Dental Hypotheses

CLINICAL INNOVATION
Year
: 2013  |  Volume : 4  |  Issue : 4  |  Page : 139--142

New clinical technique for fabrication immediate partial denture


Abdulsalam Ali Zwiad 
 College of Dentistry, Al-saeed University, Taiz, Yemen

Correspondence Address:
Abdulsalam Ali Zwiad
PO. Box-2436, Sana«SQ»a
Yemen

Abstract

Immediate partial denture is a choice of treatment due to various cases of teeth extraction such as badly carious teeth, periodontal disease, eruption problems, trauma, and other reasons. Many choices are used to replace the lost teeth; one of these choices is a removable plastic denture in which hot cured acrylic resin should be used to fabricate such denture. Aim of Study: To provide an applicable technique to fabricate an immediate partial denture by reducing and declining the prosthetic steps and some materials in proportional to the conventional method. Clinical Procedures: Maxillary and mandibular stone casts are mounted to a simple articulator and the procedures are explained as step by step to fabricate an immediate partial denture without using the conventional methods and material, just using a small quantity of white cold cure acrylic resin to fabricate the artificial teeth, hot cure acrylic resin for the denture base and mold made of a silicon impression material are used to fabricate an immediate partial denture. Conclusion: The finished immediate partial denture showed a good retention and produced the exact shapes and sizes of the extracted teeth with low cost and less time for a dentist and patient.



How to cite this article:
Zwiad AA. New clinical technique for fabrication immediate partial denture.Dent Hypotheses 2013;4:139-142


How to cite this URL:
Zwiad AA. New clinical technique for fabrication immediate partial denture. Dent Hypotheses [serial online] 2013 [cited 2020 Sep 22 ];4:139-142
Available from: http://www.dentalhypotheses.com/text.asp?2013/4/4/135/122677


Full Text

 Introduction



Various reasons lead to extract natural teeth such as, dental caries, periodontal disease, eruption problems, trauma, orthodontics, and other reasons. [1] Many choices are used to replace the lost teeth; one choice for replacing lost teeth is the removable plastic dentures. Proposed changes in a laboratory and clinical techniques in prosthodontics may lead to change in options of treatments. Several studies have dealt with the subjects of providing alternative and applicable techniques in general dentistry and various prosthodontic treatments. [2],[3],[4],[5] Immediate dentures remain an important tool for providing patients with an instant replacement option for extracted teeth. Clinical and laboratory techniques can be used to facilitate the accurate construction of immediate dentures, as well as some of the problems that can compromise their final outcome. [6] The immediate denture has been documented since 1860 and still some patients insist to avoid extraction of their hopeless teeth due to their desire to avoid the condition of comparative esthetic and may be for emotional factors. Immediate denture is fabricated before all the remaining teeth have been removed. Its advantages include maintenance of a patient's appearance, muscle tone, facial height, tongue size, normal speech, and reduction of postoperative pain. [7] Patients may expect to wear dentures of a particular shape and size and are familiar with the polished surface shape, the position of the teeth, the base extension, and the vertical dimension of occlusion. [7] It is necessary and important for a patient to be provided with an acceptable and well-tolerated new appliance of an immediate denture. Therefore, the task of providing immediate denture for such patient needs a dentist or prosthodontist be well familiar and hardly seeking to maintain, or slightly modifying these aspects to overcome faults that have developed. Patients should find it easier to accept and learn to use their new dentures. [8] A study showed that plastic removable partial denture was the main type of replacement offered. And most of the patients, surprisingly, tolerated anterior edentulousness. However, it appears that anterior edentulousness was more abhorrent to female patients and younger individuals. [9] Acrylic dentures are still needed in dental practice for patients who need a complete maxillary or mandibular denture, the results of study suggested that the adult population in need of one or two complete dentures will increase from 33.6 million adults in 1991 to 37.9 million adults in 2020. [10] This study has been concerned with an alternative technique for fabricating a transitional immediate partial denture in less appointments, less consuming of dental materials and equipments, less clinical and laboratory procedures, and to provide the aims of preservation esthetics and functions.

Aim of the study

The aim of this study is to provide:

An applicable technique to fabricate an immediate temporary partial denture by reducing and declining the prosthetic procedures and materials in proportional to the conventional method.

 Clinical Procedures



After producing the necessary working stone casts for a patient, the procedures of this study is started as follows:

The working casts for this study are represented by stone models which was mounted on a simple articulator that they should be articulated in their correct intercuspal position [Figure 1].The suggested extracted teeth are determined on the working cast and in respect to this study they were the four maxillary incisors.Draw and design the extension of the denture base on the maxillary working cast, then carve the beading line by using a lacron carver [Figure 2].Soften a piece of modeling wax, place it with adaptation on the palatal surface of the maxillary working cast and cut the excessive wax to the exact shape and design according to the extension of denture base [Figure 3], this adding of wax will serve to compensate the thickness of the acrylic, while the space for the labial flange of the denture will be prepared by shaving the inner surface of the silicon impression later on.Using a silicon impression material, to make an impression for the maxillary working cast with its additional wax [Figure 4].After separating the impression from the cast, extract the four maxillary incisor teeth from the working stone cast [Figure 5].Use the impression to produce a set of an artificial teeth for the four extracted maxillary incisors by using white cold cure acrylic resin as follows:

Mixture of white cold cure acrylic resin is poured in the space of the imprinted four maxillary incisor teeth, adapt it on the cast, and wait the material to be set and cured.The produced artificial teeth are picked up from the impression as one piece.Clean and carve the artificial teeth to their normal shapes, sizes, and check them to be fit to the space in the cast. The produced teeth are saved for next step.

Determine the abutment teeth (canines are used for this case) and prepare an accurate clasp for each canine by using stainless steel wire gauge 0.7.The prepared clasps are adapted, placed on the abutments teeth, and fixed on the abutments by using a small drop of sticky yellow wax should be dropped on the clasp's arm labially [Figure 6].Set the produced artificial teeth in their space on the cast and check for correction of the occlusion and adjustment on the articulator, then start to put in step by step a sufficient mixture of acrylic resin (Triplex hot- Type I Class I, Ivoclar Liechtenstein) and in a proportional mixing ratio 3:1 on the palatal surface of the cast [Figure 7].Cut any excessive material in respect to the extension of the denture base, also put a sufficient mixture on the labial site [Figure 8] to form the labial flange.Convey the silicone impression alone without its tray and adapt it on the entire maxillary compartment including the maxillary working cast, clasps, and the mixture of the heat cure acrylic resin to be ready for the polymerization cycle [Figure 9].Introduced the entire maxillary compartment in to the heat pressure machine to achieve the curing cycle for polymerization the hot cure acrylic resin, the machine is set on 120°C, three bars, and 20 min.After setting time; the compartment is picked up, left on the bench to cool, separate the immediate partial denture to be finished, and polished by the conventional procedures of finishing a denture.Place the finished denture on the working cast, remount the cast on the articulator, and do a selective grinding for a necessary correction for the occlusal contacts of the teeth.{Figure 1}{Figure 2}{Figure 3}{Figure 4}{Figure 5}{Figure 6}{Figure 7}{Figure 8}{Figure 9}

 Discussion



The study could provide an accurate immediate partial denture with good esthetic for it compensates the exact shapes and sizes of the previous extracted teeth. It provides good adaptation and retention on the working cast, so it is expected to be so in the patient mouth for it will serve as a wound splint in the time of the extraction of the teeth. The technique is economic that it saves time, materials, and tools such as modeling wax, gypsum products, and metal flasks. As the denture produced by this technique provides the same sizes and shapes of the extracted teeth; therefore, this will be expected to develop an excellent toleration of the natural teeth at the time of insertion of the immediate denture. This technique could be applicable to fabricate a transitional single partial denture and fabrication of a surgical splint in case of maxillofacial prosthesis, for example, in hemimaxillectomy operation. The technique needs a normal skill of dental technician, but in case if it is fabricated by a dentist it may need more training or improving laboratory skill with consideration of just supplying the dental clinic with a heat pressure machine during furnishing the dental office.

 Conclusion



The finished immediate partial denture by this technique provided a good retention, could restore the exact shapes and sizes of the extracted teeth, and preserve time and esthetic; with a low cost for patient and dentist. It is applicable in dental clinic and providing the general requirements of producing an immediate temporary denture.

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