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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.


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INTRODUCTION

HEAVY MAXILLARYCOMPLETE DENTURE

LARGERESTORATIVE

SPACE

NARROWERRIDGE DUE TORESORPTION

DECREASEDSUPPORTING

TISSUE

Extreme resorption of

the maxillary denture-

bearing area

problems with prosthetic

rehabilitation.


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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.


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INTRODUCTION

Historically, weight reduction approaches

have been achieved using a solid 3-

dimensional spacer, including Dental stone,

Cellophane wrapped asbestos,

Silicone putty, Modelling clay


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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.


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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


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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.


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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.


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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.


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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.


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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.


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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.


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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.


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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.


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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.


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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.


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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


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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.


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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


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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.


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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.


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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.


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TECHNIQUE

Pour stone into the flask

through the open hole

Boil out the wax shim.

Pack in acrylic resin,

process,and separate.


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TECHNIQUE

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

original flask.


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TECHNIQUE

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

residual ridge area.


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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 Insta-mold.

Fuse the two resulting acrylic resin

parts together with cold-cure acrylic

resin.


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Notching of processed acrylic resin and

the wax shim for keying


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Denture is floated in water totest for leakage


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SPLIT FLASKTECHNIQUE

SILICONEPUTTY


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REFERRENCES

1. O'Sullivan M, Hansen N, Cronin RJ, CagnaDR.The hollow maxillary complete denture:

A modified technique. J Prosthet Dent 2004

Jun;91(6):591-4

2. el Mahdy AS. Processing a hollow obturator.J Prosthet Dent 1969;22:682-6

3. Fattore LD, Fine L, Edmonds DC. The

hollow denture: an alternative treatment foratrophic maxillae. J Prosthet Dent

1988;59:514-6.

4. Holt RA Jr. A hollow complete lower denture.

J Prosthet Dent 1981;45:452-4.


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