The dentist, in an effort to help her out, made a reline impression of her lower denture without relieving the tissue side, and he indicated that he had to do a couple of washes to get it right. So what happened? In consultation with the patient’s dentist to defuse the negative emotions between the two, I discovered that the patient was in a hurry to get her denture tightened and did not want to have a new prosthesis fabricated at that time.
The dentist refunded her money while blaming the lab, and the technician told the dentist that everything fit the model. This patient’s reline created an opening of her existing vertical, which in turn created instability, loss of retention, an altered esthetic midline, and an unnatural, gummy appearance. The occlusal plane is superior to all referenced dental concepts.
This, of course, resulted in instability due to the fact that the tongue, when in function, virtually pushed the denture outside of the mouth. The incisal edges of the mandibular prosthesis in relationship to the lower lip measured 18 mm. As seen in Figure 1, this patient had a mandibular reline performed, and at its completion, the patient’s occlusal plane was increased beyond functional capacity. It is a known fact that esthetics, stability, and retention may adversely be affected if an increase in the patient’s existing occlusal vertical dimension exceeds 2 mm or more of thickening of the denture base. However, from what we know today in dentistry, these patient complaints are valid and can be addressed to a successful conclusion. In general, dentists and technicians have felt that edentulous patients are just unhappy since they’ve lost their teeth, and they blame everyone but themselves. In Part 2, I will provide a step-by-step procedure and a protocol which should eliminate the six complaints listed above. In the first of this two-part series, I would like to address the reasons why these problems exist. The technician told the dentist that the prosthesis fit the model.The dentist blamed the lab and reluctantly refunded the patient’s money.
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