denture repair

1. Denture repair
DR. BHAVIN MILIND PATIL
PROSTHODONTICS JR1

2. INDEX
• PLASTIC ANTERIOR TOOTH
REPLACEMENT
• PORCELAIN ANTERIOR TOOTH
REPLACEMENT.
• PLASTIC POSTERIOR TOOTH
REPLACEMENT.
• PORCELAIN POSTERIOR TOOTH
REPLACEMENT
• REPAIRING FRACTURED DENTURE
1. NON SEPERATED FRACTURE
2.FRACTURED DENTURE WITH TWO
OR MORE PIECES
3.FRACTURED DENTURE WITH
MISSING PIECES
• ADDING A POSTERIOR PALATAL SEAL

3. REPAIRING
DENTURE WITH
FRACTURED
TEETH
• Fracturing or chipping a denture tooth is not
an uncommon problem.
• Although porcelain teeth are more
prone to breakage, particularly when dropped
onto a hard surface, either porcelain or acrylic
denture teeth may he fractured.
• The method used to replace these teeth
depends on the tooth material.

4. PLASTIC ANTERIOR TOOTH
REPLACEMENT
 1. Remove the fractured tooth by grinding it with a
No. 8 round bur.
 2. Do not grind the labial gingival margin.
 3. Remove denture base resin from the denture
lingual surface adjacent to the tooth to be replaced.
Do not perforate the base.

5.  4. Select a plastic tooth of the appropriate size and
shade, and custom grind its ridge lap to facilitate correct
positioning on the denture.
 5. Check the replacement-tooth position from front and
above views. Sticky wax may be used to secure it
in position.
 6. When .the tooth position is acceptable, make a putty
index onto the labial surface of the tooth to be replaced
and on the labial surfaces of adjoining teeth on
each side.

6.  7. After the putty sets, separate the index and tooth
from the denture, and remove all traces of sticky wax
 8. With a No. 6 bur, place shallow indentations in
the denture-tooth ridge lap to provide an additional
bonding area.
 9. Replace the index and tooth on the denture, and
carefully paint in autopolymerizing resin from the
lingual or palatal side.

7.  10. Continue to add resin, taking care to minimize
voids, build it up to the desired contour
 11. Place repaired denture in a pressure pot of warm
water, and cure it at 20 psi for 30 minutes.
 12. Remove the denture, and polish the
autopolymerizing resin with flour of pumice and either a
rag wheel or rubber prophy cup on a standard
handpiece that reduces the likelihood of overreducing
the denture surfaces.

8. PROBLEM AREAS

10. Porcelain anterior
tooth replacement
THE PROCEDURE FOR REPLACING
PORCELAIN DENTURE TEETH
DIFFERS FROM THAT FOR PLASTIC TEETH
IN THE MANNER OF REMOVING THE
FRACTURED TOOTH FROM THE DENTURE
BASE

11. PROCEDURE
 1. Heat the end of a roach carver or wax spatula in a
flame, and press it against the fractured porcelain tooth
Several applications may be necessary to
heat the tooth sufficiently.
 2. Gently pry the porcelain tooth from the denture
base .The tooth should separate cleanly
from the base.
 3. Examine the ridge lap of the tooth for mold identification
marks.

12.  4. Select a replacement tooth of correct mold and
shade.
 5. To provide space for repair resin to be added later,
remove the denture base resin from the lingual or pin,
area. Do not remove resin from the labial margin of the
socket or perforate the base.
 6. Try the tooth in position, and adjust it if required
A fine-cut wheel is good for reducing porcelain.

13.  7. Wax the tooth in position with two droplets of
sticky wax on the incisal edge, and check its position
carefully.
 8. Pour a plaster index as described previously for
plastic teeth.
 9. After removing the wax and preparing the tooth,
paint repair resin between the ridge lap and denture
base. Take care to avoid air entrapment.

14.  10. Cure the repaired denture in a pressure
container at 20 psi for 30 minutes.
 11. Polish the repaired denture with flour of
pumice and a rag wheel or a rubber prophy cup.

15. Plastic posterior tooth replacement
 The method for replacing fractured plastic and porcelain posterior teeth is similar
to that for anterior teeth, but with a significant difference.
 Since occlusion is usually a factor when replacing posterior teeth, the denture will
need to be remounted for occlusal correction.
 This is particularly important for plastic teeth, since their occlusal surfaces are
often worn , and a new tooth of the same mold will differ considerably in occlusal
contour.
 A possible exception would occur if the plastic posterior tooth was fractured
during deflasking or while the denture was being constructed. In this situation the
new tooth would be added, and the occlusion adjusted in the articulator when the
processing error was corrected

16. PROCEDURE
 1. Mount the denture in an articulator to facilitate
correcting the occlusion.
 2. Remove the fractured resin posterior tooth by
grinding it with a No. 8 round bur taking
care to not perforate the denture base. Preserve the
facial gingival margin of the denture base resin.
 3. Select a resin posterior replacement tooth.

17.  4. Grind the ridge lap of the replacement tooth to
allow correct placement on the denture.
The tooth can be occluded and sealed to the opposing
denture tooth during this procedure.
 5. Paint autopolymerizing resin into the ridge lap
area to seal the tooth to the denture base.
 6. Place the denture in a pressure container of warm
water, and cure it for 30 minutes at 20 psi.
 7. Polish the repair, and adjust the occlusion.

18. Porcelain posterior tooth replacement
 1. Mount the denture on an articulator.
 2. Heat the broken porcelain tooth with a hot wax
spatula to remove it from the denture base.
Grind away the denture base resin extending into the
retentive recess of the denture tooth.
 3. Check the indentation in the denture base to
determine if the mold number is discernible
An impression of the indentation can be made in inlay
wax: then the impressed mold number can be read in
the wax.

19.  4. Select a replacement tooth, and grind the ridge lap
if necessary to achieve the correct position.
 5. Occlude the replacement tooth, and seal it with
sticky wax to the opposing tooth or index.
 6. With the tooth secured in this position, paint
autopolymerizing resin into its retention recess and
into the denture base indentation .Close the articulator.

20.  7. Place the denture in a pressure container of warm
water at 20 psi for 30 minutes.
 8. Remove the denture, polish it, and adjust the occlusion.

21. If the occlusal surface of a fractured tooth is
not affected. an occlusal index can be made
of plaster before
the fractured tooth is removed. This
eliminates the
need to mount the denture in an articulator.
For occlusion adjustment, use the index
instead of the opposing
occlusion.

22. PROBLEM AREAS
 The principal problems with posterior tooth replacement are
similar to those for anterior teeth
 An additional problem exists, however, with the occlusion.
 The posterior replacement tooth must harmonize with the
existing occlusion to avoid deflective contacts.
 Careful placement of the tooth and correction of the
occlusion after the repair resin has set will reduce occlusion
problems

23. REPAIRING
FRACTURED
DENTURE
Nonseparated
fracture
Denture fractured
into two or more
parts (components)
Fractured denture
with section(s)
missing

24. Nonseparated fracture
 This type of fracture often occurs in the midline of a
maxillary denture, with the fracture line frequently
originating at a deep labial frenum notch.

25.  1. Carefully examine the denture to determine the
extent of the fracture .Gently flexing the
denture, but taking care to prevent breakage, will aid
this determination.
 2. If the fractured denture is self-approximating, pour
plaster into the denture to form a repair cast .Depending on
the size of the fracture, pouring the denture completely may
not be necessary; instead, pour a cast incorporating the
fracture and extending approximately 10 mm to either side of
the fracture line.
 3. If the denture is undercut in the region of the repair, place
a mix of silicone mold release into the undercut area to
facilitate removing and replacing the denture after the cast
has set.

26.  4. Remove the denture from the set cast, and use a
No. 558 bur to grind out the fracture line from beginning to
end .Bevel the cut outward to increase the bonding surface
.In the palate of maxillary dentures, place dovetails to
strengthen the repair joint .
 5. Paint the stone cast with tinfoil substitute, and allow it to
dry .Do not place the denture onto the cast before the tinfoil
substitute is thoroughly dry; otherwise, coating of the resin
may occur, which will severely reduce the repair strength.
 6. Replace the denture carefully on the cast.

27.  7. Paint autopolymerizing resin into the groove, taking care to
avoid air entrapment
 8. Build up the repair resin slightly above the surface of the
denture .
 9. Secure the denture to the cast with a rubber band and
cure it for 30 minutes in a pressure container .
 10. Remove the cured denture from the cast, then
finish and polish it.

28. Denture fractured into two or more
parts (components)
 A denture fractured into two or more parts (components)
often occurs when the denture is dropped on a hard surface.
This type of breakage requires care to assure that the
components are accurately oriented before a cast is poured

29.  1. Examine the denture to determine that all pieces
are present.
 2. Assemble the individual pieces carefully and lute
them together with sticky wax .An assistant
may be needed to seal the wax while the denture is
being held together. Modeling clay can often be used
to hold the pieces in contact while the denture is being
luted together .
 3. Pour a stone cast into the reassembled denture
.Undercut relief may not be required, depending on the
degree of fragmentation. When needed,
a silicone mold release or alginate irreversible hydrocolloid
can be placed in denture undercuts to facilitate
removal and replacement.

30.  4. After the cast has set, remove the denture, and
groove and dovetail the various pieces as previously
described: use wire reinforcement to strengthen the repair
if desired Moisten the margin with monomer before
painting the repair resin.
 5. Paint tinfoil substitute on the cast, and allow it to
dry.
 6. Replace the denture on the cast, and carefully
paint autopolymerizing resin into each groove and
dovetail .Use autopolymerizing Build up the repair resin
as previously described.

31.  7. Secure the denture to the cast with plaster or rubber
bands, and cure it in a pressure container of warm
water for 30 minutes at 20 psi.
 8. Remove the repaired denture from the cast, and
finish and polish it.

32. Fractured denture with section(s) missing
 A fractured denture with a section missing will usually require the
dentist to make an impression with the denture in place to make a
cast, particularly when a flange is broken, and the broken flange
section has been lost.
 In addition, if the denture is broken into several sections, the denture
may require a preliminary repair as previously described, prior to
making the impression of the lost flange.
 Autopolymerizing resin is then painted onto the cast to replace the
missing portion. The repair is very similar to constructing a resin
baseplate

33. PROBLEM AREAS
 When repairing complete dentures, the principal
problems are associated with correctly aligning the denture sections
and achieving a strong break-resistant repair.
 Alignment problems can be minimized if proper relationship of the
various parts is assured as the broken denture is assembled.
 A high quality denture repair resin and pressure-container curing
will improve the physical properties of the repair.

34. ADDING A POSTERIOR PALATAL SEAL
 Occasionally it may be necessary to add a posterior Palatal
seal to a maxillary denture after the denture has been
constructed.
 The dentist should use wax or an impression compound to
develop the desired thickness and extension of the seal. The
laboratory converts this to autopolymerizing resin.

35. PROCEDURE
 1. Pour an artificial stone cast into the denture.
The cast must include all of the posterior palatal
seal addition and extend 4 to 6 mm beyond it
posteriorly
 2. After the cast has set, remove the denture .The
denture may be placed in warm water for a few
minutes to soften the wax or compound addition
prior to removal.
 3. Trim the cast, and remove all traces of wax
and compound from the denture.

36.  4. Check the fit of the denture to the cast .
 5. Paint the cast with tinfoil substitute .
 6. With autopolymerizing monomer, moisten the
denture surface that is to receive the resin.
 7. Add autopolymerizing resin to the cast, and paint
additional resin on the denture surface.

37.  8. Assemble the denture and east , and use firm
finger pressure to squeeze out the excess resin.
 9. Secure the cast and denture with a rubber
band, and cure it in a pressure container.
 10. Remove the cast after curing, and finish and
polish it.

38. PROBLEM AREAS
 Problems associated with adding a posterior palatal seal to an existing denture
are related to controlling the amount of resin added and preventing voids in the
completed addition.
 The amount of resin added to the cast should approximate the volume of the
wax or compound used to make the posterior palatal seal. Excessive resin will
How forward onto the tissue contacting surface of the denture and will require
removal. Too little resin will result in undesirable voids in the posterior palatal
seal, which will have to be filled
with resin

39. REFRENCES
 RUDD AND MORROW (2ND EDITION) DENTAL LABORATORY PROCEDURES FOR
COMPLETE DENTURES