Hollow Dentures

  • Published on
    31-Oct-2015

  • View
    155

  • Download
    0

Embed Size (px)

Transcript

  • 7/16/2019 Hollow Dentures

    1/31

    The hollow maxillary

    complete denture: Amodified techniqueMADE BY-Dr. AMIT

    MDS PROSTHODONTICS

    (1ST YR)

    O'Sullivan M, Hansen N, Cronin RJ, Cagna DR.The hollow

    maxillary complete denture: A modified technique. J Prosthet

    Dent 2004 Jun;91(6):591-4.

  • 7/16/2019 Hollow Dentures

    2/31

    #

    INTRODUCTION

    HEAVY MAXILLARYCOMPLETE DENTURE

    LARGERESTORATIVE

    SPACE

    NARROWERRIDGE DUE TORESORPTION

    DECREASEDSUPPORTING

    TISSUE

    Extreme resorption of

    the maxillary denture-

    bearing area

    problems with prosthetic

    rehabilitation.

  • 7/16/2019 Hollow Dentures

    3/31

    #

    INTRODUCTION

    Reducing the weight of a maxillary prosthesis has

    been shown to be beneficial when constructing an

    prostheses for the restoration of a large maxillofacial

    defect or severe residual ridge resorption.

    make the denture base hollow.

    el Mahdy AS. Processing a hollow obturator. J Prosthet Dent

    1969;22:682-6.

  • 7/16/2019 Hollow Dentures

    4/31

    #

    INTRODUCTION

    Historically, weight reduction approaches

    have been achieved using a solid 3-

    dimensional spacer, including Dental stone,

    Cellophane wrapped asbestos,

    Silicone putty, Modelling clay

  • 7/16/2019 Hollow Dentures

    5/31

    #

    INTRODUCTION

    Multiple and separate pieces of the prosthesis are polymerized

    around a 3-dimensional spacer.

    Following the initial polymerization process, the solid spacer is

    removed.

    Individual pieces of the prosthesis are then joined using

    autopolymerizing acrylic resin repair techniques.

  • 7/16/2019 Hollow Dentures

    6/31

    #

    TECHNIQUE

    1. Impression of the maxillary residualridge and fabricate to trial denture

    stage.

    2. Index the land area of the cast & sealthe trial denture to the definitive cast

  • 7/16/2019 Hollow Dentures

    7/31

    #

    TECHNIQUE

    3. Duplicate the trial denture in reversible

    hydrocolloid and pour the impression indental stone.

    4. Make a clear template on the

    stone cast using a 0.3-mmthermoplastic sheet

    5. Process the trial denture in the

    standard manner through

    the wax elimination stage.

  • 7/16/2019 Hollow Dentures

    8/31

    #

    TECHNIQUE

    6. Adapt 2 layers of baseplatewax to the definitive cast inthe drag, conforming to theborderextensions.

    7. Use a second flask toinvest the baseplate waxand again complete thewax elimination process.

    Pack the cope and seconddrag with heat-polymerizedacrylic and process.

  • 7/16/2019 Hollow Dentures

    9/31

    #

    TECHNIQUE

    8. Separate the cope, with thepolymerized acrylic resinstill attached, from thedrag. Place the clear matrixon the definitive cast usingthe indices in the land areaas seating guides .

    9. Use an endodontic file witha rubber stop to measurethe space between thematrix and the processedresin.

  • 7/16/2019 Hollow Dentures

    10/31

    #

    TECHNIQUE8. Mix and adapt vinyl poly-

    siloxane putty to the bur-

    roughened acrylic resin andshape to the approximatecontours of the matrix .Shape the polymerized puttywith a bur to leave 2-3 mm of

    space between the putty andmatrix.

    9. Provide an additional 1-mm

    space over the tooth portionof the denture.Fix the putty tothe acrylic resin usingcyanoacrylate.

  • 7/16/2019 Hollow Dentures

    11/31

    #

    TECHNIQUE

    Reseat the original cope on the drag and verifycomplete closure of the flask.

    Mix, pack, and polymerize the acrylic resin.

    Verify adequate thickness of resin around the teethat the packing stage using a periodontal probe.

    Recover the processed denture in the usualmanner.

  • 7/16/2019 Hollow Dentures

    12/31

    #

    TECHNIQUE

    Remount the denture on anarticulator and adjust the occlusionas necessary. Cut 2 openings with abur into the denture base distal to themost posterior teeth.

    Remove the silicone putty byscraping with a sharp instrument.Widen the openings as necessary,laterally, to facilitate access.

    Remove the putty and fabricate 2covers using clear auto-polymerizingresin.

  • 7/16/2019 Hollow Dentures

    13/31

    #

    Clean and disinfect the cavity

    Attach the clear resin covers by bonding them into positionusing auto-polymerizing resin or light-polymerizing .

    Polish the denture in the usual manner. Verify that thecavity is sealed by immersing the denture in water.

    If no bubbles are evident, an adequate seal is confirmed.

  • 7/16/2019 Hollow Dentures

    14/31

    #

    DISCUSSION

    Heat-polymerizing portion of the dentureagainst polymerized resin may reduceleakage at the junction of the 2 portions ofthe denture.

    The small window in the cameo surfacefacilitates recovery of the spacer in an

    area that is not commonly adjusted afterdenture insertion and has a small marginalong which leakage could occur.

  • 7/16/2019 Hollow Dentures

    15/31

    #

    DISCUSSIONControlling and verifying resin thickness

    Putty and clear matrix, ensuring an even depthof resin to prevent seepage and preventdeformation under pressure of flask closure.

    Using a periodontal probe, allowingrecontouring of the putty at that time if required.

    Why Silicone putty ?

    Stability

    Its ability to be carved

    Does not adhere to acrylic resin. The cyano-acrylate bond between the resin and

    the putty may be easily removed.

  • 7/16/2019 Hollow Dentures

    16/31

    #

    The hollow denture: An

    alternative treatment for

    atrophic maxillae

    This article describe the fabrication of

    hollow denture using double flasktechnique

    Fattore LD, Fine L, Edmonds DC. The hollow

    denture: an alternative treatment for atrophic

    maxillae. J Prosthet Dent 1988;59:514-6.

  • 7/16/2019 Hollow Dentures

    17/31

    #

    TECHNIQUE

    Impression of the maxillary residual

    ridge and fabricate to trial denture

    stage with heat cure denture base.

    Invest the waxed denture in a flask Heat the flask, open it, and flush away

    the remaining wax

    After the flask has cooled, adapt a

    2 mm thick portion of baseplate waxto the tooth side of the flask.

    Note: The heat-cured baseplate is in

    place on the tissue side of the flask

  • 7/16/2019 Hollow Dentures

    18/31

    #

    TECHNIQUE

    Place the halves of the flask togetherwith a plastic sheet between them.

    Remove the knock-out plate from the

    bottom half of another similar flask andplace it on the upper part of the original

    flask containing the teeth with wax

    adapted over them.

  • 7/16/2019 Hollow Dentures

    19/31

    #

    TECHNIQUE Vibrate dental stone through the knock-out hole in

    the alternate half flask until it is level full.

    Boil out, clean, and apply tin foil substitute as

    usual.

    Pack and process with heat-curing, high-impact

    acrylic. resin. Cool, separate the flask, and carefully remove any

    flash but do not deflask.

    Both halves of the original flask now contain a

    processed acrylic resin shell. Fit the two halves of the flask together and remove

    any acrylic resin that interferes with complete flask

    closure

  • 7/16/2019 Hollow Dentures

    20/31

    #

    TECHNIQUE

    Make a rope of doughy, heat-curing, high-impactacrylic resin approximately the diameter of a lead

    pencil.

    Adapt the acrylic resin rope around the border of the

    cured acrylic resin in the tooth side of the flask.

    Add a plastic sheet, trial pack, trim the flash, andcontinue packing until no flash is evident.

    Moisten the new acrylic resin slightly with monomer.

    Close the flask, place it in a curing press, and

    process with a long-curing cycle.

  • 7/16/2019 Hollow Dentures

    21/31

    #

    A hollow complete lower

    denture

    This article describe the fabrication of

    hollow denture using split flasktechnique

    Holt RA Jr. A hollow complete lower denture. J Prosthet Dent

    1981;45:452-4.

  • 7/16/2019 Hollow Dentures

    22/31

    #

    TECHNIQUE

    The complete lower wax denture is boiled out, and the flask is separated inthe usual manner. The hollow denture is constructed using two split dental

    flasks as follows:

    Place a wax shim (consisting of

    two layers of baseplate wax) over the

    denture teeth area.

    Place the top half of a second split

    flask over the wax shimmed lower

    half of the flask.

  • 7/16/2019 Hollow Dentures

    23/31

    #

    TECHNIQUE

    Pour stone into the flask

    through the open hole

    Boil out the wax shim.

    Pack in acrylic resin,

    process,and separate.

  • 7/16/2019 Hollow Dentures

    24/31

    #

    TECHNIQUE

    Place two layers of baseplate wax overthe residual ridge in the top half of the

    original flask.

  • 7/16/2019 Hollow Dentures

    25/31

    #

    TECHNIQUE

    Place Insta-mold between the wax shimand the processed acrylic resin on the

    residual ridge area.

  • 7/16/2019 Hollow Dentures

    26/31

    #

    TECHNIQUE

    Notch the processed acrylic resin and

    the wax shim for keying when the two

    halves are put together later. Boil out the wax shim, pack, and

    process and separate the flask.

    Remove the I