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Complete Denture - The BPS Way

Article · January 2014

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 COMPLETE DENTURES
- THE BPS WAY

C
l Dr. Abby Abraham Dr. Deepika Lakshmi R.
i
n
i Introduction
c
a The Bio-functional Prosthetic System (BPS) is used for the treatment of
l
edentulous and partially edentulous patients. Today, the use of clinical
protocols and simple, reliable treatment methods that can be easily adjusted
F
e to the needs of the patient is of prime importance and usually preferred by
both patients and dentists .
1
a
t
u
r
e 20 THE DENTCARE | JANUARY 2014
 COMPLETE DENTURES
- THE BPS WAY

What is the BPS system?

It is a “System consisting of series of steps from impression making, bite registration, Set up of
denture teeth, polymerization and finishing to delivery that are carried out according to the
clearly defined BPS procedures using Ivoclar Vivadent's devices and materials, with the
ultimate goal of a Happy Patient.”

The BPS system provides the dental team a simple, time saving procedure based on
gnathological principles. All the steps, procedures and materials are coordinated with each
other to achieve excellent results.

Through this article, we would like to highlight on the step by step clinical procedures in the
fabrication of BPS dentures.

BPS vs CONVENTIONAL DENTURES

PATIENT VISIT BPS CONVENTIONAL

First Primary Impression Primary Impression

&
tentative Jaw relation

Second Secondary Impression, Secondary Impression

final Jaw relation
&
Gothic arch tracing

Third Wax trial Jaw relation

Fourth Denture insertion Gothic arch tracing &

Face Bow transfer
( optional)

Fifth _ Wax trial

Sixth _ Denture insertion

First clinical visit

Primary Impression
and tentative Jaw
relation

System 1 Alginate and

Trays for primary
Fig. 1 Fig. 2 Fig. 3
impression

There are 15 trays provided for recording the primary impression, of which 5 trays are meant
for the maxillary impression and 10 for mandibular impression (Figs. 1, 2 & 3). The mandibular
trays have been modified to suit different clinical situations such as highly resorbed ridges
(Figs. 4, 5, 6 & 7). There is a difference in the inclination of the slopes on the distal aspect of

JANUARY 2014 | THE DENTCARE 21

 COMPLETE DENTURES
- THE BPS WAY

these trays. The sharply inclined tray is used The material that is
for highly resorbed ridges to ensure that used for making This is an
the retromolar pad is recorded in the the primary
advantage
impression. impression is
alginate. There are when
This is an advantage when compared to 2 different kinds of compared to
the conventional trays which may need to alginate, the tray the
be modified to compensate for resorbed alginate and the conventional
ridges or in most situations, the clinician syringe alginate.
ignores this crucial aspect during trays which
The difference
impression making. between them is may need to
their viscosities. be modified to
The selection of upper and lower tray is
made simpler by the use of a compass and
compensate for
As the name
the hamular notch, retromolar pad or indicates, the
resorbed ridges
position of the first molar is used as a guide. syringe material is or in most
The “tray selection tool” facilitates the loaded into the situations, the
proper size selection for the maxillary and syringe and clinician
mandibular impression tray (Fig. 8 & 9). injected into the
ignores this
sulcus areas of the
Measure approximately where the first maxilla and crucial aspect
molars are located on patients' existing mandible, the during
denture or on their ridge and select a tray palatal region of impression
that lines up to the centre of the retentive maxilla, and some
holes of the tray making.
situations on the
lingual aspect of
the mandible. The
syringe material has a setting time of 3
minutes and tray material has a setting
time of 3 minutes 30 seconds. So ensure the
syringe material is mixed first and loaded
into the syringe, before the tray material is
mixed. While loading the upper tray,
Fig. 4 Fig. 5
ensure the bulk of the tray material is in the
anterior aspect and for the lower tray, the
bulk of the material is in the posterior
aspect.

The advantage of this material is that it

"attaches"("hydrophilic") to the tissue and
does not "drip" ("non-slumping").

Fig. 6 Fig. 7 The syringe material is first injected and

then the tray with alginate is placed.
Gentle border moulding is done to ensure
that the important anatomical landmarks
are recorded (Figs. 10, 11, 12, 13, 14, 15, 16
& 17).

The Primary impression is checked for

accuracy and any discrepancy must be
Fig. 8 Fig. 9

22 THE DENTCARE | JANUARY 2014

 COMPLETE DENTURES
- THE BPS WAY

putty can be used as per the operator's

convenience. The Jaw relation is
recorded, at the patient's vertical
dimension of occlusion. At the end of the
first visit, we have the upper and lower
primary impression and a tentative jaw
relation. Using the tentative jaw relation,
Fig. 10 Fig. 11
the upper and lower cast is mounted (Figs.
20, 21, 22, 23, 24 & 25).

Fig. 12 Fig. 13

Fig. 20 Fig. 21

Fig. 14 Fig. 15

Fig. 22 Fig. 23

Fig. 16 Fig. 17

corrected with a new impression (Figs. 18 &
19). Check for hamular notch, retro molar
pad and other limiting structures in the
impression.
Fig. 24 Fig. 25
The upper and lower mounted casts are
used for fabrication of special trays and
attachment of the Gnathometer (Figs. 26
& 27). A face bow can also be used at this
stage. However, studies have shown that
transfer of the mandibular cast using the

Fig. 18 Fig. 19

Another innovative step in BPS is the use of

a centric tray. A Centric tray is a device
that is used to record the tentative jaw Fig. 26 Fig. 27
relation of the patient. Alginate or silicone

JANUARY 2014 | THE DENTCARE 23

 COMPLETE DENTURES
- THE BPS WAY

horizontal guides provides good results determined vertical dimension of

and better patient compliance when occlusion (Figs. 33, 34, 35, 36, 37, 38 & 39).
compared with the use of a facebow 2.

Second clinical visit

Secondary Impression, final Jaw relation

and Gothic arch tracing

Ensure that the special trays are 2 – 3 mm

short of the sulcus depth. It is then tried in
Fig. 33 Fig. 34
the patient's mouth and overextensions
are modified. Heavy body, light body,
and extra light body are used for recording
the functional secondary impressions
3

(Figs. 28, 29, 30, 31 & 32).

Fig. 35 Fig. 36

Fig. 28 Fig. 29

Fig. 37

Secondary Impression and Final Jaw

relation recorded in a Single Sitting
Fig. 30 Fig. 31

A f t e r t h e
impressions are
made, the white
plastic spacer's
are removed,
Fig. 32 and the upper Fig. 38 Fig. 39
and lower plates
with the screw are fixed into position. The A Form selector can be used to determine
vertical dimension can be adjusted at this the most accurate size and shape of the
stage, by turning the screw in the lower artificial teeth used for the particular
member. The upper plate is then coated patient.
with a colouring agent and an intra oral
Gothic arch tracing is recorded 4. A plastic The selector measures the inter ala
sleeve is inserted, and oriented to the distance and the reading is used to select
centric point. Bite registration paste is the upper anterior teeth. Using a mould
injected, between the 2 plates and the chart, the lower anterior and posterior
final centric position is recorded at the teeth are selected (Figs. 40, 41, 42 & 43).

24 THE DENTCARE | JANUARY 2014

 COMPLETE DENTURES
- THE BPS WAY

Form Selector and Selection of teeth Model Analysis and arrangement of teeth
using the 2D template

Fig. 40 Fig. 41
Fig. 44 Fig. 45

Fig. 42 Fig. 43 Fig. 46 Fig. 47

Tooth set-up in the Stratos 100/300

Geometric articulation and the set-up of

teeth were performed according to the
rules of M.A.P (Model Associated
Positioning). This system utilizes the Fig. 48
anatomical landmarks present on the cast
to determine the position of the artificial
teeth. Additional auxiliary instruments like Third clinical visit
the special 2 -D is used (Figs. 44, 45, 46, 47 &
48). Wax trial (Figs. 49 & 50)

Posterior Teeth: Occlusion and functioning

principle

The concept, which has been termed

'biofunctional' by Ivoclar Vivadent, also
takes into account lateral, protrusive,
retrusive and side-shift movements. It can
be easily applied, either after the primary
set up of teeth or after remounting. The
Fig. 49 Fig. 50
mortar-and-pestle principle according to
Gerber, the principle of balanced
occlusion according to Gysi/Hanau,
group function on the lateral and Injection moulding
mediotrusion side according to
The denture is then processed using the SR
Strack/Ivoclar, sequential guidance on
Ivocap injection moulding system. The
the laterotrusion side according to
system employs a pressure/heat
Slavicek/Kulmer and anterior/canine
polymerization procedure which achieves
control according to Gausch 1.

JANUARY 2014 | THE DENTCARE 25

 COMPLETE DENTURES
- THE BPS WAY

an exceptionally high degree of Professor, Department of Prosthodontics &

polymerization. The pressure is maintained
during the whole polymerization
procedure to ensure continuous pressure
feeding of additional material to
compensate for material shrinkage. The
vertical dimension is maintained, and a
high accuracy of fit is achieved. In
addition, the homogeneous, bubble-free
denture base surface minimizes the risk of
irritating the mucous membrane .
5,6
Dr. Iyappan Shankar, Dencity, Trichy for
their constant support and
encouragement.
References
1. Olivier Hue et al, Dental Spectrum, Issue IV,
5/99
2. Lt. Col M Kumar et al; Comparative
Evaluation of Two Techniques in achieving balanced
occlusion in complete denture. MJAFI 2010.

3. Solomon Eg, Single stage silicone border

Fourth clinical visit
Denture insertion (Figs. 51, 52 & 53)
moulded closed mouth impression technique- Part II;
J Indian Prosthodont Soc. 2011, Sep Issue 11(3), 183-8.
4. Rubel B et al; Gothic arch tracing; NY state
Dent J, 2011 Aug-Sep
5. Strohaver RA et al, Comparison of changes
in Vertical Dimension between compression and
injection molded Complete Dentures; J Prosth Dent
1989, Dec 62(6) 716-8
6. Noqueira SS et al; Comparison of accuracy
between compression and injection moulded
Complete Dentures; J Prosth Dent 1999 Sep 82(3) 291-
300.

Fig. 51 Fig. 52

Fig. 53

Conclusion

The BPS System from Ivoclar Vivadent

enables the dental team, to provide
patients with long-lasting, high-quality
dentures. The biofunctional set-up
philosophy along with the MAP (model
associated positioning) approach and the
heat/pressure injection moulding
procedure represent the cornerstones of
the system 1.

Acknowledgements

Sincere thanks to Dr. Annapoorni, Head of

Department of Prosthodontics, Meenakshi
Ammal Dental College; Dr. S. Lakshmi,

26 THE DENTCARE | JANUARY 2014

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