User talk:Csysmith

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We need page numbers for textbooks. Please read WP:MEDRS about what makes a suitable reference. Have moved the text here so you can work on it more. Also please read WP:MEDMOS regarding wording. Best Doc James (talk · contribs · email) 15:33, 7 February 2019 (UTC)

Each material chosen is done so to fulfill a specific purpose which a clinician consciously decides during treatment. This decision is made based upon each individual patient and their examination/history. Knowing the variety of materials used for denture base construction, combined with the reasons for their use and the selection of supporting products available, is crucial to help the clinician provide the most efficient treatment for each patient.

Framework

When natural teeth are extracted the bone in which they previously resided tends to resorb and disappear gradually, leaving in its place a dense “basement” type of bone covered by a thin layer of oral mucosa. The provision of dentures is paramount for many humanly functions, of which are are hugely impacted upon by the loss of an individual natural dentition and the supporting bone. Examples of these functions, as previously stated, are: speaking, eating and the aesthetic smile and support of the facial tissues. In order to restore these factors a clinician has to take into account the patients expectations; the materials which can be utilized to give the best result; the correct articulation of the prosthetic teeth and also have the ability to maintain the aesthetic facial contour. These factors are all thought about in the construction of the denture base.

The denture base covers the residual ridge in the mouth, mimicking the natural aesthetic of the patients’ original dentition and facial contour. Since this is in direct contact with the tissues intra-orally the materials must be exceedingly biocompatible and able to withstand the oral environment i.e. the rapid fluctuation of temperatures and the fluid movements of the mouth and muscles of facial expression. This means that the relationship the denture with the patient natural oral environment is paramount, an example of this relationship would be that of the denture base and the saliva. The saliva is a major component in order to obtain a “hermetic seal” for retention of the denture.

The most common material used for a denture base is a Polymer (Plastic). The reasoning for this is that they are easy to manipulate to the correct form needed and are very lightweight in comparison to metallic dentures. The way in which the Polymer is made is a simple chemical reaction between a liquid monomer (methyl methacrylate) with a powder, which forms a newly polymerized material (polymethyl methacrylate). The structure of this polymerized material is very tangled providing strength to the final product. This can further be manipulated to have added elasticity which ultimately leads to the formation of a high impact denture which is more resistant to fracture upon high impact.

To have a better understanding of the processing of this polymer material below is a brief outline as to what may occur when manufacturing such a denture:

·     The Denture Design previously discussed with the patient is constructed in wax. This Holds the artificial teeth for patient to see a rough example as to what the final outcome will be.

·     An inter-occlusal record is taken so that these wax dentures can be correctly articulated.

·     Once the wax denture Is accurate it is invested in a large, brass flask. This is then immersed in boiling water so that the wax denture material melts out leaving behind the model of the denture to be constructed in the flask.

·     The base resin polymer and monomer are mixed to the correct dough consistency and then are packed into the flask.

·     This is done under a significant amount of pressure so that the filling of the denture imprint is done completely and without any inconsistency.

·     The flask is then placed into water and heated to a specific temperature at a specific rate needed for that material being used.

·     Once this has been completed the newly formed denture is removed from the flask and then trimmed, polished and stored in water to then be tried in by the patient.

Of course this sequence of events can vary in relation to what polymer is used as each material has a specific regime of treatment. According to the National Institute of Health, acrylic resin, or plastic, has become the highest on-demand material for dentures. As previously stated this is due to the ease of adjustment and the comfort to the patient.

If so applicable there is another material which can be used effectively in the provision of dentures, which is metal. The metal component is usually featured on the tissue bearing side whilst a polymer is still used at the gingival aspect, as this is a much more aesthetic outcome for the patient. The way in which metal bases are fabricated involves a process of, replacement of the wax form of the desired base (a.k.a The Lost Wax Technique).

The advantage of having a metallic base is that it is a much more accurate fit for the patient and allows the sensation of temperature of food to reach the palate. This ultimately gives the patient a much higher level of enjoyment whilst eating food being able to feel this sensation.

On the lower arch the weight of the metal is seen to be advantageous as it aids the dentures placement on the often resorbed lower ridge, although this weight may be problematic when used in the upper arch.

The dentures which employ a metal base and usually smaller than than the acrylic dentures. This smaller size makes them more adaptable and tolerable for the patient, specifically those who cannot tolerate extensive palatal coverage which is needed a lot of the time for acrylic dentures.

It is duly noted and discussed with patients that the metallic dentures cost more than other dentures as they are more labour-intensive. This is due to the greater amount of time and skill that is required to make them.

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