Dennis Urban, CDT
Jason J. Kim
Dental Aesthetics
Port Washington,
Long Island, NY

Connie
New York

“Ultaire™ AKP allows for a more natural tooth morphology without worrying about metal getting in the way.”

— Dennis Urban, CDT

A rigid polymer solution for poor occlusion

Case overview

Too many partial denture wearers believe they must endure the discomfort, poor aesthetics, and difficulty chewing that comes with wearing a removable appliance.

This was certainly the case with Connie. For decades, Connie wore low-quality upper and lower partials with poor occlusion, putting remaining teeth at risk. The team at Jason J. Kim Dental Aesthetics worked with Connie’s new dentist, Gerald Grossman, DDS to design high-quality partials that would provide long-overdue comfort, oral protection, and pleasing aesthetics.

Challenge Solution
Support remaining tooth structures, which were weak and brittle Selected Ultaire™ AKP framework for its rigidity, strength, and exceptional support without damaging remaining dentition
Accommodate lack of occlusal space The Ultaire™ AKP frame creates enough space for VITA denture teeth with a 23° cuspal inclination
Achieve retention without covering the palate with material Used a custom impression tray and VPS impression material to ensure CAD design captured all anatomical landmarks for a horseshoe-shaped frame on the upper partial
Patient wants to avoid trips to New York City to visit the dentist for adjustments Many patients with Ultaire™ AKP RPDs need no additional adjustments
Patient does not want metal showing when she smiles Ultaire™ AKP frames do not have metal clasps

 

Design technique

Creating the framework

It took a mere 30 minutes for the team to design both the upper and lower frames, and they snapped right onto the model when they were released from the milling disc. This was attributed to the efficiency and accuracy of the CAD/ CAM process. The 3Shape™ software was programmed with material settings especially for working with Ultaire™ AKP. For example, it set the undercut depth to about 0.5 mm, which is ideal for clasp engagement. Deeper undercuts are a benefit of the high-performance polymer material and would not be possible with metal.

The team did not design a lingual flush on Connie’s lower partial because of the instability of her anterior teeth between the cuspids. Instead, they opted for a tapered lingual bar that sat 3 mm to 4 mm below the gingiva of the teeth with a clasping rest seat on the distal of #20 and #28. The Ultaire™ AKP rest seat design is the same as you would see with metal frames, yet it provides strength and stability without the weight, irritation, and poor aesthetics of metal.

Ultaire™ AKP clasp designs are shorter and thicker
yet they improve retention by encircling a minimum of 200° of their respective tooth

Ultaire™ AKP clasp designs are shorter and thicker, yet they improve retention by encircling a minimum of 200° of their respective tooth.

To finish the Ultaire AKP frame
follow standard processes

To finish the Ultaire™ AKP frame, follow standard processes.

For Connie’s upper partial, the team created a horseshoe design, which was stable while allowing Connie to feel her palatal area. With the lower partial, they avoided the flush up in areas where they were concerned about gingival recession or the integrity of the teeth.

Providing proper tooth morphology

To ensure that Connie’s lateral excursions would have full function, they used a fully-adjustable articulator mounting to mimic her natural occlusion. This guided the process of setting the fully anatomical 23° denture teeth and ultimately eliminated the need for chairside adjustments to the finished partial.

Teeth are set on the Ultaire AKP frame in wax
and then the wax is carved and colorized to mimic the natural gingiva of the patient

Teeth are set on the Ultaire™ AKP frame in wax, and then the wax is carved and colorized to mimic the natural gingiva of the patient.

Fitting and processing

With Ultaire™ AKP frameworks, the 3Shape™ software blocks out the undercuts with enough retention so the frames seat perfectly without adjustments to the clasps or rest seats. Connie’s partials snapped into place perfectly, so the team proceeded to the final waxing, investing, press pack, microwave processing, and finishing steps. The final partials were processed, polished to a glass-like finish and completed in one day.

For those occasional times when adjustments are needed
a carbide bur or an acrylic grinding stone is appropriate

For those occasional times when adjustments are needed, a carbide bur or an acrylic grinding stone is appropriate.

 

Discussion

Patient feedback

When Connie and Dr. Grossman first held the finished partials in their hands, both remarked at how light they were, estimating them to be about one-third the weight of metal partials.

Upon try-in, Connie’s finished partials fit perfectly without adjustments to the frame or acrylic, which was astounding to Dr. Grossman. To this day, Connie has not had to return for adjustments, nor has she had any sore spots.

Connie says that the Ultaire™ AKP material is very smooth and she likes how it follows the contours of her mouth. “I think the Ultaire is very comfortable, very lightweight, and very easy to speak with,” she said. “I don’t feel that it moves as I talk or I eat.”

Connie also likes that her new partials are not made with metal – both for aesthetic and health reasons. “If anyone has issues about metal getting into their body, I would tell them this would be a better way to go,” she said. “And it is much nicer to smile without reflective metal in your mouth!”

“I think the Ultaire is very comfortable, very lightweight, and very easy to speak with.”

— Connie,
Ultaire™ AKP Patient