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One-hour dentures open new doors for edentulous
By Kathy Kincade, Editor in Chief

September 27, 2011 -- SAN FRANCISCO - Is it possible to fabricate a full set of dentures in one hour, without the need for multiple visits or lab fees?

Yes, according to Lawrence Wallace, DDS, an oral and maxillofacial surgeon who has developed the Larell One Step Denture system.

The need for affordable dental care for the edentulous is on the rise, Dr. Wallace emphasized in a presentation September 22 at the California Dental Association (CDA) fall session. There are currently 37 million edentulous people in the U.S., and only 10% of them have insurance coverage, he noted. As a result, being able to afford dentures or dentures with implants is often out of the question.

“The current economy is making it difficult for thousands of edentulous to obtain dentures.”
— Lawrence Wallace, DDS

"The number of people able to afford dental care as it should be given is getting smaller," he said. "The current economy is making it difficult for thousands of edentulous to obtain dentures."

Dr. Wallace, who practiced in Chicago for 25 years before back problems forced him to retire, said this is what prompted him to develop the Larell system.

"In my 25 years as an oral surgeon, I saw firsthand the devastating effects of edentulism --financially, emotionally, and physically," he said.

How it works

Dentists need an alternative to the established method of pricey dentures made in multiple visits, Dr. Wallace noted, adding that "dentures have been made the same way for over 100 years."

The Larell system offers just such an alternative, he said. It features a set of customizable thermoplastic templates (upper and lower) in various sizes made from ADA- and FDA-approved materials.

Larell One Step Dentures can be fabricated in about an hour and retail for $1,200
Larell One Step Dentures can be fabricated in about an hour and retail for $1,200. Images courtesy of Lawrence Wallace, DDS.

The practitioner first makes a quick-set stone model of the jaws, then selects the preformed acrylic template with the closest fit based on the size of the patient's alveolar edentulous ridge. After heating the template in boiling water for 30 seconds, the practitioner can mold it to the palate, adjust as needed, then reline as for any denture. The process is repeated for the lower.

To adjust for occlusion, the practitioner checks the vertical dimension with the patient in a standing, relaxed position. The final vertical should be the standard 2 mm less than the initial measurement, according to Dr. Wallace.

"A basic understanding of occlusion is all you need," he said.

Helping hundreds at free clinics

What started out as a commercial venture has also become a philanthropic effort, Dr. Wallace said. In the past year, the company has participated in a number of Mission of Mercy (MOM) and Remote Area Medical (RAM) free clinics, providing free dentures to hundreds of edentulous individuals, each in a two-day clinic with two or three dentists:

  • Oneida, TN, RAM clinic, January 2011 -- 31 dentures
  • Gloucester, VA, MOM clinic, February 2011 -- 38 dentures
  • Roanoke, VA, MOM clinic, April 2011 -- 48 dentures
  • Wise, VA, MOM clinic, July 2011 -- 100 dentures
  • Virginia Department of Public Health, August 2011 -- 92 dentures

"These clinics provide much needed care and extractions," Dr. Wallace said. "But few of them can offer dentures because it is logistically difficult to fabricate full dentures in a two-day clinic."

The Larell dentures can also play a role in other challenging venues, such as nursing homes, assisted living residences, mobile dental clinics, rural towns with no regular dentist, Veterans Affairs clinics, and safety net clinics.

But one-hour dentures can also boost business in a private practice by attracting patients you might not otherwise have seen and generating $1,200 per denture set (suggested retail price), Dr. Wallace emphasized. Producing one set of dentures per week would generate more than $62,000 in additional gross income annually for only an additional hour of work per week.

"With this denture system, you can increase your patient base and income substantially," Dr. Wallace said. "The results are predictable, aesthetic, functional, and a strong practice builder."

The dentures also address a larger issue in dentistry, he added.

"If dentists don't figure out ways to provide needed care that is also affordable, someone else -- like the government -- will step in and do it," he said. "We need to maintain control of dentistry by providing cost-effective solutions and provide care for all those who need it."

Conventional dentures Larell one-step dentures
Made in dental office Can be made anywhere
Made in 4-5 visits Made in 1 visit
Total time 3-4 hours Total time 1 hour
$200-$400 lab cost No lab cost
Retail cost $3,000-$5,000 Retail cost $1,200


Copyright © 2011 DrBicuspid.com

Last Updated hh 9/26/2011 4:11:13 PM

4 comments so far ...
9/28/2011 1:55:53 PM
S. Bornfeld
"A basic understanding of occlusion is all you need," he said.
Basic indeed.
9/28/2011 2:51:34 PM
Buckeye DDS
$1200.00 for a set of pre-fabricated Larell system dentures.  Why so expensive?  The Medicaid population in our state (Ohio) is in need of affordable dentures.  Medicaid in our state pays $800.00 for a set of full upper & lower dentures.  Medicaid rules specifically forbid the use of prefabricated dentures.  The few of us willing to make dentures for this population are forced to use multiple appointment traditional denture techniques with associated chair time & lab costs.  Any wonder why few dentists in this state are willing to provide this badly needed service to this population?  I provide full dentures to this population as a service only, I do not make a dime on these cases after I pay the associated lab bill & cover my overhead & material costs (impressions, stone models, base plates, wax rims).
 
In the early days of my career (late 1970's) there was a prefabricated denture system being sold.  I don't remember the name of the system but they came in 3 basic sizes (Small, Medium, Large) and a couple of different tooth shapes & shades.  I had the displeasure of trying to help a couple of dozen patients get comfortable with these pre-fab dentures that were made elsewhere.  The aesthetic results were horrible & the fit was even worse. 
 
There is no substitute for the fit & aesthetics of traditional denture fabrication techniques.  I have been using the Massad technique for the last 4 years with outstanding results (even better if the patient can afford implant retention of the lower denture).  This technique uses Dentsply Aquasil addition reaction silicone impression material with outstanding results, but the material is expensive & the impression technique requires extra chair time & there is a learning curve involved to become proficient with this technique.  You get what you pay for!!  Post op adjustments are minimized with this technique.  But you can't get these kind of results while working at PPO or Medicaid fee levels.
9/28/2011 4:42:51 PM
S. Bornfeld
Thanks for the tip.
I just looked at the short video--it seems they still are stock trays--even if "anatomical".
You and I are of similar vintage.  I remember some of the PG prosthodontic students would do 1-day impressions--using disposable metal  trays that were contoured and trimmed, with impression compound cake and some kind of wash over it.
I'm not sure what the advantage of Massad is.
9/28/2011 6:20:08 PM
clifford the big red dog
Go ahead and Google Dr. Greg Folse. He lectures throughout the country.
He uses stock impression trays and alginate! Very low incidence of denture adjustments. He does a lot of nursing home dentures. Certainly there is a lot of medicaid so limited lab fees is important. I have modified his technique slightly and come out with pretty darn good results. Also my lab costs are minimal with this technique. Factoring in time and number of appts (3-5), medicaid dentures in california are minimally profitable but its a good service for those in need.
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