One-appointment complete denture Zafrulla
construction using visible
Khan, DDS,a and C. Brent
Haeberle,
of an immediate transitional light-cured resin DMDb
University of Louisville, Schoo\ of Dentistry, Louisville, Ky. A technique is described for construction of an immediate transitional complete denture in one appointment using self-curing tooth color and visible light-cured resins. Conventional immediate denture therapy may be too prolonged for medically or physically compromised patients. This alternative treatment reduces laboratory, dentist, and patient time, thereby providing a fast and economical service. (J PROSTHET DENT 1992;68:500-2.)
T
he conventional timetable for immediate denture therapy may be too prolonged for handicapped, elderly, or institutionalized patients. Alternative therapy using a provisional denture may be indicated. This article presents a technique in which visible light-cured (VLC) denture resin and self-curing resin are used to construct an immediate denture in a single appointment. A visible light-cured resin such as Triad (Dentsply International Corp., York, Pa.) can be used in place of conventional denture resins. Studies have shown this material to have superior strength and dimensional stability.ls2 Other advantages of VLC resins are complete polymerization without residual compounds, no free monomer, and ease of manipulation that eliminates the need for the usual armamentarium used for denture processing (wax, flasks,
aProfessor and Acting Chairman, Department of Prosthodontics. bAssistant Clinical Professor, Department of Prosthodontics. 1011135886
boil-out tanks, and heat processing units). The material seems to be biocompatible and well tolerated by patients. A minimum of time and effort can be spent to construct the prosthesis in one clinical appointment.
TECHNIQUE 1. After examination, perform occlusal equilibration if needed (Fig. 1). Make an impression with irreversible hydrocolloid in a stock tray. Inspect for accuracy, especially the borders, and mark the posterior palatal seal with an indelible pencil. 2. Place tooth-color self-curing resin (Jet Acrylic, Lang Dental Mfg., Chicago, Ill.) in tooth imprints in the impression up to the neck of the clinical crown (Fig. 2) and allow to set. 3. Complete the pouring of the impression with dental stone (Fig. 3). 4. Separate the cast from the impression and mount the cast on an articulator using a facebow. Carve the posterior palatal seal that was previously delineated in the impression (Figs. 4 and 5).
Fig. 1. Patient before treatment is examined to evaluate tissue contour and to equilibrate occlusion, if needed. Fig. 2. Tooth-color self-curing resin is placed in tooth imprints of impression.
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Fig. 3. Remainder of cast is poured in vacuum-mixed Fig. 4. Cast after removal from impression. Fig. Pig.
5. Casts are mounted on articulator. 6. Cast is lubricated before application
Fig.
7. VLC resin is applied to cast and is cured.
Fig.
8. Tissue surface of denture after curing.
5. Lubricate the stone cast with a light coat of Triad Model Release agent (Dentsply International Corp.) (Fig. 6). 6. Apply Triad VLC bonding agent or acrylic monomer to the teeth of the stone cast. 7. Adapt uncured Triad VLC denture resin to the remainder of the stone cast making certain not to trap THE
JOURNAL
OF PROSTHETIC
DENTISTRI’
dental stone.
of VLC resin,
air beneath the resin and adapting the material against the resin teeth. Cure for the recommended time, inspect for inaccuracies, and correct with additional rope or sheet resin as needed (Fig. 7). 8. Separate from the stone cast, finish, polish, and disinfect before delivery to the patient (Fig. 8). 9. Extract the teeth, insert the transitional denture, and 501
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a surveyor to determine the need for surgical correction to ease placement of the transitional complete denture and subsequently, of the final prosthesis. A surgical stent made from a duplicate cast will enable the surgeon to recontour ridges as needed following extraction of the teeth.6
SUMMARY
Fig. 9. Finished complete denture inserted after extraction of teeth.
Some circumstances require planning and using alternative techniques to construct an immediate transitional denture. A quick and economical alternative method for its construction is described using visible light-cured denture resin (Triad) and conventionaf tooth-color self-curing resin (Jet Acrylic). This technique can be used for physicallycompromised patients as well as for those with limited finances. REFERENCES
verify the necessary structions ments for
accuracy of fit and occlusion. Following adjustments, dismiss the patient with inon home care. Schedule patient appointneeded future adjustments (Fig. 9).
DISCUSSION Several investigators3-5 have described different techniques for constructing interim or transitional prostheses. The procedure described has the advantage of completing the treatment in one rather than in multiple appointments. In most instances, denture teeth need not be used in the set-up, thus providing a more economical service to the patient. In situations where the patient presents with severe bony protuberances, the dentist can place the diagnostic cast on
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1. DaRreo EL. A light-cured interim obturator prosthesis: a clinical report. J PROSTHETDENT 1990;63:371-3. 2. Khan Z, van Fraunhofer AJ, Razavi R. The staining characteristics, transverse strength, and microhardness of a visible light-cured denture base material. J PROSTHETDENT 1987;57:384-6. 3. Hales WV, Sussman L. Intermediate dentures. J PROSTHETDENT 1969;21:448-55. 4. Rayson JH, Wesley RC. An intermediate denture technique. J PROSTHET DENT 1970;23:456-63. 5. Javid N, Porter MR. The construction of transitional immediate dentures. J PROSTHETDENT 1973;30:210-4. 6. Demer WJ. Minimizing problems in placement of immediate dentures. J PROSTHETDENT 19'72;27:275-84. . Reprint requests to: DR.ZAFRULLA KHAN UNIVERSITYOF LOUISVILLE SCHOOLOFDENTISTRY LOUISVILLE,KY 40292
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