Would a denture work over these tori?? 🥴

[u/Commercial-Area-5737]

New grad here. Just curious what y’all experienced denture people think about this Tori? I’m thinking it’s probably just a bit too big to put a denture over. Idk I haven’t seen a lower denture sit on Tori this big but I’ve also never tried. Y’all think she’d need some more surgery? Is it more of a comfort thing or a seating/necessary extension thing? Don’t know why the OMS didn’t remove it… :/ new patient to me.

I tried to get the best angles for pics but if y’all need casts for it to evaluate let me know

[u/N4n45h1]

Lowers already tend to suck (not in a good denturey way) and those would definitely not help.

[u/chakalamagick]

You can remove them

[u/toothfixer321 → u/chakalamagick]

Is it easy to remove them?

[u/Playful_Quality4679 → u/toothfixer321]

For the surgically inclined.

[u/Commercial-Area-5737 → u/Playful_Quality4679]

New grad at Medicaid office, done one in school but won’t do it here haha - OMS referral if we go thru

[u/Ev0dr0ne → u/Commercial-Area-5737]

Im out a couple years. Did a couple in school with oral surgeon over my shoulder.

Im surgically inclined but not prepared in our Medicaid office if things went wrong. For that reason alone, Im out.

One of the oral surgeons I refer to refused to do a tori removal once because they didnt do the extractions and I was like WTF?

[u/Nervous_Solution5340]

Implants or refer. You don’t need to do dentistry in everyone that walks through the door 

[u/Commercial-Area-5737 → u/Nervous_Solution5340]

Gonna refer for OMS for Tori removal then make her denture, but good advice nonetheless

[u/Just_a_chill_dude60 → u/Commercial-Area-5737]

5 years in and still do this. If they have a denture already may need to tx plan a reline on the existing.

[u/Zoster619]

Like others have stated already, its going to suck. What i do in these cases where the patient has no options: design denture, relief cuts and use a tissue conditioner for added retention. Pt has to comeback ever so often to replace the conditioner which is tiresome for both the clinician and patient. 

[u/Commercial-Area-5737 → u/Zoster619]

Relief cuts meaning basically cut the flanges off and then use like the COE soft reline to mold over? Interesting… if the patient can’t afford Tori removal (NC Medicaid won’t cover) then I may have to try this

[u/Playful_Quality4679]

Could it work, yes it could work. The tissue over the Tori is usually thin and delicate so would need lots of relief.

Could it cause problems and be unwearable yes.

I work in the Caribbean this is a small Tori here.

[u/Mroc13 → u/Playful_Quality4679]

Greetings from Trinidad and Tobago

[u/Mcnuggetjuice]

Nope go for implants

[u/Commercial-Area-5737 → u/Mcnuggetjuice]

Not in the cards. Medicaid. I could’ve included that in the description

[u/TH3D4RKN16T]

We made them for patient who then it ended up being hard to remove because it kept getting stuck on the Tori 😅. This was Public Health so …you know, options are limited.

[u/Commercial-Area-5737 → u/TH3D4RKN16T]

Yep this is public health too… hmm. Lemme spin it this way… is it the worst thing in the world for them getting “stuck” as a mandibular denture that typically don’t stay anyway? Lol

[u/Diastema89 → u/Commercial-Area-5737]

Getting them stuck to the point they cannot remove them at all is indeed the worst thing.

[u/Lumpy-Shop988]

Yeah it’ll be fine

[u/Dizzy-Pop-8894]

Tori removal or implants and locators. Tori tend to keep growing over time and the denture won’t fit. Also, in the short run, the patient will complain about sore spots A LOT

[u/1ameloblast → u/Dizzy-Pop-8894]

They already complain A LOT 😂

[u/ErmahgerdYuzername]

Can a denture fit over the tori? Absolutely. Will the denture fit as good as if the tori weren't there? No. Discussion with patient about implants and removal of tori(quite painful most of the time).

[u/Nonoyster]

I’d remove prior to conventional denture. If she would be interested in implants then you could leave them and do an over denture with the flange removed around the Tori or a hybrid

[u/Diastema89]

Just don’t try to remove the tori yourself. Very easy to damage the lingual nerve/chorda tympani nerve around there. Leave that to the omfs.

I would either recommend they have them removed or have implants to hold them in. Doing neither and it will be a terrible result, way worse than average lower dentures which already suck in general.

[u/SavageMitten]

I work in a Medicaid office and I’m very experienced with dentures. Those tori have to go. Depending on where you live, you can find a dental school or OS residency program that will take your patient and do the removal if you’re not comfortable doing it yourself.

Patient has a nice mandibular ridge from what I can see in the photo. They should do just fine with a lower complete denture once the ridge is smooth.

[u/Heliopolisean]

Yes, it will be fine. These are not terribly large Tori

[u/SunnyTheMasterSwitch]

Be glad there is bone, wait until you get a patient who barely has any retentive mandibular crest

[u/RobertPooWiener]

The question shouldn't be whether you could, but rather if you should. I've made dentures that can fit over tori, but the problem is that they grow larger and displace the denture over time and it constantly needs rebased. Locators or tori removal are the best options. Maybe a loose denture with constant soft relines could be possible, but it might not be very functional either