Contemporary Techniques for Denture Fabrication
J. Fraser McCord, BDS, DDS, FDS
Department of Restorative Dentistry, Glasgow Dental Hospital and School, Glasgow, UK
Keywords Complete denture; technology; impression methods. Correspondence Fraser McCord, Glasgow Dental Hospital and School—Restorative Dentistry, 378 Sauchiehall St, Glasgow G2 3JZ, UK. E-mail:firstname.lastname@example.org
This article reviews the fabrication of complete dentures and presents ﬁndings of recent technological studies that have relevance to current complete denture practice. In addition, summaries of two recent randomized controlled studies demonstrate the need for more deliberate prescription of impression materials.
Presented as part of the FDI 2008 World Dental Congress:“Facing the Future of Edentulism: 21st Century Management of Edentulism—A World of Challenges in a Universe of Helpful Technologies.” September 26, 2008, Stockholm, Sweden.
Accepted September 23, 2008 doi: 10.1111/j.1532-849X.2009.00439.x
Teeth may be lost through neglect or accident, or by virtue of orthodontic or prosthodontic treatment planning; they may also be missing for congenital oracquired reasons. People with missing teeth may opt to have them restored or not largely because of sociological, functional or, in the case of nonrestoration, for ﬁnancial reasons. How teeth are replaced largely depends on the level of dental and technological sophistication on offer. The splinting of teeth with thread or wire has an extensive history, and early Greek and Phoenician applianceswere based on this concept. Etruscan technology was slightly more sophisticated; here, gold bands were applied around remaining teeth onto which a small tooth of bovine origin would be riveted as a replacement.1 Until about the mid 1800s, ivory was the principal denture base material; teeth from the hippopotamus, predominantly, were sliced up, and appropriately sized pieces were carved bycraftsmen with varying degrees of skill and success.2 When he prescribed dentures, Fauchard used neither impressions nor models. Ivory from the walrus or hippopotamus or the long bones of oxen were carved to form, simply through estimation, that is, via observing the shape of the mouth and measuring where required with a measuring device such as a pair of compasses. At a later stage, beeswax was used asan impression material. These prostheses were usually maintained in position by means of springs, which exerted constant pres-
sure. In favorable cases, Fauchard made dentures maintained in position solely by atmospheric pressure.3 At the turn of the 20th century and for the next 50 years, dental technology developed, as did options for replacement of lost or missing teeth. In the latter halfof the 20th century, as dentistry and dental technology developed, so the list of treatment options increased. Fixed prostheses became more predictable and more desirable. Where ﬁxed replacement was contraindicated, removable prostheses became more elaborate, with precision attachments being used to enhance stability and appearance by potentially eliminating clasps. This was truly the pinnacle ofthe mechanical age of prosthodontics. More recently, the biological age developed, with the development of dental implants and also in consequence of their continuing and predictable success. It is surely incontestable that the gold standard for edentulous patients, advocated by Feine et al,4 is to have at least a maxillary complete denture opposed by an implant-stabilized mandibular denture.For many patients, dental implants may not be countenanced for a variety of reasons, and the purpose of this article is to investigate clinical and technical parameters of relevance to the fabrication of contemporary complete dentures. For hundreds of years humankind has searched relentlessly to ﬁnd a material capable of providing properties considered essential for use in the mouth. According to...