Saturday, November 12, 2016

# case history. # Complete denture

I am happy, if you are happy

I was posted in prostho dept. for one and half months. For our un -luck it was the month of festivals.  Each clinical batch has 12 members. Fortunately or unfortunately, I am the last member of our batchI i always get the case last. as it was a festival season, none of the members got either CD or TPD case. we were so unfortunate. in the second half of the month, the first member got patient. i saw all the cases. even though, i got no patient i attended posting everyday. i helped all my friends. got inspired by two interns who were so dedicated in their work. saw them helping all my friends and i learned work from them. going everyday to college to attend posting was never boring, because i could watch my friends going wrong in each steps. this way i learned, how to go wrong in each steps and  how to avoid it.as the days passed by, i still got no patient. As a joke i asked my prof, if i would get a patient. and he asked me to be optimistic and hope to get one before posting get done.,.. me being optimistic made no change to the situations. i was still roaming around the clinic and helping my friends make impression, border molding, jaw relation etc. finally we got few holidays. we all went home. i bunked one whole day. but me being optimistic drove all the way back to college three days before my friends came in hoping to get a patient.

yup that was my day, I laid eyes on my first CD patient. it was a she. taking the case history I knew, she was going to be difficult. I was going to deliver her 5th denture, she has good ridge and she is just 50yrs old and was so concerned about aesthetics.she came on Friday evening at 16:15. I just took her phone number and asked her to come on Monday to start the procedures as it was too late. Monday was the last week of our posting. I have to recall patient for 5 times according to the procedure.I need at least two weeks to complete both clinical and lab work. I agreed to take the case and that was the end of my life. taking primary impression was a piece of cake. took less than an hour. It was a huge deal since it's our first case. all my friends patient's impression was either by profs or the two interns whomIi mentioned before.  it took two seating to complete the border molding.it was a huge loss. but i am glad that profs let me do it. they always encouraged me. when I am done with each step, they say its good work. i have seen my profs helping my friends do their clinical work. and the lab technicians helps them with their lab work. they ends up doing nothing. i am grateful to my profs who trusted me with my patient and let me do my work even though i was damn slow. i have been making ideal occlusal rims in second year. Height of the occlusal rims were high(diff at diff location).  Having made an occlusal rim that huge, made it difficult for me to reduce the height during jaw relation. i tried for first few hours. then interns tried to help me. we didn't get jaw relation. i was devastated. i finally called my in charge prof at 16:15. it took her less than 15mins to complete the jaw relation. i was astonished. i stared at her and smiled like an idiot. she laughed seeing my expression. man that was the moment of truth. the jaw relation which we were trying to do for more than 2 hours is done. there was no occlusal rims, only temporary denture. it was a complicated case for a third year student who has done no CD case before. Then try - in was done with teeth arrangement in the next seating.

Then the permanent denture was made. it was the day for final insertion. i was scared to death. i needed to worry about so many thing. its retention, its aesthetics, patient acceptance etc...the day i tried it on her, she had way too many complaints. she complaint about her denture color, the labial fullness, and she could see way too much denture rather than teeth. I was devastated. my first CD patient didnt like her denture. profs asked me to sent the patient, and rather than her opinion asked me tell her to ask her family about the new denture.i left the patient with 24hr recall statement. All these works are done in extra hours since my protho postings were done. we are in PHD dept. they sent us to library and the first half hour we were discussing on our CD and TPD patients. We were sharing the story about how unsatified our patients were about our hard work. patients complaint about tiniest of our mistake.or they make up problems which cannot be understood. MAN!!!!!our life is a tragedy.

the next day when i was attending OP practical class,damn!!! i got call from my patient. my heart skipped a beat. soon after the class got over, i ran to prostho dept. i didnt see my patient and i waited for her. she came in with a huge smile on her face telling her family loved her new denture. she asked me to trim the denture here and there because of the sharpness of the denture. now she had no complain with the denture color, denture exposure etc. i corrected all the falls concept on the denture. the color of the denture suited her skin color, labial fullnes is normal to an extend, and when we give a denture, the upper teeth should have more exposure than lower teeth. Her previous denture exposed her lower teeth rather than upper teeth. it felt like she had no upper teeth. and taught her how to remove a denture.

she loved her new denture and she said it looks real.. All my hard work payed off with the repeated thanks that she was saying to me. also she gave me treat from dominos. That gave me a huge boast to work hard. I am so glad that my profs didnt help me as they did with other students, and allowed to do my work in slow pace.I can't forget how cooperative she was while doing all the clinical procedure and came to the hospital whenever I called her even though she was from far.

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