Our group of three dental offices in Indiana focuses on high quality removable dentures and Oral Surgery, so we make a lot of dentures! Without fail, we are often presented with difficult denture cases. Much of the time those challenging cases are older patients who have severely atrophic mandibles. After 40 years of denture wearing, they are unable or unwilling to get dental implants. Frequently these are the same patients that dislike their loose and uncomfortable lower denture and complain about it a lot!
Last April, one of those patients was in my chair, but thankfully she didn't complain about the denture. That patient was our office manager Kelli’s lovely mother, who everyone on the McCall Dentures-Team has affectionately nicknamed ‘Momma’.
Momma's chief complaint, to put it bluntly, was the fit of her lower denture, one that she has had for more than 40 years. With such prolonged denture wearing, often comes a severely resorbed residual ride and Momma was a classic case. To say that she lacks mandibular bone would be a understatement, she unfortunately has none. Last year, we made her new upper and lower dentures, using great acrylic and the nicest teeth.
Her upper denture was perfect and she loves everything about it. Despite our tedious attention to fitting and fabricating of her dentures, Momma has been consistently frustrated by her 'loose lower denture'. I knew we had to try a soft liner when Kelli very succinctly told me that she wanted to 'just reach over and hold it down with my hands when she eats!’
Momma is unfortunately not a candidate for mandibular implants, so with great anticipation Kelli and I turned to Tokuyama’s Sofreliner Tough®, a silicone-based denture reline material that can be used on both full and partial dentures. It is extremely resilient and bonds well. Two years is a long lifespan for a soft liner, and unlike other silicone materials it does not build up plaque easily. There is no unpleasant odor and after trying literally every soft liner on the market, I found the packaging and delivery method saved material!
This material can be used both chairside or in a lab setting, using a gypsum model and a stone index for the teeth. Since we were unbelievably busy that Friday afternoon and Momma only had 30 minutes to spare in between doctor’s appointments, we opted to use the denture reline material chairside.
We started by removing the intaglio acrylic of the lower denture with a round bur and then a large cross cut bur was used to remove the existing denture liner surface. All of the borders were beveled to ensure the liner rolled over and the entire intaglio area was rinsed and air dried thoroughly. I used Sofreliner Tough primer over the entire border and air dried. The paste material was applied over all primed areas and inserted inside the mouth. After placing it in the mouth we massaged Momma's cheek muscles and had her make 'S' sounds and stick out her tongue. We carefully trimmed the excess material with a sharp scalpel and used a coarse bur to smooth out the borders. We then smoothed the entire area with a scotch brite brown wheel. The denture and liner were polished on a rag wheel with pumice and prior to delivery.
When I walked into the treatment room after less than 10 minutes and saw Kelli showing our dental assistants the amount of suction her mother’s lower denture had, I was ecstatic. Suction shouldn't be expected with every case, but there was a dramatic increase in retention and Momma's newfound comfort brightened my day. We gave her a fighting chance.
For our patients that cannot accommodate or afford dental implants, permanent soft liners can be a life saver and a huge time saver. I have done nothing but dentures for the last 10 years and we have tried every soft liner on the market. This one is solid. After two months, Momma is doing amazing and the soft liner looks better than ever. There's no plaque build-up and I didn't notice any odor. Hopefully it will last more than two years, and then we can do another one! Sofreliner Tough's fast setting time and ease of use keeps our schedule flowing and can be delivered perfectly by Expanded Function Dental Assistants.
What could have been a difficult situation was made simple and fulfilling and took very little of my valuable chair time. Using Sofreliner Tough can turn a difficult and frustrated patient into a solid source of referrals and the cost is super reasonable!
I couldn't be happier with the dentures fit, function, and retention. Kelli even told me yesterday that she doesn’t feel the urge to reach over the dinner table any longer. I look forward to using Sofreliner Tough for many years to come.
