calculation formula - Next few slides are a different person to preserve Mary’s anonymity
Upper central incisor tooth size calculation formula - Next few slides are a different person to preserve Mary’s anonymity
Upper central incisor tooth size calculation formula - Next few slides are a different person to preserve Mary’s anonymity
Upper central incisor tooth size calculation formula - Next few slides are a different person to preserve Mary’s anonymity
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
If a frontal dentate photograph of the patient is available then Dr John Besfords tooth size calculation formula can be used to calculate the size of the prosthetic teeth.
Upper central incisors of 8.5mm wide - Schottlander Enigmalife teeth. To match the same shape as her daughters teeth.
Upper central incisors of 8.5mm wide - Schottlander Enigmalife teeth. To match the same shape as her daughters teeth.
The correctly trimmed rims are used to set the vertical dimension of the patient during visit 3. The working casts which had been articulated after visit 2 with the primary rims are used for this.
The correctly trimmed rims are used to set the vertical dimension of the patient during visit 3. The working casts which had been articulated after visit 2 with the primary rims are used for this.
The central bearing apparatus is set to the same occlusal vertical dimension as the carved wax rims, by opening or closing the screw on its lower part. This sets the vertical dimension of the central bearing apparatus to Mary’s OVD. Therefore the gothic a
The central bearing apparatus is set to the same occlusal vertical dimension as the carved wax rims, by opening or closing the screw on its lower part. This sets the vertical dimension of the central bearing apparatus to Mary’s OVD. Therefore the gothic a
Part 2 of visit 4 - Gothic arch tracing - made to fit accurately the working casts - using light cured tray maker material. This allows precise recording of the centric relation - much better than wax blocks
Part 2 of visit 4 - Gothic arch tracing - made to fit accurately the working casts - using light cured tray maker material. This allows precise recording of the centric relation - much better than wax blocks
This fits over the implants and onto the denture supporting soft tissues accurately
This fits over the implants and onto the denture supporting soft tissues accurately
The next few slides show how to use the gothic arch tracing system
The next few slides show how to use the gothic arch tracing system
Sequence of use - patient is instructed to move lower jaw forward
Sequence of use - patient is instructed to move lower jaw forward
Sequence of use - patient is instructed to move lower jaw back - this is near centric relation
Sequence of use - patient is instructed to move lower jaw back - this is near centric relation
Sequence of use - patient is instructed to move lower jaw the right
Sequence of use - patient is instructed to move lower jaw the right
Sequence of use - patient is instructed to move lower jaw the left
Sequence of use - patient is instructed to move lower jaw the left
Sequence of use - patient is instructed to move lower jaw the left
Sequence of use - patient is instructed to move lower jaw the left
The tip of the triangle is the most reproducible jaw position for an edentulous patient - centric relation
The tip of the triangle is the most reproducible jaw position for an edentulous patient - centric relation
The tip of the triangle is the most reproducible jaw position for an edentulous patient - centric relation Occasionally I verify with a tapping point using articulating paper if the triangle tip is not quite clear.
The tip of the triangle is the most reproducible jaw position for an edentulous patient - centric relation Occasionally I verify with a tapping point using articulating paper if the triangle tip is not quite clear.
Plastic disc with hole is fitted with melted wax onto the plate directly over the triangle point
Plastic disc with hole is fitted with melted wax onto the plate directly over the triangle point
The central bearing apparatus is placed back into the mouth and the lower jaw part is guided into the hole on the upper plate
The central bearing apparatus is placed back into the mouth and the lower jaw part is guided into the hole on the upper plate
The central bearing apparatus is fixed together with Futar D bite registration material - locking the jaw position to centric relation
The central bearing apparatus is fixed together with Futar D bite registration material - locking the jaw position to centric relation
The central bearing apparatus is fixed together with Futar D bite registration material - locking the jaw position to centric relation
The central bearing apparatus is fixed together with Futar D bite registration material - locking the jaw position to centric relation
The central bearing apparatus out of the mouth fixed solidly together
The central bearing apparatus out of the mouth fixed solidly together
The central bearing apparatus out of the mouth fixed solidly together
The central bearing apparatus out of the mouth fixed solidly together
Visit 4 The bite fork is attached to the wax rim is be used to mount the upper working cast on the articulator
Visit 4 The bite fork is attached to the wax rim is be used to mount the upper working cast on the articulator
The bite fork is attached to the wax rim is be used to mount the upper working cast on the articulator
The bite fork is attached to the wax rim is be used to mount the upper working cast on the articulator
The face bow attached to the wax rim is used to mount the upper working cast on the articulator
The face bow attached to the wax rim is used to mount the upper working cast on the articulator
At the end of visit 3 Rowan gets back the carved upper and lower rims, the face bow transfer (used with the upper wax rim, the central bearing apparatus fixed together in CR, along with the working casts previously supplied.
At the end of visit 3 Rowan gets back the carved upper and lower rims, the face bow transfer (used with the upper wax rim, the central bearing apparatus fixed together in CR, along with the working casts previously supplied.
The working casts are detached from their bases which previously attached the articulator using the primary jaw registration. The upper work cast is fitted to the articulator using the bite fork
The working casts are detached from their bases which previously attached the articulator using the primary jaw registration. The upper work cast is fitted to the articulator using the bite fork
The upper working cast is fitted to the top member of the articulator using plaster
The upper working cast is fitted to the top member of the articulator using plaster
The wax rim is removed and the central bearing apparatus is fitted to the upper work cast.
The wax rim is removed and the central bearing apparatus is fitted to the upper work cast.
The lower working cast is attached to the lower member of the articulator using the central bearing apparatus
The lower working cast is attached to the lower member of the articulator using the central bearing apparatus
Rowan then uses the carved wax rims to set up the teeth. Notice the Class III skeletal arrangement
Rowan then uses the carved wax rims to set up the teeth. Notice the Class III skeletal arrangement
Rowan then uses the carved wax rims to set up the teeth.
Rowan then uses the carved wax rims to set up the teeth.
Rowan then uses the carved wax rims to set up the teeth. - teeth ready for try in. - Notice the Class III skeletal arrangement
Rowan then uses the carved wax rims to set up the teeth. - teeth ready for try in. - Notice the Class III skeletal arrangement
Rowan then uses the carved wax rims to set up the teeth. - teeth ready for try in. - Notice the bilateral crossbite arrangement
Rowan then uses the carved wax rims to set up the teeth. - teeth ready for try in. - Notice the bilateral crossbite arrangement
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Reinforcement to implant supported dentures is crucial to reduced breakages
Wax try in ready for visit 4
Wax try in ready for visit 4
Wax try in ready for visit 4
Wax try in ready for visit 4
Wax try in ready for visit 4 - notice distinct shape of the denture
Wax try in ready for visit 4 - notice distinct shape of the denture
Wax try in ready for visit 4 - notice distinct shape of the denture
Wax try in ready for visit 4 - notice distinct shape of the denture
Wax try in ready for visit 4.
Wax try in ready for visit 4.
Wax try in. Reinforcement to the opposing dentures is also crucial to reduced breakages
Wax try in. Reinforcement to the opposing dentures is also crucial to reduced breakages
Wax try in. Reinforcement to the opposing dentures is also crucial to reduced breakages
Wax try in. Reinforcement to the opposing dentures is also crucial to reduced breakages
Visit 4 - The patient assesses the try in
Visit 4 - The patient assesses the try in
Visit 4 - The patient assesses the try in
Visit 4 - The patient assesses the try in
Visit 4 - The patient assesses the try in
Visit 4 - The patient assesses the try in
Try in the occlusion is checked first. No occlusal errors are found when using the gothic arch tracing
Try in the occlusion is checked first. No occlusal errors are found when using the gothic arch tracing
Note - irregularity of the lower anterior teeth - to make them more real/lifelike
Note - irregularity of the lower anterior teeth - to make them more real/lifelike
Photos are taken first
Photos are taken first
Photos are taken first
Photos are taken first
A video is taken of the patient with the try in. Claire my nurse does this.
A video is taken of the patient with the try in. Claire my nurse does this.
Mary watches her video (with the sound turned off) whilst talking, smiling and communicating with the denture try in – in place. I have found the use of video to be very helpful in gaining patient acceptance. Claire does this part.
Mary watches her video (with the sound turned off) whilst talking, smiling and communicating with the denture try in – in place. I have found the use of video to be very helpful in gaining patient acceptance. Claire does this part.
Post dam is drawn from tuberosity to tuberosity over the fovea palatini - this is then scored into the cast
Post dam is drawn from tuberosity to tuberosity over the fovea palatini - this is then scored into the cast
Prior to processing the post dam will be incorporated int the finished denture
Prior to processing the post dam will be incorporated int the finished denture
Working casts - class III skeletal relationship
Working casts - class III skeletal relationship
Finished dentures
Finished dentures
Working casts - class III skeletal relationship
Working casts - class III skeletal relationship
Finished dentures
Finished dentures
Working casts - class III skeletal relationship
Working casts - class III skeletal relationship
Finished dentures
Finished dentures
Working casts - class III skeletal relationship
Working casts - class III skeletal relationship
Finished dentures
Finished dentures
Working casts - class III skeletal relationship
Working casts - class III skeletal relationship
Finished dentures
Finished dentures
Finished denture
Finished denture
Finished metal reinforced upper denture finished to the land area of the model for optimal polished surfaces
Finished metal reinforced upper denture finished to the land area of the model for optimal polished surfaces
Post dam has been scored into the cast forming a posterior palate seal
Post dam has been scored into the cast forming a posterior palate seal
Finished metal reinforced upper denture finished to the land area of the model for optimal polished surfaces
Finished metal reinforced upper denture finished to the land area of the model for optimal polished surfaces
Finished upper denture
Finished upper denture
As the patient was travelling from Ireland I decided to have the housings processed into the denture. This ensures a better finish where the housings fit into the denture. The downside of this is that the tissue fit on the soft tissues is not quite as goo
As the patient was travelling from Ireland I decided to have the housings processed into the denture. This ensures a better finish where the housings fit into the denture. The downside of this is that the tissue fit on the soft tissues is not quite as goo
Preservation of a land area on the cast allows correct shaping of the polished surfaces
Preservation of a land area on the cast allows correct shaping of the polished surfaces
Finished metal reinforced lower denture finished to the land area of the model for optimal polished surfaces
Finished metal reinforced lower denture finished to the land area of the model for optimal polished surfaces
Finished metal reinforced lower denture finished to the land area of the model for optimal polished surfaces
Finished metal reinforced lower denture finished to the land area of the model for optimal polished surfaces
Finished metal reinforced implant supported over denture
Finished metal reinforced implant supported over denture
Finished metal reinforced implant supported over denture
Finished metal reinforced implant supported over denture
Finished metal reinforced implant supported over denture - notice shape of the denture
Finished metal reinforced implant supported over denture - notice shape of the denture
Finished metal reinforced implant supported over denture - notice shape of the denture
Finished metal reinforced implant supported over denture - notice shape of the denture
Anatomically set up Schottlander Enigmalife teeth - in balanced articulation
Anatomically set up Schottlander Enigmalife teeth - in balanced articulation
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Finished dentures - mimicking Mary’s daughters natural teeth
Lip support improved
Lip support improved
Lip support improved
Lip support improved
Lip support improved
Lip support improved
After - optimally border moulded to the functionally depth and width of the suli - giving optimal support to the dentures, not being overly reliant on the implants.
After - optimally border moulded to the functionally depth and width of the suli - giving optimal support to the dentures, not being overly reliant on the implants.
After - optimally border moulded to the functionally depth and width of the suli - giving optimal support to the dentures, not being overly reliant on the implants.
After - optimally border moulded to the functionally depth and width of the suli - giving optimal support to the dentures, not being overly reliant on the implants.
Testimonial - it was worth travelling from Ireland…. One review was required.
Testimonial - it was worth travelling from Ireland…. One review was required.
Difficult class III Lower complete metal based denture supported by dental implants and upper complete metal based denture - full protocol

FACE TO FACE OPEN EVENING Thursday 4th November 2021

Clinical Updates – resin retained bridges, dentures, orthodontics, endodontics and periodontics

Dear Colleague

We would like to invite you and your team to our free verifiable CPD open evening on Thursday 4th November 2021 from 5.45pm at Garstang Country Hotel and Golf Club. Presentations from the team at Garstang Dental Referral Practice:

  • Finlay Sutton, Specialist in Restorative Dentistry, Prosthodontics, Periodontics, Endodontics - Getting the teeth in the right place for complete dentures - 6 secrets to carving a wax rim.
  • Zohaib Ali, Specialist in Prosthodontics - Resin retained bridges: Predictably successful
  • Rachel Seed, Specialist in Orthodontics - Clinical case presentation
  • Syed Abad Specialist in Periodontics - Surgical Periodontics - A step by step approach
  • Rob Jacobs, Specialist in Endoodontics - Top tips for negotiating curved root canals

Aims and objectives of the presentations and open evening are to:

  • Provide practical advice, hints and tips, which can be applied straight into clinical practice
  • Highlight potential pitfalls and problems when treating patients within our disciplines
  • Help identifying patients who will benefit from specialist referral and management
  • Provide evidence that you can refer patients to us with confidence
  • Meet the team and discuss clinical cases

We look forward to celebrating our 14th year anniversary with you at our open evening on Thursday 4th November 2021 from 5.45pm at Garstang Country Hotel and Golf Club. The hot buffet will be served from 5.45pm with the presentations starting at 6.30pm providing 2 hours of free verifiable CPD. Please pass this invitation onto your referring colleagues.

Ways to book
By email - office@garstangdrp.co.uk
By phone - 01995 606091

Booking form

Reference material

Full access PDF to my published scientific papers which explain my philosophy and clinical techniques. Please click on the link below and scoll down this page to find lots of useful clinical techniques, reference material and previous lectures:

https://www.finlaysutton.co.uk/resources

Previous Newletters:

https://www.finlaysutton.co.uk/case-studies

 

Aide memoire - for various combinations of missing upper teeth.
*****Partial denture Masterclass***** TWO PLACES LEFT ONLY
Thursday 4th November 2021 from 5.45pm at Garstang Country Hotel and Golf Club. Clinical Updates – in fixed prosthodontics, dentures, orthodontics endodontics and periodontics
Thursday 4th November 2021 from 5.45pm at Garstang Country Hotel and Golf Club. Clinical Updates – in fixed prosthodontics, dentures, orthodontics endodontics and periodontics
Immediate dentures - Impression Club Live with Finlay Sutton and Rupert Monkhouse

Finlay's Blog

Aide memoire - for various combinations of missing upper teeth.

Partial denture design is difficult. This Aide memoire is designed to make it easier. Generic universal removable partial denture (RPD) designs - these cover most arrangements of missing teeth - but every RPD is a unique "prototype". The main changes to the designs I generally make are when there are gaps between the teeth (metal backings show between the teeth) and if the teeth have good long term prognosis - in these cases metal backings are often not needed. The aim of this Aide Memoire is to help dentists quickly produce superb RPD designs for their patients. As a result patients will benefit from comfortable, stable, healthy, robust and adaptable RPDs.

*****Partial denture Masterclass***** TWO PLACES LEFT ONLY

*****Partial denture Masterclass***** TWO PLACES LEFT ONLY

Learn how to do this on my one day masterclass. Angela is my demonstration patient - see her full treatment protocol I will be showing the amazing Scandinavian partial denture design system, primary impressions, working impressions, gothic arch tracing bite registration and much much more - on Angela as my live demonstration patient. Cost per delegate £1,154. Thursday 18th November, at Lancaster University, UK.

www.finlaysutton.co.uk/app/finlay_sutton/files-module/local/documents/Finlay%20Sutton_Partial%20Denture%20Course%2021_22.pdf

If you would like to book please email ASAP at education@finlaysutton.co.uk

It would be great to see you.......

Garstang Dental Referral Practice 2021 Open Evening

Clinical Updates – in fixed prosthodontics, dentures, orthodontics endodontics and periodontics

Immediate dentures - Impression Club Live with Finlay Sutton and Rupert Monkhouse

Finlay Sutton answers questions about immediate dentures put to him by Rupert Monkhouse in Rupert's Impression Club Live - Instagram.

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