Professional Documents
Culture Documents
A cast is: "A reproduction of the surface form of oral or facial tissues obtained from an
impression".(Source: British Standards Glossary of Dental Terms. BS 4492 1983).
The margins must be smooth and rounded, 2mm thick. The result will be an impression that has
an optimum denture border width. If the tray borders are too long then the denture will be
overextended.
The tray may (meaning, it is permissible to) be overextended posteriorly. On the maxilla, this will
ensure that you will have the hamular notch on the master cast. A long cast does not mean the
denture will be too long. When you do the posterior palatal seal you will determine the proper
length of the denture.
Pressure buttons
- used only on mandibular custom tray
- placed on the middle of the crest, corresponding premolars,
- parallelepiped shape
- dimensions:
Length=10-15 mm,
width= 4-6mm,
height = 5-7 mm
- Height and width usually correlates with that of the residual ridges
ROLE – even pressure during the final impression
Reinforcement elements
– metal plates or wires in the lingual slope of the mandibular custom tray
Roles: increase the mechanical resistance of the shellac custom tray
Advantages
- easy to work with
- low cost
Disadvantages
- low resistance
- the material is very brittle and breaks easily
- on high temperature deform
Technical steps
- Outline tray borders on preliminary casts
- Block out undercuts
- isolating the cast
- The baseplate is heated and then gently pressed into place on the cast with care taken to maintain
a uniform thickness. The borders are reduced to approximately 2 mm from the extended borders
of the cast as recorded by the preliminary impression (with a sharp spatula or a scissors). Care is
taken to ensure that the areas of any fraenum are adequately reduced as these areas are usually
under-recorded by an alginate impression.
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- the reinforcement element is heated and insert in the tray material
- Excess material can be shaped into a tray handle and placed onto the front of the tray in the
shape to the LENGTH OF 1 CENTRAL INCISOR, WIDTH AND INCLINATION OF 2
CENTRAL INCISORS.
-The handle should be positioned just lingual to the crest of the ridge, in the midline and so that it
will not interfere with the lip or with border molding.
- adaptation and formation of the pressure buttons –
- finishing the tray with acrylic burs –
MASTER CAST
Materials and devices:
- final impression
- mixing bowl
- plaster spatula
- type III dental stone (Moldano)
- water (room temperature)
- Lab Vibrator
- Model trimmer
- Model base former
Steps
1. Disinfection of the final impression
2. Checking of the accuracy of final impression
3. Preparing the impression – beading and boxing
BEADING
AIM: to preserve the mucobuccal fold on the master cast
Place 1 strip of periphery wax (4mm) around the entire edge of the impression, about 2-3 mm
below the height of the impression. Be certain that, when viewed occlusally, the beading wax
can be seen around the entire impression.
The mandibular impression must also be filled with a sheet of wax in the lingual/tongue area
because the mandibular casts have a full base
The beading creates the "land" of the cast and preserves the outer portion of the mucobuccal
fold or border area.
BOXING = shaping the master cast base
Use a strip of boxing wax (15-20mm width) and long enough to surround the impression.
Place the boxing wax strip about the beading wax
1. THE RECORD BASE is very similar to the base of custom tray. It is made by the same
techniques and .materials (shellac baseplates, heat-cured resins, Cold cured resins, Light cured
resins)
2. OCCLUSION RIMS
Materials: wax (different colors)
Characteristics:
- shape - arch
- dimensions – frontal: h = 10 mm, w = 6 mm; lateral: h = 6-8 mm, w = 8-10 mm
- the posterior limits correspond to distal surface of M1 and are cut oblique (45°) to prevent
pressure spots between the occlusion rims during the relationship registration
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- Are placed on the crest of the ridge, except the maxillary frontal rim, that is placed more
labially – esthetic reason!
- When the labial surface of the rim is improperly formed, the anterior teeth will be
malpositioned resulting in a non-esthetic denture.
Occlusion rims can be obtained by 3 methods:
- introducing melted wax into a silicon former
- rolling a heated baseplate wax
- preformed rims
Fabrication of wax occlusion rims
• A sheet of baseplate wax is warmed and softened over the Bunsen burner flame.
• The wax is rolled after heating to make a log of wax.
• The soft log of wax is bent and placed on the baseplate, centered over the crest of the ridge
and fixed in place with a hot spatula and melted wax.
• While wax is still soft the cast should be inverted onto the table to flatten the occlusal
surface.
• A broad wax spatula is used to flatten the facial, buccal and occlusal surfaces of the
occlusion rim.
• The final smoothing and finishing will be done with the torch flame
MOUNTNG IN ARTICULATOR
Articulators are prosthetic devices designed to reproduce the relationship between maxilla
and the mandible, and to simulate mandible movements.
Types of articulators
Articulators are classified according to the instrument capability and record acceptance into:
1. Simple hinge articulators.
2. Mean value or fixed condylar path articulators (non-adjustable or average)
3. Adjustable condylar path articulators:
a. Semi-adjustable articulators.
b. Fully adjustable articulators.
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After the mandibulomaxillary relationship record, the record base & occlusion rims will be
joined together and placed again on their master casts and sent to the dental laboratory, to be
mounted in the simulator.
Technique:
Check to see that the relationship is stable, and that there is sufficient clearance for mounting
plaster between the maxillary cast base and the superior arm of the simulator
Mark the midline of the maxillary cast base with a pencil.
On the master cast bases should be make some retention ditches about 1.5-2 mm deep
The master cast bases will be joined together by 3 match sticks, placed one frontal and 2
lateral
The master casts must be hydrate in order to prevent the plaster (gypsum) to instantly set
(due to the absorption of water by dry casts)
Unlike mounting in simply hinge, the mounting in an articulator begins with the maxillary
cast. Another difference lies in the fact that theocclusion rims are not interlocked to each other,
because the two casts will be mounted separately.
1. Casts preparation
Mark the midline of the maxillary cast base with a pencil.
The master casts have to be hydrate 3-4 minute in order to prevent the plaster (gypsum) to
instantly set (due to the absorption of water by dry casts)
2. Occlusion rims preparation
Trace some landmarks in the lateral edges of the occlusion rims in order to put them back in
the same position (after being separated for mounting) and separate them with a spatula
3. Mounting of maxillary master cast
- Soak the upper cast in water 3-5 minutes
- Place soaked and notched maxillary master cast and the occlusion rim on the mounting
platform so that the middle line of the cast coincides with the middle line of the upper arm and the
interincisiv point contacts the horizontal rod tip sliding on vertical incisal pin
- Check for adequate clearance of master cast superiorly.
- The incisal pin should touch the incisal table!
- fix the occlusion rim with melted wax on the mounting platform
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- Prepare plaster paste and apply it on the cast base
- Attach maxillary cast to articulator with mounting plaster.
- Trim and smooth mounting plaster when set.
4. Mounting of mandibular master cast
- Remove the mounting platform
- Reverse the articulator
- Affix the mandibular master cast and occlusion rim on the
maxillary cast and occlusion rim, in the same position they
were in the beginning, using the landmarks marked previously;
- Interlock the occlusion rims one to each other with melted wax
- Prepare plaster paste and apply it on the mandibular cast base
- Attach mandibular cast to articulator with mounting plaster.
- Trim and smooth mounting plaster when set.
DENTURE WAX-UP
Areas to be relieved:
I- Hard bony areas.
II- Sensitive areas.
Denture Tooth Arrangement
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1. Every tooth has two antagonists (exceptions: Mandibular Central Incisor and the last
maxillary molar – who have only one antagonist)
2. The denture teeth are set-up on the crest of the ridge (exception: the maxillary frontal teeth,
placed more buccally for esthetics)
3. Denture teeth meet on a plane named occlusal plane, which has three curves: incisal, saggittal
and transversal.
MAXILLARY TEETH
The maxillary denture teeth are set-up starting from the midline
Central Incisors: Labial surface is perpendicular to the horizontal and to the midline based on the
frenum, filtrum and the center of the face. Incisal edge on occlusal plane. Neck slightly
depressed.
Lateral Incisors Incisal edge 0-2mm above the occlusal plane (this will vary according to the
age of the patient; older patients would not normally be expected to have a ‘youthful’ step
between their centrals and laterals, due to wear of the centrals and canines.). Neck slightly
depressed.
The centrals and laterals should have their incisal edges placed more anteriorly than their necks to
support the lips in a slightly prominent and natural position.
Canines: Incisal edge touches the occlusal plane. The canines should be positioned to show their
mesial aspects when viewed from the front. The distal aspect should link into the
posterior teeth and create a natural looking buccal corridor. The neck of the canine
should be prominent and more anteriorly placed than the incisal edge to emphasize the
canine eminence and to support the lips.
The upper posterior teeth are set over or slightly buccal to the ridge, such that their occlusal
surfaces lie slightly buccal to the lower ridge. The teeth are positioned to create a compensating
curve. The curve of Spee, antero-posterior curve of the posterior teeth, should match the condylar
angle to maintain contact between the teeth in protrusive excursions.
The upper first premolar is positioned with buccal cusp contacting the occlusal plane and the
palatal cusp lifted slightly off the occlusal plane by 0.5–1 mm. The long axis of the tooth is
vertical when observed from the buccal aspect.
The second premolar is positioned with a vertical long axis when viewed buccally, with palatal
and buccal cusps contacting the occlusal plane.
The first molar tooth is positioned with the mesiopalatal cusp contacting the occlusal surface and
the remaining cusps lifted to continue the compensating curve started by the second premolar. The
mesio-palatal cusp is the nearest to the occlusal plane and the disto-buccal cusp the furthest away.
The lower first molar tooth is positioned to occlude with the upper such that the mesiopalatal
cusp of the upper tooth occludes with the central fossae of the lower tooth.
The lower canine is placed to occlude with the upper lateral incisor and canine
The lower central incisor is placed to occlude only with the upper central incisor
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The lower lateral incisor is placed to occlude with the upper central and lateral incisors
The first premolars are placed to occlude with the upper first premolar and the distal aspect of
the canine.
The lower second premolar is placed to occlude with the upper second and first premolars.
The second molar teeth should only be placed if there is room to do so without placing them over
the sloping parts of the ridges, which would cause denture instability.
This procedure is defined as the contouring of the wax base of a trial denture into the
desired form.
SPECIAL CONSIDERATIONS:
1. Palate of maxillary denture should be even in thinness, provide room for the tongue, and not
interfere with speech. The palate may be completely smooth or have rugae in the anterior portion.
2. The denture must be self-cleaning. Holes or rough areas provide food traps. Interdental papillae
must be smooth and flat or slightly convex.
3. Lingual flange of mandibular denture may be slightly concave but not so much as to cause
dislodgment of the denture by the tongue.
4. The denture must replace lost bony structure; therefore the canine eminence at the corner of
the mouth and the gingival bulge on the buccal are very important.
7. The denture base must be uniform in outer thickness. Lumps and bumps are very
uncomfortable, draw attraction to their presence and provide a site for debris accumulation.
8. The waxed denture is exactly duplicated. Care must be taken to wax the denture exactly as you
wish the final denture to appear.
9. The posterior palatal seal helps retain the denture and must be performed before the denture is
sealed down and processed.
Maxillary
Sulcus - Filling the sulcus with the denture base provides the optimal seal around the denture,
adding retention. The denture base should be extended fully into the sulcus to achieve a good seal
between the denture periphery and the tissues.
Palate- The palate should generally be smooth and extend to the junction of the hard and soft
palate. The shape of the anterior palate can have a significant effect on speech and this should be
assessed and modified at the try-in stage by the clinician and technician. Artificial rugae may be
provided relatively easily using a silicone impression of the patient’s own rugae to aid in sculpting
the wax. Smooth dentures are easier to clean, and some patients who have worn smooth palate
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dentures for a long time may find such features an irritant. However, they may be worth
considering if difficulty is being experienced with phonetics. The undulating surfaces may allow a
more natural contact with the tongue and aid word formation. The formed rugae should be smooth
so they do not irritate the tongue, collect food debris or encourage plaque accumulation.
Mandibular
Lingual
Wax the posterior lingual flanges from the teeth to the peripheral roll making an incline plane that
slopes toward the tongue and is not convex. It may be slightly concave but not so much as to
cause the tongue to dislodge the denture. Flame and smooth with torch.
STEPS
- Flasking.
- Wax elimination.
- Packing of acrylic resin.
- Processing and curing
- Deflasking
- Finishing and polishing.
1. Investing (flasking)
The investing procedure is the placing of the waxed denture bases and teeth
in suitable investing media in preparation for wax elimination and packing
of acrylic resin in its place. Plaster and stone, contained within a split metal
flask, are the investing materials because of their hardness and ability to
reproduce surface detail.
The processing flasks contain a lid, an upper and lower component (divided
according to whether it is used for an upper or lower denture) and a bottom
knock out disc.
Before beginning:
-ALL wax must be removed from the clinical crowns of denture teeth.
-Seal the waxed-up dentures to cast around the entire periphery
- immerse the cast in water for 5 minutes
Prepare the appropriate flask by lubricating internal surfaces and the cast.
Each denture is first invested in the lower half of the respective flask. Make a mix of plaster and
place it into the flask. Position the cast into the plaster allowing the excess plaster to squeeze
upward around the periphery. Trim off excess plaster and clear of the flask lip. The depth to which
the cast is placed into the plaster is determined by the height of the teeth in relation to the top of
the flask. Therefore it is advisable to place the upper half on the flask, without the lid, to make this
determination. A minimum of one half inch clearance from the top of the flask to the teeth is
essential. No difficulty will be experienced if the cast thickness is correct as described in the
procedure for pouring and trimming the master cast. The cast may be further pressed into the
plaster until the correct height is achieved. This must be accomplished while the plaster is still soft
and all excess should be removed after each manipulation. Allow plaster to set a minimum of 20
minutes. Trim and smooth all paste surfaces. Remove excess plaster edges so that the halves of the
flask can be placed in opposition (there should be metal-to-metal contact).
Apply a separating agent to the exposed plaster and stone surfaces. The separator is painted on
with a brush until a shiny surface is attained. Allow the separator to dry. Place the upper half of
the flask in place without the lid. Make a mix of plaster and vibrate it into the flask. Place the lid
on and press completely to place, allowing excess stone to squeeze out of the lid holes. Clear
excess stone and place the flask in a press under light pressure. Artificial stone is used over the
teeth because its greater strength will better resist pressures against the teeth during packing.
Allow the stone to set for 45 minutes.
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2. Wax Elimination:
Immerse the flask in boiling water for 5-6 minutes to soften the wax. Remove from water and
carefully open the flask halves. Peel away the baseplate and unmelted portions of wax. Note that
the teeth are retained in the upper half of the flask. Clear all traces of wax from all surfaces and
teeth by flushing repeatedly with clean boiling water.
4. Curing:
The flasks should remain under pressure for at least 15 minutes. The manufacturer's should be
followed for curing. The flasks are removed and allowed to bench cool. Bench cool is very
important as separating the denture while is to hot may cause fracture.
5. Deflasking
Open the flask and dislodge the investment from the flask. Using
plaster shears or nippers, chip the plaster from around the
periphery of the stone cast until the base is exposed. Using plaster
saw and shears remove al plaster until the denture is exposed. The
plaster should be removed in small increments so that the acrylic,
the cast nor the teeth are fractured. You should recover a processed
denture base containing teeth attached to a stone master cast.
6. Finishing
Trim all gross excess acrylic down to the original waxed denture form, being careful not to
remove the following:
- Buccal, facial and lingual fold contour
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- Post-dam area
- Gingival festooning around the teeth
- Surface contour and root eminences
Minor alteration of these areas may be made with acrylic buts, small burs and stone
- Inspect the tissue side of the dentures for small blebs due to voids in the casts. Remove these
with burs
- Finish the external surface and peripheral fold with rubber wheels to remove gross defects and to
impart final contour
- Using a wet rag wheel mounted on a lather, polish the external surfaces up to the peripheral
fold with medium pumice followed by fine flour of pumice until all scratches are removed. It is
advisable to use the low speed on the lathe in order to better control the amount of polish.
Maneuver the denture so that the depressed or concave areas are polished. Maintain the surface
contour during this procedure. Final impart a high shine on the same areas using a felt wheel and
green compound. Note that the basal seat surfaces are not altered or shined!.
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