Focus - February 2015

focus
Edition 2 - February 2015
with Carl Fenwick
www.dental-education.co.uk // www.ivoclarvivadent.co.uk
iDenture; a revolutionary
concept in complete
denture prosthetics
Since the introduction of the Biofunctional Prosthetic System (BPS), Ivoclar
Vivadent has led the way in the field of complete dentures. The BPS system
has developed somewhat over the years but always stayed true to it’s core
principles, accurate impressions, correct bite registration, highest quality
materials, superb fitting and both functional and aesthetic prosthesis.
I think it’s widely accepted amongst many dental
professionals that the provision of successful prosthetics
for the completely edentulous patient can be a challenge
for the most gifted clinician, and has caused many sleepless
nights.
bow and help us improve our complete denture provision?” This
was the challenge we were faced with.
Presenting complaint
In 2013, whilst attending the Ivoclar Vivadent International Expert
Symposium, Vienna, I attended Dr Jiro Abe’s lecture on what
sounded like the holy grail of removable prosthetics…suction on
complete lower dentures!
Our latest development in the BPS system or iDenture as it
will be known in the UK and Ireland is the addition of some
new techniques to improve both function and aesthetics even
further. This was brought about to, in part address the question;
“What about patients who are unsuitable for implants, if they
cannot afford them or simply do not like the idea of them? Is
Among many other qualifications, Dr Abe is a Professor and
specialist in Tokyo, an international Opinion Leader for Ivoclar
Vivadent and president of the Japanese Denture Association.
After this lecture I signed up and attended Dr Abe’s two hands on
course in Sengawa, Tokyo to find out more. I am so pleased I did
as it has changed the way I work forever.
there anything that can give the
clinician another string to their
Carl completing his suction denture training with Dr Abe in Japan.
“What about patients
who are unsuitable for
implants, if they cannot
afford them or simply
do not like the idea of
them? Is there anything
that can give the clinician
another string to their
bow and help us improve
our complete denture
provision?”
Fig 1
Patients existing dentures
Fig 3
Accudent maxilliary impression
Fig 2
Fig 4
Using Dr Abe’s suction technique we would achieve suction on this ridge
Mandibular impression using Frame cut back
tray
Fig 5
Dr Abe FCB tray
Fig 8
Tooth set up according to BPS principles
Fig 3
Fig 6
Centric tray impression
Fig 7
Custom trays incorporating Gnathometer M
A prospective patient presented himself to the clinic expressing
a desire for a more natural looking set of dentures with which
he hoped would lead to improved chewing ability and increased
stability, additionally he expressed concerns about age related
wear as well as trapped food.
On examination the patient had satisfactory maxilla ridge
however the mandibular ridge showed evidence of considerate
resorption anteriorly (fig 2). The patients existing dentures (fig
1) were adequate in both fit and appearance but a definite
improvement could be achieved using the new iDenture system.
Good saliva production was also observed and the patient was
an experienced denture wearer of some 40+yrs.
Treatment provision
After consultation the treatment plan was to provide the
patient with a new F/F iDenture incorporating Dr Abe’s suction
technique. Starting with both Accudent and FCB impressions,
jaw registration using the Gnathometer-M and try in with
Phonares II teeth. This will then be processed in the Ivobase
injection moulding system using Ivobase High Impact Resin,
once processed lifelike characterisation will be completed with
SR Nexco gingivae composite. Emphasis would be on providing
premium aesthetics and function as well as incorporating Dr
Abe suction impression technique.
The process
Primary impressions using Accugel (fig 3) in the Accudent
upper tray were taken and the lower impression (fig 4) was
taken using Vival alginate in the bespoke FCB tray (fig 5) as
designed by Dr Abe.
An accurate Centric tray was used with Virtual putty to record
a preliminary jaw relationship and OVD (fig 6), these were
cast and mounted on a Stratos 200 Articulator in order that
the Gnathometer M custom trays could be designed (fig 7).
Using these trays our secondary impressions were taken using
Virtual PVS impression material, the border impression was
taken using heavy body regular set on the upper and lower
with monophase reg set around the retremolar pads.
Dr Abe’s 5 movements were then carried out, the second part of
the impressions used Virtual light body reg set. The combination
of these two materials and the 5 Dr Abe movements give a fully
functional, accurate and easy impression. Suction was checked
on both impressions and was present. If this is not achieved the
impression must be retaken as this is a direct 1-1 of your fitting
surface, using the Ivobase means that my denture bases are as
true to the impression as is possible so no suction now means
no suction at the fit appointment.
Fig 9
A detailed natural gingival wax up was created
Fig 10
Finished wax tray in with aesthetic and
functional contouring
With the secondary impressions taken, the OVD was determined
by the use of phonetics getting the patient to count from 55-60
and 50-40, if sufficient FWS (around 3mm) is observed without
any contact then the FWS is deemed ideal.
A mould of tooth which was similar in size to the existing denture
was preferred by the patient albeit in a lighter shade. Back to
the laboratory for the teeth to be set up according to the BPS
principles (fig 8) using set up templates to achieve perfect Wilson,
Spe and Monson curves. Once the teeth were set up a natural
wax up was achieved to assess tooth length and tissue support
Fig 11
Dentures processed in high impact using
Ivobase injection moulding
(fig 9/10), the try in was a success needing nothing altered,
speech and stability proved to be superb and the decision was
made to continue to finish in the Ivobase injection system (fig 11)
Fitting
Upon fitting, the suction of both upper and lower was checked,
as well as the occlusion was to ensure smooth and balanced
excursions were present with no displacement due to occlusal
interferences, none were observed.
Finished iDenture and patient’s new smile
Conclusion
Finally the BTC point was checked by applying Virtual light body around the Retromolar pad area and asking the patient to carry
out two movements, swallow and tongue pressure. The patient was delighted with all aspects of the prosthetics, he commented
on the strong suction of the lower in particular giving him extreme confidence and the aesthetics now felt like real teeth which
gave him the ability to smile confidently knowing people were looking at his smile and without the fear of people looking at
his ‘dentures’.
Our new iDenture is the next evolution of the BPS system and was designed in-house with the intention of bringing together
premium products and enhancing the BPS by incorporating our latest developments in removable prosthetics. Namely the Dr
Abe technique to achieve mandibular suction, the new Phonares II teeth for outstanding aesthetics and function, the Ivobase for
unparalleled accuracy and convenience in processing and SR Nexco to create lifelike aesthetics.
We have already run our first course on all stages of the process, receiving the highest feedback possible from CDT’s, Dentists and
Dental Technicians all commenting on how it will change their approach after attending.
There are a wide range of courses available on the www.dental-education.co.uk website for this new process which include, live
patient courses as well as specific courses for dentist and technicians.
For more information please call our ICDE team on 0116 284 7326.
An IvoBase
Training
An IvoBase
Training
Day
SR Nexco) Day
with SR (with
Nexco
with Carl Fenwi
ck
with Carl Fenwick
This is a hands-on course in which you will be taken through all the stages involved in processing a complete denture in
Ivobase injection moulding.
Objectives:
You will flask, inject and de-flask one denture which you can take home to polish and use as a demonstration piece for your
laboratory or practice. While we process the dentures you will then have a chance to get hands
• Understand the investing
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flask one denture
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• Learn how to appropriately
Feldspar Close, Enderby,
your laboratory or practice.
place the aeration channels.
Objectives:
Leicester, LE19 4SD
While we process the dentures you will then have a chance to get hands on with our gum
DATE:
12th Mar
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DATE: 11th June 2015
prosthetic work. lockingclasps
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March 2015 // 11th June 2015
10th Sept 2015 // 10th Dec 2015
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VENUE: Ivoclar Vivadent, Compass Building
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Feldspar
Close, Leicester, LE19 4SD
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DATE: 10 Dec 2015
TIME: 9.30am - 5.00pm
CLICK
With over 26 years experience in Dental Technology and having initially started out as a
Karen:
0116of 284
7326
Dental Technician,
Carl brings toCall
the company
a wealth
valuable
experience. In 2009,
HERE
TO
he began an advanced 2-year CDT
training
course programme with KSS Deanery (Health
Visit:
www.dental-education.co.uk
Education Kent, Surrey, Sussex).
BOOK
Qualifying in 2011, he soon opened his own CDT Denture Centre, Consett Denture Centre,
which he still manages today.
Carl also progressed into becoming a member of the teaching team at KSS Deanery and
continues to be involved in the training of new Clinical Dental Technicians.
Carl Fenwick, Consett Denture Centre, 42 Medomsley Road, Consett, County Durham, DH8 5HA
e. [email protected]
Products mentioned
Phonares II
IvoBase High Impact
Ivobase Injector
SR Nexco Pastes
For more information on products used on this course please speak to your
local Product Specialist.