Ask yourself, how many advancements have been made in full dentures in modern times? “Well compared to what?” Since they made George Washington’s teeth using hinges in the back?”Successful prosthetics depend upon the awesome tenacity of the patient. In almost every instance, if the dentist who delivered the dentures, and the technician who fabricated the dentures don’t hear from the complaining and unhappy patient, then that was a success- or was it? Think about it- how would you handle a new set of dentures? You would experience looseness, tipping, saliva flow increase, clinging and sticking food, passages of food under the bases, gagging, tongue crowding, speech deflection and psychological adjustments due to appearance.

In a recent survey, it was found that a majority of Dental schools only require one or two full dentures to be made and delivered in order to graduate. (There are some exceptions to that requirement.) There are 43,000,000 people in the U.S. who are edentulous or partially edentulous. The actual insurance tables are rising rapidly. Fifty percent of the population uneducated never sees a dentist in their lifetime. These people who are dentally under privileged will ignore any warning signs until it is too late. This shows the need for full and partial dentures, now and in the long term future!

Progressive thoughts must prevail- both from the dentist and the laboratory in order to compete and be financially successful. Both must begin to concentrate on advanced procedures, techniques and the patient’s awareness regarding comfort and esthetics. A basic concern of an edentulous patient is retention of their dentures.  This has lead to the growth of a very large “denture adhesive” industry. Take a look in any drug store. The basic need of retention for denture wearers has led to considerable experimentation and research in efforts.

To perfect dentures that compensate for the loss of natural teeth and to enhance retention through any means possible, like attachments, magnets, clasps, etc. The use of multiple miniature suction cups made for a soft material lining the denture, satisfies the requirements of retention and stability. But perfection in the laboratory fabrication skills required kept this technology from gaining acceptance in the industry. Dentists and patients loved it, laboratories hated it, and let’s face it, if the labs won’t or can’t make it, the dentist can’t prescribe it.

History of Experimental Dentures

Patents on suction cup dentures were issued to J. Spyer and R.S. Ingalls in 1885. These patents covered multiple projections on the tissue surface of the denture. A patent was issued in 1907 to G.W. Morgan for the suction cavities in a soft rubber sheet. A large number of other devices have been proposed, but all of them failed to meet the prerequisites of simplicity, comfort, permanency, tissue tolerability, practicality and aesthetics.     Since 1992 I have experimented in our research and development department at Aesthetic Laboratories with attaching individual suction cups, and group sections of cups to dentures. These were made of latex rubber, polyethylene, vinyl polymers, soft methyl methacrylates, mercaptan, rubbers, and silicone elastomers.  Most of the materials were too hard, or would not remain soft.  All of these materials, except the silicones, present difficult technical problems, which add excessively to the cost of the prosthetic appliance. The lining material used in these applications was Silastic – a high molecular weight dimethylopolysi-loxane polymer.  Sufficient clinical evidence of its toleration by oral tissue was available to justify our using it to construct more that 50 suction cup dentures.  Some of the problems encountered could only be solved by trial and error. Among those problems were the size and shape of the tentacles or suction cups. I first attempted to duplicate the typical shape of the suctions cups, but the construction of such a shape proved to be both difficult and expensive.  The cups settled into the tissue or soft-tissue tended to conform to the shape of the cups, or both occurred simultaneously. Further testing indicated that the best results were obtained with a cup shaped with straight sides and a tapered interior.  The ideal angle of the tapered sides proved to be 12.5 degrees outward, similar to those of a typical suction cup.  This degree of taper allows for the correct resiliency of the silicone material, so that it “gives” and conforms to the contracting tissue rather than acting as a repelling force.

Solves Extreme Resorbed Ridges

The chief indication for a denture with multiple suction cups is a desire on the part of the patient for extra retention and stability of his or her dentures.  Many patients have extremely resorbed ridges and could not master the use of dentures, let alone retain these prosthetic appliances in their mouths.  This “Multi-Cup” technique (multiple suction cups) answers their problem along with the knife-edge or flat ridges and can be made with or without palates.

The problem for the dentist has been to find a lab that even knows about this technology, or willing to offer it, let alone has learned the skills required, or can fabricate it economically.

Dr. Arthur Jermyn, D.D.S., an implantologist and inventor, helped to solve this problem several years ago. He had developed a system and technique for simplified production of suction cups onto soft denture liner.  Although it is simplified, it is not simple, at least not simple enough for most lab owners.

Dr. Jermyn has been marketing this system for over 20 years but acceptance has been slow for the labs. I have studied suction cups in the past and know the positive performance that they can provide the patient, if only they could be made economically.  I have learned the technical skills required and now offer “Multi-Cup” denture services to my accounts.

Contraindications – Allergic Reactions

To date we have had no allergic reaction to the silicone liners. The only possible cause for deferment of construction of dentures is the presence of moniliasis in the mouth. This organism should be eradicated if possible, because the available silicone liners act as a propagating media for growth of fungi.

Technique

Before impressions are made, it is necessary to restore the oral tissues to optimum health.  Sometimes this means having the patient go without his or her dentures for several days. Otherwise, it is necessary that the tissue be reconditioned by relining the old dentures with tissue-conditioning resins. Directions for applying and using these soft resin materials are available from their manufacturers.

New Dentures

The first step in making a new set of dentures is making an accurate set of impressions trays. The handle on the tray should be centered directly over the anterior ridge, so that it does not interfere with the movement of the lips. The borders of the tray should be slightly under extended and rounded.  Severe under extension can be corrected by adapting tracking stick modeling compound to the tray and manipulating the border tissues to make a functionally accurate adaptation.

The final impression is made in a soft syringe type, rubber-base impression material should be free of any voids or air bubbles.

Rebasing Old Dentures

Dentures may be rebased with the multiple suction cup technique, providing the dentures have the correct occlusion, centric relation and occlusal dimension. Before rebasing old dentures with this technique, sufficient space must exist under the teeth for both new silicone liner and the new acrylic resin. Before rebasing old dentures, the dentist may have to cut away much of the under impression surface of the denture, and first treat the tissue with a tissue conditioning resin.

The borders should be corrected with tracking stick modeling compound, making sure they are nicely rounded and accurate.  The soft syringe type, rubber-base impression material is then used for making the final impression directly into the old denture.

Placement of Dentures

After the laboratory has precisely processed the denture, it is returned to the dentist. Prior to the insertion, the new dentures are soaked in the fungicide solution for at least 15 minutes and then rinsed with distilled water before being place in the patient’s mouth.  The patient is asked to maintain a closing pressure on the dentures for several minutes in order to allow the suctions cups to flare out and partly settle into the tissue.  The occlusion is then checked with articulating paper for the necessary occlusal adjustments.  The patient is then dismissed with a warning to eat a soft diet for the next few days, and to leave the dentures out during sleeping hours.

The patient is recalled within a week for further occlusal adjustments, and again a month later for final adjustments. During this time, any sore spots that occur due to excessive height of individual suction cups are easily located and relieved and should be trimmed with modified cuticle nippers.

Conclusion

A simple technique (for the dentist) for enhancing the retention and stability of dentures has been described. A large number of small suction cups formed from a soft resilient silicone rubber are processed in an otherwise conventional denture. They grip the oral tissue without causing any pathosis.  The tissue tends to temporarily assume the form of the cups, but then return to normal when the dentures are removed. The tissue appears normally pink, moist and healthy.

This technique solves many of the physiological and psychological problems associated with the denture wearing, but this is no panacea for all denture troubles.

The procedure calls for working with a laboratory that is technologically advanced in the construction of this technique-sensitive procedure, but when properly done, the use of these multiple suction cups can make the difference between success and failure.

Because it is not much more expensive now, due to the “Jermyn’s” fabrication process, it should be considered for all your denture patients.  It can save your patient the cost and mess of denture adhesive creams and powders and has a much better retention rate than using these adhesives.

In conclusion – these are exacting times in dentistry, with new developments and products ushering in a new era. We now have lighter, more comfortable, more aesthetic denture prosthesis, which are greatly needed.