The hollow maxillary complete denture: A modified technique

MADE BY-Dr. AMIT MDS PROSTHODONTICS (1ST YR)

O'Sullivan M, Hansen N, Cronin RJ, Cagna DR.The hollow maxillary complete denture: A modified technique. J Prosthet Dent 2004 Jun;91(6):591-4.

INTRODUCTION
Extreme resorption of the maxillary denturebearing area
NARROWER RIDGE DUE TO RESORPTION DECREASED SUPPORTING TISSUE

problems with prosthetic rehabilitation.

LARGE RESTORATIVE SPACE

HEAVY MAXILLARY COMPLETE DENTURE

INTRODUCTION
Reducing the weight of a maxillary prosthesis has been shown to be beneficial when constructing an prostheses for the restoration of a large maxillofacial defect or severe residual ridge resorption.

make the denture base hollow.

el Mahdy AS. Processing a hollow obturator. J Prosthet Dent 1969;22:682-6.

INTRODUCTION
Historically, weight reduction approaches have been achieved using a solid 3dimensional spacer, including Dental stone, Cellophane wrapped asbestos, Silicone putty, Modelling clay
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INTRODUCTION
Multiple and separate pieces of the prosthesis are polymerized around a 3-dimensional spacer.

Following the initial polymerization process, the solid spacer is removed.

Individual pieces of the prosthesis are then joined using autopolymerizing acrylic resin repair techniques.

TECHNIQUE
1. Impression of the maxillary residual ridge and fabricate to trial denture stage. 2. Index the land area of the cast & seal the trial denture to the definitive cast

TECHNIQUE
3. Duplicate the trial denture in reversible hydrocolloid and pour the impression in dental stone. 4. Make a clear template on the stone cast using a 0.3-mm thermoplastic sheet

5. Process the trial denture in the standard manner through the wax elimination stage.
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TECHNIQUE
6. Adapt 2 layers of baseplate wax to the definitive cast in the drag, conforming to the border extensions. 7. Use a second flask to invest the baseplate wax and again complete the wax elimination process. Pack the cope and second drag with heat-polymerized acrylic and process.
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TECHNIQUE
8. Separate the cope, with the polymerized acrylic resin still attached, from the drag. Place the clear matrix on the definitive cast using the indices in the land area as seating guides . 9. Use an endodontic file with a rubber stop to measure the space between the matrix and the processed resin.

TECHNIQUE
8. Mix and adapt vinyl polysiloxane putty to the burroughened acrylic resin and shape to the approximate contours of the matrix . Shape the polymerized putty with a bur to leave 2-3 mm of space between the putty and matrix.
9. Provide an additional 1-mm space over the tooth portion of the denture.Fix the putty to the acrylic resin using cyanoacrylate.
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TECHNIQUE
Reseat the original cope on the drag and verify complete closure of the flask. Mix, pack, and polymerize the acrylic resin. Verify adequate thickness of resin around the teeth at the packing stage using a periodontal probe.

Recover the processed denture in the usual manner.

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TECHNIQUE
Remount the denture on an articulator and adjust the occlusion as necessary. Cut 2 openings with a bur into the denture base distal to the most posterior teeth.

Remove the silicone putty by scraping with a sharp instrument. Widen the openings as necessary, laterally, to facilitate access. Remove the putty and fabricate 2 covers using clear auto-polymerizing resin.

 Clean and disinfect the cavity

Attach the clear resin covers by bonding them into position using auto-polymerizing resin or light-polymerizing .

Polish the denture in the usual manner. Verify that the cavity is sealed by immersing the denture in water.
If no bubbles are evident, an adequate seal is confirmed.

DISCUSSION
Heat-polymerizing portion of the denture against polymerized resin may reduce leakage at the junction of the 2 portions of the denture. The small window in the cameo surface facilitates recovery of the spacer in an area that is not commonly adjusted after denture insertion and has a small margin along which leakage could occur.
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DISCUSSION
Controlling and verifying resin thickness Putty and clear matrix, ensuring an even depth of resin to prevent seepage and prevent deformation under pressure of flask closure. Using a periodontal probe, allowing recontouring of the putty at that time if required. Why Silicone putty ? Stability Its ability to be carved Does not adhere to acrylic resin. The cyano-acrylate bond between the resin and the putty may be easily removed.
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The hollow denture: An alternative treatment for atrophic maxillae

This article describe the fabrication of hollow denture using double flask technique

Fattore LD, Fine L, Edmonds DC. The hollow denture: an alternative treatment for atrophic maxillae. J Prosthet Dent 1988;59:514-6.

TECHNIQUE
Impression of the maxillary residual ridge and fabricate to trial denture stage with heat cure denture base. Invest the waxed denture in a flask Heat the flask, open it, and flush away the remaining wax After the flask has cooled, adapt a 2 mm thick portion of baseplate wax to the tooth side of the flask. Note: The heat-cured baseplate is in place on the tissue side of the flask

TECHNIQUE
Place the halves of the flask together with a plastic sheet between them. Remove the knock-out plate from the bottom half of another similar flask and place it on the upper part of the original flask containing the teeth with wax adapted over them.

TECHNIQUE
Vibrate dental stone through the knock-out hole in the alternate half flask until it is level full. Boil out, clean, and apply tin foil substitute as usual. Pack and process with heat-curing, high-impact acrylic. resin. Cool, separate the flask, and carefully remove any flash but do not deflask. Both halves of the original flask now contain a processed acrylic resin shell. Fit the two halves of the flask together and remove any acrylic resin that interferes with complete flask closure

TECHNIQUE
Make a rope of doughy, heat-curing, high-impact acrylic resin approximately the diameter of a lead pencil.

Adapt the acrylic resin rope around the border of the cured acrylic resin in the tooth side of the flask. Add a plastic sheet, trial pack, trim the flash, and continue packing until no flash is evident. Moisten the new acrylic resin slightly with monomer. Close the flask, place it in a curing press, and # process with a long-curing cycle.

A hollow complete lower denture

This article describe the fabrication of hollow denture using split flask technique
Holt RA Jr. A hollow complete lower denture. J Prosthet Dent 1981;45:452-4. #

TECHNIQUE
The complete lower wax denture is boiled out, and the flask is separated in the usual manner. The hollow denture is constructed using two split dental flasks as follows:

Place a wax shim (consisting of two layers of baseplate wax) over the denture teeth area.

Place the top half of a second split flask over the wax shimmed lower half of the flask.

TECHNIQUE
Pour stone into the flask through the open hole Boil out the wax shim. Pack in acrylic resin, process,and separate.

TECHNIQUE
Place two layers of baseplate wax over the residual ridge in the top half of the original flask.

TECHNIQUE
Place Insta-mold between the wax shim and the processed acrylic resin on the residual ridge area.

TECHNIQUE
Notch the processed acrylic resin and the wax shim for keying when the two halves are put together later. Boil out the wax shim, pack, and process and separate the flask. Remove the Insta-mold. Fuse the two resulting acrylic resin parts together with cold-cure acrylic resin.

 Notching of processed acrylic resin and the wax shim for keying

Denture is floated in water to test for leakage

SPLIT FLASK TECHNIQUE

SILICONE PUTTY

REFERRENCES
1. O'Sullivan M, Hansen N, Cronin RJ, Cagna DR.The hollow maxillary complete denture: A modified technique. J Prosthet Dent 2004 Jun;91(6):591-4 2. el Mahdy AS. Processing a hollow obturator. J Prosthet Dent 1969;22:682-6 3. Fattore LD, Fine L, Edmonds DC. The hollow denture: an alternative treatment for atrophic maxillae. J Prosthet Dent 1988;59:514-6. 4. Holt RA Jr. A hollow complete lower denture. # J Prosthet Dent 1981;45:452-4.

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