Nobody loves dentures – especially dentists. During my first semester of dental school, one of my teachers told the class: “You marry your denture patients. You will see them more often than your spouse.”
Many dentists dread making dentures because it takes a long time. Using the conventional technique (the one taught at most dental schools), at least six appointments are needed. Because of this time commitment, some dentists are simply unable to make a profit fabricating dentures. Many dentists just throw in the towel and choose not to make dentures at all.
However, based on statistics from the ADA and the ACP, Dr. Mark Durham, Division Chief of Prosthodontics at the University of Utah School of Dentistry, estimates that “28 patients will need … dentures your first year out of [dental school] and that number will increase every year.” If Durham’s calculations are correct, it is important for dentists to find ways to make the process less difficult, more efficient and more profitable.
There are two major types of techniques in denture fabrication: conventional and simplified. Conventional techniques usually include multiple impressions (alginate and PVS), use a semi-adjustable articulator, and require at least six appointments. Simplified techniques often forego the second impression, use mono-plane articulators, and take at least four appointments.
To some, the simplified techniques are heresy. But according to a study published in 2005 by Kawai et. al., “there is no major difference in patient satisfaction or in the perceived quality of conventional dentures produced with traditional or simplified fabrication methods.”
Wayne Newton Rim
For those who are skeptical of certain aspects of the simplified technique, here’s a little trick developed at the Salt Lake City VA Hospital by Dr. Durham. This technique has been used successfully by dental students at the University of Utah. It combines the conventional and simplified techniques. It uses an apparatus we call the Wayne Newton Rim (WNR) – appropriately named because it will make you and your patients say, “danke schoen!” and because Mr. Las Vegas is a pretty cool guy.
Here’s how you do it: after the initial alginate impression is taken, a cast is poured up and a baseplate is made. The wax rim is then added to the baseplate. (These together make the WNR). A final impression is first taken with PVS using the baseplate portion of the WNR as the custom tray. Then, the wax portion of the rim is adjusted and marked to communicate to the lab where the teeth should go. All this is done in one appointment. The WNR is then sent off to the lab for teeth to be mounted into the wax rim.
There are multiple benefits of the WNR:
- Like most simplified techniques, fewer appointments are needed – only three if you use a WNR.
- Like the conventional technique, a quality PVS final impression in a custom tray (baseplate of the WNR) can be obtained.
- With most techniques, adhesives are needed to keep the baseplate and wax rim from moving around, but a WNR will stay put and make it easier to obtain accurate measurements and markings.
The biggest benefit of using a Wayne Newton Rim is that it only requires three appointments. As dentists are able to reduce the time required for dentures, it reduces their costs, increases their profits and makes it possible for them to serve the growing population of patients who lack their pearly whites.
~Daniel Hoopes, Utah ’17, chapter president