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Additions and Repairs

Lecture for 2nd year dental students providing an early survival guide for removable prosthodontic problems on clinic
by

Damien Walmsley

on 16 June 2017

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Transcript of Additions and Repairs

Aim
To provide a survival guide for those Prosthetic emergencies that will occur on Clinic
Learning Objectives
What to do when a patient
Has a loose denture
Needs a tooth out and either has or does not have a denture
Breaks a denture
Additions and Repairs
Prof Damien Walmsley
Tissue conditioners


trade name = viscogel
short term, soft linings
Cold-cure acrylics
Self-cure acrylics
Total (butyl methacrylate)
temporary linings
correction of underextensions
Clinical technique (1) for additions to denture
Alginate impression with denture in situ
Opposing impression for occlusion
Complete laboratory cards
Clinical technique (2)
Date for insertion
(usually 1 week minimum)
Arrangements for follow up and maintenance
Referral to oral surgery for extractions if indicated
Learning Objectives

What to do when a patient
Needs a tooth out and
either has or does not have a denture
Acrylic dentures
Limitations with metal dentures
use 4-meta acrylic
Learning Objectives


What to do when a patient breaks a denture
Find out that Prosthetics is a cool teaching unit
Let’s think about the world and summer!
Light Cured Acrylic

Triad light curing oven
Advantage to mould in mouth
then process in oven
Adhesives
Cyano-acrylate
Short term repairs
Temporary Fixation
Sticky wax
Superglue
Cold-cure acrylic
Locating impression
Direct chairside repair
Denture Fractures
Types
History of fracture
Diagnosis
Relevance to treatment plan
If this cannot be done then an impression is required to locate / position denture inside the mouth
http://www.scribd.com/doc/38467451/Acrylic-Partial-Dentures
Useful materials

Tissue Conditioners
Self-cure acrylics
Light cured acrylic


Ethyl Alcohol and
Citrate Ester as a Plasticizer
(Liquid)
Polyethylmethacrylate (Powder)
Mineral oil,
spearmint oil
(separator)
Use manufacturers instructions and
add powder to increase viscosity
This mix is too runny
By adding powder, this mix is now ready for the reline
A clinical practice case
Patient requires routine treatment including

oral hygiene
dietary advice
periodontal treatment
restorations

BUT the most important worry for the patient is........
A loose ill-fitting denture
Add Viscogel
Denture now comfortable and retentive
Good temporary lining
Clinical result

Patient is pleased

Clinician can undertake the treatment that is necessary and remake the denture at the end of the treatment plan

Based on butyl methacrylate
Complete and Partial Dentures will become loose and unstable over time. This may be caused by the following
Alveolar Bone resorption
Tooth movement/drifting
Deterioration and/or damage of the denture base and teeth
Mix too runny
Mixed correctly
Although still temporary provides a more permanent solution
May assist with retention of the denture
Command set by light and not by chemicals - assists in manufacturing process
Patient has lost a tooth and partial denture no longer fits
Impression of denture taken in situ
Do you know why?
Tooth added to denture
Will require a new denture
Two Upper canines require extraction - Can you identify them?
Here is the denture
Impression of denture in situ
New artificial teeth added
Natural teeth extracted
Denture with additions inserted
Wait at least 6 - 12 months and construct a new denture
Why wait 6 - 12 months for a denture?
UL23 are to be extracted
Loose (Grade III) and series of pain and abscesses
Impression only
Dont forget the shade
Teeth to be extracted, removed on cast
Teeth extracted
Denture inserted immediately
Resorption over time and new denture needed
Paper Alert
Tooth coloured material for adjusting the occlusion or adding to teeth generally
Teeth to be
removed
Good impression of the teeth to be removed
Broken metal denture not easy to repair
Locating impression and cast with denture in place
4 meta acrylic bonds to metal and to acrylic
Pink acrylic
Ivory acrylic
Able to adjust the occlusion and then command set with the Triad light oven
England beat Australia
But lose to Pakistan
Someone is happy about India getting to the final
http://damienwalmsley.com
Full transcript