Finlay's Case Presentation 53
Welcome to Newsletter 53 showing the making and fitting of ultra life-like dentures for Valena, a 66 -year-old woman, with a history of medication-related (Intra venous bisphosphonates) osteonecrosis MRONJ. The full protocol workflow is presented including the use of dentate photographs to mimic her beautiful natural teeth.
Valena was referred to me by her general dentist.
Dental concerns
- “Dentures not fitting as should be”
- “Cannot cope with top denture”
Dental wish list
- “To be able to eat when dentures are in”
Medical History
- Breast Cancer
- Medication-related (Intra venous bisphosphonates) osteonecrosis (MRONJ) of the jaw resulting from extractions of 43, 35.
Diagnoses
- The upper and lower ridges were large, offering good stability for complete dentures. However, this causes considerable technical challenges owing to limited space for correctly sized dentures.
- The lower ridge was sore in the left owing to MRONJ making it technically challenging to make good fitting dentures. 20% chance a lower with a soft lining may be required. Space limited for this.
- The set of dentures currently used although, relatively well made had several technical faults namely: 1. C/- upper teeth set too far back and too far down over the crest of the upper ridge 2. OVD too large 3. Denture peripheries not adapted to the functional width and depth of the sulci – resulting in poor retention, stability and support.
- Aesthetically the dentures did not mimic the natural teeth.
Treatment options discussed with the patient
- Do nothing - Valena did not want this
- Complete dentures – metal reinforced. The lower denture may have needed a soft silicone lining – if the new lower denture proved to be sore- exacerbating MRONJ in lower left jaw. This is the treatment Valena wanted and is presented in this case study Newsletter.
- Implants not advised or wanted owing to history of MRONJ
The clinical situation and treatment process is shown in detail below. I provided the clinical work. Rowan Garstang provided the technical work.
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Courses given by me (Finlay) at the practice
I love running removable prosthodontic courses consisting of lectures and live clinical demonstrations at the practice. I give live treatment demonstrations of impression making, registration, try in and fitting of dentures. These courses are aimed at general dentists, prosthodontists, clinical dental technicians and dental technicians. They are completely clinical, demonstrating how to provide dentures which have optimal function and superb aesthetics. I give live patient demonstrations along with lectures abundantly illustrated with step-by-step photographs and videos of all procedures. Delegates will take many “nuggets of gold”, being able to put the advice straight into practice with immediate improvement in professional satisfaction and patient outcomes.
Speaking at dental and prosthodontic conferences throughout the UK, Europe and the World.
I also love speaking at conferences with the main aim of igniting enthusiasm for removable prosthodontics. I truly believe that well designed and well-made removable dentures are a valid alternative to implant supported restorations and I like to demonstrate this clearly in my lectures. In addition, I enjoy demonstrating the positioning of denture teeth in their natural place, this being an essential skills for dentists who are replacing missing teeth using dental implants as support. Giving patients appropriate lip support and placing artificial teeth into the best aesthetic position is a skill which dentists placing dental implants must have and is a fundamental part of complete denture discipline. If you would like me to speak at a conference please contact me at education@finlaysutton.co.uk.
My speaking/honoraria fees are high, reflecting the quality of the clinical work I present and the dedication I have put into removable prosthodontics throughout my career. There is a huge amount of free to access resources available on my website (Resources and Case Studies) and on my FaceBook page. My lecturing and speaking engagements pay for this free to access material. I am completely honest and transparent, holding nothing back technically and emotionally so that delegates benefit maximally - which I find they truly love. My presentations have meticulous documentation of each patient I treat, beautifully illustrated with photos and videos. My lectures are designed so that delegates can put into practice the practical advice straight away on Monday morning. In addition, I deliver content in a stimulating and entertaining way, keeping the attention of attendees.
Please see details of courses and lectures (in UK and rest of the world) to be given by Finlay over during 2023 at the end of this Newsletter
Information about Finlay's In-House Courses
Information about Finlay's speaking engagements
