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Journal of Interdisciplinary Dentistry / Jan-Jun 2011 / Vol-1 / Issue-1 45

I
t is obvious that in large maxillofacial defects
and in severe resorption of the edentulous
ridges, there is a decreased denture bearing area for
support, retention and stability. Increased interridge
space compounds this problem. To decrease the
leverage, reduction in the weight of the prosthesis
was recommended and was also found to be
beneficial.
[1,2]
Various weight reduction approaches
have been achieved using a solid three-dimensional
spacer, including dental stone,
[1-6]
cellophane
wrapped asbestos,
[7]
silicone putty
[8]
or modeling
clay
[9]
during laboratory processing to exclude
denture base material from the planned hollow cavity
of the prosthesis.
Holt et al,
[8]
processed a shim of indexed acrylic resin
over the residual ridge and used a spacer which was
then removed and the two halves luted with auto
polymerized acrylic resin.
Fattore et al,
[10]
used a variation of the double
flask technique for obturator fabrication by adding
heat polymerizing acrylic resin over the definitive
cast and processing a minimal thickness of acrylic
resin around the teeth using a dif ferent drag.
Both portions of resin were attached using a heat
polymerized resin.
OSullivan et al,
[11]
described a modified method for
fabricating a hollow maxillary denture. A clear matrix
of the trial denture base was made. The trial denture
base was then invested in the conventional manner
till the wax elimination. A 2 mm heat polymerized
acrylic resin shim was made on the master cast using
a second flask. Silicone putty was placed over the
shim and its thickness was estimated using the clear
template. The original flask with the teeth was then
placed over the putty and the shim and the processing
was done. The putty was later removed from the distal
end of the denture and the openings were sealed with
auto polymerizing resin.
The technique was useful in estimation of the spacer
thickness, but removal of putty was found to be
difficult especially from the anterior portion of the
denture. Moreover, the openings made from the
distal end had to be sufficiently large to retrieve
the hard putty. In this case report, a 45-year-old
edentulous male patient with increased interridge
distance was treated with a light weight maxillary
denture, using ther mocol, a common packing
material, as spacer.
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DOI:
10.4103/2229-5194.77208
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Light weight maxillary complete denture: A case
report using a simplifed technique with thermocol
Vibha Shetty, Sivaranjani Gali, Smitha Ravindran
Department of Prosthodontics, M S Ramaiah Dental College And Hospital, Bangalore, Karnataka, India
Address for correspondence: Dr. Sivaranjani Gali, E-mail: galisiva@yahoo.com
ABSTRACT
The success of a complete denture relies on the principles of retention, stability and support. The prosthodontists skill lies in
applying these principles efficiently in critical situations. Severely resorbed maxillary edentulous ridges that are narrow and
constricted with increased inter ridge space provide decreased support, retention and stability. The consequent weight of the
processed denture only compromises them further. This article describes a case report of an edentulous patient with resorbed
ridges where a simplified technique of fabricating a light weight maxillary complete denture was used for preservation of denture
bearing areas.
Key words: Complete dentures, hollow maxillary denture, inter ridge distance, light weight dentures, residual ridge
resorption
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Journal of Interdisciplinary Dentistry / Jan-Jun 2011 / Vol-1 / Issue-1 46
CASE REPORT
A 45-year-old patient walked into the dental clinic with a
chief complaint of replacing missing teeth. He had been
edentulous for 10 years and had been wearing dentures
for 7 years. On examination, he had severely resorbed
ridges, the upper being narrow and constricted and with
an interridge space of 38 mm [Figure 1]. Other clinical
abnormalities were not seen.
Because of narrow constricted ridges and increased
interridge distance, a criss-cross teeth arrangement (with
the lower right posterior teeth placed on the upper left
posterior ridge and lower left posterior teeth placed on the
upper right posterior ridge) was planned for better stability
as the forces are directed better towards the ridges. A
light weight maxillary complete denture was planned to
counteract the lateral forces better and decrease leverage.
Technique
1. Keeping in mind the strength of the denture, the
distance from the teeth to 3 mm of the denture
base was calculated. The rest of the denture base
till the border was then calculated [Figures 2 and 3].
Therefore, the spacer would occupy the area between
the shim of 2 mm thickness and teeth with 3 mm of
the denture base.
2. The trial denture base was invested and processing
carried out till the wax elimination stage. Two layers of
hard base plate wax over the definitive cast in the drag
(lower half of the flask or the cast side) conforming to
the border extensions was added [Figure 4].
3. A second flask was used to invest the base plate wax
till wax elimination stage and the cope (upper half of
the flask or cavity side) was packed and processed
with heat polymerizing resin [Figure 5].
4. The second cope with the polymerized acrylic resin
shim of 2 mm attached with the drag was separated.
A denser ther mocol was placed over the bur
roughened acrylic shim along the ridge and luted with
cyanoacrylate [Figure 6].
5. The spacer thickness was modified according to the
calculation done above, leaving 3 mm from the teeth
to the denture base.
Figure 1: The casts mounted on the articulator with the interridge distance
Figure 3: Calculate the distance of 2 mm of denture base Figure 4: 2 mm of modeling wax on the defnitive cast
Figure 2: Calculate the distance from teeth to 3 mm of denture base
Shetty, et al.: Light weight maxillary denture
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Journal of Interdisciplinary Dentistry / Jan-Jun 2011 / Vol-1 / Issue-1 47
6. The original cope over the drag was reseated and
complete closure of the flask was verified. The
heat polymerizing resin was then mixed, packed
and processed at 74
o
C for 7-8 h. Pre insertion
occlusal corrections were made and the denture
was inserted in the patients mouth [Figures 7
and 8].
DISCUSSION
The method described has advantages over the previously
described techniques. Thermocol being a light weight
material can be left in the denture without compromising
the integrity of the denture, avoiding the tedious effort to
remove the spacer material from the denture. Moreover,
the small window in the cameo surface in the previous
techniques has potential for leakage between the heat
polymerized resin and auto polymerized resin portions.
This technique is simple to execute and allows control of
spacer thickness.
CONCLUSION
A simplified technique for fabricating light weight maxillary
denture using thermocol as a spacer that can be left in the
denture without compromising denture strength.
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Figure 5: Heat cured shim of denture base processed on the defnitive cast Figure 6: Thermocol luted to the denture base
Figure 8: Denture inserted in the patients mouth Figure 7: Denture inserted in the patients mouth
Shetty, et al.: Light weight maxillary denture
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Journal of Interdisciplinary Dentistry / Jan-Jun 2011 / Vol-1 / Issue-1 48
Source of Support: Nil, Conflict of Interest: None declared.
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Shetty, et al.: Light weight maxillary denture
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