Light-cured

combination

Gregory

L. Polyzois,

University

of Athens

School

obturator

prosthesis

DDS, Dr. Dent, M&D” of Dentistry,

Athens,

Greece

This article describes a procedure to make an open partial denture obturator prosthesis by using a denture base resin and a resilient liner polymerized by visible light. (J PROSTHET DENT 1992;68:345-7.)

v.

lslble light-cured (VLC) denture basematerials were introduced in 1984by the advent of the Triad system and materials (Dentsply International Inc., York, Pa.). The useof VLC resin materials provides innovative methodsof denture relining and easy fabrication of maxillofacial prostheses. A review of the literature reveals many clinical applications in maxillofacial prosthetics suchasradiation stents,’ soft palate obturator prostheses,”surgical obturator prostheses,3-5 hollow obturator prostheses,6interim obturator prostheses7and palatal augmentation prostheses,8and feeding and mouth-stick prostheses.4 Other materials recently introduced into the dental market are a powder and liquid (Extoral, Pro-Den Systems, Inc., Portland, Ore.; and Astron, Astron Dental Corp., Wheeling, Ill.), and pliable sheets9(Eporex-R, Nippon Oil and Fats Co., Tokyo, Japan). The VLC direct relining materials are of the hard type. Recently, VLC resilient relining materials have becomeavailable for direct (LiteLine, L.D. Caulk Division, Dentsply International, Milford, Del.) and indirect relining procedures(l?ERform SOFT, Whaledent Dentalprodukte GmbH, Friedberg, Germany). This article describesa technique for making an open partial denture obturator prosthesisby using the combiaAssistant Professor, Department Removable Prosthodontics.

of Prosthodontics,

10/l/36925

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nation of VLC denture baseand indirect resilient relining materials. PROCEDURE 1. Obtain an accurate master cast with the usual techniques. Make the partial denture framework. 2. Make a stonebasefor the mastercast and section it to facilitate removal of the obturator prosthesis after curing, especiallywhen the defect has deep undercuts (Fig. 1). 3. Isolate the defect region of the cast with a separating medium (PERform Special Separator, Whaledent) allow it to dry. 4. Adapt the resilient VLC material, which is in paste form (PERform SOFT, Whaledent) directly from the tube to the walls of the defect. To easeadaptation, an instrument or brush moistened with modeling fluid (DS-SPRI, Whaledent, Friedberg, Germany) supplied by the manufacturer can be used. Modeling fluid is made of the samematerial as the paste (Fig. 2). 5. Apply the prescribed bonding agent, which is in the form of adhesive pearls (DS-ADPB). The adhesive pearlsare dusted to the resilient liner until a little excessis created (Fig. 3). 6. Cure the material for approximately 17 minutes in the Triad II VLC curing unit (Fig. 4). 7. Adapt a sheetof Triad VLC denture baseresin over the resilient liner and engagethe retentive loops of the

Fig. 1. Sectioned master cast with framework and stone base. Fig. 2. Application of VLC resilient liner directly from tube. THE

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Fig. Fig. Fig. Fig. Fig. Fig.

3. 4. 5. 6. 7. 8.

Dusting of granulate adhesive on resilient liner. Cured VLC resilient open obturator section. Cured VLC hard resin scaffolding of obturator section. Master cast dissembled. Combination obturator prosthesis removed. Addition of the wax rim.

framework. Cure the prosthesis for 5 minutes in the Triad II curing unit. Covering of the resilient liner with Triad denture resin may be unnecessary according to the clinical requirements of the prosthesis. The absence of hard Triad denture resin scaffolding offers greater resiliency and flexibility (Fig. 5). 8. Apply Triad VLC bonding agent to the margins of the 346

palatal opening of the obturator section. Adapt a sheet of Triad VLC resin to close the opening, creating the open obturator. Cure the prosthesis for 5 minutes. This step can be done immediately after step 6 when a rigid scaffolding is not desirable for the obturator prosthesis (Figs. 6 and 7). 9. Add the wax occlusion rim, secure the jaw relation AUGUST

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Fig. Fig.

9. Artificial teeth arranged. 10 Completed hard resilient open obturator prosthesis.

record, arrange the artificial teeth, and wax according to standard conventional prosthodontic methods(Figs. 8 and 9). 10. The artificial teeth are added according to the manufacturer’s recommendedtechniquelO(Triad VLC teeth matrix) or the technique reported by Fellmanll (gypsum teeth sectional matrix). 11. Trim and polish the completed open obturator prosthesis before insertion (Fig. 10).

A technique for the fabrication of an open combination (hard-resilient) obturator prosthesiswith VLC materials for patients undergoingpartially edentulousmaxillectomy is described. VLC denture resinsand resilient liners are an exciting innovation in prosthodontic treatment and offer the maxillofacial prosthodontist a wider choice of treatment modalities. The technique and the resultant obturator prosthesis have the following advantages: 1. The easeand rapidity of the technique savestime for both the patient and the maxillofa.cial prosthodontist by introducing the open obturator prosthesisat the earliest opportunity. 2. The combination open obturator prosthesisprovides a stable record basefor securingjaw relation records. 3. The thickness and resiliency of the obturator prosthesis can be managedmore easily. Flexibility and resiliency can be modified by the thicknessof the resilient liner or by adding a rigid scaffolding accordingto the clinical requirements. 4. Prosthesesare easy to repair or modify by using increments of VLC hard or resilient materials.

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5. The combination VLC obturator prosthesisprovides stability, retention, and decreasedweight and obduration of residual palatal defects. 6. The technique can be usedfor partially edentulousor edentulouspatients after maxillary resection. REFERENCES 1. Knudson RC, Williams EO. Radiographic&y detectable intraoral radiation stem. J PROSTHET DENT 1989;61:1-3. 2. Khan Z. Soft palate obturator prosthesis made with visible light-cured resin. J PROSTHET DENT 1989;62:671-3. 3. Fischman B. The use of light-cured material for immediate hollow obturator prosthesis. J PROSTHET DENT 1989;61:215-6. 4. Shifman A. Clinical applications of visible light-cured resin in maxillofacial prosthetics. Part I. Denture base and reline material. J PROSTHET DENT

1990;64:578-82.

5. Caputo TL, Ryan JE. An easy fast technique for making immediate surgical obturators. J PROSTHET DENT 1989;61:473-5. 6. Benington IC. Light-cured hollow obturators. J PROSTHET DENT 1989;62:322-5.

7. DaBreo EL. A light-cured interim obturator prosthesis: a clinical report. J PROSTHET DENT 1990;63:371-3. 8. Meyer JB, Knudson RC, Myers KM. Light-cured interim palatal augmentation prosthesis: a clinical report. J PROSTHET DENT 1990;63:1-3. 9. Hayakawa I, Nagao M, Matsumoto T, Masuhara E. Properties of a new light-polymerized relining material. Int J Prosthodont 1990;3:278-84. 10. Dentsply Triad-VLC system technique manual. York, Pa: Dentsply International, 1986. 11. Fellman S. Visible light-cured denture base resin used in making dentures with conventional teeth. J PROSTHET DENT 198%62:356-g. Reprint

requests

to:

DR. GREGORY L. POL~OIS DEPARTMENT OF PROSTHODONTICS UNWER~ITY OF ATHENS, SCHOOL OF DENTISTRY 2 THIVON ST. 115 27 ATHENS, GREECE

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