NMDA Journal Summer 2018

16 New Mexico Dental Journal, Summer 2018 The basic setup consists of two parts: a striking plate, and a threaded set screw. When properly mounted on full upper and lower dentures, the intraoral central bearing plate acts as a device for achieving balanced denture occlusion. With the simple addition of the centric pin receiver a comfortable, balanced, firmly seated, and supported denture is developed at the wax try-in appointment. Items needed: • MS hex nut 8/32 $2.80/100 • Cup point socket set screw 8/32 $4.00/100 • 1-inch flat, smooth metal button cover $9.50/100 • Therefore, approximately 17 cents per patient Geriatrics and Aesthetics Don’t make the mistake of assuming that the elderly patient is not concerned about aesthetics. Aesthetics is a predominant factor for complete denture success. It is the most frequent complaint among complete denture patients. Comfortable, but unaesthetic dentures seem to be poorly accepted by the majority of patients. Compensating alveolar bone loss, correctly supporting lips and re-establishing the correct vertical dimension of occlusion are basic steps for achieving the patient’s normal appearance. However, this is not sufficient to achieve individual denture aesthetics. Denture aesthetics has been defined as the cosmetic effect produced by a dental prosthesis that affects the desirable beauty, attractiveness, character, and dignity of the individual, This means the proper form and shade of denture teeth and also the individual set-up of the teeth to achieve individual aesthetics (Fig 5). Fig 5—(left) Patient presents with aesthetic concerns. She is too embarrassed to wear her dentures in public and subsequently has become socially isolated. (right) Patient demonstrates her new appearance. Dentures constructed after listening to her aesthetic issues. Implants A consensus statement by McGill University, Montreal, Quebec, Canada (2002) concluded that a complete denture for the edentulous mandible should no longer be considered the first choice of treatment. Instead, the placement of two to four implants should and has now become the first choice, especially for the compromised atrophic mandible. This among many other factors has led to an increase in the fabrication of implant overdentures for restoring edentulous patients. Implant overdentures can be supported/retained by several different attachment systems; i.e., a bar and clip or individual attachments for improved retention. For clinicians looking to provide their edentulous patients with better function, stability, and quality of life, a stud attachment implant overdenture is an excellent, cost-effective option (Fig 6). Stud attachments include Locators® and o-ring/ball attachments. The restorative protocol is relatively easy to learn and presents an accessible gateway to implant therapy and the tremendous benefits it affords the patient. Fig 6—(left) Locator® stud abutments placed in the mandibular arch osseointegrated implants. (right) Locator® metal caps precisely placed and cemented into the mandibular denture. Like traditional dentures, implant overdentures are removable appliances that include prosthetic teeth. The advantage of the mandibular overdenture is obvious, in that the patient has a stable, and retentive prosthesis. Vertical Dimension This is perhaps the single measurement that ultimately relies on the clinician’s intuitive judgment. It has been our experience that no standardized measurements are applicable to patients universally. The clinician should bear in mind that the patient can assist by becoming the “de facto” articulator. The patient may also have input by verifying how much of the incisal edges of the maxillary anterior teeth they desire to have showing continued from page 15 “Seven Nuggets” for the Successful Denture