One of the most common complaints of dentists offering dentures is how many appointments it takes.
Now there’s a better way. Here’s an excerpt of my recent interview with Dr. Lawrence Wallace, oral surgeon and inventor of the one-step denture:
Just going back to my practice, I remember that, in my practice, about 70% of the immediate dentures that I delivered, the dentist would send over the case with the patient, and I would do the surgery to deliver the immediate, and then they would go home. Most of them didn’t fit. And that bothered me. Also having the need to provide prosthetics for nursing home residents, assisted living home residents, even safety net clinic clients, there wasn’t access to care, and the costs were prohibitive. This is when I decided to develop this process. It took me a lot of years to develop this process. We went through many materials, many prototypes, and finally got to the point where we developed the ability to create the complete denture in a single visit of about an hour, that’s upper and lower. Its base was developed through measuring 1000s of edentulous models consecutively that came through a major dental lab. Putting those numbers together into a spreadsheet and coming up with the five sizes of our dentures that we have. I’m getting a little ahead of myself here. So, I developed this process, basically to give back to society to provide teeth for the hundreds of 1000s of teeth that I removed.
The One Step Process
The natural process is based on a thermoplastic pre-formed denture template. It is made out of thermoplastic acrylic, which when heated in boiling water becomes malleable. So, the process is very intuitive. All of you know how to take vertical dimensions. You all know basic occlusion. It’s not utilizing any processes that you don’t already use in your office.
So, the process is to take an alginate impression, pour up a Quick Set stone model, and then take that model and the denture template which fits the closest to that model. And now, as I said, there are five sizes, and it’s going to be close, but it’s not going to be perfect. It’s not going to fit right down on the ridge, but it will fit in the mouth. The next step is to put it in the boiling water pot and make it malleable 30-45 seconds, maybe a minute, if you’re a little higher elevation, and then from that model to that template. At that point, you take it to the mouth. Check patients with a fox plate to make sure you have the electrical line and the interocclusal line Frankford horizontal. But I like to go by the pupillary line. If you match the pupillary line, and that is not necessarily perfectly horizontal, you will get a more aesthetic look for your denture.So, if you try it in the mouth, you will trim off the flanges because you need two or three millimeters of flange space to do their line and then take it to the mouth and do a chairside reline. We do recommend a certain relying material, but any PMMA acrylic denture relines material will work. So, the upper is typically done. First, you get the smile line, the patient gets to look at it.The process is then repeated with a lower one. It is recommended that when you start the process and you want to measure the vertical dimension, on the nose and chin, measure that distance with the patient in a relaxed position. And then just put that aside for later on.
But an even easier way to determine vertical dimension is to take your four fingers, put them up underneath your nose. At the bottom of your fingers is your vertical dimension. It just couldn’t be easier. Here that on the chin point. There’s your vertical. And you’ll go back to that later. As long as you don’t lose a finger between now and when you get it. And then you will continue to do the upper denture first and get the smile line. Repeat the process with the upper one as well. Finish the denture which is a manual process that takes 10 to 15 minutes, and it’s done. Check with articulating paper. But it is recommended to use pressure indicating paste for the upper.
You don’t need an outside laboratory. So, it’s one visit of which you are in total control with no outside laboratory needed. There’s no time factor of waiting several days or a week between visits. So, you get to complete it on that first visit. You can complete it to patient satisfaction right there on the spot. They get to see the aesthetics when they finish it. If there are any high spots, you have adjusted them with the pressure indicating paste, or, and the articulating paper, which is always recommended.
Last time. Decrease cost. More patient satisfaction!
It’s been great for my practice and could be for yours too. (By the way, I have no financial interest in this product, just wanted to pass along something that I thought you could benefit from as well).
Until next time,
Dr. Tyler Williams
Pinecrest Practice Growth