Creating the perfect denture for a patient is a delicate balancing act between aesthetics, functionality, and patient comfort. One of the most common challenges faced by both dentists and clinical dental technicians (CDTs) is minimising the number of adjustments needed after a denture has been fabricated. The more adjustments required, the longer the patient will have to wait to receive a functional and comfortable denture. In this blog, we’ll discuss techniques to minimise denture adjustments by focusing on quality impressions, precise tooth positioning, and efficient trimming practices.
The Importance of Good Impressions
The foundation of any well-fitting denture starts with an accurate impression. An accurate impression ensures that the final denture will not only fit well but also provide the necessary retention, stability, and comfort. Using the right materials is key in achieving this goal.
Alginate impressions, while affordable and commonly used, can be prone to distortion over time. This can lead to inaccurate fitting, requiring multiple adjustments. On the other hand, silicone impressions are much more stable and accurate over time, making them ideal for creating high-quality dentures. By using accurate materials and techniques, you ensure that the denture will fit well without needing constant adjustments.
Border Moulding: The Key to Perfect Fit
One of the techniques that can significantly reduce the need for adjustments is border moulding. Border moulding involves creating the correct peripheral shape and contour of the denture by capturing the mucostatic border of the soft tissue. This technique is particularly important when dealing with full dentures.
A common mistake made during the impression-taking process is overly compressing the tissues to capture every detail. While functional impressions may seem ideal, they often lead to an overextended denture that requires trimming and adjustments after the fact. Instead, using a more controlled technique where soft tissues are moved but not compressed too much can achieve better results. By leaving the soft tissues more in their natural position, your denture will fit more accurately, leading to fewer adjustments (British Dental Association, 2024).
Reducing Extensions to Prevent Lift
When adjusting acrylic dentures, one critical area that requires attention is the perimeter or flange of the denture. If the denture extends too far, it can cause discomfort and lift when the patient smiles or moves their lips. In these situations, trimming the edges to a more conservative size can help. By following the mucostatic border closely, you can reduce the chances of the denture lifting out of place and minimise the need for future adjustments (National Institute of Dental and Craniofacial Research, 2024).
Overextended dentures can push up against soft tissue, causing irritation, or even shifting during chewing and speaking. Reducing these extensions by trimming the denture appropriately means the denture will stay securely in place, even with normal lip movements. This technique is especially useful for patients who have experienced past discomfort from overextended dentures.
Adjusting the Teeth for Proper Occlusion
Another significant factor that influences how often dentures need adjusting is the positioning of the teeth. When a denture’s teeth are set improperly, the patient may experience problems with occlusion, bite issues, or general discomfort. Ensuring that the teeth are positioned optimally from the start can save you a lot of time down the road.
In some cases, the teeth may be too far forward or backward, leading to uneven occlusion. When this happens, the technician can make small adjustments to the positioning of the teeth, either by pushing them back or forward slightly. Trimming the occlusal surfaces can also help balance the bite. This is where having the right tools, such as a wax knife or a lacron, is essential for making precise adjustments without damaging the acrylic or the teeth (Journal of Prosthetic Dentistry, 2024).
The Role of Material Quality in Minimising Adjustments
Another significant factor in minimising adjustments is the quality of the materials used. Low-grade acrylic or poorly placed teeth can contribute to frequent fractures and poor fit, as seen in many NHS dentures (National Health Service, 2024). Low-quality teeth and weak acrylic are more likely to cause issues, meaning you will spend more time making repairs and adjustments.
Investing in high-quality materials, such as injection-moulded acrylics or composite hybrid acrylics, can reduce the likelihood of denture fractures and ensure that the dentures fit better from the start. With these materials, the dentures are more durable, functional, and comfortable for the patient.
Conclusion
Minimising denture adjustments is crucial for both patient satisfaction and your practice’s efficiency. By focusing on accurate impressions, carefully controlling the border moulding, trimming overextended areas, and positioning the teeth correctly, you can create dentures that fit well from the beginning. Additionally, using high-quality materials will help ensure that the dentures are durable and reduce the need for future repairs. By applying these techniques, you’ll find that your denture adjustments will become less frequent, leading to happier patients and smoother practice operations.
As a dentist or CDT, mastering these techniques is essential for providing the best care for your patients. Remember, when in doubt, always take the time to assess the denture thoroughly and make necessary adjustments as required.
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