Denture delivery

Steps
1. Explanation prior to the delivery
2. Adjusting the fitting of denture base
3. Adjusting the peripheral denture base extension
4. Adjusting the labial flange
5. Detection and correction of occlusal discrepancies
6. Adjusting retentive clasps
7. Give patient instructions

Explanation prior to the delivery

• The goal of RPD is to replace teeth as well as preserve the dentoalveolar structure
• Explain that the denture will be uncomfortable

Adjusting the fitting of denture base

1. Apply pressure indicator paste (a mix of ZnO and vegetable oil) to the fitting surface of the
denture with a hard bristle brush to leave a distinct stroke pattern on the surface
2. The RPD is inserted, firmly seated, and removed
3. Inspect the stroke pattern
• No contact Stroke pattern remains
• Moderate contact Obliterated stroke pattern
• Heavy contact Paste is gone
4. Adjustment of the fitting surface
• Consult tutor’s opining on adjusting the denture
▪ Experience is necessary to differentiate between marks that indicate normal
contact with soft tissues and those that indicate excessive contact
• Heavy contact is relieved with bur
▪ Relieve the denture base little by little, as cutting away acrylic is irreversible
5. Remove the PIP, repeat the whole process as necessary

PIP – No contact; Moderate contact; Heavy contact

 ➢ Do we apply PIP in the very first insertion?
➢ If the patient does not complain about discomfort, do we still adjust the heavy contact as
indicated by the PIP?

Adjusting the peripheral denture base extension

1. Upper/ lower buccal extension
• Buccal tissue is held between the thumb and index finger and moved apically,
laterally and occlusally
• Examine the soft tissue movement adjacent to the denture flange
2. Lower lingual extension
• Place an index finger on the occlusal surface of the LHS
• Ask the patient to protrude the tongue and then move the tongue to the RHS
• If over-extended, then denture on the LHS will lift away from the supporting tissue
• Repeat on the opposite side
3. [Optional] Apply disclosing wax to the border of the flange and repeat step 1 and 2
• Distorted disclosing wax indicates over-extension
• This is to pin point the site of over-extension for ease of adjustment
4. Adjustment of the extension

Disclosing wax at the flange border

Adjusting the labial flange

1. Apply PIP to the fitting surface of the anterior flange
2. The denture is seated with gentle pressure
3. If resistance to seating of the labial flange is encountered, the denture is removed
4. Examine the stroke pattern for heavy tissue contact
5. Vertical reduction of the flange length to the point of contact with the edentulous ridge
6. Remove remaining PIP, repeat the whole process as necessary
 ➢ Why do we shorten the flange instead of making the flange thinner? Wouldn’t this result in
under-extension? Is this because we want to preserve some soft tissue undercut for better
retention?

Detection and correction of occlusal discrepancies

1. Shim stock is sued to identify contact before the placement of denture
2. Seat the denture and check the contact with shim stock
3. Use articulating paper to identify the occlusal high spot
4. Remove and only remove the high spot until the natural contact is re-established
• Adjustment of the acrylic teeth should be done extra-orally
5. Use articulating paper to identify non-working side interference
6. Remove and only remove the non-working side interference
7. Reshape the occlusal surface to optimize mastication

Adjusting retentive clasps

1. Adjust clasps with pliers as we do in 4B lab

Give patient instructions

• Do not drop the denture
• Remove and rinse denture after eating
• Denture should be removed at night so that the tissue can recover
• Remove denture when tooth brushing
• Clean the denture with a soft-bristle brush
o Without toothpaste
o At least one a day
• Soak the denture in water when not in use

Reference
Stewart’s Clinical Removable Partial Prosthodontics 4th edition Ch.16 Delivering the Removable
Partial Denture