Dentures are removable replacements for missing teeth and surrounding soft tissues, restoring function and aesthetics. Creating these prosthetic devices requires precision and collaboration between the dental clinician and the laboratory technician. The complex process involves multiple stages of planning, measurement, and fabrication to ensure the final appliance fits securely and functions correctly within the patient’s unique oral anatomy.
The Initial Clinical Blueprint
The journey of denture fabrication begins with a comprehensive planning phase conducted by the dental professional. This initial phase involves a thorough patient consultation to understand their specific needs regarding functionality and appearance. The clinician assesses the patient’s overall oral health, carefully examining the condition of the gums, supporting bone structure, and any remaining natural teeth.
Determining the appropriate type of denture (full or partial) is a primary goal, based on the extent of tooth loss. Planning establishes treatment goals, prioritizing a balance between a natural look and the ability to chew and speak effectively. The health of the soft tissues and underlying bone structure must be optimized, as they provide the foundation and support for the finished denture.
Capturing the Patient’s Oral Dimensions
Once the treatment plan is established, the next stage focuses on gathering accurate physical data for fabrication. The process starts with preliminary impressions, which are initial molds of the arch using a stock tray. These molds are sent to the laboratory to create a custom-fitted impression tray designed to precisely follow the patient’s anatomy.
The custom tray is then used to take the final impressions, typically with materials like polyvinyl siloxane, to record the fine details of the gum tissue and anatomical landmarks. Recording the precise jaw relationship, or bite registration, is also essential. This involves using wax rims to determine the correct vertical dimension of occlusion—how the upper and lower jaws meet—and the horizontal relationship of the jaws.
Finally, the clinician and patient select the appropriate artificial tooth size, shape, and shade to ensure a natural appearance. This selection is guided by the patient’s facial features and aesthetic desires. These detailed measurements and molds are then transferred to the dental laboratory, providing the technician with the necessary information.
Crafting the Denture in the Lab
Upon receiving the clinical records, the laboratory technician pours the final impressions with dental stone to create accurate master casts of the patient’s arches. Using these casts and the bite registration records, the technician mounts the models onto an articulator, a mechanical device that mimics jaw movements. The artificial teeth are then carefully arranged in wax on the casts according to the prescribed bite and aesthetic specifications.
This wax set-up is sent back to the clinic for a try-in appointment, allowing the patient and clinician to approve the fit, aesthetics, and bite before final processing. Once approved, the technician begins flasking, encasing the wax model and master cast in a metal flask using dental plaster. The flask is then heated in a process called “boil-out” to remove the wax, leaving a perfect mold of the denture base and embedded teeth.
Acrylic resin, which forms the final denture base, is mixed and packed into the mold cavity under high pressure. The flask is placed in a water bath for polymerization, which heat-cures the soft resin into durable, hard plastic. After curing, the denture is removed (deflasked), then finished and polished to ensure a smooth, comfortable surface that minimizes tissue irritation.
Final Fitting and Adaption
The final stage is the insertion appointment, where the finished denture is delivered and checked for fit and function. The clinician carefully inserts the appliance, assessing its stability, retention, and support on the patient’s gums. They then check the occlusion, ensuring the artificial teeth meet correctly to facilitate effective chewing and prevent undue forces.
Minor adjustments are often necessary during this visit, as the hard acrylic may create pressure spots on the soft gum tissues. The clinician uses a pressure-indicating paste to identify these areas and trims or polishes the denture base for optimal comfort. The patient receives detailed instructions on cleaning, proper storage, and the expected adjustment period for eating and speaking. Follow-up appointments are scheduled to make further adjustments as the patient’s mouth adapts.