Full Immediate Upper Soft Reline Question

[bumpthumper]

As some of you may be aware of, I had my remaining 9 top teeth and 2 lower molars extracted on Feb 18, 2010. These teeth were:
03, 04, 05, 06, 07, 08, 09, 10, 11 AND 17, 20

This left me with 7 remaining teeth on the bottom. I had an immediate full upper denture placed, and have been quite happy with it for the most part.

Since then I have had 1 more tooth on the bottom extracted,(24) and have just this week gone to have my impression done for my bottom partial denture. That same day, we did my 2nd (which also turned in to my 3rd) soft reline done on the top denture as I was losing suction.

I knew I would have a problem getting a good soft reline, due to the lack of bottom teeth in my mouth. I cannot bite down with the soft reline goo they place in the denture - I actually have to press my denture UP to try to get a good reline. After doing this the first time, I knew when I went in the other day for my 2nd reline, I asked the dentist if there was any way we could put something in my mouth to try to make it so I wouldn't have to hold it up (I was thinking we'd get a better impression that way. She ended up putting some gauze (loose - not the little logs) on both sides of my bottom, while I was holding the denture in place with the reline material already in there.

The first try at this produced a reline that was WAY too thick (she said that the reline material had started to harden too quickly. We went at it again, the same way, but she used a thinner mix this time, and it seemed to have worked. This was all done Thursday the 29th. It felt better when I walked out of the office that day, so I thought I was good. Then Friday morning when I put my denture in, I noticed that the right side teeth (my right hand) was a little lower than the left side. I took the denture out and really looked at the reline, and noticed that there is a lot more of the reline material there.
This is what it looks like:






So - I don't think that side had enough pressure at the time I was biting down (I'm thinking maybe there was more gauze on the left so that side got much better pressure than the right), and I am wondering this . . .

Does anyone have any suggestions on how I might achieve a better result for my next soft reline. I will go to the dentist, and pay $50.00 to have this done, but before I do, I want to have a few ideas to bring to the table (or the chair - as it were LOL) on how I can get the best impression possible with me lacking lower back teeth.

If it helps, these are the teeth I now have left in my mouth:
21, 22, 23 GAP 25, 26, 27

The contact point between the upper denture and my lower teeth is tooth 21, that is the highest tooth in my mouth. I know when I eat, I chew on my left side, because I got a tooth on that side that is relatively good for chewing, and when I feel my denture slip while eating, it is the back right side that lets go. I am also thinking that this might have been the cause of the reline not doing as well in that area. That part of my denture is also wider, because I had a lot of teeth extracted on that side, but I still would like to get a better reline than the few I have gotten so far.

Any suggests would be appreciated - sorry this has been so long, but I am hoping one of the terrific dentists on this forum will have an idea that my dentist and I haven't tried. I know a good overall inpression is critical to good suction, and between using my fingers to hold the denture UP, and trying the gauze . . .I'm hoping there is another way to insure a good overall impression.

Please let me know if you can think of anything . . . Thanks!!

 

[drhirst]

Hi,
The main problem here is that you have had nine teeth out at the top. This means that your gums are shrinking all over the place, so the only area where the denture still fits is the palate (which does not shrink). Indeed, if you look at the photos (best quality I have ever seen posted here!), the only area where there is no reline material is the centre of the palate.
I think the best chance of success would be to let the dentist position the denture for the first couple of minutes then very lightly close together as the setting process starts - more easily said than done.
Alternately, it might be better to leave the reline material alone and ask your dentist to adjust the biting surface until you achieve a more even bite. I think I would go for this option as the reline looks pretty well done in the photos.

Unfortunately, whatever you do the denture will not be stable while the gums are rapidly shrinking. This process takes about three months or so. After this time your dentist will be able to make you a new denture which should be much more stable. I generally refer to the first denture as a temporary denture as it always needs replacing after the first three months.

Hope this helps

Lincoln

 

[bumpthumper]

Thanks for your response Dr Hirst -

I am sure that I will be getting my bite adjusted when I get my permanent bottom partial.

I've been for the impression this past Thursday (the 29th), I will go for a try in with just wax over the metal frame on May 14th. I believe she said I'd have another try after that with the teeth in it, still wax - then a final try in before getting the finished partial. Hoping that this will all be done by the end of May.

She also told me, because I asked, that the denture I have now IS my permanent denture. At the 6 month post extraction mark, we'll do a hard reline in acrylic on the same denture I have now. By then, I will have the bottom partial, so I am not worried about getting the impression for the hard reline, I'm sure I'll have a much better bite with the partial in place and my upper will have bottom teeth in there to press against.

I guess I'll just stick it out with this reline for now. I'll ask her when I get my bottom partial to do another one then, because I'll still have two and a hlaf months to go before the hard reline, and I'm sure my gums will be doing more healing in the interim. But again, I thank you for your response, it is appreciated!!