The Patient’s Need: Economic Esthetics and Functionality

A 72 year-old female patient presented in the office because she could not eat properly with her removable rehabilitations. The partial denture in the lower jaw broke several times and was uncomfortable and unstable. Because of that she stopped wearing it. Despite the age-appropriate bone atrophy, the remaining teeth, 32 and 33, did not show any signs of inflammation. Tooth 32 had a mobility of one. The patient wanted to keep both teeth and refused implants, which would have distributed the forces more evenly. The disadvantages of an uneven load and the accelerating effect on her remaining teeth were explained. In case of necessary extractions in a later stage, an easy denture teeth addition to the new partial denture could be provided, which was satisfactory to the patient. She was currently only using the full denture in the upper, which did not function well, as the occlusal forces were unbalanced. She desired an improvement of esthetics and eating conditions with new rehabilitations. Her limited budget made an economic solution necessary. Based on these factors, VITA Multi Functional Teeth (VITA MFT) were chosen for the new full denture in the upper and a partial denture in the lower to guarantee esthetics and functionality for an ideal price-performance ratio.

After anatomic impressions of the upper and lower jaw, models were fabricated on which individual trays were created for the mucodynamic impression. Master models were manufactered to be able to produce fitting bite registration plates with a wax rim to record the position of the mandible in relation to the maxilla and to transfer the midline, the canine position, the incisal length and expansion of the buccal corridor. According to the clinical bite registration, the two master models were articulated and the model analysis was performed.

VITA MFT Anterior was used for the setup in the anterior area. For a budget denture tooth, the anterior sets are very esthetic. They are designed naturally in morphology and texture. The anatomical structure is simulated with neck, dentine and enamel layers, which leads to a three-dimensional play of light and color. Tooth axis and coordinated angle characteristics, according to the esthetic rules, make a quick match of the front teeth possible. Due to the position of the remaning canine and incisor, all lower teeth were used in addition to the natural incisor 32 to provide stability while eating with the new denture. So altogether, there were five lower central incisors established. The setup was performed edge to edge to the remaining natural teeth to improve the esthetics of the upper smile line.

VITA MFT Anterior was used for the setup in the anterior area. For a budget denture tooth, the anterior sets are very esthetic. They are designed naturally in morphology and texture. The anatomical structure is simulated with neck, dentine and enamel layers, which leads to a three-dimensional play of light and color. Tooth axis and coordinated angle characteristics, according to the esthetic rules, make a quick match of the front teeth possible. Due to the position of the remaning canine and incisor, all lower teeth were used in addition to the natural incisor 32 to provide stability while eating with the new denture. So altogether, there were five lower central incisors established. The setup was performed edge to edge to the remaining natural teeth to improve the esthetics of the upper smile line.

After a succesfull clinical try in and final anatomical contouring, the rehabilitations were transferred into polymer. First, the setups were duplicated with hydrocolloid. Then the teeth were cleaned, conditioned and repositioned in the hydrocolloid index. Before the flasking of the denture base with the auto-polymerizing and pourable Castdon Resin, internal colors of the DentureArt System (both Dreve Dentamid, Unna, Germany) were applied into the flask to simulate the appearance of the gingival anatomy. After the polymerization, finishing and polishing was performed. The new rehabilitations were inserted intraorally and checked by the practicioner and the patient. Both were very satisfied with the lifelike appearance and functional integration. The patient’s requirements of an economical, esthetic and functional rehabilitation were all met.