The Pankey Institute

Turbyfill: Live Patient Complete Dentures for Dentists and Technicians

Presented by
Dr. W. F. “Jack” Turbyfill and Andrew R. Turbyfill, CDT

After 51 years in practice, Dr. Jack Turbyfill has much to share. He writes, “Dr. L. D. Pankey said that there is no pride or joy in slip shod work, only on work that is one’s best. I have spent a lifetime trying to keep patients from ever having to wear dentures. Even if dentures are not ideal, we should do them as well as possible.

“Most dentists today believe that we don’t need to know much about dentures now that we have implants. This thinking can get dentists in trouble. I believe that removable prosthodontics are the most lucrative area in dentistry today. Senior citizens are the fastest growing segment in today’s society. They want and can afford the best since they control more money than any group in the history of the world.

“A successful treatment denture makes the implant process easy and predictable with no surprises. The correct position of the teeth dictates the position of the implants. The treatment denture can be used as a surgical guide and later as the restorative guide.

“Often I hear dentists say, ‘I hate to do dentures, they are so unpredictable.’ The same dentists say, ‘I like to do fixed restorations.’ I feel the reason for this is that fixed restorations are more predictable than complete dentures.”

Over the last 100 years, the clinical approach to the edentulous patient has been taught the same way. The clinician records impressions, bases, and jaw relations, and then places casts in an articulator. A wax-up is prepared and after try-in, dentures are processed and delivered. At this time, problems typically arise leading to patient dissatisfaction and dentist frustration.

In fixed prosthodontics, the results are predictable because the patient wears a provisional prior to the final restoration. The denture technique used by Dr. Turbyfill consists of:

• Visualizing the final prosthesis and wax-up.
• Creating a provisional treatment denture.
• Placing the provisional treatment denture and evaluating the denture for all areas of concern: aesthetics, function and comfort.
• Using the treatment denture as a guide for the construction of the final prosthesis after the provisional denture is tested to dentist and patient satisfaction, and ideal functional impressions have been made.

Learning Objectives:

Dentists

• Anatomic positioning of maxillary anterior teeth
• Mandibular anterior tooth positioning using natural phonetics
• How to use phonetics and the closest speaking position to develop vertical dimension of occlusion
• Edentulous centric relation bite registrations using central bearing points
• Complete denture occlusion—how denture occlusion differs from natural tooth occlusion
• Delivery of a diagnostic denture and the art of refining these “training wheels” gaining patient acceptance
• How to develop perfect functional impressions
• How to go from the perfect training denture to final delivery of the final dentures
• Delivery of the final dentures and refinement of the occlusion
• A more patient friendly immediate denture technique

Technicians

• Anterior aesthetic teeth set-up
• Lingualized occlusion
• Fabricating a diagnostic denture
• Finalizing and processing of diagnostic denture
• Waxing
• Tinting
• Final processing
• Softliners for lower dentures
• Tinting for ethnic dentures
• Communicating your needs to the dentist