No abstract

The prosthetic management of the edentulous patient has long been a major challenge. Complete maxillary and mandibular dentures have been the traditional standard of care. However, most of the patients report problems adapting to their mandibular denture due to a lack of comfort, retention, stability and inability to masticate. Implant-supported overdentures have been a common treatment for edentulous patients for the past 20 years and predictably achieve good clinical results. Implant supported overdentures offer many practical advantages over conventional complete dentures and removable partial dentures. These include decreased bone resorption, reduced prosthesis movement, better esthetics, improved tooth position, better occlusion, increased occlusal function and maintenance of the occlusal vertical dimension. This article presents a design and fabrication technique of the implant-retained overdenture that uses four freestanding mandibular implants.

Retention, stability and support are the basic principles on which the success of a complete denture relies. The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased interarch space provide decreased support, retention and stability. To decrease the leverage, reduction in the weight of the prosthesis was recommended and also found beneficial. This article describes a simple procedure to reduce the weight of maxillary complete denture by use of an autopolymerizing acrylic resin shell which is incorporated during the packing stage. This method has the advantage of being easy and requires very little additional time. Hollow maxillary complete denture considerably reduces the weight of the prosthesis, which in turn prevents transmission of detrimental forces by reducing leverage action. This results in increased retention and stability and up to some extent it also preserves the existing residual alveolar ridge. The technique uses a clear matrix of trial denture to facilitate shaping of dough spacer to ensure an even thickness of acrylic to resist deformation and prevent seepage of saliva into the cavity making this technique more predictable. An autopolymerizing acrylic resin shell which creates hollow space and also has strength. Technique is simple to execute, easy economical and matching the shade of autopolymerizing acrylic resin with heat cures acrylic resin enhances esthetics. Light weight hollow dentures provide healthy and comfortable living for the geriatric edentulous patient.

For the fabrication of a prosthesis, the Prosthodontist meticulously performs all the steps. The laboratory technician then make every effort/strives to perform the remaining lab procedures. However when the processed dentures are remounted on the articulator, some changes are seen. These changes may be divided into two categories: Pre-insertion and post-insertion changes, which deal with the physical properties of the materials involved (Parker, J Prosthet Dent 31:335-342, 1974). Split cast mounting is the method of mounting casts on the articulator. It is essentially a maxillary cast constructed in two parts with a horizontal division. The procedure allows for the verification of the accuracy of the initial mounting and the ease of removal and replacement of the cast. This provides a precise means of correcting the changes in occlusion occurring as a result of the processing technique (Nogueira et al., J Prosthet Dent 91:386-388, 2004). Instability of the split mounting has always been a problem to the Prosthodontist thereby limiting its use. There are various materials mentioned in the literature. The new technique by using Dowel pins and twill thread is very easy, cheaper and simple way to stabilize the split mounting. It is useful and easy in day to day laboratory procedures. The article presents different methods of split cast mounting and the new procedure using easily available materials in prosthetic laboratory.

No abstract