Complete denture clinical protocols
Successful oral rehabilitation of edentulous patients with removable prostheses demands careful adherence to a clinical protocol. Some simplified protocols have been successfully introduced.
Clinical objectives are met by using a routine clinical protocol that includes most or all of the following steps:
Restoration of soft tissue health. Absence of a wide band of attached mucosa does not seem to adversely affect soft tissue health. Gingival/mucosal grafting procedures are rarely prescribed. Irreversible hydrocolloid impressions in stock trays are made to produce required stone diagnostic casts.
Fabrication of custom impression trays and final impressions using elastomeric materials in conjunction with recording functional border extensions of the prosthesis. Definitive stone casts are then poured.
Fabrication and adjustment of wax occlusion rims to establish height of the occlusal plane, while establishing the correct vertical dimension of occlusion, suitable smile and lip lines.
Registration of the maxillo-mandibular relation record and articulator mounting (with or without use of a face-bow).
Artificial teeth selection and their arrangement for a try-in of the provisional set-up.
Clinical evaluation of the desired restoration of vertical and horizontal jaw dimensions, centric relation and overall esthetic outcomes.
Denture placement to include evaluation of patient comfort, function and esthetic appearance. Careful attention must be paid to denture base fit and extensions, functional elements of speech and mastication, occlusion, and appearance/soft tissue support.
Post-placement evaluation of patient comfort, function and esthetics. Adjustments are made as necessary.