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CONSTRUCTING A DENTURE

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					CONSTRUCTING A
DENTURE: Technique exercise


Dr S Gonsalkorale
Types of dentures




   Complete dentures/full dentures
   Partial dentures
   Cobolt-chromium dentures
   Acrylic dentures
Cobolt chromium dentures
Treatment Sequence
   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


                   Aim: To obtain an
                    accurate models of
                    the patients
                    maxillary and
                    mandibular oral
                    tissues.
Facebow record
    Facebow Record
   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
                 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?

   Hand articulate
   If you cannot hand articulate you will
    need to use base plates with wax rims.

   (The casts are then articulated)
Surveying and denture design

                   The articulated
                    casts are surveyed
                    before the denture is
                    designed.
Special trays

   Once the design has
    been finalised
    special trays are
    constructed.
Tooth modification

                   Based on the
                    denture design carry
                    out any tooth
                    modification:
                     – Rest seat
                       preparation
                     – lowering of survey
                       lines
                     – Guideplanes
Secondary impression

   Once the tooth
    modification has
    been carried out a
    new impression is
    taken using the
    special tray.
Retake MMR

   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

   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

   Heat cure acrylic - invest and pack
   Cold cure acrylic - construct key
Issue

   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
   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.

				
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