Step in complete denture fabrication Laboratory and clinical remounting of complete dentures.

1. Remounting
PRESENTED BY: DR. RAJVI NAHAR
1ST YEAR POST GRADUATE

2. Contents
• Introduction
• Definitions
• Need for remounting
• Direct correction in mouth
• Laboratory remounting
• Clinical remounting
• Selective grinding
• Remounting with different articulators
• Adjustment in complete and partial dentures
• Conclusion
• References

3. Introduction
• Complete dentures are prosthetic replacements for lost natural
teeth and lost soft and bony tissues, which are fabricated in
order to restore impaired functions and appearance.
• The comfort of a prosthesis is a commonly recognized
prerequisite for positive adjustment to a newly fabricated
complete denture.
• Occlusal discrepancy is reported to be one of many factors that
may cause tissue irritation.

4. • This discrepancy may lead to an unstable denture, applying
uneven pressure to both hard and soft tissues.
• Occlusal discrepancy can result from warping of the record
bases, incorrect centric relationship recording, or other faulty
procedures in mounting and processing.
• The efficiency and comfort that a patient experiences using
complete dentures depends to a large extent on the harmony
of the occlusion.

5. Definitions (According to GPT 9)
• Remount cast: A cast formed inside the intaligo of a prosthesis for
the purpose of mounting
the prosthesis on an articulator.
• Remount procedure:Any method used to relate restorations to an
articulator for analysis and/or to assist in development of a plan for
occlusal equilibration or reshaping.
• Remount record index: A record of maxillary structures affixed to
the mandibular member of an articulator useful in facilitating
subsequent transfers.

6. Causes of error in occlusion
• Errors in registering jaw relation:
1. Record bases that do not fit accurately.
2. A shifting of the record bases over displaceable tissues.
3. Record bases placed on soft tissues that have been deformed
by ill-fitting dentures.

7. 4. Excessive pressure exerted by the patient during jaw relation.
5. Unequal distribution of stress during registering maxillo-
mandibular relations.
6. Patients not registering centric relations due to systemic
factors- muscle spasm, abnormalities ofTMJ, or mental failure,
age, senile patients.

8. Errors in mounting casts:
1. Record bases that are not properly seated and secured to casts
during mounting procedures.
2. Occlusal rims not being definitely locked for correct orientation
during mounting on articulators.
3. Interference of casts in posterior region during mounting.
4. Articulator not maintaining horizontal and vertical jaw
relationship of casts.
5. Inaccuracies introduced by changes
in the plaster used to mount
the cast.

9. • Errors while flasking and packing
1.Tooth movement while de-waxing.
2. Excessive packing pressures results in the artificial teeth being
forced into the investing plaster.
3. If the acrylic resin has reached an advanced dough stage.

10. 4. Normal packing pressures when the investing mix is weak can
break the mould .
5.Tooth movement while flasking and packing.
6. Incomplete Flask closure.
7. If pressure on the flask is released during the curing cycle.
8. Separation of the two halves of the flask by a layer of excess
resin which should have been removed during trial closure of
the flask(flash).

11. Indexing the master cast
1. Groove indexing method
2. Notch indexing method

12. Direct correction in mouth
Laboratory Remounting
Clinical Remounting
Methods to correct Occlusal
Discrepancies

13. Direct correction in mouth
• Articulating Paper:
• It will not give an accurate indication of
premature contacts –
1. Resiliency of supporting tissues
2. Tipping of denture bases
3. If placed on one side of the arch,
induce the patient to close to or away from that side.
• Place articulating
paper on both sides.

14. • Central Bearing Devices:
• THE CORRELATOR:
A central bearing pin
works on spring.
Pin in mandibular mounting
contacts metal plate in
the vault of maxillary
denture.
Pin creates tension before
the teeth contacts.
Interceptive occlusal contacts
with articulating ribbon.
• THE COBBLE DEVICE:
A central bearing pin without
spring.

16. • Occlusal wax:
Adhesive green wax:
Excellent method for correcting
occlusion in centric position only.
Disadvantage – shifting of
dentures on resilient supporting
tissues in eccentric jaw position
will give false markings.
• Abrasive paste:
Disadvantages: shifting of base as
a result of premature contact may
result in altering the occlusion.
Cusps that maintain occlusal
vertical dimension may be
destroyed.

17. Laboratory Remount Procedure
• A laboratory remount procedure removes the processing errors
that occur prior to removal of dentures from the definitive cast.
• A remount procedure begins with fabrication of remount casts,
determination and transfer of interarch relationships into the
articulator.
• Deflective contacts on dentures are eliminated by selective
grinding carried out in the articulator in the intercuspal position
and by excursive tooth guided movements.

18. Preparation of dentures for fabrication of remount casts
Check relationship of the incisal
guide pin to the incisal guide table

19. Check contacts between heel of
mandibular dentures and tuberosity
region of maxillary denture
Place articulating paper to check
deflective contacts

20. Adjust occlusion in centric relation
position and in eccentric relation,
according the rules of selective
grinding.
Move the articulator into working
position and examine the occlusal
relationship.

21. Eliminate deflecting contacts
Examine balancing contacts
Check occlusion by moving articulator in
various position
Incisal guide pin should contact the
incisal guide table
Recheck the occlusion

22. Making a face-bow index
• Remove mandibular denture and cast from mounting and scrape
off any sticky wax.
• Box the lower mounting stone with boxing wax
• Extend upper edge of boxing wax 1-2mm above the level of
occlusal surface of maxillary teeth.
• Seal the boxing wax to the stone to make it watertight.
• Pour water into the boxed stone to soak it and facilitate joining of
the next pour of the stone.

23. • Paint the occlusal surfaces of the maxillary teeth with the microfilm
of separating medium.
• Mix the stone and fill the boxed area.
• Place additional stone on occlusal surfaces of maxillary teeth.
• Allow the stone to set;
then remove the
boxing wax and trim it.
• The face-bow index is
complete.

24. Split Cast Mounting Technique
• The ‘‘split cast’’ (Given by J.W. Needles in 1923) is essentially a
maxillary cast constructed in two parts with a horizontal division.
• The first part of the split maxillary master cast with index
grooves, is known as primary base.
• The design, number, and position of the index grooves are
determined on the basis of the height of the palatal vault, depth
of the sulcus and the personal preference of the clinician.
Gundawar SM, Pande NA, Jaiswal P, Radke UM. SplitCast Mounting: Review and New
Technique.The Journal of Indian Prosthodontic Society. 2014 Dec 1;14(1):345-7.

25. • The second part, which is fitted to the master cast and is
attached to the upper member of the articulator is referred to
as secondary base or sandwich.
• The perfect fit of the master cast, sandwich and upper member
of the articulator verifies the correct centric relation record.
• If gap is present between the master cast and sandwich or
sandwich and upper member of the articulator that determines
the previous recording of centric relation is incorrect.

26. Nogueira, S. S., Russi, S., Compagnoni, M. A., & deAssis Mollo, F. (2004). A variation on split-cast mounting for complete denture construction.The
Journal of Prosthetic Dentistry, 91(4), 386–388. doi:10.1016/j.prosdent.2004.02.002

27. • The sandwich should have a contrasting color for easy detection
and should also have index grooves.The split cast mounting
procedure allows for:
(i) Ease of removal and replacement of the casts.
(ii) To program the articulator by means of eccentric records.
(iii) Verification of centric jaw relation records.
(iv) For correcting occlusal errors as a result of the processing
technique.

29. • After the final impression, beading and boxing is completed.
• Two dowel pins with plastic/metal sleeves, are then inserted in
the boxing wax, with a gap of 2–3 mm on right and left side.
• Remove the dowel pins from their sleeves and after finishing of
the cast, the dowel pins are reinserted in their sleeves.
• Base of master cast is sharply grooved. Secondary base is
poured.

30. • Using face bow, the combined primary and secondary base cast
are mounted on the upper member of the articulator.
• Two metal plates with serrations on one end (routinely available
forks) are cut in required length.
• The other end is also slightly notched, for encircling the ligature
wire.
• During mounting, before plaster sets hard, these plates with
serrated end, are inserted into plaster on right and left side.

31. • Once the plaster sets hard, the ligature wire is moved around the
two dowel pins which is attached to the master cast. It is
encircled over the notched surface of the metal plate, tightened
to stabilize the upper mounting.
• Advantage: Damage to cast is minimum. Mounting is stable. Easy
to use. Easy removal and reattachment of maxillary cast to the
articulator.
• Disadvantage: Extra time is required in attaching the dowel pins
to the cast .

32. Modified Split Cast technique
• BEFORE APPOINTMENT:
• Fabricate maxillary and mandibular remount casts.
• Mount the maxillary remount cast and maxillary denture with
the preserved face bow record in the upper jaw member of the
semi-adjustable articulator
Liu FC, Luk KC, Suen PC,TsaiTS, KuYC. Modified Split‐CastTechnique: A New,Timesaving
Clinical RemountTechnique. Journal of Prosthodontics: Implant, Esthetic and
Reconstructive Dentistry. 2010 Aug;19(6):502-6.

33. • Fabricate mandibular secondary remount base.
• The incisal pin is set at −3 and locked.
• The articulator is inverted for convenience in mounting.
• Using maximal intercuspation of the maxillary and mandibular
dentures, secure the mandibular denture along with its remount
cast.
• Apply plaster separator (tin foil, tin foil substitute, or lubricating
jelly) to the bottom of the mandibular remount cast.

34. • Mount the mandibular cast, along with its denture, on the lower
jaw member of the articulator with dental plaster, forming a
secondary remount base.
• Separate the mandibular remount cast from the secondary
remount base, reset the incisal pin, and lock at zero.
• Thus, a space approximately
1- to 2-mm thick is created
between the mandibular remount
cast and the secondary remount
base.
• Remove maxillary and mandibular
dentures from the corresponding
remount casts.

35. • Attach maxillary remount cast and mandibular secondary remount
base cast to the upper and lower jaw members of the articulator,
making ready for the clinical remount procedure.

36. Clinical remount procedure
• Cover the tissue side of each denture with pressure indicating
paste or disclosing agent and make appropriate corrections
intraorally.
• Make a centric relation interocclusal record with an addition-type,
silicone bite-registration material.

37. • Secure the maxillary and mandibular dentures on their
respective remount casts.
• Relate the mandibular cast to the maxillary cast according to the
interocclusal record and lute them together with wooden rods
and sticky wax.

38. • Adjust incisal pin height and inject the Futar D into the space
created between the mandibular remount cast and the
secondary mounting base, close the lower jaw member of
articulator, and wait for Futar D to set.
• Because Futar D is fast setting (2-minute setting time) and has
low elastic properties , it can be used as a remounting medium.
• Check the interocclusal
relationship on the
articulator, if necessary.

39. • Separate mandibular remount
cast, then repeat steps 4 and 5
until a repeatable and stable
centric relation position is
obtained.
• After the accuracy of the
articulator mountings is verified,
occlusal errors can be corrected
by selective grinding procedures.

40. • This clinical remount technique utilizes maxillary and mandibular
Customized Mounting Plates (CMPs) that are fabricated over mounting
plates of articulator.
1. Enfold boxing wax around the outside edge of the maxillary and
mandibular mounting plates to form diverging housing for holding the
dental plaster.
A simplified chair-side remount technique using
customized mounting platforms

41. • Customized mounting platforms (CMP) has these advantages:
(1) remount casts are not fabricated separately for remounting
complete dentures;
(2) the mandibular denture can be remounted quickly with a new
centric relation record, in case of incorrect centric relation record;
(3) blocking out undercuts from the tissue surface of denture is not
necessary;
(4) mounting can be performed at chair-side with minimal mess and;
(5) the putty impression material can be conserved as a record to be
used in successive appointments if needed.
Chauhan MD, Dange SP, Khalikar AN,Vaidya SP.A simplified chair-side remount technique using
customized mounting platforms.The journal of advanced prosthodontics. 2012Aug 1;4(3):170-3.

42. • 2. Reduce the boxing wax for the maxillary and mandibular
mounting plates such that the diameter at the opening is 6.5 cm.
• 3. Similarly, trim the height of maxillary boxing wax at 2.5 cm and
that of mandibular boxing wax at 2 cm.
• 4. Pour a mix of dental plaster to fill both the divergent cylinders.
• 5. Allow the dental plaster to set and remove the boxing wax.

43. • 6. Carve a horse-shoe shaped groove on the flat surfaces of both
the divergent cylinders .
• 7. Form a mix of self cure acrylic resin into two spools and place
over the grooves of both the maxillary and mandibular divergent
cylinders to form U-shaped positive replica of edentulous ridges.
Adjust the vertical height of the ridges to 5 to 6 mm.

44. • 8. Trim these acrylic edentulous ridges with fissure bur to make
buccal and lingual undercuts that will provide port for the putty
impression material during subsequent mounting of the dentures.
• 9. Finish and polish both the customized mounting platforms.

45. Chair-side remounting of the dentures
• 1. Check the intaglio surface of each
denture in the mouth with pressure-
indicating pastes or waxes and make
the needed adjustments.
• 2. Make a centric relation inter-
occlusal record with a soft medium
such as warm Aluwax to confirm
closure without contact of the
denture teeth or bases.
• 3. Attach the maxillary and
mandibular CMPs in the articulator.

46. • 4. Place the putty impression
material in the form of a U-
shaped roll over the mandibular
acrylic resin edentulous ridge on
the CMP and position the
mandibular denture on it.
• 5. Secure the maxillary denture
over mandibular denture with the
help of the centric interocclusal
record in aluwax, place the putty
material in the denture in the
region of alveolar ridge, and close
the upper member of the
articulator into the putty material.

47. • 6. After the putty impression material has set, open the articulator
and remove the interocclusal record.
• 7. The putty material serves as remount casts .
• 8. Close the denture onto articulating paper and adjust the
occlusion.

48. Patient Remount Procedures
• The patient remount method is to remount the dentures on an
articulator by means of interocclusal records made in the
patient’s mouth.
• Advantages:
1. Reduces patient participation.
2. Permits dentist to see the procedures better.
3. Provides stable working foundation.
4. Absence of saliva makes possible accurate markings with the
articulating paper or tape.
5. Corrections can be made away from patients.

49. Procedure
Place two thickness (1½ mm) of passive–type wax on the occlusal surfaces.
Soften wax with alcohol torch or immerse in water at 130°F.
Have the patient close into the wax when the jaws are in centric relation.
Trim the wax and expose the facial side.

50. Seat the mandibular cast in the denture
and attach to mandibular member of
the articulator with plaster.
Orient mandibular denture to the maxillary denture by means of
interocclusal record with jaws in centric relation with sticky wax.
With the condylar elements freed, place
teeth in the indentations in the wax
interocclusal record. Condylar elements
should rest against stops.
Repeat procedure until two consecutive
records are accepted.Verify the accuracy
of articular mountings.

51. • Definition:The intentional alteration of the occlusal surfaces of
the teeth to change their form.
• Articulating paper of minimum thickness is used for marking the
actual contacts of the teeth.(less than 21 µm thick)*
• The diagnostic adjustment was first made on the casts and then
on the patient using four differently colored ribbons:**
1. Red: centric stops
2. Black: protrusive interferences
3. Green: working side interferences
4. Blue: balancing side interferences
Selective Grinding Procedures
**Raheja R, MahajanT, Singh R, Singh N. SELECTIVEGRINDING/OCCLUSAL RESHAPING IN PROSTHODONTICS.
*Malta Barbosa, J., Urtula,A. B., Hirata, R., & Caramês, J. (2017). Thickness evaluation of articulating papers and foils.
Journal of Esthetic and Restorative Dentistry, 30(1), 70–72. doi:10.1111/jerd.12343

52. • In the first step, cusp form teeth are altered by selective grinding to
obtain balanced occlusion when the jaws are in centric relation.
• Occlusal balance in a lateral direction is obtained by having all of
the posterior teeth and the cuspids in contact on the working side
and in posterior contact only on the balancing side.
• In the protrusive balance the anterior teeth should
make incisal edge contact at the same time
that the tips of the buccal and lingual cusps
of the posterior teeth contact.
• Adjust horizontal and lateral condylar inclinations
of the articulator to the settings dictated by the
protrusive interocclusal maxillomandibular
relation record.

53. • Raise incisal guide pin from the guide table and secure it above
the height of the table.
• Evaluate areas of contact in the centric and eccentric positions
prior to the selection of the point or area to be reduced or
altered.
• With the condylar elements against the centric relation stops ,
close the articulator until the posterior teeth are in contact . the
anterior teeth should not be in contact .
• Examine the lingual cusps of the maxillary posterior teeth and
the buccal cusps of the mandibular posterior teeth .
• Premature contact appears when the remainder of the teeth fail
to make maximum intercuspation. Record the area or areas of
premature contact .

54. • Grinding in Centric :
1.The first objective is to remove premature contacts in centric
occlusion.
2. Mark the interfering cusps
with articulating paper.

56. 3. In the retruded contact position there are three types of occlusal
errors and each can be corrected by specific grinding :
(i) Any pair of antagonist teeth can be too long and thus hold
other teeth out of contact.
1.If the offending cusp makes premature contact in centric as well
as eccentric ground the cusp.
2.If the offending cusp makes premature contact in centric only,
deepen the opposing fossa .

57. • The lower and upper teeth can be placed almost edge- to-
edge:
1. Grinding cuspal inclines- palatal inclines of maxilla and buccal
inclines of mandible. Cusps are not shortened.

58. • Too much horizontal overlap :Maxillary palatal and mandibular
buccal cusps are made narrow, not short.

59. • Grinding in Eccentric :
1.The maxillary buccal cusp and the mandibular lingual cusp are
too long :The inner inclines of BUCCAL cusps of UPPER and
LINGUAL cusps of LOWER (BULL) are adjusted.

60. 2.The buccal cusps are in contact, but the lingual are not :The
lingual inclines of upper buccal cusps are ground.

61. 3.The lingual cusps are in contact, whereas the buccal are not ▫
Buccal inclines of mandibular lingual cusps are reduced in order
to shorten the cusp.

62. 4.The maxillary buccal or palatal cusps are positioned more
mesially from their intercuspal position(MU-DL): Grinding
should be done on the mesial inclines of the maxillary buccal
cusps and distal inclines of the mandibular buccal cusps.

63. 5.The maxillary buccal or lingual cusps are positioned more distally
from their intercuspal position : Grinding should be done on
distal inclines of maxillary buccal cusps and mesial inclines of
mandibular buccal cusps .

64. 6. No contact on working side due to excessive contact on the
balancing side: buccal cusps of the mandibular teeth
(balancing side) are altered on their inclines.

65. • Occlusal Errors on the Non-working side : Mandibular buccal
cusp are adjusted to reduce the incline of the part of the cusp
that prevents tooth contacts on the working side.

66. • Eliminating Occlusal Errors in Non- AnatomicTeeth:
• Maxillary posterior are flattened by sanding on ultrafine sand
paper against a truly flat surface .
• After placing on the remount casts and articulation, occlusal
contacts are marked .
• Selective grinding is done only on the mandibular teeth

67. • Occlusal Adjustment in AverageValue Articulator:
• Remounting of the dentures requires an average value or semi-
adjustable articulator be used to examine the lateral and
protrusive occlusal contacts.
• Using a simple hinge articulator is not satisfactory, as lateral
excursions are not possible.
• The retruded contact position is recorded intraoral using soft wax.

68. • The upper denture is articulated so that the center pin, touches
the mid-line at the upper incisal edge.
• The lower denture is attached to the articulator ensuring that the
occlusal plane is horizontal and parallel to the base of the
articulator .
• When the plaster has set, the wax is removed between the
occlusal surfaces of the teeth and the occlusal adjustment is
carried out.
• When the wax is removed,
the teeth than contact,
rotating around condylar axis
of the articulator.

69. Full Dentures Opposed to Partial
Dentures :
• Maxillary complete dentures and mandibular partial
dentures:
1. Similar procedures as previously mentioned are carried out .
2. Avoid grinding natural teeth.

70. • Partial Upper denture and
Lower complete Dentures:
• For maxillary and mandibular
distal extensions with only
anterior teeth remaining
previously described
procedures can be carried out.
• For small partial dentures, the
opposing natural dentition is
adjusted .

71. Conclusion
• Correct occlusal relationships are a part of the success in
prosthetic treatment for edentulous patients with complete
dentures.
• A clinical remount procedure of the finished dentures is a
constituent part of prosthetic patient treatment in practice of
complete dentures.
• The laboratory and clinical remount procedures, along with
occlusal corrections, reduces the number of areas of tissue
irritation, post insertion visits, pain during mastication and
swallowing, and discomfort during mastication, and enhanced
the comfort of the patient .

72. • The clinical remount also maintains the stability of dentures
when the mandible is in centric relation position
• Selective grinding helps to remove the occlusal errors in a
systematic way .
• Occlusion of such dentures is more stable for longer time and
with less parafunctional movements.
• Hence, a more satisfied patient.

73. References
• Syllabus of complete Dentures ;Heartwell 4th edition
• ProsthodonticTreatment for Edentulous Patients ;Zarb ,Hobkirk et al 13th edition
• Dental Laboratory Procedures volume 1 ;Rudd and Morrow
• Nallaswamy D.Textbook of prosthodontics. JP Medical Ltd; 2017 Sep 30.
• Gundawar SM, Pande NA, Jaiswal P, Radke UM. Split Cast Mounting: Review and NewTechnique.The
Journal of Indian Prosthodontic Society. 2014 Dec 1;14(1):345-7.
• Liu FC, Luk KC, Suen PC,TsaiTS, KuYC. Modified Split‐Cast Technique: A New,Timesaving Clinical
RemountTechnique. Journal of Prosthodontics: Implant, Esthetic and Reconstructive Dentistry. 2010
Aug;19(6):502-6.
• Chauhan MD, Dange SP, Khalikar AN,Vaidya SP. A simplified chair-side remount technique using
customized mounting platforms.The journal of advanced prosthodontics. 2012 Aug 1;4(3):170-3.
• Nogueira, S. S., Russi, S., Compagnoni, M. A., & de Assis Mollo, F. (2004). A variation on split-cast
mounting for complete denture construction.TheJournal of Prosthetic Dentistry, 91(4), 386–388.
doi:10.1016/j.prosdent.2004.02.002
• Raheja R, Mahajan T, Singh R, Singh N. SELECTIVE GRINDING/OCCLUSAL RESHAPING IN
PROSTHODONTICS
• Malta Barbosa, J., Urtula, A. B., Hirata, R., & Caramês, J. (2017). Thickness evaluation of articulating
papers and foils. Journal of Esthetic and Restorative Dentistry, 30(1), 70–72. doi:10.1111/jerd.12343 .