Fourth Week: Removable

        During our fourth week we had the opportunity to attend the clinic of Removable where we were able to observe the students from third and fourth year deliver removables and complete dentures.  The procedure they use is similar to ours and to the techniques we have learned here I will describe the appointments they use.

1) They use the first appointment to take impressions in order fabricate the custom tray. We were able to observe how they make the custom tray. They use aluminum foil so that the wax doesn’t melt on the model and a resin material to cover it for the custom tray. They have a lab equipped with all the instruments to do these steps.

 

This is the lab where every student has
their models, equipment to work and materials.

Here is the making of the custom tray: which consists of
three layers: aluminum foil, wax and resin for the tray

This is the TRIAD is a machine used to photocure
the costum tray evenly

2) Here they are trying the custom tray in the patient, they have to add modeling clay in the borders of the custom tray so that they are able to copy the delimitation of the area in order to get a precise impression.

3) After having the jaw relations you are able to develop the wax up of where the patient is going have their teeth, so you are able to try the wax in their mouth in order to evaluate the vertical dimension, the support of the lip, the patient’s smile, where the facial midline is, the nasal wing to determine the canine’s cusp,  the patients occlusion, facial bow, the parallelism of the Camper line and the occlusal line, choose the color of the teeth and its shape.

Here we have the materiales needed to check the occlusal line,
 the color of the teeth and the patients occlusion

4)Then comes the appointment where you try the anterior teeth and see how the patient reacts to them  and how they suit the their face. Then you can try the posterior in order to get them to the optimum occlusion for the patient (centric occlusion). They have articulate paper that is shaped like the patient’s arch in order to detect any areas that occlude prematurely.

5) When everything seems to be fitting correctly the denture is sent to the lab in order to have the acrylic poured in.  Here in Baylor they have their own lab in the General Dentistry floor, which is really convenient because they assure that the things get there on time because they deliver them themselves and it makes the waiting time shorter.

6) When the denture is completed, there is an appointment to try it on, adjust occlusion or any high spots.  The patient receives a 24 hour appointment and a one week follow up in order to check how the denture is suiting them.  They receive a packet of adhesive and a set of instructions to help them get used to the dentures.

This experience has helped us reinforce all of the theory we have learned in our classes of removable and to prepare us for our clinical work in January 2014. This will helped me get a visual idea of how to explain the steps to the patients and how to approach the psychological part of complete dentures, because some patients are really hesistant and do not want to use them, and its our goal to make them feel at ease and positive with their treatment.