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    What you need to know about the evolution of dentures

    Exploring how the artistry and craft of denture creation has changed.

    Dentures are, certainly, nothing new. They have been around in some form or another for almost 3,000 years. For much of that time, denturists used human or animal teeth to give edentulous patients the chance to chew again. And while that may sound uncivilized in this day and age, the fact remains they were the best materials for the job.

    Materials and processes have most certainly evolved – especially in the last century. In fact, laboratory technicians have seen the biggest development in the past two decades. As such, those same technicians have had to change the way in which they work.

    A time of change

    “Both dentures – full and partial – have been fabricated the same way for the last hundred years,” Justin Marks, CDT, founder and CEO of 3D printer manufacturer, Arfona, says. “You take prefabricated denture teeth and arrange them in wax, on a box or model, and that wax-up would be covered with more plaster inside a flask. That process called ‘lost wax casting’. The denture would be either injection molded or pressure packed with acrylic polymer, or in the case of a partial denture, the wax would be burned out or evaporated in the high temperature furnace, and then cast in metal alloy. Both of those procedures, whether it be full dentures or partial dentures, didn’t really change all that much for the greater part of a hundred years.”

    In the 21st century, CAD/CAM changed all that, but not immediately so. Technicians, like Marks, tend to adopt a digital workflow incrementally.

    “I started to experiment with CAD/CAM going back about 10 years, maybe a little more,” Marks remembers. “At the time, digital full dentures hadn’t really been invented yet.

    Digital partial dentures were starting to make their way into the marketplace. But it was really limited to being able to do a digital design on a screen, print out a resin pattern, and then you would cast that in metal using old-fashioned techniques. A few years after that, you were able to design dentures, digitally, because the software caught up, but the manufacturing techniques really hadn’t. For both dentures and partials, the first CAD/CAM systems were: You could design it and look at it on a screen, but you couldn’t actually take it off the screen and turn it into a tangible object. That really has been more in the last five years that we have actually brought digital dentures to fruition, and not just with 3D printing, but even milling, before that. There are ways to actually produce that now, as a tangible item.”

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    While CAD/CAM is certainly gaining in prevalence, not everyone has jumped ship from the analog workflow. Technicians like Dan Elfring still rely on those traditional, analog methods.

    Elfring has been a dental lab technician for four decades – the first 28 years in the Air Force and for the past 12 as an in-house lab technician at Pickle Prosthodontics in Colorado Springs, Colorado.

    Even though that workflow has been more or less the same for the past hundred years, it has evolved. The dentures that Elfring makes now are different than the ones he made at the beginning of his career.

     “A lot has changed over the years, especially in the way of dental materials, equipment and processing,” Elfring says. “Before I was press packing and heat curing, and then I went to Ivocap, which is injected processing. Now I’m currently using IvoBase, which is continuous injection. The acrylic is cured much differently and I’m using better acrylics, better material, and better teeth.”

    Change is a good thing, and the results are evident in better prostheses.

    “Denture bases are denture bases, teeth are teeth, if you will, but the way I inject or process the acrylic has really changed,” Elfring says. “We feel we can get a better end product, and because so much of our work is hybrid work, which means it’s fixed-removable, it’s all-on-four fixed hybrid, so it’s dentures that are implant-retained and screwed into the mouth. We get a better, denser acrylic by injecting it, versus press packing it and heat curing it. Because we are a high-end practice, we want to use the best materials and processes we can. It fits well with our workload to try and improve the process. We’re not a high-production laboratory to where we’re looking at, ‘How can we do it faster and cheaper?’ We are more customized and we are looking at, ‘How can we do it better?’”

    Trending article: How digital dentistry and 3D printing are changing dentures


    Next: Enter CAD/CAM

    Robert Elsenpeter
    Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author ...


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