Clinical Procedures

Clinical Procedure for Partial Dentures

Usage:

A partial denture can be found either on the upper or lower jaw. A removable partial denture (RPD) can be made for patients in need from 1 to13 missing natural teeth. Partial dentures “fill in the gaps”, they are false teeth you can remove to clean or during sleep. A partial denture enhances the persons appearance and aids in function such as improved eating and speaking. The use of a partial denture spreads the forces placed upon natural teeth during eating and chewing. It also stops natural teeth from “drifting” as the back teeth tend to drift forward and the upper back teeth drift downwards or upwards to find an opposing missing tooth.

Materials used

Partial dentures at our denture clinics can be manufactured using chrome cobalt (a type of metal). Metal dentures are smaller thinner, stronger and last longer due to NO wear and tear. The clasps (clips) made from metal fit around the natural teeth perfectly and often tend to support them. This is due to a casting machine adapting the clasps directly onto your natural teeth during the process. Alternatively, plastic material can be used including “hi impact” acrylics. The chemical structure of such acrylics makes the denture material stronger, more resilient to wear and breakage, but it does not compare to the strength and size of a chrome cobalt denture material. The clasps of a plastic denture are hand wrought and cannot compete with the accuracy when using a centrifugal casting machine for a chrome cobalt denture. Then there are flexible thermoplastic dentures. These types of appliances are undetectable, durable and resistant to breakage. Our clinics more often provide this type of denture to any other.

Clinical Procedures:

Prior to commencement the Dental Prosthetist will take a health and dental history and obtain a reason for presenting. This includes answering a few questions concerning the patient’s general and dental health. The old dentures are also examined. This process allows the practitioner to obtain patients expectations, a treatment plan and a prognosis. Often a quotation of fees is given and the method of payment discussed. If agreement is reached the next step for the denture treatment is arranged. Commencement of the denture construction follows immediately after the assessment or an alternative appointment time may become necessary.

( Time: approx.30-40mins)

An initial impression (imprint) of the upper and lower jaw are made. This involves placing special material (non drip) into an appropriately sized impression tray and placing it into the mouth. Once to the upper jaw and once to the lower jaw. The reason for this procedure is to produce an initial model of the mouth in order to produce specially fitting trays, referred to as “special trays”. These trays will be produced by the Prosthetist in his laboratory.

(Time: approx.20mins)

Another lot of impressions is taken in the specially prepared “special trays” using different (usually non drip) material. The reason for this procedure is to obtain a more accurate representation of the mouth. “bite blocks (wax rims resembling a denture shape)” will then be produced in the laboratory.

(Time: approx.20mins)

Both “bite blocks” are placed into the patients mouth and skillfully trimmed and manipulated to obtain the correct contour and length. Special measurements such as: centre, lip length and jaw relation ship will be taken. This procedure will be checked on the next visit for its accuracy. At times the skill of the operator is not enough to get this procedure correct on the first time without the help of a relaxed and responsive patient. Also during this visit, teeth will be selected. This is discussed closely with the patient. The complexion, colour of hair, eyes and shape of the face as well as the previous teeth on the old dentures are all taken into consideration. Once selected the next step will be prepared by the Prosthetist in his laboratory.

The teeth selected during the previous visit are now presented to the patient set into the bite rims. Like dentures made out of wax with the teeth on them will be placed into the patients mouth. Initially the practitioner will check all necessary dimensions as well as the previously taken bite registration. If all looks well then the patient is reminded of the purpose of this visit and handed or pointed to a mirror where the patient can check the appearance. It is a good idea to bring a trusted friend or a member of the family to give a second opinion. This visit is very important as generally the appearance cannot be changed when the denture is finished.

(Time: approx.20mins)

The dentures are now ready and the wax has been replaced with highly polished and characterised acrylic that resembles human gingival tissue (gums). All dimensions and the fit is checked once again and the patient is shown the finished dentures in a mirror. Instructions concerning the care of gums and dentures are given at length and the patient expectations are discussed. Patient is instructed to persevere with the new dentures but not over persevere and encouraged to return for a check visit in a week or earlier if necessary.

During this visit the patient tells the prosthetist his/her problems (if any) with the new dentures . The gums and dentures are then thoroughly checked and any necessary adjustment to the dentures is made. Once again the patient is reminded of returning for further adjustments if necessary.

Note: There are circumstance where this process described above may not be used. The Dental Prosthetist may decide on a totally different technique he considers more appropriate for a particular patient.