Flanges And Design Flashcards
Full flange
extends to depth of sulcus
Half flange
half extent although – 1-2mm beyond
Maximum bulbosity
Open faced flange
- (bottom right) no flange (usually anterior only- would have posterior flange)
Socket fit
often immediate denture- model around extraction site ‘scooped away’ denture base sits into the removed socket area
Full flange design positive
Does not alter appearance of appliance due to resorption of bone
Allows for optimum placement of dentition and can be moved off the ridge for a maxilla
Highly stable- resists displacement due to adhesion/cohesion/surface tension
If altered path of insertion used moderate undercuts can be utilised for retention
Less likely to fracture
Full flange design negative
Poor considerations of thickness and design can produce irregular appearance, therefore correct.
However excellent for patients with a lot of resorption.
Correct impression technique must be used for border seal- not applicable in other designs
Half flange consideration positive
Same benefits as a full for dentition placement.
Only relates to anterior section
Smaller thickness can allow for patients natural pigmentation to show through PMMA (Besford and Sutton 2018).
High smile line and a shorter flange can show border line between acrylic and natural pigmentation
Used on completes if large undercuts
Half flange design negative
Not as stable and not as retentive for certain dentures
(acrylic or completes)
Open faced- Complete
Not as stable and retentive- no border seal.
Can be highly aesthetic at first but when resorption occurs can then show black triangles.
Can cause tissue damage (scalloped effect), if using socket fitted.
Good for patients who cannot tolerate flanges
Limitation of tooth placement directly over the ridge.
Does not necessarily lower facial aesthetics in those with
Minimum bone resorption
Socket fit
usually provided post extraction in the form of an ‘immediate denture’ technician is provided with a model- we remove the tooth and some tissue and a denture is provided to patient immediately post extraction
•Dentition placed in the socket area
•Short term use due to resorption and would need relining- this is hard to achieve and reline material can bond easily to dentition
•As discussed will cause scalloping
•Not recommended in either mandible or maxilla
(Basker et al,. 2011)
Consideration to speech
This is in relation to both tooth placement and the acrylic plate and therefore both must be considered to not only restore masticatory function but a patients ability to pronounce words or sounds.
Patient consideration
A patient must have the final say when it comes to arrangement of dentition and the appearance of the wax/acrylic component, often patients are not given the opportunity to have a say over the aesthetics. Whilst patients may shy away from having input as they believe a clinician is the expert, it is unwise to assume a clinician or technician is more an expert.
A patient who is invited to have an opinion in the correct way regarding the arrangement of the dentition and the wax up, with trusted friends or family (as it is those who will see them) with them can be vocal.
It is unwise to finish a wax try in until a patient has accepted a denture
Consideration aesthetic
During the function of dentures individual patients will show varying levels of gum work. Monochrome and flat gum work looks artificial in appearance however this is often due to finance or skill set level. Considerations of aesthetics should include
•Colours
•Root eminences
•Gingival recession
•Papillary recession
•Stippling
Some of the issues above are age dependant
Technician influences that can aid in the fitting of an appliance:
If a finishing line is indicated (posterior border or flange), utilising it
Removal of sharp areas:
•nodules and spicules- fitting surface and flange
•If a fitting surface spacer has been used for relief these can present with sharp edges and should be bevelled.
•Removal of an over undercut flange that would cause pain or discomfort
Returning to an articulator to check the occlusion and re-establishing this
