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Medical Forum / General / Dentistry / June 2005Soft denture for bruxer
I have this pt. that admits he cannot stop clenching against his upper denture. He came to me for a soft reline of his existing denture which I did. He has since decided he needs a new denture and it have to be with a soft lining from the beginning. I've used Cu-sil on partials but never had the need to make a new denture with a soft lining as the original treatment plan. I'm wanting something really cushy but that will not harden and can stand up to normal cleaning procedures. Glidewell makes Valplast, but I've used that before in partials and it doesn't seem that soft. Any suggestions would be appreciated. -- I got teeth Processed (not chairside) soft liners fall into two classes: silicones and plasticized acrylics. Silicones are better. Labs tend to have their own preferences for soft liner materials. The most difficult to use, and the ones that give the best results, are the processed silicones. e.g. Prolastic, Molloplast & my current favorite: Luci-Sof from Dentsply/Caulk. Has to be done right, i.e. good clean bonding technique, correct curing cycle and no less than 2mm thickness in critical areas. I would assume your patient has chronic ridge soreness, perhaps the anterior nasal spine/nasopalatine area? When I have such a patient, I place an "island" of silicone where the problem occurs. I've rarely had to carry it into the vestibule. Good luck Charlie Thanks for the response - Can you recommend a good lab that knows how to use these processed silicones? Also, how would you go about placing an 'island' of the material where needed since it it lab processed? My patient has NO sore spots, yet complains about constant ridge soreness (generalized). I'm stareting to feel married to this one... > Processed (not chairside) soft liners fall into two classes: silicones and > plasticized acrylics. Silicones are better. [quoted text clipped - 19 lines] > Message posted via MedKB.com > http://www.medkb.com/Uwe/Forums.aspx/dentistry/200506/1 Have you tried adjusting the base using a Pressure Indicating Paste with cotton rolls between the posteriors? You might want to check the occlusion also. Try using a pin tracer, Start with the pin keeping the bite open, then slowly closing the bite and reducing all prematurities as they show up. Then refine the excursions still using the pin tracer at the final vertical. If it is way off on excursions, you might want to do a clinical remount and refine on the articulator. Works best if you have done a face bow, if not then you are stuck adjusting intra orally.  SignatureRoy rem NADA to reply | Thanks for the response - Can you recommend a good lab that knows how to | use these processed silicones? [quoted text clipped - 27 lines] | > Message posted via MedKB.com | > http://www.medkb.com/Uwe/Forums.aspx/dentistry/200506/1 >Thanks for the response - Can you recommend a good lab that knows how to >use these processed silicones? >Also, how would you go about placing an 'island' of the material where >needed since it it lab processed? >My patient has NO sore spots, yet complains about constant ridge soreness >(generalized). I'm stareting to feel married to this one... Could be parafunction. Remove the dentures during sleep ? >> Processed (not chairside) soft liners fall into two classes: silicones and >> plasticized acrylics. Silicones are better. [quoted text clipped - 20 lines] >> Message posted via MedKB.com >> http://www.medkb.com/Uwe/Forums.aspx/dentistry/200506/1 -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com It is definitely parafunction. The patient told me up front that he can't stop clenching his lower natural teeth against the upper denture. He is paranoid that it will come loose accidentally and keeps pressing it up hard to be sure it is secure. Of course I told him to stop doing that, but thats just him..he's going to do it anyways > >Thanks for the response - Can you recommend a good lab that knows how to > >use these processed silicones? [quoted text clipped - 36 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Daytime NTI ? >It is definitely parafunction. The patient told me up front that he can't >stop clenching his lower natural teeth against the upper denture. He is [quoted text clipped - 43 lines] >> Take out the G'RBAGE >> wubbabubbazG@RBAGEyahoo.com -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Brien Lang at Michigan used to place splints over complete dentures for bruxing patients, don't know if he does this any more. Anybody out there experienced with this? NTIs for the edentulous, maybe? I'd think it'd just dislodge the dentures, but who knows? In response to your technique question: For my patients I work out the "island" in tissue conditioner first, then I replace this with Luci-Sof. I don't send them out, but if I did there are two local labs run by techs who used to work here at the University and who are very up on the process. Upstate NY. They could do it with spacers. The best reline materials - truesoft of Bosworth takes you 15 minutes single cost of materials 3$ (based on PEMMA) I love this stuff !! - Dentusil - silicon Its cure light (1minutes of light) 15 minutes more expensive cost 12 -14 $ - pro-cure- Its ok but you must put it in 10 minutes into cure light unit - >I have this pt. that admits he cannot stop clenching against his upper > denture. He came to me for a soft reline of his existing denture which I [quoted text clipped - 10 lines] > -- > I got teeth of course these are chair relines materials I preffer to lab..:)) > The best reline materials > - truesoft of Bosworth takes you 15 minutes single cost of materials 3$ [quoted text clipped - 20 lines] >> -- >> I got teeth Luci-sof Molloplast B Both lab processed. Anticipated life span = 2 years. SignatureRoy rem NADA to reply |I have this pt. that admits he cannot stop clenching against his upper | denture. He came to me for a soft reline of his existing denture which I [quoted text clipped - 8 lines] | -- | I got teeth |
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