Textbook of Complete Dentures Plummer - Ebook download as PDF File . pdf), Text File .txt) or read book online. CONMPLETE DENTURE. PROSTHODONTICS. A STUDY AND PROCEDURE GUIDE by. Brien R. Lang, D. D. S., M. S.. Professor and Chairman. Department of . Presents various aspects of the basic principles of complete denture prosthodontics. This book relates the basic sciences of anatomy, physiology, pathology.
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Download medical-site.info Heartening for Pinkalicious dentures oral surgery, oral rehabilitation, Rahn's Textbook of Complete. The Textbook of Complete Dentures, sixth edition has been totally reformatted into a user-friendly education resource as well as an effective clinic manual. Textbook of Complete Dentures, 6th Edition: Medicine & Health Science Get your Kindle here, or download a FREE Kindle Reading App.
Download PDF. Recommend Documents. Complete denture prosthodontics. Pre-clinical complete denture prosthodontics. Essentials of complete denture service.
The significance of the fovea palatini in complete denture prosthodontics. The ala-tragus line in complete denture prosthodontics. Clinical applications of concepts of functional anatomy and speech science to complete denture prosthodontics.
The future of complete prosthodontics. Facebow transfer does not achieve better clinical results than simpler approaches in complete denture prosthodontics.
BOOK REVIEWS and encourages the logical progression to an initial differential diagnosis based on radiographic evidence, followed by a more definitive diagnosis using the additional evidence provided. Also included in the presentation of each case are two or three relevant questions, often slanted to test the knowledge of the reader on points such as alternative views or other investigations which may be indicated.
Not unnaturally one is tempted to turn rather too rapidly to the Answers towards the end of the book and this must be resisted.
Transverse horizontal axis. Incisai guidance—1. The influence of the contacting surfaces of the mandibular and maxillarv' anterior teeth on mandibular movements. The influences of the contacdng surfaces of the guide pin and guide table on articulator movements. Interim complete denture—An immediate denture that is fabricated to sene only during the healing phase following extractions. It is generally less costly than a conventional denture, and the master cast is often fabricated from an irreversible hydrocolloid impression.
Interocclusal clearance—The arrangement in which the opposing occlusal surfaces may pass one another without any contact. Interocclusal distance—The distance between the occluding surfaces of the maxillarv' and mandibular teeth when the mandible is in a specific position. Monoplane occlusion—An occlusal arrangement wherein the posterior teeth have masticatoi7 surfaces thai lack any cusp height. Nonworking side—That side of the mandible that moves toward the medial line in a lateral excursion.
Occlusal vertical dimension—The distance measured between two points when the occluding members are in contact.
Overextended—Being excessively long or deep. The term usually applies to an impression tray or impression, which may eventually lead to the final denture being overextended. The position is usually noted wben the head is held upright, 3 the postuiul position of the mandible when an individual is resting comfortably in an upright position and the associated muscles are in a state of minimal contractual activity.
Protrusion—The position of the mandible anterior to centric relation. Rebase—The laboratory process of replacing the entire denture base material on an existing prosthesis.
Rehning—Tbe procedure used to resurface the tissue side of a removable dental prosthesis with new base material, thus producing an accurate adaptation to the denture foundation area.
Vertical dimension of rest. Retention—The quality of a denture chat resists movement of the denture away fVoiii the tissue. Support—The quahty of a denture that resists movement of a denture toward ihe tissues. Underextended—Being excessively short or shallow. This term usually applies to an impression tray or impression. Being underextended may result in a denture with lack of stability or retention.
Working side—The side toward which the mandibles moves in a lateral excursion. References Douglass.
The Glossary of Prosthodontic Terms. Prosthet Dent. The Glossary of Proslhodontic Terms. J Prosthet Dent. Preface The editors have felt for many years that there was no simple textbook designed for the undergraduate dentaJ student or family dentist that explains the fundamental treatment needs for completely edentulous patients.
This textbook was nol designed to contain all the informalion a graduate student or prosthodontist might desire, but provides the basic information for consistent and quality treatment of the typica! The primary chaptei-s relate to the second portion of the textbook, which is an Atlas of figures and legends to supplement the chapter information.
The figures are all new and in color, which supplements the text nicely. The material is easy to read and clinically related to place the fundamental steps in denture fabrication in an easy-to-use reference. Our hope is that ihis textbook will help make the treatment of denture patients a rewarding aspect of your clinical practice. Kevin Plummer. Georgia Frederick A. Georgia John R. Georgia Kevin D. Georgia Arthur O. Geor"gia Henry W.
Georgia Carol A. Georgia Dennis W. Georgia W. Georgia XVII. Jack Morris. Associate Professor Vice Chair. MS Professor. Because the denture base leplaces mucosa-covered bone and will be visible to others. The elevated contour of this tisstie that remains is termed the "edenuilous" or "residual" ridge. Resin-Based Bentures Heat. The liquid monomer methyl nit'thacr iate is added with ground.
In addition. Textbook of Complete Dentures The fabrication of dentures involves a wide tange of materials and products. The most common method has been used for more than 60 years and includes a heat-polymerized resin.
The purpose of the "denture base" then is to cover the existing residual ridge. Denture Base Materials WHien the natural teeth are extracted. In this method. The bulk. In most denture base materials. The resulting polymer consists of strands of newly polymerized material polvTnethyl methacrylate surrounding but not chemically bonded to tlie pre-polymerized material originally added. Loss of these tissue results in the typical "sunken" appearance of edentulous patienLs.
The thin layer of saliva that exisLs between the tissue-bearing side of the denture base and tlie oral mucosa helps form a hermetic seal. Denture bases are fabricated of either polymeric materials or metal. Knowledge of the underlying materials used for denture base constiaiction. In considering replacing the missing natural teeth. Some products include a rtibber-like molecule that provides elasticity to the denture and decreases the potential for fracture.
Previous to tooth extraction. The most popular material for denture base construction is a pohiiier. PoHmers are very easily shaped and formed. The result is a very tajigled mass of polymer chains that provides sti'ength.
The artificial teeth are positioned in wax on the casts to have the angulation desired in the final denture. This process is easy. In the "fluid-pour" technique. Instead of being inserted into the conventional brass flask.
A conventional. Once the teeth are in their desired location and the wax denture base has been sculpted. Because of resin shrinkage during polymerization approximately 0.
For this reason. This assembly is made outside of the patient's moutli. The base resin polymer and monomer are mixed to a dough-like consistency. Pressing also helps to extrude and eliminate excess.
The assembly is then placed into a large unit where it is exposed to ver ' intense light. After the material inside tiie flask has maximally polymerized.
The denture is "Basked" in a similar manner. Pohmerization of the resin denture base inside the special flask is caused by exposure to microwave radiation. Dental Materials for Complete Dentures material to temporarily hold the artificial teeth.
The dough-like material could have been specially formulated so tliat the polymerization process would not require any heat to react. The brass flask is placed into water and heated to a specific temperature at a specific rate.
This material is also formulated to undergo an autopolymerizatiou setting reaction. Rather than pressing the dough into tlie mold. The warmth ofthe water eventually reaches the unpolymerized dough where it activates a setting mechanism of the polymer heat-pohinerized resin. Another type of denture base is also mixed into a dough and flasked like those dentures mention above.
A polymer denture base can also be made from different types of materials. The flask is then allowed to sit at room temperature where the autopolymerizing reaction takes place.
The product is placed directly onto the master cast. The flask halves are closed and pressed together. Using interocclusal records. The wax is also sculpted to simulate the form and natural contours of the gingiva and mucosa that were present prior to tooth extraction. Disadvantages of porcelain denture teeth include their hardness. In mechanical bonding. Porcelain teeth were tbe first to be developed. Within each type of material. The metal base is fabricated in a process that involves replacement of the wax form of the desired metal base with one tiial is made of metal using the lost wax technique.
This added sensation provides a great enhancement of the pleasure gained from eating for many edentulous patients. The teeth are retained to the demure base by either a mechanical undercut with no chemical bonding.
Advantages of the metallic base are that it provides a much more accurate fit to the underlying mucosa. These teeth are made of ceramic material and are quite hard and wear resistant.
Porcelain Teeth Denture teeth are made of either porcelain or plastic a polymer. For the mandibular denture. This void has small vent holes into which the unpolymeiized denture base material flows during packing.
There is no method to chemically bond any type of denture tootli to the denture base. I Denture Teeth Tooth Retention The function of an artificial loolh in a dennire is to provide esthetics. Porcelain teeth also tend to transmit impact forces from biting lo the underlying. Plastic teeth can be classified into a N-ariety of types.
E Denture Liners Over time. Plastic teeth are retained to the polymerizing denture base using a micromechanical interlocking of the new denture polymer enmeshing the polymer network of the denture tooth in contact with the curing base.
Because of this space. Because these teeth are fabricated of ceramic material. Conventional plastic teeth are homogeneous in their composition and contain a polymer network that is basically only one type of resin.
Being softer. Dental Matertals for Complete Dentures 11 mucosa. Being ceramic. Plastic teeth are easily contoured to fit the underlying ridges and are easy to adjust at insertion. Many clinicians would prefer thai padents exhibit a loss of denture tooth material as opposed to loss of bone. These teeth are much softer than are their porcelain counterparts.
Because of their comparative softness. IPN teetli.
Excess movement of the denture base against the underlying mucosa loosefitting dentures occurs. Polymer Plastic Teeth The other type of denture teeth are made from polymers called "plastic teeth".
The combination of tlie different properties of these polymers as well as their mechanical entanglement help to enhance their properties compared with conventional teeth. The hardness ofthe porcelain teeth may direct forces to the underhing bone and cause a loss of occlusal vertical dimension because of bone loss. In IPN teeth. They are less likely to fi"acture than porcelain teeth. The difference is tliat the hard material sets to a relatively inflexible consistency.
The mixed material is placed direcdy onto the denture base. If the space is large and occlusal vertical dimension has been lost. Extreme care must be taken because the heat released dtiring the polymerization reaction occurring immediately against the oral mucosa is high enough to cause pain and scalding.
Chairside Reiine Materiais If performed chairside. The denture is placed into die patient's motith and held in position until tlie polymerization process has been completed. To alleviate this ill-fitting condition. The decision ultimately rests upon the amount of ridge loss and resulting space.
This later treatment is called a "rehne" and can be performed either direcdy on the existing denture at chairside. Both hard and soft reiine materials are available using this type of delivery system.
This fiexibility helps to decrease biting forces on the underlying tissues by creating a soft cushion. When the trigger is pressed. In this system. WHien polymerized. In this reiine process. Both of these products consist of a powder and liquid that. Because of the high stresses and lateral movements imposed ou the delicate oral mucosa. For the lab-processed relines.
For this process. A metliod must be ttsed that allows these tissttes to heal. If impressions were made for a new denture at this time. This loss of resiliency' is the result of dissolution leaching of a component plasticizer that helps to keep the material fiexible. Instead of using silicone. Laborator " metiiods are also used to process a "permanent. These materials do not tmdergo any type of polymerization when "curing. Dental Materials for Complete Dentures 13 laboratory Refine Materiais Denture reline materials that are sent to the laboratory for processing polymerize to a higher degree than those that are used chairside.
This is the function of a "tissue conditioner. As a result of this long-term use. Iftissueconditioner is allowed to remain on the patient's denttu"e for too long. This bond is more durable than the adhesive bond upon which the silicone material relies. The sponginess of this material absorbs loads to the underKing residual ridge. The resulting liner has tiie advantage of staving flexible for considerably longer periods tliaii those made totally of a modified methacrylate-based polymer.
Tlie new denttire base material is added and polymerized directiy against the old base under heat and pressure. In this manner. The conventional denture polymer is placed directly over tiiis soft material. When joining broken.
Macromechanical aspects involve the purposeful fabrication of mechanical interlocks or undercuts. Alginate Hydrocolloid Alginate hydrocolloid an irreversible hydrocolloid is usually packaged as premeasured powder to which a specified volume of liquid water is added.
In each situation. Wlien tiie fluid repair resin comes into contact with this swollen surface. If the repair resin is allowed to polymerize under high pressure and heat. This mixed mass will have the consistency of very heavy dough. The selection of each type material is based on the degree of accuracy needed.
Pressure is applied to the pot by asing the existing in-house compressed air supply. To create such conditions. Micromechanical retention involves application of a liquid.
The liquid is spread on the broken sections to cause only the outer layers of polymerized denture polymer to absorb the fluid and then physically swell.
The components are actively mixed. Once again. This technique will produce a more dense. The viscositv' to he used is based on the consistency of tlie tissues to be. If left for too long. This softening allows the adhesive to diffuse into the outer portions of the tray. Alginate will absorb water from the set stone. Dental Materials for Complete Dentures 15 usually by the presence of small boles. The alginate may be diificult to remove because of excellent adaptation to the ridges.
Once set. The impression is examined to make sure that all desired areas were captured. These dentisLs will use the preliminary casts derived from alginale impressions to fabricate plastic custom or final impression trays. The major component of alginate is water. These materiais are known for their high degree of accuraq. This waiting time is necessary to allow the volatile components of die adhesive to evaporate and to allow die adhesive to slighdy soften the surface of the impression tray.
PVS materials are available in a range of viscosities: The tray is seated on the ridge. Dental stone is poured into the impression and vibrated to remove air bubbles and allow the stone to cover all impression surfaces. The impression should be immediately separated firom the set dental stone and not allowed to remain in contact with die stone.
The impression should not be immersed in disinfectant because alginate can easily absorb water and swell. A synthetic. Even with good intentions. This process usually takes a few minutes. The tray is adjusted intraorally and the borders are correcdy adapted to the ridges using. Once the borders of the trays are conected. The tray is then painted with a specific adhesive material.
An alginate impression should be poured immediately. Manufacturers provide detailed guidelines on the ratio of powder-to-water that shotild be present to provide optimal stone quality. To help develop the proper consistency. WTien dental stone sets. For disinfection. For this purpose. Each material is packaged as two different pastes that. The PVS material is strong enough to withstand multiple pours of stone. Once poured. In either case.
It is not. Reduction of air incorporation is a goal when mixing the powder and liquid components. By treating the grotuid mineral in various manners heating and application of pressure.
To help the stone wet cover the impression material surface and to reduce the possibility of bubbles forming at this interface. The concept of filling the impression with stone is one that stresses displacement of trapped air and replacement with the stone slurry mixture. The pastes can be mixed by hand using a spatula. These materials do not need to be poured immediately. The dentist has a wide variety of mechanical devices articulators to which these casts can he attached that will not only correctly orient the casts.
Once the heat maximum occurs. Tliis material is also used to orient the completed dentures at in. These materials may be softened in wann water and harden readily when cooled in the mouth when a stream of air or cold water is directed at them. Thus care needs to be taken in handling these registration materials once used. Type II products model plaster. The thermoplastic materials are usually a fiber-reinforced.
A variety of materials are used for this purpose. Registration Materiais A variety of materials are used for the registration process. Dental Materials for Complete Dentures 17 Once the impression is filled. Model plasier is used mostly for stabilizing master casts in position to articulators. Bentai Waxes Among other uses.
This type of wax is available in three different levels of hardness. The other type of wax commonly used in denture base fabrication is "sticky wax" and is knovm for its ability to adhere to casts. The most typical type of wax used for denture base fabrication is termed "baseplate" wax. Once cooled and hard. These materials are mixtures of natural and synthetic hydrocarbons specifically designed to soften at pre-desired temperatures.
These waxes are easily distorted. Advantages of this material are that. Type 1 wax is used mostly in denture base construction. At room temperature. When cooled. As is the case for all types of waxes used in denture fabrication.
Benture Gieansers Proper denture cleaning is essential for maintaining denture base color and the general health of the patient's moutii. If warmed. If the dentures and underKing mucosa are not maintained. A disadvantage is that the material is not rigid. In the warm. Anotiier excellent method of cleaning dentures is through the use of an ultrasonic cleaner specifically made for denture cleaning and home use.
These oxygenating agents should not be used if tiie denture base contains a soft liner. Dental Materials for Complete Dentures 19 which the denture rests.
Patients shouJd be warned to avoid use of high levels of heat to clean dentures because the dentures may waip irreversibly. Solution Cleaners: Mild Acids Hypochlorites Stidium hypochlorite is a well-known antibacterial agent. Denture cleansers can be divided into two groups: Fven with the unending list of denture cleansen tiiat are commercially available. Dzygenating Agents.
The use of an ultrasonic cleaner in conjunction with any of the following materials will yield excellent results. In additi n. Cleansing of the tissue-ljearing side of the denture is often overlooked. The bubbling activity developed from the tablet dissolution also creates a small agitation ttiat helps cleanse debris from tlie denture surface. Denture bases retain plaque and accumulate debris that should be periodically removed. It is the clinician's responsibility to educate the patient in proper cleansing methods as well to recommend specific types of ancillary cleaning products.
Efforts to reinforce compliance with proper cleaning of all surfaces ofthe denture. A g e n t s Solutions of oxygenating agents such as peroxides. Abrasive Cleansers The abrasiveness of conventional toothpastes especially the "whitening" formulations is excessive for the relatively soft polymer of denture bases.
Powder based adhesives allow more sodium to be released into the saliva because of the increased surface area of the powdei"s: Adbesives are also useful for those patients with little-to-no remaining residual ridge to help supply resistance to lateral denture movement stability.
To alleviate this misfit. It should be mentioned. Relining the denture is often the best method of resolving this problem. These agents dissolve calculus deposits.
The powdered material is sprinkled over the surface of a wet denture base and is then inserted into the mouth. These products work best if used as a thin layer. Patients who use these t 'pes of supplementary products should be educated about the need for frequent removal of the products from both the denture base as well as the tissues upon which they rest.
Two studies indicate that dentures adhesives may cause problems to a limited number of patients. The resiilting stickiness to both tissues and denture material helps to retain the dentures. It is not uncommon that patients continue to place additional product to help "tighten their teeth.
Denture adhesives are often "self-prescribed" by the patienl and are readily available in a variety of over-the-counter formulations. Plasucs in Prosthetics. Textbook of Complete Dentures.
Soft Liners. What are some ofthe advantages o f a laboratory denture reline as opposed to a chair-side reline? Restorative Dental Materials. Properties and Manipulation.
What is the approximate shrinkage ofa denture base resin during polymerization processing? Denture Adhesives. Paste is extruded directly onto the denture base and is spread until it forms a thin layer. Dental Clinics of North. In Agar. In Agai. Why must an irreversible hydrocolloid alginate impression be poured within 10 minutes? Prosthetic Applications of PoIvTners. As opposed to the powdered products. In Craig. References Beaumont. How does the strength o f a repaired denture compare to the original unbroken denture?
Complete Denture Impressions. Why should a tissue conditioner be replaced reasonably frequently? Dental Materials. Content and solubility of sodium in denuire adhesive. I IVosthel Dent. Saunders Company. J ProsLhet Dem List four advantages of resin denture teeth over porcelain denture teetli. List three of the four methods of polymerizing denture base resin.
Denture resin will absorb water from its storage fluid. Saiinders Company: WTiy is this important? Removable Prosthodontics. An irreversible hydrocoiloid alginate impression should be potired immediately. Wiiat are two characteristics of denture adhe. Tliis softening allows the adhesive to diffuse into the outer portions of the tray. Better retention to the denture base. Microwave Energy. The resulting polymer from this laboratory polymerization is much stronger.
Light 2. Chemical Reaction. If tissue conditioner is allowed to temain in the patient's mouth for too long. Wliy should the adhesive for an impres. Approximately 0. This vraidng time is necessary.
Dental Materials for Complete Dentures 23 Denture adhesives may cause problems to a limited number of patients. Altiiough a thorough knowledge of all anatomical landmarks of the edentulous mouth is indispensable tor the. These structures, which affect tlie fabrication of complete dentures, and the structures that underlie those important landmarks will be discussed in this chapter.
Accurate impressions of the maxillaiy and mandibular arches should reproduce the landmarks that do not cbange their position with function Ex: Identifying the anatomical landmarks in casts of the maxillary and mandibular arches and comparing them lo the same structures in a patient's mouth should help to provide the clinician with the confidence that the impression procedure accurately reproduced the area to be covered with tiie denture.
The philtrum is a midline shallow depression of the upper Up, which starts at the labial tubercle and ends at the nose. Insertion Chapter Post Insertion Chapter Relining Complete Dentures Chapter Implant Supported Complete Dentures show more.
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