Labs Team Up to Solve Patient’s Recurring Denture Fractures

By the time Dr. Thomas Brown called our laboratory for help with this case, his patient had struggled with her maxillary denture for more than seven years and both patient and doctor were frustrated. During that time, they had attempted many different dentures: a denture that achieved posterior occlusion using monolithic denture base acrylic instead of teeth, multiple dentures with cast metal mesh as a strengthener, and even placed six root-form implants and fabricated Locator dentures with a cast metal strengthener bar. Each attempt ended with similar fractures multiple times.

My lead denture technician, Chris Brooks, and I sat down to plan the case and decided on a cast metal substructure that kept all of the posterior occlusion in metal with a removable appliance retained by the patient’s six Locator implants. All of the posteriors would have metal occlusion but we still wanted to maintain some esthetics, so we decided on denture tooth facings instead of all-cast facials.

We contacted our good friend and fellow lab owner, Justin Gerard at Colonial Dental Lab in Mechanicsville, VA, to discuss our ideas and evaluate our treatment plan. He was on board with our proposal and agreed to fabricate the cast frame.

We set up the denture on a Panadent articulator with a confirmed bite taken by Dr. Brown and marked the denture teeth for occlusal coverage. We sent the case to Colonial Dental where Justin worked his magic: during his design phase, he cut the teeth back to outline the metal occlusions and then hand cast the CoCr framework with space that would accommodate the denture teeth facings. Once we received the frame, we finalized the denture setup, injected the acrylic, finished the denture and shipped it back to Dr. Brown.

A few days later, Dr. Brown called to offer his and the patient’s thanks for a successful denture delivery. About a week after that, we got another call from the practice saying the patient had called again in happy tears; she is able to eat an apple for the first time in seven years and is thrilled to have an appliance that lets her smile once again!

This outcome would not have been possible without all the incredible dental team members going above and beyond on this case. The end result speaks volumes about their skills and dedication and the love we all have for this industry.

The cast metal substructure with denture tooth facings.

he completed restoration on the model.

The natural-looking final result.