Lee Gause, DDS

Lee Gause, DDS
Smile Design Manhattan
New York City, NY

Jaclyn, Ultaire AKP patient

Jaclyn
New York

“Because this Ultaire™ AKP material is so rigid, and because it needs such little adjusting, it’s actually allowing me to provide a better product in a more efficient way, which is huge for a dentist.”

— Lee Gause, DDS

Polymer RPD provides rigidity, strength, and secure fit

Case overview

Jaclyn’s missing molars made her self-conscious, and she stopped wearing her poorly fitted lower metal removable partial denture because she couldn’t bear the mouth pain and migraines it caused. Upper and lower metal partials were provided to Jaclyn as part of a government-assistance program during a difficult time in her life. Her dentist, Lee Gause, DDS, owner of Smile Design Manhattan, worked with Jason J. Kim Dental Aesthetics on a new lower partial that would be more comfortable for Jaclyn and also provide better retention and aesthetics.

Challenge Solution
Maximize use of patient’s two remaining molars with few opportunities for undercuts Selected Ultaire™ AKP framework for its rigidity, strength, and secure clasp design
Design a new lower partial that would work with patient’s existing upper partial until it was replaced Left spaces in the new lower partial with the intention of adding molars at a later date
Achieve retention without covering the patient’s palate with material Created a custom impression tray and VPS impression material to ensure frame captured all anatomical landmarks
Accommodate patient’s desire to have no metal showing when she smiled Selected Ultaire™ AKP metal-free framework because it provides exceptional support without damaging remaining teeth
Allow patient to eat nuts and granola without the worry of food getting stuck under her partial Designed a horseshoe-shaped frame with lingual plate that fits securely and does not move around in the mouth with chewing

 

Design techique

Creating the framework

Jaclyn’s dentist, Lee Gause, DDS, created a custom impression tray for her mouth. The detailed impression, combined with a horseshoe-shaped design, resulted in a frame that snapped right onto the mold. Jaclyn’s frame was also designed with a lingual plate to utilize her stable anterior teeth for a secure fit. The flange area was extended and the undercuts were taken down minimally to achieve maximum balance and retention. The anterior part of the frame was designed to be very thin, so it felt smooth and natural on her tongue, one of the advantages of the Ultaire™ AKP material.

The horseshoe-shaped frame was designed with an open palate area

The horseshoe-shaped frame was designed with an open palate area.

A lingual plate used the stable anterior teeth for a secure fit

A lingual plate used the stable anterior teeth for a secure fit.

Adding teeth to the frame

Jaclyn was missing most of her molars. She had one remaining upper molar and one lower molar. Adding molars to her new lower partial denture could create an uncomfortable and unnatural occlusion. It had to be designed to work with her existing teeth, and also with her existing upper metal partial denture, until she could replace it at a later time.

The team decided to add only two molars on each side of the lower partial denture, and to leave molar-free spaces directly behind the teeth. During the fitting process, acrylic was added to the molar-free spaces until an even bite was achieved.

Acrylic was added to the molar-free areas until an even bite was achieved

Acrylic was added to the molar-free areas until an even bite was achieved.

The anterior part of the frame is very thin, so it feels smooth and natural to the tongue

The anterior part of the frame is very thin, so it feels smooth and natural to the tongue.

 

Discussion

Patient feedback

Jaclyn needed many adjustments to her previous metal denture, and it never felt quite right to her. “I was disappointed with the metal one because it was uncomfortable and I couldn’t use it when I ate foods, so I wound up not actually using it for most of the time that I had it,” she said.

When Jaclyn put in her new Ultaire™ AKP partial for the first time, she and Dr. Gause were both pleased that no adjustments were needed. She said, “It actually fit perfectly the first time.”

“Jaclyn’s metal partial did not have good retention, so it was very uncomfortable. Giving her something that was rigid that she could actually grind and chew her food was a huge thing for her, and that’s a great option that I’m happy to be able to provide,” said Dr. Gause.

Since receiving her new Ultaire™ AKP, not only have Jaclyn’s migraines subsided, but she is also able to eat all the healthy foods that she couldn’t chew before. “It has been life-changing for me,” she said.

“It actually fit perfectly the first time…It has been life-changing for me.”

— Jaclyn
Ultaire™ AKP Patient