Not an everyday case: designing dentures for your own grandma
Dental technician Erwin Eitler from Zahnmanufaktur Zimmermann und Mäder AG in Bern/Switzerland was given an unusual assignment: crafting the dentures for his own grandmother. This interview tells you more about this extraordinary case. Find out why the interviewee describes complete denture prosthetics as the supreme discipline in dentistry and what he thinks of the future relevance of prosthetics.
Mr Eitler, you have had the rare opportunity to provide your own grandma with new dentures. What was her dental situation?
Erwin Eitler: My grandma suffered with severe periodontal damage in her upper and lower jaw. Her periodontium had been severely damaged by periodontal disease. Her existing upper teeth could no longer be preserved. The dentist also had to remove some of her lower teeth. However, the lower premolars and canines were still in a good enough condition to be used as anchors for the lower denture.
What impact did this situation have on your grandma?
Erwin Eitler: She had difficulty chewing and speaking. She also felt uneasy about the way she looked. Her wish was to have a beautiful smile again and to be able to speak without impediment. She also wanted her prospective dentures to be hard-wearing and easy to handle and clean.
What additional challenges did this case present to you?
Erwin Eitler: My grandma wanted to avoid any additional surgical intervention. Implants were out of the question for her. The treatment at the dentist should remain limited to the necessary minimum. And because she is a close relative of mine, I set even higher demands on myself and the outcome than I usually already do.
What type of tooth replacement did you decide on?
Erwin Eitler: It was decided to restore the upper jaw with a complete denture and the lower jaw with a partial model cast denture. In other words, the restoration consisted of a combination of complete and partial dentures.
Which tooth material did you choose - and why?
Erwin Eitler: For the upper anteriors, I used the premium quality SR Vivodent S PE moulds. They result in impressive anterior esthetics: The expressive texture and internal stratification of these moulds provide an age-appropriate, lively naturalness - they look like natural teeth. In addition, the teeth met the requirement for durability as they are made of highly cross-linked DCL (Double Cross Linked) acrylic, a modified polymethyl methacrylate. This material features a higher compressive strength compared with conventional PMMA materials and has therefore a beneficial effect on the durability of the teeth.
Can you tell us something about the completion of the dentures?
Erwin Eitler: I chose IvoBase to transfer the upper wax-up into composite - a system that combines efficiency and reliability. At the end, I reproduced the soft tissue esthetics using a variety of shades to reproduce the natural gums. I achieved this with the light-curing lab composite SR Nexco and its variety of gingiva shades.
What was the result like?
Erwin Eitler: My patient was impressed with the dentures at first sight. Once the dentures were inserted, their natural and highly esthetic effect became manifest. The harmonious interaction of white and pink esthetics is impressive.
My grandmother discovered a whole new zest for life. Now she is able to laugh again with all her heart and eat and speak without impediment. With her newly gained quality of life, she feels much more positive about herself and her life. She is interested in meeting up with friends again and become involved in the social life around her.
What do you think of the future of complete prosthetics?
Erwin Eitler: If you look at the demographic changes, the number of edentulous patients is likely to increase sharply in the coming years. Because of this, complete prosthetics will continue to be important for dentists and technicians and it should not be neglected in the education and training of dental professionals or in everyday working life.
As a young technician, don’t you find complete prosthetics utterly “unsexy” and “dusty”?
Erwin Eitler: Not at all. Complete prosthetics is a supreme discipline that allows individualized concepts. An appropriate approach can be chosen from a diverse range of processing technologies to meet the requirements of the individual patient. For instance, you can choose a digital method to achieve a “simple” and sound set of full dentures with relatively little effort. Alternatively, highly esthetic dentures can be designed using high-quality materials and - as cherry on top - a manual layering technique (for the gingiva).
Complete prosthetics not only offers good prospects for the future but it is also an extremely captivating area of work.
ZT Erwin Eitler is an employee of the renowned Zahnmanufaktur Zimmermann und Mäder AG in Bern/Switzerland. The case described above has been published in issue 2/2018 of the dental magazine Reflect in November 2018.