Things People Don't Teach You When Making Complete Denture

Heyyo 👋 

Read the title? Yeah. Today, I'm making a sharing about things only experience are able to teach you along the journey of making a complete denture. 

1. Special tray

Jangan buat handle dia 90 degree, bcs it will be difficult utk you take out impression from patient's mouth. Plus handle takleh interfere dgn patient's lip bcs they wouldn't feel comfortable with the tray.

2. 2nd Impression Taking (I'll write down when I remember)

Mandibular 

Maxillary

3. Working Cast Preparation 

Better buat je mixture dental stone banyak2 and biar je penuh dalam bekas  impression with beading and boxing tu. Unless your rasa nak tambah later and buang masa nak trim apa bagai.

4. Base Plate

This one, my mandibular base plate srs pendek gila, and bila finally dah setting teeth for mandibular, I baru perasan yang my base plate tak stable!  Maybe impression I amek tu tak betul atau, my edentulous model tu mmg tak same dengan orang lain... hmm to be figured out later 🤔 

5. Occlusal Rim 

Make sure occlusal rim sit betul2 kat middle of ridge and so forth. Follow the handbook betul2. Jangan main buat ikut suka je.

Why? Bcs I salah place the rim and the process of repairing the rim itself took me longer than everyone started later than me. So I agak menyesal di situ. 

6. MMR Taking

Before amek MMR, you kena measure the parallelism, all tragal line, interpupillary line semua and measure canine line, midline and lip line. Btw lip line ni u kena make sure patient in resting condition and u lukis lip line tu atas occlusal rim tu. Reference lip line ialah bila patient senyum, hokey¿? Pastu from resting position tu, u hanya boleh nampak 2mm of the teeth incisally, not gingivally. This is what I learnt from todays lecture lah.. And there are a few factors you need to take into account jugak, which idk bcs I havent entered clinics.

MMR- this time I tak igt kenapa I kena redo MMR. 

7. Mount the Cast to Articulator

Yang ni tips dia kena 

- tenang jangan rush, jangan rasa panic tgk orang lain panic

- buat mixture biar banyak and agak2 boleh mold supaya senang nak shape guna tangan je

- smooth kan guna sandpaper bawah air mengalir nanti effect dia smooth gilah! 

- Make sure POP jangan cover metal plate, nanti dia akan effect you punya occlusion of your rim.

8. Teeth Setting Up

- Bila pasang rim dekat articulator, make sure all screws ketat. Bcs you don't want to set the teeth it correctly today, and the next day the teeth position is different. why? I dah set my maxillary teeth correctly in position, as the way dental technology handbook said. Tapi, lepas beberapa secs letak gigi, dia jadi salah balik sampai aku doubt mata aku rosak.

- make sure masa set gigi tu,takde sehabuk wax pun dekat gigi sbb kalau tak, dia Alan effect contact point gigi kau. Mcm aku kena harini. Tiba2, denture in process aku ada median diestema. Nak nangis weh , dah berminggu set gigi ngan polish, tiba2 ada ruang kecik antara gigi tu pulak. Rasa nak carut!!

- jangan risau kalau masa set gigi, gum denture tu colour gelap mcm perokok sbb kau guna api oren yang mengeluarkan jelaga sbb later kau kena waxing up. Which is tambah wax pink kat gusi tu. So don't worry..

- check segala2 requirement nak setting gigi. Slow take,asalkan betul.

    -   Make sure symmetry ye semua gigi tu, quadrant kanan kiri kena symmetry,  overjet overbite kena symmetry.

    - Make sure intercuspation tu betul

    - check lateral, protrusive movement,  make sure occlusion dia balance (at least 3 cusps touching)

8. Waxing and Polishing

The cycle always go like

- add modelling wax

- Unite modelling wax + the wax behind by heat the wax knife really hot sampai keluar asap then press to remove air bubbles. 

- smoothen, kalini takpe kalau gum kau tebal semacam sbb later kau kena buat gum work ngan carve root. So ok je

- dah habis smoothen, hilang air bubble utk bahagian labial n palatal, then proceed to gum work. Yang ni korek je pakai lecron carver and then kalau nak hilangkan serbuk2 wax tu guna je torch spray lightly.

- then proceed buat root, 1 or 2 mm belum cervical line, korek sikit2 slow2 in diagonal shape kan setiap below interdental area. Bak kata my friend, Alya, buat slow2 je one by one and immediately after Korea the use blower to melt it and cepat lap guna (cotton + air sabun) the it will shine through your eyes gitu.kahkahkah

Jangan bagi wax tertumpah atas articulator kau, nanti kena marah dengan Dr A. 

OK bye kalau ingat lagi aku continue..