Don’t you just hate flippers?
I’ve written before about my disdain for flippers (“A Flipper Shouldn’t Be our First Choice: Alternative Implant Provisional Restorations”) and the creative options that we have to use in their place.
An acrylic removable partial denture (aka “flipper”) presents some big disadvantages for us and our patients. Briefly: (1) they are tissue supported, so they can exert unexpected pressure on the tissue underneath, (2) they do not develop an emergence profile, which can compromise the final result, (3) pick acrylic can trick the patient into thinking they have gingiva that they don’t actually have, and (4) patients hate them because they’re removable and clumsy.
Seriously, Mr. Flipper, you're not fooling anybody. You stink.
So I prefer to use alternatives, which you can read about here.
But sometimes a flipper seems like our only choice. The adjacent teeth are virgin, so we don’t want to chop them down just to use a temporary fixed partial denture (aka “acrylic bridge”). And a resin-bonded bridge (aka “Maryland bridge”) can be a hassle because it’d hard to remove and replace for impressions, try-in, etc.
But there is another option in these cases. Snap-On Smile (DenMat) is a lab-processed resin material that is custom made for your patient. It simply slides over the adjacent teeth and holds in place by friction: no cement needed here.
Notice that the occlusal surfaces are left open on the adjacent teeth so as to not increase the vertical dimension. In the middle, is a pontic just like the pontic of a temporary fixed partial denture.
Patients can eat with it in place and wear it while they sleep. They only need to remove it during brushing and possible after a meal if necessary. Not only does this make them more comfortable, it also means we have a better chance to sculpt an emergence profile.
Perhaps most importantly, Snap-On Smile is tooth-supported, which means no unexpected tissue pressure to hurt a graft or prematurely load an implant.
Fabrication is easy. Take PVS impressions, bite, and shade, fill out a prescription, and send out to DenMat. In 2 weeks you’ll get the case back. These can go in without any adjustments or with minor alterations.
If it’s not seating, first check to make sure that the material is not interfering with the interproximal contacts. If there’s still a problem, you may need to relieve some material from the inside. I apply some ink (Thompson’s Marking Sticks work great) to the inner surface and seat it. You’ll get an idea of what areas need to be adjusted. Lastly, just make sure that the patient is not occluding on the material. The occlusal holes may need to be widened slightly.
Adjusting a Snap-On Smile using Thompson's Marking Sticks
Pretty simple, no? Just make sure you’re charging a reasonable fee. The lab costs can range in the few hundreds depending on how many teeth you’re replacing.
Completed Snap-On Smile from occlusal and buccal views.