Review of Complete Denture by Lovely M – Short Notes

DIAGNOSTIC CAST

The diagnostic cast should be an accurate reproduction of the teeth and adjacent tissues, poured in
dental stones because of its strength and abrasion resistance

The impression for the diagnostic cast is made with irreversible hydrocolloid (alginate) in a
perforated impression tray.

IMPORTANCE OF DIAGNOSTIC CAST

1. Diagnostic cast permits viewing of the occlusion from the lingual and buccal aspect.
2. To analyse the existing occlusion in case of occlusal adjustments and occlusal reconstruction.
3. Aids in diagnostic wax up, to determine the occlusion before definitive treatment is begun.
4. Diagnostic cast helps to survey the dental arch as a whole
5. Helps in surveying of the cast to determine existing soft tissues undercuts, parallelism of
teeth as for overdenture cases.
6. Aids in mouth preparation decisions, as to the removal of soft tissues undercut.
7. Helps to show and discuss the case with patient regarding the treatment plans, needed
corrections and problems if any.
8. Aids to select and fabricate trays.
9. If needed can duplicate diagnostic cast in a case an undercut has to be blocked.
10. Diagnostic casts may be used as a constant reference.
11. In areas where alterations are required as in soft tissues or hard tissues, a rough alteration
can be mocked on the duplicate cast to assess the outcome.

TYPES OF UPPER DENTURE BEARING AREAS (BASED ON FUNCTION)

Primary Stress Bearing Area

The residual ridges, most of the hard palate are the primary stress bearing areas in the upper jaw.

The fibrous connective tissues covering the crest of the residual alveolar ridge and the compact bone
made up of harversian system aids in supporting the denture due to its firmness and position.

Primary and Secondary Retentive Areas

a. The rugae area in the anterior part of hard palate is at an angle to the occlusal plane of the
residual ridge which helps in secondary retention, provided it is not distorted in the
impression procedures.
b. The glandular region in the posterior part of the hard palate if covered by denture help in
retention of the denture

Relief Areas

a. Incisive Papilla – the incisive papilla covering the incisive foramen is located behind and
between the central incisors. If this area is not relieved, it may cause interferences with the
blood and nerve supply
b. Median Palatine Raphe – as the mucosa in the median palatal suture is thin and attached to
the periosteum, not relieving this area can cause soreness and rocking of denture

Other Areas
Review of Complete Denture by Lovely M – Short Notes

a. Zygomatic Process – In long term edentulous patients, the zygomatic or malar process,
located opposite the first molar region, need to be relieved. If not can lead to soreness of
the underlying tissues and affects retention.
b. Posterior Palatal Area – As the posterior palatine foramina are thickly covered by soft
tissues, they do not need to be relieved except in extreme cases of resorption.
c. Vibrating line of the palate – it is an imaginary line drawn across the palate that marks the
beginning of motion when the patient says “ah”. It extends from one pterygomaxillary notch
to the other and passes about 2mm in front of the fovea palatinae. Ideally the distal end of
the upper denture should end 1 to 2mm posterior to the vibrating line, covering the
tuberosities and extending into the hamular notches. Posterior palatal seal area is an area
between the anterior and posterior vibrating lines which should be closely contacted by the
dentures. If a gap exists it jeopardises the retention of the denture.

STABILITY AND SUPPORT IN COMPLETE DENTURE