3. Clinical
Stage
01
02
The dentist evaluates the
patient's oral condition, takes
into account their needs and
expectations, and plans the
treatment accordingly.
Diagnosis and Treatment
Planning:
An initial impression of the
patient's mouth is taken
using alginate or other
suitable materials. This
provides a basic model of
the oral structures.
Preliminary Impressions:
4. Laboratory
Stage
01
02
03
04
05
Based on the preliminary impressions, a master cast is created in
the dental laboratory. This cast accurately replicates the patient's
oral structures.
Master Cast Fabrication:
A more detailed and precise impression is taken using a custom tray
and elastomeric material. This impression captures the fine details of
the oral tissues, including the shape and position of the edentulous
(toothless) areas.
Final Impressions:
The dentist records the relationship between the upper and lower
jaws, determining how they come together during biting and chewing.
Jaw Relationship Recording:
Wax rims are created and placed on the master cast to establish the
correct jaw relationship and determine the optimal position and
height of the denture teeth.
Wax Rim Fabrication:
The wax rims, teeth, and denture base are set up in wax for a try-in
appointment. This allows the patient and dentist to assess the
esthetics, speech, and bite before the final denture is fabricated..
Try-in:
5.
6. Laboratory
Stage
06
07
08
09
After the try-in, the wax setup is invested in a mold, and the wax is
eliminated through a heating process called "burnout." The
remaining mold is then filled with acrylic resin or other suitable
denture base material, which is cured to form the final denture base.
Processing:
The denture base is trimmed, excess material is removed, and the
surfaces are polished to achieve a smooth and comfortable finish.
Finishing and Polishing:
The denture teeth, selected based on the patient's preferences and
appearance, are set up in the denture base using acrylic resin or
other suitable materials. The teeth are arranged according to the
established jaw relationship and esthetic considerations.
Teeth Setup and Processing:
The completed denture is further polished and inspected for any
defects or inaccuracies. Adjustments are made as necessary to
ensure proper fit, comfort, and esthetics.
Final Polishing and Quality Control:
7. importance of accurate
measurements and impressions
:Bite and Chewing
Function
Precise
measurements and
impressions allow for
accurate jaw
relationship recording,
ensuring that the
dentures replicate
the natural bite and
chewing movements.
This helps restore
proper oral function
and improves the
patient's ability to eat
a variety of foods.
Longevity:
Accurate
measurements
and impressions
help in creating
dentures that are
structurally
sound and
durable. A well-
fitting denture
reduces the risk
of fractures,
breakages, and
the need for
frequent repairs
or relines.
Speech:
Well-fitting dentures,
achieved through
accurate
measurements and
impressions, can
significantly improve
speech clarity and
pronunciation. A
precise fit allows the
patient to articulate
sounds properly,
minimizing speech
difficulties.
Esthetics:
Accurate
impressions
capture the fine
details of the oral
tissues, helping
to create
dentures that
closely resemble
the natural
appearance of
the patient's
teeth and gums.
This contributes
to a pleasing
smile and
improved self-
confidence.
Fit and Comfort:
Accurate
measurements
and impressions
ensure that the
denture fits
precisely on the
patient's oral
tissues, providing
optimal comfort
and stability. Ill-
fitting dentures
can cause sore
spots, discomfort,
and difficulty in
speaking and
eating.
01 03 04 05
02
9. Stamped Metal Bases
01
03
Stamped metal bases can be highly precise, allowing
for a close fit to the patient's oral tissues and optimal
stability.
Accuracy:
02
The stamping process allows for the creation of
thin and lightweight metal bases, which can be
more comfortable for the patient.
Thin and Lightweight:
Stamped metal bases can be produced
relatively quickly and efficiently, making them a
cost-effective option.
Cost-effective:
04
Cobalt-chromium alloys used in stamped metal
bases have good biocompatibility, reducing the
risk of adverse reactions in the patient.
Good Biocompatibility:
Technique:
Stamped metal bases involve the use of a
sheet of metal, typically a cobalt-chromium
alloy, which is shaped and formed using a
specialized press or stamping machine. The
metal is pressed to create the desired shape
of the denture base, including the framework
that supports the artificial teeth.
05
Durability:
Stamped metal bases are known for their
strength and resistance to fracture, providing
long-lasting prostheses.
Advantages
10. Cast Metal Bases
01
03
Cast metal bases allow for greater customization, as
the wax pattern can be modified and sculpted
according to the patient's specific needs and oral
anatomy.
Customization:
02
The casting process allows for the creation of
denture bases that adapt well to the contours of
the oral tissues, enhancing comfort and stability.
Adaptability:
Cast metal bases can be veneered with tooth-
colored materials, such as ceramic or composite,
to improve the esthetic appearance of the
prosthesis.
Esthetics:
04
Cast metal bases are known for their high
strength and resistance to deformation, making
them suitable for patients with a strong bite or
parafunctional habits.
Strength:
Technique
Cast metal bases involve the use of a wax pattern,
which is invested in a mold and then replaced with
a molten metal alloy, such as a cobalt-chromium
or a high-noble alloy. The molten metal fills the
mold, creating the desired shape of the denture
base.
Advantages
11. Comparison between Stamped and Cast Metal Bases:
1. Accuracy: Stamped metal bases offer high accuracy due to the precision of the stamping process, while
cast metal bases can be more adaptable to individual anatomical variations.
2. Weight and Thickness: Stamped metal bases are generally thinner and lighter than cast metal bases,
providing enhanced comfort for the patient.
3. Customization: Cast metal bases allow for greater customization and modification during the wax pattern
stage, providing a more tailored fit.
4. Esthetics: Cast metal bases offer the option of veneering with tooth-colored materials, enabling improved
esthetics, while stamped metal bases typically have a metallic appearance.
5. Production Time: Stamped metal bases can be produced more quickly and efficiently compared to cast
metal bases.
6. Cost: Stamped metal bases are generally more cost-effective due to the simpler production process, while
cast metal bases may incur higher costs due to additional customization and laboratory procedures.
13. Technology for the Manufacture of
Prostheses with Reinforced Bases:
The technology used for manufacturing prostheses
with reinforced bases typically involves the
incorporation of additional materials or techniques to
strengthen the base. This can be achieved through
the use of fiber reinforcement, metal reinforcements,
or other innovative methods.
14. Benefits of
Reinforced
Bases
01
02
03
04
05
Reinforced bases offer improved strength and resistance to fracture,
making them more durable and long-lasting.
Increased Strength:
The added reinforcement helps to stabilize the prosthesis, reducing
the risk of movement or displacement during chewing and speaking.
Enhanced Stability:
Reinforced bases distribute occlusal forces more evenly, reducing
stress on the underlying tissues and minimizing the risk of
complications such as bone resorption..
Better Load Distribution:
The use of reinforcement materials can allow for a thinner base
design while maintaining sufficient strength, providing increased
comfort for the patient.
Thinner Design:
Reinforced bases can be designed to be tooth-colored or translucent,
allowing for improved esthetics, especially in cases where the base
might be more visible.
Esthetic Considerations:
15. Different Reinforcement Materials and Techniques:
1. Fiber Reinforcements: Fiber-reinforced materials, such as glass or carbon fibers, can be incorporated into the
base material (e.g., acrylic resin) to enhance its strength and stability. These fibers are typically embedded in the
resin matrix, providing reinforcement in specific areas of the prosthesis.
2. Metal Reinforcements: Metal frameworks, such as cobalt-chromium or titanium, can be used as a
reinforcement within the base material. These metal frameworks add strength and rigidity to the prosthesis,
particularly in cases where a high level of support is required.
3. Polymer Reinforcements: Polymers, such as polyethylene or polypropylene fibers, can be added to the base
material. These materials improve the mechanical properties of the prosthesis, including impact resistance and
flexural strength.
4. Zirconia Reinforcements: Zirconia, a strong and biocompatible ceramic material, can be used as a
reinforcement within the base. Zirconia-reinforced prostheses offer excellent mechanical properties and esthetics.
5. Computer-Aided Design and Manufacturing (CAD/CAM): CAD/CAM technology allows for the precise
fabrication of reinforced bases by digitally designing the prosthesis and milling it from a solid block of material,
such as zirconia or metal. This technique ensures accurate fit and optimal strength.
18. Features of the Manufacture of
Prostheses with Combined Bases
Combined bases allow for a customized approach, where
different materials or designs are combined based on the
patient's specific requirements and oral condition.
Customization:
01
The combination of different materials enables the utilization
of their individual properties to achieve the desired outcome,
such as strength, durability, flexibility, or esthetics.
Material Selection:
02
The use of different materials in the base can help distribute
occlusal forces more evenly, reducing stress on the
underlying tissues and improving the longevity of the
prosthesis.
Load Distribution:
04
Combined bases can be designed to adapt to the patient's
oral tissues, ensuring a better fit and improved stability of the
prosthesis.
Adaptability:
03
19. Explanation of Combined Base
Designs
Metal-Ceramic
Combination:
In this design, a metal framework is used as the
support structure, while ceramic material is applied
on top to create natural-looking teeth. The metal
framework provides strength and stability, while the
ceramic enhances the esthetics and wear resistance
of the prosthesis.
Metal-Acrylic
Combination:
In this design, a metal framework is used as the
primary support structure, while acrylic resin is applied
to provide the esthetic appearance and functional
aspects of the prosthesis. The metal framework
provides strength and stability, while the acrylic resin
allows for customization of the denture teeth and gum
appearance.
Fiber-Acrylic
Combination:
This design incorporates fiber-reinforced materials,
such as glass or carbon fibers, within an acrylic resin
base. The fibers enhance the strength and durability of
the prosthesis, while the acrylic resin provides the
necessary flexibility and esthetics.
20. Advantages Associated with
Combined Bases
Combined bases can offer improved strength
and stability compared to single-material
bases, allowing for better longevity and
functional performance.
Enhanced Strength and Stability:
The combination of materials allows for
customization based on the patient's specific
needs, ensuring an optimal fit, esthetics, and
function.
Customization:
Combined bases can provide superior
esthetics by incorporating materials that
closely resemble natural teeth and gums.
Esthetics:
Combined bases can distribute occlusal
forces more evenly, reducing stress on the
underlying tissues and promoting better oral
health.
Improved Load Distribution:
21. Challenges Associated with
Combined Bases
The fabrication process of combined bases may be more complex and
time-consuming compared to single-material bases, requiring
specialized knowledge, skills, and equipment.
Complexity in Manufacturing:
If the bonding between different materials is not properly executed,
there is a risk of delamination or separation of the base components
over time, leading to functional or esthetic issues.
Potential for Delamination:
Selecting compatible materials and ensuring their compatibility with the
patient's oral environment is crucial to avoid adverse reactions or
complications.
Material Compatibility:
22. Clinical Stage Errors
Errors in recording the relationship
between the maxillary and mandibular
arches can result in improper
occlusion, compromised chewing, and
discomfort.
- Prevention and Correction:
Follow established protocols for
recording jaw relation records, such as
using bite registration materials and
employing reliable techniques. Verify
and confirm the accuracy of records
before proceeding to the laboratory
stage.
2. Incorrect Jaw Relation
Records:
Inadequate communication with the
patient regarding esthetic
expectations can lead to
dissatisfaction with the final
prosthesis.
- Prevention and Correction:
Engage in comprehensive
discussions with the patient to
understand their esthetic desires. Use
visual aids, mock-ups, or digital smile
design tools to facilitate effective
communication and establish realistic
expectations.
3. Improper Esthetic
Evaluation:
1. Inadequate Impressions:
Insufficiently detailed impressions
can lead to ill-fitting dentures,
discomfort, and compromised
stability.
- Prevention and Correction:
Ensure thorough and accurate
impressions using appropriate
impression materials and
techniques. Regularly review and
update impression techniques
and materials based on best
practices.
23. Laboratory Stage Errors
Errors in the fabrication of the denture
base, such as inadequate contouring
or poor fit, can lead to discomfort,
instability, and compromised function
- Prevention and Correction:
Ensure meticulous laboratory
procedures, including accurate
processing of the acrylic resin, proper
contouring of the base to adapt to the
patient's oral tissues, and meticulous
finishing and polishing techniques.
2. Inaccurate Denture Base
Fabrication:
Failure to properly adjust occlusion
can result in difficulties with chewing,
discomfort, and tissue irritation.
- Prevention and Correction:
Thoroughly evaluate occlusion during
try-in appointments and make
necessary adjustments to achieve
harmonious occlusion. Utilize
articulators and occlusal indicators to
aid in achieving proper occlusal
contacts.
3. Insufficient Occlusal
Adjustments:
1. Incorrect Teeth Selection
and Arrangement:
Errors in selecting and arranging
denture teeth can result in
improper occlusion, compromised
speech, and an unnatural
appearance.
- Prevention and Correction: -
Ensure proper tooth selection
based on the patient's age,
gender, and facial characteristics.
Follow established guidelines for
tooth arrangement, including
proper occlusal schemes and
tooth position within the arch.
24. Strategies for
Avoiding and
Correcting
Errors
01
02
03
04
05
Maintain open and clear communication between the clinician and
the dental laboratory, ensuring the accurate transfer of information
and expectations.
Effective Communication:
Stay updated with the latest techniques, materials, and technologies
through regular continuing education programs. Attend workshops
and courses to enhance clinical and laboratory skills.
Continuing Education and Training:
Implement robust quality control measures in both clinical and
laboratory settings, including thorough checks at each stage of the
manufacturing process.
Quality Control Processes:
Establish a collaborative relationship with dental technicians,
fostering open dialogue and sharing feedback to improve the overall
quality of the prostheses.
Collaboration with Dental Technicians:
Actively involve patients in the decision-making process, educating
them about the various stages of prosthesis fabrication, and
addressing their concerns and expectations.
Patient Involvement:
25. Challenges Faced by Patients During the Adaptation Period:
1. Discomfort and Sore Spots: Initially, patients may experience discomfort and sore spots as their oral tissues
adjust to the presence of the dentures. This can cause irritation and difficulty in wearing the dentures for
extended periods.
2. Altered Speech: Dentures can affect speech patterns, causing difficulty in pronouncing certain sounds or
words. Patients may experience a lisp or slurred speech initially.
3. Chewing and Eating Challenges: Chewing efficiency may be reduced, and patients may struggle with certain
foods initially. This can lead to dietary restrictions and changes in eating habits.
4. Increased Salivation: Some patients may experience increased salivation due to the presence of the
dentures, leading to discomfort and difficulty in speaking or swallowing.
5. Psychological and Emotional Adjustment: The absence of natural teeth and the reliance on dentures can
cause emotional distress and self-consciousness, affecting the patient's self-esteem and confidence.
26. Tips and Recommendations for a Smoother Adaptation Process:
1. Follow Dentist's Instructions: Follow the dentist's instructions and guidance regarding the use, cleaning, and
care of the dentures. Adhere to the recommended wearing schedule and gradually increase the wearing time as
advised.
2. Practice Speaking: Practice speaking aloud, reading aloud, and engaging in conversations to help train the
tongue and oral muscles to adapt to the dentures. Repeating challenging words or sounds can aid in improving
speech clarity.
3. Gradual Introduction of Foods: Start with soft and easily chewable foods initially, gradually introducing a wider
variety of foods as comfort and confidence increase. Cut food into smaller pieces to facilitate chewing.
4. Denture Adhesive: Denture adhesive can help improve denture stability and reduce movement during speech and
chewing. Consult with the dentist to determine the appropriate type and amount of adhesive to use.
5. Proper Denture Care: Clean the dentures thoroughly using a denture brush and a non-abrasive denture cleaner.
Soak the dentures overnight in a denture cleaning solution to remove stains and bacteria. Follow proper oral hygiene
practices for the remaining natural oral tissues.
6. Regular Dental Check-ups: Schedule regular dental check-ups to ensure the dentures are fitting correctly and to
address any issues or discomfort that may arise. Denture adjustments may be necessary to improve fit and comfort.
7. Patience and Persistence: Understand that adaptation to dentures takes time and patience. It is normal to
experience some initial challenges, but with persistence, most patients adapt successfully over time.
8. Support and Counseling: Seek support from family, friends, or support groups to share experiences and
emotions related to denture adaptation. Consider counseling or therapy if needed to address any psychological or
emotional challenges.
27. Indications for Prosthesis Correction:
1. Poor Fit: If the denture does not fit properly, it may cause discomfort, sore
spots, or instability. This can occur due to changes in the oral tissues, such
as bone resorption or gum shrinkage, or improper fabrication of the
denture.
2. Loose or Unstable Prosthesis: A denture that moves or dislodges during
speaking or chewing indicates a lack of stability. This can be due to changes
in the supporting tissues, inadequate denture base adaptation, or improper
denture design.
3. Occlusal Irregularities: Occlusal discrepancies, such as premature
contacts, imbalanced bite forces, or difficulties in chewing, may require
adjustment to achieve proper occlusion and function.
4. Esthetic Concerns: If the denture does not provide satisfactory esthetics,
such as unnatural tooth positioning, inadequate lip support, or incorrect tooth
shade, it may require correction to improve the patient's appearance and
satisfaction.
5. Speech Impairment: Persistent speech difficulties, such as lisping or
slurred speech, may indicate the need for adjustments to improve the patient's
ability to speak clearly.
28. Techniques for Adjusting the Fit, Stability, and Occlusion of Dentures:
1. Relining: If the denture lacks proper fit and stability, relining can be performed to improve the adaptation.
Chairside relining involves adding a new layer of denture base material to the tissue surface of the denture,
enhancing its fit and reducing movement. Laboratory relining involves sending the denture to a dental laboratory for
professional relining procedures.
2. Rebase: In cases of significant bone resorption or changes in the oral tissues, a rebase may be necessary. This
procedure involves replacing the entire denture base while retaining the existing denture teeth, providing a new
foundation for the prosthesis.
3. Tissue Conditioning: Tissue conditioning involves placing a temporary soft liner material in the denture to
improve comfort and adaptation to the altered oral tissues. This technique is useful when the underlying tissues are
sensitive or inflamed, providing a cushioning effect.
4. Denture Adjustment: Adjustments to the denture can be made to improve stability, occlusion, or esthetics. This
may involve selective grinding or polishing of the denture base or teeth to eliminate any high spots, achieve proper
occlusion, and enhance comfort.
5. Denture Adhesives: Denture adhesives can be used to improve denture stability and reduce movement during
function. They can provide temporary relief for patients experiencing loose dentures; however, they should not be
used as a substitute for proper prosthesis correction.
6. Replacement of Dentures: In some cases, if the denture is severely worn, damaged, or the patient's oral
condition has significantly changed, complete replacement of the denture may be necessary to achieve optimal
function and esthetics.
29. Types of Denture Adhesives:
1. Creams or Pastes: Creams or pastes are the most common type of denture
adhesives. They usually come in tubes and are applied to the tissue surface
of the denture before insertion. Upon contact with the oral tissues, the
adhesive forms a thin, cushioning layer that helps improve denture stability
and reduce movement.
2. Powders: Denture adhesive powders are sprinkled onto the tissue surface of
the moistened denture. The powder particles absorb saliva and create a sticky
layer that enhances the denture's grip. Powders are often preferred by
individuals who dislike the feeling of creams or pastes.
3. Strips or Pads: Strips or pads are pre-cut adhesive sheets that can be
placed directly onto the tissue surface of the denture. They provide a convenient
and mess-free option for denture wearers.
30. Instructions for Proper Application of Denture Adhesives:
1. Clean the Denture: Thoroughly clean and dry the denture before applying the adhesive. Remove any
debris, food particles, or previous adhesive residue.
2. Apply the Adhesive: For creams or pastes, squeeze a small amount (as recommended by the
manufacturer) onto the tissue surface of the denture in thin strips or dots. Avoid applying too close to the
denture edges. For powders, sprinkle a thin layer evenly over the moistened tissue surface of the denture. For
strips or pads, peel off the backing and press the adhesive onto the tissue surface.
3. Insert the Denture: Place the denture into the mouth and firmly press it into place. Bite down gently to
ensure even distribution of the adhesive.
4. Wait and Avoid Eating or Drinking: Follow the manufacturer's instructions regarding the recommended
waiting time before eating or drinking. This allows the adhesive to reach its optimal adhesive strength.
5. Clean the Oral Tissues and Denture: After removing the denture, gently clean the oral tissues using a soft-
bristle toothbrush or clean cloth. Thoroughly clean the denture, removing any residual adhesive, using a denture
brush and a non-abrasive denture cleaner.
31. Instructions for Proper Removal of Denture
Adhesives:
1. Rinse the Mouth: Rinse the mouth with warm water to help loosen the
adhesive.
2. Remove the Denture: Gently remove the denture by rocking it back and
forth to break the adhesive seal. Avoid using excessive force or sharp
objects that could damage the denture.
3. Clean the Denture: Clean the denture thoroughly using a denture brush
and a non-abrasive denture cleaner to remove any remaining adhesive.
4. Clean the Oral Tissues: Rinse the mouth again with warm water and
use a soft-bristle toothbrush or clean cloth to clean the oral tissues and
remove any adhesive residue.
5. Store the Denture: Store the cleaned and dry denture properly in a
denture container or a glass of water to keep it moist and prevent warping or
damage.
