INTRODUCTION
Sebuah gigi tiruan lebih adalah gigi tiruan lepasan lengkap atau parsial
didukung oleh akar dipertahankan atau gigi atau kancing implan, yang
dimaksudkan untuk memberikan dukungan ditingkatkan, stabilitas, taktil
dan sensasi proprioseptif dan untuk mengurangi ridge resorpsi. Ini adalah
prostesis yang didukung baik oleh mukosa dan oleh tersisa gigi alami yang
telah diubah untuk mengizinkan gigi tiruan untuk menyesuaikan atas
mereka. Sebuah gigi tiruan Fleksibel di sisi lain terdiri dari resin injeksi
termoplastik yang menawarkan fleksibilitas yang superior, transparansi
untuk estetika yang optimal dan ketahanan stres retak. Hal ini monomer
bebas polimer gigi dengan modulus lentur rendah. Laporan kasus klinis ini
merupakan upaya untuk menggabungkan kelebihan dari dua modalitas
pengobatan yaitu lebih gigi tiruan dan gigi tiruan fleksibel untuk
memberikan kenyamanan, estetika dan fungsi untuk pasien sebagian
edentulous.
Kata kunci: Selama gigi tiruan, gigi tiruan fleksibel, mengatasi logam,
gnathodynamic, resin termoplastik.
Case Report 1
Laporan kasus 1
Case Report 1 :
Procedure 1
Ideally sound teeth in good periodontal health were sought. Both mandibular
canines, and maxillary right canine and first premolar were selected to act as over
denture abutments (13, 14, 33, 43).
Procedure 2
Abutments were prepared to a height of 4-5 mm cervico-occlusally with a uniform
taper of 3-5 degree and apical chamfer at dento-gingival junction.
Procedure 3
The canals were lightly lubricated and auto polymerizing resin was mixed and
rolled into thin cylinders to form dowels.
Procedure 4
Procedure 5
The wax was eliminated and separator was applied. T-shaped diatoric holes were
prepared in the acrylic resin teeth (Acry Rock, Ruthinium Dental Products (P)
Ltd. India.) to provide mechanical retention.
Procedure 6
The patient was given home care instructions about wearing and care of flexible
overdenture.
Procedure 7
The patient was advised to put flexible dentures in warm water before wearing
them. The patient was periodically recalled for follow up.
Prosedur 1
Idealnya cara berbicara itu jelas dalam pengucapannya .Kedua caninus rahang
bawah, dan caninus rahang atas dan premolar pertama yang dipilih untuk
bertindak sebagai abutment gigi tiruan (13, 14, 33, 43)
Procedure 2
Abutment disiapkan hingga ketinggian 4-5 mm serviks-oklusally dengan lancip
seragam 3-5 derajat dan talang apikal di persimpangan dento-gingiva junction.
Procedure 3
Kanal dilumasi dengan ringan dan resin polimerisasi otomatis dicampur dan
digulung menjadi silinder tipis untuk membentuk pasak.
Procedure 4
Pola diinvestasikan dalam bahan investasi terikat fosfat karena kekuatannya yang
lebih tinggi, dan dicor dalam paduan nikel - kromium, Finishing coping, disemen
menggunakan semen glass ionomer.
Procedure 5
Procedure 6
Procedure 7
Pasien disarankan untuk menempatkan gigi palsu fleksibel dalam air hangat
sebelum memakainya. Pasien secara berkala mengingat untuk tindak
lanjut
Discussion
There are two physiologic tenets related to this therapy; the first concerns
the continued preservation of alveolar bone around the retained teeth while the
second relates to the continuing presence of periodontal sensory mechanisms that
guide and monitor gnathodynamic functions.
Diskusi
Conclusion
Two dental therapies i.e. flexible denture and overdenture both have their
own set of advantages and when these two therapies are combined together they
have a synergistic effect. In cases where hard tissue undercuts are present
relieving these undercuts can lead to loss of retention as well as irritation to the
tissues due to food impaction. In such cases flexible dentures can be a solution as
they are flexible enough to pass over these undercuts without irritating the tissues
and also utilize these undercuts to enhance the retention .The results showed much
better denture stability, improved retention, better patient acceptance, lesser post
insertion sore spots, grossly reduced alveolar bone resorption and shorter
adjustment period .Yet long term follow up is essential for long term prognosis of
this therapy.
Kesimpulan
Dua terapi gigi yaitu gigi tiruan yang fleksibel dan overdenture keduanya
memiliki keunggulan masing-masing dan ketika dua terapi ini digabungkan
bersama-sama mereka memiliki efek sinergis. Dalam kasus-kasus di mana
potongan jaringan keras hadir melegakan potongan-potongan ini dapat
menyebabkan hilangnya retensi serta iritasi pada jaringan karena impaksi
makanan. Dalam kasus seperti itu, gigitiruan yang fleksibel dapat menjadi solusi
karena mereka cukup fleksibel untuk melewati undercut ini tanpa mengiritasi
jaringan dan juga memanfaatkan undercut ini untuk meningkatkan retensi.
Hasilnya menunjukkan stabilitas gigi tiruan yang jauh lebih baik, peningkatan
retensi, penerimaan pasien yang lebih baik, postingan yang lebih rendah
penyisipan bintik-bintik sakit, resorpsi tulang alveolar yang berkurang secara
signifikan dan periode penyesuaian yang lebih pendek. Tindak lanjut jangka
panjang sangat penting untuk prognosis jangka panjang dari terapi ini.
References
1) Hargreaves AS. Nylon as a denture base material. Dent Pract Dent Rec
1971; 22 :122-8.
4) Yunus N, Rashid AA, Azmi LL, Abu-Hassan MI. Some flexural properties
of a nylon denture base polymer. J Oral Rehabil 2005; 32: 65-71.
12) Miller PA. Complete denture supported by natural teeth. J Prosthet Dent
1958; 8(6) : 924-8.
13) Braden M. Some aspects of the chemistry and physics of dental resins.
Adv Dent Res 1988; 2(1) : 93-7
Latar Belakang
(2) Custom trays were fabricated, border moulding was done, and secondary
impressions were made in light body elastomeric impression material (Aquasil
Ultra LV Dentsply Caulk) (Figure 2).
(3) Occlusal rims were fabricated using impression compound (DPI Pinnacle) and
jaw relation was obtained using closed mouth technique using temporary tissue
liner material (Visco-gel Dentsply CE) on the tissue surface of the maxillary and
mandibular temporary denture bases for their better stability (Figure 3)
(4) Impression compound occlusion rims were replaced with modeling wax
(Hindustan Modelling Wax Number 2, Hyderabad, India) occlusion rims and
tissue relining material with cold cure acrylic resin (DPI RR cold cure) (Figure 4).
(5) Teeth were arranged on occlusal rims and palatal surface of the maxillary
denture base was covered by the wax to the thickness of 6 mm. Try-in was done
using temporary tissue liner material on the polished surface and was allowed to
stand in patient’s mouth for 30 mins to allow recording the functional movements
of tongue and to check for retention,
stability, and speech (Figure 5).
(7) Shellac base plate of 1 mm thickness was adapted over the maxillary cast and
cut into the same size and shape as that of thermoplastic sheet for later use (Figure
7).
(8) Mandibular complete denture was processed in the conventional manner.
(9) For maxillary trial denture which has a thickness of 6 mm (step number (5)),
flasking and dewaxing were done in conventional manner. Heat pressed
thermoplastic sheet was placed over the cast. Heat cure acrylic resin was packed
into the mould. Heat curing was done in conventional manner (Figure 8).
(11) Space of 5 mm created afer retrieval of thermoplastic sheet was flled with the
elastomeric putty material of thickness 4 mm (GC Flexceed) and closed with the
shellac base plate lid of thickness 1 mm on the tissue surface of denture later to
create space for clear heat cure acrylic resin and the base flask was closed with its
counterpart (Figure 10).
(12) Afer the setting of putty material the base flask was opened and any excess
putty and also shellac base plate lid (1 mm) were removed. It was again packed
with clear heat cure acrylic resin to get the tissue surface of the denture and base
flask was closed and it was heat cured again in the
conventional manner.
(13) Both the dentures were then fnished and polished.Now the processed
maxillary denture has
(a) pink heat cure acrylic on the polished surface (1 mm);
(b) elastomeric putty material in-between (4 mm);
(c) clear heat cure acrylic on the tissue surface (1 mm).
(14) Before removing putty spacer, an index impression of the tissue surface of
denture was made using putty elastomeric impression material (Figure 11).
(15) Te putty spacer was removed by creating a hole on the tissue surface of the
denture as shown in Figure 12.
(16) Afer removal of putty spacer, the hole was closed using cold cure clear
acrylic material (DPI-Heat Cure, Mumbai) using the putty index (Figure 13).
(17) Two holes were made: one bigger inlet hole at the tissue surface posteriorly
and another smaller outlet hole on the polished surface on anterior palatal on mid-
palatine raphae (Figure 14).
(18) Trough the inlet hole artifcial saliva was injected using 18 mm gauge needle
and outlet was in the diameter of 26 mm gauge needle.
(19) Te maxillary and mandibular dentures were checked in the patient’s mouth
for their retention, stability, occlusion, and border extensions and they were fnally
inserted and the patient was instructed for routine for denture and oral hygiene
maintenance and recalled afer one week(Figure 15). She was given instructions
about how to fll the artifcial salivary substitute through the inlet.
Prosedur
basis gigi palsu sementara rahang atas dan rahang bawah agar
basis gigi tiruan rahang atas ditutupi oleh lilin dengan ketebalan
(Gambar 6).
(Gambar 7).
konvensional.
(9) Untuk gigitiruan uji coba rahang atas yang memiliki ketebalan
(Gambar 9):
dan ditutup dengan tutup pelat dasar lak dengan ketebalan 1 mm pada permukaan
jaringan gigi palsu kemudian untuk menciptakan ruang untuk resin akrilik heat
(12) Setelah pengaturan bahan dempul, alas dasar dibuka dan setiap dempul
berlebih dan juga tutup pelat dasar shellac (1 mm) dilepas. Itu sekali lagi dikemas
jaringan gigitiruan dan dasar pangkalan ditutup dan itu panas sembuh lagi di
cara konvensional.
(13) Kedua gigi palsu itu kemudian selesai dan dipoles. Sekarang sudah ada gigi
(a) akrilik heat cure merah muda pada permukaan yang dipoles (1 mm);
mm).
(14) Sebelum melepas spatula dempul, cetakan indeks permukaan jaringan gigi
(15) Spacer putty dihilangkan dengan membuat lubang pada permukaan jaringan
(17) Dua lubang dibuat: satu lubang masuk yang lebih besar di permukaan
jaringan posterior dan lubang outlet yang lebih kecil pada permukaan yang
dipoles pada palatal anterior pada raphae palatina menengah (Gambar 14).
(18) Melalui air liur artifisial lubang inlet disuntikkan menggunakan jarum
mm.
(19) Gigi palsu rahang atas dan rahang bawah diperiksa di mulut pasien untuk
dimasukkan dan pasien diinstruksikan untuk rutin untuk perawatan gigi dan
kebersihan mulut dan dipanggil kembali setelah satu minggu (Gambar 15). Dia
diberi instruksi tentang cara mengganti pengganti saliva artifisial melalui inlet.
Discussion
Depending on the etiology of the xerostomia, various treatment aspects are
available as mentioned above [4]. However 2 or 3 methods are employed to make
the prosthesis successful. Te goal in management of the xerostomia is to reduce
the suffering from the disease and make wearing of dentures and performing
normal oral functions comfortable for the patients. At the same time priority
should be given to retention and stability of the dentures [4]. In order to enhance
retention in xerostomic patients oral moisturizers, denture adhesives, denture
reservoirs, sof liners, various denture bases, and various surface treatments are
used in order to relieve them from the effects of xerostomia [7–9]. Tis case report
describes the technique of fabrication of the maxillary denture with salivary
reservoir. Xerostomic patients can beneft immensely from it as reservoir
chamberof xerostomia and lack of retention due to resorbed ridges in completely
edentulous patients. Since the quality and quantity of saliva have an important
role in the success of complete dentures, the patients with hyposalivation need to
be treated to prevent adverse effects on the oral mucosa [5, 6].
Diskusi
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