Transcript CONSTRUCTING A DENTURE - Egypt Dental Forums 4Drs

CONSTRUCTING A
DENTURE: Technique exercise
Dr S Gonsalkorale
Types of dentures
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Complete dentures/full dentures
Partial dentures
Cobolt-chromium dentures
Acrylic dentures
Cobolt chromium dentures
Treatment Sequence
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History, Exam, Primary impressions
MMR, Face bow
Treatment plan, design, informed
consent
Tooth modification, secondary
impressions
Casting try-in
MMR, shade selection
Wax try-in
Primary issue
Secondary issue
Fluoride treatment/ Exam/ Recall
Primary Impressions
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Aim: To obtain an
accurate models of
the patients
maxillary and
mandibular oral
tissues.
Facebow record
Facebow Record
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Adjustable articulators allow the cast of the
maxillary denture to be located accurately in
relation to the mandibular condyles and to a
horizontal plane of reference (frankfurt plane).
The Facebow records this information
clinically and transfers this relationship to an
articulator.
The mandible moves along an arc of rotation
as it opens and closes. The centre of rotation
is in the condyle. The distance from the
centre of rotation of the arc to the teeth is
relevant in developing the occlusion
MMR: maxillo-mandibular
relationship
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Aim:
– relate the upper cast
to the lower cast in
the correct
anatomical
relationship.
– Relate the upper
cast to the condyles
in the correct
relationship
How do you do this?
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Hand articulate
If you cannot hand articulate you will
need to use base plates with wax rims.
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(The casts are then articulated)
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Surveying and denture design
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The articulated
casts are surveyed
before the denture is
designed.
Special trays
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Once the design has
been finalised
special trays are
constructed.
Tooth modification
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Based on the
denture design carry
out any tooth
modification:
– Rest seat
preparation
– lowering of survey
lines
– Guideplanes
Secondary impression
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Once the tooth
modification has
been carried out a
new impression is
taken using the
special tray.
Retake MMR
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The new cast needs to be re-articulated
against the existing lower cast.
If the casts cannot be hand articulated
new baseplates and wax rims will be
required.
Set teeth and wax-up
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Once the casts have been re-articulated
the teeth are set on the baseplate.
The wax contours are finalised.
The denture is now ready to
process…...
Process denture
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Heat cure acrylic - invest and pack
Cold cure acrylic - construct key
Issue
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Trim and polish denture carefully to
maintain contours and maintain contact.
Polish with pumice and then with
dentishine.
The denture is now ready to issue…...
References
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McGivney GP, Castleberry DJ. McCracken’s
Removable Partial Prosthodontics. 9th Ed.
1995.
Removable partial prosthodontics : a case
oriented manual of treatment. Lechner SK,
MacGregor AR. St. Louis : Wolfe c1994.
CD: ROM : Interactive Prosthodontics.
Learning to design removable partial
dentures. Lechner SK, Thomas GA. The
University of Sydney.