2038 https://www.journal-imab-bg.org J of IMAB. 2018 Apr-Jun;24(2)

Original article

METHODOLOGY FOR FABRICATION OFFORMING DENTURE WITH SILICONE BASE

Ivan GerdzhikovDepartment of Prosthetic dentistry, Faculty of Dental Medicine, MedicalUniversity - Sofia, Bulgaria.

Journal of IMAB - Annual Proceeding (Scientific Papers). 2018 Apr-Jun;24(2)Journal of IMABISSN: 1312-773Xhttps://www.journal-imab-bg.org

ABSTRACT:Introduction: The prosthetic treatment in patient

with alveolar resorption is very difficult, and sometimesit is possible only after surgical preparation of the pros-thetic field. In the cases, where surgical lift of the soft tis-sues in the vestibulum is performed, a forming denture,which has to shape the denture-bearing area, is requiredto design the healing of the soft tissues.

Aim: The aim of the described method is to presentthe abilities of the forming dentures with silicone base,for conducting surgical preparation of prosthetic treat-ment in patients with resorption of the alveolar bone.

Materials and methods: The prosthetic rehabilita-tion of 54-years-old female patient with completeedentulism and maxillary resorption, as a result of unsuc-cessful implant treatment with subperiosteal net, is de-scribed. After its surgical removal a complete dentures ofthe both jaws were made. The upper denture was used asa custom tray for taking impression with additive silicone,during the vestibuloplasty. The impression material wassubstituted with one-component heat-cured siliconeMolloplast B in the dental laboratory and the denture wasfinished on the classical technology. After cleaning, pol-ishing and disinfection , the denture was adjusted and ar-ticulated in patient’s mouth.

Results: The described methodology of prosthetictreatment and fabrication of forming denture allowed suc-cessful surgical treatment. The silicone base reduced themasticatory pressure and provided atraumatic conditionsfor the healing process. The vestibuloplasty ensured den-ture’s retention and stability, which helped patient’s chew-ing, feeding and speaking.

Conclusion: The application of appropriate meth-odology and technique for fabrication of forming denturesprovides successful design of the vestibulum and denture-bearing area. This facilitates the conducting of the fol-lowing prosthetic treatment.

Key words: forming denture, denture-bearing area,complete denture, silicone relining material.

INTRODUCTIONForming dentures are common applied devices in

treatment of patients with maxillofacial disorders. Theyprovide appropriate hard base for conducting of plasticsurgery and shaping of soft tissue box. They also deter-

mine the growth and healing path of the soft tissue (1, 2).Different materials and methods are used for their fabri-cation, which increases the treatment effect and improvespatients’ life quality (3, 4).

The acrylic dentures with silicone base are com-monly used in treatment of edentulous patients. The rea-son for this is that these dentures provide good mastica-tory function, retention and oral hygiene (5). The re-searches revealed, that the denture’s silicone is non toxic,tissue compatible material, which does not cause traumaor irritation (6,7). Its application is very appropriate inpatients with alveolar resorption, retentive tubers or ir-regular bone atrophy (8). The electromiographic exami-nations shows, that treatment with silicone based denturesincreases the activity of temporal and masseter musclesand chewing efficiency (9, 10).

The main problem in fabrication of silicone baseddentures is creating of a reliable and durable connectionwith the acrylic resin (11). This imposes a preliminarypreparation of denture’s surface with different materialsand methods. Some authors (12, 13) use phosphoric acid,as an etching device for the borders of the denture, butothers create micro retentions with lasers (14). The inves-tigations discovered, that preliminary rib of the acrylicresin with monomer increases the connection with the sili-cone material, and sandblasting procedures reduces it (15).Better long lasting adhesion is achieved when heat curedsilicone materials are used and the polymerization of bothmaterials is performed in the same time (16, 17).

There is a lot of data in the literature, about thequality and properties of the materials, used for reliningof dentures (5, 6, 8). According to some of them,Molloplast B is the optimum silicone material for thispurpose (11). The researches show its good adhesion withthe acrylic resin, which provides long lasting connectionand stability (18). Polysiloxane base of the material pro-vides the preserving of soft and smooth surface, whichprevents from accumulation of plaque and facilitates den-ture’s cleaning (19, 20). These advantages are very im-portant, because of other investigations, which reveals,that the porous surface of the silicone materials create aprecondition for Candida albicans growth (21). Disinfect-ants are recommended for solving this problem, but theycoloring the dentures and destroy the connection with theacrylic resin (22). The examinations say, that the appli-

https://doi.org/10.5272/jimab.2018242.2038

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cation of appropriate silicone materials and methods forcleaning prevent the coloring and prolong the expirationdate of the denture (23, 24).

AIMThe aim of the described method is to present the

abilities of the forming dentures with silicone base, forconducting surgical preparation of prosthetic treatment inpatients with resorption of the alveolar bone.

MATERIALS AND METHODSThe clinical case described the prosthetic treatment

of 54-years-old woman with complete edentulism andmaxillary resorption, due to unsuccessful implant treat-ment with subperiosteal net and fixed constructions (fig.1). Surgical treatment for net elimination was performed,because of infection. After this, the patient is advised tomake consultation with prosthetic treatment specialist.The intraoral examination revealed severe maxillary boneresorption, without any teeth left. The healing process af-ter the surgery had not been completed and the treatmentwas deferred (fig. 2).

Fig. 1. Unsuccessful treatment with subperiostealnet

The examination after one month showed signifi-cant bone resorption with unfavorable prognosis (fig. 3).A treatment plant was compiled, which involved prelimi-nary surgical preparation in the vestibulum of the max-illa. The fabrication of forming denture with silicone basein the upper jaw and complete denture in the lower jawwas planned. The preliminary impressions were takenwith standard trays and irreversible hydrocolloid impres-sion material and the finals were taken with custom traysand additive silicone. The dentures were fabricated, ac-cording to the classical technique. During the operation,after the flap preparation and vestibuloplasty, a new im-pression was taken with additive silicone and the denture,as an individual tray. It was followed by immediateflasking in the laboratory. The impression material wassubstituted with one-component heat-cured siliconeMolloplast B (DETAX GmbH & Co. KG). An air chamberwas formed for additional retention and stability (fig. 4).The dentures, polished and disinfected, were adjusted andarticulated in patient’s mouth immediately after the sur-gery. Regular examinations, for decubitus wounds andocclusal disturbances, were performed while the healingprocess completed.

Fig. 3. Alveolar resorption of upper jaw

Fig. 2. Intraoral patient’s viewFig. 4. Completed dentures

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RESULTSThe results of the conducted treatment revealed

successful soft tissue design in the denture bearing area,which provided the needed retention and stability (fig.5). The normal occlusal relationships were restored, whichallowed normalization of patient’s chewing and feeding(fig. 6). The healing processes went without any compli-cations or soft tissue decubitus wounds. During the check-ups were made only small occlusion corrections. After theend of the healing process was formed a vestibulum withclearly expressed denture bearing area and maxillary tu-bers, which was the main goal of the treatment (fig. 7).The prepared denture base up provided conditions forflawless future prosthetic treatment with complete den-tures.

Fig. 5. Adjusted forming denture

Fig. 7. Formed denture bearing area

Fig. 6. Restored occlusion

DISCUSSIONThe prosthetic treatment in patient with complete

edentulism is accompanied by many difficulties and prob-lems, which are connected with insurance of good reten-tion and stability. Often, the alveolar bone resorption dis-rupts dentures’ retention, which leads to the applicationof surgical treatment methods and preparation of the den-ture’s base up. This sometimes includes a flap techniquein the area of the vestibulum and design of an appropri-ate dental bearing area. Forming dentures, which deter-mine the shape of the healing soft tissue and formed a softtissue box, are required for successful surgical treatment.The applied materials and methods should provide a nor-mal healing process and atraumatic masticatory pressuredelivery. The numerous advantages of the silicone mate-rials were used in this clinical case. The achieved resultsconfirmed the state, that their application provide opti-mum retention and stability (5, 8). This allowed success-ful restoration of the masticatory function and showed,that silicone materials improved the chewing efficiency,which other authors report (9, 10). The normal healingprocess and the luck of decutibus wounds proved, that thedenture silicone is non toxic, biocompatible material, asmost of the authors claim (6, 7). The data from some re-searches, for uncertainty and temporary connection withthe acrylic resin, was not confirmed (11). The heat-curedsilicone Molloplast B was chosen, which is considered asthe best option for this type of treatment. The clinical re-sults revealed good adhesion with the acrylic resin, whichconfirmed the state of many authors (18). During the fol-low-up appointments we did not establish any hardeningor waste of silicone elasticity. The polysiloxane surfaceremained soft and smooth, which facilitated denture’scleaning. The application of antibacterial soap and softbrush did not affect the connection with the acrylic resinor colored the denture, as well, which some researchesclaim to happen (22). This improved the state, that thechoice of appropriate silicone materials, methods andcleaning tools prevent denture’s coloring and prolong theexpire date (23, 24).

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CONCLUSIONThe application of the specific methodology and

materials for fabrication of forming dentures allows suc-cessful design of the vestibulum and dental bearing area,which allows the conduction of the prosthetic treatment.Even though it is related with surgical intervention, theforming prosthetic treatment is an alternative of patients,who refuse or have contraindications for implant treat-ment.

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Address for correspondence:Dr. Ivan GerdzhikovDepartment of Prosthetic Dental Medicine, Faculty of Dental Medicine, MedicalUniversity - Sofia,1, St. Georgi Sofiyski blvd., 1431Sofia, Bulgaria.e-mail: ivan_ger1971@abv.bg

Please cite this article as: Gerdzhikov I. Methodology for fabrication of forming denture with silicone base. J of IMAB.2018 Apr-Jun;24(2):2038-2042. DOI: https://doi.org/10.5272/jimab.2018242.2038

Received: 16/04/2018; Published online: 19/06/2018