II Year Preclinical Prostho Journal_240705_125933

GOVERNMENTDENTALCOLLEGEANDHOSPITAL
MUMBAI
DEPARTMENT OF PROSTHODONTICS
PRE-CLINICAL PROSTHODONTICS
GOVERNMENTDENTALCOLLEGEANDHOSPITAL
MUMBAI
CERTIFICATE
This is to certify that

Roll no. has completed the Pre-clinical work in the DEPT. OF
PROSTHODONTICS as prescribed by MAHARASHTRA UNIVERSITY OF
HEALTH SCIENCES, NASHIK for Second B.D.S Course.
Date:-
In charge Professor &Head of Department

Pre-clinical Prosthodontics Dept. of Prosthodontics
Govt. Dental College & Hospital Mumbai.
University Seat No. :
Examination Centre :
Date of Practical Exam:
Signature of Examiners:
Internal External
Examiner Examiner
SECTION I:
COMPLETE DENTURE
SR. NO. DATE TOPIC PAGE NO. SIGN

1 SEQUENTIAL STEPS IN THE
FABRICATION OF COMPLETE DENTURE
2 INTRODUCTION TO COMPLETE DENTURE
3 ANALYSIS OF STUDY MODEL
4 PRELIMINARY IMPRESSION
5 PREPARATION OF PRIMARY CAST
6 FABRICATION OF SPECIAL / CUSTOM
TRAYS
7 FINAL IMPRESSION
8 FABRICATION OF
TEMPORARY DENTURE BASE
9 FABRICATION OF RECORD RIMS
10 JAW RELATION RECORD
11 TRANSFER OF JAW RELATION TO THE
ARTICULATOR
12 SELECTION OF TEETH FOR
COMPLETELY EDENTULOUS PATIENT
13 ARRANGEMENT AND ARTICULATION OF
TEETH
14 TRY-IN OF WAXED DENTURES (TRIAL)
15 PROCESSING OF COMPLETE DENTURE
A.FLASKING
B.DEWAXING (WAX ELIMINATION)
C.PACKING
D.POLYMERIZATION / CURING CYCLE
E.DEFLASKING
16 LABORATORY REMOUNT
17 FINISHING AND POLISHING OF THE
DENTURES
18 REPAIR OF COMPLETE DENTURES
SECTION II:
REMOVABLE PARTIAL DENTURE

1 SEQUENTIAL STEPS IN FABRICATION OF
2 INTRODUCTION TO
3 CLASSIFICATION OF PARTIALLY
EDENTULOUS ARCHES AND
APPLEGATE’S RULES
4 MAJOR CONNECTOR
5 MANDIBULAR MAJOR CONNECTORS
6 DESIGNING OF
MANDIBULAR MAJOR CONNECTOR
7 MAXILLARY MAJOR CONNECTORS
8 DESIGNING OF
MAXILLARY MAJOR CONNECTOR
9 MINOR CONNECTOR
10 OCCLUSAL REST AND REST SEAT
11 DIRECT RETAINERS
12 INDIRECT RETAINERS
13 DENTURE BASES
14 MOVEMENTS OF
15 SURVEYOR
16 DESIGNING OF
SECTION III:
FIXED PARTIAL DENTURE

1 SEQUENTIAL STEPS IN FABRICATION OF
2 INTRODUCTION TO
3 PRINCIPLES OF TOOTH PREPARATION
4 MARGIN DESIGN IN
5 ABUTMENTS OF
6 RETAINERS IN FIXED PARTIAL DENTURE
7 PONTICS IN FIXED PARTIAL DENTURE
8 CONNECTORS IN
9 PREPARATION OF MAXILLARY CENTRAL
INCISOR TO RECEIVE FULL VENEER
CERAMIC CROWN /
ACRYLIC JACKET CROWN
10 PREPARATION OF MAXILLARY CENTRAL
INCISOR TO RECEIVE FULL VENEER
PORCELAIN-FUSED-TO-METAL CROWN
ST
11 PREPARATION OF MAXILARY 1 MOLAR
TO RECEIVE FULL VENEER ALL METAL
CROWN
12 PREPARATION OF MAXILLARY
PREMOLAR TO RECEIVE PARTIAL
VENEER CROWN (THREE QUARTER
CROWN)
13 RESTORATION OF
ENDODONTICALLY TREATED TEETH
SECTION IV:
MAXILLOFACIAL PROSTHODONTICS
AND
IMPLANTOLOGY
SR DATE TOPIC PAGE SIGN

NO. NO.
1 MAXILLOFACIAL PROSTHODONTICS
2 IMPLANT PROSTHODONTICS
COMPLETE
DENTURE
1
2
EXERCISE - 1 Date:
SEQUENTIAL STEPS IN THE FABRICATION

OF COMPLETE DENTURE
Sr. Clinical /
Step
No. Laboratory
Case history, Clinical examination, Diagnosis and Treatment
1 Clinical
planning.
2 Clinical Making primary impression
Impression pouring, retrieval and preparation of primary cast
3 Laboratory
(Dental plaster)
4 Laboratory Fabrication of custom / special tray
5 Clinical Making final impression
Impression pouring, retrieval and preparation of final cast
6 Laboratory
(Dental stone)
7 Laboratory Adaptation of shellac base plate (Temporary record base)
8 Laboratory Preparation of record rims/wax rims (Modelling wax)
9 Clinical Recording of jaw relation.
10 Laboratory Transfer of jaw relation to an articulator
11 Clinical Selection of teeth
Teeth arrangement
12 Laboratory a. Anterior teeth arrangement
b. Posterior teeth arrangement
13 Laboratory Waxing and carving
14 Clinical Try – in of wax-up dentures.
15 Laboratory Sealing of wax-up dentures and flasking
16 Laboratory Dewaxing
17 Laboratory Packing
18 Laboratory Curing/ Polymerization
19 Laboratory Deflasking of denture
20 Laboratory Laboratory remount
21 Laboratory Finishing and polishing
22 Clinical Denture delivery & post insertion instructions
23 Clinical Patient recall
3
4
EXERCISE - 2 Date:
INTRODUCTION TO COMPLETE DENTURE
Definition:
PROSTHODONTICS:-
Prosthodontics is the dental speciality pertaining to the diagnosis, treatment planning,
rehabilitation and maintenance of the oral function, comfort, appearance and health of patients
with clinical conditions associated with missing or deficient teeth and/or maxillofacial tissues
using biocompatible substitutes.
BRANCHES:-
1) Removable prosthodontics 3) Maxillofacial prosthodontics
2) Fixed prosthodontics 4) Implant prosthodontics
Removable prosthodontics: The branch of prosthodontics concerned with the
replacement of teeth and contiguous structures for edentulous or partially edentulous
patients by artificial substitutes that are readily removable from the mouth.
Fixed prosthodontics: The branch of prosthodontics concerned with the
replacement and/or restoration of teeth by artificial substitutes that are not readily removed
from the mouth.
Maxillofacial prosthodontics: The branch concerned with restoration and replacement of
the stomatognathic and craniofacial structures with prosthesis that may or may not be
removed on a regular or elective basis.
Implant prosthodontics: The phase of prosthodontics concerning the replacement of
missing teeth and/or associated structures by restorations that are attached to dental
implants.
AIM AND OBJECTIVES:-
The basic objectives in prosthodontics are restoration of function, facial appearance
and maintenance of patient’s health.
The patient should be able to speak distinctly and experience oral comfort with the
prosthesis in the mouth. Mastication of food with the prosthesis assists the edentulous
patient in adequate nutrition. However, prosthesis fabricated even under the most ideal
condition will not have a chewing efficiency same as that of natural dentition but the
prosthodontist should aim to achieve maximum efficiency of prosthesis made for the
patient. Esthetics is of paramount importance to great number of patients. Fortunately, it is
possible in dental profession to consistently fabricate a virtually undetectable prosthesis for
the patient. The emotional and psychological effect of improved appearance can create
new outlook towards life for many patient.
_
Sign of Teacher
5
ANATOMICAL LANDMARKS OF MAXILLARY EDENTULOUS ARCH
1. Labial frenum
2. Labial vestibule
3. Buccal frenum
4. Buccal vestibule
5. Incisive papilla
6. Midpalatine raphae
7. Palatine rugae
8. Residual alveolar ridge
9. Alveolar ridge slope
10. Pterygomaxillary notch
11. Hard palate
12. Fovea palatini
13. Maxillary tuberosity
14. Posterior palatal seal area
6
EXERCISE - 3 Date:
ANALYSIS OF STUDY MODEL

MAXILLARY ARCH
1) Limiting structures of maxillary arch:
The denture base should include maximum surface area possible within the physiological
limits of health and function of the tissue it covers and contacts.
i. Labial frenum: It is a fold of mucous membrane in the midline. It contains no
muscle and has no action of its own. This band of tissue starts superiorly in a
fan shaped manner and converges as it descends to its terminal attachment
on the labial side of the ridge.
ii. Labial vestibule: It is the space between the ridge and lip extending from the
labial frenum to the buccal freni on either side.
iii. Buccal frenum: It is a fold of mucous membrane on the buccal side of the
ridge present on both the sides. The muscle attachments associated with it
are levator anguli oris, buccinator and orbicularis oris.
iv. Buccal vestibule: It is the space extending from buccal frenum to the
hamular notch on lateral side of the ridge.
v. Pterygomaxillary notch: It is situated between the tuberosity of maxilla and
the hamulus of medial pterygoid plate. The notch is used as a boundary for
the posterior border of maxillary denture behind the tuberosity.
vi. Fovea palatini: They are indentation near the midline of the palate and
formed by the collection of several mucous gland ducts located close to the
palpating line and always in the soft tissue. They act as a guide for the
location of posterior border of maxillary denture. Fovea are ductal openings
into which ducts of other palatal mucous glands drain.
vii. Vibrating line of palate:
a) Anterior vibrating line: It is an imaginary line located at the junction of
the attached tissues overlying the hard palate and the movable tissues of
immediately adjacent soft palate. It marks the beginning of motion of soft
palate.
b) Posterior vibrating line: It is an imaginary line at the junction of
aponeurosis of the tensor veli palatini muscle and the muscular portion of
soft palate. It marks the distal extension of the maxillary denture.
7
MAXILLARY STRESS BEARING AREAS & RELIEF AREAS
Primary stress bearing area-
Secondary stress bearing area-
Relief area-
Posterior palatal seal area-
8
2) Supporting structures of maxillary arch:
a) Primary stress bearing area: Posterior part of hard palate on either side of
the mid palatine raphe, slopes of the residual alveolar ridge.
b) Secondary stress bearing area: Palatine rugae, crest of alveolar ridge, maxillary
tuberosity.
c) Relief area: Incisive papilla, mid palatine raphe, torus, canine eminence, sharp and
spiny prominence.
9
ANATOMICAL LANDMARKS OF MANDIBULAR EDENTULOUS ARCH
1. Retromylohyoid eminence
2. Pterygomandibular raphe
3. Lingual frenum
4. Buccal frenum
5. Labial frenum
6. Buccal sulcus
7. Lingual sulcus
8. Mylohyoid ridge
9. Retromolar pad
10. Alveolar ridge
11. Labial sulcus
12. Premylohyoid fossa
13. Buccal shelf area
14. Genial tubercles
10
MANDIBULAR ARCH
1) Limiting structures of mandibular arch:
Denture base should include the maximum surface area within the physiological limits of
health and function of tissues and structures that support and surround them.
i. Labial frenum: It contains band of fibrous connective tissues that helps to attach
orbicularis oris.
ii. Labial vestibule: It is the space between labial frenum and buccal frenum on the
labial side of crest of ridge.
iii. Buccal frenum: Buccal frenum connects as a continuous band through modiolus
and corner of mouth to buccal frenum in the maxilla. These fibrous and muscular
tissues pull actively across the denture border, polished surfaces and teeth.
Therefore, denture should extend less in this region and impression must be
functionally trimmed to have maximum seal and yet not displace the denture when
the lip is moved.
iv. Buccal vestibule: It is the space which extends from buccal frenum to distobuccal
corner of the retromolor pad on the buccal side of the ridge..
v. Massetric notch: It is located at the distobuccal area of lower buccal vestibule. It is
formed by the pulling effect of masseter on buccinator muscle.
vi. Retromolar pad: It is a pear shaped pad of tissues at the distal end of lower ridge.
The distal end of mandibular denture is bounded by the anterior border of ramus of
mandible.
vii. Lingual sulcus: It is the space between residual ridge and the tongue extending
from the lingual frenum anteriorly to the retromylohyoid curtain posteriorly. It is
divided into three parts.
a) Premylohyoid area – extends from the lingual frenum to the point where the
mylohyoid ridge begins.
b) Mylohyoid area – Extends from premylohyoid fossa to the distal end of

mylohyoid ridge. The sulcus curls medially from body of mandible.
11
MANDIBULAR STRESS BEARING & RELIEF AREAS
Primary stress bearing area-
Secondary stress bearing area-
Relief area-
12
c) Retromylohyoid area – It extends from the end of mylohyoid ridge to the
retromylohyoid curtain. It is bounded by anterior tonsillar pillar on the lingual side,
retromylohyoid curtain and superior constrictor muscle distally and on the buccal
side it is bounded by the mylohyoid ridge, ramus of mandible and the retromolar
pad.
viii. Lingual frenum: It is the anterior attachment of tongue on the lingual side of crest of
the ridge. It is extremely resistant, active and often wide.
2) Supporting structures of mandibular arch:

a) Primary stress bearing areas : Buccal shelf area.
b) Secondary stress bearing areas: Slopes of alveolar ridge.
c) Relief areas: Prominent mylohyoid ridge, lingual tubercle and crest of alveolar ridge
when it is knife edge.
Buccal shelf area:

It is defined as that part of basal seat located posterior to the buccal frenum and
extending from the crest of lower residual ridge to the external oblique ridge. It extends to
the anterior portion of masseter muscle, swings wide into cheek and nearly at right angle to
biting force, thus providing greater surface for resistance to vertical occlusion forces. The
compact nature of bone plus horizontal supporting surface makes it more suitable primary
stress bearing area. The horizontal direction of buccinator fibres allows the denture to rest
on this part of muscle without damage to the muscle or displacement of the denture.
Posterior palatal seal area:
It is defined as soft tissue along the junction of hard and soft palate on which
pressure within physiological limit of tissue can be applied by the denture to aid in retention
of the denture. The posterior palatal seal area is divided into two separate but confluent
areas based upon anatomical boundaries.
i. Postpalatal seal area extending from one tuberosity to another.
ii. Lateral pterygomaxillary seal area, extending through the pterygomaxillary notch
(hamular notch) anteriorly and laterally.
Posterior palatal seal area lies between the anterior and posterior vibrating lines.
13
The function of posterior palatal seal is to maintain contact with the anterior portion of
soft palate during the functional movements of the stomatognathic system (mastication,
deglutition and phonation), thus aiding retention of denture.
Sign of Teacher
14
EXERCISE - 4 Date:
PRELIMINARY IMPRESSION
Definition of impression in complete denture:- It is a negative likeness of entire denture

bearing, stabilizing, retentive and peripheral limiting area, present in the edentulous mouth
which is recorded by a plastic material which sets or hardens in contact with tissue
surfaces.
I. Principles of impression making:-
a) Broad tissue coverage within physiological limits.
b) Intimate tissue contact.
II. Objectives of impression making:-
a) Retention
b) Stability
c) Support
d) Preservation of tissues
e) Aesthetics
III. Materials:-
a) Impression compound
b) Irreversible hydrocolloid
c) Elastomeric impression material
Sign of Teacher
15
IDEAL MAXILLARY CAST
IDEAL MANDIBULAR CAST
16
EXERCISE - 5 Date:
PREPARATION OF PRIMARY CAST

I. Definition:
It is the positive replica of the impressions made of the upper and lower jaws over
which an impression tray is fabricated.
II. Objectives of study models:
a) Diagnosis and treatment planning.
b) To confirm and correlate intra-oral clinical records.
c) Fabrication of custom tray.
d) As a record for future reference.
III.Material of choice: Dental Plaster
IV. Armamentarium:
a) Stiff rubber bowl b) MacIntosh c) Vibrator d) Paper cutter and tile
e) Straight spatula f) Wax knife
V.Types of technique:
a) Single pour method
b) Pouring the impression surface first and then inverting to form the base.
(Dual, Double Pour)
VI. Steps in fabrication:-
After the impression is removed from the mouth, it should be washed in a gentle stream
of tap water. Remove excess water and pour in mixed plaster.
VII. Requirements of study model:-
a) All the surfaces should be accurate and free of voids or nodules.
b) The surface should be hard, dense and free of any grinding sludge left by the model
trimmer.
c) Model should extend sufficiently to cover all the areas available for tray extension.
d) The sulcus should be complete and not deeper than 3-4mm and protective ledge of
the study model extending out from the sulcus should be approximately 3–4mm wide
and at an angle of 45ºoutward and downward to the long axis of the study model.
e) The side wall of the model should be straight or slightly tapered outside without any
undercuts.
f) The base of the model should not be less than 15 – 16mm from the deepest part of
the model.
g) The tongue space in the mandibular cast should be flat and smooth. However lingual
sulcus must remain intact.
_
Sign of Teacher
17
MAXILLARY SPACER DESIGN
MANDIBULAR SPACER DESIGN
18
EXERCISE - 6 Date:
FABRICATION OF SPECIAL OR CUSTOM TRAYS

A special tray is fabricated to record the final impression. Prior to tray fabrication, sulcus
extension, tray border and spacer outline are marked on the primary cast. Additional relief
is provided if required by adapting extra wax in the required areas.
Armamentarium:
1) Mixing jar
2) Lecron carver and a pair of scissors.
3) Dappen dish
4) Glass slab
5) Petroleum jelly
Material used: Special auto polymerizing acrylic resin impression tray material
Conventional autopolymerising acrylic resin
Thermoplastic resin sheets
Thermoplastic shellac base plate materials.
Methods of fabrication:
a) Autopolymerizing resin impression trays:
i. Sprinkle on method.
ii. Dough method.
b) Vacuum adapted method
c) Shellac method.
a) Autopolymerizing resin impression trays

Autopolymerizing acrylic resins specially modified for trays and conventional
autopolymerizing resin used for repairs and baseplates are the materials frequently used
for impression trays. Resin materials are easy to use, require no special equipment and
when manipulated properly make excellent impression trays. Resin impression trays can be
made thin but reasonably rigid, modified easily by grinding with an acrylic bur, and
smoothened or polished. Properly constructed resin impression trays have sufficient
dimensional stability to make accurate impressions.
19
MAXILLARY SPECIAL / CUSTOM TRAY
MANDIBULAR SPECIAL / CUSTOM TRAY
20
i. Sprinkle on method:
Although the sprinkle on method is commonly used for constructing acrylic resin
trays, it is not the most frequently used method for constructing resin impression trays.
Some tray resin powders are not wetted well with liquid monomer dispensed from an
eyedropper in the sprinkle on method. Factory modifications in the autopolymerising tray
resin formula have made it possible to finger adapt the material easily and rapidly when it is
in dough stage, however if tray resin is unavailable the sprinkle on method with
conventional autopolymerising resin can certainly be used. After drawing the tray and
spacer outline, the spacer is adapted, then a separating medium is applied on the cast. A
tray is then formed by sprinkling resin powder and dispensing monomer over it.
21
ii. Dough method:
The finger adapted dough method is used extensively for making resin impression
trays. Specially modified resin trays materials can be formed into a dough that can be
thinned readily or rolled to the desired thickness and adapted to the cast with finger
pressure. The method is quick and the resultant impression trays fit well and have
acceptable dimensional stability.
Requirements of individualized impression trays:

a) The tray should be rigid but not overly thick.
b) It should retain its shape from its construction till retreival of the final cast..
c) The method of construction should be simple enough and acceptable trays should be
made in minimal amount of time at a reasonable cost.
d) It should be possible to or thin the tray readily with bur, mounted stone scissors or an
arbor band.
e) The tray should be smooth because edges may injure oral tissues.
Sign of Teacher
22
EXERCISE - 7 Date:
FINAL IMPRESSION
Purpose of making final impression is –
1) To record accurate details of denture bearing, supporting and limiting areas with free
flowing material.
2) To establish a positive peripheral seal.
Steps in making final impression –

1) Border molding or peripheral sealing.
2) Making of wash impression.
Materials used for border molding –

1) Low fusing impression compound Type IB
2) Rubber base impression material (heavy body)
Materials used for wash impression –

1) Zinc oxide impression paste
2) Medium or light body rubber base impression material
3) Impression plaster
4) Mouth temperature impression waxes.
Border molding –
It is the process by which the shape of the border of the tray is made to conform accurately
to the contours of buccal and lingual vestibules.
Border molding is carried out to achieve peripheral or border seal.
Methods of recording posterior palatal seal –

1) Conventional
2) Fluid wax technique
3) Arbitrary scraping of master/final cast.
23
Boxing and beading of an impression
The enclosure of an impression by building up vertical walls to produce desired size,
form and base of cast and also to preserve desired details of an impression.
Purpose of boxing and beading

1) To preserve the extensions
2) To preserve the thickness of border of impression
3) To establish form and thickness of base of the cast
4) To facilitate placement of remounting plates in the cast
5) Conserve dental stone.
Sign of Teacher
24
EXERCISE - 8 Date:
FABRICATION OF TEMPORARY
DENTURE BASE
Definition:-
A temporary form representing the denture base that is used as a temporary record
base for registering maxillomandibular relationship and arranging artificial teeth for trial
placement in the patient’s mouth.
Function:-
1) Used to record jaw relationship
2) To arrange and articulate artificial teeth in wax for the try in stage
3) To check accuracy of final impression made
Requirements:-
1) It should adapt accurately to the denture base area
2) The border of denture base should be same as that of final denture
3) It should be sufficiently rigid
4) It should be dimensionally stable
5) Fabrication should be easy and economical
6) Procedure should not damage the cast
7) Removal of the base should be easy during dewaxing procedure
Materials used for temporary denture base

1) Self cure or autopolymerising acrylic resin
2) Shellac base plate
3) Light cure resin
4) Vacuum formed sheets
Methods of fabrication of temporary denture base with different materials:-

1) Sprinkle on method
2) Dough method
3) Warm confined method
4) Vacuum adapted method
5) Heat cured compression moulding method
The most commonly used method is shellac base plate by warm confined method.
25
Armamentarium:-
1) Shellac base plates
2) Sharp scissors
3) Wax spatula
4) Files
a) Straight
b) Rat tail
5) Spirit lamp or Bunsen burner.
Procedure for fabrication of temporary denture base by using shellac base plate:-
1) Apply French chalk to the master cast, so that the shellac does not stick to the cast.
In case of any undercuts, block them with pumice plaster mix or tin foil.
2) Base plates are available separately for maxillary and mandibular arches.
3) Choose the correct base plate and soften it by dry heat (flame).
4) Adapt the softened base plate to the cast uniformly. There should not be any folds,
wrinkles or voids during adaptation.
5) Cut the excess base plate along the border of ledge of cast.
6) Fold the borders of the base plate upwards from the sulcus outline to form rounded
borders except at the posterior palatal seal area of maxillary cast and the retromolar
pad area of mandibular cast where shellac base plate is trimmed with half round file.
7) Place the base plates on the respective casts and allow it to cool to minimize
warpage.
Sign of Teacher
26
EXERCISE - 9 Date:
FABRICATION OF RECORD RIMS

Purpose of record rims:
1) To record maxillomandibular relationship and to transfer it on the articulator.
2) To establish the occlusal plane.
3) To establish the anterior esthetic plane.
4) To mark the canine line, midline and high lip line.
5) To contour the desired amount of lip support.
Armamentarium:-
1) Mackintosh sheet
2) Straight spatula
3) Wax knife
4) Wax spatula
5) Paper cutter
6) Glass slab
7) Spirit lamp
8) Bowl of water
9) Wax sheet
Maxillary record rim:

1) The shape of the maxillary rim should follow the arch form.
2) It should be 10mm in height in the anterior incisor region and 8mm in molar region.
3) The width of the rim in the incisal region is 5-6 mm and in molar region 8- 10mm.
4) The extent of the wax rim should be upto beginning of maxillary tuberosity and never
beyond it.
5) In the anterior region, the rim should have labial inclination resembling that of
incisor.
6) The anterior curvature of the rim should follow the curvature of the arch up to the
canine and then from the premolar to the molar region it should be straight and
exactly above the crest of the ridge (The central axis of the rim should coincide with
the crest).
7) The occlusal plane should be sloping uniformly anteroposteriorly.
27
MAXILLARY RECORD RIM (SIDE VIEW)
A = 10-12 mm
B = 20-22 mm
MANDIBULAR RECORD RIM (SIDE VIEW)
A = 10-12 mm
B = 20-22 mm
28
MAXILLARY RECORD RIM (OCCLUSAL VIEW)
A = 4-6 mm
B = 8-10 mm
F = 3-6 mm
MANDIBULAR RECORD RIM (OCCLUSAL VIEW)
A = 4-6 mm
B = 8-10 mm
F = 3-6 mm
29
Mandibular record rim:
1) The shape of the rim should follow the arch form.
2) For pre-clinical purpose, the posterior height is maintained up to 2/3rd of height of

retromolar pad.
3) The width should be 6mm anteriorly up to the canine and 8mm posteriorly.
4) The central axis of record rim should coincide posteriorly with the crest of
mandibular ridge and passing through the bisecting line of retromolar pad.
Procedure for fabrication of record rims:

1) Warm 3/4th of sheet of modelling wax over the Bunsen burner and roll the wax by
folding the sheet. Avoid entrapment of air bubbles.
2) Adapt the roll of wax over the temporary denture base according to the arch form.
3) Seal the wax to the denture base
4) Contour and adjust the dimensions of record rims with the help of plaster spatula,
wax knife and wax spatula.
5) Smoothen and polish the record rims
6) Record rims should be well contoured and polished for recording jaw relation.
Sign of Teacher
30
EXERCISE - 10 Date:
JAW RELATION
There are three types of jaw relation:-
1) Orientation relation:-
It establishes reference in the cranium.
2) Vertical relation:-
It establishes the amount of jaw separation.
3) Horizontal relation:-
It establishes the antero – posterior and side to side relation.
1) Orientation relation:
Definition The relationship of mandible to maxilla (cranium) when the mandible is in
its posterior most position from where it can rotate in a sagittal plane around an
imaginary axis (terminal hinge axis) which passes through or near the centre of
condyles.
The axis can be located with the help of face bow. There are 2 types of facebows
i. Arbitrary
ii. Kinematic
V. Vertical relation:
Definition
It is expressed as the amount of separation of maxilla and mandible under specified
condition.
They are I) Vertical dimension at rest II) Vertical dimension at occlusion.
3) Horizontal relation:
They are of 2 types:-
i. Centric relation
ii. Eccentric relation
Centric relation:
The maxillomandibular relation in which condyles articulate with the thinnest
avascular portion of their respective articular discs with the entire complex in the
antero – superior position against the shape of the articular eminences.
This portion is clinically discernible when the mandible is directed superiorly and
anteriorly. It is restricted to a purely rotatory movement around the transverse,
horizontal axis.
Sign of Teacher
31
JAW RELATION RECORD
32
EXERCISE - 11 Date:
TRANSFER OF JAW RELATION TO THE

ARTICULATOR
The ultimate success of a complete denture depends on accurate jaw relation and
the transfer of record to a suitable articulator.
Definition of an articulator:
It is a mechanical device on which the maxillary and mandibular cast may be
attached representing the temporomandibular joint and jaw members in order to simulate
jaw movements.
Articulators are used to hold the cast in one or more positions in relation to one
another for the purpose of diagnosis, arrangement of artificial teeth and development of
occlusal surfaces of a fixed restoration.
Mounting:
It is the laboratory procedure of attaching the maxillary and mandibular cast to the
articulator.
Requirements of mounting:
1) Mounting medium (dental plaster) should have sufficient working time and should set
with minimal dimensional changes and should acquire good strength.
2) The plaster should separate cleanly.
3) Mounting should provide reattachment after processing the denture.
4) It must not damage the cast or articulator.
Armamentarium:-
1) Three point articulator/ Mean value articulator
2) 2 rubber bowls
3) Straight spatula
4) Wax knife
5) Paper cutter
6) Cotton
7) Mackintosh sheet
33
TRANSFER OF JAW RELATION TO MEAN VALUE ARTICULATOR (CLASS-I)
34
MOUNTING FOR CLASS- II JAW RELATION
35
MOUNTING FOR CLASS- III JAW RELATION
36
Procedure for mounting:
1) Prepare the index of orientation grooves (V or Δ shape). Anteriorly in the midline
region and posteriorly in the tuberosity region (for the maxillary cast) and retromolar
pad region (for the mandibular cast).
2) Place the recorded maxillary – mandibular relation on the cast and seal it.
3) A thread is attached to the centre of articulator. The superior surface of vertical
incisal pin must always flush with the upper member of the articulator.
4) Place an appropriate mounting medium (clay or wax buttons) to provide support
during mounting. The casts can be raised or lowered to adjust the orientation of the
occlusal plane with the help of the thread attached to the centre support.
5) The incisal pointer should be aligned at the point of intersection of the midline and
the anterior incisal plane.
37
1) Place the casts 2mm away from the pointer. The vertical center pin should touch
the incisal table when the articulator is closed.
2) Open the articulator and apply separating medium (petroleum jelly) to the base of
maxillary cast.
3) Mix the mounting material and place it on the maxillary cast.
4) Close the articulator until the incisal pin (centre pin) touches the incisal guide
table.
5) Fill the voids with the mounting material and contour and finish maxillary cast
mounting.
6) After the plaster has set, invert the articulator and mount the mandibular cast in a
similar way.
7) Clean the articulator and polish the mounting. Transfer the midline and canine
line on the mounting with copying pencil.
Sign of Teacher
38
EXERCISE - 12 Date:
SELECTION OF TEETH FOR A

COMPLETELY EDENTULOUS PATIENT
The knowledge and understanding of a number of physical and biological factors
directly related to the patient are required to approximately select the artificial teeth in
complete dentures in order to restore esthetics and function. Teeth selection is divided
into:-
I. Selection of anterior teeth
II. Selection of posterior teeth
Anterior teeth selection:

Method
Patient’s pre-extraction records:
a) Diagnostic cast of patient’s natural or restored teeth prior to extraction of
remaining teeth.
b) Recent photographs before loss of teeth.
c) Radiographic measurements of teeth.
d) Use of facial photographs and radiographs for selecting the anterior teeth and
determining their placement to achieve desired facial support.
Post extraction records:

a) Previous denture (if any)
b) Patient’s evaluation as per the ‘SPA’ factor (Dentogenic concept). The SPA
factor is a useful guideline for selecting anterior teeth by considering the sex
(male / female), personality and age of patient.
c) William’s theory of matching teeth according to the face form (square, tapering
or ovoid).
d) Measurement of the bizygomatic width and dividing it by 16 to arrive at an
estimate of the mesiodistal width of the maxillary central incisor.
e) Marking the corners of the mouth (canine line) on the wax rim will give the
approximate width of the 6 maxillary anterior teeth.
39
Selection of posterior teeth:
Posterior teeth should be selected according to the colour, bucco-lingual width,
mesiodistal width and cuspal inclination.
1) Bucco-lingual width – Buccolingual width of the posterior teeth should be
comparatively lesser than the width of the natural teeth. This is done in order to
reduce the stresses induced during occlusal load and to maintain the stability of the
denture.
2) Mesiodistal width – Mesiodistal width of posterior teeth should be selected in such

a manner so as to accommodate the teeth anterior to the maxillary tuberosity in the
maxillary arch and the anterior border of retromolar pad in the mandibular arch. A
line is marked on the crest of the mandibular ridge from distal end of canine to
center of retromolar pad area which dictates the dimension of posterior teeth.
3) Types of posterior teeth according to cuspal inclination:

Anatomic teeth-33º
Semi-anatomic teeth-20º
Non-anatomic teeth -0º
Selecting the cuspal inclination of posterior teeth is dependent on the concept,
philosophy and scheme of occlusion planned for the individual patient.
Sign of Teacher
40
EXERCISE - 13 Date:
ARRANGEMENT AND ARTICULATION

OF TEETH
CLASS I TEETH ARRANGEMENT:-
Placement and positioning of anterior teeth
i. Maxillary anterior teeth:
a) Occlusal plane:
 Central incisor is at an inclination, slightly offset with the incisal edge touching the
plane.
 Lateral incisor is set with a more eccentuated slope than that of a central incisor.
The incisal edge is 0.5mm above the occlusal plane.
 Canine is placed with its neck more prominent and the central axis perpendicular
to the occlusal plane with the canine tip touching the occlusal plane.
b) Sagittal plane:
The desired angulations of teeth in sagittal plane can be correlated to the form of
the arch and shape of the teeth which may be square or ovoid arranged to the same
angulation while the tapering form arranged at a slightly greater angulation.
The maxillary anterior teeth should follow the arch form. The distal half of maxillary
canine should not be visible when viewed from the frontal aspect.
ii. Mandibular anterior teeth:
From the frontal view, the arrangement is a horizontal alignment of incisal edges of
mandibular anterior teeth.
a) Long axis of canine should be still more distally inclined at its neck. The
mandibular anterior teeth should follow the anterior curve of the mandibular arch.
b) Long axis of mandibular central incisor should be perpendicular to the occlusal
plane. Long axis of lateral incisor should be slightly distally inclined at its neck.
The sequence of arrangement of anterior teeth should be central incisor, lateral
incisor and canine. At one side of the arch and then proceed with the other side. A
uniform overjet (horizontal overlap) and a uniform overbite (vertical overlap) should
be 2mm each.
Surveying the mandibular cast to aid and determine the position of posterior teeth
with the pencil, mark the crest of mandibular ridge from center of the retromolar pad
to the tip of the canine line. This line serves as an aid to align and position maxillary
posterior teeth. The mesiopalatal cusps of maxillary molars should follow this line.
41
ARRANGEMENT OF MAXILLARY ANTERIOR TEETH
FRONTAL VIEW
INCISAL VIEW
ARRANGEMENT OF MANDIBULAR ANTERIOR TETH
FRONTAL VIEW
INCISAL VIEW
42
ARRANGEMENT OF MAXILLARY POSTERIOR TEETH
C. Arrangement of maxillary posterior teeth:
a) Place the maxillary 1st premolar with its long axis perpendicular to the plane and
its buccal cusps touching the occlusal plane.
b) Place the maxillary 2nd premolar in the same manner but with both its buccal and
palatal cusps touching the occlusal plane.
c) The mesiopalatal cusp of maxillary 1st molar should touch the occlusal plane and
the distobuccal cusp should be 0.5 – 0.7mm above the occlusal plane.
d) Raise all the cusps of maxillary 2nd molar following the curvature of the 1st molar.
Mesiobuccal cusp should be 1mm above the occlusal plane.
43
FRONTAL VIEW OF ARTICULATION (CLASS-I)
BUCCAL VIEW OF ARTICULATION (CLASS-I)
44
ARTICULATION OF MANDIBULAR POSTERIOR TEETH
Articulation of mandibular posterior teeth:

The sequence of arrangement of mandibular posterior teeth is mandibular 1st molar,
2nd molar, 2nd premolar and 1st premolar.
With the articulator open, remove the wax posterior to the canine and position the
mandibular 1st molar in a way so as to articulate-
a) Mesiobuccal cusp of maxillary 1st molar coinciding with buccal grove of the
mandibular 1st molar.
b) Mesiopalatal cusp of maxillary 1st molar to articulate in the central fossa of mandiblar
1st molar.
c) The mandibular 2nd molar is arranged in the similar manner.
d) While arranging 2nd premolar, its buccal cusp should rest between the maxillary 1st
and 2nd premolar.
e) The mandibular 1st premolar is arranged is such a way that its buccal cusp rest
between maxillary canine and maxillary 1st premolar. Maximum intercuspation
should be achieved after the teeth arrangement is complete. Care should be taken
to coincide the midline and not to alter the occlusal plane.
CLASS II TEETH ARRANGEMENT

In class II ridge relationship, there is a skeletal disproportion between the maxilla
and the mandible either due to retrognathic mandible, prognathic maxilla or a combination
of both. There is an increased overjet when the anterior teeth are arranged in the usual
manner, while in some cases, the overjet is not altered. In other cases, the lower anteriors
are flared out in a fan shaped manner to decrease the overjet.
In the fan shaped lower anterior teeth setting, mandibular lateral incisors are set
1mm below the mandibular central incisor and mandibular canine is set 1mm below the
lateral incisor.
Care should be taken that there is no dip in the occlusal plane at the canine
premolar junction and the occlusal plane should smoothly curve up to join them.
In order to achieve class I molar relationship during the mandibular posterior teeth
arrangement, the mandibular 1st premolar is omitted.
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ARRANGEMENT OF ZERO DEGREE POSTERIOR TEETH
Zero degree posterior teeth are used for a flat occlusal form. It is possible to set the
flat teeth to a curve or to a flat plane.
Setting of teeth to a flat plane:
Set the maxillary teeth so that their centers lie approximately over the line marked
over the mandibular wax rims corresponding to the crest of the ridge. All the teeth should
touch a flat surface and correspond to the occlusal plane of the mounted wax rims.
Set the mandibular teeth to occlude flatly with the maxillary teeth. If the upper and
lower space available for setting teeth anteroposteriorly is mismatched, it is possible to set
the premolar to oppose molars since there is no interdigitation of cusps. Modify the canine
by giving a blunt incisal edge to get optimal contacts with the premolar.
Sign of Teacher
46
EXERCISE - 14 Date:
TRY–IN OF WAXED
DENTURE (TRIAL)
Try in of waxed denture is done to evaluate:-
I. Esthetics
II. Phonetics
III. Occlusion
I. Esthetics:
Check for –
1) Midline harmony – facial midline to coincide with dental midline.
2) Low lip line
3) Smile line
4) Canine line and canine prominence
5) Occlusal plane and visibility of anterior teeth
6) Shape, size and color of teeth
47
II. Phonetics:
Check for –
Clarity of speech, dentolabial sounds like ‘F’ and ‘V’, sibilant sounds and Silverman’s
closest speaking space (when the patient pronounces words containing ‘s’).
III. Occlusion:
Check for –
a) Vertical relation
b) Freeway space
c) Centric relation and centric occlusion
Check for overall comfort and appearance of the patient and take the patient’s consent for
acceptance of the trial dentures.
Sign of Teacher
48
EXERCISE - 15 Date:
PROCESSING OF COMPLETE DENTURE

A.WAXING AND CARVING
Waxing and carving is defined as the contouring of the wax pattern of the denture
base for the trial dentures in the desired form.
Wax – up of the denture:-
1) Adapt a softened roll of modeling wax on the trial denture base and contour it to a
desired thickness.
2) Contour the necks of the teeth by adding small pieces of melted wax with the help of
a wax spatula.
3) Produce fullness or a gingival bulge simulating the attached gingiva on the necks of
the anterior teeth.
4) In the canine region, produce the canine eminence which should blend with the
peripheral border without producing additional thickness of the border.
5) Develop a slight root prominence over the maxillary central incisor and lateral incisor
following the contour of the imaginary roots (it should not be as prominent as the
canine eminence).
6) Carve a slight depression above the premolars extending from the canine eminence
following the canine fossa to give a normal facial appearance.
7) Seal the wax around the necks of the teeth and curve with the help of a sharp carver
or the pointed end of a wax spatula to achieve the desired amount of tooth structure.
8) Give a stippled appearance (orange peel) for the attached gingiva with the bristles of
a tooth brush.
9) Seal the wax of the palatal and lingual surfaces.
10) The trial denture base should be polished until it presents a smooth shiny surface.
11)Before flasking, the denture bases are sealed to their respective master casts with a
thin strip of modeling wax, softened and adapted all along the periphery of the trial
denture border.
B.FLASKING
Definition:It is the act of investing a wax pattern or a wax trial denture along with the cast
in a flask.
Armamentarium:-
1) Maxillary & Mandibular Universal Flasks
2) Rubber bowls
3) Plaster spatula
49
4) Petroleum jelly
Steps in flasking:
1) Seal the waxed up denture to the cast with a thin strip of modeling wax. Care should
be taken to completely seal the peripheral border and not to overflow the wax on the
cast border.
2) Select the flask that fits accurately and lubricate with Vaseline to facilitate cleaning
after processing of the denture.
3) Demount the cast with sealed dentures from the articulator and paint the cast with
separating medium.
4) Place the waxed up denture along with the cast in the flask to check the level of the
denture teeth in relation to the rim of the flask.
5) Soak the cast in a clean slurry for a few minutes. This prevents water absorption
from the investment plaster.
6) Mix dental plaster and pour the mix in the base flask. Settle the waxed denture with
the cast into the mix. The cast is adjusted in the centre keeping the occlusal plane
approximately parallel to the base of the flask.
7) Smoothen the plaster all along the borders of the cast and remove the undercuts
that would prevent the separation of the flask during dewaxing.
8) Place counter flask over base flask and check that no plaster remains on the rims of
the flasks which would prevent their close approximation. Allow the plaster in the
base flask to set.
9) Apply separating medium (Vaseline) on the plaster in the base flask taking care not
to apply vaseline on the waxed denture and teeth.
10) Place the counter flask in position and pour relatively thin consistency of plaster mix
till the rim and then place the lid.
11) Place the flask under a bench clamp and allow it to set.
C.DEWAXING (WAX ELIMINATION)

1) Place the flasks in boiling water for approx. 5 minutes. Remove the flasks and try to
separate the base flask from the counter flask by wedging a plaster knife in between
the two rims of the flasks.
2) Discard the softened wax and temporary denture base.
3) Check that no denture teeth have been dislodged while opening the flasks.
50
4) Place the flasks under flowing boiling water (containing a detergent) so that the
water flows over the surfaces of the teeth and the cast to eliminate all traces of wax.
5) Place the flasks aside in an upright position to cool to allow drainage of water.
6) Paint separating medium (cold mold seal) with a paint brush on the plaster and the
cast surfaces except the teeth surfaces and allow it to dry. This is followed by
packing.
D.PACKING
Armamentarium:-
1) Mixing jar
2) Lid to cover
3) Clean wax knife
4) Lecron carver
5) Cellophane paper
6) Heat cure denture base resin
7) Dappen dish and vaseline
8) Flasks and clamps
9) Mackintosh sheet.
i. Proportionate quantity of required heat cured acrylic resin polymer and monomer are
taken and mixed in a clean mixing jar with a stainless steel spatula or a wax knife.
ii. The jar is covered with a lid and placed aside till the resin just reaches the dough
stage. When it reaches this stage it is removed and molded into a roll and adapted
into the counter flask. Application of vaseline to the hands is necessary to prevent
the material from sticking to the fingers.
iii. Moistened cellophane paper is placed over the resin and the two parts of the flask
are closed in position. It is then closely compressed under a bench clamp to permit
flow of the resin into minute interfaces of the mold. The excess resin called flash is
cut away. This procedure is trial closure.
iv. Open the flasks and remove the cellophane paper. Repaint the cast portion with
separating medium. Prolonged exposure of the resin to the atmosphere should be
avoided to prevent porosities.
v. The flasks are assembled again and placed under a bench clamp for 24hrs. This is
called ‘bench curing’.
vi. Later the flask is placed in a curing unit and the packed denture is cured according
to the heat curing cycle selected.
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vii. After curing, the flasks are allowed to cool which is called bench cooling. The
denture is now ready for deflasking, finishing and polishing.
E.POLYMERIZATION OR CURING CYCLE

The heating process used to control polymerization is termed as polymerization or
curing cycle.
There are 3 techniques for polymerization:-
1) It involves processing the heat cured denture base resin in a constant temperature
water bath at 74ºC for 8 hours or longer with no terminal boiling treatment.
2) It involves processing the denture base resin in a constant temperature bath at 74ºC
for approximately 2 hrs and then increasing the temperature of the water bath to
100ºC and curing it for 1 hour.
3) It involves processing the denture base resin in a constant temperature water bath at
74ºC for 8 hrs and then increasing the temperature to 100ºC and curing it for 1 hour.
After completion of the polymerization cycle the flask should be cooled slowly till
room temperature is achieved and then removed from the water bath and bench cool it for
another 30 minutes. Only then is the denture deflasked and prepared for denture delivery.
F.DEFLASKING
Steps:-
1) Wedge a plaster knife between two halves of the flask and separate them.
2) Remove the plaster from the palatal or lingual surface of the denture and relieve the
borders.
3) Remove the denture from the sides of the investing plaster by gently tapping sides of
the flask. Do not apply excessive pressure as it might result in cracking of the
denture.
4) Use a tooth brush to clean the index grooves from the base of the cast. This makes
it possible to reposition the cast on the articulator for elimination of the processing
errors by laboratory remount.
Sign of Teacher
52
EXERCISE - 16 Date:
LABORATORY REMOUNT
After the dentures are cleaned along with the cast, they are repositioned on the
articulator and stabilized with sticky wax for the procedure of the laboratory remount.
For correction of occlusal interferences the following points have to be checked.
1) Relationship of the incisal pin with the incisal guide table.
Often the incisal pin is not in contact with the table because of the changes during
processing. Error of 1mm is not significant and can be corrected. Error of more than
1mm requires considerable preparation of the occlusal surfaces of the denture teeth to
regain vertical dimension of occlusion.
2) Check for contact between the retromolar pad area of the mandibular denture and
the tuberosity region of the maxillary denture. Make sure that there is no increase in
the vertical dimension or open bite as a result of thick denture bases in these areas.
53
3) Check the occlusion.
Place an articulating paper between the teeth and gently tap the articulator to
determine the areas of occlusal interferences (detected as dark points). The occlusion is
adjusted by using the rules of selective grinding.
Sign of Teacher
54
EXERCISE - 17 Date:
FINISHING AND POLISHING OF THE

DENTURES
After deflasking the dentures and cleaning the excess investing plaster, the excess
flash along the borders of the denture is trimmed on the lathe wheel (gross finishing). Care
is taken to maintain the rounded borders and not to over trim them.
In the region of the buccal and labial frenum, with a tapered fissure bur (frenum
reliever) the borders are relieved to house the frenum.
Check the impression surface of the denture with the help of the finger to locate
nodules of acrylic resin or any roughened irregularities. Remove them with a small round
acrylic trimmer.
Finish the borders on a mounted hand piece with a flame shaped acrylic trimmer and
alpine stone. Thin out the palatal portion of the maxillary denture if necessary, avoid
forming any grooves or rough surfaces. Trim any irregularities between the interdental
areas with a thin fissure bur to create the desired gingival architecture. Sand paper the
dentures (dry and wet sand papering) till a smooth surface is obtained. Do not alter the
impression surface of the denture.
Steps in polishing of the dentures
1) Make a slurry of fine pumice with water and use copious amount of slurry to polish
the denture at a low speed starting first with a black brush, then a white brush (less
coarse) and finally a wet rag wheel (wet buffing) maintaining the same sequence in
polishing. Move the denture throughout the polishing procedure to avoid formation of
any flat surfaces.
2) Wash the denture thoroughly with water. Dry it completely and examine for any
scratches or roughened areas. Polish again if required. Also polish the areas
between the denture teeth with a bristle brush and slurry if required.
3) Final polish of the denture is done with a dry buff and dry pumice power to obtain a
mirror like polish called the Beilby’s layer.
4) The denture is now ready to be delivered to the patient.
Sign of Teacher
55
REPAIR OF MAXILLARY DENTURE
PIECES OF FRACTURED DENTURE ASSEMBLED DENTURE
PIECES HELD TOGETHER

BY STICKY WAX
PARTS TO BE REPAIRED FINISHED DENTURE

ARE BEVELLED
56
EXERCISE - 18 Date:
REPAIR OF COMPLETE DENTURES
I. Repairing denture with fractured teeth:

Steps:
1) Remove the fractured tooth by grinding with a round bur. Do not grind the
labiolingual margins.
2) Remove the denture base resin from the lingual surface adjacent to tooth to
be removed. Do not perforate the base.
3) Select a tooth of approximately same size, mold and shade and grind the
tooth to facilitate the correct positioning on the denture. Sticky wax is used to
secure it in position.
4) Pour a plaster index on the labial surface of the tooth to be replaced and
adjacent teeth.
5) After the plaster sets, separate the index and the tooth from the denture and
remove all traces of sticky wax.
6) With a round bur make shallow indentations in the ridge lap area of the
denture tooth to provide additional bonding surface.
7) Replace the index and the tooth on the denture and carefully flow
autopolymerising resin from the lingual or palatal side.
8) Build up the desired contours, cover it with a bowl and allow it to set.
9) Remove the index and then polish the dentures.
10) To replace posterior teeth, the denture has to be mounted on an articulator to

obtain correct occlusion.
57
II. Repairing non-separated fractured denture:
Steps:
1) Gently flex the denture to detect the extent of the fracture.
2) If the fracture is approximating then pour plaster into the denture to form a
repair cast. The cast should extend 10mm to either side of the fractured line.
3) Undercuts in the denture must be blocked with blockout wax or silicone
before pouring the cast. Separate the cast from the denture. Use a round bur
to grind the fracture line from the beginning to the end.
4) Bevel the cut outward to increase the bonding surface.
5) On the palate of the maxillary denture, place a dovetail to strengthen the
repair joint.
6) Paint the cast with separating medium and allow it to dry.
7) Reposition the denture carefully on the cast.
8) Pour autopolymerising resin into the groove avoiding air entrapment.
9) Build the repair resin slightly above the surface of the denture (over
contoured).
10) Allow it to cure under a bowl.
11)Finish and polish the denture.
III. Repair of denture fractured into two or more parts:

Steps:
1) Assemble individual pieces carefully and join them together with sticky wax.
2) Reinforce with orange wood stick and sticky wax. Modeling clay is used
initially to assemble the components.
3) Block the undercuts and pour a cast. Make grooves and dovetail on the
fractured pieces.
4) Paint separating medium on the cast.
5) Repair with autopolymerising resin and allow to cure.
6) Remove, finish and polish the denture.
58
REPAIR OF MANDIBULAR DENTURE
MIDLINE FRACTURE OF ASSEMBLED DENTURE

MANDIBULAR DENTURE
PIECES HELD TOGETHER BY

STICKY WAX
PARTS TO BE REPAIRED FINISHED DENTURE

ARE BEVELLED
59
IV. Repairing denture parts which are lost:
Steps:
1) If a part is lost after preliminary repair of existing fractured part, an impression
is made with denture placed in the patient’s mouth.
2) Later, the lost part is built with autopolymerising resin.
3) In case of repairs in posterior palatal seal (PPS) area, the PPS area is
developed with mouth temperature waxes or low fusing impression
compound.
4) Pour a cast in dental stone into denture with added PPS.
5) Extend 4-6mm beyond it posteriorly.
6) Allow stone to set.
7) Remove the denture and place in warm water to soften the compound on
wax.
8) Add self cure resin to the cast and paint additional resin on the denture in
PPS region.
9) Place the denture on the cast and hold with firm finger pressure. Squeeze out
excess resin posteriorly.
10) Allow it to cure.
11) Remove, finish and polish the denture.
Sign of Teacher
60
REMOVABLE
PARTIAL
DENTURE
61
62
EXERCISE - 1 Date -
SEQUENTIAL STEPS IN THE FABRICATION

OF REMOVABLE PARTIAL DENTURE
Sr. Clinical /
Step
No. Laboratory
Case history, Clinical Examination, Diagnosis and Treatment
1 Clinical
planning.
2 Laboratory Preparation of diagnostic cast.
3 Laboratory Surveying the diagnostic cast.
4 Laboratory Designing of cast partial denture.
5 Clinical Mouth preparation.
6 Clinical Final impression.
7 Laboratory Impression pouring, retrieval and preparation of final cast

8 Laboratory Surveying of master cast.
9 Laboratory Block out of master cast.
10 Laboratory Duplication of master cast.
11 Laboratory Preparation of refractory cast.
12 Laboratory Adaptation of wax pattern according to design specification.
Spruing, investing and casting of wax pattern of cast partial
13 Laboratory
denture.
14 Laboratory Fitting of cast partial denture framework to the master cast.
Finishing of cast partial denture framework on the master
15 Laboratory
cast.
16 Clinical Trial of cast partial denture framework in mouth.
17 Clinical Functional impression of distal extension (if required).

18 Laboratory Fabrication of altered cast.
19 Clinical Jaw relation records.
20 Laboratory Transfer of jaw relation to an articulator.

21 Laboratory Arrangement of artificial teeth.
22 Clinical Try in of waxed up partial denture.
23 Laboratory Processing of denture.

24 Laboratory Laboratory remount.
25 Clinical Denture insertion and post insertion instruction.
26 Clinical Patient recall
63
64
EXERCISE - 2 Date:
INTRODUCTION TO REMOVABLE PARTIAL DENTURE

Removable prosthodontics:
The branch of prosthodontics concerned with the replacement of teeth and
contiguous structures for edentulous or partially edentulous patients by artificial substitutes
that are readily removable from the mouth.
Removable partial denture:

Definition-
Any prosthesis that replaces teeth in partially edentulous arch.
It can be removed from the mouth and replaced by the patient.
Types of Partial Denture:
(A) Tooth supported
Tooth-tissue supported
(B) Immediate
Interim
Transitional
Treatment
Definitive
Components of removable cast partial denture:

1) Major connector
2) Minor connector
3) Rest
4) Direct retainer
5) Indirect retainer
6) Denture base
7) Teeth
Sign of Teacher
65
KENNEDY’S CLASS I
KENNEDY’S CLASS II
KENNEDY’S CLASS III
KENNEDY’S CLASS IV
66
EXERCISE - 3 Date:
CLASSIFICATION OF PARTIALLY
EDENTULOUS ARCHES
The classification of partially edentulous arches should –

1) Allow immediate visualization of the type of partially edentulous arch being
considered.
2) Permit differentiation between tooth-supported and tooth-tissue supported
removable partial dentures.
3) Serve as a guide to the type of design to be used.
4) Be universally acceptable.
A number of classification systems have been proposed but few have satisfied these
criteria. The most commonly used and universally accepted method of classifying
edentulous arches is Kennedy’s classification. Dr. Edward Kennedy proposed this
classification in 1925.
Kennedy’s Classification :
Class I: Bilateral edentulous areas located posterior to the remaining natural teeth.
Class II: A unilateral edentulous area located posterior to the remaining natural teeth.
Class III: A unilateral edentulous area with natural teeth remaining both anterior and
posterior to it.
Class IV: A single but bilateral (crossing the midline) edentulous area located anterior to the
remaining natural teeth.
67
APPLEGATE’S RULES FOR APPLYING
KENNEDY’S CLASSIFICATION
Rule 1:
Classification should follow rather than precede any extractions of teeth that might alter the
original classification.
Rule 2:
If a third molar is missing and is not to be replaced it is not considered in the classification.
Rule 3:
If a third molar is present and is to be used as an abutment, it is considered in the
classification.
Rule 4:
If a second molar is missing and is not to be replaced it is not considered in the
classification.
Rule 5:
The posterior most edentulous area or areas always determine the classification.
Rule 6:
Edentulous areas other than those determining the classification are referred to as
modifications and are designated by their number.
Rule 7:
The extent of modification is not considered, only the numbers of additional edentulous
areas are to be considered.
Rule 8:
There can be no modification areas in Class IV arches.
Sign of Teacher
68
EXERCISE - 4 Date:
MAJOR CONNECTOR
Definition:
A major connector is the unit of the partial denture that connects the parts of
prosthesis located on one side of the arch with those on the other side.
Requirements:
i. Should be made from an alloy compatible with oral tissues.
ii. Should be rigid and employ the principle of broad stress distribution.
iii. Should not interfere with or irritate the tongue.
iv. Should not substantially alter the natural contour of the lingual surface of the
mandibular alveolar ridge or of the palatal vault.
v. Should not impinge on oral tissues when the restoration is placed, removed or
rotates in function.
vi. Should not cover more tissues than is absolutely necessary.
vii. Should not contribute to retention or trapping of food particles.
viii. Should obtain support from other elements of the framework to minimize rotational
tendencies in function.
ix. Should contribute to the support of the prosthesis.
MANDIBULAR MAJOR CONNECTORS:

1) Lingual bar
2) Lingual bar with continuous bar retainer
3) Linguoplate
4) Labial bar
MAXILLARY MAJOR CONNECTORS:

1) Single posterior palatal bar.
2) Palatal strap.
3) Antero-posterior strap or Double palatal bar.
4) Horse-shoe or U- shaped parallel major connector.(Palatal strap like connector)
5) Closed horse-shoe or Antero-posterior palatal strap.(Palatal plate type connector)
6) Complete palatal coverage.
Sign of Teacher
69
MANDIBULAR LINGUAL BAR
MANDIBULAR LINGUOPLATE
70
EXERCISE - 5 Date:
MANDIBULAR MAJOR CONNECTORS

I. LINGUAL BAR:
Indication for use:
The lingual bar should be used for mandibular removable partial dentures where
sufficient space exists between the slightly elevated alveololingual sulcus and the lingual
gingival tissues to place a rigid bar.
Characteristics and location:
a) Half pear shaped with bulkiest portion located inferiorly .
b) Superior border tapered towards the soft tissue.
c) Superior border located at least 4mm inferior to gingival margin.
d) Inferior border located at the ascertained height of the alveololingual sulcus when
the patient’s tongue is slightly elevated.
II. MANDIBULAR LINGUOPLATE:
Indication for use:
a) Where the alveololingual sulcus approximates the lingual gingival crevices so closely
that adequate width for a rigid lingual bar does not exist.
b) In instances where the residual ridge in Class I arch has undergone such vertical
resorption that the ridge will offer only minimal resistance to horizontal rotations of
the denture base.
c) For using periodontally weakened teeth in ‘group’ function to furnish support to the
prosthesis and to help resisting horizontal rotation of distal extension type denture.
d) When the future replacement of one or more incisor teeth will be facilitated by the
addition of retention loops to an existing linguoplate.
a) Half pear shaped with bulkiest portion located inferiorly.
b) Thin metal apron extending superiorly to contact cingula of anterior teeth and lingual
surfaces of involved posterior teeth at their height of contour.
c) Apron extended interproximally to height of contact points, that is, closing
interproximal spaces.
d) Scalloped contour of apron as dictated by interproximal block out.
e) Superior border finished to continuous plane with contacted teeth.
f) Inferior border at the ascertained height of the alveololingual sulcus when the
patient’s tongue is slightly elevated.
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DOUBLE LINGUAL BAR
MANDIBULAR LABIAL BAR
72
I.DOUBLE LINGUAL BAR OR KENNEDY BAR OR LINGUAL BAR WITH CONTINUOUS
BAR RETAINER:
Indications for use:
a) When a linguoplate is otherwise indicated but the axial alignment of anterior teeth is
such that excessive blocking of interproximal undercuts would be required.
b) When wide diastemata exist between mandibular anterior teeth and a linguoplate it
would objectionably display metal in frontal view.
Characteristics and locations:
a) Conventionally shaped and located same as lingual bar major connector component
when possible.
b) Thin narrow (3mm) metal strap located on cingula of anterior teeth scalloped to
follow interproximal embrasures with inferior and superior borders tapered to tooth
surfaces.
c) Originates bilaterally from incisal, lingual or occlusal rests of adjacent principal
abutments.
III. MANDIBULAR LABIAL BAR:
a) When lingual inclinations of remaining mandibular premolar and incisor teeth cannot
be corrected, preventing the placement of a conventional lingual bar connector.
b) When severe lingual tori cannot be removed and prevent the use of a lingual bar or
lingual plate major connector.
c) When severe and abrupt lingual tissue undercuts make it impractical to use a lingual
bar connector or lingual plate major connector.
a) Half pear shaped with bulkiest portion located inferiorly on the labial and buccal
aspects of the mandible.
b) Superior border of connector located at least 4mm inferior to labial and buccal
gingival margin and more if possible.
c) Superior border tapered towards soft tissue.
d) Inferior border located in the labial and buccal vestibules at the junction of non
mobile and mobile mucosa.
Sign of Teacher
73
STEP-1 STEP -2
STEP-3 STEP-4
74
EXERCISE - 6 Date:
DESIGNING OF MANDIBULAR MAJOR

CONNECTOR
Step 1:
Outline the basal seat areas on the diagnostic cast.
Step 2:
Outline the inferior border of the major connector.
Step 3:
Outline the superior border of the major connector.
Step 4:
Unification – Connect the basal area to the inferior and the superior borders of the major
connector and add minor connectors to retain the acrylic resin denture base material.
Sign of Teacher
75
SINGLE POSTERIOR PALATAL BAR
PALATAL STRAP
76
EXERCISE - 7 Date:
MAXILLARY MAJOR CONNECTORS

I. Single posterior palatal bar
The single posterior palatal bar is narrow, half oval with its thickest point at the
centre. The bar is gently curved and should not form a sharp angle at the junction with the
denture base.
Advantages:
Although for many years it was one of the most widely used maxillary major
connectors, at present the main and perhaps only indication for the single posterior palatal
bar is as an interim partial denture until more definitive treatment can be rendered.
Disadvantages:
(1) One of the most difficult maxillary major connectors for a patient to adjust to, because to
maintain rigidity it has to be bulky.
(2) If the bar is placed any farther forward than the center of the dental arch, severe
interference with tongue action will be encountered.
(3) The single palatal bar should never be used in a distal extension edentulous situation,
nor should it be used when anterior teeth require replacement.
(4) Because of its narrow antero-posterior width it derives little vertical support from the
bony palate and must therefore be supported positively by rests on remaining areas.
II. Palatal strap:

Bilateral edentulous spaces of short span in a tooth borne restoration.
a) Anatomic replica form.
b) Anterior border follows the valleys between rugae as nearly as possible at right
angles to median suture line.
c) Posterior border at right angle to median suture line.
d) Strap should be 8mm wide or approximately as wide as the combined width of a
maxillary premolar and first molar.
e) Confined within an area bounded by the four principal rests.
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ANTERIOR – POSTERIOR STRAP
COMPLETE PALATAL COVERAGE
78
III. Anterior – posterior strap:
a) Class I and Class II arches in which excellent abutment support and residual ridge
support exists and direct retention can be made adequate without the need for
indirect retention.
b) Long edentulous span Class II with modification areas.
c) Class IV arches in which anterior teeth must be replaced with a removable partial
denture.
d) Inoperable palatal tori that do not extend posteriorly to the junction of the hard and
soft palates.
a) Parallelogram shaped and open in centre portion.
b) Relatively narrow (6-9mm) anterior and posterior palatal straps.
c) Lateral palatal straps 5 – 6mm broad and parallel to curve of arch, minimum of 6mm
away from gingival crevices of remaining teeth.
d) Anterior palatal strap: Anterior border not placed further anteriorly than anterior rests
and never closer than 6mm to lingual gingival crevices, follows the valleys of the
rugae at right angles to the median palatal suture. Posterior border if in rugae area,
follows valleys of rugae at right angles to the median palatal suture.
e) Posterior palatal strap: Posterior border located at junction of hard and soft palates
and at right angles to median palatal suture and extended to hamular notch area(s)
on distal extension side(s).
IV. Complete palatal coverage major connector:-

Indications for use
a) In most situations where only few teeth are remaining.
b) Class I arch with one or four premolar and some or all anterior teeth remaining and
abutment support is poor and cannot otherwise be enhanced, residual ridges have
undergone extreme vertical resorption, direct retention is difficult to obtain.
c) In the absence of a pedunculated torus.
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U – SHAPED PALATAL MAJOR CONNECTOR
CLOSED HORSE-SHOE SHAPED MAJOR CONNECTOR
80
a) Anatomic replica form of palate metal casting supported anteriorly by positive rest
seats.
b) Palatal plate supported anteriorly and designed for the attachment of acrylic resin
extension posteriorly.
c) Contacts all or almost all the teeth remaining in the arch.
d) Posterior border terminates at the junction of the hard and soft palate, extends to
hamular notch area(s) on distal extension side(s) at a right angle to median suture
line.
IV. U – shaped palatal major connector:-

This connector should be used only in those situations where inoperable tori extend
to the posterior limit of the hard palate. The U shaped palatal major connector is the least
favorable design of all palatal major connectors because it lacks the rigidity of other types
of connectors where it must be used. Anterior border areas of this type of connector must
be kept at least 6mm away from adjacent teeth. If for any reason, the anterior border must
contact remaining teeth, the connector must again be supported by rests placed in properly
prepared rest seats. It should never be supported even temporarily by inclined lingual
surfaces of anterior teeth.
V. Closed horse-shoe shaped major connector

a) Class I or Class II arches when anterior teeth are also to be replaced.
b) A torus palatinus is present.

a) The thickness of metal in the strap should be uniform.
b) The borders of the connector should be kept 6mm away from the free gingival
margins or should extend on the lingual surfaces.
c) If the anterior tooth are not being replaced, the anterior strap should be as far back
as the rugae area as possible to minimize interference with speech.
Sign of Teacher
81
STEP-1 STEP -2
STEP-3 STEP -4
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EXERCISE - 8 Date:
DESIGNING OF MAXILLARY MAJOR CONNECTOR

Step 1:
Outline of primary bearing areas
The primary bearing areas are those that will be covered by the denture base(s).
Step 2:
Outline of non – bearing areas
The non – bearing areas are the lingual gingival tissues within 5-6mm of the
remaining teeth, hard areas of the median palatal raphe. (including tori and palatal tissues
posterior to the vibrating line.)
Step 3:
Outline of strap areas
Steps 1 and 2 when completed, provide an outline or designate areas that are
available to place components of major connector.
Step 4:
Selection of bar type
Selection of the type of connecting bar(s) is based on four factors – mouth comfort,
rigidity, location of denture bases and indirect retention. Connecting bars should be of
minimum bulk and so positioned that interference to the tongue during speech and
mastication is not encountered. Connecting bars must have a maximum of rigidity to
distribute stress bilaterally. The double bar type of major connector provides the maximum
of rigidity without bulk and total tissue coverage. In many instances the choice of a strap
type is limited by the location of the edentulous ridge areas. When edentulous areas are
located anteriorly, the use of only a posterior bar is not possible and vice versa. The need
for indirect retention influences the outline of the major connector. Provision must be made
in its essential location so that indirect retainers may be attached.
Step 5:
Unification
After selection of the type of bar(s) based on the considerations in Step 4, the denture base
areas and the connecting bars are joined.
Sign of Teacher
83
TYPES OF MINOR CONNECTOR
LATTICE WORK CONSTRUCTION
MESH CONSTRUCTION
BEAD, WIRE OR NAIL HEAD
84
EXERCISE - 9 Date:
MINOR CONNECTOR
Definition: The connecting link between the major connector or base of a removable
partial denture and the other units of prosthesis such as the clasp assembly, indirect
retainer, occlusal rests or cingulum rests.
Functions of minor connector:

a) To transfer functional stresses to abutment teeth
b) To transfer the effect of retainers, rests and stabilizing components to the rest of the
denture.
c) Unification.
Types of minor connectors:

i. Minor connector joining the clasp assembly to major connector.
ii. Minor connector joining indirect retainer or auxillary rests to major connector.
iii. Minor connector joining the denture base to major connector.
a) Of lattice work construction.
b) Of mesh construction.
c) Bead, wire or nail head minor connector (used with metal denture base).
iv. Minor connector serving as an approach arm for vertical projection of bar type clasp.
Sign of Teacher
85
TYPES OF REST SEAT
OCCLUSAL REST
CINGULUM REST
INCISAL REST
86
EXERCISE - 10 Date:
OCCLUSAL REST AND REST SEAT

Occlusal rest:
A rigid extension of removable partial denture that is placed on the occlusal surface
of a tooth or restoration, the occlusal surface of which may have been prepared to receive
it.
Rest seat:
The prepared recess in a tooth or restoration created to receive the occlusal, incisal
or cingulum rest.
Types of rests:
i. Occlusal rest: It is so named because it is seated on the occlusal surface of
posterior tooth. Occlusal rest may be mesial occlusal rest or distal occlusal rest.
ii. Cingulum rest: Seated on the cingulum of tooth.
iii. Incisal rest: Situated on incisal edge of tooth.
Form of the occlusal rest and rest seat:

i. The outline form of an occlusal rest seat should be rounded triangular in shape with
the apex towards the centre of the occlusal surface.
ii. It should be as long as it is wide and the base of the triangular shape (at the
marginal ridge) should be at least 2.5 mm for both molars and premolars. Rest seats
of smaller dimensions do not provide for an adequate bulk of metal for rests,
especially if the rest is contoured to restore the occlusal morphology of abutment
tooth.
iii. The marginal ridge of abutment tooth at the side of the rest seat must be lowered to
permit a sufficient bulk of metal for strength and rigidity of the rest and minor
connector. This means that a preparation of the marginal ridge of 1.5mm is
necessary.
iv. The floor of occlusal rest seat should be apical to marginal ridge and should be
concave or spoon shaped. Caution should be exercised in preparing a rest seat to
avoid creating sharp edges or line angles in the preparation.
v. The angle formed by the occlusal rest and the vertical minor connector from which it
originates should be less than 90º. Only in this way, can the occlusal forces be
directed along the long axis of abutment tooth. An angle greater than 90º fails to
transmit occlusal forces along the long axis of abutment tooth. It also causes
slippage of the prosthesis away from the abutment.
87
Functions of occlusal rest:
i. Maintains components in their planned position.
ii. Maintains established occlusal relationships by preventing settling of denture.
iii. Prevents impingement of soft tissues.
iv. Directs and distributes occlusal load to abutment teeth.
Sign of Teacher
88
EXERCISE - 11 Date:
DIRECT RETAINERS
Definition:
That component of removable partial denture used to retain and prevent
dislodgement, consisting of cast assembly or precision attachment.
Direct retention:
Retention obtained in removable partial denture by the use of clasp or attachment
that resist removal & displacement of prosthesis from basal seat tissues & from abutment
teeth.
Classification of direct retainers:
Extracoronal Intracoronal
Combination clasp Bar clasp Circumferential clasp

Modification Simple circlet
T clasp Ring clasp
Y clasp Back action clasp
I clasp Embrasure clasp
Half and half clasp
Reverse action clasp
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Components of clasp assembly:
i. Rest provides support for prosthesis.
ii. Body connects rest and clasp arm to the minor connector.
iii. Reciprocal clasp arm must be rigid and lie above the height of contour of the crown.
iv. Retentive clasp arm includes shoulder and retentive terminal.
v. Retentive clasp arm is positioned in the gingival third of crown in measured
undercut.
vi. Minor connector joins body of clasp assembly to the remainder of frame work.
vii. Approach arm is a component of vertical projection clasp. It is a minor connector that
joins body and retentive terminal of clasp to the framework. It is the only minor
connector that is not rigid.
viii. Retentive terminal is a position of vertical projection clasp positioned below the
survey line.
Requirements:
i. Retention
ii. Support
iii. Stability
iv. Reciprocation
v. Encirclement
vi. Passivity
90
COMPONENTS OF CLASP ASSEMBLY
A REST B BODY C RECIPROCAL

CLASP ARM
Rest provides support Body connects the rest It must be rigid and lie
for the prosthesis. of clasp arms to minor above the height of
connectors. contour.
D RETENTIVE CLASP E RETENTIVE F MINOR CONNECTOR
ARM TERMINAL
Distal 1/3rd of retentive

It includes shoulder and Joins body of clasp
retentive terminal clasp is positioned assembly to remainder
below the height of of framework.
contour
G APPROACH ARM H RETENTIVE TERMINAL
It is a component of vertical projection Retentive terminal is that portion of

clasps. It is a minor connector that vertical projection clasp positioned
joins body and retentive terminal of below the survey line.
clasp to the framework.
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Differentiation between circumferential clasp and bar clasp:
Circumferential clasp Bar clasp
i This clasp approaches the This clasp approaches undercut

undercut from occlusal surface. from gingival direction
ii It offers pull type of retention. It offers push type of retention.
iii More encirclement. Less encirclement.
iv Offers excellent stability. Increased flexibility of the retentive

arm decreases the stability.
v Less esthetic. More esthetic.
vi Difficult to adjust but easier to Easy to adjust but difficult to repair.

repair.
Sign of Teacher
92
EXERCISE - 12 Date:
INDIRECT RETAINERS
Definition: The component of removable partial denture that assists the direct retainer(s)
in preventing dislodgement of extension of denture base by functioning through lever action
clasp on the opposite side of fulcrum line when denture base moves away from the tissue
in pure rotation around the fulcrum line..
Definition of fulcrum line :An imaginary line connecting occlusal rest around which a
removable partial denture tends to rotate under masticatory forces. The determinants of
fulcrum line are usually the cross arch occlusal rests located adjacent to tissues.
Auxiliary function:
i. It tends to reduce anteroposterior tilting leverages on the principle abutments.
ii. Contact of its minor connector with axial tooth surface aids in stabilization against
horizontal movements of denture.
iii. Anterior teeth supporting indirect retainer are splinted against lingual movements.
It may provide the first visual indication for the need to reline a distal extension partial
denture.
Factors influencing effectiveness of indirect retainers:
i. Distance from the fulcrum line:
a. Length of distal extension base.
b. Location of fulcrum line
c. The distance of the indirect retainer from the fulcrum line.
ii. Rigidity of connector, support to the indirect retainer. All connectors must be rigid if
the indirect retainer is to function.
iii. Effectiveness of supporting tooth surface. The indirect retainer must be placed on a
definite rest seat where slippage or tooth movements will not occur.
Form of indirect retainers:
i. Auxiliary occlusal rest
ii. Canine extension from occlusal rest
iii. Canine rest
iv. Bar retainer and linguoplate
v. Modification area
vi. Rugae support.
Sign of Teacher
93
ACRYLIC
COMBINATION OF ACRYLIC & METAL
94
EXERCISE - 13 Date:
DENTURE BASES
Definition:
The part of denture that rests on the foundation tissue on which teeth are attached.
Classification:
i. Acrylic
ii. Metallic
iii. Combination
i. Acrylic denture bases:
Advantages Disadvantages
(a) Esthetics. (a) Less thermal conduction.
(b) Light in weight. (b) Difficult to maintain cleanliness.
(c) Easy for relining and rebasing. (c) Requires increased bulk to impart
strength.
(d) Economical.
ii. Metallic denture bases

Advantages Disadvantages
(a) High thermal conduction. (a) Not esthetically accepted.
(b) Dimensional stability, less (b) Difficult to reline and rebase.
distortion.
(c) Easy to fit. (c) Requires mechanical interlocking
with artificial teeth.
(d) Accurate to fit. (d) Expensive.
Sign of Teacher
95
MOVEMENTS OF REMOVABLE CAST PARTIAL DENTURE
96
EXERCISE - 14 Date:
MOVEMENTS OF REMOVABLE
PARTIAL DENTURE
A. Rotation around fulcrum line passing through two principal occlusal rests when
denture base moves towards supporting residual ridge.
B. Rotation around longitudinal axis formed by crest of the residual ridge.
C. Rotation around vertical axis located near centre of the arch.
Sign of Teacher
97
Ney’s Surveyor
98
EXERCISE - 15 Date:
SURVEYOR
Surveyor
A paralleling instrument used in construction of prosthesis to locate and delineate
the contours and relative position of abutment teeth and associated structure.
Surveying:
An analysis and comparison of the prominences of intra-oral contours associated
with the fabrication of prosthesis.
Survey line:
A line produced on a cast by a surveyor, marking the greater prominences of
contour in relation to the planned path of placement.
Types:
i. Ney’s surveyor
ii. Jelenko’s surveyor
Parts:
i. Platform on which the base is moved.
ii. Vertical arm that supports the super structure.
iii. Horizontal arm from which the surveying tool is suspended.
iv. Table to which the cast is attached.
v. Paralleling tools or guideline markers.
vi. Mandrel for holding special tools.
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SURVEYING TOOLS
JELENKO’S CARBON MARKER NEY CARBON MARKER
NEY UNDERCUT GAUGE AN ALYSING ROD
W AX T R I M M E R
J E L E N K O U N D E R C U T G AU G E TAPER TOOL
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Purpose of surveyor:
i. Surveying the diagnostic cast.
a) To determine path of placement and path of removal.
b) Identifying proximal tooth surfaces for guide planes.
c) Locate and measure areas of retention.
d) To determine tooth and bony areas of the interferences to be eliminated.
e) To locate the retainers and artificial teeth for the best esthetic advantage.
f) To do accurate charting of mouth preparation.
g) To delineate the height of contour on abutment teeth.
h) To record cast position related to selected path of placement for future reference.
(tripoding).
ii. Recontouring abutment teeth on diagnostic cast.
iii. Contouring wax pattern.
iv. Measuring a specific depth of undercut.
v. Surveying ceramic veneer crown.
vi. Placing intracoronal retainer.
vii. Placing internal rests.
viii. Placing the cast rest.
ix. Surveying and blocking out the master cast.
101
Path of placement:
The path of placement is a direction in which a restoration moves from the point of
initial contact of its rigid parts with the supporting teeth to its terminal resting position with
rests seated and the denture base in contact with the tissues.
(The path of placement is a specified direction in which prosthesis is placed on
abutment teeth.)
The path of removal is exactly the reverse of path of placement.
Factors that determine path of placement and the removal:
i. Guide planes
ii. Retentive areas
iii. Interferences
iv. Esthetics
Sign of Teacher
102
EXERCISE - 16 Date:
DESIGNING OF REMOVABLE PARTIAL DENTURE

Factors influencing design:
1) Which arch is to be restored and if both, then their relationship to one another
including,
a) Occlusal relationship of remaining teeth.
b) Orientation of occlusal planes.
c) Space available for restoration of missing teeth.
d) Arch integrity.
e) Tooth morphology.
2) Type of major connector indicated.
3) Whether the denture will be tooth borne or tissue borne.
a) Need for indirect retention.
b) Clasp design that will best minimize the forces applied to abutments teeth.
c) Need for rebasing which influences type of base material used.
d) Secondary impression procedure.
4) Material to be used, both for framework and bases.
5) Type of replacement teeth to be used.
6) Need for abutment restoration.
7) Patient’s past experience with removable partial denture and reason for making new
denture.
8) Response of oral structure to previous stress. Periodontal condition, if teeth
remaining and the amount of abutment support.
9) Method to be used for replacing single tooth or missing anterior teeth.
Philosophy of design:
i. Stress equilibration.
ii. Physiologic basing
iii. Broad stress distribution.
Steps in designing:
i) Determining how a removable partial denture is to be supported.
a) Tooth supported b) Tissue supported c) Tooth – tissue supported
ii) Connecting the tooth and tissue support unit by a major and minor connector.
iii) Determining how the denture is to be retained by direct or indirect retention.
iv) Connecting retention units to support units by minor connectors.
v) Outline and join the edentulous area in already established component.
Sign of Teacher
103
104
FIXED
PARTIAL
DENTURE
105
106
EXERCISE - 1 Date:
SEQUENTIAL STEPS IN FABRICATION OF

Sr. Clinical /
Step
No. Laboratory
Case history record and oral examination.
1 Clinical
2 Clinical Investigation, radiographs and study models.

3 Clinical Interocclusal record registration.
4 Laboratory Transferring study model to articulator.

5 Laboratory Formulation of treatment plan.
6 Laboratory Mock preparation and fabrication of provisional restoration.
7 Clinical Impression for special tray fabrication.
8 Clinical Tooth preparation.
9 Clinical Gingival retraction.

10 Clinical Final impression.
11 Clinical Luting of provisional restoration.

Fabrication of final / master cast.
12 Laboratory
13 Laboratory Die preparation.

Fabrication of wax pattern / casting.
14 Laboratory
15 Clinical Metal try in.
16 Clinical Shade selection.
17 Laboratory Fabrication of ceramic restoration.

18 Clinical Bisque try in
19 Laboratory Final glazing.

20 Clinical Luting of final restoration.
21 Clinical Instruction to patient.
22 Laboratory Patient recall.
107
108
EXERCISE - 2 Date:
INTRODUCTION TO FIXED PROSTHODONTICS

Definition:
The branch of prosthodontics concerned with the replacement and / or restoration of
teeth by artificial substitutes that are not readily removed from the mouth.
Fixed partial denture:
A partial denture that is limited or otherwise securely retained to natural teeth, tooth
roots and / or dental implants abutments that furnish the primary support for the prosthesis.
Parts of a fixed partial denture:
i. Retainer
ii. Connector
iii. Pontic
Types of fixed partial denture:
There are four types of basic designs
i. Fixed – fixed bridge – It has a rigid connector at both ends of pontic.
ii. Fixed – movable bridge – It has a rigid connector usually at the distal end of the
pontic and a movable connector that allows some vertical movements of the mesial
abutment teeth.
iii. Cantilever bridge – It provides support for the pontic at one end only.
iv. Spring cantilever bridge – It is recommended for the replacement of upper incisor
only. Only one tooth / pontic is replaced by a spring cantilever bridge.
Sign of Teacher
109
PRINCIPLES OF TOOTH PREPARATION
110
EXERCISE - 3 Date:
PRINCIPLES OF TOOTH PREPARATION

Definition:
Tooth preparation is defined as mechanical treatment of dental diseases or injury to
hard tissues that restore the original tooth form.
Objective of tooth preparation:
i. Preparation of tooth in miniature to provide retainer support.
ii. Preservation of healthy tooth structure to secure resistance form.
iii. Provision of acceptable finish lines.
iv. Performing preparation to encourage favourable tissue responses from artificial
crown contours, fluting of molars.
Principles of tooth preparation:
The principles of tooth preparation may be divided into 3 categories.
i. Biological considerations: Which affects the health of the oral tissues.
ii. Mechanical considerations: Which affects the integrity and durability of restoration.
iii. Aesthetic considerations: Which affects the appearance of the patient.
i. Biological consideration:
A. Prevention of damage during tooth preparation
a) Adjacent teeth
b) Soft tissues
c) Pulp
B. Conservation of tooth structure:
a) Use of partial coverage rather than complete coverage restoration.
b) Preparation of teeth with minimum practical convergence angle (occlusal /
incisal table) between the axial walls (total / combined).
c) Preparation of occlusal surface so that the preparation follows the anatomic
planes / to give uniform thickness to the restoration.
d) Preparation of axial surface so that tooth structure is removed evenly / if
necessary tooth or teeth should be orthodontically repositioned.
e) Selection of conservative margins, compatible with the other principles of
tooth preparation.
f) Avoidance of unnecessary apical extensions of the preparation.
C. Avoidance of over – contouring.
D. Supragingival margins.
E. Protection against possible tooth fracture.
111
ii. Mechanical considerations:
A. Providing retention form
a) Magnitude of dislodging forces.
b) Geometry of tooth preparation.
c) Roughness of the fitting surfaces of restoration.
d) Material being cemented.
e) Type of luting agents.
f) Film thickness of luting agents.
B. Providing resistance form:
a) Magnitude and direction of the dislodging forces.
b) Geometry of tooth preparation.
c) Margin design.
C. Deformation of an alloy:
a) Alloy selection
b) Adequate tooth preparation / preparation.
c) Margin design.
iii. Aesthetic considerations:
a) Minimum display of metal.
b) Maximum thickness of porcelain.
c) Porcelain on occlusal surfaces.
d) Subgingival margins.
Steps in tooth preparation:

i. Occlusal or incisal preparation for sufficient clearance.
ii. Axial preparation and proximal and facial, lingual preparation to establish optimal
contours and embrasures.
iii. Resistance and retention form for predictable results.
iv. Refinement and smooth surfaces to reduce stresses during function.
v. Establishment of finish lines to control microleakage.
Sign of Teacher
112
EXERCISE - 4 Date:
MARGIN DESIGN IN FIXED PARTIAL DENTURE

Definition of margin:
The outer edge of a crown – inlay, onlay or other restoration, the boundary surface
of a tooth preparation and / or restoration is termed as finish line.
Definition of finish line:
i. A line of demarcation.
ii. Peripheral extension of tooth preparation.
iii. The plane junction of different materials.
iv. The terminal portion of prepared tooth.
Criteria for successful margins.
i. Acceptable margin adaptation.
ii. Tissue tolerance surfaces.
iii. Adequate contour.
iv. Sufficient strength.
Margins are classified as follows:
a) Depending on location of finish lines: b) Depending on configuration
- Supragingival - Feather edge
- Subgingival - Chisel edge
- Knife edge
- Bevel
- Chamfer
- Shoulder
- Sloped shoulder
- Beveled shoulder
- Radial shoulder
Definitions:
a) Bevel: A slanting edge. A process of slanting the finish line and curve of a tooth
preparation.
b) Chamfer: A finish line design for tooth preparation in which the gingival aspect meet
the external axial surface at an obtuse angle.
c) Shoulder: A finish line design for tooth preparation in which a gingival floor meets
the external axial surface at approximately right angle.
113
MARGIN DESIGNS
FEATHER EDGE
CHAMFER
114
CHISEL
BEVEL
115
SHOULDER SLOPED SHOULDER
BEVELED SHOULDER
116
Advantages and disadvantages of different margin design
Design Advantage Disadvantage

i) Feather edge Conservation of tooth Does not provide sufficient
structure. bulk.
ii) Chisel edge Conservation of tooth Location of margin difficult

structure. to control.
iii) Bevel Removes unsupported Extend the preparation into

enamel, allows finishing of sulcus if used on apical
metal margins.
iv) Chamfer Distinct margin, adequate Care needed to avoid

bulk, easier to control. unsupported lip of enamel.
v) Shoulder Bulk of restorative material Less conservation of tooth

and advantages of bevel structure.
vi) Sloped shoulder Bulk of restorative material Less conservation of tooth

and advantages of bevel. structure.
vii) Shoulder with Bulk of restorative material Less conservation of tooth

bevel and advantages of bevel. structure and extends the
preparation apically.
Sign of Teacher
117
PRIMARY ABUTMENT
SECONDARY ABUTMENT
INTERMEDIATE ABUTMENT
118
EXERCISE - 5 Date:
ABUTMENTS OF FIXED PARTIAL DENTURE
Definition:
A tooth, portion of a tooth, or that portion of dental implant that serves to support and / or
retain a prosthesis.
Types of abutments:
i. Primary abutment – located immediately next to edentulous area.
ii. Secondary abutment – located remote from edentulous area in the same arch.
iii. Intermediate abutment – (pier abutment)- A natural tooth located between terminal
abutments that serves to support a denture.
Abutment evaluation:
- Crown root ratio
- Root configuration
- Periodontal ligament area
Ante’s law: The combined pericemental area of the abutment teeth should be equal to or greater than
the pericemental area of the tooth or teeth to be replaced
Implant abutment: The portion of a dental implant that serves to support and / or retain
any prosthesis.
Sign of Teacher
119
EXTRACORONAL RETAINER
INTRACORONAL RETAINER
RADICULAR RETAINER
120
EXERCISE – 6 Date:
RETAINERS IN FIXED PARTIAL DENTURE

Definition:
Any type of device used for the stabilization or retention of a prosthesis.
Classification of retainers:
i. Extracoronal retainer
ii. Intracoronal retainer
iii. Radicular retainer
i. Extracoronal retainer:
It is used as veneer to restore external surface of a prepared tooth to tissue
compatible contour and obtain retention and resistance to displacement primarily
from the fit of the restoration to the external walls of preparation.
Types: a) Complete veneer crowns: b) Partial veneer crowns:
- All metal - Three quarter crown
- All porcelain - Reverse three quarter crown
- Metal ceramic - Seven-eighth crown
- Resin processed to metal -
ii. Intra – coronal crown:
It obtains their retention and resistance to displacement from the intimate fit of the
restoration within the confines of the coronal portion of the tooth.
Types:
a) Inlay b) Onlay c) Pin-retained
iii. Radicular retainer:
It consists of a post or dowel with an attached core that obtains its retention and
resistance to displacement from the prepared root portion of an endodontically
treated tooth.
Selection of retainer in fixed partial denture:
i. Alignment of abutment teeth and retention.
ii. Appearance and cost.
iii. Condition of abutment teeth.
iv. Conservation of tooth structure.
v. Occlusion.
Sign of Teacher
121
SANITARY
CONICAL
OVATE
122
EXERCISE - 7 Date:
PONTICS IN FIXED PARTIAL DENTURE

Definition:
An artificial tooth on a fixed partial denture that replaces natural tooth, restores its
function and usually fills the space previously occupied by the clinical crowns.
Classification of pontic:
I. Depending upon design:
- Saddle (ridge lap)
- Modified saddle
- Hygienic
- Conical
- Ovate
II. Depending upon the tissue contact:
a) Mucosal contact
- Saddle
- Modified saddle
- Ridge lap
- Modified ridge lap
b) Non – mucosal contact
- Sanitary (hygienic)
- Modified sanitary
- Bullet
III. Depending upon the material used:
- Cast metal
- Metal ceramic
-
IV. ending upon the fabrication technique:
- Pre – fabricated
- Custom made
Function of pontics:
1) To improve appearance
2) To stabilize the occlusion
3) To improve masticatory function
123
SADDLE – RIDGE LAP
MODIFIED – RIDGE LAP
124
Surfaces of pontics:
i. Gingival
ii. Occlusal
iii. Proximal
iv. Buccal
v. Lingual
Principles guiding the design of pontic:
i. Biological
ii. Mechanical
iii. Esthetics
Sign of Teacher
125
NON – RIGID CONNECTORS
RIGID CONNECTORS
LOOP CONNECTOR
126
EXERCISE - 8 Date:
CONNECTORS IN FIXED PARTIAL DENTURE

Definition:
The portion of a fixed partial denture that unites the retainer(s) and pontic(s).
Types of connectors:
I. Rigid connector
II. Non-rigid connector
III. Loop connector
I. Rigid connector:
A cast, soldered or fused union between the retainer(s) and pontic(s).
Types:
- Castable
- Weldable
- Solderable
II. Non – rigid connector:

Any connector that permits limited movement between o independent members of a
fixed partial denture.
Types:
- dove tails (key – key ways)
- split pontic (connector inside the pontic)
- tapered pins
III. Loop connectors:

It is used when there is diastema, eg: midline diastema.
Sign of Teacher
127
DEPTH GROOVES FOR INCISAL PREPARATION
INCISAL PREPARATION
DEPTH GROOVES FOR FACIAL

FACIAL PREPARATION PREPARATION
128
EXERCISE - 9 Date:
PREPARATION OF MAXILLARY CENTRAL INCISOR

TO RECEIVE FULL VENEER CERAMIC CROWN /
ACRYLIC JACKET CROWN
Tooth Preparation:
Teeth do not possess the regenerative ability found in most other tissues. Therefore,
once enamel or dentin is lost as a result of caries, trauma or wear, restorative materials
must be used to reestablish form and function. Teeth require preparation to receive
restorations, and these preparations must be based on fundamental principles from which
basic criteria can be developed to help predict the success of prosthodontic treatment.
Indications:
- High esthetic requirement
- Considerable proximal caries
- Incisal edge reasonably intact
- Endodontically treated teeth with post and cores
Armamentarium:
a) Mackintosh sheet
b) Straight probe
c) Marking or lead pencil
d) Chip blower
e) Cotton holder and waste receiver
f) Soap solution.
g) Contrangle micromotor handpiece
h) Diamond burs
1) Straight fissure
2) Tapered fissure
3) Wheel shape
4) Flame shape
5) End cutting bur
6) Torpedo bur
7) Sandpaper disc safe sided
8) Mandril for sandpaper disc
i) Ivorine teeth
j) Inlay or tooth coloured wax
k) Dappen dish
129
PROXIMAL PREPARATION
LINGUAL PREPARATION
130
LINGUAL FOSSA PREPARATION
FINAL PREPARATION
131
l) Spirit lamp
m) Wax spatula and lecron carver
Sr. Recommended Criteria

Preparation steps
No. Armamentarium
Approx 1.3mm deep to allow for
Depth grooves for Straight fissure additional preparation during
i)
incisal preparation diamond bur finishing, perpendicular to long
axis of opposing tooth.
Clearance of 1.5mm. Check
ii) Incisal preparation Wheel Shaped
excursions.
Depth of 0.8mm needed for
Depth grooves for Straight fissure
iii) additional preparation during
facial preparation diamond bur
finishing.
Preparation of 1.2mm needed,
iv) Facial preparation Straight fissure two planes, as for metal ceramic
crown preparation.
Proximal Tapered fissure 6 degree of convergence.
v)
preparation diamond bur
Football shaped
diamond bur Should provide 1mm clearance
vi) Lingual preparation
and straight in all excursions.
fissure bur.
Straight fissure
Lingual shoulder and flame
vii) Rounded shoulder 1mm wide.
preparation shaped
diamond bur
Mandril with All surfaces smooth and

viii) Finishing safe sided continuous, no unsupported
sandpaper disc enamel, 900 cavosurface angle.
Sign of Teacher
132
EXERCISE – 10 Date:
PREPARATION OF MAXILLARY CENTRAL INCISOR TO

RECEIVE FULL VENEER
PORCELAIN-FUSED-TO-METAL CROWN
Indications:
- Esthetics
- If all ceramic crown is contraindicated
Armamentarium:
a) Mackintosh sheet
b) Straight probe
d) Chip blower
e) Cotton holder
f) Waste receiver
g) Contrangle micromotor handpiece
h) Diamond burs
1) Straight fissure
2) Tapered fissure
3) Wheel shape
4) Flame shape
5) End cutting bur
6) Torpedo bur
i) Ivorine teeth
k) Dappen dish
l) Spirit lamp
m) Wax spatula
n) Lacron carver
o) Soap solution
133
Recommended
Preparation steps Criteria
armamentarium
1.5 to 2mm of clearance in
Depth grooves for
i) Straight fissure intercuspal positions and all
Incisal preparations
excursions
ii) Incisal preparation Wheel shaped
Labial preparation 1.2 – 1.5mm of preparation
iii) (guide grooves two Straight fissure for metal and porcelain
planes) Shoulder margin line
iv) Labial preparation Straight fissure 6 degree convergence
6 degree convergence
Proximal Tapered round
v) Shoulder and Chamfer
preparation tipped diamond
margin line
Should provide 1mm of
Football shaped clearance in all excursions
vi) Lingual preparation diamond & (1.5mm if occlusal is
Straight fissure porcelain) Chamfer margin
line
Shoulder must extend at
least 1mm lingual to proximal
Finishing of Tapered flat
contact area, bevel, if
vii) shoulder or beveled tipped diamond
selected should as far
shoulder hand instrument
incisally as possible relative
to epithelial attachment
Safe sided All line angles rounded and
viii) Finishing
sandpaper disc. preparation surfaces smooth
Sign of Teacher
134
EXERCISE - 11 Date:
PREPARATION OF MANDIBULAR FIRST MOLAR TO

RECEIVE FULL METAL CROWN
Indications:
- Extensive destruction from caries or trauma
- Endodontically treated teeth
- Necessity for maximum retention and strength
- To provide contours to receive a removable appliance
- Other recontouring of axial surfaces (minor corrections)
- Correction of occlusal plane
Armamentarium:
a) Mackintosh sheet
b) Straight probe
d) Chip blower
e) Cotton holder and waste receiver
e) Contrangle micromotor handpiece
f) Diamond burs
1) Straight fissure
2) Tapered fissure
3) Wheel shape
4) Flame shape
5) End cutting bur
6) Torpedo bur
g) Ivorine teeth
h) Inlay or tooth coloured wax
i) Dappen dish and spirit lamp
j) Wax spatula and lecron carver
k) Soap solution
135
DEPTH GROOVES FOR OCCLUSAL
OCCLUSAL PREPARATION PREPARATION
DEPTH GROOVES FOR BUCCAL

BUCCAL PREPARATION PREPARATION
136
PROXIMAL PREPARATION LINGUAL PREPARATION
FUNCTIONAL CUSP BEVEL FINAL
137
Preparation steps Recommended Criteria
armamentarium
i) Depth grooves for Straight fissure Minimum clearance on
occlusal Preparation noncentric cusps: 1mm
Minimum clearance on
centric cusps: 1.5mm
ii) Occlusal preparation Wheel / Flame Should follow normal
Shaped anatomic configuration of
occlusal surface.
iii) Alignment grooves Regular-grit, round- Chamfer allows 0.5mm
for axial preparation tipped thickness of wax at
margins
iv) Axial preparation Regular-grit, round- Preparation performed
(half at a time) tipped, tapered parallel to long axis
diamond
v) Functional cusp Tapered diamond. Flatter than cuspal plane,
bevel to allow preparation of
functional cusp.
vi) Finishing of chamfer Wide, round-tipped Smooth mesiodistally and
diamond or carbide buccolingually, resistance
to vertical displacement
by tip of explorer or
periodontal probe.
vii) Additional retentive Tapered carbide Grooves, boxes, pinholes
features if needed as described for partial-
coverage restorations
viii) Finishing Fine-grit diamond Rounding of all sharp line
or carbide angles to facilitate
impression making, die
pouring, waxing, and
casting
Sign of Teacher
138
EXERCISE - 12 Date:
PREPARATION OF MAXILLARY PRE-MOLAR TO

RECEIVE PARTIAL VENEER CROWN
(THREE QUARTER CROWN)
Indications:
i) Sturdy clinical crown of average length or longer.
ii) Intact buccal surface not in need of contour modification and well supported by sound
tooth structure.
iii) No conflict between axial relationship of tooth and proposed path of withdrawal of fixed
partial denture.
Armamentarium:
a) Mackintosh sheet
b) Straight probe
d) Chip blower, cotton holder and waste holder
e) Contrangle micromotor handpiece
f) Diamond burs
1) Straight fissure
2) Tapered fissure
3) Wheel shape
4) Flame shape
5) End cutting bur
6) Torpedo bur
i) Ivorine teeth
k) Dappen dish and spirit lamp
l) Wax spatula, lecron carver and soap solution.
139
PROXIMAL
OCCLUSAL
140
PREPARATION WITH RETENTIVE GROOVES
FINISHING OF PREPARATION
141
Preparation steps Recommended armamentarium Criteria
Palatal preparation
i) Palatal preparation Torpedo diamond parallel to long axis of
tooth.
Smooth and continuous to
minimize marginal length
and facilitate finishing,
ii) Proximal preparation Tapered fissure
distinct resistance to
vertical displacement by
periodontal probe.
Clearance of 1mm on non-
iii) Occlusal preparation Flame shaped centric cusps 1.5mm on
centric cusps.
Preparation of Distinct resistance to
retentive grooves: Thin and tapered diamond and lingual displacement by
iv)
Proximal and inverted cone. probe, parallel to path of
Occlusal withdrawal to restoration.
All sharp angles (except
v) Finishing Safe sided sandpaper disc grooves) rounded to
smooth transitions
Sign of Teacher
142
EXERCISE - 13 Date:
RESTORATION OF
ENDODONTICALLY TREATED TEETH
Endodontically treated teeth present a special kind of restoration coverage, for teeth
with little or no clinical form that have roots with adequate length, bulk and straightness. A
dowel core is utilized in such cases. A crown is then fabricated and cemented over the core
just as a routine restoration. The endodontically treated tooth needs to be assessed
carefully for the following:-
i. Good apical seal
ii. No sensitivity to pressure
iii. No exudates
iv. No fistula
v. No apical sensitivity
vi. No active inflammation
Methods of fabrication of post and core:

i. Pre fabricated dowel core
ii. Custom made dowel core
Armamentarium:
i. Hand piece
ii. Flat and tapered diamond bur
iii. Flame shaped diamond bur
iv. No. 170 bur
v. Round bur
vi. Endodontic condenser
vii. Set of 6 peeso reamers
viii. Dowel kit including dowel, pins and drill for pre-fabricated dowel core.
143
FACIO-LINGUAL CROSS-SECTION
144
For custom cast dowel core:
i. Straight hand piece
ii. Coarse garnet disc on moore mandril
iii. Fine sandpaper disc on moore mandril
iv. Large green stone
v. Burlew wheel on mandrill
vi. 14 gauge solid plastic screw
vii. Dappen dish
viii. Cement spatula
ix. Cotton pellets
x. Petroleum jelly
xi. Resin monomer and polymer
xii. Medicine dropper
xiii. Plastic filling instrument.
Methods of fabrication:
i. Removal of root canal filling material to the appropriate depth.
ii. Enlargement of the canal.
iii. Preparation of coronal tooth structure.
Sign of Teacher
145
146
MAXILLOFACIAL
PROSTHODONTICS
AND
IMPLANTOLOGY
147
148
EXERCISE - 14 Date:
MAXILLOFACIALPROSTHODONTICS
Definition:
The branch of prosthodontics concerning with the restoration and / or replacement of
the stomatognathic and craniofacial structures with prosthesis that may or may not be
removed on a regular or elective basis.
Types of maxillofacial prosthesis
I. Obturator: A prosthesis used to close a congenital or acquired tissue opening
primarily of the hard palate and contiguous alveolar structures. Prosthetic
restorations of the defects often include use of a surgical obturator, interim obturator
and definitive obturator.
i. Surgical obturator:
A temporary prosthesis used to restore the continuity of the hard palate immediately
after surgery or traumatic loss of a posterior or all of the hard palate and/of contiguous
alveolar structures eg: gingival tissue, teeth.
ii. Interim obturator:
A prosthesis that is made several weeks or months following the surgical resection
of one or more maxillae. It frequently includes replacement of teeth in the defective
area. This prosthesis when used replaces the surgical obturator that is placed
immediately following the resection and it may be subsequently replaced with a
definitive obturator.
iii. Definitive obturator:
A prosthesis that artificially replaces part or all the maxilla and associated teeth lost
due to surgery and trauma.
II. Palatal lift prosthesis: A removable prosthesis that aids in nasopharyngeal closure
by elevating an incompetent soft palate that is dysfunctional due to drifting / trauma /
unknown disease.
The palatal lift prosthesis is divided into the following types based on expectations of
length and utilization of materials in fabrication.
i. Interim palatal lift prosthesis.
ii. Definitive palatal lift prosthesis.
Palatal lift prosthesis modification:

Alteration in adaptation, contour, form or function of an existing palatal lift necessitated
due to tissue impingement, lack of function, poor clasp adaptation or the like.
149
III. Speech aid: Any therapy or any instrument or apparatus or device used to improve
speech quality.
IV. Mandibular resection prosthesis:

Mandibular resection : The surgical removal or a portion of all of the mandible and
related soft tissues. It is also called mandibulectomy.
Mandibular resection prosthesis: A maxillary or mandibular prosthesis delivered
after mandibular resection to allow the remaining mandibular segment improve the
occlusal contacts with maxillary dentition. This can require the use of a flange guide
or occlusal platform incorporated in the prosthesis to guide the mandibular segment
into occlusal contact. This is also called as –
i. Mandibular guide prosthesis – resection prosthesis.
ii. Mandibular resection prosthesis with guide
iii. Mandibular resection prosthesis without guide.
V. Radiation carrier: A device used to administer radiation to confined areas by

means of capsules, beads or needles of radiation emitting materials such as radium
or cerium. Its function is to hold the radiation source securely in the same location
during the entire period of treatment.
The various types of radiation carrier prosthesis are –
i. Carrier prosthesis
ii. Intracavity application
iii. Intracavity carrier
iv. Radiation applicator
v. Radium carrier
vi. Radiotherapy prosthesis
Sign of Teacher
150
EXERCISE - 15 Date:
IMPLANTOLOGY
Definitions
Implantology:-
Study of science of placing and restoring dental implants.
Implant prosthodontics:
The phase of prosthodontics concerning the replacement of missing teeth and/or
associated structures by restoration that are attached to dental implants.
Implant Prosthesis:
Any prosthesis, fixed, removable, maxillofacial that utilize dental implants in part or
whole for retention, support and stability.
Dental implant:
A prosthetic device of alloplastic materials implanted into the oral tissues and/or
within the bone to provide retention and support for a fixed or removable prosthesis. A
substance that is placed into and/or upon the jaw bone to support a fixed or removable
prosthesis.
Classification of dental implants:-
Dental implants are classified based on their anchorage components as it leads to
the bone that provides support and stability. There are 3 basic types of dental
implants.
1) Endosteal Dental implant (Endosseous implant):
A device placed into the alveolar or basal bone of the mandible or maxilla and
transecting only one cortical plate.
2) Subperiosteal dental implant:
Any dental implant that receives its primary bone support by means of resting upon
the bone.
3) Transosteal dental implant:
i. A dental implant that receives its primary bone support by means of resting upon
the bone.
ii. A dental implant composed of a metal plate with retentive pins to hold it against
the inferior border of the mandible that penetrate through the full thickness of the
mandible and pass into the mouth in the parasymphyseal region.
The attachment of prosthesis on an implant
i. Cement retained fixed implant prosthesis
ii. Screw retained prosthesis
151
SCHEMATIC DIAGRAM OF GENERIC IMPLANT COMPONENTS
AND
TERMINOLOGY
152
Components/Parts of an Implant
1. Implant body
2. Second stage permucosal extension or healing abutment
3. Abutment
4. Hygiene screw
5. Transfer coping
6. Analogue
7. Prosthetic screw
Materials
Materials used in implants are
i. Metals - Stainless Steel
- Chromium – Cobalt – Molybdenum alloy
- Titanium and its alloy
ii. Ceramics
iii. Polymers and composites
- Polyhydroxy ethyl methacrylate
- Polytetrafluoroethylene (PTFE)
- Polymeric graphite with vitreous carbon
Sign of Teacher
153

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GOVERNMENTDENTALCOLLEGEANDHOSPITAL

This is to certify that

In charge Professor &Head of Department

University Seat No. :

Date of Practical Exam:

SR. NO. DATE TOPIC PAGE NO. SIGN

SR. NO. DATE TOPIC PAGE NO. SIGN

SR. NO. DATE TOPIC PAGE NO. SIGN

SR DATE TOPIC PAGE SIGN

SEQUENTIAL STEPS IN THE FABRICATION

ANALYSIS OF STUDY MODEL

Primary stress bearing area-

Secondary stress bearing area-

Posterior palatal seal area-

b) Mylohyoid area – Extends from premylohyoid fossa to the distal end of

Primary stress bearing area-

Secondary stress bearing area-

2) Supporting structures of mandibular arch:

Buccal shelf area:

Definition of impression in complete denture:- It is a negative likeness of entire denture

IDEAL MANDIBULAR CAST

PREPARATION OF PRIMARY CAST

MANDIBULAR SPACER DESIGN

FABRICATION OF SPECIAL OR CUSTOM TRAYS

a) Autopolymerizing resin impression trays

MANDIBULAR SPECIAL / CUSTOM TRAY

Requirements of individualized impression trays:

Steps in making final impression –

Materials used for border molding –

Materials used for wash impression –

Methods of recording posterior palatal seal –

Purpose of boxing and beading

Materials used for temporary denture base

Methods of fabrication of temporary denture base with different materials:-

FABRICATION OF RECORD RIMS

Maxillary record rim:

MANDIBULAR RECORD RIM (SIDE VIEW)

MANDIBULAR RECORD RIM (OCCLUSAL VIEW)

2) For pre-clinical purpose, the posterior height is maintained up to 2/3rd of height of

Procedure for fabrication of record rims:

TRANSFER OF JAW RELATION TO THE

SELECTION OF TEETH FOR A

Anterior teeth selection:

Post extraction records:

2) Mesiodistal width – Mesiodistal width of posterior teeth should be selected in such

3) Types of posterior teeth according to cuspal inclination:

ARRANGEMENT AND ARTICULATION

ARRANGEMENT OF MANDIBULAR ANTERIOR TETH

C. Arrangement of maxillary posterior teeth:

BUCCAL VIEW OF ARTICULATION (CLASS-I)

Articulation of mandibular posterior teeth:

c) The mandibular 2nd molar is arranged in the similar manner.

CLASS II TEETH ARRANGEMENT

1) Midline harmony – facial midline to coincide with dental midline.

2) Low lip line

4) Canine line and canine prominence

5) Occlusal plane and visibility of anterior teeth

6) Shape, size and color of teeth

c) Centric relation and centric occlusion

acceptance of the trial dentures.

PROCESSING OF COMPLETE DENTURE

C.DEWAXING (WAX ELIMINATION)

E.POLYMERIZATION OR CURING CYCLE

For correction of occlusal interferences the following points have to be checked.