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The fabrication of a maxillary and a mandibular
prosthesis to restore the natural dentition of a
patient
Elwin Burger
In Partial fulfilment of BTech: Dental Technology
Department of Dental Sciences CPUT 2008
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Overview
 Patient history
 Comparative study
 Clinical procedures
 Treatment options
 Treatment options: Advantages and disadvantages
 Treatment of choice
 Technical laboratory procedures
 Problems experienced
 Future treatment options
 Conclusion
 Acknowledgements
 References
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Patient history
 Gender: Male
 Age: 55
 Middle class income group
 History of severe periodontitis
 Loss of some maxillary teeth
 Loss of all mandibular teeth
Fig 1. Gingiva and gum resorption1
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Clinical Procedures
 Cleaning and scaling
 Periodontal surgery
 Extractions
 Tooth preparations for
crowns
Fig 4. Example of Periodontitis3
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Comparative study
Fig 2. Boys vs Girls1
Fig 3. Age groups vs Oral hygiene1
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Treatment Options
Implant-retained bridge
Dentures
Maxilla and
mandible
Upper acrylic RPD
Upper CoCr RPD
Implant-retained overdenture
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Clinical option 1
Implant retained bridge
R150 000
Advantages
• Improve aesthetics1
• Tooth-saving1
• Improve patient
confidence1
• Reliable2
• Long life
expectancy2
Disadvantages
• Expensive2
• Time consuming2
• Discomfort or
pain2
• Bruising and
minor swelling2
• Crown
replacement in
10-15 years2
Fig 5.11
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Clinical option 2
Dentures
R 1313
Disadvantages
•Take time to get
use to4
• Speech problems
• Mouth irritation or
sores4
• Replacement after
time4
• Masticatory
deficiencies4
• Bulky
Advantages
• Improve natural
appearance.4
• Made from durable
materials4
• Last between five
to ten years4
• Correction of
masticatory and
related problems5
Fig 6.7
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Clinical option 3
Partial acrylic RPD
R 587
Advantages
• Replace missing
teeth3
• Improve
mastication and
oral health3
• Preserving natural
teeth3
• Improve aesthetics
• Comfourtable4
Disadvantages
•Tooth Damage
caused by
moving clasps4
• Traps food
• Loss of fit4
• Tipping can
occur4
• Speech
difficulty
Fig 7.15
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Clinical option 4
Partial CoCr RPD
R1977
Advantages
• Biocompatible and
hypoallergenic2
• Provide added
strength2
• Natural feeling2
• Weight may
contribute to
additional denture
stability6
Disadvantages
• Oral hygiene is
essential2
• May feel bulky2
• Frequent
maintenance and
examinations
necessary4
• More expensive
than acrylic RPD
Fig 8.
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Clinical option 5
IR overdenture
R 26 000
Advantages
• Can be
removed
easilly.4
• Excellent
stability4
• Lower cost
• Good hygienic
properties6
• Good
aesthetics
Disadvantages
• Increased cost6
• Discomfort
• Implant takes time
to heal4
Fig 9.7
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Treatment of Choice: Maxilla
PFM Crown on 2.1
Gold Crowns on 1.7, 2.8 with
precision
milled shoulder attachments
Add Your Title
Cobalt Chrome RPD
Fig 10. Kennedy
classification 3 mod 2
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Treatment of choice: Mandible
Full acrylic denture with selective
labial gum tinting
F Goetzer
Fig 11. Tinted mandibular denture
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Technical Laboratory Procedures
1.Standard model preparation
6.Wax up and
Sprue of CoCr
RPD
5.Duplicate and pour
refractory model
2.Fabrication of PFM Crown
1-6
3.Wax up and
precision mill
of posterior
crowns in wax
stage
4.Cast gold crowns, trim
and precision mill
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Technical Laboratory Procedures cont.
7.Invest and
elimination of wax
8.Cast, trim and
finish of Cobalt
Chrome RPD
7-9
9.Set up of
artificial teeth
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Technical laboratory procedure cont.
E. Burger
Fig 12. Milling of wax crowns
E. Burger
Fig 14. Wax Design
E. Burger
Fig 13. PFM and milled gold crowns
E. Burger
Fig 15. Cast, trimmed and high shined
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Problems Experienced
Incomplete
Casting
Poor
fitting around
Gold Crowns
Milling
difficulties
Porosity
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Future treatment options
 14 Unit upper and lower implant-retained bridge
(Full oral rehabilitation)
 Dental Implants
 Full upper and lower dentures
 Implant-retained overdentures
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Conclusion
Patient
Final
prosthesis
Dentist
F. Goetzer
Technologist
Fig 15 Complete prosthesis
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Acknowledgements
 Mr. M Mazeema
 Mr. A Latief
 Mr. LA Steyn
 Dr. J Wright
 Mrs. A De la Crouse
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References
1. Lindhe J. Clinical Periodontology and Implant Dentistry. 4th ed.
Oxford: Publishing Co. 2003: 47-53
2. MayoClinic.com-Tools for Healthier Lives. Available:
http://www.mayoclionic.com/health/periodontitis. 26 July 2008
3. Oral Health-Common Problems- All About Periodontitis. Available:
http://www.health24.com/medical/condition_centres. 26 July 2008.
4. Smith GNB. Planning and Making Crowns and Bridges. 3rd ed.
London: Martin Dunitz Ltd. 1998: 24-25.
5. Van Noort R. Introduction to Dental Materials. 2nd ed. Edinburgh:
Elsevier Science Ltd. 2002: 180, 238, 240.
6. Wulfes H. Precision Milling and Partial Denture Constructions-A
Manual. 1st ed. Bremen: Academia Dental International School
BEGO Germany. 2004: 57-59; 138; 195.
7. Muraoka H. A Colour Atlas of Complete Denture Fabrication.
Chicago: Quitessence Publishing Company. 1989: 41-43.
8. Babbush CA. Dental Implants- The Art and Science. Philadelphia: W
B Saunders Company. 2001: 3-19.
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References cont.
9. Morrow RM, Rudd KD, Rhoads JE. Dental Laboratory ProceduresComplete Dentures. Volume 1. St. Louis: The CV Mosby Company.
1986: 223-240, 312-320.
10. Basker RM, Davenport JC. Prosthetic Treatment of the Edentulous
Patient. 4th ed. Oxford: Blackwell Publishing co. 2002: 146-241.
11. Roberts DH. Fixed Bridge Prostheses. 2nd ed. England: John
Wright and Sons Ltd. 1980: 129-130, 139-140, 166.
12. Mclean JW. The Science and Art of Dental Ceramics. Volume 1The Nature of Dental Ceramics and their Clinical use. Chicago:
Quintessence Publishing Co. 1979: 23-28, 37-39.
13. Dykema RW. Johnston’s Modern Practice in Fixed Prosthodontics.
4th ed. Philadelphia: W.B Saunders Company. 1986: 8-16, 22-25,
60-63.
14. Jenkins G. Precision Attachments- A Link to Successful Restorative
Treatment. London: Quintessence Publishing Co. Ltd. 1999: 33-40.
15. Stewart KL. Clinical Removable Partial Prosthodontics. St. Louis:
The C V Mosby Company. 1983: 18-20; 56-60.
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