I had an interesting visit to a company here in Scottsdale that is fabricating “digital” dentures.
The technique is based on impressions that are stitched to an interarch measurement and positioning device that lets the clinician set the position of the maxillary incisors, the vertical dimension of occlusion, and the centric relation position as determined by a single-point stylus that creates a gothic arch tracing. After records are gathered, the impressions are scanned, the interarch record device is scanned, and the two are stitched to produce a virtual mounting.
The technicians now take sets of virtual teeth and “set” the denture just as you or I would at the lab bench. Rotations, curves of Spee and Wilson, and any customization desired can be completed just as if you were working with real denture teeth and wax. Once completed, the denture bases are now milled out of a “puck” of Lucitone 99 that has been processed under intense pressure.
Check out the detail on the milled lower prior to its removal from the puck.
Notice the detailed positions created for the denture teeth. They are now cemented into the prepped areas and the denture is polished and delivered.
A single records visit, one seating visit, and adjustments as required. The company claims fewer of those are required, since the middle steps and the processing reduce the errors inherent in the “old” way of fabricating a denture.
I'm additionally intrigued by the possibility of using this within Earl Pounds' branching technique, creating the preliminary denture for the functional impression by milling a denture base that is 1.5 mm off the tissue, milling a tissue model, then lining the denture base with Hydrocast and beginning the functional impression process. Since the denture for creating the functional impression was made using the interarch positioning device developed by AvaDent, I believe there would be fewer occlusal adjustments required in the functional impression process.
I'll keep you posted on what I learn.