Clinical Stages Appointments and Expected Visit
When the dentures are being made , you can expect around six visits. And the total procedure will most likely take approximately two to three weeks.
First visit we will record your history, diagnose your situation, assess your needs and make a basic prognosis of what is expected from practitioners pin of view as well as the patients. Usually, oro-facial measurements are pursued, crucial for establishing bite and TMJ relationship, as well as assessing the correct and natural dentition sizes shapes and colure of the future dental appliance to construct a natural dental appliance to suite the face.
There are several steps in making a dental appliance, from taking the first impressions to inserting the new dentures
Visit 1 – Initial Evaluation and Preliminary Impressions
(Starting Point)
1. Medical and previous dental history taking is extremely important, so that for me is the priority. Straight after that, I will check and assess the mouth for any soft tissue problems. We always ask the patient bring in any radiographs or x-rays to help with the general assessment of the underlying bone structure under the gums. If necessary we will ask the patient to arrange to get them for their own benefit. This will allow us to make a more accurate prognosis of the dental appliance. This also begins the formulation of an individualized treatment plan.
2. The very next stage of the oral examination will be to evaluate the required available landmarks that will determine the extension of the dental appliance will need. I take note of the shape and structure of the bony ridges, their height, width and flaccidity to help in the overall design format of the proposed dental appliance.
3. I ask if the patient has brought previously worn dental appliances to obtain some idea of change and general previous patient acceptances. I take note of the necessary dimensions such as heights thicknesses extensions and position of previous occlusal position of dental appliances. Other factors such as size, shade, shape and existing positions of the teeth This will be help us to determine the outcome new appliance features.
4. Primary impressions are taken purely for diagnosing purposes and for the fabrication of custom trays for more accurate secondary impressions. This step ensures optimal impression accuracy so that the resulting fit of the denture is excellent
5. Shade and shape is assessed as required for the appropriate aesthetics for the patient
Various shapes and shades, from a number of different companies
Visit 2 – Secondary Custom tray Impressions
1. The trays will be tried in and adjusted or built up around the peripheral borders as required.
2. The accurate secondary impressions will be taken with the personalised special trays, made from the previous impressions and cast models. These secondary impressions will be casts to make a precise working model
Visit 3 – Is for determining how the jaws dimensionally align with one another with aid of Wax bite blocks.
This procedure is necessary to establish the position of the maxillary jaw in relation to the mandibular jaw and positioning of the teeth and establish effective facial support.
1. The wax rims will be fitted adjusted until you are considered dimensionally perfect.
2. A precise record will be made of the centric bite position.
3. We will also determine the shade, shape and position of the teeth that will be set on these wax bite rims for the next stage of the trial denture bases.
This is an extra visit and the procedure is only undertaken if a functional articulator and facebow is used with the purchase precision dentures.
A pin tracing of a patient's jaw movements and bite position, along with facial placement of a facebow used to perfectly locate the upper maxilla in relation to the joints that articulate the mandibular jaw, this assures the correct and functional position of the jaw and actual position of the dentures. This will facilitate precise functions and interdigitation of the dentures according to the patient's Physiological dimensions. Using a fully adjustable articulator and associated face bows specifically developed for the intricate fabrication of high quality precision dentures. The wax bite for this format will have a more accurate acrylic base making them also more stable, minimising discrepancies that occur with a less accurate fitting wax base.
Visit 4 – Test, Assess and authenticate the colour, style, aesthetics and dimensions of your newly made dental appliance.
1. It is imperative to be aware that the fourth visit is the most important. It not only allows you, as the patient, to see and feel the works of your newly made denture, but its also grants your practitioner the chance to check and assess that the work performed on your dental appliance is crafted perfectly both within the clinic and laboratory.
2. This visit allows the patient the chance to assess every aspect of the new dental appliance, in terms of its colour, dimensions, teeth and fit. If for any reason the patients feel that something needs to be changed or amended, arrangements can be made to address any problems.
3. Changes can be made to the dental appliance as the teeth are positioned on the wax.
4. Patients at this stage will be granted the chance to reconsider the positioning of the teeth on their dental appliance. This allows the patient to discuss with the practitioner any particular characteristics they want of their dental appliance.
5. At this stage, we will make sure that the casts of your dental appliance are extremely accurate. It is crucial that there is correct positioning of the posterior palatal.
6. If it’s that rotated tooth, or that small gap between certain teeth that you love, rest assure that we can make and replicate your dentures as life like as you wish. Certain distinctive characteristics that you would like kept in your dentition is to your avail upon discussion with your practitioner. All variation can be hand crafted to your dental appliance.
7. It is not uncommon that the new dental appliance may need to be changed or slightly altered. Another visit is suggested, ensuring that you receive the best and most perfectly crafted dental appliance.
Visit 5 –The insert of your new dental appliance.
1. At this state, you are given the chance to properly trial your newly made dental appliance. The teeth will undergo the process of the acrylic, which will then result in a more life like replica of gum tissue. From there, the practitioner will make careful and specific, distinctive changes to your dentures to assure you a more natural looking dental appliance. Of course, this process will only happen if the patient requests this particular appliance.
2. We will precisely assess and careful check, the dimension and fit of your new dental appliance, to assure you with a comfortable appliance. We will also assess your gums, the stability of the appliance and retention.
3. The bite will be evaluated and refine the occlusal interdigitation and intercuspal disturbance to precision and minimise discomfort
Re-Check Equilibration Visit (only if necessary)
It is almost always advised that you return to your practitioner after a few days of wearing your new dental appliance, as this provides you, and your practitioner with the knowledge of how your appliance is functioning. This visit will give your practitioner and yourself the chance to correct and fix the bite of your appliance. We will also assess the total performance of your new appliance, by placing it back on the adjustable articulators, which will further test and assess any changes that may have transpired.
