ar

f t LUME ONE

1 DENTAL LABORATORY
/ PROCEDURES
1
COMPLETE DENTURES
r '

^ BERT M. MORROW , D.D.S., F. A .C.D., F.I.C.D.

i
vss< date Dean for Advanced Education,
>or and Head, Postdoctoral Division,
nent of Prosthodontics,
hi u liversity of Texas Health Science Center
-
at v ''n Antonio, Dental School,
3an Antonio, Texas

KENNETH D. RUDD, D.D.S., F. A. C.D., F.I.C.D.

Associate Dean for Continuing Education,
°rofessor of Prosthodontics, Department of Prosthodontics,
he University of Texas Health Science Center
.it San Antonio, Dental School,
San Antonio, Texas

JOHN E. RHOADS, D.D.S ., F. A . C.D., F.I.C.D.

Formerly Associate Professor, Prosthetic Dentistry ,
•niversity of the Pacific, School of Dentistry,
• an Francisco
. California V
I

ECOND EDITION

vith 2067 illustrations including 12 in full color

THE C. V. MOSBY COMPANY

.
ST. LOUIS • TORONTO • PRINCETON 1986
 A

CONTENTS
1 Effective dentist-technician communication, 1 Wax boxing method. 57
Basic communication principles, 1 .
Plaster of Paris and pumice boxing method 67
Medium( a), 1 Caulking compound and paddle boxing method, 74
Barriers, 1 .
Pouring casts 80
Feedback , 2 Indexing the cast, 80
Planning, 2 .
Requirements for indexing 80
Technician — soliciting new accounts, 2 Groove indexing method. 80
I Dentist — searching for a laboratory, 2 Notch indexing method, 84
Agreements 3. .
Split remounting plates 85
.
Legal and ethical obligations 5 .
Summary 89
Developing the relationship, 5
.
Visiting facilities 5
5 Baseplates and occlusion rims, 90
Treatment planning, 5
Prescriptions, 5 KENNETH D. RUDD and ROBERT M MORROW
Terminology, 5
Requirements for baseplates, 90
Communicating tooth shades, 6
Baseplate materials, 90
Feedback, 6
Autopolymerizing baseplates, 91
Third-party communication, 7
Sprinkle-on method, 91
Evaluation, 7
i
Finger -adapted dough method. 99
* 2 Preliminary impressions: care and pouring, 9
Confined dough methods, 103 •
Shellac baseplates, 112
Stabilized shellac baseplates, 113
KENNETH D. RUDD and ROBERT M MORROW. Baseplates stabilized with zinc oxide-eugenol impression
Requirements, 9 .
paste 115
Alginate preliminary impressions, 10 Baseplates stabilized with elastomeric impression
Modeling plastic impressions, 22 .
materials 121
Summary, 25 Baseplates stabilized with autopolymerizing resin, 121
Thermoplastic resin baseplates and vacuum-adapted resin
baseplates, 125
3 Impression trays, 26 Wax baseplates, 129
KENNETH D. RUDD and ROBERT M MORROW. .
Heat-cured compression-molded resin baseplates 132
Construction mounting casts, 136
Requirements for impression trays, 26 Fluid resin baseplates, 136
Impression tray material, 26 Metal baseplates, 143
Autopolymerizing resin impression trays, 27 Wax occlusion rims, 143
Impression trays for immediate dentures, 44 .
Maxillary occlusion rims 143
.
Full-arch impression trays 44 Mandibular occlusion rims, 144
Custom posterior trays, 49 Modeling plastic occlusion rims, 145
.
Two-piece trays 51 Summary, 145
Summary, 56

6 Articulators and mounting casts, 147

4 Final impressions, boxing and pouring, 57 KENNETH D. RUDD and ROBERT M. MORROW
.
KENNETH D. RUDD ROBERT M MORROW , and EARL E.
Requirements for mounting stone, 147
FELDMAN

* Boxing impressions, 57
Mounting casts, 147
Retrieving mounting plates, 184
Summary, 186
xi
xii Contents

7 Artificial teeth and gold occlusals, 187 Try-in, 275

Grinding porcelain teeth, 275
KENNETH D. RUDD , ROBERT M. MORROW , CLARENCE L.
KOEHNE. and WILLIAM B. AKERLY
Summary, 275

Materials for artificial teeth, 187

Porcelain teeth, 187 9 Waxing and processing, 276
.
Resin teeth 187 KENNETH D . RUDD, ROBERT M . MORROW. EARL E . FELDMAN,
Metal-insert teeth, 188 AMBROCIO V . ESPINOZA , and CHARLOTTE GORNEY
Artificial with metal occlusals, 188
Components of artificial teeth, 189 Waxing for try -in, 276
Mold and shade identification, 191 Waxing the maxillary trial denture, 276
Mold numbering systems, 191 Waxing the mandibular trial denture, 282
Constructing metal occlusals, 201 Waxing for flasking, 284
Technique for silicone mold for multiple waxing of similar Adding a plastic palate form, 284
tooth contours, 222 Flasking the denture, 287
.
Summary 222 Wax elimination, 296
Painting the tinfoil substitute, 300
Preparing ridge laps, 303
8 Arranging and articulating artificial teeth, 223 Packing the denture, 303
Denture identification, 306
RICHARD A . SMITH. A . ANDERSEN CAVALCANTI ,
and HUGH E. WOLFE
Alternate flasking procedure, 307
Curing the denture, 311
Natural anteroposterior placement of maxillary anterior Deflasking the denture, 311
teeth, 223 Summary, 311
Relationship of arch form to tooth arrangement, 225
Considerations affecting placement and positioning of
anterior teeth, 226 10 Finishing and polishing, 312
Influence of asymmetry on tooth arrangement, 229 KENNETH D. RUDD , ROBERT M. MORROW. AMBROCIO V.
Spacing of anterior teeth, 230 ESPINOZA , and JESSE S. LEACHMAN
Crowding and lapping, 231
Arranging maxillary anterior teeth, 232 Deflasking, 312
Positioning of maxillary canines, 233 Remounting dentures, 318
Personalization of setup by selective grinding, 233 Making a face-bow index, 321
Considerations affecting arrangement of mandibular Removing dentures from cast, 324
anterior teeth, 235 Polishing the complete denture, 324
Overall evaluation of anterior tooth arrangement, 236 Preparing rag wheel, 328
Posterior tooth arrangement, 237 Pumicing denture, 331
Selection of posterior molds, 237 Polishing teeth, 338
Surveying the mandibular cast ( to aid in determining Polishing porcelain teeth, 338
position for posterior teeth), 237 Summary , 338
Arranging 33-degree anatomic maxillary posterior teeth,
238
Articulation of 33-degree anatomic mandibular posterior
11 Duplicate dentures, 339
teeth, 240 KENNETH D . RUDD and ROBERT M. MORROW
Checking completed setup of 33-degree anatomic
Methods, 339
posterior teeth, 245
Modified — denture flask method, 339
Alternate method of articulation of 33-degree anatomic
maxillary posteriors to mandibular posteriors, 245 - —
Pour resin flask method, 348
Cup-flask method, 356
Arranging 20-degree maxillary posterior teeth, 249
Summary, 363
Articulation of 20-degree posterior mandibular teeth, 251
Alternate method of articulation of 20-degree maxillary
posterior teeth to mandibular posterior teeth, 255 12 Relining and rebasing, 364
Articulation of maxillary second molar, 259
Checking completed setup of 20-degree posterior teeth, KENNETH D. RUDD, ROBERT M. MORROW. R. NEAL EDWARDS,
and AMBROCIO V . ESPINOZA
260
Arranging Pilkington- Turner 30-degree posterior teeth, 260 Articulator method, 364
Arranging Rational 0-degree posterior teeth, 262 Relining jig method, 372
.
Arranging Anatoline posteriors in a linear occlusion 263 Rebasing, 377
Arranging Anatoline posteriors in a bilateral balance , 266 .
Jig method 377
Arranging Monoline posteriors in a flat linear type Flask method, 380
occlusion, 268 Summary, 382
Arranging Monoline posteriors in a bilateral balance, 270
Arranging Monoline mandibular posteriors with Anatoline
maxillary posteriors in a lingualized, balanced occlusion,
272
 Contents

13 Repairs, 383 Mandibular bases, 460

%
Resin retention, 462
.
KENNETH D. RUDD ROBERT M. MORROW,
Blockout and relief , 463
and ALEXANDER R. HALPERIN
Materials for cast metal bases, 463
Repairing denture with fractured teeth, 383 Conversion of cast base to record base 477.
Plastic anterior tooth replacement, 383 .
Summary 478
Porcelain anterior tooth replacement, 389
Plastic posterior tooth replacement, 392
Porcelain posterior tooth replacement, 395 18 Maxillofacial procedures, 479
Repairing fractured denture, 398 FREDRICK M. MATVIAS
I
Nonseparated fracture, 398
Denture fractured into two or more parts (components), Immediate obturators, 479
401 Requirements, 479
Fractured denture with section(s) missing, 406 Materials, 479
Adding a posterior palatal seal, 409 Interim obturators, 481
Summary, 412 Requirements, 481
Materials, 481
Definitive obturators, 484
14 Immediate dentures, 413 Requirements, 484
KENNETH D. RUDD and ROBERT M. MORROW
Materials, 484
Mandibular resection devices, 491
Constructing immediate dentures, 413 Requirements, 491
Summary, 424 Materials, 491
Edentulous mandibular resection device, 491
V .
Dentulous mandibular resection device 494
15 Fluid resin complete dentures, 425 Mandibular guide prosthesis, 496
WALTER L. SHEPARD Acrylic resin guide flange, 497
Speech aids, 497
Denture base processing with a hydrocolloid investment, Requirements, 497
425 Materials, 497
Requirements for dental resin, 426 Acrylic resin palatal lift, 497
Synopsis of method, 426 Metal framework with reenforced acrylic posterior
Materials and equipment required, 426 extension, 497
Preparation of cast and wax pattern, 427 Edentulous and dentulous maxillary speech bulb, 498
Preparation of hydrocolloid, 427 Facial prostheses, 499
Investment, 429 Requirements, 499
Dewaxing, 429 Materials, 500
Spruing and venting, 431 .
Laboratory facility requirements 500
Replacing teeth in mold, 431 Radiation appliance, 505
Mixing and pouring resin, 432 Requirements, 506
Curing dentures, 433 Materials, 506
Deflasking, 434 Cranial implants, 508
Finishing and polishing, 434 Requirements, 508
Removable partial dentures, 436 Materials, 508
Rebasing, 438 Silastic implant, 509
Repairing, 438 Requirements, 509
Summary, 440 Materials, 509
Summary, 511
16 Soft liners, 441
MICHAEL J. MAGINNIS and GERALD T. GAUBERT 19 Laboratory procedures for immediate
overdentures, 512
Resilient denture base liners, 441
Requirements of resilient denture base liners, 441 ROBERT M. MORROW
Resilient liner materials, 441 Constructing impression trays, 512
•Silicone rubber materials, 442
Constructing baseplates, 516
Summary, 459
Shellac baseplates, 516
Resin baseplates, 518
17 Metal bases, 460 Occlusion rims, 524
\ / Setting the teeth, 525
/
JAMES S. BRUDVIK Setting the posterior teeth, 526
Requirements for cast metal bases, 460 Setting anterior teeth, 528
Design principles, 460 Preparing cast abutments, 531
/ % Waxing the immediate overdenture, 534
Maxillary bases, 460

*
xiv Contents

Flasking the Immediate overdenture, 536 21 Custom mouthguards, 551

Making an impression of the overdenture cast, 536
ROBERT M. MORROW. WILLIAM KUEBKER ,
Making a surgical template, 537 and RICHARD SEALS
Preparing ridge laps, 537
Applying tinfoil substitute, 538 Mouthguard with faceguard attachment, 555
Packing the overdenture, 538 Custom mouthguard without attachment, 561
Correcting processing error, 541
Polishing the overdenture, 541
Summary, 544
COLOR PLATES following p. 544

20 Denture base tinting, 545 1 Pigmented oral tissues

.
KENNETH D. RUDD ROBERT M MORROW,
and MEADE VAN PUTTEN
. 2 Contouring and tinting denture base
3 Procedure for tinting denture base
Tinting the denture base, 545
Use of practice mold, 550
Summary, 550

#
 4

DENTAL LABORATORY
PROCEDURES
COMPLETE DENTURES

T*

I
•* •

CHAPTER I
EFFECTIVE DENTIST-TECHNICIAN
COMMUNICATION
Effective communication is svnonvmous with terms
«* 0
such as quality and success. Many failures of dental
prosthesis can usually be traced to a breakdown in com -
munication between members of the dental team ( usu -
ally the dentist and the technician ). These communica -
tion failures almost always result in a lower quality
appliance produced at a higher than normal cost . But
I what is most important is the adverse psychologic effect
on the effectiveness of the team members and their re-
lationships with each other. Both dentist and technician
spend considerable money and time each year on con -
tinuing education to improve their skills and tech -
niques, but little effort is expended toward formal
courses in improving team communication .
The profound desire of humans to be understood by
colleagues and associates often is regarded as a major
obstacle or problem . As a result , communication
emerges as a major source of irritation or a stumbling
block . Although it is generally recognized that ineffec-
tive communication places undue stress and demands
on a co-working relationship, it is equally unclear as to
how to overcome these barriers and establish good rap-
port between working groups, hi order to function ef-
ficiently, the dental technician and the dentist must be
thought of as a working team , using all means of effec-
tive communication to obtain a positive desired result .
BASIC COMMUNICATION PRINCIPLES
Theorctically, communication may be viewed from
many different aspects. Common to most theories per -
* taining to this skill , however , are certain dominating
principles. It is generally agreed that communicating
-
t" N*
parties participate to achieve a desired goal. However,
the mere desire of the dentist to communicate with the
dental technician is not enough . He or she must also
have an underlying purpose to convey a message that
will result in a desired behavioral response.
Medium(a )
The communication media the dentist or technician
chooses to use are as vast as they are varied . Commu -
nication is traditionally defined as the successful trans-
mission of a message from a sender to a receiver by an
appropriate mode. Selection of the proper channel or
mode takes on extreme importance. Most dentists and
dental technicians choose those means of communica-
tion with which they feel comfortable. Basically, the
medium includes verbal communication , written and
pictorial accounts, and physical and behavioral ges-
tures . The dentist, when communicating with the den -
tal technician, may utilize either one channel or all the
modes of communication within the course of one day.
Therefore, it is of paramount importance that the
sender of the message select the appropriate means of
communication . Face- to-face communication that in -
volves the technician and dentist mav at one time or
0
another be an impractical means of communication , and
a less direct means may be employed to yield a greater
measure of success.
Barriers
Messages transmitted by the sender to the receiver
may become distorted , inhibiting accurate transmis-
sion . These distortions become stumbling blocks or bar-
1
F Dental laboratory procedures: complete dentures
riers to both the dentist and the technician . At this
point , it is important to recognize that individual expe-
riences are never identical. Environment, education ,
personal preferences, social prejudices, and genetic
make-up help determine how we approach communi-
cation with other people. Consequently , an individual s
location , state of mind , whom he or she is with at the
time of confrontation , and degree of stress have a direct
bearing on message distortion . Pride, intimidation , in -
securities, fears, and personal ambitions often act as
barriers to effective communication , as well as tone of
voice, appearance, and undesirable surroundings. Too
often , messages between the dentist and technician are
sent and received inaccurately, resulting in one party
assuming that a word has the same meaning for the
other party.
Poor listening is a major obstacle. The inability to
listen and ask questions contributes to the confusion
and makes a very simple solution into a complex prob-
lem . Often , instead of listening when others are speak -
ing, we formulate our own thoughts in anticipation of
responding. To complicate matters further, messages
transmitted become transcribed fragments that are in -
complete and frequently plagued with colloquial jargon
and abbreviations.
Feedback
Feedback is the reflection of communication . Send -
ers must rely on feedback to ascertain the receiver s
comprehension of the message. In fact , it should be the
receiver’s duty to report to the sender the clarity of the
message. A message not acted on becomes wasted ef-
fort . Feedback between the dentist and technician
should be encouraged , leaving open the gateway to
communication . Feedback is a mechanism that can be
utilized to correct and adjust meanings, to increase
• clarity of communication , and to determine if the mes-
sage sent is perceived by the receiver in the same man -
ner as it was intended .
PLANNING
A successful dentist - technician relationship is usually
the result of planned communication . These relation -
ships can be compared to marriages that begin with the
best of intentions but often terminate in bitter conflict .
(The number of failures in relationships could be dras-
tically reduced with the practice of systematic plan -
ning. )
Technician— soliciting new accounts
The best time to eliminate problem accounts is dur-
ingthe marketing phase of tlu * laboratory operation .
Many laboratories attempt to expand their market by
concentrating on quantity rather than quality in their
client recruitment program . Quality accounts are those
that result in a high degree of personal satisfaction and t 6
mutual respect between the technician and the dentist.
The perfect account does not exist; however, by search -
ing for some basic qualities , a laboratory can select sev-
eral very good accounts:
1. When soliciting accounts, give top priority to those
dentists located near the laboratory. Time and distance
are major factors in maintaining a good working rela-
tionship.
2. Search for dentists whose techniques, ethics, and
philosophies are compatible with your laboratory.
3. Search for those dentists who are concerned about
credentials of the technician , as well as everyone in -
volved in patient treatment. The technician will per -
form with more enthusiasm when recognized for train -
ing and experience.
4. Avoid any account who has earned the reputation
of a “ problem payer. ” Delinquent accounts can lead to » -
the demise of any laboratory .
5. Try to determine if a dentist is searching for a
quality laboratory or merely searching for unreasonably
discounted prices.
6. Always ask dentists why they are willing to change
laboratories. Find out what they liked most and least
about their last laboratory . Listen carefully to answers;
they may provide clues that will lead to an excellent
working relationship.
7. Search for those dentists who are responsive to
comments and inquiries from the technician concerning
clinical techniques that could affect laboratory proce-
dures.
8. Search for those dentists who are willing to take
the time to provide constructive criticism on laboratory
procedures . Often dentists who are unsatisfied with a
laboratory’s services will not discuss their dissatisfaction
and will switch laboratories, giving no explanation .
It is highly unlikely that all of these qualities will be
found in any one client; however, they should serve as
useful guidelines for recruiting new accounts. The tech -
nician must use discretion when using these guidelines
to qualify a client . The sole purpose of qualifying a
client should be to determine compatibility with your
laboratory. Do not engage in unethical gossip that may
result in damage to a dentist or to his/ her practice. l
Dentist— searching for a laboratory
The dental health team as viewed by the public has
reached a new position of high esteem for its excellence
in a health field . In no way is this more exemplary than
the association that exists between the dental laboratory
$
technician and the dentist . The technician s high de-
 4 Dental laboratory procedures: complete dentures
^

Table 1- 1. Basic materials checklist

5
Complete dentures Fixed partial dentures Removable partial dentures Orthodontics

Impression material Impression material Impression material Impression material

Casts Cast and dies Casts Casts
Baseplate Investments Refractory material Wire
Artificial teeth Cast metals Cast metal Cast metals
Acrylic resin Porcelain Miscellaneous hardware Miscellaneous hardware
Miscellaneous Facing, backing, etc. Baseplate material Acrylic resin
Miscellaneous hardware Artificial teeth Miscellaneous
Miscellaneous Acrylic resin
Miscellaneous

situation the dentist should he notified as soon as pos-

sible.
Table 1- 2. Sample checklist for procedures Some dentists may make the mistake of giving the
Complete denture laboratory an early due date to provide a margin of
Impression, diagnostic
safety . This practice will jeopardize the dentist s credi-
Diagnostic cast and tray bility with the laboratory. The technician who thinks
Final impression that the dentist is providing early due dates is least
Final cast likely to notify the dentist when a case is going to be
Baseplate and occlusal rims late.
Occlusal rim registrations
Jaw relations
Turn -around time is time the laboratory takes to re-
Facebow turn the case to the dentist. Most laboratories have es-
Articulator and articulation tablished times for various procedures. Occasionally the
Tooth selection dentist will request a shorter than normal turn-around
Tooth arrangement time. This is usually referred to as a rush case. Rush
"

Occlusion
Trial wax -up
cases will usually alter the normal work flow in a labo-
Wax try -in ratory, often resulting in the owner having to pay over-
Post -palatal seal time or to hire temporary help. Will there be an extra
Final wax -up charge, or will this be a special courtesy to the client?
Characterization A basic agreement should be outlined ; however, it is
Processing
wise to allow some flexibility for extenuating circum -
Correcting and perfecting occlusion
Finishing stances.
a. Denture borders 5. Discuss remake policies. What is an acceptable
b. Polish percentage of remakes? Who will bear the cost of re-
Miscellaneous makes ? How will dates be adjusted ? Remakes are a sen -
sitive subject and should be discussed with equal con -
sideration to the position of both the dentist and
laboratory . The important thing to remember is that
trous to the dentists who have already quoted fees to when a case fails, one or both parties are usually frus-
their patients. A more desirable policy would be to give trated . Therefore the climate is not conducive to estab-
clients reasonable advance notice for price changes on lishing rules for remakes. A good rule on remakes is
routine procedures. one that is acceptable to both parties before the first
4. Discuss policies on due dates, turn -around time, case is sent to the laboratory. *
and rush cases. Most dentists will have a complete se- 6. Credit and payment policies must be agreed on
ries of appointments for each of their patients; if an ap- before the first case. Laboratories are like dental prac-
pointment is broken , it has a domino effect. Also, the
image of that dentist is jeopardized when the patient
—
tices they cannot continue to operate without suffi -
cient cash flow. Most laboratories operate on a very
cannot be provided the services scheduled for a given limited cash flow , and delinquent accounts can be
appointment . On some occasions it will be impossible costly or can even bankrupt the business. Since many
for a laboratory to meet a scheduled due date. In this
%
laboratories are competing for accounts, they tend to

avoid discussing credit and payment policies until they
have accumulated substantial delinquent accounts. De-
i veloping laboratories are often reluctant to approach a
2 client about a delinquent account, and often this frus-
tration results in a less than enthusiastic effort toward
that client’s cases.
7. The dentist should be notified in advance if it be-
comes necessary to introduce a new material or tech-
; nique. Likewise, the dentist who introduces a new ma-
terial or technique should alert the technician in
i
advance. The laboratory might have to make costly
modifications to adapt to the changes.
Legal and ethical obligations
Both the dentist and the technician have certain legal
and ethical obligations. It is the responsibility of each
team member to become familiar with the basic legal
and ethical obligations or related professions.
> While discussion and feedback are vital to effective
communication , everyone must remember that the
dentist bears the ultimate responsibility for the resto-
ration that goes into the patient s mouth . This chapter
stresses the importance of constructive feedback from
all members of the dental team ; however, the dentist
must make the final decision as to the quality and quan-
tity of care the patient receives. Once decisions on pa-
tient care have been made, every member of the team
should lend full support. Being supportive does not
necessarily imply blind loyalty or involvement of a con -
spiracy of silence in situations where inappropriate con -
i duct is suspected . In the very' rare situations where
professional conduct or competency becomes suspect ,
the responsibility of investigative action should be left
to the appropriate professional groups. The members of
the dental team must support and respect the dentist
as a competent professional responsible for the health
and safety of the patient .
t From time to time a technician may receive a request
to perform a procedure or service that represents a
9 compromise of legal or ethical responsibilities. A com -
mon example is a dentist sending a case to the labora-
tory with the intention of sending the work authoriza-
tion at a later time. Good communication and mutual
respect will minimize the chances of these embarrass-
ing situations.
DEVELOPING THE RELATIONSHIP
Visiting facilities
i The technician should invite both dentist and staff to
visitthe laboratory and see the operation. A definite
time and date that will be mutually convenient for ev-
eryone should be set . On arrival , the visitors should be
given a warm welcome and introduction to the labora-
* tory personnel. Then they should be taken on a tour of
Effective tan communication 5
*
+*
-
st techni
the operation and given an explanation of the workflow
by tracing a case through the laboratory.
Soliciting questions about the operation is helpful .
This is an excellent time to discuss pickup and delivery
procedures with the dental assistant and which items
will be expected with new incoming cases (such as op-
posing cast and shade tab). The inspection procedures
for a case leaving the laboratory and the selection of
items to be sent back to the clinic should be discussed .
Dentists should reciprocate by extending an invita -
tion to the laboratory personnel. If it is not practical to
invite all the laboratory personnel , the invitation should
include at least the manager and the delivery person.
Treatment planning
Problems with complex cases can be minimized if the
technician is involved in the treatment planning phase.
The dentist and technician can discuss the treatment
planning as it relates to the laboratory procedures, and
the technician should be allowed to follow through and
see the completed restoration in the mouth .
Prescriptions
Most laboratories will provide the dentist with pre-
scription forms. State laws require that every case in
the laboratory be accompanied by a prescription that
has been completed and signed by the dentist. In some
situations the prescription will represent the only
means of communication between the dentist and lab-
oratory . Therefore it is very important that the form be
designed in such a manner that it will conform to state
laws and allow the dentist to clearly communicate in -
struction to the laboratory. A terminology chart will en -
hance the clarity of the instructions.
Even a well-designed prescription can be misleading
if is not completed properly. Some dentists may del-
it
egate the filling out of the prescription to the assistant.
The assistant will either have the dentist sign it or will
use a signature stamp. This practice promotes commu -
nication problems and resultant errors.
Terminology
Conflicting terminology is a common barrier to effec-
tive communication . One method to minimize termi-
nology problems is use of a terminology calibration
chart (see boxed material ). The two primary rules for
developing and using a term chart are the following.
1 . Use those terms most common to the type of ser -
vice being performed .
2. Every team member must have access to identical
charts: v fw*
The effectiveness of such a chart is greatly enhanced
when both the clinical and laboratory personnel can
meet as a group and develop the chart .
 6 Dental laboratory procedures : cgfnplete dentures
i
SAMPLE TERMINOLOGY CALIBRATION CHART *
Commonly used terms
Anatomic crown — The part of a tooth covered with enamel.
—
Anatomic teeth Denture teeth with cusp angles of 30 de-
grees or more.
—
Attrition Wearing away of the biting surfaces of the teeth .
—
Blind vent A riser or vent which does not extend outside
the mold.
Cantilever fixed partial denture — A fixed partial denture
with only one abutment .
Clinical crown — That part of a crown visable in the mouth
above the gum line.
Curve of Spee — The lower natural teeth, including the lower
incisors and cuspids, present an arch- like arrangement
.
when viewed from the side This curve is referred to as
the Curve of Spee.
—
Height of contour The greatest circumference of the
crown of a tooth.
Line angle — The angle formed by the union of two surfaces
of a tooth. The junction of the mesial surface with the labial
surface of an incisor is called the mesiolabial line angle.
Sanitary pontic — A conical type of artificial tooth contoured
so that the tongue and cheeks can keep it clean.
Stabilized baseplate — A baseplate lined with an impression
material to increase its stability.
'These terms and definitions were taken from Air Force Manual 162 6: Dental laboratory technician ' s manual , Washington, D C., 1982, U S.
Government Printing Office.
Communicating tooth shades
The most descriptive terms fail to accurately convey
various tooth shades and stains. Therefore color com
munication remains a serious concern for both the den
tist and the technician . Some laboratories have at
tempted to solve this problem by ensuring that their
shade guides are identical to those used by the dentist.
However, because of environmental and lighting differ-
ences , shades will not appear the same in the laboratory
as they may in the mouth . The ideal solution to the
color communication dilemma is for both the dentist
and the technician to see the patient at the same time.
Unfortunately, many times it is not practical for the
technician to see the patient.
Feedback
Feedback is the lifeline of a relationship. An effective
feedback system will allow technician and dentist to
correct minor problems before they become major and
costly. Constructive feedback will strengthen the rela-
tionship and provide each member with valuable infor-
mation on the accuracy of work. Feedback on a person s
efforts will usually provoke a positive or negative emo-
Indirect inlay technique— A method of waxing the pattern
on a die outside of the mouth.
Occlusion rim — The built -up wax attached to the baseplate
to establish measurements of the patient s teeth which are
positioned in the occlusion rim during the setup.
Pier — The intermediate or middle abutment in a fixed partial
denture of three abutments. In a fixed partial, extending
from cuspid to second molar with the second bicuspid
present , the second bicuspid would be the pier.
—
Posterior palatal seal An elevation of acrylic resin on the
tissue side of the posterior border of an upper denture for
the purpose of sealing the denture against the resilient soft
tissue in the palate.
Proximal surface— The surface of a tooth which lies next to
another tooth.
Reciprocal arm or bracing arm — The rigid arm of the clasp
so located on the tooth as to oppose any pressure exerted
by the retentive arm . It acts to stabilize the appliance and
resist lateral displacement.
Reverse curve — A plane of occlusion which instead of form-
ing the usual compensating curve assumes an opposite
downward curve.
Vibrating line— A line in the soft palate that marks the junc-
tion between tissue which moves, as in swallowing, and
that which is stationary.
-
X
tional reaction, which may range from a slight facial ges-
ture to emotional expressions of great joy or anger . All
- feedback must be constructive, tactful , and professional.
- Suggesting ways to correct problem areas requires tact ,
- and most important is never passing up an opportunity
to compliment team members on a job well done.
Feedback comes in many forms. Most laboratories
rely on telephone calls from the dentist. Some dentists
contact the laboratory only when there is a problem ,
but this is not good for a healthy working relationship.
Since there are degrees of quality, both the dentist and
technician need constant feedback to maintain a good
relationship and provide a high quality of service. An
excellent way to get constant feedback is to design a
critique card to send out with the completed case (Ta -
ble 1 -3). Each laboratory would select or design a cri-
*
tique form to satisfy its specific needs. The critiques
may be sent out on a random basis, with every case, or
with the monthly bills. These forms can serve a good
purpose; however, they are not as effective as a con -
structive person -to- person meeting. I
A common excuse for not meeting face to face is the
lack of time. The time problem can be solved by having
 Y3
M
Effective dent 1st -technician communication 7

Table 1-3. Laboratory /clinical feedback ( fixed partial dentures) *

A
Procedure Unsatisfactory Satisfactory Excellent Comments

Laboratory
Cast and dies
Design
Occlusion
t Contour
Contact area
Margins
i Color shade
Overall fit
Overall appearance
Miscellaneous

Clinical
Impression
Tooth preparation
a . Reduction
b. Design
c. Margins
> Occlusal registration
Prescription (clear and precise)
Miscellaneous
' Write any additional comments on back of form.

lunch together , even if it is only a brown - bag meeting.
A one-hour meeting at least once a month can pay gen -
erous dividends in correcting or preventing costly er-
i rors. Distance, which sometimes presents a problem
can best be dealt with by regular telephone conversa-
tions.
To assist in communicating, it might be beneficial for
the dentist and technician to attend continuing educa-
tion programs , thus improving understanding of clinical
problems that may affect the end result. The continuing
advent of new dental materials and methods makes
i
such attendance mandatory. This information should be
shared by both dentist and technician . To encourage
team efforts, professional meetings and social gather -
ings can be scheduled to provide a medium for sharing
information .
THIRD- PARTY COMMUNICATION
Perhaps no other communication instrument is used
more widely than the telephone. Communication be-
standable. Use of the telephone can also be an asset to
the technician when an emergency arises after hours
and it is necessary to contact the dentist; in this situa-
tion , an agreement should be made between the labo-
ratory and dentist as to whom to call .
Occasionally a dentist may rely on the dental assis-
tant to act as a third -party communicator of a highly
technical message. It then becomes that person’s re-
sponsibility to relay the dentist’s message in exact den -
tal terminology to minimize mistakes. As in any in -
stance where a third party is introduced as a “ go-
between ,’ the potential for ineffective communication
is established . It is the sole responsibility of the dentist
to make instructions legible and precise. Often the den -
tist may choose to illustrate specifications with diagrams
to facilitate understanding. The illustrated work author -
ization strengthens the link between dentists and tech -
nicians.
EVALUATION

T tween the dental office and the laboratory takes on new

dimensions once the dentist has the opportunity to dis-
! cuss a case with the technician . Diagrams and instruc-
tions of the work authorization can be supplemented by
the telephone conversation . The telephone makes it
possible to acquire immediate feedback and provide a
means of clarifying written instructions . Similarly, the
telephone becomes a handy instrument for the labora-
tory technician if instructions are not legible or under-
I
As a means of evaluation , critiques should accompany
the finished product sent to the dentist and should also
be completed by the technician .
After a suitable period working with a selected labo-
ratory , it is a good idea to evaluate performance, qual -
ity , services, percentage of remakes, and the dentist/
laboratory technician rapport . It is mutually beneficial
to discuss these matters pertinent to improving the re-
lationship and thus produce a better service for the pa -

f
8 Dental laboratory procedures: complete dentures

Table 1- 4. Communications troubleshooting chart ( technician)

A
Problem Probable cause Solution

Delinquent account
Misinterpreting instructions
Lack of mutual respect
High percentage of re - Weak links in the clinical and/or laboratory
makes
Inefficient or inconsistent credit and payment Review and or revise credit and payment poli -
policies cies to include client credit checks, billing
and payment procedures
Lack of common terminology or general in- Develop a terminology calibration sheet ; com-
structions; lack of a common core of experi- municate in specific rather than general
ence terms; attend training seminars together;
meet face to face to discuss solutions
Poor communication; dentist is not aware of Establish better communication; discuss ways
your education, experience, and profession- that your education and experience can
alism complement the quality of patient care; al -
ways conduct yourself in a professional
manner
Improve communication and feedback system;
procedures. A few areas for concern are; spend time together discussing problems
1. High occlusion and techniques
2. Insufficient tooth reduction
3. Faulty impression
4. Contacts
5. Wrong shade
6. Porosity
7. Distorted cast
8. Margins
9. Incorrect occlusion records

Table 1-5. Communications troubleshooting chart ( dentist)

Problem Probable cause( s ) Solution( s)
. '
r
Laboratory late on due Incorrect or no due date on prescription; labora- Improve communications; clinic and laboratory
dates tory experienced a problem; poor communica- verify due dates when any double exists
tions
High percentage of re- Faulty clinical and or laboratory procedures ; lack Visit the laboratory; discuss problems; seek cor -
makes of compatibility between the clinical and labo- rective measures; attend continuing education
ratory procedures; inadequate feedback sys- programs together; most important : communi-
tern cate !
Increased chair time to Inconsistent quality from the laboratory; person- Work with dentist to identify the problems and
insert appliances nel changes in the laboratory; new laboratory correct them; use an effective two- way feed-
or clinical techniques back system
Laboratory does not Prescriptions too vague ; technician having diffi- Be more specific on the prescription; technician
follow instruction culty following instruction should be encouraged to ask for clarification
when in doubt
Technician alters cast Flaws in cast; lack of adequate reduction on Encourage technician to ask for clarification be -
and or dies preparation undercuts or unclear margins fore making alterations to a cast or die

tient. Failures and successes should he reviewed with REFERENCES

equal emphasis.
Communication lines should always he open , even to
the extent of developing a communication troubleshoot -
ing chart for technicians (Table l -4 ) and for dentists (Ta-
ble 1-5). In keeping matters open and visible, the den -
tal team can rise to new heights for the benefit of the
patient.
J . L., and Huntsman , A . J.: Communicating effectively. Wake-
field , Mass. , 1981 , Nursing Resources, Concept Development Inc. .
Green , E . J ., and Nathan , k : Selection , hiring, and training of dental
.
auxiliaries Philadelphia, 1970. W. B. Saunders Co.
Sowter. J . B.: Dental laboratory technology , orientation , ethics , and
business management . Chapel Hill, N . C . , 1907. The University of
North Carolina Press. £
Stein , P.: Managing for profit . Alexandria, Va. , 1976, National Asso-
ciation ol Dental Laboratories. Inc.
 If.

CHAPTER 2

PRELIMINARY IMPRESSIONS:
CARE AND POURING
KENNETH D . RUDD and ROBERT M MORROW .

'

preliminary impression An impression made for the purpose of REQUIREMENTS

diagnosis or construction of a tray,
preliminary cast A positive reduction of the upper or lower jaw
tissues that is made in an impression and over which impression
trays may be fabricated.
f inclusion of air in the impression , but handcarving in
A complete denture depends on an artificial stone
cast for its dimensions, contours , and ultimate clinical
success. This artificial stone cast is the direct link be-
tween clinical procedures completed in the dentist’s of-
fice and the complete denture constructed in tin * dental
laboratory . Therefore proper care and handling of the
impression are essential for a high -quality cast .
A cast should possess the following qualities:
1. All surfaces to he contacted by the tray and den -
ture should be accurate and free of voids or nodules. ( It
is essential to remove nodules resulting from voids or
critical areas is not acceptable. ) •
2. The surface of a cast should be hard , dense, and
free of any grinding sludge left by the cast trimmer .
3. A cast should extend sufficiently to include all of
the area available for denture support . For example, a
mandibular cast should extend 3 to 4 mm beyond the
retromolar pads.

* -
3 4 mm 3-4 mm
-1
r
3- 4 mm 3-4 mm
A r *
T
15-16 mm
i

3-4 mm 3- 4 mm
i i' r
l B
3- 4 mm
T T
15-16 mm
3-4 mm

Fig. Sides of the cast should be vertical and perpendicular to base. They should not incline
inward or outward. Tongue space on mandibular casts should be trimmed flat. Note recommended
. .
dimensions for maxillary cast A and mandibular cast B . .
9
a
i

*
10 Dental laboratory procedures: complete dentures
4. The peripheral roll should he complete and no
deeper than 3 to 4 mm , and the edge of a cast extend -
ing out from this roll should he approximately 3 to 4
mm wide.
5. The side walls of a cast should he vertical or
slightly tapered outward , hut not undercut.
6. The base of a cast should not he less than 15 to 1 ft
mm at the thinnest point .
7. The tongue space on a mandibular cast should he
Hat and smooth when trimmed , but the lingual periph -
eral roll should remain intact ( Fig. 2- 1 ).
8. A cast should not show signs of having been wet
or washed with tap water .
The two materials used most frequently for complete
denture preliminary impressions are alginate irrevers-
ible hydrocolloid and modeling plastic, often referred
to as impression compound . Care of the impression and
pouring procedures for these materials are not the same
because of differences in physical properties. This chap-
ter describes care and pouring of preliminary impres-
sions made from alginate and modeling plastic.
ALGINATE PRELIMINARY IMPRESSIONS
Alginate irreversible hydrocolloid is an impression
material that is used extensively ( Rudd et al . , 19ft9).
Generally, it is used to make impressions for diagnostic
casts and removable partial dentures. It also is used fre-
quently in making preliminary impressions for com -
plete dentures (Sharry , 1974 ) . Alginate impression ma -
terials were developed during World War II when the
halting of agar imports from Japan resulted in a scarcity.
Alginates are the salts of alginic acid , which is ob-
tained from kelp. By an irreversible chemical reaction ,
alginates change from sol to gel , thereby accounting for
the designation irreversible hydrocolloid . The sol form
is a soluble salt of alginic acid , and the gel is. an insol -
uble salt. (Guide to Dental Materials and Devices 197ft -
1978). For the best results, it is necessary to pour
impressions made with alginate irreversible hydrocol -
loid soon after making the impression . Two-stage pour-
ing usually results in better cast surfaces ( Young, 1975) .
It is impossible to store alginate impressions in air or
water, since they dehydrate in air and absorb water if
stored in it for any significant length of time. If an al -
ginate impression dehydrates, it shrinks; conversely , if
it absorbs water, it expands. Both types of changes re-
sult in an inaccurate cast . Therefore it is mandatorv to*
pour alginate impressions as soon as possible to mini -
mize distortion . A delay in pouring the stone mix to
form the cast is probably the most common error asso-
ciated with the use of this material.
PROCEDURE
1 . Prior to pouring, examine the impression carefully
for voids in critical areas and possible pulling away of
the alginate from the tray ( Fig. 2-2). It is better to re-
ject a poor impression than to attempt to use it , since
remaking the impression because of defects costs less
than remaking the completed restoration .
2. Run cold tap water over the impression gently to
wash it ( Fig. 2-3). Sprinkle artificial stone on the
impression to disclose films of saliva; then wet the
impression and scrub in the stone gently with a soft
camel’s hair brush ( Fig. 2-4). Flush the impression with
water to make certain that no stone remains on the
impression .
3. Remove excess moisture from the impression with
a gentle stream of air ( Fig. 2-5). Do not use a strong
blast of air because it can dislodge the impression ma-
terial from the tray. Once loosened from the tray , it
cannot be returned to position accurately . The surface
of the alginate impression should not be thoroughly
dry; it should glisten or shine. However, no droplets or
liquid film should he discernible. To prevent dehydra -
tion of the impression , mix the stone immediately.
Usually it is best to avoid filling in the tongue space
with wax, since it is difficult to make wax stick to the
alginate, and the procedure requires more time.
4. With a sharp knife trim excess alginate that ex -
tends beyond the back of the tray ( Fig. 2-ft ). This step
prevents any alginate from touching the laboratory
bench when the impression rests on it ( Fig. 2-7). II ex -
cess material comes in contact with the bench top . dis-
tortion of the impression could result. II use of excess
material is vital to the impression , making trimming
impossible, support the impression hv the tray handle.
An excellent tray holder can be made by cutting a hor-
izontal slot wide enough to accept the handle in a
length of wood 1 x 2 inches (2.5 x 5 cm ), or nail two
hoards together with a suitable space between them
( Fig. 2 8). When fastened to a wall or case pan , this
-
block may be used to hold a tray so that it avoids con -
tact with the bench top ( Fig. 2-9).
5. Weigh the artificial stone, and mix it with the rec-
ommended volume of water ( Phillips , 1973). Since the
proper powder -water ratio is essential for a good cast
surface , weigh the stone on a balance scale ( Fig. 2-10).
Preweighing stone in the required amounts for individ -
ual impressions also results in economy of material by
reducing the amount of waste when handling too large
a mix. The majority of impressions require 200 gm of
stone. A 4-ounce ( 112-gm ) ointment jar is a convenient
container for 1 ( K ) gm portions of preweighed stone ( Fig.
2-11). Use a larger container for larger mixes of stone
( Fig. 2-12 ). When stored in open containers or bins,
stone is subject to hydration and is not usable in pour-
ing impressions for high -quality casts ( Fig . 2- 13). How-
ever , stone stored in bins is satisfactory for mounting
casts in articulators, Hashing, and pouring indexes.
Stone stored in open containers is subject to contami-
I
 Preliminary impressions: care and pouring 11

I
I

A B

-.
Fig. 2 2 A , Alginate impression is examined carefully under good light . B, Impression is examined
for voids in critical areas and for evidence of alginate impression material pulling away from tray
( arrow ) .

nation from water droplets and other types of stone or

plaster when using the same scoop for several contain -
ers ( Fig. 2- 14).
6. Mix the preweighed stone in a mechanical spatu -
i lator* under reduced atmospheric pressure ( Fig. 2- 15).
% Stone mixed in this manner contains less air and results
in a dense cast .
7. Gently vibrate the stone into the impression ( Fig.
2- 16). Avoid harsh or prolonged vibrations, and exercise
care in handling the alginate in the tray to keep it from
touching the vibrator , which may result in separation
and distortion.
t 8. Continue to add stone in only one distal corner of
the impression ( Fig. 2- 17). This procedure will help
4 prevent voids, which result from the entrapment ol air .
Observe the flowing stone carefully during this stage,
and add stone slowly until the impression is full . Cover
the entire anatomic portion of the impression during
the first pour.
9. Apply the remaining stone in droplets on the pre-
viously poured stone to make irregular undercuts ( Fig.
2-18). In the final , or base, pour , stone will engage the
undercuts and produce a strong cast that will not sepa-
rate during the usual dental laboratory procedures.
-
Fig. 2 3. Cold tap water is run over impression gently to remove all 10. Insert the handle in a tray holder, and suspend
traces of saliva. the poured impression while it sets ( Fig* 2-19 ).

-
f
•

1 * Combination Vac- U-Vestor/ Power Mixer, Whip- Mix Corp., Louis-

ville, Ky.
Text continued on p. 17 .
 A

Fig. 2- 4. A , Plastic mustard or catsup dispenser can be used to

sprinkle stone into impression. B. Soft camel’s hair brush is used
to scrub stone into impression gently. C, Impression is placed under
running cold tap water, and camel 's hair brush is used to remove
all traces of stone.

Fig. 2- 5. Excess moisture is removed from impression with gentle .

Fig. 2-6 Excess alginate protruding beyond posterior extension of
stream of air. Strong blast of air can cause separation of impression tray is removed with sharp knife. Sharp Bard-Parker blade in knife
from tray. is excellent for this purpose.
 Preliminary impressions: care and pouring 13

r*
* Fig. 2- 7. Tray is trimmed of excess alginate to keep remaining al-
ginate from making contact with surface of laboratory bench ( ar -
row). If alginate is not trimmed and is allowed to contact surface of
bench by being placed on it, impression can be distorted.

.
Fig. 2-8 A, Two boards nailed together, with spacer between them that is wide enough to permit
placement of tray handle, make excellent device for suspending impression. B, Boards attached to
wall or workbench are readily available for use. Impression is suspended by handle to eliminate any
possibility of distortion, resulting from resting on heel portion.

Stove bolt and washer

1/ 8-inch space made by

using washers for
spacers H. 1 inch ( 2 cm)
[--3— 1/ 8 inch (0.32 cm)
8 ^
^ jr 1 inch ( 2 cm)

2 inches ( 5 cm )
i

% Fig. 2 9. Two pieces of wood 1 x 2 inches ( 2.5 x 5 cm) have been fastened together with spacer
-
between them and attached to case pan to support impression tray.

i
14 Dental laboratory procedures: complete dentures

Fig. 2-10. A, Artificial stone is proportioned by weight, using small balance scale. After stone is
weighed, it can be stored in suitable jar with tight -fitting lid. Then weighed stone is mixed with man-
ufacturer’s recommended amount of water. B, Usually 200 gm of stone are sufficient for majority of
impressions.

Fig. 2 11. Four-ounce (112-gm) ointment jar can be used for storing
-
smaller mixes, such as 100 gm of stone or less. This quantity gen-
erally is used to pour very small impressions or impressions for
removable dies. Lid is placed on jar securely, and jar is labeled to
indicate type of stone, amount, and required volume of water to
make mix.

*
 Preliminary impressions: care and pouring 15 V

.
Fig. 2-12 Larger container, such as plastic bottle, left , can be used
to store larger mixes of stone. Four-ounce ( 112- gm) ointment jar,
right, is used for smaller mixes, such as 100 gm or less. Both are
excellent containers for storing stone.

Fig. 2-13. Storage in bins is satisfactory for stone used to mount

casts in articulators or to flask, but it is poor storage method for
stone used to make casts.

B
A

same scoop in
- .
Fig. 2 14 A, Stone stored in open containers is subject to contamination from use of
be avoided to obtain best
% various types of stone and from water droplets. Contamination should
results. B, Stone adhering to scoop can contaminate future mixes.
 4

-
Fig. 2 15. A, Water is added to plastic bowl used for making mixes
in mechanical spatulator. B, Preweighed stone is added to water.
C, Mix is stirred with spatula to incorporate water and powder. D,
Spatula top is placed on bowl, and stone is mixed in mechanical
mixer for approximately 20 seconds.

.
Fig . 6. Stone is vibrated intowi prpssion gently by adding stone
"
in small increments to posterior portion or mipraejon
 V
: care
' is and pouring 17
^

*- •

Fig. 2- 18. Small droplets of stone are added to poured impression

to create mechanical undercuts, which form firm attachment be-
tween first and second pours of casts.
Fig. 2- 17. Stone is added until impression is filled .

11 . After the stone has set initially, and while it is

still warm from the heat of crystallization, place the
impression containing the stone in clear slurry water*
for 3 to 5 minutes ( Fig. 2- 20 ).
12. Remove the impression and blow off excess slurry
water with a stream of air prior to pouring the base in
the same kind of stone as used for the first portion . Do
not overdry; the surface of the stone should glisten
( Fig. 2-21 ). Invert the first pour , and check the height
prior to pouring the base ( Fig. 2- 22 ). If it is too high,
reduce the height by grinding on a model trimmer;
then recheck the height . Fig. 2- 19. Poured impression is placed in slot of tray holder and
13. Make a mix of stone in the power-mixer using the allowed to set .
same powder-water ratio and place a patty on a glass
,

or plastic slab ( Fig. 2-23). Shape the patty to the ap-

proximate size and thickness needed for the base.
14. With a spatula add a small amount of stone to the
undercuts of the first pour ( Fig. 2- 24 ) .
15. Invert the poured cast into the stone patty , and
draw the stone up onto the sides of the first- pour stone
i Fig. 2- 25) .

16. Remove the excess carefully, particularly in the

area lingual to the mandibular ridge, and shape it until
the surface is flat ( Fig. 2-26 ).
17. Separate the cast from the impression approxi-
mately 45 minutes to 1 hour after the first pour (Fig. 2-
27). If the alginate remains in contact with the stone
longer , it can make the surface of the stone cast rough
or soft . Do not remove the cast too soon , because the
second-pour stone may not have set.

Slurry water is made by placing stone debris or particles in a con -
*% tainer of water and allowing them to soak for 48 hours; the resultant
supernatant solution is used for rinsing or soaking casts.
Fig. 2- 20. Poured impression is placed in clear slurry water for 3 to
5 minutes to wet surface of first -pour stone and assure good bond
between first and second pours.
 ' M

.
Fig. 2- 21 Excess slurry water is blown off with stream
of air before
pouring base. Avoid overdrying; surface of stone should glisten
.

A
B l

C
D

Fig. 2- 22. A , First pour is inverted on bench top to determine

whether or not stone droplets are too
high. B, If too high, first pour is reduced easily on cast trimmer
. C, Portions of stone droplets added
to first pour to serve as mechanical undercuts have been reduced
Trimmed first pour is placed on bench top to determine its thickness .
in height to make cast thinner D,
after correction.

|
•

i
 1

Fig. 2- 23. Second mix of stone using correct powder-water ratio is Fig. 2-24. Small amount of mix is wiped into undercuts of first pour
made, and patty is placed on glass slab. Patty should approximate with spatula to minimize voids.
contours of base of cast.
i

\
i

Fig. 2-25. Impression with first pour is settled into stone patty care- Fig. 2- 26. Excess stone, particularly in area lingual to mandibular
fully, and stone is drawn up around borders of first pour. ridge, removed and surface shaped. Unless area is flat, it will re-
quire trimming later. It is exceedingly difficult to trim at that time.

rig. 2-27. Before attempt at removing impression from poured cast,

excess stone is cleared away carefully from sides of tray to free it.
 20 Dental laboratory procedures: complete dentures

18. Examine the case carefully to determine its ac-
ceptability . Remove small nodules of stone and alginate
particles ( Fig. 2-28). Do not rinse or soak the cast in
tap water because it can dissolve the surface of the cast
( Rudd et al. , 1969 ). Perhaps this problem is not too
critical in a preliminary cast used to make a tray; how-
ever , it is exceedingly important in a master cast .
19. Soak the cast in slurry water for a few minutes
and then trim it on a cast trimmer ( Fig. 2-29 ). The
soaking will keep sludge created during trimming from
sticking to the cast . Rinse the cast in slum water as
needed to remove the sludge. Do not allow sludge to
dry on the cast , since it is exceedingly difficult to re-
move ( Fig. 2-30). Be careful in trimming to avoid re-
moving essential areas of the cast ; otherwise, it may he
necessary to make a new impression. Smooth the lin -
gual space of mandibular casts to improve access later
( Fig. 2-31).
20. Permit the trimmed cast to dry , and then exam -
ine it critically ( Fig. 2-32).
21 . Identify the cast by labeling it with a pencil ( Fig.
-
2 33).

£
f
A B

Fig. 2-28. A, Cast is examined carefully, and small nodules or projections are removed. Small scraper
is ideal for this procedure. B, Small nodules of stone on cast are smoothed before cast is trimmed
on cast trimmer .

.
Fig. 2- 29 A, Stone cast is soaked in clear slurrv water before trimming it on cast trimmer. B, This
procedure keeps sludge created during trimming from adhering to cast.
 Preliminary impressions: care and pouring 21

* 4

Fig. 2- 30. Dry sludge is difficult to remove without damaging cast.

*
<

Fig. 2-31. A, Chisels can be used to smooth lingual area of mandibular casts. B, Right-, straight-,
and left-bevel chisels (Dixon) are available.

v/
i

*
Fig. 2- 32. Examine trimmed cast carefully to make certain that es- Fig. 2- 33. Each cast is identified by marking patient ’s name or case
sential areas have not been trimmed away. number on it in pencil.

\
A
22 Dental laboratory procedures: complete dentures
PROBLEM AREAS MODELING PLASTIC IMPRESSIONS
Problems associated with pouring alginate irrevers - Modeling plastic, or impression compound , is a ther-
ible hydrocolloid impressions are ( 1 ) failure to identify moplastic material usually composed of gum dammar t
a faulty impression ( 2) too long a delay in pouring the
, prepared chalk , and other materials ( Boucher, 1974 ) . It
,
, *
<

impression , ( 3 ) poor pouring technique, and (4) incor-
rect trimming on the cast trimmer (Table 2- 1) . Examine
impressions carefully before pouring, and obtain an-
other impression instead of using a defective one. To
proceed with an inadequate impression is poor econ -
omy for everyone involved . Pour the alginate impres -
sion as soon as possible after making it . Do not wrap
the impression in a wet towel for transporting to the
laboratory . Follow the recommended procedures for
pouring the cast use a two-stage technique , and avoid
, final impression , whereas others use modeling plastic to
so-called shortcuts that can compromise quality . Trim
the cast, so that it is no thinner than 15 to 1 (5 min at
the thinnest point . Trim the sides perpendicular to the
base , but do not remove anatomic portions of the cast .
On mandibular casts , smooth the area lingual to the
mandibular ridge to permit access to the lingual area
during fabrication of the tray'. Do not allow sludge from
the cast trimmer to dry on the cast , and do not dissolve
the cast by repeated rinsing in tap water.
is used especially for making complete denture impres -
sions . The material is available in a variety of consisten -
cies , often identified by color . For example , black mod -
eling plastic may soften at a higher temperature than
red , and green , gray , and white may soften at progres-
sively lower temperatures . Black and red modeling
plastics are probably the ones used most frequently for
complete denture preliminary impressions. Some den -
tists use modeling plastic impressions as trays for the
make preliminary impressions and then pour them in
stone . They construct a tray on the cast as when using
alginate preliminary' impressions. The care and pouring
procedure for modeling plastic impressions differ from
those from alginate impressions . Modeling plastic is not
a hydrocolloid and , being rigid , it is less subject to dis -
tortion . However , modeling plastic changes as a result
of flow or memory and, although the changes are not iis
critical as for alginates , it is recommended that it be
poured as soon as practicable .

-
Table 2 1. Alginate preliminary impressions
Problem Probable cause Solution

Voids in impression
Impression separated from
tray
Alginate pulled away from
tray and dry
Cast surface chalky and soft
Voids on surface of cast
Cast too thin or too thick
Critical areas of cast
trimmed away
Cast broken easily
Slurry sludge stuck on cast,
making surface rough
Voids in impression material dur -
ing making of impression
Too much time between impres-
sion and pouring
Too much time between making of
impression and pouring
Impression not separated from
cast within 1 hour after pouring
Incorrect powder - water ratio, mak-
ing mix too thin
Mechanical spatulator not used
Stone poured into impression too
quickly
Cast trimmed improperly on cast
trimmer
First -pour stone not checked for
thickness and not reduced prior
to pouring of base
Trimmed improperly on cast trim-
mer
Improper powder - water ratio in mix
Cast trimmed too thin
Cast not dipped in clear slurry wa-
ter prior to trimming on cast
trimmer
Obtain another impression if first defective ,
Pour alginate impression as soon as possible
Pour alginate impressions soon after making them
Separate cast from impression within 1 hour after pouring
Weigh stone and mix with recommended amount of wa-
ter
Mix stone in mechanical spatulator under reduced atmo-
spheric pressure
Pour slowly into only one distal corner of impression to
minimize voids
Exercise care when trimming cast on cast trimmer; check
thickness of base frequently to prevent overtrimming
Check first-pour stone to determine that it is not too
thick ; if needed, thin cast on cast trimmer prior to pour-
ing base
Check cast frequently when trimming to prevent overtrim-
ming I
Use recommended powder- water ratio; mix in mechani-
cal spatulator under reduced atmospheric pressure
Do not overtrim
Soak or wet cast in clear slurry water when trimming on
cast trimmer to prevent sludge from sticking to cast
^-
i
*

PROCEDURE
s 1. Examine the impression to make certain that it has
A not been broken or chipped while in transit between
tin* dental office and the laboratory ( Fig. 2-34 ).
2. Place the impression in a holder, and make a mix
of stone, as described earlier .
3. Pour the stone mix into the modeling plastic
impression , taking care to avoid entrapping air and the
resultant voids ( Fig. 2-35).
l
l PROBLEM AREAS
( f
I Fig. 2-34. Modeling plastic impression is examined carefully before
pouring in artificial stone. It is checked for chips and voids, which
could make cast unusable.
:
Fig. 2-35. Modeling plastic impression is poured on vibrator , and
stone is added in small amounts at only one corner of impression.
Preliminary impressions: care and pouring 23
Si
4. Fill the impression, and make certain to cover the
anatomic portion , as described previously.
5. Replace the poured impression in the tray holder
( Fig. 2-36).
6. After the initial set, make another mix of stone,
and pour the base, as described earlier.
7. Approximately 45 minutes to 1 hour after the first
pour , place the poured impression in warm slurry water
to soften the modeling plastic ( Fig. 2-37). Lift the soft -
ened modeling plastic impression off the cast carefully
( Fig. 2-38).
8. Examine the cast and , if it is acceptable, trim it on
the cast trimmer, as described earlier .
9. The preliminary cast is ready for fabrication of the
tray ( Fig. 2-39). j
Problems associated with pouring modeling plastic
impressions arise with failure to soften the material ad-
equately before separating the cast from the impression
(Table 2-2). Frequently, the cast breaks during the sep-
aration . Conversely, overheating the modeling plastic
makes it stick to the cast tenaciously, and removal may
be impossible. As with the use of alginate, proper pour-
ing and trimming procedures are essential to the suc-
cessful use of modeling plastic.
Fig. 2-36. Modeling plastic impression with first pour of stone is
placed in tray holder again and allowed to set . Two-pour method
gives good base thickness control.
24 Dental laboratory procedures: complete dentures

rr

V\ •* -

Fig. 2 37. After stone has set, modeling plastic impression with
-
stone is placed in low temperature- water bath to soften modeling
plastic before separation is attempted.
Fig. 2 38. Softened modeling plastic impression is lifted away from
-
stone cast carefully. If modeling plastic is not soft enough, placing
it back in water bath will allow it to soften longer, thereby avoiding
breaking cast.

.
Fig. 2-39 On separation, stone cast is examined carefully to make
certain that there are no voids. Then cast can be trimmed on trim-
mer, as described previously.

Table 2- 2. Modeling plastic impressions

Problem Probable cause Solution

Cast broken during separation -

from impression
Modeling plastic stuck to cast
at time of separation
Cast too thin or too thick
Modeling plastic not softened ad
equately before removal at -
tempted
Modeling plastic overheated when
placed in water that is too
warm
Cast poured or trimmed too thin
Thick base as a result of first
pour being too thick
Immerse poured impression in warm water to soften
modeling plastic before separating from cast
Do not oversoften modeling plastic; place in warm
water only long enough to soften and remove; do
not overheat or use dry heat
Pour cast to proper thickness; do not trim too thin
Check thickness of first pour before pouring base:
trim on cast trimmer if needed r

SUMMARY
This chapter presents methods for the care and pour-
i Louis. 1974 , The C.V. Mushy Co.
ing of ‘ preliminary complete denture impressions made
* of alginate irreversible hydrocolloid and of modeling
plastic. Making accurate casts demands systematic at -
tention to a multitude of minor details that , singly , may
be of little consequence. It is the cumulative effect of
main errors in technique that assures poor results. Use
of the procedures described will make it possible to
pour accurate, hard , dense casts in alginate or in mod -
eling plastic impressions. An accurate , properly ex-
tended , preliminary cast is a significant step toward a
successful complete denture.
r
> 1
Preliminary impressions: care and pouring 25
REFERENCES
Boucher, C. O., editor: Current clinical dental terminology , ed . 2. St .
Murtinelli , N . : Dental laboratory technology, ed . 3. St. Louis, 1981
.
The C. V. MosbyCo. pp. 100-115.
Phillips, R. W.: Skinner's science of dental materials , ed . 7. Philadel -
phia . 1973, W. B. Saunders Co. , p. 130.
.
Rudd. K. D., Morrow, R. M. and Bange, A. A.: Accurate casts, J .
Prosthet. Dent. 21:545-554. 1969.
Sliarry, J J .: Complete denture prosthodontics, ed . 3. . New York.
1974. McGraw-Hill Book Co. , pp. 209- 210.
Sowter, J . B . : Dental laboratory technology, prosthodontic tech-
niques, Chapel Hill , N . C., 1968, University of North Carolina
Press, pp. 11-14 .
Young. J. M . : Surface characteristics of dental stone: impression ori -
entation , J . Prosthet. Dent . 33:336-341 , 1975.
.•

CHAPTER 3
IMPRESSION TRAYS
KENNETH D. RUDD* and ROBERT M. MORROW
impression tray A receptacle or device used to carry the impres-
sion material to the mouth, confine the material in apposition to
the surfaces to be recorded, and control the impression material
while it sets to form the impression .
LaVere and Freda ( 1976) classified impression trays
as stock trays of various sizes made by manufacturers
and individualized trays made specifically for one pa-
tient and discarded later. / Jamieson ( 1954 ) stated that
individual , or custom -made, trays should adapt to the
cast readily; be rigid , but not bulky; retain their shape;
and be easy to trim . Ellinger (1973) further added that
the impression tray should simulate the finished den -
ture in size and shape, be able to earn the impression
material to the mouth , and control and confine the ma-
terial to enable it to record accurately minute details of
the denture-bearing area.
REQUIREMENTS FOR IMPRESSION TRAYS
The requirements for individualized impression trays
are as follows:
1 . The tray should be rigid but not overly thick.
2. It should retain its shape throughout the construc-
tion and pouring of the impression .
3. The method of construction should be simple
enough so that an acceptable impression tray can
be made in a minimal amount of time at a reason -
able cost.
4 . It should be possible to trim or thin the tray read -
ily with a bur, mounted stone, scissors, or an ar - tRepair Resin, The L. D. Caulk Co. . Milford , Del., or equivalent.
bor band.
5. The tra \ should be smooth because sharp edges
may injure oral tissues.
/
26
*
IMPRESSION TRAY MATERIALS
Materials used to make impression trays are special
autopolymerizing acrylic resin impression tray materi-
als, * conventional autopolymerizing acrylic resins, t
thermoplastic resin sheets used in vacuum- or pressure-
adapting devices , $ and thermoplastic shellac baseplate
materials . Probably the most commonly used impres-
sion tray materials are the special autopolymerizing
resin tray materials that are modified to improve their
adaptability to a cast. If finger adapted to a cast , these ^
tray resins satisfy many of the requirements for impres-
sion trays; they are available in a variety of colors, and
are excellent for the purpose. Thermoplastic vacuum -
adapted resins also are popular . Their principal advan -
tages are the ease and rapidity with which it is possible
to make an impression tray, but they require special
equipment . Thermoplastic shellac baseplate material,
generally in a double thickness, is usable for impression
trays, although its dimensional instability can be a dis-
tinct disadvantage
*
Impression trays usually are fabricated on prelimi -
nary stone casts made from alginate irreversible hvdro-
colloid or impression compound impressions. Since it is
customary to overextend preliminary impressions, a
dentist should indicate the extension of the impression
tray, as well as the outline and type of relief desired
when drawing the tray outline on the cast ( Fig. 3-1).
*Format ray, Kerr Manufacturing Co. , Romulus, Mich., or equiva -
lent .
-
tVaeu Press, Dentsply International, Inc. , York, Fa . , or Sta-Vac Vac-
uum Adapter, Buffalo Dental Manufacturing Co. , Inc., Brooklyn,
N. Y. , or equivalent .

1
*
-.
Fig 3 ! Preliminary impressions usually are overextended ; con-
^
sequently, outline of tray border is short of cast border.
Autopolymerizing resin impression trays
t areas that require additional relief such as sharp bony
AutopoK merizing acrylic resin specially modified for
trays and conventional autopolymerizing resin used for
repairs and baseplates are the materials frequently used
-
for impression trays ( Fig. 3 2). Resin materials are easy
to use, require no special equipment , and when manip-
ulated properly make excellent impression trays. Resin
impression trays can be made thin but reasonably rigid ,
modified easily by grinding with an arbor band or an
acrylic bur. and smoothed or polished readily. Properly
constructed resin impression trays have sufficient di -
t
mensional stability to make an accurate impression .
The two methods of using these materials are the
sprinkle-on method and the finger-adapted dough
method.
Sprinkle - on method
-
Although the sprinkle on method is commonly used
lor constructing acrylic resin baseplates ( McCracken ,
1964 ), it is not the most frequently used method for
constructing resin impression trays| . Some tray resin
powders do not wet well with liquid monomer dis-
pensed from an eyedropper in the sprinkle on method - later removal of wax from the impression tray . If the
( Fig. 3-2). Factory modifications in the autopolymeriz-
ing tray resin formula have made it possible to finger
adapt this material easily and rapidly when it is in the
dough stage. However , if tray resin is unavailable, the
-
sprinkle on method with conventional autopolymerizing
resin * can certainly be used ( Fig. 3- 2 ).
Martone (1963) identified the two methods of achiev
ing relief as grinding out the material from the interior
surface of the tray and providing required relief during
construction of the tray ] In the work-order request , the
ft
*Caulk .
Repair Resin, The L. D . Caulk Co. Milford , Del.
f
Impression trays 27
J* r rvooucn y
fORMATRA* /
POWDER
l
- .~.
**' nmo n*»w ** *
mm m
'l
*
•
w * »» z~
* ^**'
KtHH
syfiaacinyis''
Fig. 3 2. Specially modified autopolymerizing resin is used for
-
impression trays. Conventional autopolymerizing repair resin also is
used for impression trays.
dentist should specify the preferred method , as well as
ridges and soft displaceable hyperplastic tissues. The
usual method is to warm a sheet of baseplate wax 1 mm
thick and adapt it over those portions of the cast in
need of relief.
PROCEDURE
1 . Make an outline of the impression tray on the cast
with a pencil ( Fig . 3-3). Although the dentist may have
specific requirements for this outline, the borders usu-
ally are short of the vestibular reflections of the cast.
Often the posterior border is determined by a line ex -
tending between the hamular notches, with the mid -
point approximately 2 mm distal to the fovea palatina
( Fig. 3-4).
2. Block out the severe undercuts with wax , and
adapt a layer of baseplate wax to the cast for relief ( Figs.
3-5 and 3-6 ). Trim the relief wax to the desired outline
( Fig. 3-7).
3. Paint tinfoil substitute on the stone cast and over
the relief wax ( Fig. 3-8). The tinfoil substitute facilitates
tinfoil substitute does not wet the baseplate wax relief,
—
often 1 or 2 drops of surface tension reducing agent *
added to the tinfoil substitute will increase the wetta-
bility and result in easier separation later .
4. Sift powdered polymer onto the cast and relief
wax, and saturate it with liquid monomer from an eye-
dropper ( Fig . 3-9). Apply more powder and liquid until
- there is a uniform layer approximately 2 mm thick . The
same considerations apply when sifting resin onto the
cast for impression trays as when sifting resin for base-
*Ti -SoI. Ticonium. Albany , N . Y.
28 Dental la bora ton/ procedures: complete dentures

-
Fig. 3 ? Pencil is used to outline tray border on cast. Tray outline
can be beaded to facilitate training if desired.
Fig. 3- 4 . Posterior border is determined by hamular notches on
each side ( arrows) and midpoint approximately 2 mm distal to fovea
palatina (center arrow).

Fig. 3-5. Cast undercuts are blocked out with baseplate wax.

Fig. 3-6. Sheet of baseplate wax is adapted to cast. Slit in wax Fig. 3 7. Baseplate wax is trimmed to desired outline.
-
facilitates adaptation without wrinkles.

A B
Fig. 3 8. A, Tinfoil substitute is painted on cast . B, Tinfoil substitute is painted on relief wax to aid in
-
removing it from tray later .
l
a*
Fig. 3 9. Polymer powder is sifted into cast and relief wax and wet
- -
with liquid monomer from eyedropper. Note rectangular sections of
wax removed to create tissue stops (arrow ).
plates (Chapter 5). The cast should he tilted during sift-
ing to prevent unnecessary buildup of resin in the pal -
atal region of maxillary casts or in the mueobuceal fold
areas of mandibular casts.
5. Cure the impression tray under an inverted plaster
bowl to reduce the porosity .
f 6. Mix more resin in a paper cup and , when it is in
the dough stage , form handles and adapt them to the
impression tray. Some dentists prefer only. one handle
in the anterior portion of the tray ( Dresen , 1958),
whereas others have suggested three handles or finger -
rests for mandibular impression trays ( Merkeley , 1959;
<h
Martone , 1963) ( Fig. 3- 10 ). Position the handles in the
first molar region and the anterior region of mandibular
impression trays. Make the handles approximately 3 to
Impression trays 29
• -
Fig. 3 10. Some dentists prefer mandibular impression tray with
three handles or finger rests .
4 mm thick , 8 mm long, and approximately 8 mm high .
Place horizontal grooves across the facial and lingual
surfaces of the handles to improve the grip. If neces -
sary , the dentist can adjust the handles easily. Usually
anterior handles do not protrude horizontally unless re-
quested ( Fig. 3- 11 ). When handles protrude, they can
interfere with lip movements of patients and make an
.
impression faulty Handles on the impression tray
-
should approximate the posit ion of the teeth on the fin -
ished denture (Fig. 3-12).
7. Adapt the resin dough to the approximate size of
the * handle , and wet the resin tray at the point of at-
tachment with liquid acrylic monomer in an eyedropper
or a cotton pledget saturated with it to facilitate chem -
ical bonding ( Fig. 3- 13).
r 30 Dental laboratory procedures: complete dentures

- .
Fig. 3 11 Anterior handles protruding horizontally can interfere with
lip movements while making impression. This design should be
avoided unless specifically requested.

Fife Handle on impression tray should approximate position of anterior teeth.

A B

- .
Fig. 3 13 A, Eyedropper bottle is used to place liquid monomer on tray in area where handle is to
be attached. B, Resin dough is shaped and positioned on tray.
 Impression trays 31

8. After setting, remove the impression tray from the -.

cast, and trim it with an arbor band or bur ( Fig. 3-14 ).
9. Examine the completed tray , and adjust and polish
rough areas that can cause discomfort to the patient .
Pumice the borders of the tray lightly to make the sur-
face smooth ( Fig. 3 15).
- der and liquid can compensate for the How characteris
10. Store the impression tray on the cast until
.
needed ( Fig. 3-16) /
PROBLEM AREAS
The principal problem with the sprinkle-on method
is the difficulty in controlling the thickness of the
impression tray (Table 3 1) During sifting and wetting,
the resin tends to flow into the deeper recesses of the
cast and make the impression tray too thick in the pal-
ate and too thin over the convex or ridge portions of
the cast . Tilting the cast while applying the resin pow-
-
tics. If severe undercuts are not blocked out , the
impression tray or cast can be broken during separa-
tion . The sprinkle-on method is better for conventional
autopolymerizing acrylic resin , such as repair resins,
and the finger-adapted dough method is better for the
modified acrvlic trav resins.

also is used for

Fig. 3- 14. A , Mounted arbor band is used to trim borders. B , Bur in handpiece
trimming. Cast beading simplifies border trimming of tray.

Fig. 3-15. Tray can be pumiced lightly to smooth surface.

r 32 Dental laboratory procedures: complete dentures

-
Fig. 3 16. Completed impression trays are stored on cast until
f
needed.

Table 3- 1 . Sprinkle- on method

Problem Probable cause Solution

Entire impression tray too
thick
Impression tray too thin over
ridges and too thick in pal-
ate
Impression tray or cast broken
during separation
Impression tray too flexible
Too much resin buildup on cast
from too generous application of
powder and liquid
Resin flow not controlled by tilting
cast during sprinkle on and re-
sultant pooling of resin in palate
region
Undercuts not blocked out
Tinfoil substitute contaminated or
not used
Impression tray too thin or anterior
ridge on lower cast flat
Control applications of powder and liquid to create
uniform layer approximately 2 mm thick; check
thickness of resin with periodontal probe
Tilt cast while sifting resin to minimize pooling
Thin palate with bur on arbor band
Identify undercuts and block them out with wax before
sifting resin on cast
Paint tinfoil substitute on cast; avoid using contami-
nated tinfoil substitute
Make impression tray approximately 2 mm thick; use
wire reinforcement for added strength and rigidity

Finger - adapted dough method
The finger-adapted dough method is used extensively
for making resin impression trays . Specially modified
resin tray materials can In formed into a dough that can
* to the manufacturer s recommendations, and mix in a
be thinned readily or rolled to the desired thickness
and adapted to the cast with finger pressure , The
method is quick , and the resultant impression trays (it
well and have acceptable dimensional stability.,;
PROCEDURE
1 . Place the outline for the resin impression tray on
the cast , and bead the outline with a sharp instrument
if desired ( Fig. 3-17). The resultant beading on the
cured resin tray serves as a guide when trimming ( Fig.
3-18).
2. Place the outline for areas of relief on the cast ( Fig.
3-19 ).*
3. Block out undercut areas with wax. and adapt the
relief wax to the cast ( Fig. 3-20 ). Removal of 4- mm
squares of relief wax will expose the cast , thereby pro-
siding tissue stops ( Fig. 3-21 ).
4. Paint tinfoil substitute on the cast and relief wax
( Fig. 3-22 ).
5. Proportion the impession tray material according
paper cup or other suitable container.
6. Check tlu * consistency ol the resin periodically,
and remove it from tin * paper cup when it reaches the
dough stage. Roll the resin to the* desired thickness
with a roller* or use a special formt to make the*
impression tray uniformly thick ( Fig. 3-23 and 3-24 ).
7. Hand adapt the material to the cast carefully to
avoid overthinning the* resin on the* convex portions of
the cast ( Fig. 3-25). It is easy to overthin the impression
tray by applying too much finger pressure. Light -
colored impression tray resins offer an advantage, since
it is frequently possible to see the relief wax through
them and avoid overthinning.
8. Remove* excess trav material from the cast borders .
. . .
* RolU* ttc* I’ nit . Kerr Manufacturing Co , Romulus Mich
tStone mold .
 \
y

Fig. 3 17. Tray outline can be beaded on cast to facilitate border

- - .
Fig. 3 18 Cast beading now transferred to resin tray (arrows ) is
trimming. excellent guide during trimming.
(

A B
1

-
0

6 I
^
*

- .
Fig. 3 19 A, Outline for relief wax is drawn on cast. B, Edge of relief wax is usually 2 to 3 mm short
of tray border.

»W

41 /

. - .
f j 3 20 One layer of baseplate wax is adapted to cast and . - .
Fi < 3 21 Tissue stops are made by removing 4 mm squares of
%

trimmed to previously drawn outline. wax to expose cast . Exact location of tissue stops can vary.
n Dental laboratory procedures: complete dentures

Fig. 3- 22. Tinfoil substitute is painted on cast and relief wax . Note
cutout tissue stops. Tissue stops may or may not be requested.
Their size and position may also vary according to the dentist s
requirements.

A B

*1

.
Fig. 3- 23. A Rollette unit is convenient for rolling resin into sheets of uniform thickness. B, Resin
dough is rolled into sheets before adapting it to cast . Roller and wood block should be lightly lubri-
cated to minimize sticking.

Fig. 3- 24. A, Stone mold made by impressing double- thickness shellac baseplate material also is
used to make tray resin sheets of uniform thickness. B, Plastic bottle serves as roller when making
resin sheets in stone mold. Both should be lubricated to prevent sticking.

A B
Fig. 3- 25. A , Resin dough is adapted to cast carefully . B, Do not overthin resin over ridge portion of
cast.
< r
{
-
lL
Fig. 3- 26. Excess resin is shaped into handles or finger rests and
adapted to tray that has been moistened with monomer.
*
9. Form tin excess material into handles, and adapt
* 14 . Smooth all rough areas and store the tray on the
them to flu * tray as described previously. Put more
acrylic monomer on the impression tray with a cotton
pledget or an eyedropper at the point of attachment to
improve bonding of the handles to the tray ( Fig. 3-26 ).
10. Make the handles small , so that they require only
a minimal amount of time for finishing to the proper
size ( Fig. 3-27).
i 11. Continue finger adaptation until the impression
tray material remains adapted to the cast and does not
*
rebound.
12. Cure the impression tray on the bench or under
? an inverted plaster bowl.
13. After setting, remove the impression tray from
the cast, and trim the borders ( Fig. 3-28).
1
Impression trays 35 |
v
Fig. 3- 27. Handles are too large and require too much time for fin-
ishing .
-
cast ( Fig. 3 29 and 3-30 ).
PROBLEM AREAS
Problems with the finger-adapted dough method
usually are related to the finger adaptation (Table 3-2 ).
There is a tendency to overthin the impression tray ma-
terial by finger pressure over the convex or ridge por-
tions of the cast . Adaptation should begin when the
resin is in the dough stage. If allowed to progress be-
yond that stage, the resin becomes rubbery and impos-
sible to adapt to the cast accurately. Failure to roll out
impression tray material to a uniform thickness before
adapting it to the cast can make the tray too thick , re-
quire too much time to finish , and increase the cost.
f 36 Dental laboratory procedures : complete dentines

.
Fig. 3- 28. Tray is removed from cast before trimming borders Note Fig. 3-29. Tray borders have been trimmed and smoothed. Borders
that relief wax remains in tray. can be pumiced lightly.

Fig. 3- 30. Completed impression trays are stored on casts until

needed. Note groove in anterior handle of mandibular tray for ease
in holding while making impression.

-.
Table 3 2 Finger - adapted dough method
Problem Probable cause Solution

Impression tray too thin
in some areas and
too thick in others
Failure of tray to fit cast
Impression tray or cast
broken on separation
Impression tray material overthinned
by finger pressure over residual
ridges and allowed to become too
thick in concave areas
Resin not rolled to uniform thickness
prior to adaptation
Resin past dough stage before start of
finger adaptation and adaptation in-
accurate
Finger adaptation discontinued too
soon
Undercuts not blocked out or tinfoil
substitute not used
Exercise care during adaptation to avoid exerting too
much pressure on resin over convex portions of cast
Use roller to make sheet of resin of proper thickness
Start adaptation when resin is in dough stage: do not wait
until resin is rubbery
Continue adaptation until resin begins to set to prevent
rebound
Block out undercuts: pain"cast with tinfoil substitute
 Impression trays 37

Fig. 3 32. After outline of tray has been beaded on cast (arrows),
-
outline of relief is drawn on cast.

- .
Fig. 3 31 Omnivac vacuum adapter can be used to make impres-
sion trays quickly and easily. Vacuum-adapting equipment is avail-
able from several manufacturers.

I nless finger adaptation continues until the resin be-

'

gins to set , it may rehound and lift off the east , making
the tray fit poorly. However, it is easy to master this
technique and make excellent impression trays .
Vacuum - adapted method
-
Vacuum or pressure-formed thermoplastic resin
sheets can make good impression trays; the method is . -
Fig 3 33. Wet sheet of nonasbestos casting ring lining matenal has
been adapted to cast for required relief . Wetting material thoroughly
quick and easy, but it requires special equipment * for with water improves adaptability.
adapting the resin sheet to the cast ( Fig . 3-31). The ma-
terials are available in a variety of colors and thick -
nesses as well as different degrees of flexibility. Al -
though manufacturers issue specific instructions for
their equipment , the vacuum -adapted methods lor
making impression trays are similar.

PROCEDURE
1 . Place the outline of the impression tray on the cast
with a pencil , or bead the outline with a sharp instru -
ment if desired ( Fig. 3-32).
2. Block out the undercuts and place the relief on the
A.
cast with a material , such as a wet sheet of nonasbestos
casting ring lining material ( Fig . 3-33), that will not
melt during heating of the resin sheet.
•Omnivac. Sta-Vac, Vlini -lab Vacuum Adapter, Buffalo Dental Man -
ufacturing Co. , Inc. Brooklyn , N . Y.; Dentsply Vacu - Press, Dcntsplv
International , Inc., York. Pa. .
Fig. 3-34 Cast is centered on vacuum adapter plate.
-
I

k
38 Dental laboratory procedures: complete dent tires

-
3. Center the cast on the vacuum adapter plate ( Fig.
3-34 ).
4. Place a resin sheet of the appropriate color and
thickness in the heating frame, and rotate the heating
-
unit into position ( Fig. 3 35).
5. Activate the heating switch , and continue heating
until the specified sag in the material occurs.
6. Lower the frame and resin sheet onto the cast , and
start vacuum adaptation . After adaptation is complete,
allow the resin sheet to cool , and then remove it from
the vacuum -adapting unit ( Fig. 3 36). -
7. Trim the excess material with a large bur and lathe
( Fig. 3-37).
8. Remove the tray from the cast , and trim the bor -
-
ders ( Fig. 3 38).
9. Add handles made of autopoK merizing acrylic
resin or use preformed metal handles ( Fig. 3-39 ) .
10. Store the tray on the cast until ready to use ( Fig.
-
3 40).
PROBLEM AREAS
The principal limitation of the vacuum-adapted
method is the need for special equipment and materials
to vacuum -adapt impression trays. In addition , some
tray -weight materials are not rigid enough after being
formed into a tray (Table 3-3). Providing relief in the
impression tray is difficult , particularly if it is necessary
to retain the relief in the impression tray during part of
the impression- making procedure. W ax relief is unsat -
isfactory because it melts during vacuum adapting. Use
of wet nonasbestos casting ring lining material as a heat -
resistant relief on the cast during vacuum adaptation is
satisfactorv; however, it must be removed from the trav
prior to use ( Fig. 3-41).
The advantages of this method are the ease and ra -
bidity with which it is possible to fabricate an impres -
sion tray from resin sheets of a variety of thicknesses
and colors.

Fig. 3 35. A, Tray - weight resin sheet is placed in adapter frame. B, Heating unit is rotated into
-
position before activating switch.

- .
Fig. 3 36 Adapted resin is allowed to cool before trimming. .
Fig. 3-37 Lathe-mounted large carbide bur is used to trim excess
tray material.
 Impression trays 39
\

. A
B

. A, Maxillary tray. B, Man-

- .
Fig. 3 38 Vacuum-adapted trays are removed from cast before trimming
dibular tray.
<
M

N1
/

t/

be used. C,
Fig. 3-39. A, Resin handles can be adapted to tray. B, Preformed metal handle can
Metal handle can be bonded to tray with autopolymerizing resin.

i
40 Dental laboratory procedures: complete dentures

Fig. 3- 40. Completed tray with metal handle is stored on cast until
needed . Metal handle should not interfere with lip movements. The
bend in this handle should prevent such interference.

Table 3-3. Vacuum-adapted method

Problem Probable cause Solution

Impression tray too flexi- Impression tray material too thin Use thicker stock material for tray; reinforce it with wire to
ble improve rigidity
Cast or tray broken during Undercuts not blocked out Identify and block out undercuts before vacuum adaptation
separation

Shellac method
The dental profession has used shellac baseplate ma-
terial for many years, primarily for baseplates. Although
it is possible to make an adequate impression tray from
shellac, autopolymerizing resins specially modified for
constructing impression trays seem to have displaced
shellac to a large extent .
Double- thickness shellac baseplate material is essen -
tial for fabricating an impression tray. An advantage of
this method is the rapidity with which the shellac base-
plate material can be adapted to the cast and the tray
fabricated . The serious disadvantage is the lack of di-
mensional stability of the material , especially during

f
the application of heat when border molding the tray
with impression compound.
PROCEDURE

1 . Place an outline of the impression tray on the cast ,

Fig. 3- 41. Nonasbestos relief material must be removed from tray
before use . Here it was removed before trimming the borders.
and bead if desired , as described previously.
2. Block our undercuts on the cast with a plaster and
pumice mix or with wet nonasbestos casting ring lining
material.
3. Provide relief as required with a layer of wet non -
asbestos casting ring lining material ( Fig. 3-42). Base-
 Impression trays 41 -
V

!•

Fig. 3- 42. A , Wet nonasbestos casting ring lining material strip is adapted to cast to provide relief . B,
Completed relief is seen on cast .
I

Fig. 3- 43. Sheet of double- thickness shellac baseplate material is

heated with alcohol torch or Bunsen burner and wilted onto cast.
Exercise care to avoid overheating and charring shellac material.

plate wax used for relief will melt during adaptation of
the shellac baseplate material.
4. Center a sheet of double- thickness shellac base-
plate material over the cast , and wilt it onto the cast
with flame ( Fig. 3-43).
5. Fold the excess shellac material at the borders
8. Allow the impression tray to cool , then remove it
from the cast , and trim it to the border outline ( Fig. 3-
47). If the cast has been beaded , use the heading on
the tray as a guide when trimming. Remove the relief
from the tray ( Fig. 3-48).
9. Perforate the shellac tray with a No. 8 round bur

t: hack onto itself to make them of the proper thickness

( Fig. 3-44).
6. Continue adaptation until the shellac, material
makes intimate contact with the cast and relief material
( Fig. 3-45).
7. Form a handle from scrap shellac baseplate mate-
rial , warm it , and adapt it to the impression tray ( Fig.
3-46).
if using alginate impression material ( Fig. 3-49).
10. Store the impression tray on the cast until ready
for use ( Fig. 3-50).
PROBLEM AREAS
The primary problem in using shellac baseplate ma-
terial for an impression tray is the inherent lack of di -
mensional stability and rigidity associated with its ther -
42 Dental laboratory procedures: complete dentures

Fig. 3 44. Excess shellac is folded back onto itself to make borders
- .
Fig. 3-45 Shellac material is adapted until it makes intimate contact
with cast and relief material. Dip fingers in cool water when adapt -
of proper thickness.
.
ing

Fig. 3 46. Handle is made by warming and shaping shellac base-

-
plate material into handle. Embedding paper clip wire across pos-
terior border improves tray rigidity.

.
Fig. 3 47 A, Large bur can be used to trim shellac tray if rotated slowly and used with light pressure
-
to avoid clogging and loss of effectiveness. B, Tray borders are trimmed to desired outline.
 Impression trays 43

1 If

Fig. 3- 48. All relief material is removed from tray.

.
Fig. 3- 49. A Tray is perforated to aid in retaining alginate impression material. B, Completed tray
has multiple perforations.

moplastic nature (Table 3-4). The incorporation of relief

I in the impression tray is more difficult because base-
plate wax relief can melt during adaptation of the shel -
lac material , and it is difficult to remove the relief after
the tray hits cooled. Since many dentists prefer to have
the relief remain in the tray during part of the impres-
sion procedures, it is more difficult to satisfy this re-

, \ 1
quirement when using shellac baseplate material. In
addition , adjusting or trimming shellac impression trays
is particularly difficult because the material tends to
ruin or clog arbor bands and burs ( Fig. 3-51). The use
of wire reinforcement , as discussed in Chapter 5 for
shellac baseplates, improves the rigidity and dimen -
sional stability of shellac impression trays. Shellac base-
f* plate materials are not as satisfactory for making
Fig. 3- 50. Completed tray is stored on cast to minimize dimensional impression trays as modified autopolymerizing acrylic
change . resin or thermoplastic vacuum-adapted resin materials.
I
44 Dental laboratory procedures: complete dentures

Table 3- 4. Shellac method

Problem Probable cause Solution

Warping of impression tray
and failure to fit cast
Impression tray too flexible
Tray stuck to cast
Shellac baseplate material warped
during cooling
Shellac baseplate material not rigid
enough , and anterior ridge on man-
dibular cast flat
Shellac baseplate material overheated
during adaptation
Readapting shellac baseplate material
Using double- thickness shellac baseplate material
and reinforcing anterior ridge region with wire
Wetting cast before heating shellac baseplate material
and not overheating and charring shellac baseplate
material

Each of the three impression methods for immediate

Fig. 3- 51. Arbor band can be used to trim shellac tray if shellac is
not overheated .
IMPRESSION TRAYS FOR IMMEDIATE
DENTURES
Appleby and Kerchoff (1955); Lutes, Ellinger, and
Terry (1967); Campagna ( 1968); Lambreeht ( 1968); Cu -
pero ( 1972 ); and Javid , Tanaka , and Porter ( 1974 ) have
described impression trays for immediate dentures.
When making trays for immediate dentures the con -
siderations are different from making trays for conven -
tional complete dentures because of the presence of
teeth on the cast. The immediate denture treatment se-
quence used by many dentists consists of removing the
posterior teeth; after a healing period , making an
impression of the relatively well-healed posterior
ridges; completing the denture; and then removing the
anterior teeth and inserting the denture. Therefore two
areas of impression trays for immediate dentures that
require consideration are ( 1 ) the impression of the
edentulous ridges and ( 2 ) the impression of the remain-
ing natural teeth .
dentures requires a different type of tray ( Fig. 3-52 ). In
one method , a one- piece full -arch impression tray cov-
ers the edentulous ridges and natural teeth. The dis -
advantage of this type of tray is its tendency to he bulky
because it is necessary to have the relief over the nat -
ural teeth to block out undercuts. A second method of
making an immediate denture impression is to use a
-
custom made impression tray for the posterior edentu -
lous portion of the impression , and then make an over -
all impression over the posterior tray and natural teeth .
The third method is to use a two-piece tray . The first
impression tray is made over the edentulous portion of
the arch , and the second over ‘the anterior portion of
the arch and the anterior teeth joining the first tray .
Several methods of keying the two impression trays are
available, and the principal advantage is that these trays
-
are less bulky than the stock trays or one piece custom
trays. The disadvantage is the increased time required
-
to construct the keyed two piece trays.
Full-arch impression trays
Appleby and Kerchoff (1955) have described a
method of making an overall acrylic resin impression
tray for an immediate maxillary denture impression .
Their method requires placing the tray outline on the
cast, blocking out the natural teeth on the cast with
wax , and adapting a layer of baseplate wax over the cast
that extends to the border outline. The purpose of this
relief is to provide space for the impression material.
Autopolymerizing resin is used to make the overall
impression tray. The procedure for making the full arch -
impression trays involves the finger-adapted vacuum -
adapted , or the sprinkle-on method .
Finger - adapted dough method
PROCEDURE
1. Outline the border of the impression tray on the
cast with a pencil , and bead it if desired ( Fig. 3-53).
 Impression traps 45

Fig. 3-52. Impression trays for immediate dentures are of three

types: two-piece tray ( 1 ) , custom posterior tray ( 2) , and one-piece
full-arch tray (3) .

Fig. 3-53. A, Outline for impression tray and relief is drawn on cast with pencil. B, Outline can be
beaded for use as guide in trimming.

2. Block out the teeth on the cast with baseplate wax, 6. Adapt the resin sheet over the relieved cast ( Fig.
so that the tray can be removed without breaking the 3-56). Fold or trim the excess resin extending over the
teeth, adapt a layer of baseplate wax over the cast , and borders of the cast ( Fig. 3-57).
trim to the relief outline ( Fig. 3-54 ) . 7. Continue finger adaptation until the resin begins
3. Paint tinfoil substitute on the stone cast and base - to set .
plate relief wax, as described earlier in this chapter. 8. Permit the resin to cure on the cast , and then
4. Proportion the autopolymerizing tray resin accord - carefully remove the tray from the cast ( Fig. 3-58).
ing to the recommendation of the manufacturer, and 9. Finish and polish the borders, and smooth rough
mix it in a paper cup. Immediately prior to reaching areas to avoid discomfort for the patient . Perforate the
the dough stage , remove some material from the cup tray with a No. 8 bur to aid in retaining elastic impres-
with a spatula , and place it in the border areas of the sion materials if desired ( Fig. 3-59).
cast ( Fig. 3-55) . The finger-adapted dough method is preferable to
5. When the material reaches the desired dough the sprinkle-on method for full -arch impression trays,
stage, remove it from the cup, and roll it into a sheet but either is usable.
of the proper thickness ( 2 mm ). *
PROBLEM AREAS
9 A potential problem with the finger-adapted dough
* RolIette Unit , Kerr Manufacturing Co., Honiulus, Mich . method is the difficulty in maintaining tray thickness
46 Dental laboratory procedures: complete dentures

A B

1/

Fig. 3 54. A, Teeth on cast are blocked out with wax . B, A sheet of baseplate wax is adapted over
-
the cast and trimmed to relief outline.

A B

.
Fig. 3-55 Resin dough is placed in border reflections of cast with spatula to minimize voids.

.
Fig. 3-56 Resin sheet is adapted to cast and relief wax. .
Fig. 3-57 Excess resin is trimmed with knife.
 Impression trays 47

.
Fig. 3-58 Resin tray is left on cast to cure . Fig. 3 59. Resin tray can be perforated with bur to improve reten-
-
tion of impression material.

r
Table 3-5. Full- arch impression tray: finger - adapted dough method
Problem Probable cause Solution

Tray thick in some areas:
thin in other areas
Tray or cast broken dur-
ing removal of tray
from cast
Resin overthinned over convex
areas of cast by too much finger
pressure
Teeth on cast not blocked out ade -
quately ; and undercuts else-
where on cast not blocked out
Tinfoil substitute contaminated or
not used
Too much force used in prying tray
from cast
Exercise care when adapting resin to cast , particularly over
ridges and teeth: use only enough pressure to achieve
adaptation
Block out teeth on cast with baseplate wax to eliminate un-
dercuts; identify and block out other undercuts on cast
Coat cast with uncontaminated tinfoil substitute
Use minimal force when removing tray; pry gently around
borders of tray to lift it from cast without breaking it

when applying pressure (Table 3-5). There is a distinct PROCEDURE

tendency to overthin the material over the convex areas
of the cast and teeth thereby making the impression
, pencil or head it with a sharp instrument ( Fig. 3-53).
tray too thin in these areas ( Fig. 3-60). Another prob-
lem is the overall bulk of the tray required over the
blocked-out teeth and edentulous portions of the cast
( Fig. 3-61 ).
Vacuum - adapted method
It is possible to make a one- piece full -arch immediate
denture impression tray by vacuum adaptation . The
procedure is similar to that described previously for
conventional complete dentures with a modification in
the blockout. The principal advantage of this method is
the minimal amount of time used in constructing a tray ,
and the principal disadvantage is the investment re-
^ quired for specialized equipment .
1 . Place the outline of the tray on the cast with a
2. Block out undercuts and relief areas with a heat -
stable relief material ( Fig. 3-62 ).
3. Position a sheet of resin of the proper thickness in
the heating frame of the vacuum adapter as described
previously.
4. Center the blocked out cast iu the vacuum former
( Fig. 3-34 ).
5. Start the^ heater and , when the recommended
amount of sag occurs, lower the heating frame and ac-
tivate the vacuum .
6. After completing the adaptation , allow the resin to
cool and trim the borders with a large bur in a lathe
( Figs . 3-63 and 3-64).
7 . Remove the tray , and trim it to the previously es-
tablished outline.
 =» 1

Fig. 3-60. Care should be exercised to avoid overthinning resin .

Fig. 3 61 One-piece full arch impression trays often are bulky be
- -
over convex portions of cast. Note relief wax showing through (ar - cause of presence of teeth and relief wax .
row ).

- .
Fig. 3 62 A, Wet nonasbestos casting ring lining material strips are adapted to teeth on cast to block
out undercuts. B, Additional layer of relief is adopted to desired outline before vacuum adapting resin
tray.

- .
Fig. 3 63 Resin is permitted to cool before trimming. Fig. 3-64. Large lathe-mounted bur is convenient for trimming ex -
 "V
.
Fig 3-65. Usually, resin projecting over anterior teeth serves as
handle on this type of tray. Perforations in tray aid in retaining
impression material.
Table 3- 6. Full-arch impression tray: vacuum- adapted method
Problem Probable cause
Cast or tray broken on Undercuts or teeth on cast not
separation blocked out
Tray not adapted to cast in Tray material not heated sufficiently
some areas before vacuum adaptation started
Tray too flexible Stock material used for tray too thin
* Custom posterior trays
8. Smooth and finish all borders.
9. lfse the resin that projects over the anterior teeth
-
as a handle for this type of tray ( Fig. 3 65).
10. Remove all traces ol blockout and relief material
from the interior of the impression tray ( Fig. 3-66 ).
11 . If specified, perforate the tray with a bur to im -
1 with tray resin and the finger-adapted dough method .
prove retention ol the impression material in the tray
-
( Fig. 3 66).
12 . Store the completed tra \ on the cast until needed
( Fig. 3-66).
PROBLEM AREAS
Problems with the vacuum -adapted method are min -
imal (Table 3-6 ). Occasionally, trav-weight resin sheets
do not adapt to all areas of the cast , particularly in the
border reflections. It is possible to minimize this prob-
lem In making certain that the recommended amount
ol sag has occurred before starting adaptation . Occa-
sional!) the tray is too flexible, probably as a result of
using a sheet ol resin that is too thin . The principal
r» disadvantage to this method is the requirement for spe-
cialized equipment.
Impression trays 49 IJ
V
Fig. 3 66. Perforations made in tray with No. 8 or 10 bur. Note all
-
of relief material has been removed from interior of tray. Tray is
stored on cast until needed.
Solution
Examine cast carefully to identify undercuts; block them
out
Make certain the recommended amount of sag occurs in
tray resin before activating vacuum
Use tray-weight resin sheet to assure adequate rigidity
A simple form of the sectional impression tray for an
immediate denture is a tray made over only the eden -
tulous portion of the cast. A second overall impression
is made of the teeth and anterior vestibule with a stock
tray. Making a custom posterior tray is quick and easy
It also can he made by the sprinkle-on or vacuum -
adapted method by using the procedures discussed pre -
viously'.
Finger - adapted dough method
PROCEDURE
1 . Place an outline ol the tra > on the cast with a pen -
cil ( Fig. 3-67).
2 . Extend the impression tray outline to contact lin -
gual surfaces of the anterior teeth . This extension aids
in positioning the tray in the patient ’s mouth and in-
creases the accuracy of the impression ( Fig. 3-68). An
alternate method is to use a wax ledge approximately 2
mm wide anterior to the incisive edges of the teeth (El-
linger and Terry. 1967). It allows the tray to extend in
 1
Impression trays 51

Fig. 3-71. Single thickness of baseplate wax is adapted over Fig. 3-72. Adaptation of resin to cast is continued until it begins to
blocked out teeth and trimmed to desired relief outline. set .

0
Fig. 3-73. Tray borders are trimmed to previously established out -
line with lathe-mounted arbor band.

Table 3-7. Custom posterior impression tray: finger - adapted dough method
Problem Probable cause Solution

Teeth on cast broken on Spaces between anterior teeth on cast not Examine cast to find spaces between teeth and other
removal of tray blocked out with wax undercut areas; block them out with wax
Tray too thin Resin not rolled to uniform thickness prior Roll resin into sheet approximately 2 mm thick before
to adaptation adapting to cast
Tray stuck to cast Tinfoil substitute contaminated or not used Paint cast with uncontaminated tinfoil substitute

acrylic resin extrudes between the teeth during con -
struction of the tray , usually the teeth break from the
cast on removal of the tray . Blocking out the spaces
between the teeth with baseplate wax will solve this
problem .
Two-piece trays
It is possible to construct two-piece impression trays
lor immediate dentures with autopolymerizing resin
tray materials (Javid et al. , 1974 ). The first stage -
impression tray is fabricated over the posterior eden -
tulous portion of the cast . The second-stage tray, which
52 Dental laboratory procedures: complete dentures
is constructed for placing over the first -stage tray , cov -
ers the anterior teeth and labial flange portion of the
cast . The two sections of the tray assemble and allow
removal as a unit or in sections after completion of the
impression.
The advantage of the two- piece tray method is that it
permits the dentist to make the impression for an im -
mediate denture in a two-stage procedure. The princi-
pal disadvantage is the additional time required to
make the two- piece tray .
Finger - adapted dough method
The finger-adapted dough method should be used for
this tray .
A B
Fig. 3-74. A , Relief wax is adapted to cast and over incisal edges of teeth. B, Wax is cut away over
several incisal edges to provide positive stops.
Fig. 3-75. Cast and relief wax are coated with tinfoil substitute.
PROCEDURE
1 . Draw the outline for the posterior section of the
tray on the cast with a pencil.
2. Adapt the relief wax and hlockout wax as required
( Fig. 3-74).
3. Coat the cast and wax with tinfoil substitute ( Fig.
3-75).
4 . Mix the acrylic resin according to the manufac-
turers specifications, and roll it to the proper thick -
ness.
5. Adapt the resin to the cast .
6. Trim the excess resin from the borders of the cast
( Fig. 3-76).
7. After setting, separate the impression tray and re-
Fig. 3-76. Resin sheet is adapted to cast , and excess is trimmed
with knife.
 Impression trays 53

lief wax from the cast and trim to the outline ( Fig. 3-
, 11. Mix the resin, and form it into a sheet , as de-
77 ). Replace the tray on the cast ( Fig. 3-78 ).
S. Adapt two layers of baseplate wax over the teeth
* on the cast ( Fig. 3-79).
9. Apply tinfoil substitute to the cast .
10. Coat the anterior part of the previously formed
tray with silicone lubricant * or cover it with a layer of
tinfoil ( Fig. 3-80 ).
’ Masque. The llarn J . Bosworth Co. , Chicago. 111.
scribed previously; adapt it over the blocked out teeth -
and the previously constructed tray .
12. After setting, remove the trays from the cast and
trim them ( Fig. 3-81 ). Make certain that the impression
trays overlap sufficiently for a positive, accurate fit ( Fig.
3-82 ). Examine the impression trays for rough areas,
and smooth them wherever necessary ( Fig. 3-83). Store
the completed two- piece tray on the cast until ready for
use by the dentist ( Fig. 3-84 ).

Fig. 3-77. Impression tray is removed from cast , and borders are Fig. 3-78. Tray is replaced on cast .
^ adjusted for extension and thickness.

A B

Fig. 3-79. A, Two thicknesses of baseplate wax are adapted over facial surfaces of teeth , and wax
is trimmed below resin overlying incisal edges. B, Anterior teeth are blocked out before making an-

* terior tray section. Lines indicate desired overlap of tray sections.

 1

Fig. 3-80. Silicone lubricant is applied to first section of tray to pre-

vent second section from bonding to it.

A
B

4
*

Fig. 3-81. A , After curing, anterior tray section is removed. B, Sections are reassembled and then
trimmed to proper thickness.

A B

*
* *
Fig. 3-82. A , Sections of tray should interlock positively. Note projection in midline to aid in assembly
(arrow ). B, Interior view of two-piece tray .
 Impression trays 55

A B

Fig. 3-83. A, Completed impression tray is examined for sharp edges. B, Edges are smoothed wher -
ever necessary.

SDMCDS

00058

- .
Fig. 3 84 Completed impression tray Is assembled and stored on
cast until needed.

Table 3-8. Two-piece impression trays: finger - adapted dough method

Problem Probable cause Solution

Tray sections stuck together First-stage tray not coated with Coat part of first - stage tray that contacts second section to
and unable to be sepa- separating medium, such as prevent chemical bonding and resultant inability to sepa-
rated silicone lubricant or tinfoil rate tray sections

&8 ) (
ir rr> n A nv
56 Dental laboratory procedures: complete dentures
PROBLEM AREAS
In addition to many of the previously discussed prob-
lems, the two-piece impression tray method can pres-
ent another problem associated with failure to apply a
separating medium to the first tray before making the
second, or anterior, tray. In this instance, the two trays
become bonded together (Table 3-8). Making two-piece
trays also requires considerable time and effort.
SUMMARY
Methods of constructing impression trays for conven -
tional complete dentures and immediate dentures have
been described. Conventional and tray autopolymeriz-
ing resins, shellac baseplate material , and thermoplastic
resins make satisfactory impression trays , fray resins
are easy to use, require minimal equipment , make ex-
cellent impression trays when manipulated properly
and , consequently, enjoy widespread usage. Vacuum -
forming equipment also can produce good impression
trays, particularly when minimal construction time is a
requirement . Although used extensively in the past for
baseplates and impression trays, shellac is less satisfac-
tory for impression trays because of its lack of dimen -
' cording phases, J . Prosthet . Dent. 12:4-33, 1963.
sional stability.
REFERENCES
Appleby, R .C. , and Kerchoff, W. F.: Immediate maxillary denture
impression, J . Prosthet . Dent . 5:443-451, 1955.
Barone, J . V.: Physiologic complete denture impression , J . Prosthet.
Dent. 13:800-809, 1963.
Boos, R. ll .: Physiologic denture technique, J . Prosthet . Dent . 6:726
740, 1956.
- 1952.
Campagna , S . J . ; An impression technique for immediate dentures, J .
Prosthet . Dent . 20:196-203, 1968.
Carlton , J . R . : Complete denture prosthesis, J . Prosthet . Dent . 5:342-
349, 1955.
Chase. W . W.: Adaptation of rubber base impression materials to re-
move denture prosthetics, J . Prosthet. Dent. 10:1043-1050, 1960.
Choudharv. S. C.: Modified pressure impression techniques for eden -
tulous patients, J . Prosthet. Dent. 23:199-204, 1970.
Cupero, H . M . : Technique for making complete maxillary’ immediate *
denture impression , J . Prosthet . Dent. 28:546-548, 1972.
Dresen, O. M .: The rubber base impression materials, J . Prosthet.
Dent. 8:14- 18, 1958.
Ellinger, C. W .: Minimizing problems in making a complete lower
impression , J . Prosthet , Dent . 30:553 5.58, 1973.
*
Filler, W. H.: Modified impression techniques for hyperplastic alveo-
lar ridges, ] Prosthet Dent. 2&609 612,
.
- 1671
Fusayania, T. , and Nakazato, M : The designs of stock trays and the
*
retention of irreversible hvdrocolloid impression J . Prosthet. .
-
Dent. 21:136 142, 1969.
Harris, L. W.: Facial templates and stabilized baseplates with the new
.
chemical set resins. J . Prosthet. Dent 1:156 160, 1951. -
Jamieson , C. H .: A complete denture impression technique, J .
Prosthet. Dent. 4:17-29, 1954.
Javid , N . , Tanaka , II . , and Porter, M .: Split tray impression tech -
nique for immediate upper dentures, J . Prosthet . Dent. 32:348-
351, 1974.
.
Klein , I . E : Complete denture impression technique , J . Prosthet .
Dent 5*739 755, 1955.
Lambrecht , J . R .: Immediate denture construction: The impression
.
phase, J . Prosthet. Dent 19:237-245, 1968.
.
LaVere, A , and Freda, A . L. : An individual impression tray utilizing
the patient 's existing denture , J . Prosthet. Dent. 36:334 346, 1976. -
Leathers, L. L.: Overcoming obstacles and objections to immediate
dentures . J . Prosthet . Dent 10: 5 13 I960
Lutes , M . R. , Ellinger , C. W . , and Terry, J . M .: An impression pro-
cedure for construction of maxillary immediate dentures, J .
. .
-
Prosthet Dent. 18:202 210, 1967
Martone, A. L.: Clinical applications of concepts of functional anatomy
and speech science to complete denture prosthodontics. N il . Re -
McCracken, YV . L.: Externally stabilized mandibular impression , J .
Prosthet Dent . 14:5- 11 . 1964
.
Merkeley. II . J .: Mandibular rearmament II . Denture construction ,
J Pmstlu t . Dent 9:567 -577. 1959 .
.
Munz, F. R : Impressions in transparent trays. J . Prosthet. Dent .
-
4:596 605, 1954 .
Parker. H . C.: Biomechanical procedures based on anatomic consid -
erations in full denture prosthetis, J . Prosthet. Dent . 2:477 490, -
Rosenthal , L. E . , Boyer, R . , Lane, J . V., and Lane, S . L.: Rehabilita -
tion after partial glossectomy, J . Prosthet . Dent . 10:270-277, 1960.
Schieffer, F. J . , Jr.: The neutral zone and polished surfaces in com -
.
plete dentures, J . Prosthet Dent. 14:854 865, 1964. -
Sowter, J . B. : Custom impression trays from complete dentures, den -
tal laboratory technology , Prosthodontic technique Chapel Hill , .
N . C., 1968, University of North Carolina Press.
Tilton , C . E .: A minimum pressure complete denture impression
technique, J . Prosthet. Dent. 6:6-23, 1956.
Wagner’ A . G.: Making duplicate dentures for use as final impression
trays, J . Prosthet. Dent. 24:111-113. 1970.
.
Woelfel , J . B : Contour variations in impressions of one edentulous
- .
patient, J . Prosthet. Dent . 12:229 254 19(52.
/
TC

CHAPTER 4

FINAL IMPRESSIONS, BOXING

AND POURING
KENNETH D. RUDD , ROBERT M. MORROW, and EARL E. FELDMANN

boxing an impression Building up vertical walls around an impres- thereby facilitating retrieval of the cast from the boxed
v sion, usually in wax, to produce the desired size and form of the impression ( Harris , 1960; Sowter, 1968; Heartwell and
base of the cast and to preserve certain landmarks of the Kahn , 1974; Bolouri , Hilger, and Gowrylock , 1975).
impression.
This method , winch is excellent for boxing impressions
BOXING IMPRESSIONS made in elastomeric materials, serves equally well for
zinc-oxide paste impressions.
Boxing final impressions before pouring preserves
It is also possible to use caulking compound for box-
the extension , as well as the thickness, of the border;
ing impressions. Beading the border of the impression
controls the form and thickness of the base of the cast ;
with strips of caulking compound makes the border of
facilitates placing remounting plates* in the cast; and
the cast the desired width . The beaded impression is
conserves artificial stone ( Sow ter, 1968; Air Force Man -
then boxed with metal or wax boxing strips. Blank
ual 160-29, 1959; Bolouri , Hilger . and Cowry lock,
( 1961) describes the use of a “ paddle grip wax tech -
1975 ). Several methods and a variety of materials are
nique for boxing impressions. The impression is sealed
available for boxing impressions ( Air Force Manual 160-
to wax on a paddle, which is used as a handle for hold -
29, 1959; Boucher, 1964; Sowter, 1968). The materials
ing the boxed impression while pouring it on the vibra -
are wax, metal strips, plaster of Paris alone or modified
tor.
hy adding pumice, and caulking compound .
This chapter presents three methods of boxing
Boxing with wax is especially suitable for impressions
impressions and the technique for pouring and indexing
made in zinc-oxide impression paste, since wax beading
casts .
adheres to this material readily . However, boxing a
rubber base or silicone impression with wax is more Wax boxing method
difficult because it is almost impossible to make the wax
Wax boxing is effective for zinc-oxide paste impres-
stick to these materials. Another method of boxing
sions and is usable also for rubber base or silicone
makes it necessary to settle the impression into a mix
impressions, but only after thoroughly drying them be-
ol plaster and , alter setting, to trim the plaster to the
fore adapting the beading wax. This wax is available in
desired border outline, box the impression , and pour it
round or square strips* ( Fig. 4-1). Orthodontic waxt or
in artificial stone. In a modification of this procedure,
the addition of pumice to the plaster mix weakens it .
•Beading Crip Wax. The L. D. Caulk Co. Milford. Del.
•SplitRemounting Plate Assembly Complete, Teledyne Dental Prod - + Ort I union tie Tray Wax, Hygienic Dental Manufacturing.Co., Akron.
.
ucts Co. , Hunan Division. Buffalo , N. Y Ohio.
57
58 Dental laboratory procedures: complete dentures
utility wax* also is usable for beading an impression.
Some orthodontic tray waxes, which are especially flex-
ible, adapt to the impression easily. After the beading
wax is adapted and sealed , the impression is boxed with
a wax strip, and the cast is poured.
PROCEDURE
1. Place the impression on the bench with impression
surface up. and use soft wax or modeling clay to align
the impression so that the ridge portion is approxi-
H' tility Wax Strips, Hygienic Dental Manufacturing Co. , Akron ,
Ohio, or equivalent.
Fig. 4- 1. Beading wax is available in round or square strips of var -
ious sizes.
A B
Fig. 4-2. A , Soft wax or modeling clay is used to support impression so that ridges are approximately
parallel to bench top. Height of impression should be controlled. B, Maxillary impression is oriented
to make residual ridges parallel to bench top.
mately parallel to the bench top ( Fig. 4-2 ). Adjust the
height until a boxing wax strip extends approximately
13 mm above the highest point on the impression ( Fig. ^
4-3). 1
2. Fill in the tongue space of a mandibular impres-
sion by adapting and sealing a sheet of baseplate wax
cut to the proper form. Use a wax spatula to seal the
wax to the impression ( Fig. 4-4 ). Seal it to the impres-
sion on both sides ( Fig. 4-5). Make the waxed - in tongue
area smooth and seal it approximately 3 to 4 mm below
the border of the impression ( Fig. 4-6). Lower place-
ment will compromise access to parts of the cast , such
as when making baseplates.
3. Adapt orthodontic tray wax or beading wax around
the periphery of the impression ( Fig. 4-7). This wax
should be approximately 4 mm wide and 3 to 4 mm
below the border of the impression TFSg. 4 -8).
4. Adapt another short length of beading wax to the
heel region of the mandibular impression and across the
posterior edge of the waxed-in tongue area to make the
border wider in these areas ( Fig. 4-9).
5. Seal the beading wax to the impression with a wax
spatula ( Fig. 4-10). Handle the hot spatula carefully to
avoid damaging the impression or allowing the wax to
flow onto the border of the impression .
6. Check the width of the beading by looking down on
the impression from directly above to determine
whether a border of acceptable width is visible around
the entire impression ( Fig. 4-11).
7. Set the impression on the bench top, warm a strip
of boxing wax* over a Bunsen burner until flexible, and +
carefully fold it around the impression wa\ j ( Fig. 4- 12 ).
lake care to avoid distorting and thinning the beading
wax while adapting the boxing strip.
. . .
Boxing Grip Wax The I I ) . Caulk Co. , Milford Del .
 Final impressions , boxing and pouring 59

Fjg. 4- 3. A, Soft wax is used to adjust height of impression. Boxing wax should extend approximately
13 mm above highest point on impression to produce cast of desired thickness. B, Maxillary impres-
sion is adjusted for height. Note that measurement is made from highest point on border of impres-
sion.

* *
impression. B, Baseplate wax is removed, and indentations ( arrows) produced by border of impres-
sion are used as guides in trimming wax. C, Trimmed wax is adapted to lingual area of mandibular
impression.

t
A B

Fig. 4- 5. A , Baseplate wax blocking out tongue area of mandibular impression is sealed carefully to
impression approximately 3 to 4 mm below border of impression. B, Wax is sealed also on undej ide
of impression to make strong junction that will not separate during pouring. ^

Fig. 4-6. A, Blockout of tongue area has been completed and wax sealed to lingual border of impres-
.
sion B, Wax is sealed approximately 3 to 4 mm below border of impression to preserve thickness of
border during fabrication of denture.

A B

T .A
*
Fig. 4 Orthodontic tray wax or beading wax is adapted around riphi
r>
 Final impressions, boxing and pouring 61

A B

Fig. 4-8. A, Wax beading should be approximately 4 mm wide to make border of cast proper width.
B, Position of beading wax 3 to 4 mm below border of impression is verified.
<

A B

Fig. 4*-% A , Heel area of mandibular impression is widened by applying another short length of
beading wax . Beading wax is placed below mandibular impression to permit land area of cast to be
above impression surface of cast . B, Note position of beading wax in heel area of mandibular impres-
sion.

- Fig. 4- 10. Beading wax is sealed to impression carefully.

4
I 62 Dental laboratory procedures: complete dentures
.
Fig. 4- 12. A With beaded impression in position on bench, strip of boxing wax is warmed and
adapted around wax beading. B, Boxing wax strip is folded around beaded impression to form base
of cast.
S. Seal the ends of the boxing strip to the underlying
layer of wax ( Fig. 4-13).
9. Seal the beading wax to the boxing strip on both
the impression side and the underside to make it wa -
tertight ( Fig. 4-14 ). Handle the hot spatula carefully to
avoid perforating the boxing wax or dripping wax into
the impression .
10. Check the boxed impression for adequate width
of the border, sealing, and height before pouring it in
stone ( Fig. 4-15). Fill the impression with cool water to
Fig. 4-11. Impression with tongue area blocked out with wax and
beading wax in position . Note that uniform width of beading around
border of entire impression must be preserved when boxing strip is
adapted.
check for leaks. Pour the impression in vacuum -
spatulated * artificial stone ( Fig. 4- 16 ).
PROBLEM AREAS
Problems arise with the wax boxing method when the
beading wax is of the wrong width and . consequently,
the border is too narrow or too wide (Table 4-1). It is
- . .
*Yac l - Vestor Combination Power Mixer Whip- Mix Corp , Louis-
ville, Ky.
 *

' Fig. 4-13. A, Boxing wax strip is sealed with hot spatula. B, Interior joint of boxing wax is sealed with
hot spatula.

• Fig. 4- 14. A , Beading wax is sealed to boxing wax with hot spatula. B, Boxing wax is sealed on
underside also to make it watertight and to prevent separation of boxing wax from beading wax when
pouring stone cast .

Fig. 4- 15. Boxed impression is examined carefully to determine

whether border is of correct width and beading wax is sealed to
boxing wax properly .
64 Dental laboratory procedures: complete dentures

.
Fig. 4-16 A, Artificial stone is proportioned by weight and mixed with recommended volume of water
in vacuum spatulator. Stone mixed under reduced atmospheric pressure results in cast that is dense
and free of bubbles and voids. B, Boxed impression is placed on vibrator, and vacuum-mixed stone
is added slowly at one corner of impression and permitted to flow over entire surface of impression.
Initial pouring should be done slowly to minimize entrapment of air and resultant voids in master cast .

Table 4- 1. Wax boxing method

Problem Probable cause Solution

Borders of cast too narrow
or too wide
Border of cast not high
enough to preserve thick -
ness of impression flanges
Border of cast too high
Base of master cast too thin
(less than 13 mm in thin-
nest area)
Base of master cast too thick
(more than 13 mm in
thickest area )
Cast lopsided ( high on one
side and low on other
side)
Boxing wax separated from
beading wax during pour -
ing of cast
Beading wax too narrow or too
wide
Cast overtrimmed on cast trimmer
Beading wax placed too high on
impression
Beading wax placed too low on
impression
Boxing strip is not extended high
enough above impression
Boxing strip extended too high
above impression
Impression not oriented properly
prior to boxing
Beading wax not properly luted to
boxing strip
Make beading wax approximately 4 mm wide
Exercise care in adapting boxing wax to avoid reducing
width of beading wax
Be careful when trimming cast on cast trimmer
Adapt beading wax ; seal it 3 to 4 mm below border of
impression
Place beading wax 3 to 4 mm below border of impression
Trim cast to reduce border height
Extend boxing strip approximately 13 mm above highest
area on impression
Keep boxing strip approximately 13 mm above impres-
sion and no higher
Position impression used to make ridges approximately
parallel to bench top; use soft wax or modeling clay to
maintain position when boxing
Exercise care to see that boxing strip is luted to beading
wax securely ; use hot spatula to make watertight seal
66 Dental laboratory procedures: complete dentures

Fig. 4- 19. Beading wax has been placed too high in heel area of Fig. 4- 20. Beading wax has been placed too high across posterior
mandibular impression (arrows ). In this area, border of cast will be border of maxillary impression (arrows ). In some instances, poste-
below surface of impression. Beading wax in heel areas of mandib- rior border may be below surface of impression.
ular impressions always should be below impression. When bead-
ing and boxing impressions, it is always necessary to think in re-
verse, that is, if high on impression, it will be low on poured cast.

.
Fig. 4- 21. A , Cast was poured in impression with beading wax placed incorrectly Note that land area
( arrow ) is below surface of impression. B , Posterior border of maxillary impression was beaded in-
correctly, and border of resultant cast is below surface of impression (arrows ). It is necessary to think
in reverse to determine effect on cast; placing beading wax too high on impression results in border
that is too low on cast .

Plaster of Paris and pumice boxing method
The plaster of Paris and pumice boxing method - is ex
eellent for boxing impressions of rubber base or silicone
*
materials because maintaining contact between the box -
ing material and the impression material presents no
problem.
PROCEDURE
1. Make a 1 : 1 mixture by volume of plaster of Paris*
and flour of pumice, and stir thoroughly while dry to
assure uniformity ( Fig. 4-22 ). The pumice weakens the
set plaster and facilitates separation of the cast after
pouring. Approximately 200 gm of plaster usually is ad-
equate for the majority of impressions.
2. Add enough water to make a stiff mix and spatulate
thoroughly ( Fig. 4-23).
* Laboratory Plaster, Whip- Mix Corp. , Louisville. Kv., or equivalent .
Final impressions , boxing and pouring 67
3. Place a patty of the mix on a glass slab ( Fig. 4-24.
A ).
4 . Keeping the ridge portion of the impression par-
allel to the bench top, settle the impression into the
patty ( Fig. 4-24. B and C ). Use a spatula to draw the
plaster mix around the impression until it is 3 to 4 mm
below the border.
5. Smooth the plaster mix around the impression
with a wet spatula to make the border of the cast
smooth ( Fig. 4-25).
6. As the plaster and pumice mix begins to set , trim
it to remove excess material . Do not trim closer than 5
to 6 mm ( Fig. 4-26 ).
7. After the plaster has set , remove it from the glass
slab, and trim it on a cast trimmer until the border is 4
mm wide ( Fig. 4-27). Set the cast trimmer table to pro-
duce sides on the cast that are perpendicular to the
base.

Fig. 4-22. A, Plaster of Paris and flour of pumice are rtiixed in approximately 1 : 1 ratio while dry . B,
Plaster and pumice are mixed thoroughly with spatula before water is added.

Fig. 4-23. Water is added to make stiff mix. It is spatulated thor-

t oughly to reduce setting time.
‘
A B

Fig. 4-24. A , Patty of plaster and pumice mix is placed on glass slab. B, Impression is settled into
plaster and pumice patty gently, and ridge portion of impression is kept parallel to bench top. C,
Spatula is used to draw the plaster and pumice mix to height of approximately 3 to 4 mm below
border of impression.

Fig. 4-25. A, Wet spatula is used to smooth plaster and pumice mix around impression. This proce-
dure will result in cast with smooth surfaces in border area. B, Wet spatula should be handled care-
fully when smoothing plaster and pumice mix to keep plaster 3 to 4 mm high below border.
 Final impressions, boxing and pouring 69 VI
.
*
.
Fig. 4- 26. As plaster and pumice mix begins to set excess material
can be cut away carefully with sharp knife. It should be done cau-
tiously to prevent breakage of plaster and pumice mix.

Fig. 4- 27. A , Impression enclosed in plaster and pumice is removed from glass slab. Flowing tap
water on glass slab and gently sliding impression off slab makes removal easy. B, Plaster and pumice
boxing material is trimmed on cast trimmer until border is desired width. Care is required to keep
from overthinning border. Q, Impression boxed in plaster and pumice and with border trimmed to
correct height and width.
70 Dental laboratory procedures: complete dentures

8. Trim the plaster with a sharp knife until it is 3 to
4 min below the border of the impression . This is es
pecially necessary in the heel region of mandibular
impressions and across the posterior border of maxillary
impressions ( Fig. 4-28). In these regions the plaster
may be 2 mm below the border.
9. Remove the plaster that adheres to the border of
the impression by brushing gently with a soft bristle
toothbrush ( Fig. 4 -29 ).
10. Adapt the boxing wax to the invested impression
- so that the wax extends at least 13 mm above the high -
est point on the impression ( Fig. 4-30).
11. Seal the boxing strip to the plaster with a hot
*
spatula and wax ( Fig. 4-31 ).
12 . Paint the plaster surfaces with a separating me-
dium * ( Fig. 4-32 ).
-
-
*Super Sep Separating Fluid. Kerr Manufacturing Co., Romulus,
Mich.

Fig. 4- 28. A , Height of plaster and pumice boxing can be adjusted with sharp plaster knife. B, It is of
primary importance to see that boxing in heel area of mandibular impression is below surface of
impression.

A B

Fig. 4 29. A, After trimming with knife, some plaster still adheres to surface of impression. B, Plaster
-
has been removed with soft -bristle toothbrush.

13. Fill the boxed impression with cool water to
check for leaks. The water also wets the plaster ,
thereby minimizing voids in the stone cast that can oc-
^ cur when pouring stone onto dry plaster.
14 . Proportion the stone by weight, according to the
manufacturer’s recommendation , mix it in a vacuum
spatulator under reduced atmospheric pressure, and
pour the cast ( Fig. 4-33). Generally 200 gm of artificial
stone is enough to pour most impressions, but large
ones may require more.
15. After setting, cut away the plaster and pumice
hexing , and remove the impression and cast .
* adaptation to the trimmed plaster and pumice-encased
Fig. 4- 30. Boxing wax adapted to invested impression should stand
at least 13 mm above highest point on impression.
Fig. 4- 31. Boxing wax strip is sealed to plaster and pumice invest-
ment with hot spatula.
Final impressions, boxing and pouring 71 v
16. Place the impression and cast in a plaster bowl
containing warm water to soften the impression mate-
rial , permitting separation without breaking the cast
( Fig. 4-34). Do not overheat , or the compound may
stick to the cast.
17. Using a sharp knife, reduce the * height of the bor-
der on the. cast where necessary ( F i g . 4- 35).
18. Adjust the width of the border of the cast on a
cast trimmer until it is approximately 4 mm . Soak the
cast in clear slurry water for 3 to 4 minutes before trim -
ming it to prevent slurry splatter from the cast trimmer
from sticking to the cast ( Fig. 4-36 ). Trim the sides of
the cast perpendicular to the base ( Fig. 4-37).
19. The trimmed cast is ready for fabrication of the
baseplate ( Fig. 4 -38).
PROBLEM AREAS
As in the wax boxing method , failure to make the
plaster and pumice border the proper height or width
results in a poor master cast (Table 4-2). The border of
the boxing should be 4 mm wide and 3 to 4 mm below
the border of the impression . The boxing wax should
be high enough above the impression ( 13 mm ) so that
the cast will be thick enough . The impression should
be parallel to the bench top when settling into the plas-
ter and pumice mixture to ensure that the base of the
cast is of uniform thickness. The plaster should have a
coat of separating medium before pouring the impres-
sion to avoid breaking the cast during separation . The
boxing wax strip should not be overly soft prior to its
impression . It is easy to distort an oversoft wax strip
. i ••
Fig. 4- 32. Separating medium is painted on plater and pumice in-
vestment. Failure to do this will allow cast to adhere to plaster and
pumice investment and may result in breakage of cast on separa-
tion.
 *

Fig. 4- 33. Boxed impression is poured with artificial stone that has
been mixed in vacuum spatulator under reduced atmospheric pres -
sure. Usually 200 gm of artificial stone is adequate for boxed
impression.

Fig. 4- 34. A, Cast with impression is placed in plaster bowl containing warm water. This procedure
will soften impression material and facilitate removal of impression from cast without breaking. B,
After cast with impression is removed from warm water, impression is pried from cast gently. This
procedure should be done slowly and carefully to prevent fracture of cast .

Fig. 4- 35. Height of border on cast can be reduced where neces-

sary with sharp knife.
 Final impressions, boxing and pouring 73 vi

Fig. 4-36. A, Cast is soaked in clear slurry water before trimming on cast trimmer. Cast should not
be dry when trimming on cast trimmer because splatter from cast trimmer will stick to cast, and
removal will be difficult. B, Wet cast is trimmed on cast trimmer. Care should be exercised to see
that border is not overtrimmed.

"J

A B

Fig. 4- 37. A, Sides of casts are trimmed so that they are perpendicular to base. B, Mandibular cast
has been trimmed so that sides are perpendicular to base.

>

Fig. 4-38. Trimmed casts are ready for fabrication of baseplate.

9
74 Dental laboratory procedures: complete dentures

and thereby make the border of the east too thin ( Fig.
4-39 ). The impression and encasing plaster and pumice
should soak in cool water for 3 to 4 minutes prior to
pouring. This soaking will reduce the frequency of
* 3. If the single caulking strip is too narrow, place an -
voids associated with pouring stone against a dry plaster
and pumice surface. A good quality artificial stone, pro-
portioned by weight according to specification and pref-
erably mixed in a vacuum spatulator under reduced at -
mospheric pressure, will prevent soft casts and voids.
Caulking compound and paddle boxing method
A paddle method for boxing impressions has been
described by Blank (1961). The impression is boxed on
a paddle, and wax or caulking compound * is used for
beading. Then the paddle is used as a convenient
holder while vibrating stone into the impression .
PROCEDURE
-
A table tennis paddle can be adapted for boxing
impressions by attaching metal stripping to the borders
of the paddle ( Fig. 4-40). Scrap wax is melted into the
metal enclosure to serve as a wax base for boxing
impressions ( Fig. 4-41) . height of the border before sealing it to the paddle ( Fig.
1. Use strips of caulking compound rope to bead
impressions, particularly for those made in zinc-oxide
impression paste ( Fig. 4-42 ). Carefully adapt a strip of
caulking compound rope 3 to 4 mm below the border
of the impression ( Fig. 4-43).
* DAP Hope Caulk , Vie inch (0.47 cm ) round. Dap, Inc. , Dayton,
Ohio.
2. Adapt the caulking compound rope 2 to 4 mm be-
low the posterior border of maxillary impressions and
the heel region of mandibular impressions ( Fig. 4-44 ).
*
other strip over the first one to make the border of the
cast 4 to 5 mm wide ( Fig. 4-45).
4 . Burnish the caulking compound with a warm wax
spatula to make the border smooth and to seal it to the
impression ( Fig. 4-46).
5. Check the width of the caulking compound border
before boxing with a wax or metal strip ( Fig. 4-47 ).
6. Fold a metal boxing strip carefully around the
impression and caulking cord , and secure it with a rub -
ber band . Make certain that the boxing strip extends
approximately 13 mm above the highest point on the
impression ( Fig. 4 -48). Have the ridges of the impres-
sion approximately parallel to the top edge of the box-
ing strip and the bench top.
7. Seal the caulking compound to the metal or wax
boxing strip on the impression side and the underside.
A warm spatula aids in sealing ( Fig. 4-49 ).
8. Check the boxed impression for the width and
4-50
9. Seal the boxed impression securely to the wax on
the paddle ( Fig. 4-51). If not sealed firmly, the boxed
impression can break away during vibration of the stone
into it .
10. Mix properly proportioned artificial stone, and
pour it into the impression while vibrating it gently
( Fig. 4-52). m

Table 4-2. Plaster of Paris and pumice boxing method

Problem Probable cause Solution

Border of cast too high or
too low
Borders of cast too narrow
or too wide
Cast unable to be separated
from plaster of Paris and
pumice boxing
Base of cast too high on one
side and too low on other
side
Base of cast too thick or too
thin
Plaster of Paris and pumice on bor-
der of cast not trimmed to proper
level or properly mixed
Mix of plaster of Paris and pumice
too thin, causing it to slump and
make border too low on impression
Plaster of Paris and pumice border of
wrong width
Separating medium not painted on
plaster of Paris and pumice invest -
ment
Impression not oriented properly prior
to boxing
Height of boxing strip wrong
Trim plaster of Paris and pumice until 3 to 4 mm below
border of impression
Use thick mix of plaster of Paris and pumice to prevent
slumping
Make plaster of Paris and pumice border approximately
4 mm wide; use thick mix so that plaster and pumice
will not slump
Paint separating medium on plaster of Paris and pum-
ice before pouring stone cast
Position impression to make ridges approximately par -
allel to bench top before boxing
Place boxing strip 13 mm above highest point on
impression; cast too thin if boxing strip is less than
13 mm above; cast too thick if boxing strip is more
than 13 mm above impression
 r

&

.
Fig. 4-39. A , Boxing wax was too soft when adapted to impression Note concavity of boxing wax in
heel area ( arrow ). B, Concavity, produced by adapting boxing wax that was too soft, will make cast
too thin in heel area (arrow ).

*
A B

Fig. 4-40. A , Table tennis paddle can be adapted for holding boxed impressions by adding metal
stripping. B, Table tennis paddle after attachment of metal stripping to borders.

Fig. 4- 41. Scrap wax melted into enclosure makes wax base for Fig. 4- 42. Caulking compound rope is suitable for beading impres-
.
attaching boxed impression -
sions, particularly for those made in zinc oxide impression pastes.
 *
Fig. 4- 43. Caulking compound rope is aligned carefully 3 to 4 mm
below border of impression.

A B

Fig. 4- 44. A , Strip of caulking compound rope is adapted below level of impression, as in wax bead-
ing method. B, Note position of caulking compound rope below level of impression.

Fig. 4-45. If necessary, another strip of caulking compound rope Fig. 4- 46. Warm spatula can be used to smooth caulking com-
can be placed over first strip to increase width of border. pound and to seal it to impression.
 Final impressions , boxing and pouring 77
4
11. Continue pouring and vibrating until the boxed PROBLEM AREAS

-
impression is full ( Fig. 4 53).
12. After setting, peel the boxing strip from the
" impression and cast ( Fig. 4-54 ). Remove the caulking
cord from the * border of the cast ( Fig. 4-55), and sepa-
rate the impression from the cast . Occasionally the
caulking compound sticks to the stone, and it is neces-
sary to scrape it off with a knife ( Fig. 4-56). Trim the
cast as needed prior to making baseplates.
The problems with the caulking compound and pad -
dle method are similar to those with previously de-
scribed methods using a wax or a plaster and pumice
mixture ( Table 4-3). Careful control of the width and
height of the boxing border, firm attachment to the
boxing strip and paddle wax , and mixing of properly
proportioned stone under reduced atmospheric pres-
sure will result in an excellent cast.

Fig. 4- 48. Metal boxing strip is adapted gently to caulking com-

Fig. 4- 47. Width and height of caulking compound beading is eval- pound beading and secured with rubber bands. It is essential that
^ uated before applying boxing strip. boxing extend at least 13 mm above highest iDoint on impression.

A B

Fig. 4- 49. A, Warm spatula is used to seal caulking compound to metal boxing strip. B, Caulking
compound is adapted closely to metal strip on underside also.
 .
Fig. 4 -50 Boxed impression is sealed to wax on paddle. In varia- .
Fig. 4-51 Boxed impression is sealed securely to wax on paddle.
tion of procedure, impression is positioned on wax paddle initially,
and beading is adapted and boxed directly while in position on pad-
die.

Fig. 4-52. A, Boxed impression, firmly attached to paddle, is poured in vacuum- spatulated artificial
stone. B, Stone is added to impression slowly while it is vibrated. C, More stone is added to fill boxed
impression.
 Final impressions, boxing anil pouring 79
N

Fig. 4-53. Stone is added until boxed impression is full. .

Fig. 4-54 After setting, boxing strip is removed from cast and pad-
dle.

>
-

-
Fig. 4 56. Occasionally, it is necessary to use knife to remove all
Fig. 4-55. Caulking rope is removed from border of cast . traces of caulking rope from border of cast.

Table 4-3. Caulking compound and paddle boxing method

Problem Probable cause Solution

Borders of cast too high or Beading placed at wrong level Place beading material approximately 3 to 4 mm below
low border of impression
Borders of cast too narrow Beading too narrow or wide Keep beading approximately 4 mm wide; exercise care
or wide in adapting boxing strip to avoid compressing or nar -
rowing beading
Cast overtrimmed on cast trimmer Exercise care when trimming on cast trimmer
Base of cast too thick or Boxing wax at wrong height bor - Place boxing strip approximately 13 mm above border
thin der of impression of impression
Cast lopsided Alignment of impression wrong Position impression to make ridges nearly parallel to
when boxed bench top
80 Dental laboratory procedures: complete dentures
POURING CASTS
Boxing the impression is the first step in making an
acceptable cast . The second , equally important , step is
correct pouring of the cast .
Although it is essential to pour master casts in artifi-
cial stone, * some dentists may prefer an improved
stone, t To achieve the best possible physical properties
of a particular stone, it is necessary to proportion it by
weight and mix it with the specified amount of water.
Mixing the stone in a vacuum spatulator under reduced
atmospheric pressure makes the stone mix and cast su-
perior. fhe resultant stone mix is smooth and free of
air bubbles , and the cast is strong and dense.
PROCEDURE
1. Proportion the stone by weight , and add it to the
recommended amount of water ( Fig. 4 -57). Usually,
200 gm of stone is ample for pouring the majority of
boxed impressions.
2. Spatulate the stone under reduced atmospheric
pressure for 20 to 25 seconds ( Fig. 4-58). Usually spat -
ulation for 20 to 25 seconds is sufficient , but it is nec-
essary to follow the manufacturer’s recommendations
for individual stones.
3. Vibrate the mix into the boxed impression . Add stone
in only one area of the impression , and lilt the impres-
sion on the vibrator to allow stone to flow over the en -
tire impression , thereby minimizing voids ( Fig. 4-59 ).
4 . Continue adding stone until the boxed impression
is full ( Fig. 4-60).
5. Allow the poured impression to set before separat -
ing the cast. Many dental stones set hard enough to
separate between 45 minutes and 1 hour after mixing.
6. Trim the border of the cast , as described previ -
ously ( Fig. 4 -61 ).
PROBLEM AREAS
The principal problems when pouring casts relate to
improper powder-water ratios, which can result in a
markedly inferior, soft cast of inadequate strength (Ta-
ble 4-4 ). Incorporating voids or air bubbles during
pouring and incorrect trimming of the poured cast also
can be problems. Omission of the separating medium
can result in broken casts when using the plaster and
pumice boxing method. Adherence to the powder-wa-
ter ratios recommended by the manufacturer (weighing
the artificial stone and mixing it with the recommended
amount of water ), mixing in a vacuum spatulator under
reduced atmospheric pressure, and careful pouring
technique contribute to producing strong, dense casts
with superior surfaces.
-
Quickstone Whip Mix Corp., Louisville, Ky . , or equivalent.
tVel Mix. Kerr Manufacturing Co., Romulus, Mich.
Careful attention when trimming the cast on the cast
trimmer will result in fewer overtrimmed borders.
Wetting the cast in clear slurry water prior to trimming
will reduce the incidence of slurry splatter sticking to fw
the cast , which is difficult to remove. A separating me-
dium always should be painted on the plaster and pum -
ice boxing prior to pouring the stone cast .
INDEXING THE CAST
Indexing casts prior to mounting them in an articu -
lator permits removal of the casts and accurate replace-
ment in the articulator. Indexing is particularly helpful
during remounting procedures, such as when correct -
ing processing errors after curing a denture. Indexed
casts also are useful during the split-cast method for
verifying jaw relation records. Grooves, notches, or
special metal* or plastic remounting plates are placed
in the cast for indexing ( Fig. 4-62 ).
Requirements for indexing
It is axiomatic that the indexing should not weaken
the cast so that it breaks during routine laboratory pro-
cedures. Neither grooves nor notches used for indexing
should be undercut to form a mechanical lock with the
mounting stone. The indexing should remain functional
in the event that the size of the cast must be reduced
to fit the flask at the time of processing ( Fig. 4-63). The
index should provide a positive three-dimensional fit
between the cast and mounting stone, permitting easy
removal and accurate replacement without damage to
the cast or mounting.! It slioijld be possible to do the *
indexing easily and rapidly with the equipment and ma-
terials generally available.
Groove indexing method
Indexing a cast by grooving the base of the cast with
a lathe-mounted wheel offers several advantages. Con -
touring the lathe wheel will produce a smooth V cut
without undercuts. Groove indexing allows reduction of
the cast border if necessary while retaining a positive
index. It is possible to modify the position of the index
groove as needed to avoid thin areas in the cast .
PROCEDURE
1. Shape the lathe-mounted wheelt with a trueing
stone to make a V-shape edge ( Fig. 4-64 ).
2 . Groove the center of the base of the cast from
front to back with the wheel ( Fig. 4-65).
. .
Split Remounting Plate Assembly Complete Teledyne Dental l ' rod -
.
uets Co. . llanau Division, Buffalo X Y .
.
tNo 21 Creen Line lathe wheels 3 inches x M* inch (7.6 x 0.97 cm )
Buffalo Dental Manufacturing Co.. Brooklyn . N Y.
 A.

Fig. 4-57. Artificial stone is proportioned by weight and mixed with Fig. 4-58. Artificial stone mixed in vacuum spatulator under reduced
recommended amount of water. Usually 200 gm of stone is ample atmospheric pressure is used to pour cast .
for impression.

A B

- .
Fig. 4 59 A, Boxed impression is tilted on vibrator when stone is added initially. B, Stone is always
added in same area and allowed to flow over entire surface of impression to preclude formation of
voids.

- .
Fig. 4 60 Stone is added until boxed impression is full.

*
 > '. '
v VV V V ' >
V > •« * - • • • ».•' •.SVVf .' -
"

/
£

A B

Fig. 4-61. A, Maxillary cast with sides trimmed perpendicular to base. B, Mandibular cast with sides
trimmed perpendicular to base.

Fig. 4- 62. Indexing can be accomplished by placing grooves in cast

( left), by using metal remounting plates (center ), or by notching cast
( right ).
<rv

Table 4- 4. Pouring the cast

Problem Probable cause Solution

Surface of cast too soft and Powder - water ratio wrong
not strong enough
Numerous voids in cast Vacuum spatulator not used
Poor vibration during pouring
Cast rough from slurry Cast not wet in clear slurry water
splatter before and during trimming on
cast trimmer
Adhere to powder - water ratio recommended by manufac-
turer ; weigh stone and mix with recommended amount
of water; mix in vacuum spatulator under reduced atmo-
spheric pressure
Mix stone in vacuum spatulator under reduced atmospheric
pressure
Use vibrator to minimize voids
Dip cast in clear slurry water before trimming on cast trim-
mer and repeat frequently during trimming procedure to
prevent slurry splatter from sticking to cast
 Final impressions , boxing and pouring 83
N

A B

Fig. 4-63. A, Occasionally, cast must be reduced in size to fit within confines of denture flask. B,
When it is necessary to reduce size of cast to fit within flask, groove indexing (left ) is preferable to
notch indexing (right ). Although cast on left can be reduced significantly, enough of groove will be
left to allow remounting on original articulator mount. Cast on right ( with notch indexing) can be
reduced to point at which notches are eliminated, making it impossible to remount on original articu-
lator mount.

Fig. 4- 64. Lathe-mounted wheel should be shaped with trueing Fig. 4-65. One groove is placed in center of base of cast from front
stone to create V-shaped edge. to back with lathe-mounted wheel.
 84 Dental laboratory procedures: complete dentures
3. Groove the rest of the cast perpendicular to the
first groove , intersecting approximately in the
center of the cast ( Fig. 4-66).
4. Where lingual flanges result in thin areas on man -
dibular casts, place the grooves opposite the
ridges in thicker portions of the cast ( Fig. 4-67).
Notch indexing method
Notches cut in the base of the cast at three or more
points provide a positive index. The notch method is
especially suitable for split -cast jaw relation record ver-
ification techniques/ This method has a potential dis-
advantage in the event that it is necessary to reduce the
cast significantly to fit in a flask / In this instance,/ the
removal of peripheral notches can result in the loss of
the index.
Fig. 4-66. Another groove is placed perpendicular to first groove
and intersecting approximately in center of cast.
PROCEDURE
Notch the base of the cast in the anterior midline and
in the right and left distobuccal regions . Use a lathe
-
mounted wheel or sharp knife to make smooth non iin - 5
dercut notches ( Fig. 4-68).
PROBLEM AREAS
The principal problems in the groove or notch meth -
od of indexing casts are making the grooves or notches
too deep, thereby weakening the cast , and under-
cutting the notches or grooves, resulting in mechanical
locks between the cast and mounting stone (Table 4-5).
As discussed earlier, it is necessary to reduce the size
of a cast occasionally to fit a flask . Cutting away notch
indexing in these instances will eliminate the index; as
a result, the groove method is preferable ( Fig. 4-69).
Fig. 4-67. Deep lingual flanges in mandibular impressions occa
-
sionally produce thin areas in cast. Breakage of thin areas can be
avoided by placing groove directly opposite thickest area of cast
and parallel to ridges.
Fig. 4-68. Notches can be placed at widely separated points on
cast with lathe-mounted wheel or sharp knife.

Table 4-5. Indexing the cast
* Problem Probable cause
Cast broken by improperly Indexing grooves too deep
cut index
Cast unable to be sepa- Indexing notches or grooves undercut
rated from mounting or separating medium not applied
stone prior to mounting
Lingual flange area of Indexing groove too deep
cast perforated by in-
dexing groove
- .
Fig. 4 69. Groove indexing, left is preferable to notch indexing
right.
SPLIT REMOUNTING PLATES
Split remounting plates offer several advantages com -
part 'd to groove or notch indexing methods ( Fig. 4 -70 ) .
Contact between the cast and mounting stone is
through precisely fitting metal plates, which also permit
rapid removal and replacement of the cast in the artic-
ulator . The dentist or technician can remove the cast
from the mounting, set teeth , adjust the position of the
teeth or wax the denture, and replace it on the articu -
lator quickly to check the occlusion .
The principal disadvantages are the cost of remount -
ing plates and the time required both to place them in
the cast and retrieve them from the cast and mounting
stone after completing the denture .
PROCEDURE
1 . Box the impression by the method of choice ( f ig .
4 - 717
2 . Make a split - plate positioning aid by embedding
one section of a split remounting plate in a 6 x 6 inch
( 15.2 x 15.2 cm ) sheet of Plexiglas V2 inch ( 1.2 cm )
thick . Embed this section of the plate flush with the
surface of the Plexiglas , with the indexing surface up
( Fig. 4 -72 ) .
Final impressions , boxing and pouring 85 .4
Solution
Place indexing grooves with trued lathe mounted wheel;
make them approximately 3/ie inch ( 0.47 cm) deep
Do not incorporate undercuts in grooves or notches; paint
separating medium on cast base prior to mounting
Do not make groove too deep ; in mamdbular cast with
deep lingual extensions, place grooves opposite ridges,
not in thinner portions of cast
3. Cut a groove in the plastic plate to accommodate
the pin that secures both sections ( Fig . 4-73) .
4 . Attach the opposing section of the split remount -
ing plate to the embedded half and use a pin to secure
,
it ( Fig. 4-74).
5. Position the sheet of Plexiglas with the remounting
plate attached over the boxed impression to center the
plate over the impression ( Fig . 4- 75). A squall notch is
cut in the boxing for the metal pin .
6 . Pour the boxed impression in stone ( Fig. 4 -76 ) .
7 . Place more stone in the undercuts of the remount -
ing plate attached to the sheet of Plexiglas ( Fig . 4 -77) .
8 . Center the sheet of Plexiglas and the remounting
plate over the poured impression ( Fig. 4-78).
9. Gently settle the sheet of Plexiglas onto the boxed
impression . Since the edges of the .boxing wax are visi -
ble through the sheet of Plexiglas , it is easy to center
the remounting plate in the cast ( Fig. 4- 79) .
10 . After setting, remove the pin and lift the Plexi -
glas positioner from the cast . Attach the other section
of the remounting plate to the section in the cast in
preparation for mounting ( Fig . 4-80 ) .
PROBLEM AREAS
In the split remounting plate method it is difficult to
,
keep the metal remounting plates from sinking into the
stone without using a Plexiglas split- plate positioner
(Table 4-6 ) . Another problem is failure to center the
remounting plate . Failure to place stone in the under-
cut of the remounting plate during the pouring proce -
dures can allow voids, which may cause the plate to
move slightly within the cast . If the boxing was is more
than 13 mm above the highest point on the impression ,
the cast can be too thick . The only solution is to remove
the remounting plates and thin the cast . Removal of the
remounting plates to correct cast thickness can weaken
the cast . For the best results , it is essential to use the
Plexiglas positioner , place stone around the borders of
the split remounting plates to minimize voids, and cen -
ter the remounting plates when pouring .
 3
,

Fig. 4-70. Split remounting plates within master cast offer advan- Fig. 4-71. Impression is boxed by method of choice.
tages. They permit rapid removal of cast from articulator and re-
placement on it. Contact between cast and mounting stone is made t
through precisely fitting metal plates.

Fig. 4- 72. A 6 x 6 inch ( 15.2 x 15.2 cm) sheet of Plexiglas Fig. 4-73. Sheet of Plexiglas with embedded section of remounting
-
14 inch (1.25 cm) thick with one section of split remounting plate plate. Note groove cut in plastic for pin (arrow ).
embedded in it aids considerably in placing split remounting plates
in cast .

Fig. 4-74. Opposing section of split remounting plate is attached to

embedded half and secured in position with pin .
%

A B

Fig. 4- 75. A, Sheet of Plexiglas with remounting plate attached is placed over boxed impression to
center remounting plate in boxed impression. B, Sheet of Plexiglas facilitates centering of metal
remounting plate.

Fig. 4-76. Boxed impression is poured in stone, as described in Fig. Fig. 4- 77. More stone is wiped into undercuts of split remounting
4-59. plate attached to sheet of Plexiglas.

Fig. 4- 78. Sheet of Plexiglas with remounting plate attached is cen- Fig. 4-79. Note edges of boxing wax visible through sheet of Plex-
tered over boxed impression and settled into place. iglas. Transparency of Plexiglas facilitates centering of remounting
plate in cast.
88 Dental laboratory procedures: complete dentures

Fig. 4 80. A, After setting of stone, pin is removed, and Plexiglas is separated from cast. B, Other
- -
section of remounting plate is attached to section of remounting plate embedded in cast, and pin is
inserted. C, Split remounting plate is mounted in maxillary cast. Removal of pin permits rapid sepa-
ration and replacement of cast in articulator mounting.

Table 4-6. Split remounting plates

Problem Probable cause Solution

Remounting plate sinking into
stone while being placed in
cast
Remounting plate too far off -
center
Remounting plate loose in cast
Cast too thick or thin
Sheet of Plexiglas not used to
suspend remounting plate
Sheet of Plexiglas not used to
suspend and align remounting
plate
Stone not in intimate contact with
remounting plate
Height of boxing wax wrong
Use 6 x 6 ( 15.2 x 15.2 cm) sheet of Plexiglas Vz
inch (1.25 cm) thick during setting of stone
Use 6 x 6 inch (15.2 x 15.2 cm) sheet of Plexiglas
1
/2 inch ( 1.25 cm) thick to aid in centering remount -
ing plate
Use spatula to wipe stone into all border areas of re-
mounting plate; once in position, do not disturb it
until stone sets
Exercise care in making boxing wax approximately 13
mm above highest point on impression

SUMMARY
This chapter describes three methods of boxing
impressions , techniques for pouring and trimming
* casts , and methods of indexing casts with grooves,
notches , and remounting plates . Since casts are the di -
rect link between laboratory and clinical procedures, it
is axiomatic that a properly boxed , poured , and
trimmed cast is essential for a successful restoration.
. «.
f
Final impressions , boxing and pouring 89
REFERENCES
Air Force Manual I (>0-29: Dental laboratory technicians’ manual.
Washington, D.C., 1959. U . S. Government Printing Office.
Blank. H . H .: Impression materials for maxillary immediate dentures,
. -
J . Prosthet Dent !1>411 419 1961
Bolonri, A., Hilger, T. G. , and Gowrylok. M . D.: Boxing impressions,
-
J . Prosthet . Dent . 33:692 695, 1975.
Boucher, C.O.: Swenson’s complete dentures, ed. 5, St. Louis, 1964 .
The C. V. Mosby Co.
Harris, L . W.: Boxing and cast pouring, J . Prosthet. Dent. 10:390,
1960.
Heartwell , C. M ., Jr. , and Hahn , A.O.: Syllabus of complete den -
tures , ed . 2, Philadelphia, 1974 . Lea 6c Febiger.
.
Sowter, J . B. : Dental laboratory technology, prosthodontic technique
Chapel Hill , N. C., 1968, The University of North Carolina Press.

CHAPTER 5
BASEPLATES AND OCCLUSION RIMS
KENNETH D. RUDD and ROBERT M . MORROW
baseplate (record base, temporary base , trial base ) A temporary
form representing the base of a denture. The baseplate is used
for making maxillomandibular ( jaw ) relation records, arranging
artificial teeth , or trial placement in the mouth
, 5. The baseplate as constructed should permit its use
stabilized baseplate A baseplate lined with a plastic , or other ma-
terial, to improve its adaptation and stability ,
occlusion rim An occluding surface built on temporary or perma-
nent denture bases for the purpose of making maxillomandibular
records and arranging teeth .
key worth ( 1929 ) states that the purposes of base-
plates are ( 1 ) to act as carriers for occlusal rims on
which jaw relations are recorded , ( 2 ) to hold the teeth
in the wax setup for the trv-in stage, and ( 3) to check
the accuracy of the previously recorded records.
Dentists use the baseplates and attached occlusion
rims to transmit important information to the dental
laboratory technician . Jaw relationships, the midline,
occlusal plane, high and low lip line, cuspid line,
amount of horizontal and vertical overlap, and desired
support for lips and cheeks can be indicated on the base-
plate and occlusion riny ( Fig. 5- 1 ). The success of a den -
tist s treatment depends on the accurate communication
of this information . Therefore it is essential that base-
plates meet specific requirements for the liaison be-
tween dentist and dental technician to be effective.
REQUIREMENTS FOR BASEPLATES
Elder gave tin following requirements for base-
( 1955) * Materials used, singly or in combination , for con -
plates:
1. The baseplate should adapt to the basal seat area
as the finished denture base.
2. The baseplate should have the same border form
as the finished denture base.
90
I
1
3. The baseplate should be sufficiently rigid to resist
biting forces.
4 . The baseplate should be dimensionally stable.
as a base for setting lip teeth .
6. It should be possible to construct baseplates
quickly, easily , and inexpensively .
7. Baseplates should have no undesirable color.
Tucker ( 1966) added that the Baseplate should not
abrade the cast during removal .and replacement; it *
should take advantage of desirable undercuts and be of
a material that bonds with that used to block out un -
dercuts on the cast so that it becomes part of the base-
plate.
Baseplates should fit the cast accurately , be suffi -
ciently rigid to resist closing forces, and have sufficient
dimensional stability to maintain fit and rigidity
throughout the clinical and laboratory procedures used
in denture construction . Although they should satisfy
these requirements, unduly thick baseplates might en -
croach on the space available for setting teeth . They
should be of an acceptable color, and the borders
should be smooth , rounded , and similar to those of the
prospective denture. Removal of the baseplate from the
cast or replacement should cause no damage to either.
BASEPLATE MATERIALS
structing baseplates are autopolvinerizing resins, shel -
lac baseplate material , thermoplastic resins, heat -curing
resins, baseplate wax, and metal. J Zinc-oxide impression
paste, elastomeric impression materials, and hard- or
soft -curing resins are other types of material used in
 1
Baseplates and occlusion rims 91

*
jtg and low lip line (2 and
Fig . 5 1 . A , Baseplates and attached occlusion rims indicate midline ( 1 ) , high
-
desired for lips and cheeks in addition to jaw relation records. B ? Side
3) , cuspid line (4), and support
(2). C, alignment
view of baseplates and occlusion rims indicates occlusal plate ( 1 ) and cuspid line
and position of anterior teeth are determined by contour of wax occlusion rim.
Note horizontal overlap
in anterior region.

combination to stabilize baseplates by improving their
adaptation and rigidity Lining the baseplate with (soft-
curing resins* and elastomeric impression materials !
’*
permits extension of the baseplate into moderate un -
dercuts and removal or replacement of the baseplate on
the cast without damage to either. t
AUTOPOLYMERIZING RESIN BASEPLATES
Autopolymerizing resins (cold-curing or self-curing
resinst ) require an activator and a catalyst for poly-
merization and no external heat. They are readily avail -
.
*Coc-soft Coe Laboratories, Inc., Chicago, Ill ., or equivalent ,
tkerr Perinlastic, Kerr Manufacturing Co., Romulus, Mich . , or
equivalent .
$Aerolite 88, Kerr Manufacturing Co., Romulus, Mich .: Caulk Repair
Material L. D Caulk Co., Milford , Del . , or equivalent.
. .
able at a reasonable cost , set hard and rigid or soft and
flexible according to the formulation , and take color sat -
isfactorily . Generally, their handling characteristics are
suitable for constructing baseplates that are both ser-
viceable and economical . Therefore autopolymerizing
resins, singly or in combination, probably are the ma-
terials used most frequently for baseplates. ' Four meth -
ods of construction from these materials will be de-
scribed
^
Sprinkle- on method
-
The sprinkle on method is excellent; it
, sifting
fxmsists
of
polymer
coating the cast with tinfoil substitute
powder on it , and saturating it with liquid monomer.
Alternate applications of powder and liquid continue
until the baseplate is of the desired thicknessj It is es-
sential that this method be performed in a hood or a
92 Dental laboratory procedures: complete dentures

Fig. 5-2. Severe undercuts blocked out with baseplate wax . Fig. 5-3. Cast is coated with tinfoil substitute.

Fig. 5- 4. Soft-curing autopolymerizing resin is placed in lesser un-

dercuts (arrows ).
-
•
/
Fig. 5- 5. Small spatula is used to place soft-curing autopolymeriz
ing resin in cast undercuts.
-

well-ventilated area to minimize exposure to resin
{limes. Placing the baseplate in a pressure pot * or un -
der an inverted plaster bowl while it is polymerizing
results in less porosity .
PROCEDURE
1 . Carefully examine the cast, and identify the un
dercuts that need relief . Severe undercuts require
blockout with baseplate wax ( Fig. 5- 2 ). Only minimal
use of wax is desirable, since excessive use can compro-
mise the fit of the baseplate to the cast . If undercuts
are not severe, soft -curing autopolymerizing resint is
-
* Acri Densc Pneumatic Curing Unit , Coe
Laboratories Inc., Chi-
.
cago, III . , or equivalent
-
tCoe soft , Coe Lal>oratnries, Inc. , Chicago, III . , or equivalent .
ideal for them . It becomes an integral part of the base-
plate , and allows the baseplate to be removed from the
cast and replaced without abrading the cast.
2. Paint tinfoil substitute* on the wet cast with ex-
treme care, so that all parts contacting the resin receive
coating ( Fig. 5-3).
- 3. Block out severe undercuts with baseplate wax to
prevent the baseplate from extending into undercut
areas.
4. Fill undercuts that are not severe with soft -curing
autopolymerizing resin ( Fig. 5-4 ). Make certain the cast
is painted with tinfoil substitute first . Three methods of
applying soft -curing resin are to mix the soft -curing
.
-
4
Modern foil. Modem Materials Manufacturing Co., St . Louis, Mo.,
or equivalent.

r mer from an eyedropper ( Fig. 5-6) , or paint the resin
Fig. 5-6. Soft -curing autopolymerizing resin powder can be sifted
into cast and saturated with monomer as alternate procedure.
.* >*
•;
*
.^• *
I *
Fig. 5-7. Soft -curing autopolymerizing resin ( arnows ) was allowed
to flow out of undercuts and into border of cast. In this position, it
will not prevent breakage of baseplate or cast .
Fig. 5-8. Soft -curing autopolymerizing resin will remain in place ( ar
row ) if dipped into warm water. Resulting surface “ set " on resin will
hold it in place.
\
Baseplates and occlusion rims 93
resin powder and liquid in a dappen dish and apply it
to the undercuts with a spatula ( Fig. 5-5), sprinkle on
the soft-curing resin powder and saturate it with mono-
into the undercuts with a brush . In the last method ,
place the powder in one dappen dish and the liquid in
another. Dip the brush into the liquid and then into
the powder and brush this combination on the cast .
These three methods work well , and the choice of
which to use should be that of the technician.
5. Occasionally , the soft -curing resin tends to flow
out of the undercuts instead of remaining in place ( Fig.
5-7 ). It is possible to prevent this problem by warming
the surface of the resin with warm air from a chip
blower or by dipping the cast into hot water momentar-
ily. Warming produces a surface set on the soft -curing
resin , thereby assuring that it will remain in place ( Fig.
5-8).
6. Sift the conventional autopolymerizing resin pow-
der onto the cast and soft -curing resin , and saturate it
with the liquid. Use a nonfibered powder because it
sifts more readily than a powder with fibers, which ob-
struct the opening in a dispenser. A plastic mustard or
catsup dispenser makes a convenient sifter ( Fig. 5-9).
Use an eyedropper to apply the monomer ( Fig. 5- 10).
Continue alternating applications of powder and liquid
until the baseplate is the desired thickness. Tilt the cast
laterally while applying the resin to prevent pooling the
liquid and powder in the palate of maxillary casts,
which can cause an excessively thick palate. After com -
pleting the upward facing surfaces, tilt the cast in the
opposite direction and build up the other surfaces in a
similar manner. This procedure helps to prevent an un -
desirable buildup in the depth of the palate. An exces-
sively thick palate requires reduction by grinding.
7. When the resin is the desired thickness, approxi -
mately 2 mm, it is ready to be cured ( Fig. 5-11). Cure
the baseplate under an inverted plaster bowl or in a
pressure pot under warm water for 20 minutes at 20 psi
( Fig. 5-12). The first method , which requires no addi-
tional equipment, produces an acceptable baseplate,
though it often has more surface porosity. Pressure cur-
ing results in less porosity; however, baseplates cured
under pressure do not seem to fit as well as those cured
at normal atmospheric pressure ( Fig. 5- 13).
8. Examine the cured baseplate on the cast to evalu -
ate its adaptation . If blockout of the undercuts on the
cast is adequate, directing a stream of air under the
border will often lift the baseplate from the cast ( Fig.
5- 14 ). Sometimes it is necessary' to pry up the baseplate
gently and lift from the cast , taking care not to break
- either one. If pry ing is necessary, do it on the side op-
posite the undercuts ( Fig. 5-15). When it is impossible
to separate the baseplate from the cast , dip both in
94 Dental laboratory procedures : complete dentures

A B

Fig. 5- 9. A , Plastic mustard or catsup dispensers make excellent sifters for acrylic resin powder. B .
Autopolymerizing resin powder is sifted onto cast before it is saturated with monomer. Use nonfibered
powder, which sifts readily without clogging.

Fig. 5- 10. Eyedropper is used to control amount of monomer ap- Fig. 5- 11. Autopolymerizing resin has been built up to thickness of
plied. approximately 2 mm and is ready to be cured.
 r

A B

Fig. 5-12. A, Curing baseplate under plaster bowl significantly reduces porosity and makes if fit well.
B, Curing baseplate under increased pressure reduces porosity, but does not seem to fit cast as well
as baseplate cured at atmospheric pressure.

Fig. 5- 13. Baseplates constructed from autopolymerizing resin. A, Upper baseplate cured in pressure
pot does not fit cast (arrow ) as well as lower baseplate cured under plaster bowl at atmospheric
pressure. B, Baseplates cured in open air may demonstrate considerable surface porosity.

i
Fig. 5- 14. When undercuts are minimal or are blocked out properly, Fig. 5- 15. If necessary to pry baseplate from cast, do it gently and
cured baseplate often can be removed from cast by directing on side opposite undercuts to prevent breakage of cast.
96 Dental laboratory procedures: complete dentures

I
* i

Fig. 5- 16. A, Arbor band on lathe can be used to reduce resin flash. Protective goggles should be
worn. B, Excess resin can be trimmed with suitable bur in handpiece.

Fig. 5 17. Slow lathe speed ( 1740 rpm) and adequate pumice slurry
- Fig. 5-18. Self - sealing plastic bag containing water or diluted
reduce buildup of heat in baseplate, minimize warpage, and expe- mouthwash is excellent for storing completed baseplate.
dite polishing. Protective goggles should be worn.

clear slurry water. * Flowing between the cast and base-
plate , this water acts as a lubricant and allows the base-
plate to be removed .
9. Trim the resin (lash around the borders with an
arbor band on a lathe , resin cutting stone, or bur in a
handpiece ( Fig. 5- 16 ). Take care to preserve the extent
and thickness of the baseplate borders because the den -
tist has exerted considerable effort to develop them in
the impression.
10. Smooth the borders and any rough spots on the
baseplates with a wet rag wheel and a slurry of water
and flour of pumice. A slow speed ( 1740 rpm ) on the
lathe with plenty of pumice slurry reduces the buildup
of heat in the baseplate during polishing and speeds the
procedure ( Fig. 5- 17). Heat built up as a result of pol -
ishing can warp the baseplate and ruin its adaptation.
Usually a high shine on the baseplate is not essential ,
since the surface is smooth enough after pumicing. Ad -
ditional polishing can warp an otherwise satisfactory
baseplate.
11 . Store the finished baseplate in water until ready
for use ( Fig. 5-18).
PROBLEM AREAS

*Slurr \ water is made by placing stone debris or particles in a con- Several problems can arise with the sprinkle-on
tainer of water and allowing them to soak for 4S hours: the resultant method . The problems, their probable causes, and so-
.
supernatant solution is used for rinsing or soaking casts lutions are presented in Table 5- 1 .
 Baseplates and occlusion rims 97

Table 5- 1. Sprinkle- on method

4 Problem Probable cause Solution

Baseplate unable to be
removed from cast
Baseplate broken during
removal
Cast chipped or broken
during removal
Both cast and baseplate
broken during removal
Baseplate too thick in
some areas and too
thin in others
Completed baseplate too
flexible
Baseplate porous
Failure of baseplate to fit
cast
Undercuts not properly
blocked out
Cast not coated with uncon-
taminated tinfoil substitute
See above
See above
Resin flow not controlled by
tilting cast during applica-
tion
Ratio of soft -cure resin in
undercut areas to hard - layer of hard- setting resin over it
setting resin too high
Wrong liquid or powder used
for hard- setting resin
Baseplate removed from
cast too soon; polymeriza-
tion not completed
Baseplate to thin or ridge flat
Some areas allowed to dry
when resin is applied to
cast
Baseplate removed from
cast before polymerization
completed
Baseplate heated by grind-
ing or polishing
Baseplate stored in dry envi-
ronment
Baseplate warped from
prying when removed from
cast
Use soft-curing resin on baseplate for only moderate undercuts;
block out extensive undercuts with wax
Coat cast with uncontaminated tinfoil substitute before adding resin
Make soft-curing resin thick enough; prevent displacement by
hard- setting resin
See above
-
Control resin flow by tilting cast while sprinkling on powder; exer
cise care in sifting powder on prominent cast areas ; use enough
powder to prevent flow of mixture
Use only enough soft-curing resin to fill undercut ; apply adequate
Use correct powder and liquid for both hard- setting and soft-curing
acrylic resins
Allow adequate time for baseplates to set before removing from
cast
Reinforce baseplates for flat ridges by wire embedded in resin
Keep all areas moist with monomer to prevent drying when apply-
ing resin
Cure baseplate in pressure pot or under inverted plaster bowl
Adequately cure resin before attempting to remove baseplate from
cast
Do not overpolish; use slow speeds and ample flour of pumice and
water while polishing
Store completed baseplate in water
Block out undercuts on cast to avoid need for prying baseplate
from cast with resultant warping

1. It is impossible to remove the baseplate from the
cast without breaking one or both during separation . A
common cause of this problem is failure to identify and
block our undercuts on the cast adequately. Blockout of
extensive undercuts is essential because soft curing
resin can compensate for only moderate undercuts. Ex
amine the cast carefully for undercuts, and note their
depth and extent. Use a surveyor to locate the under-
cuts. Block out extensive undercuts with wax and con -
firm the blockout. When applying soft -curing resin to
moderate undercuts , make certain that it is thick
enough, remains in place, and does not flow out of the
undercut before applying the conventional resin . Soft -
curing resin must be thick enough and in the proper
position to protect the cast . Failure to coat the cast or
coating it with contaminated tinfoil substitute makes
the baseplates stick to the cast tenaciously, usually re
sulting in damage to the cast on separation ( Fig. 5-19 ).
Coating the cast with uncontaminated tinfoil substitute
before adding the resin will prevent this problem. Pour
the tinfoil substitute from the bottle into a container
- before using, and discard any unused portion . Do not
- dip the brush into the main storage bottle or return the
unused portion into the storage bottle; this will avoid
contaminating and ruining its effectiveness.
2. The baseplate is too thick in some areas and too
thin in others. This variation is a common defect , par-
ticularly in maxillary baseplates in which the palate is
too thick and the ridge areas are too thin. Failure to tilt
the cast allows the saturated resin to flow from the
ridge areas into the palate or vestibules of the cast . Tilt -
-
ing the cast during the sprinkle on procedure mini -
mizes this problem . Care in sifting polymer on the cast
- can prevent thin areas. Avoid fumes from the acrylic
 warn 1
Fig. 5-19. Cast coated improperly with tinfoil substitute; both base
plate and cast broke.
Fig. 5-21. Mandibular cast, left, has a well- formed anterior ridge
( arrow). Cast on right has especially flat anterior ridge (arrow ). In-
verted U shape of left cast facilitates construction of rigid baseplate.
Flat ridge on right cast will require reinforcement.
resin monomer by constructing the baseplate in a hood
-
or some other well ventilated area.
3. The completed baseplate is too flexible. This con -
dition can occur when the ratio of soft-curing resin in
the undercut areas to overlying hard-setting resin is too
high ( Fig. 5-20). The overlying layer of conventional
resin is too thin to give the necessary strength and ri -
gidity . Using the wrong liquid or powder for the over -
lying hard -setting resin occasionally makes the base
plate flexible. Inadvertent use of soft -curing resin liquid
with the conventional powder will keep the resultant
baseplate from setting properly and make it entirely too
flexible. For adequate rigidity , place sufficient hard -
setting resin over the soft-curing resin, and clearly
identify the liquid and powders for each resin system .
After applying the soft -curing resin to the cast , set the
tv
- Fig. 5-20. This cured baseplate is too flexible, probably as result of
using too much soft -curing autopolymerizing resin or making base-
plate too thin.
kr
Fig. 5- 22. Cross section of top baseplate made on left cast results
in greater rigidity than cross section of bottom baseplate made on
right cast.
containers aside to prevent their accidental use when
applying the conventional resin . If a mandibular cast
has an extremely Hat ridge in the anterior region , the
baseplate constructed on this cast will not be rigid ,
even after correct application of the resin ( Fig. 5-21 ). A
- cross section of the baseplate does not have the usual
inverted U form in the anterior region with its inherent
rigidity ( Fig. 5-22 ). Reinforcing the baseplate with a
stiff wire embedded in the resin and extending from
premolar to premolar materially improves its strength
and increases its rigidity ( Fig. 5-23).
4. The completed baseplate is unsightly and too po-
rous. A slight amount of surface porosity in the com -
 Baseplates and occlusion rims 99

Fig. 5- 23. A , Reinforcing wire is adapted to cast lingual to crest of ridge. Note that lingual position
prevents interference when setting teeth . B, Cross section of baseplate reinforced with wire (arrow ).
Note position of wire toward lingual border of baseplate.

pleted baseplate usually is not a critical defect. Exten -

sive porosity that penetrates to the tissue surface of the
baseplate can be a problem because it reduces the ri-
gidity and makes the baseplate unhygienic. Using high-
quality autopolymerizing resins and keeping the surface
of the resin moistened with monomer during the sprin -
kle-on procedure minimize porosity . Once started , the
sprinkle-on procedure should continue to completion.
Do not allow the resin to dry out in one area while
adding some in another . Placing the baseplate under an
^
inverted plaster bowl or in a humidor during polymer-
ization also reduces the surface porosity. Pressure - pot
curing usually eliminates porosity problems.
5. The completed baseplate does not fit the cast . Ad -
aptation to the cast is critical for acceptability of the
baseplate. If the baseplate does not fit the cast, it must Fig. 5-24. Baseplate resin has been rolled into sheet approximately
be remade. This situation can occur when the baseplate 2 mm thick before being adapted to cast .
is too flexible as discussed previously, when removal
from the cast takes place before adequate polymeriza-
tion . when the baseplate warps as a result of grinding
and polishing, and when the environment used for stor-
ing is too dry. Warping of the baseplate also can occur powder and saturating it with monomer , mix the pow -
if the cast is not wet when placed in the curing pot , or der and liquid together until the mixture is the consis-
if considerable prying is needed to separate the cured tency of dough , form it into a roll or sheet , and adapt
baseplate from it . To minimize warpage and construc- it to the cast with finger pressure. A modification of this
tion of an unacceptable baseplate, avoid the previously method is to roll the dough in a sheet of the desired
discussed causes of flexibility . Allow the baseplate to thickness before adapting it to the cast ( Fig. 5-24 ). Al -
polymerize before removing it from the cast , and do not though some prefer finger adaptation which may be,

overpolish it . If prying is necessary to remove it from
the cast , do it gently opposite the undercuts.
Finger- adapted dough method
An alternate method of making resin baseplates is the
finger -adapted dough method . Instead of sprinkling on
quicker than the sprinkle-on method of constructing base-
plates, it has several disadvantages. First , unless using
gloves , needless repeated contact with resin during ad-
aptation may lead to contamination of the resin or.
more importantly , result in contact dermatitis. Second ,
it is ' exceedingly difficult to achieve uniform thickness
100 Dental laboratory procedures: complete dentures
Fig. 5- 25. Once resin has reached dough stage , it is formed into
roll and adapted to cast .
of the baseplate by hand adaptation. Invariably, , the
resin is too thin over the convex ridge portions and too
thick in the less accessible areas. Third , usually it is
necessary to continue finger adaptation throughout po-
lymerization to prevent rebound or lift-off of the resin ,
but this manipulation can cause distortion . Finger ad -
aptation also can displace soft-curing resin used to fill
in undercuts.
PROCEDURE
1. Identify the undercuts, and decide whether to use
wax or soft -curing resin for blockout . Blockout consid -
-
erations are the same for the finger adapted dough
method as for the sprinkle-on method .
2. Apply tinfoil substitute to the cast .
3. Put baseplate wax in severe undercuts and soft -
curing resin in moderate undercuts.
4. Proportion and mix the resin powder and liquid
according to the manufacturers recommendations .
When the mixture is in the dough stage, form the resin
into a roll and adapt it to the cast ( Fig. 5-25). The resin
,
baseplate should be approximately 2 mm thick . It is
possible to make a convenient mold by impressing a
double thickness shellac baseplate into a mix of artificial
stone (Swenson, 1970) ( Fig. 5-26). After the stone has
set , remove the baseplate and use the resultant mold to
shape a resin sheet of uniform thickness into a baseplate
( Fig. 5-27). An alternate , and excellent , procedure is to
roll the dough into a sheet of the desired thickness, *
trim it to the shape of a baseplate , and adapt it to the
cast ( Fig. 5-28 ).
•Rollcttc
* .
Unit, Kerr Manufacturing Co. Romulus, Mich.
Fig. 5- 26. A, Convenient mold can be made by impressing double-
thickness shellac baseplate into mix of artificial stone. B, Resultant
mold is used to make acrylic resin baseplate form for adaptation to
cast .
5. Regardless of which method is used , continue fin -
ger adaptation until the resin , being well adapted to the
cast , does not spring away or rebound ( Fig. 5-29 ).
6. Place the baseplate on the cast under a plaster
bowl or in a pressure pot for polymerization , as de-
scribed previously.
7. After curing, remove the baseplate from the cast,
trim it , and smooth it .
8. Replace the baseplate on the cast , and evaluate the
adaptation and border thickness ( Fig. 5-30). Store the
completed baseplate in water until needed.
PROBLEM AREAS
The principal problems associated with this method
are achieving and maintaining the accurate adaptation
to the cast and the uniform thickness of the baseplate
(Table 5-2).
I . The completed baseplate does not fit the cast . If
the resin progresses beyond the dough stage before
starting finger adaptation , it is difficult to obtain inti -
mate contact between the cast and baseplate. The resin
becomes rubbery and has a pronounced rebound that
.
defies permanent adaptation Finger molding the resin
at the proper stage is essential because once it reaches
the rubbery stage, accurate adaptation by finger pres - ^
 Baseplates and occlusion rims 101

,
*

A B

C D

-
Fig. 5-27. A, Stone mold Is coated with tinfoil substitute. B, Resin dough is picked up in sheet of
cellophane and placed into stone mold. C, Resin dough is rolled out to desired thickness. In this
instance, plastic bottle is used as roller. D, Excess resin is trimmed with spatula. E, Resin baseplate
is removed from mold and adapted to cast . Continue finger adaptation until resin loses rebound and
retains adaptation.
102 Dental laboratory procedures: complete dentures

Fig. 5- 28. A , Wooden roller is coated with silicone lubricant to keep resin from sticking. B, Wooden
tray also is coated with silicone lubricant to keep resin from sticking as sheet is rolled to desired
thickness. C, Use sheet of cellophane to prevent finger contact with resin dough. D, Resin dough is
rolled to uniform thickness.

Fig. 5-29. In any method used to make resin sheet, finger adapta-
la
tion must be continued until resin is well adapted to cast ; resin Fig. 5-30. Baseplate fit and adaptation. are checked on cast. This
should not spring away or rebound. baseplate is well adapted.
 Baseplates and occlusion rims 103

h Table 5- 2. Finger - adapted dough method

Problem Probable cause Solution

Failure of baseplate to fit
cast
Baseplate too thin in some
areas and too thick in
others
Resin beyond dough stage before
finger adaptation started
Finger adaptation of resin discon-
tinued too early
Convex areas too thin as result of
finger pressure
Resin not rolled to desired thick -
ness before applying to cast
Adapt resin when in dough stage
Continue finger adaptation of resin until it no longer springs
away from cast
Do not place too much pressure over convex ridge areas
when adapting resin
Roll resin into sheets of proper thickness before adapting to
cast

sure is impossible ( Fig. 5-31 ). Finger adaptation must

continue until the resin no longer springs away from
the cast.
2. The baseplate is too thin in some areas and too
thick in others because of inherent difficulties associ -
ated with finger molding. Convex areas are excessively
thin as a result of finger pressure, and depressions or
inaccessible areas are too thick . Care should be taken
in molding to avoid placing too much pressure over
convex ridge areas boll the resin to the desired thick -
,

ness before adapting it to minimize the thick and thin

spots.

Confined dough methods

Investigators have suggested various methods for
confining or applying pressure to the autopolyinerizing
resin during baseplate construction Elder ( 1955 ) has
applied pressure with modeling plastic, LaVere and
Freda ( 1971) have confined the resin with wax,’ and As-
sadzadik and Yarmond (1975) have made a stone index
to mold the baseplate. Their method offers excellent
control of thickness, reduced finishing time, and mini -
mal porosity. The disadvantages of this method are an
increase in the time required to make the mold and a
tendency to form voids in the baseplate.
Stone - mold method
PROCEDURE
1 . Adapt one layer of baseplate wax over the cast and ,

seal it around the borders to form a wax pattern for the

Fig. 5- 31. A, Baseplate did not fit cast, because resin was beyond
dough stage before finger adaptation was started . B, Interior view
of poorly adapted baseplate. Wrinkles, folds, and lack of adaptation
make baseplate unacceptable.
-
proposed baseplate ( Fig. 5 32) . Fill in the borders of
the baseplate with additional wax to make them of the
proper thickness ( Fig. 5-33). This pattern should dupli -
cate the finished baseplate in thickness and contour;
placing additional wax in undercut areas or over the
midline on maxillary casts can increase the thickness.
2. Place index indentations on the land area of the
cast at four widely separated points with a large round
bur ( Fig . 5-34).
3. Paint separating medium on the stone land areas
( Fig. 5-35 ).
102 Dental laboratory procedures: complete dentures

Fig. 5-28. A, Wooden roller is coated with silicone lubricant to keep resin from sticking. B, Wooden
tray also is coated with silicone lubricant to keep resin from sticking as sheet is rolled to desired 1
thickness. C, Use sheet of cellophane to prevent finger contact with resin dough. D, Resin dough is
rolled to uniform thickness.

Fig. 5- 29. In any method used to make resin sheet, finger adapta-
tion must be continued until resin is well adapted to cast; resin Fig. 5-30. Baseplate fit and adaptation. are checked on cast. This
should not spring away or rebound. baseplate is well adapted.
 1

Baseplates and occlusion rims 103

Table 5-2. Finger - adapted dough method

Problem Probable cause Solution

Failure of baseplate to fit
cast
Baseplate too thin in some
areas and too thick in
others
Resin beyond dough stage before
finger adaptation started
Finger adaptation of resin discon-
tinued too early
Convex areas too thin as result of
finger pressure
Resin not rolled to desired thick -
ness before applying to cast
Adapt resin when in dough stage
Continue finger adaptation of resin until it no longer springs
away from cast
Do not place too much pressure over convex ridge areas
when adapting resin
Roll resin into sheets of proper thickness before adapting to
cast

sure is impossible ( Fig. 5-31 ). Finger adaptation must

continue until the resin no longer springs away from
the cast .
2. The baseplate is too thin in some areas and too
thick in others because of inherent difficulties associ-
ated with finger molding. Convex areas are excessively
thin as a result of finger pressure, and depressions or
.
inaccessible areas are too thick Care should be taken
in molding to avoid placing too much pressure over
.
convex ridge areas Roll the resin to the desired thick -
ness before adapting it to minimize the thick and thin
spots.

Confined dough methods r *4

Fig. 5- 31. A, Baseplate did not fit cast, because resin was beyond
dough stage before finger adaptation was started. B, Interior view
of poorly adapted baseplate. Wrinkles, folds, and lack of adaptation
make baseplate unacceptable.
Investigators have suggested various methods for
confining or applying pressure to the autopolymerizing
resin during baseplate construction. 'Elder (1955) has
applied pressure with modeling plastic. LaVere and
Freda (1974) have confined the resin with wax, and As-
sad zadik and Yarmond ( 1975) have made a stone index
.
to mold the baseplate Their method offers excellent
control of thickness, reduced finishing time, and mini-
mal porosity. The disadvantages of this method are an
increase in the time required to make the mold and a
tendency to form voids in the baseplate.
Stone - mold method
PROCEDURE
1 . Adapt one layer of baseplate wax over the cast , and
seal it around the borders to form a wax pattern for the
proposed baseplate ( Fig. 5-32). Fill in the borders of
the baseplate with additional wax to make them of the
proper thickness ( Fig. 5-33). This pattern should dupli-
cate the finished baseplate in thickness and contour;
placing additional wax in undercut areas or over the
midline on maxillary casts can increase the thickness.
2. Place index indentations on the land area of the
cast at four widely separated points with a large round
bur ( Fig. 5-34 ).
3. Paint separating medium on the stone land areas
( Fig. 5-35 ;
 104 Dental laboratory procedures: complete dentures

Fig. 5-32. One layer of baseplate wax is adapted to cast and Fig. 5 33. Additional wax is added to fill in borders, and wax pattern
-
trimmed to size. is sealed to cast. Borders of cast are marked with pencil to serve
as guide when waxing.

/
\

Fig. 5-34. Index indentations are placed at four widely separated - .

Fig. 5 35 Separating medium should be painted on land areas of
points (arrows ) on land area of cast. They can be made with large stone cast.
round bur.

4. Box the cast and pattern with boxing wax ( Fig. 5-

36). This wax should extend above the cast to make the
stone at least 15 in in thick ( Fig. 5-37).
5. Mix artificial stone with slurry concentrate* to ac-
celerate the set , and vibrate it onto the boxed cast and
pattern ( Fig. 5-38).
6. Allow the boxed stone to set .
7. After setting, remove the stone index ( Fig. 5-39),
and lift the wax pattern from the cast ( Fig. 5-40).
8. Paint tinfoil substitute on the cast and stone index
( Fig. 5-41 ).
9. Reassemble the index and cast to check the fit
( Fig. 5-42 ).

•Slurry concentrate is a thick mixture of water and stone grindings - .

Fig. 5 36 Cast and wax pattern are boxed with boxing wax before
obtained from a cast trimmer The collected slurry is allowed to settle pouring stone.
overnight , and the clear solution is poured oft leaving a clear layer
’
,

approximately 1 inch ( 2.54 cm ) thick. The resultant slurry concentrate

accelerates the set when mixed with artificial stone .

\
'
Fig. 5-37. A, Boxing wax should extend approximately 15 mm above wax pattern to allow stone to
be thick enough to prevent breakage. B, Artificial stone is mixed with slurry water to accelerate set
and poured onto boxed cast and pattern.
>
- .
Fig. 5 38 Surface of poured index is smoothed with spatula.
rf 10 . Block out undercuts on the cast with wax or soft -
curing resin , aspreviously described ( Fig. 5-43).
11. Proportion the autopolyinerizing resin , and mix
according to the manufacturer’s recommendations.
When the mix reaches the dough stage, mold it onto
the cast ( Fig. 5-44 ). Usually , 8 to 10 ml of monomer
and 24 to 30 ml of polymer are enough ; use excess resin
« • to minimize voids .
12. Assemble the index and cast , and maintain clo-
k sure with heavy rubber bands ( Fig. 5-45).
13. Cure the mold in a pressure pot in warm water
at 20 psi for 20 minutes or bench cure it ( Fig. 5-46).
Confinement and pressure from the stone index greatly
~ reduce porosity.
14. After the resin has hardened , open the mold , re-
?
Baseplates and occlusion rims 105
Fig. 5 39. After setting, stone index is separated from cast.
-
move the baseplate, and finish it ( Fig. 5-47 ). Generally,
only minimal finishing is necessary.
PROBLEM AREAS
Problem areas are usually improper thickness of the
stone index, failure to include adequate resin in the
mold , and failure to close the mold completely (Table
5-3).
1 . fhe stone index breaks under pressure when clos-
ing the mold . The probable causes are too thin a stone
index ; failure of the stone to set before pressure is ap-
plied ; use of too much water in the stone mix making it
soft; or use of resin beyond the dough stage when at -
tempting to close the mold . The stone index should be
at least 13 to 15 mm thick . Make certain that the stone
r

Fig. 5-40. Wax pattern is removed, and care is taken to remove all Fig. 5- 41. Tinfoil substitute is painted onto cast and stone index .
traces of wax from cast and index. Soak cast and index in clear slurry water before painting.

Fig. 5-43. Cast undercuts are blocked out with wax or soft -curing
Fig. 5- 42. Cast and index are assembled and examined critically to autopolymerizing resin. Adequate blockout assures removal of
determine fit. baseplate from cast without fracturing baseplate or damaging cast.

A B

Fig. 5- 44. A, Autopolymerizing resin is mixed and applied to cast with spatula. Care should be taken
to place resin into peripheral roll to prevent voids. B, Additional resin is applied to interior of index
with spatula. Careful application of resin to index and cast will reduce voids in completed baseplate.
 Baseplates and occlusion rims 107

A B

Fig. 5 45. A, Cast and index are assembled, and finger pressure is used to express excess restn.
-
Adequate force should be used to achieve stone- to-stone contact because failure to do so would
make baseplate too thick . B, Heavy rubber bands placed around assembled index and cast assure
maintenance of pressure while curing. C, Heavy rubber bands in place.

•
> Fig. 5-46. Curing can be accomplished in pressure pot at 20 psi for
20 minutes, or enclosed resin can be bench cured.
Fig. 5 47. After curing, index and cast are separated, and baseplate
-
is removed, finished, and polished. Note smooth surface on base-
plate produced by stone index .

* ^
108 Dental laboratory procedures: complete dentures

Table 5- 3. Confined dough methods: stone mold method

Problem Probable cause Solution

Breaking of stone index
when pressure applied to
close mold
Voids in completed baseplate
Baseplate too thick
Stone index too thin
Stone not completely set before pres-
sure applied
Improper powder - water ratio used
when mixing stone for index
Resin too stiff before attempting to
close mold
Insufficient resin for filling mold
Mold not completely closed , resulting in
thicker baseplate
Make stone index at least 13 to 15 mm thick
Let stone set before packing resin
Use proper powder- water ratio
Pack resin at dough stage
Mix sufficient resin to overfill mold slightly
Pack mold with resin at proper stage to as-
sure closing of mold

Fig. 5- 48. A , Resin baseplate with voids, probably caused by use of insufficient resin in mold during
packing or by entrapment of air . Smaller voids can be easily repaired. B, Small nonperforating voids
on tissue surface of baseplate can be repaired with autopolymerizing resin.

has set before packing the resin , and pack it only at the
dough stage.
2. The baseplate has voids ( Fig. 5-48). The probable
cause is the insufficient use of resin to fill the mold . Mix
enough resin to overfill the mold slightly.
3. The baseplate is thicker than the pattern. The
probable cause is failure to close the mold completely,
making the baseplate thicker. Usually a mold cannot
close completely as a result of the resin being too still
( Fig. 5-49). Pack the resin at the proper stage to assure
closing of the mold . It is possible to make a second or
duplicate baseplate readily because the mold is avail -
able.
Wax -confined method
LaY'ere and Freda ( 1974 ) have described a method of
making a baseplate from wax and autopolymerizing
acrylic resin . Among the advantages claimed for this
method are that the wax pattern assures the proper
thickness of the baseplate throughout , especially in the
palate, and that the outer wax surface makes the record
base neat and pleasing in appearance.
PROCEDURE
1 . Paint the cast with tinfoil substitute. Apply three
coats , and allow the last coat to set for 10 minutes.
2. Block out all undercuts on the cast with medium -
hard baseplate wax.
3. Adapt one layer of baseplate wax over the blocked
out master cast ( Pig. 5-50) to make a wax form or tray .
Trim the wax 2 mm short of the borders of the cast ( Fig
5-51). *
4 . Make a thin mix of cold -curing acrylic resin tray ma-
terial , using two parts polymer to one part monomer.
\
 Baseplates and occlusion rims 109

.
Fig 5-49. Baseplate will be too thick because cast and index were - .
Fig. 5 50 Undercuts should be blocked out with wax before adap-
not closed completely. tation of wax tray.

.
Fig. 5-51 A, Wax tray is trimmed 2 mm short of borders of cast. B, Maxillary wax tray on cast is
approximately 2 mm short of border reflections. C, Mandibular wax tray on cast is trimmed approxi-
mately 2 mm short of border reflections.
A
110 Dental laboratory procedures: complete dentures
5. Put some of the resin mix in the borders of the
cast and on the palate of the maxillary cast ( Fig. 5-52 ).
6. Pour the rest into the wax form and spread it
evenly on the tissue side ( Fig. 5-53).
7. Invert the wax form, and carefully press the resin
into place on the surface of the cast until it is 1 to 2
nun thick ( Fig. 5-54).
8. Mold the excess acrylic resin over the borders with
the fingers until it is approximately 2 mm thick over the
wax around the borders.
Fig. 5- 52. Resin is mixed and placed onto cast with small spatula.
Acrylic resin is placed into border reflection of cast and into palate
to minimize formation of voids.
Fig. 5- 53. Rest of resin mix is placed into wax tray .
9. Cure the resin for 20 minutes in a pressure cham -
ber at 20 psi , or in warm water ( Fig. 5-55).
10. When cured, remove the baseplate from the cast
( Fig. 5-56), smooth it , and polish it . Do not overheat it .
The blockout adheres to the inside of the resin base.
11 . Fabricate occlusion rims on the record bases.
This method results in a baseplate with a coating of
baseplate wax on the exterior surface ( Fig. 5-57). The
wax coating facilitates addition of a wax occlusion rim or
setting of the denture teeth at a later time.
PROBLEM AREAS
The problems associated with the wax-confined
method are almost the same as those for the other con -
fined resin methods (Table 5-4). However, two prob-
lems are unique to this method : controlling the thick -
ness of the resin layer and keeping the wax exterior
surface free of resin . Seating ( lie wax tray with resin too
firmly makes the baseplate too thin , whereas seating it
too far from the cast makes the baseplate too thick.
Properly seating the wax tray and exercising care in
adapting and smoothing the resin borders minimize
these problems. It requires valuable time to remove
resin that is often inadvertently placed on the exterior
wax surface when adapting the borders.
Fig. 5- 54. Wax tray and resin are placed over cast and settled into
place gently to produce baseplate thickness of approximately 2
^
mm.
 I

Baseplates and occlusion rims 111

Fig. 5 55. Baseplate can be cured in pressure pot at 20 psi for 20

-
minutes.

Fig. 5 56. Cured baseplate after removal from cast is ready for fin-
- - .
Fig. 5 57 Completed baseplates have wax exterior surface that fa-
ishing and polishing. Note that blockout wax (arrows ) remains at- cilitates addition of wax occlusion rim and later setting of teeth.
tached to interior of baseplate.

Table 5-4. Confined dough methods: wax -confined method

Problem Probable cause Solution

Resultant baseplate too thin
Resultant baseplate too thick
Resin on exterior wax sur-
face of baseplate
Wax tray with resin seated too
firmly on cast
Wax tray improperly seated on
cast
Resin inadvertently placed on
exterior wax when adapting
borders
Seat wax tray with resin so as to form layer of resin ap-
proximately 1 to 2 mm thick
Same as above
Carefully adapt and smooth resin borders to keep exterior
wax free of resin
112 Dental laboratory procedures : complete dentures
SHELLAC BASEPLATES
Shellac, derived from the resinous exudate of a scale
insect , is the base of this baseplate material (Greener ,
Hareonrt , and Lau ten sell lager, 1972 ). Other materials, -
such as powdered talc or mica, serve as fillers and in -
crease the baseplate strength. When heated , shellac base-
plates are adaptable to a cast; on cooling, they remain
sufficiently stable for use as satisfactory baseplates. The
material is brown , as are some baseplates, but it is pos -
sible * to bleach and dye it a more esthetic color, usually
pink . Whereas shellac baseplates will adapt to intimate
contact with the cast, they often warp when rewarmed
as a result of the release of stresses Baseplates of shel -
’

lac, a thermoplastic material, also warp when warm wax

is added while forming the occlusion rim and setting Fig. 5-58. Talc is applied to cast to act as separator for shellac
baseplate material.
denture teeth .
The principal advantage of shellac baseplates is the
}
minimal amount of time required to adapt and make
them .' The main disadvantage is the chance of losing
their initial adaptation ; however it is equally true that
shellac baseplates readily readapt . Many dentists prob-
ably agree that although shellac baseplates are useful ,
they are inferior to those made of autopolymerizing res-
ins.

PROCEDURE
1. Soak the cast in clear slurry water to keep the
shellac baseplate from sticking to the cast when heated.
An alternate method is to rub powdered talc onto the
cast before adapting the baseplate ( Fig. 5-58). Failure
to treat the cast or heating the baseplate too much will
make them stick together and possibly damage the cast.
Irill in several undercuts with a mix of one part Hour of
pumice to one part plaster, or soften the baseplate to Fig. 5- 59. Shellac baseplate is positioned over cast and softened
with Bunsen burner. Baseplate should be centered over cast care-
make it withdraw from the undercut without breaking fully to assure that there is adequate baseplate material for borders.
the cast . It is easy to remove the plaster-pumice
mixture later .
2. Pass the baseplate through a Bunsen burner flame
until softened , and place it over the cast , or place the
baseplate on the cast and flame it with a Bunsen burner
( Fig. 5-59). When one shellac blank is not large enough
to cover a cast , it is simple to add a piece of scrap shel -
lac by flame-softening both pieces and readapting them
( Fig. 5-60).
3. Soften the baseplate more with an alcohol torch ,
as needed ( Fig. 5-61). Continue finger molding or use
a spatula to adapt the baseplate around the entire bor-
der (Fig* 5-62 ) .
4. Cool the baseplate and remove it from the cast . If
necessary , trim the borders with an arbor band , fast-cut
stone, or bur. If the lathe turns too fast and too much
pressure is exerted, it will gum up the trimmer ( Fig. 5-
63). Nonclogging rubber abrasive wheels also are avail - Fig. 5-60. Piece of scrap shellac baseplate material can be addec
able for trimming baseplates. to baseplate where needed to cover more of cast.

- .
Fig. 5 61 Alcohol torch can be used to soften baseplate material
in localized areas for adaptation.
Fic Rounded baseplate borders are formed by folding over
shellac baseplate material with spatula.
.
Fig. 5-63 A, Shellac baseplates can be smoothed lightly with arbor band. B, Using too much pres-
sure during finishing results in clogged arbor band.
Baseplates and occlusion rims 113
5. Examine the tissue side for glossy areas that indi -
cate lack of adaptation ( Fig. 5-64 ). Flame these areas ,
and replace the baseplate on the cast for more adapta-
tion .
6. Shellac baseplates should be reinforced . Heavy-
duty paper clips arc a good sourse of wire for reinforce -
ment ( Fig. 5-65). Adapt the wire to the casts ( Fig. 5-
66). Embed a piece of wire across the posterior border
of the maxillary baseplate ( Fig. 5-67). In the mandibular
baseplate, embed it lingually to the crest of the ridge
from premolar area to premolar area ( Fig. 5-67). The
reinforcement significantly improves both the strength
and rigidity of the baseplate.
7. After cooling, store shellac baseplates on the cast to
minimize warpage before use ( Fig. 5-68). Readapt them
later if necessary. To prevent breakage of a shellac
baseplate and /or cast , block out undercuts on the cast ,
or warm the baseplate prior to separation if it extends
-
into the undercut ( Fig. 5 69). Do not overheat or adapt
it to a dry cast because it can stick to the cast ( Fig. 5-
70).
STABILIZED SHELLAC BASEPLATES
Since shellac baseplates tend to warp, investigators
such as Fletcher (1951), Boos (1956), Freese (1956), Ja-
mieson (1956), Kapur and Yurkstas ( 1957 ), Hall ( 1958),
Bodine (1964), and Malson ( 1964 ) have used methods
and materials for stabilizing them . The majority of these
methods rely on the use of a second material , such as
zinc oxide-eugenol impression paste, elastomeric
impression material , or autopolymerizing resin , as a
liner to produce and maintain the desired adaptation
and rigidity.
114 Dental laboratory procedures: complete dentures

A B

Fig. 5 64. A, Glossy surfaces (arrows ) on interior of baseplate indicate lack of adaptation to cast.
-
These surfaces should be flamed and readapated to cast. B, Well-adapted shellac baseplate shows
excellent surface detail.

,a
| lot
IKI
Cl AMI ' S

*0 * 2 IOCAL CLAMPS

ACCO AC CO
12
M IOEAL
30 * 2 IOC. AL CLAMPS CLAMPS

r.

- .
Fig. 5 65 Length of heavy - duty wire paper clip is excellent for rein - - .
Fig. 5 66 Paper -clip wire is adapted to cast. Note position of man -
forcing shellac baseplates. dibular reinforcing wire lingual to crest of alveolar ridge ( left); it
keeps reinforcing wire from interfering with positioning of teeth.
Maxillary reinforcing wire is adapted to cast anterior to posterior
border (right )

Fig. 5 67. Reinforcing

- wires are embedded in shellac baseplates.
 baseplates and occlusion rims 115

A B

Fig. 5-68. A , Completed shellac baseplates, illustrating excellent surface detail. B, Completed shellac
baseplates should be stored on cast until needed to minimize possibility of distortion.

Fig. 5-69. If shellac baseplate is adapted into undercut areas, it Fig. 5-70. Overheating of shellac baseplate during adaptation re-
should be softened and pried out of undercuts gently to prevent sulted in its sticking to cast (arrow ).
damage to cast or baseplate on separation.

Baseplates stabilized with zinc oxide-eugenol
impression paste
Shellac baseplates reinforced with zinc oxide-eu -
genol impression paste exhibit better adaptation and di-
mensional stability and have been in use for some time
M ( Fletcher, 1951; Jamieson , 1956; Kapur and Yurkstas,
1957 ). Zinc-oxide impression materials adapt well to the
cast and can improve the dimensional stability of shellac
baseplates. Their disadvantages are that the baseplates
are thicker because of the thickness of the impression
paste liner, their construction requires additional time,
and bloekout of undercuts on the cast is essential be-
cause the relatively rigid stabilized baseplates cannot
extend into the undercuts.'
116 Dental laboratory procedures: complete dentures
PROCEDURE

1. Identify and block out the undercuts on the cast

with wax or a mix of one part plaster to one part flour
of pumice ( Fig. 5-71).
2. Coat the cast with 0.001-inch (0.0025-cm ) thick
tinfoil ( Fig. 5-72). A toothbrush handle and pencil
eraser may be modified to aid in adapting the tinfoil
( Fig. 5-73).
3. Adapt a shellac baseplate over the tinfoiled cast as u
described previously. Cool the baseplate and remove it
from the cast . r

- .
Fig. 5 71 Undercuts on cast are blocked out with wax or with plas-
ter and pumice mixture before adapting tinfoil.

A I

.
Fig. 5 72 A, Size of tinfoil required to cover cast can be estimated by using base of cast as pattern.
-
B, Tinfoil should be adapted to cast by using cotton burnisher to achieve intimate adaptation. Adap-
tation should be smooth and wrinkle free. C, To prevent tinfoil from coming off cast during adaptation,
small drops of baseplate wax are applied to cast. Tinfoil is adapted over baseplate wax. D, Warm
.
spatula is used to readapt tinfoil over wax drops Wax is melted to seal tinfoil to cast.
 Baseplates and occlusion rims 117

Fig. 5-73. A, Rubber pencil eraser is contoured to wedge shape for use in intimately adapting tinfoil
.
to cast. It is particularly useful in adapting tinfoil into border reflections of cast B, Another view of
0 pencil eraser used to adapt tinfoil to cast . C, Modified pencil eraser is excellent for adapting tinfoil
into borders of cast . D, Side view of toothbrush handle modified to serve as tinfoil burnisher. Ef Front
view of modified toothbrush handle used for burnishing tinfoil. F, Modified toothbrush handle bur-
nisher eliminates small folds in tinfoil to assure smooth surface.
118 Dental laboratory procedures: complete dentures

4 . Make a hole in the palate of the maxillary base-
plate with a No. 8 round bur. Mix zinc oxide eugenol
impression paste* ( Fig. 5-74 ), and place it into the base-
— may be peeled oil if desired . The baseplate is ready for
plate . The hole will allow excess impression material to
escape and to minimize voids ( Fig. 5-75).
5. Replace the baseplate containing zinc-oxide
impression paste on the tin foiled cast in a position that
will make the layer of impression material approxi -
mately 1 mm thick.
6. After it has hardened , remove the baseplate from
' Opotovv Standard ZOE impression paste. Teledyne Dental Products
-
Co., Cetz 0|X > to\v Division , Elk Grove Village, 111. ; Luralitc, Kerr
Manufacturing Co., Romulus. Mich.; Coe- Flo, Coe Laboratories.
Inc. , Chicago. 111. , or equivalent.
the cast . The tinfoil is usually left in the baseplate hut
use ( Fig. 5-76).
PROBLEM AREAS
Failure to adequately block out undercuts on the cast
before constructing the baseplate can cause breakage of
the baseplate or cast (Table 5-5). Using insufficient
impression material or trapping air during seating can
cause voids in the impression paste liner. Unless the
baseplate is seated completely, it will be too thick . To
minimize problems, block out undercuts on the cast ,
use enough impression paste to preclude the formation
of voids, and seat the tray on the cast in a position that
will produce a thin uniform layer of impression mate-
rial .

Fig. 5-74. A, Zinc oxide- eugenol impression paste is proportioned according to manufacturer s rec-
ommendation. B, Spatula is used to blend lighter color material with darker color material on paper
mixing pad. C, Mixing should continue until mix is of uniform color and has no streaks.
 Baseplates and occlusion rims 119

Fig. 5-75. A, Impression material is placed in shellac baseplate. Note hole in palate ( arrow ) to vent
excess impression material and minimize voids. B, Impression material is spread uniformly over in-
terior surface. C, Spatula is used to cover borders of baseplate with zinc oxide-eugenol impression
.
material D, Shellac baseplate with zinc oxide-eugenol impression material is seated carefully on
tinfoiled cast. E, Note extrusion of excess impression material through hole in palate. F, Before zinc
oxide-eugenol impression material sets, excess tinfoil should be reflected back onto baseplate to
make borders of proper thickness.

Baseplates stabilized with elastomeric
impression materials
Freese* ( 1956), Hotline (1964 ) , and Malson (1964 ) have
used rubber base impression materials to stabilize base-
plates. The advantages of using these materials as sta-
bilizers are their inherent flexibility and smooth sur-
face. The flexibility of this type of material permits
baseplate extensions into moderate undercuts and min
imizes the need for blockout of the cast. However, se-
- —
vere undercuts require blockout , since the rubber base
* impression material liner will not be thick enough to
compensate for deep undercuts. The principal disad -
vantage of this procedure is the added thickness of the
baseplate that results from using the elastomeric
impression material liner . This type of baseplate costs
more because of materials and the increase in construc-
tion time.
PROCEDURE
The procedures for constructing a baseplate stabi -
lized with elastomeric impression material are similar
to those using zinc-oxide impression material, as de-
scribed earlier.
1. Apply tinfoil to the cast as previously described
( Fig. 5-77).
2. Make additional holes in the adapted shellac base-
plate with a No. 8 round bur to increase retention of
the liner, and apply adhesive ( Fig. 5-78).
3. Proportion and mix the impression material ac-
cording to the manufacturer’s recommendations.
4. Apply the impression material to the interior of
p*
the baseplate, and seat it on the tinfoiled cast .
5. After it has set, remove the baseplate, and trim
the excess. Peel the tinfoil out of the baseplate.
Baseplates and occlusion rims 121
Fig. 5 77. Tinfoil 0.001 inch thick is adapted to cast.
-
6. The completed baseplate fits the cast accurately
and affords the patient considerable comfort during the
jaw relation recording procedures ( Fig. 5-79 ) .
Baseplates stabilized with autopolymerizing resin
Boos ( 1956), Jamieson ( 1956), and Hall ( 1958) have
stabilized baseplates with autopolymerizing resin .
Similar to zinc oxide eugenol impression paste and
elastomeric impression material , autopolymerizing res-
in used as a liner improves both the adaptation and
rigidity of the baseplate. The disadvantages of
this method are the possibility of warping the baseplate
as a result of internal stresses being released in the
resin liner and the additional time required for fabrica-
tion .
PROCEDURE
The technique for stabilizing a baseplate with auto-
polymerizing resin is similar to those described for zinc -
—
oxide eugenol impression paste.
1. Identify undercuts on the cast , and block them
out with wax . Since the resin liner is rigid , the base-
plate cannot extend into undercut areas without risk
of fracturing the baseplate or damaging the cast on sep-
aration .
2. Apply tinfoil to the cast , or coat it with tinfoil sub-
stitute.
3. Adapt the shellac baseplate to the cast , and trim it
2 mm short of the borders if using autopolymerizing
resin borders.
4. If the cast is not tinfoiled , recoat it with a tinfoil
substitute.
5. Place two holes in the canine area and two in the
first molar regions of the baseplate with a No. 8 round
F:
122 Dental laboratory procedures: complete dentures

A B

, lr
'

C D

m. r
Fig. 5-78. A, Holes are placed in shellac baseplate, and adhesive is painted on baseplate to assure
adhesion of elastomeric impression material. B, Elastomeric impression material is proportioned ac-
cording to manufacturer 's recommendation, mixed, and placed into shellac baseplate. C, Baseplate
with impression material is seated carefully on cast with finger pressure. Note extrusion of impression
material through perforations. D, Tinfoil can be peeled from impression material if desired.

Fig. 5-79. A , Liner of elastomeric impression material permits extension of baseplate into minor un-
dercuts. B, Baseplates lined with elastomeric impression materials fit cast accurately. These base-
plates with soft liners are especially comfortable for patient during jaw relation recording procedures.
 \

Baseplates and occlusion rims 123

Fig. 5-80. A, Autopolymerizing resin is proportioned according to manufacturer’s recommendation

and mixed with spatula. B, Autopolymerizing resin is placed in baseplate with spatula. Note holes
( arrows ) placed in cuspid and premolar regions on each side to aid in minimizing voids.

Fig. 5- 81. Resin- filled baseplate is seated carefully on cast to de- Fig. 5- 82. Baseplate stabilized with layer of autopolymerizing resin
velop layer approximately 1 to 2 mm thick. Failure to seat baseplate is removed from cast and should be stored on cast until ready for
adequately can result in too thick baseplate. use.

bur. Place another hole in the palate when constructing
a maxillary baseplate.
6. Mix autopolymerizing resin , and place it into the
baseplate with a spatula ( Fig. 5-80 ).
7. Seat the baseplate on the cast ( Fig. 5-81 ). Exercise
care in seating the baseplate on the cast to assure a thin
uniform layer of autopolymerizing resin .
8. After it has hardened , remove the baseplate
from the cast , examine it , and polish the borders ( Fig.
5-82).
PROBLEM AREAS
The problem areas for resin-stabilized baseplates are
essentially the same as those for baseplates stabilized
with the materials described in Table 5-5. However,
another problem can result after the autopolymerizing
resin lining is received . The release of internal stresses
in the resin may produce a concomitant warping of the
baseplate. Therefore baseplates fabricated in this man -
ner have few advantages over those constructed en -
tirely of autopolymerizing resin .
 s

Fig. 5-83. A, Sta- Vac vacuum-adapting equipment. (Courtesy Buffalo Dental Manufacturing Co.,
. . .
Brooklyn N.Y.) B, Dentsply Vacu- Press. (Courtesy Dentsply International, Inc. York Pa.) C, Omni-
vac vacuum-adapting device.
 Baseplates and occlusion rims 125
THERMOPLASTIC RESIN BASEPLATES AND
VACUUM- ADAPTED RESIN BASEPLATES
A ' quick and easy method of making a usable base-
plate is to vacuum mold a sheet of thermoplastic resin
to a cast . The performed resin sheet affords excellent
thickness control and reasonably good adaptation to the
cast, particularly when using thinner sheets. Terry and
Wahlberg (1966) have reported obtaining a more inti -
mate adaptation of baseplate material by vacuum adap-
tation than by manual adaptation . Alfred et al. (1968)
have described a method of vacuum molding resin base -
plates. The advantages of this method are simple tech -
nique; minimal amounts of time required; excellent
control of thickness; choice of a variety of materials for
.
Fig 5-84. Cast is positioned on vacuum plate (Omnivac) before baseplates, splints, trays, copings, and mouthguards;
baseplate is vacuum adapted. satisfactory rigidity, particularly when using thicker ma-
terials; and , in SOUK * instances, excellent adaptation to
the cast . The disadvantages are expense of the equip-
ment , difficulty in achieving an intimate adaptation to
the cast in deep recesses and border reflections, and
the problem of forming smooth rounded borders from
only one layer of a resin sheet .
PROCEDURE
1. Examine the cast and identify the undercuts that
require blockout: deep undercuts and delicate creases
-
or folds in the cast . Uso a heat stable blockout com -
pound * to preclude breaking the cast on separation . Do
not use wax because it will melt at the temperatures
required for adaptation .
r 2. Select a resin sheet of the proper thickness, usu -
ally 0.060 inch (0.15 cm ), and rigidity. Thicker material
is better for mandibular baseplates, in which achieving
adequate rigidity may be a problem .
Fig. 5 85. Sheet of resin baseplate material ( Omnivac ) is placed in
- 3. Although the specific directions for molding vary
frame.
with each manufacturer’s equipment and materials, the
principles are similar ( Fig. 5-83). Place the blocked out
cast on the vacuum plate. Make certain that the cast
bases are flat , and the sides are not undercut ( Fig. 5-
?! 84 ).
4. Position a resin sheet of the desired thickness in
the holding frame, and align and activate the heating
unit ( Fig. 5-85).
5. Watch the resin sheet while heating it , and when
it sags approximately V2 incht (1.3 cm ) below the lower
edge of the hinged frame, t lower the frame over the
-
vacuum plate ( Fig. 5 86).

*Omnidental blockout compound. Buffalo Dental Manufacturing Co.,

Brooklyn , N.yV*^
.
tOmnivac baseplate material, 0.060 inch Buffalo Dental Manufactur-
ing Co., Brooklyn . N. Y.
r tOmnivac Precision Vacuum Adapter . Buffalo Dental Manufacturing
Fig. 5-86. Baseplate resin sheet sags ( arrows ) as it is heated Co. , Brooklyn . N . Y.
w*
126 Dental laboratory procedures: complete dentures

6. Drape the material over the cast and activate the
vacuum to complete the adaptation . Keep the heating
unit over the cast until the adaptation is adequate (i .e , .
10 to 15 seconds).
7. Move the heating unit away, and continue the vac-
PROBLEM AREAS
This method presents few problems. It is sometimes
difficult to achieve complete adaptation of the baseplate
material into the vestibular reflections of the cast (Table
5-6). The material has a tendency to bridge these areas ,

uum adaptation for 30 seconds more while the base-
plate cools. Finger adaptation during this phase can of-
ten improve the fit ( Fig. 5-87 ).
8. Remove the adapted baseplate and cast , and
permit them to cool before trimming. It is easy to
cut the material with a bur or arbor band ( Fig. 5-88).
Use a small flame to heat areas in need of more adap-
tation for intimate contact , and adapt them manually
with a moistened thumb or finger. If necessary , rein -
force the baseplate with a wire and autopolymerizing
resin .
particularly when using thick resin sheets. Examination
of the tissue side of adapted baseplates often fails to
indicate the minute tissue detail typical of intimately
adapted baseplates. Often it is necessary to increase the
thickness of the border areas with wax or autopolymer-
izing resin to produce smooth borders of the proper
thickness ( Fig. 5-89). Primary advantages of this
method are the ease and rapidity with which it is pos-
sible to fabricate a baseplate ( Fig. 5-90). The devices
are also useful for constructing mouthguards, impres-
sion trays, and coping patterns.

Fig. 5-87. A, Finger adaptation often can improve fit of baseplate; however, care must be taken
because baseplate can be quite hot . B, Baseplate material is allowed to cool with vacuum-adapting
device still in operation. C, Maxillary baseplate cooling after vacuum adaptation.

O
 1

Baseplates and occlusion rims 127

Fig. 5-88, A. Removal of adapted baseplate from cast Is accomplished by cutting around periphery
with large bur. B, After baseplate material has been cut away from cast, borders can be stripped
away . C, Tongue area (arrow ) of mandibular baseplate is removed by using fissure bur and standard
handpiece. D, Additional finishing can be accomplished easily with large bur in handpiece. E, Arbor
band also is effective for smoothing borders.

r
f
128 Dental laboratory procedures: complete dentures

Table 5-6. Thermoplastic resin baseplate and vacuum- adapted resin baseplate methods
Problem Probable cause Solution

Baseplate unable to be re-
moved from cast
Cast chipped on removal of
baseplate
Baseplate borders not adapted
into vestibular reflections of
cast
Baseplate not intimately
adapted to cast
Deep undercuts not blocked out
Delicate cast undercuts not
blocked out
Vestibular reflections of cast
bridged by baseplate material
Resin not hot enough when ad-
aptation begun
Vacuum molding period too short
Block out deep undercuts with heat stable or nonwax
blockout material
Block out small folds and creases in cast to preclude
bridging
Fill in borders with wax or autopolymerizing resin for
correct thickness and adaptation
Allow resin to develop adequate sag before starting
adaptation
Continue vacuum adaptation for 30 seconds after
discontinuing heating
Readapt by manual adaptation

\
s

Fig. 5-89. A, Border contours can be thickened and rounded by adding baseplate wax. Baseplate
wax should be smoothed to prevent roughness. B, Baseplate wax can be flowed into border areas
to develop desired thickness and contour.

Fig. 5 90. Completed vacuum-adapted baseplates. Principal ad-

-
vantage of this technique is that baseplate can be made in minimal
amount of time.

ar

WAX BASEPLATES
Baseplates constructed of hard baseplate wax are sat-
isfactory ( Boucher , llickev. and Zarb. 1975). The prin -
cipal advantages of this method are that construction of
Baseplates and occlusion rims 129
2. Adapt a reinforcing wire across the posterior bor-
der of the maxillary cast and approximately 2 mm an -
terior to the posterior border. Position the wire rein -
forcement for the mandibular baseplate lingual to the

! a wax baseplate is easy and rapid , and thinning to gain

more space to set teeth is relatively simple. The disad-
vantage of this type of baseplate is primarily its lack of
dimensional stability. Although reinforced with wire ,
baseplates of wax . ' a thermoplastic material, are subject
to warpage when warmed or cooled . They are more
suitable for positioning teeth than for use as bases in
recording maxillomandibular relationships.
PROCEDURE
1 . Dust powdered talc on the east surfaces to act as a
separator.
ridge crest and extend it from premolar region to pre-
molar region . This wire reinforcement will not interfere
with later positioning of the teeth . Remove the wires
for the time being.
3. Outline the peripheral border on the cast with a
pencil to facilitate trimming the wax ( Fig. 5-91).
4. Soften a sheet of hard baseplate wax, and adapt it
carefully to the cast to assure its intimate contact with
the cast surface ( Fig. 5-92 ).
5. Remove the wax, and trim it with scissors to
the approximate contour of the denture border ( Fig.
5-93) .

,4

Fig. 5-91. Borders of cast are outlined with pencil to facilitate trim-
ming wax after adaptation.

.
Fig. 5-92 A, Hard baseplate wax is softened and finger adapted to cast. Note pencil-marked border
shows through translucent wax . B, Care should be taken to assure that baseplate wax is adapted to
cast intimately , particularly in palate and peripheral regions.
Fig. 5 93. Adapted baseplate wax is removed from cast and
- .
Fig. 5-94 ThicKness of baseplate borders is examined, and more
trimmed with scissors. Wax should be trimmed approximately 3 to wax is added if needed to fill out borders to proper contour.
4 mm beyond pencil line, which readily transfers to wax. Additional
wax is folded back onto baseplate to form rounded borders.
(

- .
Fig. 5 95 A, Reinforcing wire is placed approximately 3 mm anterior to posterior extension of base-
plate. It is embedded in wax baseplate to provide additional rigidity. B, More wax is flowed over wire .
C, Wax is flowed over embedded wire and finished to smooth surface.
 V

Baseplates and occlusion rims 131

6. Fold the wax back on itself at the borders to make

a double thickness. Pill out the thickness of the border
and extend it with more wax if needed (Fig. 5-94 ).
*
7. Embed the previously adapted wire reinforcement
in the wax baseplate, and flow additional wax over it to
-
make the surface smooth ( Fig. 5 95).
S. Do not adapt the baseplate into deep undercuts
because there is no blockout of undercuts on the cast.
Warm the wax over the undercuts, and free the base-
plate by several removals and insertions ( Fig. 5-96).
The wax should be smooth and duplicate the border
width of the impression ( Fig. 5-97). Store the com -
pleted wax baseplates on the cast ( Fig. 5-98), and re-
adapt them later if necessary.
PROBLEM AREAS

The principal problem with this method results from
warpage of the wax baseplate after construction (Table
5-7).
Fig. 5 96. Portions of baseplate extending into undercuts can be
-
softened with alcohol torch. Baseplate is placed on cast and re-
moved several times to prevent adaptation of baseplate into under-
cuts.

t
Fig. 5 97. Borders of wax baseplate should be smooth and dupli-
- Fig. 5-98. Completed wax baseplates should fit cast accurately and
cate borders of impression. be stored on cast until needed.

Table 5-7. Wax baseplate method

Problem Probable cause Solution

Failure of wax baseplate to Wax not adapted properly Adapt wax to achieve intimate contact
fix cast Wire reinforcement not used Use wire reinforcement to improve dimensional stability and
rigidity
Baseplate warped after completion Readapt warped baseplate manually
%
132 Dental laboratory procedures: complete dentures

A B

Fig. 5- 99. A, One layer of baseplate wax is adapted to cast. Cutting wax through lingual area facili-
tates smooth adaptation without wrinkles. B, Wax pattern for maxillary baseplate is removed from
cast and trimmed to border extensions. Borders of wax pattern should duplicate desired border thick -
ness and contour of completed denture.

HEAT-CURED COMPRESSION- MOLDED RESIN

BASEPLATES
Generally, heat -cured resin baseplates constructed
by conventional compression- molding methods serve as
record bases and subsequently become denture bases
( Brewer. 1962 ). Wax a pattern on the cast, flask the
cast , eliminate the wax, and pack the heat-curing den -
ture resin into the mold. After the recommended cur-
* i
ing cycle, deflask the baseplate, remove it from the
cast , and polish it . The advantages of this method are
( 1 ) the baseplate is strong and rigid , ( 2 ) it is possible to
control the thickness of the baseplate during the waxing
up, ( 3) it requires only minimal finishing and polishing,
and (4) bases constructed in this manner can serve as Fig. 5- 100. Maxillary and mandibular wax patterns. Note particularly
baseplates for maxillomandibular relationship recording position of finish line on these patterns when used as processed
procedures and setting teeth , and subsequently they bases.
become part of the denture. The disadvantages of this
method are ( 1 ) it is much more time consuming and
expensive to wax , flask , process, and finish the base-
plate; ( 2 ) it is necessary to construct mounting casts be- to the full extension and thickness of the cast as deter-
,

cause flashing and curing usually ruin the master casts; mined from the impression ( Fig. 5-99).
and (3) in the event of a broken or damaged baseplate, 3. Place a finish line on the wax pattern to conform
no cast is immediately available for constructing an - to the contours of the baseplate border and have it ap-
,

other one. proximately 2 to 4 mm from the border. This finish line

PROCEDURE
1. Do not block out cast undercuts.
2. Wax the pattern for the baseplate on the master
cast . One layer of baseplate wax is thick enough for the
ridge, or convex, portions of the cast. Wax the borders
facilitates waxing of the denture setup prior to flashing i
and completion of the denture ( Fig. 5-100 ).
4. Flask the cast and wax pattern in a denture flask
( Fig. 5-101). Boil out the wax and , after cooling the
mold , paint tinfoil substitute on the stone surfaces ( Fig.
5-102).
 £

Baseplates and occlusion rims 133

Fig. 5- 101. A , Mandibular wax pattern half flasked. B,

Maxillary wax pattern half flasked. C, Surface ten-
sion-reducing agent is painted on wax pattern to re-

E
duce bubbles and later surface roughness. D, Flask -
ing is completed by painting vacuum-spatulated
artificial stone on wax with pattern with brush. E, Up-
per part of flask is filled with stone to complete task-
ing procedure.

*
134 Dental laboratory procedures: complete dentures

- .
Fig. 5 102 Wax should be eliminated with clean boiling water. After
cooling, stone is coated with tinfoil substitute.

Fig. 5- 103. Packing is continued until all flash is eliminated.

5. Proportion and mix the denture resin , and place it

into the mold . Trial pack the resin until eliminating all
Hash ( Fig. 5-103) .
6. Use an appropriate curing cycle and . after curing,
bench cool and deflask the baseplates ( Fig. 5 104) - .
7. Smooth the borders and polish to complete the
baseplate ( Fig. 5- 105). It is preferable to store resin
baseplates in water until ready to use them.
PROBLEM AREAS
A potential problem is fracturing the baseplate dur-
ing deHasking (Table 5-8). Since processing usually
ruins the cast , a broken baseplate that is not reparable
necessitates making a new impression unless a previ- m
-
Fig. 5 104. Cured resin baseplate is deflasked carefully . ouslv made duplicate master cast is available.
134 Dental laboratory procedures: complete dentures

Fig. 5- 102. Wax should be eliminated with clean boiling water . After
cooling, stone is coated with tinfoil substitute.

Fig. 5-103. Packing is continued until all flash is eliminated.

5. Proportion and mix the denture resin , and place it

into the mold . Trial pack the * resin until eliminating all
Hash ( Fig. 5-103).
.
6 Use an appropriate curing cycle and . after curing,

M
h bench cool and deflask the baseplates ( Fig. 5 104)
7. Smooth the borders and polish to complete the
- .

f .
baseplate ( Fig. 5-105) It is preferable to store resin
baseplates in water until ready to use them .
PROBLEM AREAS

A potential problem is fracturing the baseplate dur-

Fig. 5- 104. Cured resin baseplate is deflasked carefully.
- .
ing dcflasking (Table 5 8) Since processing usually
ruins the cast , a broken baseplate that is not reparable
necessitates making a new impression unless a previ - _
ouslv made duplicate master cast is available.
134 Dental laboratory procedures : complete dentures

.
Fig. 5-102 Wax should be eliminated with clean boiling water. After
cooling, stone is coated with tinfoil substitute.

Fig. 5- 103. Packing is continued until all flash is eliminated.

5. Proportion and mix the denture resin , and place it

into the mold . Trial pack the resin until eliminating all
Hash ( Fig. 5-103).
6. Use an appropriate curing cycle and , after curing,
bench cool and deHask the baseplates ( Fig. 5-104).
7. Smooth the borders and polish to complete the
baseplate ( Fig. 5- 105). It is preferable to store resin
baseplates in water until ready to use them .
PROBLEM AREAS
A potential problem is fracturing the baseplate dur -
ing deflasking (Table 5-8 ). Since processing usually
ruins the cast , a broken baseplate that is not reparable
necessitates making a new impression unless a previ -
Fig. 5-104 . Cured resin baseplate is deflasked carefully. ously made duplicate master cast is available.
134 Dental laboratory procedures: complete dentures

Fig. 5- 102. Wax should be eliminated with clean boiling water. After
cooling, stone is coated with tinfoil substitute.

Fig. 5- 103. Packing is continued until all flash is eliminated.

5. Proportion and mix the denture resin , and place it

Fig. 5- 104. Cured resin baseplate is deflasked carefully .
into the mold . Trial pack the resin until eliminating all
flash ( Fig. 5-103 ).
6. Use an appropriate curing cycle and . alter curing,
bench cool and deflask the baseplates ( Fig. 5- 104 ).
7. Smooth tlu * borders and polish to complete the
baseplate ( Fig. 5- 105). It is preferable to store resin
baseplates in water until ready to use them.
PROBLEM AREAS
A potential problem is fracturing the baseplate dur-
-
ing dellasking (Table 5 8). Since processing usually
ruins the cast , a broken baseplate that is not reparable
necessitates making a new impression unless a previ -
ously made duplicate master cast is available.
 Baseplates and occlusion rims 135

» .
Fig. 5-105. A, Borders of resin baseplate are smoothed and polished with flour of pumice and rag
wheel. B, Completed mandibular processed baseplate. Note sharp finish lines. C, Completed maxil-
lary and mandibular processed resin baseplates.

i
Table 5-8. Heat -cured compression-molded resin baseplate method
Problem Probable cause Solution

Baseplate broken on removal
from cast
A Baseplate too flexible
Improper prying to remove baseplate
from cast
Cast not painted with tinfoil substitute
or tinfoil substitute contaminated
Wax pattern too thin
Section cast with saw to remove baseplate
Paint cast with uncontaminated tinfoil substitute
before packing
Make wax pattern thick enough to provide ade-
quate rigidity

?
v.

O
-*
(A
7
(
(
LIBRARY
J
136 Dental laboratory procedures: complete dentures
CONSTRUCTING MOUNTING CASTS
( Constructing baseplates by the conventional
compression - molding techniques or by the fluid resin
method usually damages the master casts. Therefore it
is necessary to make mounting casts for transferring
maxillomandibular relationship records to the articula-
tor and for setting teeth .
PROCEDURE
1 . Block out the interior of the processed base w ith
modeling clay to eliminate all interior undercuts ( Fig.
5-106 ). Avoid covering borders to make a firm index on
the cast .
2. Make an artificial stone cast for tin * blocked out
baseplate ( Fig. 5- 107). After the stone has set . separate
the baseplate from the mounting east .
3. Remove the modeling clay from the interior of the
proeessed base , and replace the base on the cast to
check its adaptation ( Fig. 5- 108).
4. Index these casts for use during the maxilloman-
dihular relationship recording procedure ( Fig. 5- 109 ).
borders of baseplate with spatula. C, Baseplates blocked out and ready for construction of mounting
casts.
FLUID RESIN BASEPLATES
Browning (1973) has described a method of using a
fluid resin system to make processed bases in a revers -
ible hydrocolloid mold . This method offers the advan -
tage of rapid retrieval of the processed baseplate from
the hydrocolloid mold after curing. The disadvantages
are the additional time and materials required for wax -
ing. flashing, and processing the processed base or
baseplate.
PROCEDURE
1 . Block out undercuts with baseplate wax when con -
structing a baseplate . This step is unnecessary when
constructing a processed base.
2. Wax the pattern on the master cast . The waxup
determines the thickness of the baseplate, border con -
tours, and extensions. Place a finish line parallel to and
3 to 4 mm awav from the border extension when mak -
ing a permanent base instead of a baseplate ( Fig. 5-
110). For maxillary bases place a palatal finish line lin -
gual to the crest of the ridge . Place more wax lingual to
the heel region of mandibular baseplates and palatal to
the tuberosity region of maxillary baseplates for the
7
sprue attachment .
 .\
V

baseplates and occlusion rims 137

A B

C D

Fig. 5- 107. A, Artificial stone is mixed and placed in interior of blocked out baseplate with spatula. B,
Rest of mix is formed into patties on glass slab. C, Baseplate is settled into patty. Care should be
taken to avoid submerging baseplate and allowing stone to cover sides of baseplate because it would
be impossible to remove baseplates from mounting cast. Tongue area of mandibular casts should be
smoothed with spatula. D, Maxillary and mandibular baseplates and mounting casts are allowed to
set before trimming.

Fig. 5- 108. If baseplate cannot be seated readily on mounting cast

without interference, some adjustment of mounting cast may be re-
quired. Usually, this condition exists when baseplate has been
seated too far into stone.

>
 f
*

138 Dental laboratory procedures: complete dentures

A B

Fig. 5-109. A , Maxillary baseplate and mounting casts. B, Mandibular baseplate and mounting casts.

Fig. 5- 110. If permanent base is being constructed rather than base- Fig. 5- 111. Soaking cast in slurry water under reduced atmospheric
.
plate finish line should be placed on wax pattern. Note finish line pressure expedites wetting of cast and helps to reduce voids in
placed on palate of maxillary wax pattern lingual to crest of ridge. completed baseplate.

3. Soak tin waxed master cast in clear slurry water

* 6. Paint the cast with tinfoil substitute, allow it to
for 5 minutes prior to flashing in reversible hydrocol-
loid . Soaking the cast under reduced atmospheric pres-
sure expedites this step ( Fig. 5- Ill ). Invest the cast in
a reversible hydrocolloid in a special flask* ( Fig. 5- 112 ).
4. Remove the master cast from the set hydrocolloid
mold , and remove the wax from the cast with clean
boiling water ( Fig. 5-113).
5. ( ait sprue holes with a diameter as large as possi -
ble in the hydrocolloid mold to facilitate pouring the
resin and to serve as a shrinkage compensating reser
voir j Fig, 5- 114
dry, and replace the master cast in the hydrocolloid
mold ( Fig. 5- 115).
7. Mix fluid resin * according to the manufacturer’s
recommendations, and pour it into only one sprue hole
of the hydrocolloid mold ( Fig. 5-116). Rock the mold
gently to minimize entrapment of air . Continue pouring
until the resin becomes visible and fills the other sprue
hole.
8. Cure the resin and mold in warm water under 20
- psi air pressure ( Fig. 5- 117).

.
' Pour N Cure llask . Coe Laboratories. Inc. Chicago, Ilk , or equiv
alent .
- *Pour N Cure resin , Coe Laboratories. Inc., Chicago. 111 . , or equiv
alent .
- *
 Baseplates and occlusion rims 139

A
i

+
j

E F

Fig. 5 112. A, Wax pattern for baseplate is placed on soaked cast. Additional wax extensions are
-
placed lingual to heel area of mandibular baseplate or tuberosity of maxillary baseplate (arrows ).
Sprue feeds will be attached to lingual or palatal wax additions. B, Sprue hole cutter is used to cut
sprue through hydrocolloid investing material to lingual wax extension (arrow ). C, Special flask for
flasking casts in reversible hydrocolloid. D, Cast and wax pattern are placed in assembled flask ready
J for pouring reversible hydrocolloid. E, Flask is filled with reversible hydrocolloid. F, Flask containing
i cast and reversible hydrocolloid is placed in cooling tray, and hydrocolloid is allowed to gel.

n
 *

*
Fig. 5- 113. A, When reversible hydrocolloid is poured into flask, it sometimes flows underneath base
of cast. It can be removed easily with knife before removing cast from flask. B, Frequently, it is helpful
to use two knives, one on each side of cast, to pry upward and separate it from hydrocolloid mold.
Care should be taken to avoid damaging hydrocolloid mold. C, After cast has been lifted upward from
hydrocolloid mold, it can be grasped with fingers and removed. D, Wax pattern can be lifted from
cast, and residual wax removed with clean boiling water.

Fig. 5- 114. Sprue hole cutter is used to cut sprue hole through
reversible hydrocolloid. Diameter of sprue cutter should be as large
as possible to facilitate easy pouring of fluid resin.

*
 Baseplates and occlusion rims 141

Fig. 5- 115. Cast should be coated with tinfoil substitute, allowed to

dry, and replaced in hydrocolloid mold.

A B

Fig. 5- 116. A , Cast is assembled in hydrocolloid mold ready for pouring fluid resin. B, Autopolymer -
izing pour-type resin is mixed according to manufacturer’s recommendation and poured into one
sprue hole. Pouring is continued until resin appears in other sprue hole. Voids can be minimized by
rocking flask gently during pouring procedure. Failure to do so can lead to formation of voids and
unusable baseplate.

9. Remove the processed base from the mold ( Fig. 5 -

Fig. 5-117. Flask with hydrocolloid mold filled with pour -type auto-
’ polymerizing resin is placed upright in pressure pot. Then it is cured
at 20 psi in warm water for 20 minutes.
118) and master cast . Cut off the sprues and slightly
polish the borders , thereby completing the fluid resin
-
baseplate ( Fig. 5 119). Making a processed base proba-
bly will ruin the cast , since there is no need to block
out undercuts. In this instance, a mounting cast is es-
sential ; technique for constructing them is described
earlier in this chapter.
PROBLEM AREAS
The chief problem in making fluid resin baseplates is
the failure to obtain a usable baseplate because of in -
complete filling of the mold (Table 5-9). Voids appear
or the mold does not fill completely as a result of en -
trapping air during pouring, making sprues too small or
placing them improperly , using insufficient resin , resin
curing before completing the pour, pouring resin into
both sprues, or not rocking the flask during pouring to
express air.

V
142 Dental laboratory procedures: complete dentures

Fig. 5-118. Cured baseplate and cast are removed from hydrocol-
loid mold. Use of reversible hydrocolloid mold greatly facilitates re-
covery of baseplates from mold.

Fig. 5- 119. A, Resin baseplates are polished in usual manner and stored in water until ready for use.
B, Adaptation of baseplate to cast is excellent . Baseplates fabricated by this technique show minimal
porosity and require little finishing.

4T

Table 5- 9. Fluid resin baseplate method

Problem Probable cause Solution

Baseplate incomplete or voids
present
Insufficient resin mixed
Sprues too small
Sprues improperly placed
Resin poured into both sprues
Pouring delayed and resin set
Flask not rocked during pouring
Mix enough resin to fill mold, usually one denture unit
Use larger diameter sprues
Place sprues to prevent entrapment of air in upper recesses
of mold
Pour resin into one sprue only
Pour resin immediately according to manufacturer s direc -
tions
Rock flask gently during pouring to express air

I sing sprues of larger diameters and pouring the
resin into only one sprue minimize the entrapment of
air. Hock the flask slowly while pouring to facilitate the
flow of resin into all mold recesses. Introducing sprue
feeds below the highest portion of the pattern makes
the entrapment of air almost a certainty. Flute the
sprue attachment to assure rapid unimpeded flow of
resin into the mold . Mix an adequate amount of resin
. one denture unit ), and pour it without unneces
( i.e , -
sary delay to prevent it from becoming too viscous to
pour. Larger sprues also serve as a shrinkage reservoir
to feed more resin into the mold as the curing pro * -
grosses. In spite of the potential problems, baseplates ~
fabricated by this method are excellent .
 Baseplates and occlusion rims 143

ri
-
A

'
* C

Fig. 5- 120. A, Occlusion rims can be made from softened roll of baseplate wax . Care should be

5 taken to ensure that wax is homogeneous. Folds and entrapment of air should be avoided. B, Metal
occlusion rim former can be used to make occlusion rims from baseplate wax or scrap wax ; they can
be made up in advance to be ready for use when needed . ( Courtesy Dentsply International, Inc .,
York , Pa.) C, Occlusion rim forms also can be purchased from different manufacturers. Consistency
of wax can be varied from soft to hard as needed .

METAL BASEPLATES wax, shaped with a metal occlusion rim former , * or

For a detailed description of construction methods
for metal bases see Chapter 17.
!
WAX OCCLUSION RIMS
The majority of occlusion rims are of baseplate wax.
The purpose of a wax occlusion rim is ' to transmit im -
portant information to the dental laboratory technician.
It includes the maxillomandibular relationships, mid -
line. occlusal plane, high and low lip line, cuspid line,
1 amount of horizontal and vertical overlap, and support
.
for the lips and cheeks Usually, occlusion rims art * fur-
nished to the dentist at average predetermined dimen -
sions ; however, the dentist may specify dimensions
when requesting their construction . Often they are
larger than they will be ultimately because the dentist
finds it easier to remove wax from an occlusion rim with
a warm spatula or knife than to add wax to it . Occlusion
rims may be formed with a role of warmed baseplate
preformed blanks can be purchased ready to be adapted
to the baseplate ( Fig. 5-120).
MAXILLARY OCCLUSION RIMS
Jamieson (1956 ) has indicated that the average dis-
tance from the upper sulcus to the incisal edge of the
upper central incisor is 22 mm , and the average dis-
tance from the lower sulcus to the incisal edge of the
lower central incisor is 18 mm, or a total of 40 mm .
Therefore maxillary occlusion rims are usually con -
structed to measure 22 mm from the highest point on
the labial flange to the occlusal surface in the central
incisor region ( Fig. 5- 121 ). Mandibular occlusion rims
should be approximately 18 mm from the lowest part of
the lower labial flange to the occlusal surface in the
central incisor region. The posterior vertical height of
* Bite Kiin Former , Dentsply International, Inc., York . Pa.

I
144 Dental laboratory procedures: complete dentures

.
Fig. 5-121 Maxillary occlusion rim should be approximately 22 mm Fig. 5-122. Posterior height of maxillary occlusion rim should be
long when measured from highest part of vestibular extension to approximately 8 mm when measured from tissue surface of maxil-
incisal edge of occlusion rim. lary baseplate to occlusal surface of occlusion rim.

the maxillary occlusion rim should be approximately 6

to 8 mm , i . e. , 6 mm when measured above from the
baseplate to the top of the occlusion rim , or 8 mm when
measured from the tissue surface of the baseplate, to
allow for a 2 mm thick baseplate ( Fig. 5-122). The facial
incisal edge of the maxillary occlusion rim in the central
incisor area should be approximately 8 mm anterior to
the center of the depression formed by the incisive pa-
pilla ( Fig. 5-123). The curvature of the maxillary occlu -
sion rim should correspond to the overall curvature of
the maxillary arch . The occlusion rim should be approx-
imately 8 mm wide ( Fig. 5-124), and the maxillary oc-
clusion rim should extend posteriorly to a point approx-
imately 1 cm anterior to the hamular notch .

MANDIBULAR OCCLUSION RIMS Fig. 5-123. Facial incisal edge of maxillary wax occlusion rim
should be approximately 7 to 8 mm anterior to center of depression
The mandibular occlusion rim should be approxi - formed by incisive papilla.
mately 18 mm from the incisal edge of the occlusion
rim in the* central incisor area to the deepest part of the
labial vestibule. The occlusion rim should be approxi -
mately 8 mm wide, conform to the overall curvature of
the mandibular residual ridge , and extend posteriorly
to the point on the residual ridge where the ramus of
the mandible begins its vertical ascent ( Fig. 5-125).
PROCEDURE

1 . Warm a sheet of baseplate wax over a Bunsen

burner, and form it into a roll approximately 4 inches
( 10 cm ) long ( Fig. 5-120, A ) .
2. Adapt the wax roll to the baseplate, and seal it
with a spatula ( Fig. 5-126).
3. Contour the wax rim to desired shape and dimen -
sions. A large wax melting plate is useful in establishing
the occlusal surface ( Fig. 5-127).
4. Smooth the wax to eliminate roughness, and check Fig. 5 124. Maxillary occlusion rim should be approximately 8 mm
-
dimensions. wide.
 _ =w

Baseplates and occlusion rims 145 V

Fig. 5 125. A, Mandibular occlusion rim should be approximately 18 mm from incisal edge of occlu-
-
sion rim to deepest part of labial vestibule. B, Occlusion rim should be approximately 8 mm wide and
conform to overall curvature of mandibular residual ridge.

- .
Fig. 5 126 Roll of baseplate wax is sealed to baseplate with hot Fig. 5-127. Large flat metal spatula is convenient for developing
spatula. occlusal surface of occlusion rims.

MODELING PLASTIC OCCLUSION RIMS
Occasionally a dentist makes occlusion rims of
impression compound to record jaw movement , as in
functionally generated path procedures. These occlu -
sion rims are formed from softened modeling plastic
and are adapted to the baseplate in a manner similar to
those made from softened baseplate wax.
SUMMARY
This chapter describes several methods of construct -
ing baseplates. Some methods use only one material ,
whereas others require combinations of materials to
meet specific requirements. Each combination of meth -
ods and materials has advantages and disadvantages.
Undoubtedly, it is possible to construct adequate base-
plates from all of the materials and according to the var -
ious methods described, although some seem to enjoy
more widespread use. Resin baseplates made hv the
sprinkle-on or finger-adapted method satisfy many of
the requirements and probably are in more use than
others. It is essential to know how to construct base-
plates from various materials, using several methods
to have a comprehensive knowledge of dental tech -
nology .
146 Dental laboratory procedures: complete dentures
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.
Assadzadek , A . , and Yarmond, M . A . : A technique for making tem -
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Bodine, ILL. : Essentials of a sound complete denture technique, J .
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.
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*
LaVere , A . M . , and Freda. A . L. : Accurate fitting record bases, J .
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Prosthet . Dent . 16:224- 226 , 1966.
Wienski , J . C . : Stability of lower occlusion rims . Dent . Digest 65:31 .
Jan . , 1959.
Woelfel , J . B . , and Paffenbarger, G . E . : Stability of plastic impression
trays , J . Am . Dent . Assoc . 63:705-706, 1961 .
Zuckerman . A . : Baseplate stability . Dent . Surv . 37:594-595, 1961 .

CHAPTER 6
ARTICULATORS AND MOUNTING
CASTS
KENNETH D . RUDD and ROBERT M. MORROW
articulator A mechanical device that represents the temporoman-
dibular joints and jaw members to which maxillary and mandib-
ular casts can be attached.
mounting The laboratory procedure of attaching maxillary and or
mandibular casts to an articulator or similar instrument
face-bow A caliper-like device that is used to record the relation-
ship of the maxillae to the temporomandibular joint (or opening
axis of the mandible ) and to orient the cast in this same relation-
ship to the opening axis of the articulator.
A representative variety of articulators available to
the dentist is depicted in Figs. 6- 1 to 6-4. Jaw relation
records obtained by the dentist are used to orient casts
for mounting in these articulators. In some instances, a
face-bow record may have been made for mounting the
maxillary cast in the articulator . After the maxillary cast
has been mounted , the mandibular cast is oriented to
the maxillary cast according to the jaw relation record
and mounted in the articulator. Casts can also be
mounted without a face-bow record; then they are po-
sitioned in tlu articulator arbitrarily and attached to the
*
upper and lower members with artificial stone. Al -
though casts can be mounted with plaster of Paris, ar -
tificial stone is preferable because it has less setting ex-
pansion . Slurry concentrate* is used frequently when
IS
mixing the mounting stone to accelerate the set . This
chapter presents methods for mounting casts in several
articulators.
*Slurr \ concentrate is a thick liquid made by grinding stone casts on
a east trimmer.
\*
\
REQUIREMENTS FOR MOUNTING STONE
To a large extent, the ultimate success of a complete
denture restoration depends on an accurate jaw relation
record. However, it is equally important that the accu -
rate jaw relation record be transferred to an articulator
accurately. The material used to mount casts should set
quickly and hard, with only minimal dimensional
change; be strong; separate cleanly from the cast after
use of a separating medium ; and permit reattachment
after processing of the denture. It is essential that the
mounting material does not damage the cast or the ar-
ticulator.
Mounting casts
Denar Mark II articulator and ear - bow record
t
The Denar Mark II articulator is particularly suitable
for complete dentures. The instrument is practical ,
rigid , and easy to use; it also allows casts to be mounted
quickly and easily.
PROCEDURE
1. Prepare the articulator to accept the ear- bow.
2. Set the immediate side-shift adjustments at 0 de-
grees ( Fig . 6-5).
3. Set the progressive side-shift at 5 degrees ( Fig. 6-
6) .
4. Set the protrusive condylar paths at 30 degrees
( Fig. 6-7 ).
. 5. Set the vertical dimension of the incisal pin at 0
(Fig. 6-8).
Text continued on p. 153 .
147
 148 Dental laboratory procedures: complete dentures

Fig. 6 1. A, Denar Mark II articulator, Denar Corp., Anaheim, Calif. B, Dentatus ARH articulator,
-
Almore International, Inc., Portland. Ore.
1*
* \

.
Fig. 6- 2. A, Hanau 154-1 articulator. B Hanau 130-1 articulator. (Courtesy Teledyne Dental Products
Co., Hanau Division, Buffalo, N. Y.)

I
 Articulators and mounting casts 149

••

r
-a

•• Fig. 6- 2, cont’d. C, Hanau 96H2 articulator. D, Hanau 130-28 articulator. E, Hanau H2 Arcon artic-
J
ulator. F, Hanau laboratory technical device.

-2 *

f
I

mid
 150 Dental laboratory procedures : complete dent a res

Mate.
H, Hanau Wide- Vue II articulator. I, Hanau
Fig. 6- 2, cont ' d. G, Hanau Radial Shift articulator .
 \
Articulators and mounting casts 151

Fig. 6 3. Whip-Mix articulator. (Courtesy Whip-Mix Corp., Louisville.

-
Ky.)

Fig. 6 4. Plainline articulator and Buffalo Dental No. 9 articulator. (Courtesy Buffalo Dental Manufac-
-
turing Co., Inc., Brooklyn, N Y.)
152 Dental laboratory procedures: complete dentures

Fig. 6-5. Immediate side- shift adjustment is set at 0 degrees. Lock -

screw is medial to scale ( arrow ).

-w

-.
Fig. 6 7 Protrusive condylar paths are set at 30 degrees (arrows ) . Fig. 6-8. Incisal pin is set at 0.

.
Fig. 6-9. Mounting plate is attached to upper bow and maxillary
cast support to lower bow.
- .
Fig. 6 11 Nylon earplug is removed from ear -bow .
6. Attach a mounting plate to the upper how of the
articulator and maxillary cast support to the lower bow
( Fig. 6-9).
-
7. Set the incisal guide table at 0 degrees ( Fig. 6 10).
8. Remove the nylon earplugs from the ear-bow to
permit its attachment to the articulator ( Fig. 6-11 ).
9. Place the posterior reference pin of the face- bow
in the index holes on the lateral aspect ot the articulator
fossae ( Fig. 6-12 ).
-
10. Place the face bow on the articulator, and adjust
the posterior reference slides to make both scales equal
(Fig. 6- 13 ) .
Articulators and mounting casts 153
- .
Fig. 6 10 Incisal guide table is set at 0 degrees.
-
Fig. 6 12. Posterior reference pin of face-bow is placed in index
holes ( arrow ) on lateral aspect of articulator.
11 . Adjust the maxillary cast support until the sup-
port crossbar contacts the undersurface of the fork with -
out lifting the reference rod from the bearing surface
( Fig. 6-14 ).
-
12. Place the maxillary cast in the face bow record on
the bite fork ( Fig. 6-15).
13. Paint the upper surface of the cast with a sepa -
rating medium * ( Fig. 6 16).-
*Super-Sep, Kerr Manufacturing Co. , Homulus, Mich .
 Fig. 6- 17. A, Artificial stone is placed on base of maxillay cast. Make certain to fill indexing notches
or grooves with stone. B, Stone is placed also in indexes of mounting plate.

Fig. 6- 18. Mounting stone is smoothed with spatula. Fig. 6- 19. Upper bow is removed and placed upside down on
.
bench Mandibular cast and occlusion rim are positioned according
to jaw relation record.

Fig. 6- 20. Lower bow is replaced, and space between cast and Fig. 6-21. Base of cast and index grooves are painted with sepa-
mounting plate is checked. rating medium.
W'

X.

-
Fig. 6 22. Stone is placed on mounting plate on lower bow. - .
Fig. 6 23 Artificial stone is placed on base and in indexing grooves
*
of lower cast.

<

V .

Fig. 6 24. Lower bow is positioned, and care is exercised to see

-
that condyles are seated in their fossae and contact is made be-
- .
Fig. 6 25 Mounting stone is smoothed with knife.

tween incisal pin and incisal table.

18. Remove the lower how, mix the artificial stone

with slurry concentrate, and fill all recesses of the
mounting plate on the lower bow with stone ( Fig. 6-
22). Place more stone on the mandibular cast base, and
make certain to put stone in the indexing grooves ( Fig.
6-23). Turn the lower bow upside down , and seat it on
top ol the upper bow ( Fig. 6-24 ). See that the condyles X

remain in the fossae and that the incisal pin contacts

the incisal table. Lock the centric latch at this time, and
smooth the stone that attaches the mandibular cast to
the lower bow of the instrument for a neat appearance
- .
Fig. 6 26 Mounted casts are ready for setting teeth. ( Fig. 6- 25). Now the mounting is complete ( Fig. 6-26).
a
 Articulators and mounting casts 157

Fig. 6 27. Condylar spheres of articulator should make contact with

-
anterior stops. Then anterior stopscrews are tightened on both
sides of articulator.

•. r

V
t

A B

Fig. 6-28. A, Tightening condylar lockscrews will maintain position of condylar sphere against anterior
stop. B, Note condylar sphere in contact with anterior stop.

Dentatus ARH articulator and face - bow
registration
The Dentatus ARH articulator is a superbly con -
structed semiadjustable articulator that is ideal for con -
struction of a complete denture. Because it is machined
accurately and has an anodized surface, this articulator
functions smoothly, creates an excellent appearance,
and removal of plaster of Paris or dental stone from ar-
W : ticulator surfaces is facilitated .
PROCEDURE
1. Tighten the anterior stopscrews on both sides of
the articulator ( Fig. 6-27).
2. Check to make certain that the condylar spheres
rest against the anterior stopscrews and that they are
secure after tightening the condylar lockscrews ( Fig. 6-
28).
3. Set the condvlar track at 40 degrees and secure it
( Fig. 6-29).
4. Set the incisal guide pin at 0 ( Fig. 6-30).
5. Set the incisal guide table Hat ( Fig. 6-31 )
6. Attach a mounting plate to the upper how of the
articulator, and tighten the lockscrew ( Fig. 6-32).
7. Set the condylar posts at 15 degrees ( Fig. 6-33).
8. Adjust the calibrations on the face-bow slide until
it is possible to obtain the same reading on both sides.
Adjust them until there is a slight tension or spring ef-
-
fect with the face bow to maintain contact between the
condylar rods and the condylar axis of the articulator
( Fig. 6-34 ).
 ' »

Fig. 6- 29. Condylar track is set by loosening setscrews for condylar Fig. 6- 30. Incisal pin lockscrew is loosened, and pin is set at 0.
track inclination. Inclination is set and then secured by tightening Lockscrew is tightened after pin is set.
setscrews. r
ij
«

Fig. 6-31. Incisal table is set flat, and locknut for incisal table is Fig. 6- 32. Mounting plate is attached to upper bow of articulator.
tightened to maintain setting.

Fig. 6-33. Condylar posts are set at 15 degrees. Locknut for con-
dylar post at base of articulator is loosened, post is set at 15 de-
.
grees and locknut is tightened. Adjustment must be made on both
sides of articulator.

>
•
 Articulators and mounting casts 159

9. Place the maxillary cast in the face-bow record ,

and adjust the height of the face- bow by turning the
anterior jackscrew. If using a third point of reference,
*4 adjust the height until the orbital pointer touches the
movable orbital axis plane indicator ( Fig. 6-35).
10. After determining the height , it is possible to
place a maxillary cast support or wooden wedges on the
articulator to support the maxillary cast ( Figs. 6-36 and
6-37). Coat the base of the upper cast with a separating
medium ( Fig. 6-38). Mix artificial stone with slurry con -
centrate to lute the maxillary cast to the upper bow of
the articulator. The mounting plate and articulator sur-
faces contacting the stone may be lightly coated with
silicone lubricant to facilitate cleanup later. Fig. 6-34. Face-bow slides are adjusted until equal on both sides.
This action is predicted on assumption that face-bow record was
made in same manner, with same setting on both sides.

Fig. 6-35. When third point of reference is used, height of cast is Fig. 6-36. After height is adjusted, maxillary cast support is at-
adjusted until orbital pointer tip is at same level as orbital axis plane .
tached to lower bow of articulator Cast support is adjusted to con-
indicator. tact maxillary occlusion rim and is locked securely.

Fig. 6-37. Wooden wedges can be used to support maxillary cast if Fig. 6-38. Base of maxillary cast is painted with separating medium.
cast support is unavailable.
160 Dental laboratory procedures: complete dentures

11. Place stone from this mix on the cast and in the
upper mounting plate to assure the How of stone into
all recesses of the mounting plate and a firm attachment
of the maxillary cast on the articulator ( Fig. 6-39) .
12. Close the articulator slowly until the stone on the
upper part of the cast joins with the stone in the
mounting plate, and tap it gently ( Fig. 6-40).
v
13. Place additional stone wherever required to com -
plete the mounting and fill the voids. It is possible to 1
remove excess stone with a spatula at this time ( Fig. 6-
41). Allowr the stone to set before attaching the mandib-
ular cast. Attach a mounting plate to the lower bow,
and invert the articulator.
H

A B

Fig. 6-39. A, Place stone into index notches B, Additional stone is worked into undercuts of upper
mounting plate.

Fig. 6-40. Articulator is closed and tapped until contact is made Fig. 6- 41. Additional stone can be added to fill voids.
between incisal guide pin and incisal guide table. Then stone
- *

mounting is smoothed with spatula.

>

14 . Relate the mandibular cast to the maxillary cast
4 according to the jaw relation record , and lute them to-
gether with tongue blades and sticky wax. Close the
articulator to check the clearance between the mandib-
ular cast and articulator and to estimate the amount of
stone required for mounting the cast ( Fig. 6-42).
r
-
Fig. 6-42. Articulator is closed to evaluate space between mandib-
ular cast and articulator. This procedure will indicate how much
stone is needed to mount cast .
Fig. 6- 44. Stone is placed on base of mandibular cast.
Articulators and mounting casts 161
15. Paint the base of the mandibular cast with a sep-
arating medium * ( Fig. 6-43).
16. Mix artificial stone with slurry concentrate, place
it on the base of the lower cast , and make certain that
the indexing grooves are full ( Fig. 6-44 ).
17. Place additional stone in the mounting plate on
the lower bow of the articulator ( Fig. 6-45).
*Super-Sep, Kerr Manufacturing Co ., Romulus, Mich .
Fig. 6- 43. Base of mandibular cast is painted with separating me-
dium.
Fig. 6- 45. Additional stone is placed in recesses of lower mounting
plate.
r
162 Dental laboratory procedures: complete dentures

Fig. 6- 46. Articulator is closed and tapped gently to obtain contact

between incisal guide pin and incisal guide table.

A B

Fig. 6 47. A, When trimming mounting stone, blade is held perpendicular to junction of stone and
-
cast. B, Separation of mounting plate from stone can result from trimming stone in this manner.

18. Close the articulator, and remove the excess or

Fig. 6- 48. Mounted casts ready for setup.
add stone wherever necessary to fill voids. While the
stone is soft , tap the articulator lower bow several times
to make certain that the incisal guide pin touches the
incisal guide table ( Fig. 6-46).
19. After the stone has set , remove the attached cast
from the articulator, and trim and smooth the mounting
stone. When trimming the casts, it is best to move the
edge of the knife perpendicular to the border of the
base of the cast and mounting plates ( Fig. 6-47). Mov-
ing the edge parallel, instead of perpendicular, to the
border can cause separation of ftie cast or mounting
plate ( Fig. 6-47, B ). Now the mounted casts are ready
for setting the denture teeth ( Fig. 6-48).

Hanau 130 -28 articulator and arbitrary
mounting
Various models of Hanau articulators have been in
use many years for constructing complete dentures.
Therefore probably the majority of articulators used are
Hanau articulators. In this series, an arbitrary mounting
method and mounting casts with a face- bow record for
the Hanau 130-28 articulator will be described.
This method requires positioning the casts in an ar -
bitral ) or average position in relation to the opening
-
axis of the articulator. It requires no face bow registra -
tion .
Articulators and mounting, casts 163
desired , if using anatomic teeth ), and lock the condylar
elements in contact with the condyle stopserews ( Fig.
6-53).
5. Place a rubber band on the articulator, extending
from the lower annular mark of the incisal guide pin
around each condyle support post . Adjust the rubber
band to form a plane that divides the space between
the upper and lower members of the articulator ( Fig. 6-
54 ).
6. Place three lumps of modeling clay on the lower
mounting plate to serve as an adjustable cast support
( Fig. 6-55).

PROCEDURE

1 . Coat the mounting plate and articulator member

with petroleum jelly or Masque* before attaching the
plate to the articulator ( Fig. 6 49). This procedure helps
-
keep the articulator free of stone and aids in retrieving
the plate from the mounting stone after completion of
the denture.
2. Attach the mounting plates to the articulator and .
if using the older Hanau mounting plate, place a small
square of paper over the threaded hole ( Fig. 6-50). It is
unnecessary to use this paper with new - model Hanau
mounting plates ( Fig. 6 51). -
3. Adjust the incisal guide table to its flat or horizon -
tal position . Set the adjustable incisal guide pin at No.
5 ( Fig. 6-52).
4. Set the horizontal condylar inclination at the ap-
propriate setting ( usually 0 degrees when using 0-
£ degree teeth or 30 degrees or another inclination , as
Fig. 6- 49. Mounting plates and articulator bows are lubricated with
1 " .
Masque The Harry J. Bosworth Co., Chicago. III . petroleum jelly or Masque .

Fig. 6-!#. A , Small piece of paper is placed over threaded hole of older type mounting plates to aid
in preventing stone from penetrating threads and act as spacer when removing mounting and replac-
ing it on articulator. It can prevent separation of mounting plate from stone if particle of stone or wax
gets in threaded hole . B, Lubricant helps hold paper in place .
164 Dental laboratory procedures: complete dentures

Fig. 6-51. Three types of mounting plates: plastic mounting plate

(left ), new closed center mounting plate ( arrow , center ), and open
.
center mounting plate ( right )

Fig. Incisal guide table is set flat, and adjustable incisal guide Fig. 6- 53- Horizontal condylar inclination is set at 0 degrees. How- a
pin is placed at fifth ring. .
ever. setting will vary with type of teeth

Fig. 6-54. Rubber band aids in orienting plane for casts mounted
arbitrarily.
 Articulators and mounting casts 165

7. With the baseplate and the occlusion rims luted

together, place the maxillary and mandibular casts iu
correct relationship on the three clay supports in the
articulator. Then align them until the occlusal plane of
the occlusion rims is parallel to the plane established
by the rubber band ( Fig. 6 56) - .
8. Open the articulator, and paint the base of the
maxillary cast with a separating medium ( Fig. 6-57 ).
9. Mix artificial stone with slurry concentrate and .
using a spatula , add stone to the base of the cast and
mounting plate ( Fig. 6 58). -
10. Close the articulator until the incisal guide pin
touches the incisal guide table , and add stone as
needed to fill voids ( Fig. 6 59). -
11 . After the stone has set , invert the articulator . Re-
move the modeling clay cast supports, paint a separat -
Fig. 6 56, Rubber band serves as reference plane to which occlusal
^
plane of occlusion rims is aligned.
ing medium on the base of the cast , and attach the
lower cast to the articulator with stone ( Fig. 6 60). -

Fig. 6 57. Base of cast

- is painted with separating medium.

A B
V

.
Fig. 6-58 A, Place stone onto base of cast and into index notches. B, Additional stone is placed in
mounting plate.
166 Dental laboratory procedures: complete dentures

Fig. 6- 59. Articulator is closed, and stone is added as needed to fill

B
A

D
C

medium. Care is
Fig. 6-60. A , Stone is placed on base of cast that has been painted with separating
in mounting plate. C,Articulator is closed to
exercised to fill index grooves. B , Stone is placed also
tapped lightly to bring incisal
join stone on cast with stone on mounting plate. D, Lower membrane is
guide pin into contact with incisal guide table.

A B
Fig. 6-61. A, Casts are removed from articulator. B, Mounting stone is trimmed to create neat smooth
appearance.
Fig. 6-62. Occlusal plane of occlusion rim is parallel to "rubber
/ band" plane.
12. Permit the stone to set , then remove the tongue
blades, casts, and mountings from the articulator, and
trim ( Fig. 6-61).
13. Properly mounted casts illustrate the parallelism
of the occlusion rim to the plane established by the
rubber baud ( Fig. 6-62). The mounted casts are ready
for positioning the denture teeth ( Fig. 6-63).
Hanau 130 -28 articulator and face - bow
registration
After accomplishing a face-bow registration, it is used
to mount the maxillary cast in the articulator. After
mounting the ' maxillary cast , orient the mandibular cast
to the mounted maxillary cast , according to the centric
relation record, and attach it to the lower member of
the articulator with artificial stone.
Articulators and mounting casts 167
Fig. 6-63. Arbitrarily mounted casts in articulator.
PROCEDURE
1 . Adjust the articulator as described for the arbitrary
method ; however, the horizontal condylar inclination is
generally set at 30 degrees instead of 0 degrees.
2. Lubricate the mounting plates and articulator
bows with petroleum jelly or Masque as described pre-
viously.
3. Place the assembled face- bow and cast on the ar -
ticulator carefully. Adjust the face- bow condylar slide
registrations until they are the same on both sides ( Fig.
6-64).
- -
4. Whenever a third point of reference record is
available, attach the orbital plane indicator to the artic-
ulator ( Fig. 6-65).
5. Attach the maxillary cast support to the lower
member of the articulator, and adjust the height of the
/i
168 Dental laboratory procedures: complete dentures

Fig. 6-64. Face-bow is assembled on articulator, and face-bow Fig. 6-65. If third point of reference is used, orbital plane indicator
slide registrations are kept equal. is placed on articulator if not already in place.

Fig. 6- 66. Maxillary cast support is adjusted to maintain cast at cor- -

Fig. 6 67. Base of maxillary cast is painted with separating medium.
rect height. Orbital point tip touches orbital plane indicator (arrow ).

Face-bow by way of the anterior jackscrew until the or- 10. The face-bow fork is removed from the occlusion
bital pointer touches the orbital plane indicator ( Fig. 6- rim by warming it over a burner. When the wax has
66 ) . -
softened , withdraw the fork ( Fig. 0 71 ). Make certain to
6. Faint the* maxillary cast base with a separating me- avoid distorting the record.
dium ( Fig. 6-67). 11 . Replace the baseplate and occlusion rims on their
7. Mix artificial stone, and attach the maxillary cast casts, invert the articulator, and assemble the casts ac-
to the articulator as described previously ( Fig. 6 68). - cording to the jaw relation record ( Fig. 6-72). If the
8. After the stone has set , release the face bow from - centric relation record was made at the vertical dimen -
the condylar extensions of the articulator ( Fig. 6-69, A ), sion of occlusion , no compensating adjustment of the
-
and then remove the face bow fork from the face bow - incisal pin is necessary. If the record was made at an
( Fig. 6 69, / ).
- increased vertical dimension , the incisal pin should he
*
9. Remove the mounted maxillary cast from the artic- lengthened by the estimated or measured thickness of
ulator; then remove the baseplate and the occlusion rim the record . Failure to observe this step may result in
^
from the cast ( Fig. 6-70). altering the vertical dimension of occlusion .
 \ rticulators and mounting casts
* 169

A B
\

Fig. 6-68. A , Stone is placed on base of cast coated with separating medium and on mounting plate.
B, Articulator is closed, and stone is added and smoothed wherever required.

A B

Fig. 6-69. A, Face-bow is removed from articulator after stone is set. B, Then face-bow is removed
from face-bow fork.

Fig. 6-70. Occlusion rim and face-bow fork are removed from max -
illary cast .

;\
 4*-

A B

Fig. 6-71. A, Face-bow fork is warmed over burner. Avoid overheating . B, Warmed face-bow fork is
pulled from occlusion rim.

«4.

Fig. 6- 72. Casts joined together according to jaw relation record are Fig. 6-73. Lower cast is attached to articulator as described previ-
assembled in inverted articulator. This procedure makes it possible ously. Too much stone was used in this instance.
to estimate volume of stone needed to attach mandibular cast .

Fig. 6-74. Mounted casts in articulator .

4r
1 Articulators and mounting casts 171
12. Paint the base of the lower cast with a separating
medium , and attach the cast of the articulator with ar-
tificial stone ( Fig. 6- 73).
i * 13. Trim the mounting stone with a knife to give a
neat appearance ( Fig. 6-74 ).
Hanau H2 Arcon Series articulator and ear - bow
record
The Hanau 112 Arcon Series articulator is especially
suitable for construction of a complete denture. Mount -
ing casts in this articulator using an ear- bow record to
orient the maxillary cast will be described.
9 * Fig. 6- 75. Horizontal condylar inclinations are set at vertical, and
thumbnuts are tightened .
*i i
Fig. 6- 77. Incisal guide table is set at 0 degrees.
Ui
PROCEDURE
1 . Adjust the horizontal inclination of both condylar
guides until they are vertical , approximately 90 de-
grees , and tighten the thuinbnuts ( Fig. 6-75).
2. Adjust the lateral indication of both condylar
guides to 0 degrees, and tighten their thuinbnuts ( Fig.
6-76).
3. Adjust the incisal guide to 0 degrees, and tighten
the locknut ( Fig. 6-77).
4. Adjust the incisal pin to align the median registra-
tion groove with the underside of the upper member ,
and tighten the thumbscrew ( Fig. 6-78).
Fig. 6- 76. Lateral indications of both condylar guidances are set at
0 degrees.
Fig. 6-78. Incisal pin is set so that median registration groove of pin
is aligned with underside of upper member .
 172 Dental laboratory procedures: complete dentures

Fig. 6-79. Centric locknut is tightened to allow articulator to operate Fig. 6- 80. Extension stud attached to upper member of articulator
as hinge. permits articulator to be inverted on bench top without special sup-
port.

Fig. 6-81. Articulator surfaces that will be exposed to stone are Fig. 6-82. Mounting plate coated with petroleum jelly is attached to
coated with thin layer of petroleum jelly. upper member of articulator.

A B

<r
Fig. 6- 83. A , Ear -bow with nylon earpiece in place. B , Nylon earpiece is removed from ear -bow.

I
 Articulators and mounting casts 173

5. Tighten the centric lock to restrict the articulator

to opening and closing movements only ( Fig. 6-79).
6. Attach the extension stud ( Fig. 6-80).
J 7. Apply a thin coating of petroleum jelly to all sur-
faces of the articulator that will he exposed to the stone
mounting medium ( Fig. 6-81).
8. Apply a thin coating of petroleum jelly to the
mounting plate, and attach it to the upper member
firmly ( Fig. 6-82).
; 9. Remove the nylon earpiece from the ear-how ( Fig.
6-83). Fully release the frame screws ( Fig. 6-84 ). With -
5 draw the scales from their frames ( Fig. 6 85). -
10. Reverse the scales, and place the condyle com -
.
pensator right ( R ) and left (1 ) at the inside of the bow
.
Fig. 6-84 Frame screws are released to permit withdrawal of ( Fig. 6-86).
scales.

Fig. 6-85. Scales are withdrawn. Fig. 6- 86. Scales are reversed, and condylar compensator is
placed toward articulator. Same procedure is used on both sides.

i*

Fig. 6-87. Scales are adjusted symmetrically, for example, 6.8 mm Fig. 6-88. Mounting jig is secured in place in articulator. Loosening
on each side, and frame thumbscrews are tightened. thumbscrew allows pivot to be raised or lowered .
r •
174 Dental laboratory procedures: complete dentures
Fig. 6- 89. A , Bow is flexed slightly to engage condyle compensators over condyle shafts. Flexing
helps to keep bow in position. B, Note how condyle compensators are positioned.
Fig. 6-90. Bow assembly is lowered to allow bite plane (bite fork )
.
to rest on horizontal study of mounting jig ( arrow )
11 . Engage the frame thumbscrews in the keyway ,
and adjust the scales laterally to 6.8 mm for each side.
Tighten the frame thumbscrews to maintain this sym -
metrical adjustment ( Fig. 6-87).
12. Attach the mounting jig with the horizontal stud
extending forward and in line with the sagittal plane.
Loosen the thumbscrew to lower the pivot of th$
mounting jig ( Fig. 6-88).
13. Flex the bow slightly to engage the condyle com -
pensators over the condylar shafts on the articulator.
The condyle compensators make the average distance
from the condyle center to the patient s external audi-
tory meatus center 12 mm ( Fig. 6-89).
14 . Lower the anterior portion of the bow assembly
to rest the aluminum frontal portion of the bite plane
on the horizontal stud of the mounting jig. This position
makes it possible to align the incisal edge of the maxil -
Fig. 6-91. Pivot is raised to contact undersurface of bite plane, and
thumbscrew is tightened. Mounting jib supports maxillary cast .
lary' occlusion rim imprint at a level with the average
incisal reference notch in the incisal pin, that is 47 mm
below the condylar plane ( Fig. 6-90).
15. Raise the pivot of the mounting jig to contact the
underside of the bite plane, and lock it in position with
thumbscrew to stabilize it and carry the weight of the
maxillary cast and stone mounting medium ( Fig. 6-91 ).
16. Paint the base of the cast with a separating me-
dium ( Fig. 6-92 ).
17. Mount the maxillary cast in the articulator with a
mixture of stone and slurry concentrate. Smooth the
mounting with a spatula, and remove excess stone to
expose the top surface of the mounting plate. This ac-
tion permits convenient removal and accurate reattach -
ment to the articulator ( Fig. 6-93). If the jaw relation r -
record is made by a conventional interocclusal record
method , and not a wafer technique, it is probably bet -
 \ rticulators and mounting casts 175

i
i

-
Fig. 6 92. Base of maxillary cast is painted with separating medium.
j

4
.

.
•

'J

•V
-t

kl
j

S'

’ V i

a
*
. .
Fig. 6-93 A Artificial stone is placed on base of cast and on mounting plate. B, Articulator is closed,
and sides of mounting stone are smoothed. C, Mounting stone is allowed to set . With top of mounting
plate ring visible, it is easy to retrieve plate later.

r*
176 Dental laboratory procedures: complete dentures
ter for the maxillary cast to be mounted in the articu
lator before making the centric jaw relation record. Af-
ter mounting the maxillary cast in the articulator , then
place the indexing grooves in the wax occlusion rim and
record the jaw relation. If using the wafer technique to
record the jaw relationship, it is unnecessary to mount
the maxillary cast before obtaining the jaw relation rec-
ord . However, in this situation it is extremely impor
tant to avoid distorting the wax occlusion rim , since this
distortion could produce an error in the centric jaw re-
lation record .
18. Remove the mounting jig, and attach the mount -
ing plate to the lower member of the articulator ( Fig.
6-94 ).
Fig. 6-94. Mounting plate is attached to lower member of articula-
tor.
Fig. 6- 96. A , Artificial stone is mixed and placed on base of cast. It is essential to apply separating
medium first. B, Articulator is closed, and mounting is completed by adding or removing stone and
by smoothing with spatula.
- 19. Invert the articulator , and place the mandibular
occlusion rim and cast on the maxillary rim by using the
centric jaw relation record to orient the cast ( Fig. 6-95). ^
If the centric relation record was made at a slightly in -
creased vertical dimension because of the thickness of
the wafer, first measure the distance between the top
of the mandibular cast and the articulator ( X dimen-
- sion ). Then take a second measurement from the same
point with the centric relation record in place. Raise
the incisal pin to this difference, or X dimension. Fail -
ure to observe this step may result in altering the ver-
tical dimension .
20. Paint the base of the cast with a separating me-
dium , and mount the mandibular cast in the articulator
-
( Fig. 6 96). This step completes the procedure.
Fig. 6-95. Articulator is inverted, and casts are assembled accord-
ing to jaw relation record. Note how extension stud supports artic-
ulator .

Whip - Mix articulator and unique quick - mount
face - bow
The Whip- Mix articulator.* an instrument in wide-
spread use. facilitates mounting casts for complete den -
tures both quickly and easily , and uses a unique quick -
mount face- bow.
PROCEDURE
l . Adjust the intercondylar distance between the two
condylar elements on the lower frame of the articulator
until it is the same as the condylar width of the patient ,
such as small , medium , or large, as recorded on the
' Whip- Mix Corp.. Louisville, ky.
Fig. 6- 97. Intercondylar distance is set by removing condylar ele-
ments and replacing them in position ( arrow ) corresponding with
index on frame of face-bow .
A B
Fig. 6-98. A , One spacer is used on upper frame to set intercondylar distance at medium, two
spacers are used on each side to set distance at large ( L), and no spacers are used to set distance
at small f'S;. B, Medium ( M ) spacer is in place.
Articulators anil mounting casts 177
-
face bow ( Fig. 6-97). Set the upper frame at the same
width . Add or remove the number of spaces on the
shafts of the condylar guides required for the correct
adjustment of the intercondylar distance on the upper
frame ( Fig. 6-98 ).
2. Set the condylar inclination at 30 degrees ( Fig. 6-
99 ).
3. Attach the mounting plates securely to the upper
and lower frames of the articulator ( Fig. 6-100).
4 . Place the plastic incisal guide table on the lower
frame of the articulator ( Fig. 6- 101 ). Remove the incisal
guide pin at this time.
5. Remove the plastic nasion relator assembly from
the crossbar of the face-bow, and loosen the three
thumbscrews slightly ( Fig. 6- 102 ). While holding one
arm of the face- bow against the body, place first one
pin and then the other on the outer flanges of the con -
dylar guide in the holes on the medial side of the plastic
earpieces ( Fig. 6-103).
6. Press the face- bow arms against the body .
7. l ighten the three thumbscrews while pressing the
face-bow arms against the body.
8. Replace the upper frame of the articulator , with
attached face- bow, onto the lower frame of the articu -
lator to permit the fork toggle of the face- bow to rest
on the plastic incisal guide table ( Fig. 6-104 ).
9. Place the maxillary cast and occlusion rim in the
face- bow registration . A maxillary cast support will pre-
vent displacement of the maxillary cast ( Fig. 6-105).
10. Mix artificial stone with slurry concentrate , and
add stone to the base of the cast . Exercise care in filling
all indentations or indexing grooves ( Fig. 6-106 ) .
11 . Place additional stone on the mounting plate on
the upper frame of the articulator, and close the upper
frame of the articulator gently until it touches the cross-
178 Dental laboratory procedures: complete dentures

Fig. 6-99. Condylar inclination is set at 30 degrees, and thumb- Fig. 6-100. Mounting plates are secured to upper and lower frames
screw is tightened. .
of articulator

Fig. 6- 101. Incisal guide table is placed on lower frame of articula-

tor.

A B

Fig. 6- 102. A , Nasion relator assembly is removed from crossbar of face-bow. B, Thumbnuts are
.
loosened slightly

Fig. 6- 103. One pin and then other pin on outer flanges of condylar
guide are placed in holes on medial side of plastic earpieces, while
one arm of face-bow is held against body. Note that upper frame of
articulator rests on crossbar of face-bow ( arrow ).
Fig. 6- 105. Maxillary cast and occlusion rim are placed in face- bow
registration. Wooden wedges can be used to support maxillary cast
although adjustable cast support is more convenient.
bar of the face- bow again . Caution: Do not use too thick
a mix of mounting stone because it can cause displace-
ment of the cast as the upper frame is closed in posi -
tion .
12. Allow the stone mounting the maxillary cast to
set , and then remove the face-bow from the articulator
( Fig. 6-107).
13. Replace the incisal guide pin in the articulator
with the rounded end down , and set it at an opening of
5 mm ( by aligning the top edge of the bushing on the
pin with the fifth line above the line that encircles the
pin ) ( Fig. 6-108). Optionally, it is possible to lock the
Articulators and mounting casts 179
Fig. 6- 104. Upper frame of articulator and face-bow are replaced
on lower frame to permit fork toggle of face-bow to rest on plastic
incisal guide table.
Fig. 6- 106. Base of cast is painted with separating medium, artificial
stone is placed on base of cast , and care is exercised to fill index
grooves or notches.
upper and lower bows of the articulator into a hinge
-
rotation by moving the side shift guides to the extreme
negative position , which is as far out as possible. When
locking them, see that the articulator is not opened too
far, and modify the mounting instructions for the man -
dibular cast in accordance with the hinge action of the
locked articulator.
14 . Invert the upper frame of the articulator, thereby
positioning the maxillary cast with its occlusion rim sur-
face up, and lute the mandibular cast to the maxillary
cast according to the centric jaw relation record ( Fig. 6-
109).
 r
180 Dental laboratory procedures: complete dentures

A B

Fig. 6-107. A, Artificial stone is allowed to set. B, Face-bow is removed from articulator by loosening
setscrew on fork toggle.

A B

*
Fig. 6-108. A, Incisal guide pin is replaced with rounded end down, and set at 5-mm opening. B,
Articulator is locked into hinge rotation by moving side-shift guides out as far as possible.

Fig. 6- 109. Articulator is placed upside down on bench, and cast is

-s
Fig. 6-110. Artificial stone is placed in base of mandibular cast that
assembled according to centric jaw relation record and luted to- has been painted with separating medium.
gether.

i&t
 Articulators and mounting casts 181

15. Paint the mandibular east with a separating me-

- .
Fig. 6 111 Lower frame is seated in position. Make certain that
condylar elements are in position and incisal guide pin touches in-
cisal guide table.
dium to permit separation of the cast from the mount -
ing stone later. Mix artificial stone with slurry' concen -
trate to form a smooth consistency. Apply stone to the
base of the mandibular cast, and make certain that the
indexing grooves or notches contain stone ( Fig. 6-110).
16. Place additional stone in the mounting plate on
the lower frame of the articulator, and seat the lower
frame in position over the upper frame of the articulator
( Fig. 6- 111 ). Make certain that the condylar elements
are in the correct position and the incisal guide pin con -
tacts the incisal guide table. * Allow the stone to set
( Fig. 6- 112 ).
PROBLEM AREAS
The principal problems with mounting casts in artic-
ulators are summarized in Table 6-1.
Split remounting plates
The advantages of using split remounting platest and
the procedure for placing split remounting plates in the
cast are presented in Chapter 4 .

PROCEDURE
1 . Assemble the split remounting plate on the cast ,
and insert the tapered pin ( Fig. 6- 113) .
2. Place the cast in the face- bow registration on the
articulator. When using an arbitrary cast mounting, po-
sition the casts as described previously. Wrap a strip of
masking tape IV2 inches (3.8 cm ) wide around the cast
to confine the mounting stone ( Pig. 6-114).

* Kefer to the Whip- Mix articulator and quick- mount face-bow in -

struction manual for setting the guidance of the articulator.
.
Fig. 6-112 Mounted casts trimmed. .
tTeledvne Dental Products Co.. Ilanau Division Buffalo, \ . V.

Table 6-1. Mounting casts

Problem Probable cause Solution

Articulator settings not adjusted
according to specification
Relationship of mounted casts
incorrect
Casts unable to be separated
from mounting stone
Manufacturer’s recommendation as
to adjustment of articulator not fol-
lowed
Incorrect jaw relation record used for
mounting
Casts not seated accurately in base-
plates
Occlusion rims not seated accurately
in jaw relation record
Cast relationship changed by jostling
casts when mounting
Vertical dimension altered
Failure to paint base of cast with
separating medium
Set instrument according to manufacturer 's directions
Obtain a new jaw relation record
Make certain that casts are completely seated in
baseplates and that baseplates are not warped
Check that occlusion rims are joined accurately, ac-
cording to jaw relation record
Add mounting stone carefully to avoid moving casts
out of position
Incisal pin not changed to X dimension with centric
relation record in place when mounting mandibular
cast
Paint base of cast and index grooves with separating
medium
 180 Dental laboratory procedures: complete de > hi rv> «
I *

182 Dental laboratory procedures: complete dentures

Fig. 6 113. Split remounting plate is assembled on cast, and ta-

- - .
Fig. 6 114 Strip of masking tape is wrapped around cast to confine
pered pin is inserted. stone.

.
Fig. 6 115 Articulator is closed to make certain that tape is not too Fig. 6-116. Small hole is placed in tape for tapered pin (arrow ).
-
high. Note that rubber band helps hold tape in position.

Fig. 6-117. Base of cast is painted with separating medium. Fig 6 118. Artificial stone is worked into undercuts of remounting
-
.
plate

A
184 Dental laboratory procedures: complete dentures
Fig. 6 122. A, Cast can be removed from mounting stone and reattached quickly. B, Metal plates
-
make adaptation precise and positioning of cast on mounting stone accurate.
The principal advantages of the split remounting
plate are quick removal and replacement from the artic-
ulator and precise adaptation through the metal plates
( Fig. 6- 122 ). The principal disadvantage is the extra
time required to place the plate in the cast and to re-
trieve it after completion of the denture.
Retrieving mounting plates
Bange* has developed a mounting plate ejector for
quick retrieval of Hanau mounting plates from the
mounting stone. The ejector works only on older
mounting plates that are through-threaded. It is impos-
sible to separate the new plates, which are closed on
the cast surface by this method .
Conventional separation methods often are time con -
suming , laborious, and harmful to the mounting plates.
One method requires the use of a dental laboratory
knife placed at the junction of the gypsum and mount-
•Bange, A . A.: Personal communication, 1977.
Fig. 6 123. Mounting plate ejector (left ) and older style mounting
-
plate (right ). Plastic tips are placed on ejector to prevent damage
to mounting plate ( arrows ).
ing plate. It is necessary to strike the knife with a ham -
mer to cleave the mounting gypsum from the mounting
plate. Tapping the remaining mounting gypsum with a
hammer releases it from retention areas of the mount -
ing plate. This method , which defaces the metal
mounting plate with dents and nicks , affects the preci -
sion fit of the mounting plate to the Hanau articulator.
The mounting plate ejector rapidly and efficiently
separates dental gypsum products used in mounting
casts on Hanau articulators from Hanau mounting
plates ( rings). Its use avoids damage to Hanau mounting
plates, maintains their accuracy, and greatly increases
.
their longevity It is useful also in cleaning and truing
the threads of mounting plates damaged by other meth -
ods of separation .
To construct the mounting plate ejector, attach a
knurled metal knob to a Vie inch (0.8-cm) twenty-four-
threaded holt ( Fig. 6-123). Extend the bolt ZA inch
(1.91 cm) beyond the knob. Drill and tap a metal pres-
.
sure plate 21A inch (5.72 cm ) long Vs inch (1.6 cm ) wide
0

and lA inch (0.64 cm ) thick to allow screwing of the
knurled knob and holt through it . Slots placed in the
ends of the metal pressure plate and rubber or plastic
tips inserted in these slots will prevent damage to the
softer metal of the mounting plate.
PROCEDURE
1 . Thread the ejection bolt into the mounting plate
until pressure is felt against the mounting stone ( Fig. 6-
124).
2. Turn the pressure plate down snugly against the
mounting plate ( Fig. 6-125).
3. Apply pressure by turning the knurled knob clock -
wise until the mounting plate ejects from the mounting
stone ( Fig. 6-126 ).
l
V
"
<4
Fig. 6-125..Pressure plate is turned down to contact mounting plate.
Articulators and mounting casts 185
4. Turn the mounting plate over, and then tap out
any stone remaining in the retentive areas of the
- mounting plate. The rubber or plastic tip prevents
damage to the mounting plates during the tapping pro-
cess ( Fig. 6-127).
An alternate conventional method of separation is to
place a small piece of carding wax in the threaded hole
of the mounting plate and tighten the mounting plate
onto the threaded lockscrew of the Hanau articulator
until the mounting gypsum pops out of the mounting
plate. This method can damage the threads of the
mounting plate if it is not perpendicular to the pressure
plate; it also can damage the Hanau articulator. How-
ever, use of this method has led to development of the
mounting plate ejector.
Fig. 6-124. Ejector bolt is screwed into mounting plate until pres-
sure from stone is felt.
 184 Drntnl -
/ / # / •/ » * / *#

186 Dental laboratory procedures: complete dentures

Fig. 6- 126. A , Knurled knob is turned to apply pressure. Note stone separating from mounting plate.
B, Stone is separated from mounting plate.

Fig. 6- 127. Remaining stone
SUMMARY
In this chapter methods for mounting casts in several
different articulators were described , as well as the use
of split remounting plates and the mounting plate-ejec-
tor method for retrieving mounting plates from mount -
ing stone.
BIBLIOGRAPHY
Air Forte Manual 160-29: Dental laboratory technicians’ manual , A.
.
Washington , D C ' . 1959 , United States Air Force, pp. 101- 102.
.
Hiekev J .C. , and Zarb, G. A.: Boucher’s prosthodontic treatment for
edentulous patients, ed. 9, St . Louis, 19M , The C.V. Mosby Co.
Sharry . J . J .: Complete denture prosthodontics, ed. 3, New York ,
.
1974 McGraw-Hill Book Co. , pp. 211 -240.
Sowter . J . B.: Dental laboratory technology : prosthodontic tech -
niques, ( bapel H i l l N.C 1968, Die University
. North Carolina
is tapped from mounting plate. Press, pp. 49-50.
CHAPTER 7
ARTIFICIAL TEETH AND GOLD
OCCLUSALS
KENNETH D. RUDD, ROBERT M. MORROW, CLARENCE L. KOEHNE,
and WILLIAM B. AKERLY
artificial teeth Teeth fabricated for a prosthesis: usually made of
porcelain or plastic.
anatomic teeth Artificial teeth that closely resemble the anatomic
form of natural unabraded teeth .
nonanatomic teeth Artificial teeth in which the occlusal surfaces
are not copies from natural forms, but are given forms that, in
the opinion of the designer, seem more nearly to fulfill the re-
quirements of mastication, tissue tolerance, etc.
cuspless teeth Teeth designed without cuspal prominences on the
masticatory surfaces.
zero-degree teeth Prosthetic teeth having no cusp angles in rela-
tion to the horizontal plane: cuspless teeth,
metal-insert teeth Artificial teeth, usually of acrylic resin, contain-
ing an inserted ribbon of metal or a cutting blade in their occlu-
sal surface, with one edge of the blade exposed. Sometimes
they are used in removable dentures . able click in function and can accumulate stain around
There are an estimated 20 million edentulous Amer-
icans and an additional 10 million who are edentulous
in one arch . Additional millions have various missing
natural teeth that are in many instances replaced with
removable partial dentures. Obviously , a considerable
number of artificial teeth are required to restore es-
thetics and function for these patients.
MATERIALS FOR ARTIFICIAL TEETH
Artificial teeth are made of porcelain , resin , and
resin -metal combinations. More porcelain teeth are
used than plastic teeth in the United States where plas-
tic teeth consist of about 30 % ol the market (Encyclo-
pedia Britannica, 1969 ).
Porcelain teeth
Advantages of porcelain teeth include greater wear
resistance than plastic and better retention of surface
polish and finishing. Polishing of the denture base is
facilitated because porcelain is not easily marred or
abraded during routine polishing procedures.
Disadvantages of porcelain teeth include difficulty in
restoring surface polish after grinding. These teeth may
weaken the denture, since they do not bond to the den -
.
ture base resin They are prone to chip or break if
dropped on a hard surface , and they cannot be used in
some instances where available denture space is mini -
mal . In addition , porcelain teeth may produce a notice-
the gingival margin because of a difference in thermal
expansion between porcelain and denture base resin .
Porcelain teeth may also abrade opposing natural teeth
or teeth restored with resin or metal restorations.
Resin teeth
Advantages of plastic teeth include natural appear -
ance and sound , ease in adjustment , restoration of sur-
face polish , break and chip resistance, and most impor-
tantly the capability to bond to most heat-cured
denture base resins. This bonding capability can result
in a strong break - resistant denture and is a particularly
important consideration when constructing overden -
tures.
Disadvantages of resin teeth include less wear resis -
187
i
1 PA

188 Dental laboratory procedures: complete dentures

tance, which can result in a reduced vertical dimension
of occlusion and the tendency to dull in appearance
during use as a result of loss of surface luster. Care
must be taken when polishing the denture to preclude
undesirable modifications in tooth contour. Placing
amalgam restorations in the occlusal surfaces of resin
posterior teeth luts been advocated as a means of im -
proving occlusal wear characteristics (Sowter and Bass ,
1968).
Metal-insert teeth
Advantages of metal-insert teeth include improved
occlusal wear resistance, bonding capability with the
denture base resin , and possibly, improved masticatory
efficiency. Metal - insert teeth are not as noisy as porce-
lain teeth , and they may strengthen the denture ( Fig.
7- 1 ) .
Disadvantages include the cost of metal-insert teeth ,
and they may not be as esthetic as other artificial teeth . 4
‘
Artificial teeth with metal occlusals
Advantages of artificial teeth with metal occlusals in -
clude excellent wear resistance and durability of occlu -
sal contours. They can occlude with natural or restored
dentitions, and their use in some instances mav effec-
tivelv disguise the wearing of complete dentures. In ad -
dition , teeth with metal occlusals can effectively rein -
force the denture, making it more resistant to breakage
( Fig. 7-2) (Schultz, 1951; Wallace , 1964; Davies and
Pound , 1966; Koehne and Morrow, 1970).

A B

-.
Fig. 7 1 A, Lingual bladed teeth. (Manufactured by U S. Shizai Corp., Los Angeles, Calif.) Metal
blades on mesiolingual cusp of first and second maxillary molars and on linqual cusp of second
bicuspid may provide improved chewing efficiency and esthetics. B, Micromold M O posterior teeth
have metal ribbon embedded in resin. ( Denture teeth manufactured by Howmedica, Inc., Chicago,
III.)

-
Fig. 7 2. Denture teeth with metal occlusals can effectively strengthen denture.

1
 Artificial teeth and &old occlusals 189

Components of artificial teeth
Porcelain anterior teeth have metal pins einhedded
into the porcelain for mechanical retention in the den -
A *
' ture base resin ( Fig. 7-3) . Resin anterior teeth do not
have retention pins, since resin teeth bond chemically
to the denture base resin ( Fig . 7- 4 ) . Porcelain posterior
teeth have retentive recesses (diatorics) in the ridge
laps that , when filled with denture base resin , retain
the teeth in the denture base ( Fig. 7 -5) . Resin posterior
teeth do not have diatorics because they are similar to
resin anterior teeth and bond chemically to the denture
base ( Fig. 7-6 ) . Recesses can be placed in resin teeth
ridge laps when the denture is packed to improve the
bond between the tooth and denture .

Porcelain anterior

Collar
labial Mold number

Pins

Crescent
trademark

Fig. 7- 3. Pins embedded in porcelain retain tooth in denture base Fig. 7- 4. Resin teeth bond chemically to denture base resin, thus
.
resin. (Courtesy Dentsply International Inc., York , Pa.) pins are not required. (Courtesy Dentsply International, Inc., York,
Pa.)

Plastic posterior
Porcelain posterior

Lingual finish
Mold
number

Diatoric

Crescent trademark

L* - Crescent trademark
Vent hole

Fig. 7-5. Diatoric holes are filled with resin during packing proce-
dure to retain teeth on denture base. ( Courtesy Dentsply Interna-
.
tional, Inc., York Pa.)
Fig. 7-6. Resin posterior teeth bond chemically to denture base.
Grooves or indentations placed in these teeth before packing den-
ture base resin can improve attachment of tooth to denture base.
.
( Courtesy Dentsply International Inc., York, Pa.)
 i OC r> _ .. * -i i i

190 Dental laboratory procedures: complete dentures

TRUBYTE ® BIOBLEND ® TRU BYTE ® BIO BLEND ® n

Mold 22 E PORCELAIN Blend
number number
/
Right
lateral lateral central central canine canine

6 inches A
(15.24 cm) i

1x6
Lower

number canine lateral central central lateral canine number

«
1x6
Upper >

i
number canine lateral central central lateral canine number !
Fig. 7-7. Representative selection of teeth manufactured by Dentsply International, Inc. (Courtesy
. .
Dentsply International Inc., York Pa.)

M TRUBYTE ® BIOFORM ® S M TRUBYTE ® NEW HUE ® VACUUM FIRED S
min min PORCELAIN B 65 3 N
TRUBYTE ® BIOBLEND ®
42F PLASTIC 114
Fig. 7 7, cont’d. For legend see p. 190.
-
MOLD AND SHADE IDENTIFICATION
Artificial teeth are available in numerous molds and
shades. Mold and shade identifying codes are not stan -
dard throughout the industry . Thus is is necessary to
maintain appropriate mold and shade data in the office
or laboratory' for each manufacturer s teeth .
Mold numbering systems
Some manufacturers have a system-logic mold iden -
tification ; however, all systems are not standard .
Dentsply International , Inc. , has the Trubyte Bio-
form mold numbering system , which uses two numbers
and one letter on the lower left of the tooth mounting
card ( f ig. 7-7). The first number indicates the classifi -
cation of the mold : 1, square; 2, square tapering; 3,
square ovoid; 4 , tapering; 5, tapering ovoid; 6, ovoid;
and 7, square tapering ovoid .
The second number indicates whether the tooth is
long, medium , or short and whether the liabial surface
is straight or convex ineisogingivally: 1 , long, straight ;
2. medium , straight; 3, short , straight; 4 , long, curved;
5, medium , curved; and 6, short , curved .
The letter indicates the width of all six anterior teeth
set on a curve: B, less than 44 mm ; C, 44 to 46 mm ;
I ). 46 to 48 min ; E , 48 to 50 mm ; F or X, 50 to 52 mm;
G, 52 to 54 mm ; 11 . 54 to 56 mm ; and J above 56 mm .
The Lincoln Dental Supply Company has suggested
a system - logic coding system in which universal coded
pf .
numbers would be provided for the shade and mold of
Xrtificial teeth and gold occlusals 191
- U- B 65
TRUBYTE ® BIOBLEND ®
§
0S
T
A
y
42 F PLASTIC 114
V
artificial teeth. The four- to five-digit system is derived
from approximate measurements of the teeth . The first
two numbers in the code would indicate the combined
width of the six anterior teeth on a curve. The third
number would be the width of the central incisor, and
the last one or two numbers would indicate central in -
cisor length ( Fig. 7-8). This system would seem to have
merit and be a positive step toward standardization .
The system could be expanded to include appropriate
identifiers for other characteristics such as tvpal form
(square, tapering, ovoid , etc.)
The Myerson Tooth Corporation identifies molds
with numbers and letters. “ A molds have subtle labial
carvings, slender forms, and excellent balance between
the ridge lap and bite. “ V molds are similar to A “
molds, but have shorter ridge laps. “ P molds have
shorter, less sloping, ridge laps and are well suited for
“
butting* ( Fig. 7-9). A more comprehensive system is
used for Myerson Special teeth . The width of the six
anterior teeth , suggested lower molds, posterior com -
binations, and central incisor width and length are all
indicated on the tooth card , which appears to be an
excellent aid for tooth selection.
Universal teeth are available in a wide range of molds
and shades in plastic (Verident ) and porcelain ( Univac).
Shades are indicated by a letter and number ( P1-P6,
Bl, Y1-Y6, R1- R3) and molds are identified bv letters
and numbers ( M 45) ( Fig. 7-10 ).
Unitek Vita teeth are available in resin and porcelain
 ..
«. -

n i
- — I

192 Dental laboratory procedures: complete dentures

1

ft

Fig. 7-8. Representative group of teeth marketed by Lincoln Dental Supply Co., Philadelphia, Pa.

L
 Artificial teeth and gold occlusals 193

.
Fig. 7 9. Representative teeth manufactured by Myerson Tooth Corp., Cambridge Mass.
-

C 010 B

F
IV
COLOR VERIDENT ® PLASTIC FORM
142
F

- . .
Fig. 7 10 Representative molds of teeth. (Courtesy Universal-Lactona, Morris Plains N.J.)
 ion I
•*
194 Dental laboratory procedures: complete dentures

UNITEK (S)

L VITA ZAHNFAB

z
o
K

O
lA

Fig. 7 11. Vita teeth manufactured by Unitek Corporation. (Courtesy Unitek Corp., Monrovia, Calif . )
-
 Artificial teeth and gold occlusals 195

-
Fig. 7 11, cont’d For legend see p. 194.

in a variety of shades identified by a letter and a num -

- .
ber ( A -1, A -2, B 2, etc ). Mold selections are related to
facial shapes (square, tapering, ovoid, etc. ) ( Fig. 7-11).
Unitek also publishes a convenient tooth shade compar-
ison chart (Tables 7- 1 and 7-2) for porcelain and acrylic
teeth .
The posterior teeth are often identified by the name
of the particular tooth form . Specific molds and shades
are identified by numbers that represent the combined
mesiodistal width of the four posterior teeth and a letter
to indicate the occlusogingival height of the tooth . S,
short; M , medium; and L, long ( Figs. 7-12 and 7-13).
Vivosit and Orthosit denture teeth are manufactured

1
by Ivoclar AO and are marketed by Degussa Dental
Inc. These teeth are made with a new material ( hydro-
phobic pyrolytically made silicium dioxide with a spe-
cial modified Bowen Resin ) ( Michl , 1978) to improve
FFST -
the physical properties of the denture teeth ( Fig. 7- 14 ). Fig. 7- 12. Representative molds and packaging of Imperial teeth
from H . D. Justi Co., Oxnard, Calif.
Vivosit and Orthosit denture teeth are esthetically ex -
cellent , and improved wear resistance over conven -
tional acrylic resin teeth is reported . Maxillary' anterior
 CD
CD

2:

3
£

Table 7-1. Tooth shade comparison chart ( porcelain) *

3
Unitek Justi Dentsply Myerson' s Universal Universal Swissedent Swissedent Dentsply

Vita
Lumin Vacuum Vivostar Bioblend
Aesthetic
M.F.
Univac
Polychrome Univac
Swissedent
Candulor
Swissedent
900 Bioform
r.
*
A -1 Lighter than 17 J 100 Lighter than 1 None None Lighter than 84 Lighter than Closest to 51 cs
A 902
A-2 Lighter than 17 M 104 H Lighter than P 1 B1 86 A 902 Closest to 62
A -3 17 S 27 J 106 66 M Closest to P 3 Lighter than V 2 90 901 65
A -4 29 M Closest to 118 D P9 Closest to Y 5 97 Darker than Less yellow
B 903 than 82
B- 2 17 J Closest to 104 Closest to 1 Lighter than P 1 Closest to B 1 87 A 902 Darker & less
pink than 62 3
c«
B -3 19 M 108 Closest to E Closest to P 3 Closest to Y 3 Lighter than 91 A 901 Closest to 68
B- 4 27 S 27 M Closest to 116 Lighter than D More yellow than Closest to Y 4 Closest to 92 902 Closest to 56
P3
C-1 17 J Darker than 100 1 P1 Less pink than Darker than 86 Less yellow Closest to 91
B1 than A 902
C -2 Darker than 37 M Darker than 106 G Greyer than P 2 More yellow than 90 None Lighter than 94
R2
C-3 39 M 113 69 M Greyer than P 4 Closest to R 4 98 904 Closest to 95
C- 4 Lighter than 39 S Darker than 113 More orange P6 R5 Darker than 99 None Closest to 96
than 69 M
D -2 37 J None None P1 Y 1 None None Closest to 92
D- 3 17 M Closest to 108 Lighter than G P2 R2 90 Darker than Closest to 93
A 902
Courtesy Unitek Corp., Monrovia, Calif .
.
NOTE: Due to the distinctive shade characteristics of Vita * Teeth, exact comparison is not possible This chart is only to be used as a relative guide ( For example Lumin Vacuum Shade C -1 is
somewhat darker than Bioblend Shade 100).

, > / l
Table 7-2. Tooth shade comparison chart (acrylic ) *
Unitek Justi Dentsply Dentsply Dentsply Universal Universal Swissedent Myerson s

Vita Lumin Swissedent Durablend

Acryl- V Imperial Bioblend Bioform Biotone Polychrome Verident 900 Durablend Special

A-1 None Lighter than 100 Lighter than 91 None None B- 1 None None
A -2 None 104 62 59 Darker than B- 1 Slightly darker Lighter than A -902 I
than Y-1
A -3 60 102 52 61 Darker than Y - 1 Y -2 901 H
B- 2 None Closest to 104 59 Lighter than 59 Y-1 Slightly lighter None 58 ( Special)
than Y -3
B- 3 62 108 64 Little more yellow None Closer to Y - 2 Lighter than 904 None
than 61
B- 4 64 116 56 None Y-5 None 903 E
C- 1 None 100 91 Slightly more grey Lighter than R -1 R -1 None Greyer than I
than 59
C- 2 69 Darker than 104 94 None R -2 R -2 Closest to A -902 H (Special)
C-3 Darker than 66 113 65 Lighter than 69 Closest to Y 3- R -3 Closest to 904 G (Special)
C- 4 70 Closest to 113 Between 95-96 69 Y -6 Y -4 903 69 (Special)
D- 3 Lighter than 60 Between 100-102 92 Closest to 59 R -1 Lighter than None Lighter than 60
Y-1 ( Special)
D- 4 65 Between 104 - 69 67 Y -3 Closest to Y- 2 B-902 Lighter than 69
106
D- 5 82 114 81 Darker than 77 Closest to Y -6 Y -6 B-903 C ( Special) 3
E -2 Closest to 62 Lighter than 104 53 None B- 1 Lighter than R -2 Lighter than 900 Between H and I
E-3 More orange 109 65 62 R -3 None B- 901 Lighter than H 2.
£
than 60 ( Special)

Courtesy Unitek Corp., Monrovia. Calif .

NOTE: Due to the distinctive shade characteristics of Vita ’ Teeth exact comparison is not possible. This chart is only to be used as a relative guide . ( For example , Lumin Acryl- V Shade D- 3 is
£
between Bioblend Shades 100 and 102 . )

Cr
D

CO
N 4
198 Dental laboratory procedures: complete dentures

M
A

30
M

UPPER
5

•ii
SLOWER
EN LY INTERNATTONAITTNC.
Fig. 7- 13. Representative posterior teeth. A ., H.D. Justi Co., Oxnard, Calif. B, Myerson Tooth Corp.,
. .
Cambridge Mass. C, Lincoln Dental Supply Co., Philadelphia Pa. D, Courtesy Dentsply International .
.
Inc., York Pa.

IN/DCLAR
S rf • V . i.n
*

IVXLAP 7 IVOOAR ? IV03AP 77

S H - O R .’ Mas ’

?H
if it iti
nxXXAP A 8 78 f \>oCLAO A 8 28 r\ XLAP A 8
*
*

Fig. 7-14. Representative molds of Vivosit anterior teeth and Orthosit posterior teeth.
 Artificial teeth and gold occlusals 199

molds are identified by the letter A and a double digit and the combined width of the four mandibular poste-
All rior teeth . A shade matching chart is also available (Ta -
number . Mandibular anterior molds are ble 7-3).
41.3 8.4 8.0
The American Tooth Manufacturing Co. markets Dy-
identified by the letter A and a single digit number mon - Hue wear- resistant plastic teeth , which are cross-
A1 linked and fluorescent ( Fig. 7- 15, A ). Molds are identi-
. Figures below the mold number from
30.8 7.9 4.4 A 26
fied by numbers and letters , with the
left to right include total width of six anterior teeth , 51 - 9.00
length of central incisor, and width of central incisor. lower numbers left to right indicating total width of the
Posterior molds are identified by the letters N for nor - anterior teeth and width of the central incisor ( Fig. 7-
mal bite, K for cross-bite, and T for overbite. Figures 15, B ). Posterior teeth are available in zero-degree, 10-
N3 degree, 20-degree, anatomical , and short-bite molds
below the mold identifier from left to right
29.3 31.8 ( Fig. 7- 16). Regal Dental Corp. also markets Regal - D-
indicate the combined width of four maxillary posteriors Blend, Regal- D- Luxe, and Novadent plastic teeth ( Fig.

Table 7-3. Orthosit and vivosit teeth: shade matching chart

Greyish-
Shade Pinkish- yellow Yellowish Brownish Greyish-brown yellow Greyish

SR - VIVODENT-PE 1 A 1C 1D 1E 2A 2B 2C 2E 3A 3C 3E 4A 4B 4C 4D 5B 6B 6C 6D

51 66 65 70 52 55 82 68 70 81 82 69 95 77 94 94 69
BIOFORM* 59 62 64 82 81 95
91 67

102 106 100 108 118 118 114 118 110 113 109 110
104 116 112
BIOBLEND - 113
114
116
.
Courtesy Degussa Dental Inc., Placentia Calif. This shade comparison guide can be used to aid in the selection of approximate shade matches.
However, as in several instances specific shades appear in more than one location, this guide can only be an aid in the skill and preferences of the
dentist or technician who must make the final choice .
‘BIOFORM and BIOBLEND are registered trade marks of Dentsply International Inc.

A B

Fig. 7- 15. A , Anterior and posterior Dymon- Hue teeth. B, Mold guide Dymon-Hue anterior teeth.
200 Dental laboratory procedures: complete dent tires

"
V •

-
Fig. 7- 16. Mold guide Dymon-Hue posterior teeth.

.
Fig. 7- 17. Representative denture teeth Regal Dental Corp.
I

-".
v

J
*
v

Fig. 7- 18. IPN Anatoline and IPN Monoline posterior teeth. ( Cour-
. .
tesy Dentsply International York Pa. )
S
 Artificial teeth and gold occlusaLs 201

** REGAL-D- BLEND AND REGAL-D- LUXE

I Mould comparison chart

Bioblend *
Bioform*

Uppers
Regal- D- Blend
Regal- D- Luxe
Bioblend *
Bioform*

Uppers
Regal-D-Blend
Regal-D-Luxe

12E A4 43F F4
12G A7 45F G5
32E B3 45H G7
32G B8 55D H2
21C C1 55F H4
21 D C2 62D J2
21 E C5 62E J3
21 X C6 62G J5
22C D1 75E K4
22D D2 Lowers
22E D3 C 1
22H D6 F 2
42C E1 H 3
42D E2 / N 4
42F E3 O 5
42G E6 P 6
42H E8 R 7
43D F1 S 8
ARTICULATION: The number which is part of the upper anterior mould designation refers to the lower anterior with which it articulates

Shade comparison chart

Bioblend * Regal-D- Blend Bioform * Regal-D-Luxe

100 AX B62 R 62
102 AA B65 R 65
104 BB B66 R 66
106 CC B67 R 67
/
108 DD B69 R 69
* 110 EE
Courtesy - Regal Dental Corp. Massapequa . N. Y .
‘Products of Dentsply International, Inc.

7-17). Molds are identified as square, tapering, ovoid ,

and combinations. Length of central incisor without
oline teeth are furnished in three molds
—
433 and the same eight Bioform shades.
— 429, 431,

collar, width of central incisor, and width of six anteri-

ors on a curve are also provided. A mold and shade
comparison chart is available from the company (see the
box above).
Dentsply International has introduced Trubyte IPN
Anatoline and Monoline zero-degree posterior teeth .
Anatoline and Monoline teeth are made with IPN (In -
ter- penetrating Polymer Network ) tooth material . The
new material reportedly provides a dramatic improve-
ment in abrasion resistance and surface luster retention
( Fig. 7- 18). IPN Anatoline teeth are available in three
——
molds 300, 332, and 334 and eight Bioform—
shades 59, 62, 65, 66, 67, 69, 77, and 81. IPN Mon -
CONSTRUCTING METAL OCCLUSALS
Unquestionably, the use of metal occlusal surfaces on
prosthetic teeth can contribute to their clinical success
( Koelme and Morrow, 1970 ). Metal occlusal surfaces
may be indicated ( 1 ) when constructing a denture that
is to be opposed by a reconstructed dentition with gold
occlusal surfaces; ( 2) when constructing a complete den -
ture, removable partial denture, or overdenture with a
functionally generated path concept in which consider-
able modification of the denture teeth is necessary to
place the occlusal surfaces and core in harmony, (3)
when special wax carving techniques are completed on
202 Dental laboratory procedures: complete dentures

-
Fig. 7- 19. A , Resin posterior teeth are set up and waxed for try
in in usual manner. B, Occlusal view of mandibular resin tooth
setup. C, Occlusal view of maxillary setup.

a fully adjustable articulator, and ( 4 )

when their use is
indicated to reinforce and strengthen the denture or
overdenture.
PROCEDURE
The procedure described is for constructing gold oc-
clusals for complete dentures. The method can be eas-
ily modified for removable partial dentures or overden -
tures.
1. After the jaw relation recording appointment, an -
terior and posterior teeth are positioned for try-in .
Resin posterior teeth are selected , since these teeth
will be cut down before waxing the occlusion ( Fig . 7-
19).
2. Reduce the resin teeth to create space for carving
wax . Reduce the central region of the tooth somewhat
more than the cusps ( Fig. 7-20) .
3. Reduce maxillary and mandibular teeth to provide
approximately 4 mm of interocclusal space. Move artic-
ulator into lateral and protrusive positions to verify
space adequacy ( Fig. 7-21).
4. Add inlay wax to the prepared teeth , and contour
the occlusal surfaces of the individual teeth ( Fig. 7-22 ).
5. Carve secondary anatomic details, and check the
waxed occlusion in centric, lateral , and protrusive po-
sitions ( Fig. 7-23). Note particularly that adequate hor-
izontal overlap has been provided to minimize cheek
biting.
6. Wash the wax occlusal surfaces gently with green
soap, rinse them in cool water, and remove excess wa-
ter with an air syringe .
7. Mix the casting investment compatible with the
metal alloy to be used , and paint it on the occlusal sur -
faces of the wax carvings ( Fig. 7-24 ). Take care to paint
the investment in the grooves of the wax-up to assure
faithful reproduction of the contours.
8. After the investment has set , carefully lift it from
the waxed occlusals. Trim the investment with a sharp
No. 25 blade to reduce excess bulk ( Fig. 7- 25 ).
9. Control the thickness of the castings by trimming
the investment occlusogingivally to produce a casting
thickness of 1 to 2 mm . Reduction is accomplished in
such a manner as to make the gold the same thickness
over the occlusobuccal line angles. This results in a
minimum gold display with an outline that resembles a
three-quarter cast crown ( Fig. 7-26 ).
 1

Artificial teeth and gold occltisals 203

A B

Fig. 7- 20. A , Resin teeth are reduced to created space for carving wax . B, Teeth are reduced some-
what deeper in central portion ( arrows ) than over cusp.

Fig. 7-21. A, There should be approximately 3 to 4 mm of space between upper and lower teeth
when casts are in centric jaw relation position. B, Articulator is moved into eccentric positions, and
space between reduced teeth checked.

10. Flow casting wax into the resultant mold to com -
pletely fill it ( Fig. 7-27).
11 . After the wax has cooled , attach a length of 14-
gauge half- round casting wax, flat surface up , to the wax
pattern . The 14 -gauge wax should be 2 to 3 mm short
of the total pattern length at each end ( Fig. 7- 28) . Paint
clear fingernail polish on the wax, and place small resin -
retention crystals or beads on the tacky surface.
12. Select a large paper clip, bend it to shape, and
sprue the wax pattern ( Fig. 7-29).
13. Add an additional 10-gauge round sprue to the
central portion of the wax pattern ( Fig. 7-30).
14. Reinforce the sprue/ pattern junctions with wax
( Fig. 7-31).
15. Seal the sprued pattern into an appropriate sprue
former ( Fig. 7-32).
16. Flow additional wax over the metal sprue to ease
its withdrawal later ( Fig. 7-33).
17. Securely wax the sprues to the sprue former ( Fig.
7-34).
18. Place the sprued pattern in the casting ring, and
fill with cool water. The investment is thoroughly
soaked to contribute to a smooth juncture with the re-
fractory investment to be added ( Fig. 7-35). After soak -
ing for a few minutes, pour the water from the ring,
and remove excess water by gently shaking. Mix the
investment , and invest the pattern.
19. Complete the burnout and casting procedure in
accordance with the alloy used . Type III gold alloys are
satisfactory. Clean and examine the completed casting
( Fig. 7-36).
 204 Dental laboratory procedures: complete dentures

Fig. 7- 22. A, Inlay wax is flowed on reduced resin teeth, and occlusal surfaces are contoured. B,
Wax patterns carved on mandibular denture teeth. C, Secondary anatomic details are placed in wax
patterns. D, Wax pattern occlusion should be checked in centric position, as well as functional eccen-
tric position.'

- .
Fig. 7 23 A, Lateral positions are checked while carving wax patterns. B, Adequate horizontal over -
lap of at least 1 mm should be provided to prevent possible cheek biting.

e
 Artificial teeth and gold occlusals 205

Fig. 7- 24. Casting investment is mixed and painted carefully on oc- Fig. 7-25. Investment index should be reduced by carving with
clusal surfaces of wax carving. sharp knife.

Fig. 7-26. Occlusal gingival thickness of investment index is re- Fig. 7- 27. Casting wax is flowed into index to make wax pattern.
duced to provide for thickness of 1 to 2 mm in casting. Carving
should be contoured to produce outline form on casting that resem-
bles three-quarter cast crown.

A B

.
Fig. 7-28. A , Strip of 14-gauge half -round wax is placed on wax pattern, flat surface up to provide
retention for acrylic resin. Small crystals or beads are also placed on wax pattern to provide additional
resin retention. B, Note how investment index has been carved (arrows ) to simulate outline of three-
quarter crown on metal occlusals.
206 Dental laboratory procedures: complete dentures

Fig. 7-29. Large paper clip is shaped and used to sprue wax pat - Fig. 7-30. Additional 10-gauge round sprue is extended from bend
of paper clip to central portion of wax pattern and sealed in position.

- .
Fig. 7 31 Junctions (arrows) are smoothed with wax to provide Fig. 7-32. Sprued pattern is sealed to sprue former.
smooth flow of gold into mold with minimal turbulence.

Fig. 7-33. Additional wax is flowed over metal sprue to facilitate Fig. 7-34. Sprue pattern is securely waxed to sprue former.
removal of sprue from casting ring later .

Fig. 7- 35. Sprued pattern and investment index are placed in cast-
ing ring and filled with cool water. Investment is thoroughly soaked
before filling ring with refractory investment.
Fig. 7-37. Note particularly if occlusal carvings have been repro-
duced faithfully.
w 26. Remove the denture teeth with gold occlusals
Fig. 7-38. Sprues are cut off flush with underside of casting .
r
Artificial teeth and gold occlusals 207
Fig. 7-36. Casting is examined carefully to determine that it is sat-
isfactory .
20. Carefully check and remove any nodules on the
casting ( Fig. 7-37).
21. Cut off sprues flush with the underside of the
casting ( Fig. 7-38).
22. Polish the casting to a high luster ( Fig. 7-39).
23. Remove the inlay wax from one upper posterior
quadrant , and place the upper gold occlusal unit in po-
sition . Check the occlusion with the opposing wax oc-
clusals ( Fig. 7-40). Usually the occlusion will be high
and upper resin teeth will need further reduction to
-
accommodate the 14 gauge half- round retentive strip
( Fig. 7-41).
24. After the vertical dimension of occlusion has been
restored , seal the upper gold occlusal unit to the upper
teeth with ivory wax ( Fig. 7-42, A).
25. Remove the wax from the lower teeth , replace it
with the gold occlusal unit, and adjust the resin teeth
as necessary to restore the occlusal vertical dimension .
Seal the lower gold occlusal to the lower resin teeth
with ivory wax ( Fig. 7-42, B ) .
from the articulator. Ivorv wax can be added at this
¥
time to modify the buccal and lingual resin contours if
desired ( Fig. 7-43). Addition of wax facilitates removal
of the resin teeth after the boilout .
27. Flask the teeth with gold occlusal surfaces in the
usual manner. When flashing, depress the buccal sur-
faces in the mold slightly toward the occlusal surface.
This facilitates positive retention of the gold occlusals in
the mold and permits easier removal of the resin teeth
after the boilout ( Fig. 7-44 ).
 208 Dental laboratory procedures: complete dentures

.
‘y*
as&v /
A

.
Fig. 7-39. A Casting should be highly polished. B, Occlusal view of polished gold occlusal.

. nidi
Fig. 7- 40. Maxillary gold occlusal has been placed in position, and
occlusion with opposing wax pattern checked. In this situation ver -
tical dimension of occlusion has been increased, and maxillary
resin teeth will require further reduction to restore vertical dimen
sion of occlusion.
-
Fig. 7- 41. Reduction of posterior resin teeth has resulted in resto-
ration of original vertical dimension of occlusion.

.
Fig. 7-42. A, Upper gold occlusal is sealed to resin teeth with ivory wax B, Upper and lower gold
occlusal units have been sealed to upper and lower teeth with ivory wax .

Fig. 7- 44. A, Teeth are flasked with buccal surfaces facing upward. Buccal surfaces of teeth are
depressed slightly toward occlusal surface to facilitate retention of gold occlusal in mold during pack -
ing. B, Note depression of occlusal surfaces that facilitates retention of gold occlusal in mold.
*
28. Complete the boilout procedure, and remove the
resin denture teeth from the mold . Resin teeth can be
removed easier if wax was flowed on the ridge lap and
lingual aspect of the teeth before flashing ( Fig. 7-45).
Space created by wax removal greatly simplifies remov-
ing the teeth .
29. Scrub the mold with detergent solution to thor-
oughly remove wax residue ( Fig. 7-46 ).
30. Flush the mold with clean boiling water (Fig.
7-47).
31. Paint tinfoil substitute on the stone mold . Avoid
coating the gold with tinfoil substitute ( Fig. 7-48).
32. Add heat -curing tooth-shaded resin to the mold
by the sifting technique ( Fig. 7-49). Powder of the ap-
propriate body shade is placed first and saturated with
heat -curing monomer ( Fig. 7-50).
33. Fill the mold with resin , and keep surface moist
with monomer ( Fig. 7-51).
34. Sift in the incisal shade last to simulate incisal
translueency ( Fig. 7-52). Normally the gold is not
opaqued.
35. Place a plastic sheet over the resin , and close the
flask in a bench press ( Fig. 7-53).
Artificial teeth and gold occlusals 209
Fig. 7- 43. Occlusal units are removed from articulator, and ivory
wax added where needed to modify buccal and lingual resin con-
tours.
36. Remove the flask from the press, open it , and
remove the plastic sheet ( Fig. 7-54 ).
37. Trim the excess Hash with a knife, and continue
trial packing until no Hash is apparent ( Fig. 7-55, A ).
Repaint the upper flask with tinfoil substitute, close the
flask in the compress, and cure it according to the man-
ufactU rer s recom mendations.
38. After curing, open the flask, remove the occlusal
units, and polish them ( Fig. 7-55, B , C , and D ) .
39. Place the gold occlusal units on the baseplates in
the articulator, and wax them for try-in ( Fig. 7-56).
40. Process the denture in the usual manner , and
polish it ( Fig. 7-57 ). Processing errors should be mini -
mal , since the occlusal discrepancy will require grind -
ing of the gold .
PROBLEM AREAS
Principal problems associated with making gold oc-
clusals are related to incorrect cast relationships on the
articulator; failure to carve the wax occlusal surfaces to
harmonize with functional movements; failure to reduce
the investment index to control thickness and the buc-
cal outline of the gold casting; failure to place retention
 210 Dental laboratory procedures: complete dentures

Fig. 7-45. A, Wax is boiled out in usual manner. B , Wax flowed over ridge laps and onto lingual
aspects of resin teeth before flaskmg facilitates removal of teeth after boilout procedure.

Fig. 7-46. Mold is thoroughly cleaned with detergent solution to re-

move all traces of wax residue.

Fig. 7-47. A , Mold is flushed with final rinse of clean boiling water. B. Mold is permitted to cool before
painting with tinfoil substitute. -

v
A

Fig. 7 48. Tinfoil substitute is painted on all parts of gypsum mold

- -
Fig. 7 49. Heat-curing tooth- shaded resins are used to construct
that will contact resin. Take care to avoid coating gold with tinfoil gold occlusal units. (New Hue-Ion has been replaced with Biolon.)
substitute.

.
Fig. 7-50 A, Body shade is sifted into mold first. B, Powder is saturated (arrow ) with monomer from
dropper.

Fig. 7 51. Mold is filled with appropriate body shade resin, and sur
- - - .
Fig. 7 52 Incisal shade is sifted in last to simulate incisal translu-
face is kept moist with monomer. cency and moistened with monomer.
212 Dental laboratory procedures: complete dentures

Fig. 7- 53. Plastic sheet is placed over resin; flask is closed and trial Fig. 7- 54. Flask is removed from press, opened, and plastic sheet
packed in bench press. removed.

> • *

Fig. 7- 55. A , Flash is removed by trimming carefully around teeth with No. 25 blade in Bard-Parker
handle. B, After curing gold occlusal unit, flask is opened, and teeth are removed and polished. C,
Polished gold occlusal unit is ready for repositioning in articulator. D, Gold occlusal unit demonstrating
contour that resembles a three-quarter crown.
 Artificial teeth and gold occlusals 213

Fig. 7 56. A, Gold occlusal units are repositioned on baseplates in articulator and denture rewaxed
-
for try-in. B, Mandibular denture waxed gold occlusal units ready for try-in. C, Maxillary denture with
gold occlusal units waxed for try-in.

wax on the underside of the casting (crystals and 14-

Fig. 7-57. Denture is processed in usual manner; then, it is finished
and polished.
gauge half- round wax form ); overcarving the investment
index, resulting in a thin casting; failure to place wax
on the resin teeth to permit removal from the mold
after blockout ; and packing the occlusal units in the in -
correct shade or with autopolymerizing resin (Table 7-
4 ). Wax carvings for gold occlusals must be completed
on casts mounted properly in the articulator. It could
be difficult and expensive to extensively modify gold
occlusals after processing because of a faulty cast
mounting. The occlusal anatomy in the wax pattern
should harmonize with functional movements of the pa-
tient . Trimming the investment index correctly is criti-
cal to success, since it controls casting occlusogingival
thickness and buccal outline form . Thin castings, as a
result of excessive trimming, may not permit occlusal
correction without perforation after the denture is pro-
W -
214 Dental laboratory procedures : complete dentures

Table 7-4. Gold occlusal units

Problem Probable cause Solution

Occlusion of gold occlusal
units incorrect on insertion of
denture
Gold occlusal units do not
function properly in func-
tional positions on articulator
Gold castings too thick, and
buccal outline is in a straight
line
Casting too thin
Resin teeth cannot be removed
from mold after boilout
Completed gold occlusal units
are of incorrect shade
Jaw relationship and original cast
mounting in error
Articulator settings were disturbed
after mounting
Wax -up not checked in lateral and
protrusive positions
Investment index was not trimmed
properly to produce casting ap-
proximately 2 mm thick with
buccal outline that resembles
three-quarter cast crown
Investment index overtrimmed oc-
clusogingivally
Wax not flowed on ridge laps and
lingual surfaces of resin teeth
before flasking
Body shade selection incorrect
Too much incisal shade used
Make certain that jaw relation record and articulator
mounting are correct before sending to laboratory
Check articulator settings periodically when con-
structing gold occlusals
Carefully adjust wax patterns to accomodate func-
tional positions
Reduce depth of index with sharp knife to produce
casting thickness of approximately 2 mm; buccal
outline must be scalloped to resemble three-
quarter cast crown
Do not overtrim; maintain approximately 2 mm
thickness
Flow wax on ridge laps and lingual surfaces of resin
teeth prior to flasking; resultant space after boil-
out facilitates removal of teeth from mold
Compare shade selector with anterior teeth on artic-
ulator
Do not use excessive amounts of incisal shade

cessed . If a thin layer of wax is not flowed on the ridge
laps and lingual surfaces of the resin teeth before flask -
ing, it may be difficult to remove them after the boilout
without breaking the mold . Gold occlusal units should
be processed in heat -curing resin of the proper shade if
maximum esthetics are to be achieved .
Fabrication of metal occlusal denture teeth
PROCEDURE
1 . Select the type of resin posterior tooth desired for
the metal occlusal form .
2. Hub the teeth lightly on a metal file to flatten the
occlusal surface if monoplane teeth are to be used ( Fig .
7-58) .
3 . Align the teeth iis desired on a Hat surface such as
a glass slab. Lute the teeth together with autopolymer-
izing resin * ( Fig. 7-59 ) .
4 . Modify the teeth , if desired, with inlay wax ( Fig.
7-60) .
5. Lightly rub them on the Hat file to ensure flatness
of the modified composite form ( Fig . 7-61 ).
6 . Apply beading wax around the composite form 1.5
7 . Add clay or wax around the beading wax to enlarge
the base , and box it with boxing wax ( Fig . 7-63) .
8 . Lubricate the occlusal form with a debubblizer* ^
and remove the excess with a stream of air ( Fig. 7-64 ) .
9 . Brush a vacuumed mix of improved stone in the
mold , making sure not to incorporate air ( Fig . 7-65) .
10. Fill the mold with improved stone ( Fig. 7 -66 ) .
11 . Trim and smooth the stone impressions of the
occlusal forms to prepare to be boxed for making the
flexible mold ( Fig. 7 - 67 ). The flexible mold will yield
multiple replicas poured in the investment material .
12 . Spray the stone impressions with clear lacquer,
which will serve as a separating medium ( Fig . 7-68) .
13 . Allow the lacquer to dry , and spray lightly once
again ( Fig. 7-69 ) .
14 . Glue the stone impressions on a Hat piece of
cardboard with Super-glue. Box the impressions with
cardboard , leaving at least V-i inch (0.64 cm ) distance
from the stone forms. Seal the cardboard boxing se-
curely with sticky wax ( Fig . 7- 70) .
15 . Assemble the silicone mold- making materials .
Follow the manufacturer s directions and weigh the
’

mm from the occlusal surface ( Fig . 7-62) . components accurately in paper cups ( Fig . 7-71). Weigh

* Dural
->
i acrylic, Reliance Dental Manufacturing Co. , Chicago, Ill. •Debubblizer, .
Kerr Manufacturing Co.. Romulus Mich.
 Artificial teeth and gold occlusals 215

.,k
- ^ XsW .
iV
w
\ i- S

tir

Fig. 7- 58. Flat plane teeth should be rubbed tightly against metal Fig. 7- 59. Teeth are aligned on flat surface such as glass slab.
file to flatten occlusal surface. Aligned teeth are luted together with DuraLay.

Fig. 7-60. Occlusal surfaces of teeth can be modified, if desired, - .

Fig. 7 61 Surfaces are again rubbed against file to ensure flatness
with inlay wax . of modified form.

Fig. 7 62. Beading wax is applied around composite form 1.5 mm

- Fig. 7-63. Clay or wax is added around beading wax to enlarge
* from occlusal surface. base for boxing with boxing wax.
216 Dental laboratory procedures: complete dentures

.
Fig. 7-64 Occlusal form is lubricated with debubblizer solution. - .
Fig. 7 65 Improved stone is mixed in mechanical spatulator under
reduced atmospheric pressure and brushed in mold, taking care to
not incorporate air that will result in voids.

.
Fig. 7-66 Mold is filled with improved stone. Fig. 7-67. Stone impression of occlusal form is trimmed and
smoothed in preparation for boxing.

u 1
PRECAUTIONS

Fig. 7 68. Stone impression is sprayed with clear lacquer that

- - .
Fig. 7 69 First coat of lacquer is permitted to dry, and impression
serves as separating medium. is sprayed again.
 k I

Artificial teeth and gold occlusals 217

Fig. 7 70. Cardboard boxing is securely sealed with sticky wax.

- - .
Fig. 7 71 Material is proportioned according to manufacturer’s rec-
ommendations, and components weighed accurately in paper cups.

the base material first , reset the scales, and add the
thinner. Mix thoroughly for 1 Vz to 2 minutes . Reset the
scale and add the catalyst . Mix thoroughly for 2'/2 min -
utes or until there are no streaks in the material.
16 . Pour into the mold and onto the model just short
of covering the stone ( Fig . 7-72 ) .
17 . Place the mold in a vacuum , preferably under a
hell jar-vacuum machine , until all air has been elimi -
nated from the silicone material ( Pig . 7-73).
18 . Pour more silicone material in the mold until VA
inch (0.64 cm ) of silicone has covered the stone ( Fig.
7-74).
-
Fig . 7 72. Material is poured into mold and onto model just short of
19. Remove the boxing material from the sides of the
covering stone.
silicone after 24 hours ( Fig. 7-75) .
20 . Rox the cardboard base with boxing wax ( Fig .
7-76).
21 . Pour improved stone around the silicone mold to
provide support and maintain accuracy ( Fig . 7 -77 ) .
22 . Remove the boxing materials and stone impres-
sions from the silicone mold ( Fig. 7-78 ) .
23. Flow an investment * into the silicone mold , us-
ing a soft - bristle artist s brush ( Fig . 7 -79 ) .
24 . Remove the investment dye from the silicone
mold and inspect for accuracy of detail ( Fig. 7-80) .
25 . Flow casting wax onto the investment model to
the desired thickness of the occlusal form ( Fig. 7 -81 ) .
26 . Lute a half- round wax form onto the previously
applied wax . This bar of wax will provide retention for
resin ( Fig. 7-82) .

it •

* -
Fig. 7 73. Mold is placed under reduced atmospheric pressure until •Select an investment compatible with metal alloy, such as Investic
.
for Ticonitim
all air has been eliminated from silicone.

i
I
218 Dental laboratory procedures: complete dentures

A i

-
Fig. 7 74. Silicone material is poured into mold until layer of % inch
(0.64 cm) is achieved.
Fig. 7 75. Boxing material is removed from sides of silicone.
-

- .
Fig. 7 76 Cardboard base is boxed with boxing wax . - .
Fig. 7 77 Improved stone is poured around silicone molds to pro-
vide additional support and maintain accuracy.

Fig. 7 78. Boxing material and stone impressions are removed from
- Fig. 7-79. Investment, suitable for metal to be used, is flowed into
silicone mold. silicone mold.
 Artificial teeth and gold occlusals 219

Fig. 7- 80. Investment dies are removed from silicone mold and in- Fig. 7-81. Casting wax is flowed into investment model to create
spected for accuracy . desired thickness of occlusal casting.

- Fig. 7- 82. A 14- gauge half -round wax form is luted to previously Fig. 7- 83. Excess wax is removed from margins of wax pattern .
applied wax to provide retention for resin.

27. Remove excess wax from the margins of the wax

patterns ( Fig. 7-83).
28. Sprue the wax patterns for investing ( Fig. 7 -84 ).
29. Soak the investment for several minutes in water
4 that is room temperature, and paint investment around
the wax and into a suitable size investing ring ( Fig.
7-85).
30. After 1 hour, place the investment in a burnout
oven at less than 900° F ( 482c C). Elevate the temper-
ature to 1300° F ( 141 ° C ), and cast after IV2 hours ( Fig.
7-86).
31. Clean the casting, and remove the sprues and
trim ( Fig. 7-87). Grind the borders smooth and Hat .
32. Wax up the metal forms to the desired tooth con -
tours. Invest them in a flask , and process them with
acry lic resin of the desired shade. Finish the forms with
disks , pumice wheels, and finally, polish them on a
* lathe with pumice and a high shine polishing material
Fig. 7- 84. Wax patterns are sprued for investing. ( Fig. 7-88).
220 Dental laboratory procedures: complete dentures

. .
Fig 7-85 Investment index is soaked in cool water for several min-
utes before filling ring.

Fig. 7 86. Gold occlusals are cast after wax has been burned out.
-

Fig. 7-87. Casting is cleaned, and sprues removed.

 Artificial teeth and gold occlusals 221

\ ^V

f
Fig. 7-88. Occlusal units are finished with disks, pum-
ice wheels, and polished on lathe with pumice fol-
lowed by a high shine polishing material.

Table 7-5. Fabrication of metal occlusal denture teeth

Problem Probable cause Solution

Improper arch form Teeth not set up properly or not
arranged properly on glass slab
Occlusal surfaces not flat or Manufacturing defects or process-
even ing changes in luting medium
Metal occlusals too thick and Improper beading; can also cause
not esthetic investment to fracture on sepa-
ration
Voids or nodules in metal oc- Failure to apply debubblizer or vi-
clusals brate stone or silicone properly
Silicone rubber material sticks Failure to apply clear lacquer to
to stone stone before covering with sili-
cone rubber
Silicone rubber does not set up Materials improperly measured or
properly mixed
Metal occlusal has ragged fin- Investment material and wax not
ishing line trimmed properly
Resin body has voids or Improper packing or processing of
porosity acrylic resin
#
Set up teeth properly before making impression for mold
investment cast
Rub teeth lightly on fine emery or metal file
Apply beading 1 to 1.5 mm from occlusal surface
Reduce surface tension with debubblizer and vibrate
stone using soft brush
Apply two coats of clear lacquer as separating medium
Measure and mix materials according to manufacturer ’s
directions
Trim investment prior to waxing; trim wax back to mar-
gin
Mix, pack , and process acrylic according to manufactur -
er’s directions
222 Dental laboratory procedures: complete dentures
Fig. 7- 90. Metal occlusal forms are placed in indexes, and silicone is repositioned to form mold .
PROBLEM AREAS
Problems particular to this procedure are shown
Table 7-5.
Technique for silicone mold for multiple
waxing of similar tooth contours
PROCEDURE
1. Wax the metal form to the desired contour ( Fig.
7-89, / ). Make a stone index with keyed sides ( Fig. 7-
89, 2 ). Apply clay or boxing wax several millimeters
thick to collars of the wax tooth forms ( Fig. 7-89, 3 ).
Box and pour silicone around the waxed form as previ-
ously described ( Fig. 7-89, 4 ).
2. Place the metal occlusal forms in the indexes, and
reposition the silicone to form a mold ( Fig. 7-90).
3. Flow' molten wax into the silicone mold. Allow the
wax to harden . Remove and trim the waxed form , and
invest and process it with acrylic resin of the desired
shade.
Fig. 7-89. Metal form is waxed to create desired contour ( 1 ). Stone
index is made with keyed sides (2 ). Clay or boxing wax is applied
to collars of wax tooth forms (3 ). Silicone material is poured around
waxed form as previously described ( 4 ).
SUMMARY
in Artificial teeth have been discussed in this chapter.
Methods used by manufacturers to identify their var-
ious molds and shades were considered briefly; how- ,
ever, it seems that a uniform system for mold and shade
identification would benefit the consumer. Methods for
constructing artificial teeth with metal occlusals were
also presented.
REFERENCES
Davies, II . G., and Pound , E . : Metal cutting surfaces aid denture
.
function Dent. Surv . 42:47 -53. Oct . 1966.
Encyclopedia Britannica 21:759, 1969.
Kochnc. C. L., and Morrow, R . M .: Construction of denture teeth
-
with gold occlusal surfaces, J . Prosthet. Dent. 23:449 455, 1970.
— .
Michl . R. J.: Isosit a new dental material Quintessence Interna
-
tional . 9: 1 5, March , 1978.
-
Schultz, A. W.: Comfort and chewing efficiency in dentures, J .
. . -
Prosthet Dent 1:38-48, Jan . March, 1951 .
. -
Sowter, J . B. and Bass , B E .: Increasing the efficiency of resin pos 5
. .
terior teeth , J . Prosthet Dent 19:465-468, 1968.
Wallace, D. II . : The use of gold occlusal surfaces in complete and
.. . . -
nartial dentures J Prosthet Dent 14:326 333. 1964.
-t
CHAPTER 8
ARRANGING AND ARTICULATING
ARTIFICIAL TEETH
RICHARD A. SMITH, A. ANDERSEN CAVALCANTI, and HUGH E. WOLFE
4
Arranging and articulating artificial teeth are critical
elements in constructing removable dental restorations.1
The purpose of this chapter is to describe the methods
of arranging and articulating anterior teeth , 33-degree
anatomic posterior teeth , 20-degree posterior teeth,
Pilkington-Tumer* 30-degree posterior teeth. Rational *
T 0-degree posterior teeth , IPN Anatoline* posterior
teeth , and IPN Monoline* posterior teeth to produce
optimal treatment results for edentulous and partially
edentulous patients. Troubleshooting information rela-
tive to preventive and corrective measures is given in
Table 8-1 on p. 262.
NATURAL ANTEROPOSTERIOR PLACEMENT
OF MAXILLARY ANTERIOR TEETH
Anteroposterior positioning of anterior teeth is ex -
tremely important in esthetics and phonetics because of
the support that teeth give to lips, cheeks, and other
tissues of the oral cavity . Since it is necessary to main -
tain proper support of these tissues for natural esthet -
ics, it is important to place artificial teeth in essentially
the same position as natural teeth . This consideration
must not be'overlooked when using a resorbed residual
maxillary ridge as the primary control for tooth posi -
tion .
Extreme changes in shape and/or size make a re-
sorbed ridge a questionable landmark to use as a posi -
.
* I )entsply International Inc , York, Pa.
tive control for tooth position . Setting artificial teeth di -
rectly over the center of ( resorbed ) residual ridges has
been quite common ; however , this practice makes the
development of natural esthetics practically impossible
or, at best , extremely difficult because the natural teeth
seldom occupy the so-called over- the- ridge position .
No dental restoration , particularly a complete den -
ture, can be truly esthetic or functional if it fails to po-
sition teeth in their proper natural place in the mouth .
Properly positioned teeth give support to the lips,
cheeks, and other tissues of the oral cavity' that is vital
to a natural appearance.
• After the removal of teeth ? the loss of bone structure
N
is usually greater on the buccolabial aspect of the max -
illary ridge than on the palatal aspect . As a result , the
center of the residual ridge is more palatal and there-
fore somewhat smaller and different in shape than it
was prior to removal of the teeth .
If artificial teeth are to have the best and /or most nat -
ural esthetic and functional qualities! it is essential to
place them in a position as close as possible to that oc-
cupied by the natural teeth , providing these were ac-
ceptable estheticallv and functionally.*
‘ Ridge resorption can have a major effect on the po-
sition of the anterior teeth . Fig. 8-1, A , illustrates the
position of the natural central incisor and its relation -
ship to the ridge. Fig. 8- 1, B . illustrates the same ridge
immediately after removal of the tooth ; dotted lines in -
dicate the position of the natural root. In Fig. 8-1 , C\
the direction of resorption is up and back; the solid line
223
224 Dental laboratory procedures: complete dentures

w'

C E
Fig. 8-1. Ridge resorption affects considerably position of anteriors. A, Natural central incisor in re-
lation to ridge. B, Same ridge after removal of tooth. C, Direction of resorption is up and back. Solid
line indicates resorbed ridge, and dotted line indicates original contour. D, Placing teeth directly over «
resorbed ridge is common error in tooth positioning. E, Dotted line indicates original position of natural
tooth for comparison with improper settiang of artificial tooth.

Fig. 8-2. Sectioned cast of natural teeth with labial matrix in posi - Fig. 8- 3. Cast has been trimmed to simulate normal ridge resorp -
tion. tion.

Fig. 8-4. Artificial tooth that has deviated considerably from position Fig. 8- 5. Distance from center of incisive papilla to labial surface of
of natural tooth after being set on resorbed ridge. central incisors.

5-mm square
6-mm ovoid
7-mm tapering
Fig. 8-6. Average distances from center of papilla to labial surface
of central incisor are shown for three types of arch forms.
identifies the resorbed ridge; the dotted line, the orig-
inal contour of the ridge. One of the most common er-
rors in tooth positioning, setting the teeth over the
ridge without consideration of the original positioning
-
of the natural teeth , is shown in Fig. 8 1, D. In Fig. 8-
1, E . the denture with teeth set over the ridge , as
shown in D , is superimposed over the original position
of the natural central incisor as shown in A . The loss of
vertical dimension and lip support , as well as the inev -
itable resultant loss in esthetics, is readily apparent.
Figs. 8-2, 8-3, and 8-4 are another series of matrix stud -
ies showing the relationship between tooth position and
.
ridge resorption Fig. 8-2 shows a cross section of the
* * matrix and cast made before the natural teeth were re-
moved . The cast has been trimmed to simulate a nor-
mal amount of ridge resorption in the anterior area in
i Fig. 8-3. Fig. 8-4 shows what happens to tooth posi -
tioning when the teeth are set up and back on the
resorbed ridge. For natural esthetics and phonetics, the
artificial teeth should be of the same length and in the
same position anteroposteriorly as the original natural
teeth. An artificial tooth set on the ridge may deviate
considerably from its true natural position ( Fig. 8-4 ).
This *“ on - the- ridge position of the teeth cannot afford
the lip the proper support .
In' determining the forward position of the maxillary
central incisor, a useful guide is the relationship in nat -
J ural dentitions between the’ upper central and the in -
cisive papilla . 1 After outlining the papilla in pencil and
bisecting it , the procedure is to measure the distance
from the center of the papilla to the labial surface of the
tooth ( Fig. 8-5). The average distances for the three
basic afeh forms , square, ovoid , and tapering, differ
( Fig. 8-6). Although these distances may vary ,' the av-
erages serve as reasonable guides and starting points
when finding out how far forward to set a central inci-
sor. 4,
4*
Arranging and articulating artificial teeth 225
Relationship of arch form to tooth arrangement
Nature tends to harmonize not only the form of the
maxillary central incisors with the form of the face; but
also with the form oi the arch and arrangement ol the
teeth . Persons with predominantly square faces often
have mainly square arrangements of teeth . In general ,
these same principles of harmony apply to the square
tapering, tapering, and ovoid types.
Although loss of teeth and consequent resorption of
the labial and buccal alveolar processes can change the
original form of the maxillary arch nature leaves a
,
guide to tooth arrangement in the form of the mandib-
ular arch . Even though resorption can and does occur ,
usually the direction is downward, primarily toward the
body of the mandible, and often the lower arch tends
to preserve its outline form. Frequently, the mandibu -
lar ridge is a fairly reliable guide to tooth arrangement
for the edentulous patient.
t
Tooth arrangement in square arch
Usually the arrangement is to set the two central in -
cisors to‘ almost a straight line across the front of the
square arch . Then the lateral incisors are placed with a
nearly full labial aspect so that they show little rotation
in at the distal aspect . This positioning of the central
and lateral incisors gives width to the positioning of the
canines and prominence to these teeth . The four inci -
sors tend to have little rotation , and the radius of the
square arch tends to be wider than that of the tapering
arch .
The larger radius of this arch allows sufficient room
for placing the incisors ' without crowding or lapping. '
Overall, in the typal square arrangement the visual ef-
fect is fairly straight from canine to canine. In addition,
teeth arranged in a‘ typal square-arch configuration tend
to be more or less straight up and down , rather than
sloping. The full or nearly full labial surface presented
by the six anterior teeth gives a broad effect that is in
harmony with the broad square face ( Fig. 8-7) .
Tooth arrangement in tapering arch
In the tapering arch , the central incisors are often
farther forward of the canines than in other types of
arches ( Fig. 8-8). ‘ A characteristic of the tapering ar-
rangement is the rotation of the central incisors on their
long axes inward at the distal aspect. This rotation more
or less sets the two teeth at an angle, thereby creating
a pointed effect to the arrangement . ’
In the tapering arch / considerable rotating and lap-
4
ping of teeth are often evident because this arch has
less space than any other type, and crowding is inevi-
table. Crowding and rotation of the teeth reduce the
amount of labial surface visible anteriorly.* The typal ta-
pering arrangement does not look as wide as other set-
226 Dental laboratory procedures: complete dentures
Fig. 8-7. Common configuration for square arch form from labial
and incisal aspects.
ups.' Usually this narrowing is in harmony with the nar -
rowing effect visible in the lower third of the tapering
face.
Other typical characteristics of arrangements of this
type are the raising of the lateral incisors from the oc-
clusal plane and the depressing of them at the gingival
plane.1 In additionJ the necks of the canines at the gin -
gival area are usually quite prominent and the incisal
tips of the canines are often at the same height or
slightly above the incisal edges of the lateral incisors. 1
In a typal tapering arrangement, the teeth exhibit some
slope' for example,'one may project the incisal edges of
the central and lateral incisors forward and bring out
the cervical area of the canines, leaving their incisal tips
in harmony with the central and lateral incisors. *
Tooth arrangement in square tapering arch
The square tapering arrangement combines charac-
teristics of the square and the tapering forms, but mod -
ifies both . It has characteristic square placement of the
central incisors, such as little or no rotation, with the
typical tapering effect or rotation of the lateral incisors
and canines.\ However, the square tapering arrange-
ment does not exhibit the illusion of fullness or width
like the square arrangement ;’ the canines often show-
more distal rotation than in a square arrangement
( Fig. 8-9).'
Tooth arrangement in ovoid arch
The ovoid arrangement has a definite curvature. The
central incisors in the ovoid anterior arch usually set
Fig. 8- 8. Common configuration for tapering-type arch form from
labial and incisal aspects.
well forward of the canines. They are usually in a posi -
tion between that of the square arch and that of the
tapering arch. In the ovoid arrangement, there is sel -
dom rotation . As a result , a typical alignment shows
fullness of the labial surface from canine to canine. This
alignment and the setting to the curved arch give a
broad , rounding effect that harmonizes with a round
ovoid face ( Fig. 8-10).
Considerations affecting placement
and positioning of anterior teeth
In placing and positioning the maxillary anterior
teeth , the objective is to provide a balance between
maximum esthetics and proper phonetics.1 As seen pre-
viously , anterior teeth set directly over the ridges are
not in the position formerly occupied by the natural
teeth . Therefore these anterior teeth fail to provide
support for the musculature of the lower third of the
face, and they interfere with proper phonetics. Without
the proper support , these facial muscles tend to sag into
unnatural positions. In positioning the maxillary ante-
riors, their relationship to the occlusal and sagittal
planes is important .
Occlusal plane
Generally the central incisor, when set at approxi -
mately the same angle as the natural tooth, is at an in -
clination slightly offset from the vertical edge, and the
incisal edge touches the occlusal plane. The lateral in -
cisor often has a slightly more accentuated slope than
that of the central incisor. The incisal edge of the lateral
 Arranging and articulating artificial teeth 227

Fig. 8- 9. Common configuration for square tapering arch form from Fig. 8- 10. Common configuration for ovoid- type arch form from la-
labial and incisal aspects. bial and incisal aspects.

«
i

r i
i

«
«
«
i »
t
«
I
«
i
i
t
*
%
*
i

Central Lateral Canine

Fig. 8- 11. Inclination of central , lateral , and canine teeth and their average relation to occlusal plane .

incisor may be raised slightly, approximately 0.5 mm tooth, can lx set to approximately the same angula-
*

from the occlusal plane. The canine usually sets more
prominently and to a line at right angles to the occlusal
plane, with the incisal edge set on that plane ( Fig.
-
8 11).
Sagittal plane
The sagittal plane divides the body vertically into
halves. In the dental arch , this plane approximates the
median line. The desirable angulation to the sagittal
plane or median line can be correlated to the form of
both the arch and the tooth . Generally , the square arch
form and tooth , as well as the ovoid arch form and
tions. The tapering forms desirably should be set to a
slightly greater angulation .
It is essential to realize that any technique for the
preliminary arrangement of teeth , both anteriors and
posteriors, is based on average, or so-called normal ,
conditions. Many times practical considerations dictate
modifications of these methods to cope most effectively
with the multitude of individual differences in the oral
and facial anatomy. However,' basic principles that ap-
ply to average situations will serve as a workable foun-
dation on which to base necessary modifications. After
placement of the six maxillary anterior teeth in position
228 Dental laboratory procedures : complete dentures
Square
Square-tapering
Tapering
Ovoid
Fig. 8- 12. Average relation of anterior teeth to sagittal plane and
occlusal plane for square, square-tapering, tapering , and ovoid
tooth-arch configurations.
with due regard to the requirements of vertical dimen -
sion , vertical overlap , and horizontal overlap, the re-
maining considerations that affect their arrangement in
the arch are essentially esthetic ( Fig. 8-12 ).
Factors of softness and vigor
Some conditions directly affect the individual ar-
rangement and esthetic appearance of a natural denti-
tion.1 Softness* in tooth arrangement depends on the se-
lection of * harmonious 'forms of teeth as a prerequisite
and the use of smaller lateral and central incisors wher-
ever indicated. With respect to tooth arrangement and
selection , softness can also mean a reduction of the la-
bial surface in terms of its visual appearance.
A rounded mesiodistal curvature of the tooth in com -
bination with an ovoid outline of the tooth appears soft -
er than a flat mesiodistal tooth with more angularity in
its outline. ' A rounded form or a curved form is much
softer to the eye than a straight line or a flat plane. '
4
Fig. 8- 13. Tooth positioning for visual effect . A, Appear normal. B,
Central incisors appear smaller. C , Teeth appear larger, creating
effect of boldness and strength.
On the other hand , a characteristic of the hold , vig-
orous face is the dominant size and alignment of the
teeth . The relatively larger size of the lateral incisors
- x
i
and canines and their straight hold arrangement are im -
portant considerations in achieving the effect of
strength. However, vigor, boldness, and strength are
not necessarily solely or primarily masculine character -
istics because many female patients also have strong,
hold faces.
Softening, or the alternate, vigor, depends on the
size and shape of teeth in relationship to the face, as
well as the positioning of the teeth in the arch. The
more labial surface of the teeth that is visible, particu -
larly in the lateral incisors, the stronger the tooth ar-
rangement appears.
Examples of the application of the principle of tooth
positioning for visual effect are shown in Fig. 8-13. Po-
sitioning the two central incisors normally makes the
front view of these teeth look normal in size or in rela -
tion to each other ( Fig. 8-13, A ). In another arrange-
ment , positioning the two central incisors with the me -
sial edges slightly more prominent and with the distal
edges rotated inwardly makes them appear smaller
( Fig. 8 13, /1).
- «r
From a straight front view , the teeth in the latter

Fig. 8 14. Asymmetry of natural teeth. Patient’s right central in-
-
cisor has mesial surface slightly turned in and its distal aspect
prominent. Right lateral incisor has distal surface turned out,
giving tooth broad appearance. Right canine has prominent cer -
vical area. Left -central incisor has distal surface turned inward,
and mesial surface slightly overlapping right central. Left lateral
incisor has slight overlap over central incisor, and distal surface
is depressed. Left canine has mesial surface turned out and
prominent cervical area.
arrangement look smaller than those in the first one.
This illusion results from merely rotating the teeth to
give them a somewhat smaller and softer look . Round -
ing the distoineisal surface of each tooth slightly with a
rubber wheel softens this effect still more. It is essential
to avoid rounding all teeth exactly alike to maintain a
slight degree of asymmetry in this arrangement.
In the third arrangement ( Fig. 8- 13, C), placing the
same two central incisors to make the teeth look larger
creates the illusion of boldness or strength . This effect
is the result of merely rotating the mesial edges in and
the distal edges out to show more facial surface. Also,
** depressing the lateral incisors slightly behind the cen -
tral incisors accentuates the boldness and strength of
the tooth arrangement more. Grinding the teeth inci
sally, thereby leaving the distoineisal area prominent,
and grinding toward the mesioincisal area make this il -
lusion even stronger.
Influence of asymmetry on tooth arrangement
Another point of interest in tooth arrangement is the
relationship between facial asymmetry and the associ-
ated asymmetry in tooth arrangement . Few faces have
true symmetry in terms of a precise left - and right -side
balance. Many faces that appear to be symmetrical on
initial observation display a variety of subtle or minute
differences on closer observation.
Similarly , subtle and minute differences exist in the
arrangement of natural teeth . Conversely, asymmetry
may be apparent to a marked degree in many faces; the
left and right sides may show considerable variance. In
instances when asymmetry in the face is pronounced,
asymmetry may also be seen in the tooth arrangement .
Asymmetry determines the relative vigor or softness
of either side of the face. The size and position of the
anterior and posterior teeth in the arrangement pro-
Arranging and articulating artificial teeth 229
duce the asymmetry. It is an extremely subtle factor,
and as minor a variation as the depression and/or rota-
tion of either the left or right canine at the gingival
surface is sufficient to create this effect. At times also
the lateral incisors may differ slightly in size, such as a
reduction in the size of a lateral incisor on one side of
the mouth to make it smaller than the corresponding
one on the opposite side. Perhaps even positioning one
central incisor slightly anterior to the other may pro-
duce the same effect ( Fig. 8-14).
In the human anatomy, asymmetry is far more prev -
alent than perfect symmetry. Natural teeth generally
reflect the asymmetry seen in the face. The con veil - \
tional method of split photography best illustrates
- asymmetry of facial form and tooth arrangement . This
technique compares an original photograph with two
composites, one made up from two right sides ( Fig. 8-
15) and the other from two left sides of the face ( Fig. 8-
16). The original photograph is that of a young woman
with natural dentition ( Fig. 8- 17).
From a careful examination of the photograph show-
ing the natural face form of the patient ( Fig. 8-16), it is
apparent that the malar (cheek ) area of the right side is
more developed than this area on the left side. The
dental arch form is wider on the right side , and the
arrangement and size of the teeth on both sides differ.
However, these features combine to create a pleasing
overall composition .
In a split photograph , using two right sides of the
patient ( Fig. 8-15), the face and dental arch appear to
be wider. In a photograph of two left sides of the pa-
tient ( Fig. 8- 17 ), the face and dental arch appear to he
smaller. In both instances, it is apparent that the face
form, arch form , and tooth arrangement no longer have
the natural, pleasing asymmetry observed in the origi -
nal photograph .
230 Dental laboratory procedures: complete dentures
Fig. 8- 15. Two right sides of face put together by split photography,
making face and dental arch look wider.
Fig. 8-17. Original photograph of natural face showing pleasing
asymmetry of face and teeth.
Fig. 8- 16. Two left sides of face put together by split photography,
making face and dental arch look smaller .
Spacing of anterior teeth
When developing more characterization in a denture,
spacing the teeth is another important consideration ,
but one that requires caution . Although spacing of teeth
may be one of the many irregularities in nature, it is
less noticeable in a natural dentition than generally be -
lieved . Dentitions with a noticeable degree of spacing
between the maxillary central incisors occur rather in -
frequently, and spacing between two or more teeth in
the maxillary arch appears only slightly more fre -
quently.
Overall spacing usually results from drifting of the
teeth . In addition , patients with an abnormally large
arch in which the size of the teeth is in proportion to
the size of the face also show spacing because the teeth
are too small to fill the arch properly. Preoperative rec-
ords, such as casts or photographs, are excellent guides
to natural spacing between central incisors or to overall
spacing, rather than arbitrary rules.
It is possible to introduce esthetic spacing into a den -
ture ( Fig. 8- 18). The inverted type of spacing shown at
the top may be difficult for the patient to keep clean .
On the lower left is a straight up-and -down vertical
space between the two central incisors. In the lower
right illustration is a conical type space; the space is
larger at the incisal opening than toward the gingival
 Arranging and articulating artificial teeth 231

•A

JJ JJ
Fig. 8-18. Types of diastemas to be used judiciously between cen- Fig. 8- 19. Embrasure modification. Teeth in top row make normal
tral incisors. contact . Teeth in lower row have been ground slightly with rubber
wheel to modify and enlarge embrasures.

opening. To he classified as a true diastema, the space

should he completely open , and the adjacent teeth
should make no contact. As noted previously , preoper-
ative records are a preferred guide to spacing.
Modification of an embrasure produces another type
of relationship ( Fig. 8-19). Here the teeth are in con -
tact , in contrast to the diastema in which the abutting
teeth make no contact. The upper illustration shows the
amount of space present after setting up the teeth to
make normal contact in the - incisal third area. In the
lower illustration , slight grinding of the teeth and mod -
ification with a rubber wheel have enlarged the embra-
sures and moved the contact toward the middle third of
the teeth .
Natural dentitions that have a pleasing appearance
often may have slight spacing, diastema, between the
lateral incisors and canines. This effect may be incor- Fig. 8- 20. Typical examples of crowding and lapping. Teeth on right
porated judiciously in a denture tooth arrangement to create visual effect of lapping without actually lapping.
improve the appearance of the patient .

Crowding and lapping
Crowding or lapping of the teeth in a natural denti-
tion often is present in abnormally small arches. The
size of the teeth is often proportionate to the size of the
face, but too large lor the amount of space in the arch .
Crowding or lapping is the method that nature uses to
deliver the lull complement of natural teeth in an arch
that is too small to accommodate them .
Crowded and lapped conditions sometimes appear in
** various facial forms and typal tooth arrangements , but
most frequently in the tapering classification . The
crowded , lapped , and considerably rotated arrange
inent is typical of the narrow tapering arch , and often
is present when the vault is quite high .
It is possible to place lateral incisors in a variety of
treatments ( Fig. 8-20). In the upper left , the extreme
lapping of a lateral over a central incisor ties the teeth
together too closely and can make them look like a solid
band of color in the mouth . An incisal view of the same
position of these teeth is in the lower left . The lateral
incisor is too far ahead of the central incisor to give a
pleasing esthetic effect . This position also can cause ir-
ritation to the lip and may exert a dislodging pressure
- on the denture.
232 Dental laboratory procedures: complete dentures

The upper right shows the results of a suggested

method for improvement. The mesial aspect of the lat -
eral incisor and the distal aspect of the central incisor
have slight embrasures ground on them . The central
and lateral incisors still maintain contact; however, the
lateral incisor is not as far forward , and the teeth make
contact at a slightly different angle.
Slight grinding has softened even more the outline
form of the lateral incisor on the distal aspect . In the
lower right, the suggested position of the central and
lateral incisors, in addition to the enlarged embrasure
and slight change in outline form , creates the visual ef-
fect of a lapped lateral incisor without actually lapping.
Arranging maxillary anterior teeth
These suggestions for arranging anterior teeth pre- Fig. 8- 22. Typical positioning for maxillary central incisors.
suppose the selection of artificial teeth that are suitable
to the patient in form , size, shade, or blend . The pro-
cedures used for arranging anterior teeth differ. The
usual method is to place each tooth individually. As
each tooth is set , it is customary to check the alignment
of its incisal edge in relation to both the maxillary and
mandibular occlusion rims ( Fig. 8-21 ).
Following are five considerations in positioning or
setting anterior teeth :
1. Anteroposterior positioning
2. Anterior slope
3. Nlesiodistal inclination
4. Inferosuperior positioning to a horizontal plane
( incisal length )
5. Rotation on long axis

Fig. 8-23. Lateral incisors are positioned slightly shorter than cen-
trals.

Fig. 8- 21. Maxillary anterior teeth are arranged carefully in relation Fig. 8-24. Canines, like central incisors, usually touch occlusal
to properly contoured occlusion rim. plane.
 Arranging and articulating artificial teeth 233
PROCEDURES
i 1. Place the central incisors in position with the in -
jk
cisal edges touching the mandibular occlusion rim ( Fig.
8-21) or , the occlusal plane selected ( Fig. 8-22).
2. Position the lateral incisors with the incisal edge
raised approximately 1 mm from this plane ( Fig. 8- 23).
3. Place the canines with the incisal tip touching the
occlusal plane or mandibular occlusion rim , and tilt the
cervical third buccally to give it prominence . Normal-
ly , when positioned properly, the mesiolabial aspect
of these teeth will he visible from the anterior view t
( Fig. 8-24 ). Fig. 8-25. Correct positioning of canines (arrows) viewed from front
with mesiolabial surface prominent.
The position of canine teeth plays an important role
in the esthetic appearance of natural dentition . In a
denture it plays an equally important role because it
influences both the anterior and posterior tooth ar-
rangement .

Positioning of maxillary canines

Proper positioning of the upper canines is highly im -
portant : the rotation showing the mesiolabial portion of
the tooth ( Fig. 8-25), the vertical long axis ( Fig. 8-26),
and the prominent gingival area with the incisal edge
tucked in to harmonize with adjacent incisal areas
( Fig. 8-27).

Personalization of setup by selective grinding

One of the most important considerations in produc-
ing a natural appearing denture is personalization , Fig. 8- 26. Profile or side view emphasizing almost vertical long axis
which is possible to introduce by carefully performed , or position of canine.
t selective grinding procedures. Two molds of artificial
anterior teeth illustrate this observation ( Fig. 8-28).
Grinding has altered both molds, left , and the teeth are
as carded , right . Alterations in the top mold , left , are
for vigor and strength . By comparison , alterations in
the lower mold , left , project an image of delicacy , soft -
ness, and youthfulness. A natural overall appearance
i
results from careful modification of the six teeth of each
set to bring about the given effects ( Fig. 8-29 ).
r

Fig. 8-28. Halves of two molds of teeth personalized by selective

grinding. Top mold after alterations to project image of vigor and
Fig. 8-27. Desirable prominent setting of canine at gingival portion strength, and bottom mold after grinding to create image of delicacy
’

.
(top arrow ) rather than at incisal edge (bottom arrow ) and softness.

*
w

234 Dental laboratory procedures: complete dentures

T^

Fig. 8- 29. Natural overall appearance obtained by careful grinding Fig. 8- 30. Top row , square tapering tooth can be modified progres-
of six teeth of each set to create desired effects. sively into stronger appearing tooth. Bottom row , ovoid mold can
be modified into vigorous and stronger appearing form.

Fig. 8-30 illustrates how to progressively make a

square tapering mold into a stronger appearing tooth ,
top. The central incisor, top left , is as it comes from the
card . The same tooth , top center . is shown after slight ,
hut relatively straight, grinding on the incisal edge. Al -
though it is possible to make many changes in this
tooth , its big strong square look creates the illusion of
strength and vigor as long as it remains square and
blocky in appearance. The next tooth , top right , shows
A
how to increase the vigorous appearance more. Grind-
ing the labial surface has increased the height of the
mesial and distal lobes. Further modification of the in -
cisal edge has strengthened and matured its appear-
ance.
Modification of a typically soft or delicate ovoid tooth
-
form is shown in Fig. 8 30, bottom . In a female patient
Fig. 8- 31. Square tapering lateral incisor , top row . as it comes from
of somewhat vigorous appearance, the desire is not only tooth card and after modification for strength and vigor (right ). Lat -
to retain the essential softness of the teeth, as empha- eral incisor , bottom row . before and after ( right ) modification for
sized by their curvature and ovoid influence, but also softer appearance .
to introduce a slightly more vigorous factor. Slight
grinding on the incisal edge of the center tooth , bottom
row , has increased its vigorous appearance and
strength . Next to this tooth is an even more vigorous
tooth form developed for the patient , with additional
characterizing on the labial and incisal surfaces.
A similar example of the same type of treatment on
lateral incisors is shown in Fig. 8-31. The upper teeth
are the same square tapering mold as the central teeth
shown in Fig. 8-30. This tooth is strong and vigorous,
and it is possible to increase the illusion of strength and
vigor by modifying the incisal edge, top right . Below
this is an alternate treatment in which the tooth has a Fig. 8- 32. Lateral incisor unmodified , left . Same tooth narrowed at
much softer and more delicate appearance than the incisal edge to strengthen overall impression, right .
 Arranging and articulating artificial teeth 235

i \
j
'
1
' ! w A
i
i
v / *
/
> /
2 / ,
v
i
l l
t

Fig 8-34. Frontal view of mandibular anterior teeth with average

positioning, which does not produce good esthetic effect .

Fig. 8-33. Upper left , stock canine as manufactured. Others have

been modified to look like natural canines. Lower right , unnatural
pattern, canine with incisal edge straight.

Vertical
I overlap
original mold as a result of slight rounding of the mesial
and distal aspects, bottom right .
Special treatment of a lateral incisor can change its
appearance ( Fig. 8-32 ). The tooth on the left is as man -
ufactured . whereas the tooth on the right is the same
one after narrowing at the incisal surface. Now the
tooth appears to be wider through the midsection . This Horizontal
treatment helps strengthen the lateral incisor and gives overlap
it a suggestion of almost primitive strength. Used with
Fig. 8-35. Vertical overlap or overbfte in which horizontal plane
h * discretion, this treatment can improve denture esthet -
ICS .
used for relating mandibular anterior teeth is above occlusal plane.

There are several interesting treatments to use on

the incisal edge of canine teeth . Fig. 8-33 shows a stock
tooth as manufactured , upper left ; an example of con -
cave grinding on the mesial angle of the tooth , simulat -
ing natural abrasion , center ; an example of grinding to
simulate distal abrasion upper right ; and an example of
, ( Fig. 8-35). Esthetic and phonetic needs of a patient
incisal modification, simulating the incisal abrasion in a
young patient , lower left . An example of what not to do
with the canine is shown on the lower right ; nature sel -
dom abrades natural canines in a straight line.
Considerations affecting arrangement
of mandibular anterior teeth
A front view of the lower anterior teeth shows them
arranged in average horizontal alignment of their incisal
The horizontal plane used for aligning lower anterior
teeth may be above the actual occlusal plane, a distance
usually described as the vertical overlap or overbite
affect the amount or degree of vertical overlap of the
teeth and , consequently, the degree of incisal guide-
table angulation. It is possible to arrange teeth in har -
mony with various degrees of incisal guide-table angu -
lation .
Some prefer to position both the maxillary and man -
dibular anterior teeth before setting the posterior teeth .
In such instances, the position of the anterior teeth , the
amount of vertical and horizontal overlap (overbite and

i edges ( Fig. 8-34 ). The long axes of the central incisors

are perpendicular to the plane. The long axes of the
lateral incisors incline slightly distallv at the neck. The
long axes of the canines incline still more distallv at the
neck . Such an even picket -fence arrangement will not
create a natural esthetic appearance, although it is pos-
sible to use it as a starting point of reference.
overjet ), and other factors, such as the condylar guid -
ance, plane of occlusion, and degree of compensating
cur\ e desired , may affect the choice of posterior teeth
for a harmonious occlusion .
As a rule, incisal guide- table angulations of more than
20 degrees may indicate the use of 33-degree anatomic
teeth or Pilkington -Turner 30-degree posterior teeth .
236 Dental laboratory procedures: complete dentures

Central Lateral Canine

V, I

s
\ i
\ i
i
i i
i i

rv #«
Fig. 8- 36. Proximal view of lower anteriors showing average anteroposterior inclinations to horizontal
plane.

Fig. 8-37. Diagram of lower anteriors set correctly with long axes Fig. 8- 38. Denture with teeth as in Fig. 7-37 rotated, lapped, or
not projecting to common center. spaced with no two long axes parallel.
A

f
Incisal guide- table angulations of 20 degrees or less may
call for the use of 20-degree posterior teeth . A flat in -
cisal guide table may indicate 0-degree Rational poste-
rior teeth . It also affects the anteroposterior compensat -
ing curve.
A proximal view of the mandibular anterior teeth in -
dicates average anteroposterior inclinations to a hori -
zontal plane ( Fig. 8-36 ). Mandibular anterior teeth are
an integral part of the esthetics and phonetics for com -
plete dentures. Crowding and/or irregularity in the po-
sition of the lower anterior teeth generally mirror con -
ditions that exist in the upper arch . However, lower
anterior teeth are usually more crowded and irregular
than upper anterior teeth with a similar condition .
By careful rotation and inclination and , on occasion ,
slight proximal grinding and polishing, it is possible to
crowd and lap mandibular teeth, thereby creating a
natural esthetic appearance. In some instances, the
lower teeth are much more conspicuous than the upper
teeth ; particular attention to their arrangement is es-
sential.
It is necessary to avoid setting the mandibular ante-
rior teeth with their long axes projecting to one com-
mon center. This type of arrangement develops a sym -
metrical , even , and unnatural appearance. Rotation of
the lower anterior teeth and lapping them produce
more characterization if no two long axes of the teeth
are parallel to each other ( Figs. 8-37 and 8-38).
Overall evaluation of anterior tooth arrangement
Although there are many methods and guides for ar-
ranging artificial anterior teeth , the overall visual effect
of teeth in the mouth of the patient resulting from their
shape, size, color, and position determines their accep-
tance or rejection . The teeth also must fulfill the phys-
iologic, phonetic, and emotional requirements of the
individual patient.
This area of dentistry is truly as much an art as a
science. In any given situation, experience and judg-
ment are the final determinants as to whether a given
arrangement of teeth is usable in completing the den- ^
ture to the satisfaction of those involved .

POSTERIOR TOOTH ARRANGEMENT
Selection of posterior molds
Many types of posterior tooth forms are available for
the prosthodontic treatment of patients. Needs of indi-
vidual patients and the preference of the dentist per-
forming the treatment determine the selection of the
various tooth types. Making a recommendation for the
use of one type over another is beyond the scope of this
chapter.
To fulfill the needs of various treatment philosophies
and techniques, a wide range of posterior tooth forms
is available. This chapter describes some of the most
popular types, such as the 33-degree anatomic poste-
rior teeth , 20-degree posterior teeth , Pilkington -
Turner* 30-degree posterior teeth , and Rational* 0-
degree posterior teeth . Another workable posterior
tooth form available from the manufacturer of the teeth
described in this text is the Functional* posterior tooth
form . It is similar to the 33-degree anatomic posterior
tooth form , but with somewhat less cuspal “ rise.
The dentist should select the type of posterior tooth
form to be used and indicate it on the work authoriza-
tion form . If the upper anterior mold used in the tooth
arrangement is in harmony esthetically with the size
and shape of the patient’s face , it is easy to select an
appropriate posterior tooth mold from the mold charts
published by a given manufacturer. The charts list
numbered molds in the ty pes of posterior teeth de-
scribed in this chapter. They also show the lines of an -
terior teeth made by this same manufacturer and the
posterior teeth that harmonize with them . Therefore
selection of a posterior tooth mold of a given type for
use with a given anterior tooth mold is a relatively sim -
ple procedure.
Selections from mold charts are not infallible; how-
ever , they usually provide workable combinations of
posterior and anterior teeth . In instances of clearly lim -
ited space between the maxillary and mandibular
ridges, it may be preferable to use a medium or short
version of a given mold instead of a long or medium
mold , although the mold chart may indicate one of the
latter. For example, if a dentist uses an upper anterior
mold 22E and wishes to use a 33-degree anatomic pos-
terior tooth , the mold chart of the manufacturer indi -
cates that 30 L is the harmonizing posterior mold. How -
ever , if the interridge space is limited , a posterior mold
30 M or even a 30S might be substituted in extreme
instances.
As a general rule, for esthetic and functional reasons,
it is usually preferable to use the posterior molds rec-
ommended by the manufacturer on the mold chart if
* Dents|) ly International Inc., Y'ork , Pa .
Arranging and articulating artificial teeth 237
feasible. Using significantly smaller posterior molds
may create the possibility of an unsightly “ stair-step
appearance between the canine and first premolar.
If there is a marked lack of interridge space, partic-
ularly in the tuberosity area , it is possible to leave the
second molar out of the setup. Some prefer to leave out
a premolar, but usually the esthetic appearance is bet -
ter with the use of both premolars and elimination of
the second molar.
Although there may be sufficient space vertically for
a given posterior mold , one should consider leaving out
the second molars (or setting them slightly out of occlu -
sion ) if they extend distallv past the area in which the
mandibular ramus begins its upward curve. Artificial
teeth in occlusion, distal to the horizontal area of, the
mandibular ridge, may contribute to instability of the
dentures.
Surveying the mandibular cast (to aid in
determining position for posterior teeth)
PROCEDURE
1. With a pencil , mark the crest of the mandibular
ridge from the base of the retromolar pad to the canine
area ( Fig. 8-39 ).
2. Using a straightedge, extend this line to the land -
area of the cast at the anterior and posterior borders
( Fig. 8-40).
3. Repeat this procedure for the other side.
%
o c* „
C r
^OfV *
Of
4
Fig. 8- 39. Crest of lower ridge is marked from canine area through
center of retromolar pad.
j
238 Dental laboratory procedures: complete dentures
Fig. 8- 40. Same surveying procedure as in Fig. 8- 39 has been used
on both sides and extended onto land area of cast .
Fig. 8- 4r. With straightedge , this line is related to and scribed onto
lower wax rim to aid in aligning maxillary posterior teeth.
4. Place the occlusion rim on the lower cast .
5. Align a straightedge with each ol the marks on the
land area of the cast ( Fig. 8-41).
6. Scribe a line on the occlusion rim corresponding
to the line drawn on the crest of the ridge. This line
serves as an aid in checking the alignment and posi -
tion when setting maxillary posterior teeth on the base-
plate.
Arranging 33-degree anatomic maxillary
posterior teeth
The procedures described here are the usual meth -
ods. Often the existing conditions warrant changes for
mechanical reasons. For example, it may be necessary
to alter the basic position of the posterior teeth to cre-
ate the required tongue room . Various cusps of the
maxillary posterior teeth may be related to a flat occlu -
sal plane in a generally easy and highly adaptable man -
ner. This method simplifies the initial positioning and
improves the later occlusion ( Figs. 8-42 and 8-43).
When using a fully adjustable articulator, set to a
given patient s needs, the starting plan is the same.
However, it may be necessary to alter the basic design
of the occlusal surfaces by selective grinding and mill -
ing to conform to the given articulator settings.
PROCEDURE
1 . Place the maxillary first premolar with its long axis
at right angles to the occlusal plane. Then place the
buccal and lingual cusps on the plane.
2. Place the maxillary second premolar in like man ** -
ner. Align the facial surfaces of the premolars and the
canine with a straightedge ( Fig. 8-44).
3. Have the mesiobuccal and mesiolingual cusps of
the maxillary first molar touch the occlusal plane. Raise
the distobuceal cusp approximately 0.5 mm and the dis -
tolingual cusp approximately 0.5 to 0.75 mm.
4. Raise all cusps of the second molar from the lower
occlusal plane after the positioning and angulation of
the first molar. See that the mesiobuccal cusp is ap-
proximately 1 mm from the occlusal plane.
5. Follow the same procedure in placing the poste-
rior teeth on the opposite side . P ig. 8-44 shows an oc-
clusal view of the setting of 33-degree maxillary poste-
rior teeth .
A straightedge may be used to align the labial ridge
of the canine with the buccal ridge of the first and sec-
ond premolars and with the mesiobuccal ridge of the
first molar. The procedure for aligning the buccal ridges
of molars is similar, but it is necessary to angle them
slightly inward. This is the usual arrangement, hut
modifications for individual conditions are possible
( Fig. 8-44). *
 y

Arranging and articulating artificial teeth 239

)
/

>

1 First premolar Second premolar First molar Second molar

Fig. 8 .
^ cal cusp
relationships of 33-degree anatomic teeth to flat occlusal plane.

>

Buccal view
'
- .
Fig. 8 43 Buccal view of same cusp relationships as in Fig. 8-42 shows distobuccal cusp of first
molar approximately 0.5 mm from this plane. Distolingual cusp is raised approximately 0.50 to 0.75
mm from this plane. Cusps of second molar are raised from occlusal plane after positioning of first
molar. Mesiobuccal cusp should be approximately 1 mm from occlusal plane.

.
Fig 8-44. Buccal ridges of molars are angled slightly inward from
t line extending along facial surfaces of canine and two premolars.

x _
240 Dental laboratory procedures: complete dentures
Articulation of 33-degree anatomic mandibular
posterior teeth
Articulation of mandibular first molar
The mandibular first molar is a key tooth in articula-
tion. If careful attention is paid to setting this tooth, it
will facilitate considerably articulation of the remaining
posterior teeth.
PROCEDURE
1. With the articulator open, use wax to attach the
mandibular first molar to the baseplate in an approxi-
rnatrK correct position, but slightly high.
2. Close the articulator carefully to bring the mandib-
ular molar to its proper position.
3. Guide it to the correct occlusal relationship with
the maxillary first molar and maxillary second premolar.
4. Check to ensure that the incisal guide pin remains
in contact with the incisal table during all excursions.
The mesiolingual cusp of the upper first molar seats
squarely in the central fossa of the lower first molar .
This position establishes the proper buccal overjet.
From the buccal aspect ( Fig. 8-45), the ridge of the me-
Fig. 8- 45. Buccal view of 33-degree anatomic mandibular first mo-
lar in centric occlusion .
Fig. 8- 47. Mandibular first molar in working occlusion, buccal view .
-f
siohuccal cusp ol the upper first molar rests in the buc -
cal groove of the lower first molar in centric occlusion.
Fig. 8- 46 shows a lingual view of the lower first molar
in relation to the upper first molar and second premo- v
lar. The mesiolingual cusp of the upper first molar is
well seated in the central fossa of the lower, and the
mesiolingual cusp of the lower first molar fills the em -
brasure between upper second premolar and first molar.
In Fig. 8-47, the working relationship of the lower
first molar, articulating with the upper first molar and
second premolar, is apparent, and the buccal cusps of
the upper and lower first molars are in contact. The
distal facet of the upper second premolar is in contact
with the mesiobuceal marginal ridge of the lower first
molar. The interrelationship of the lower first molar to
the upper second premolar and first molar is seen from
the lingual view in working occlusion in Fig. 8-48 and
from the buccal view in balancing contact in Fig. 8-49.
Articulation of mandibular second molar
The mesiobuceal inclined plane of the lower second
molar contacts the marginal ridge of the distobuccal
cusp of the upper first molar (Fig. 8-50) in centric oc-
Fig. 8- 46. Mandibular first molar in centric occlusion, lingual view .
Fig. 8- 48. Mandibular first molar in working occlusion , lingual view.

elusion. Note the position of the lingual cusp of the up-
per second molar in relation to the central fossa of the
lower second molar in centric occlusion ( Fig. 8-51). The
P position of the lower second molar as it moves into
working relationship with the upper first and second
molar is seen in Fig. 8-52. Note the cuspal contact of
the mesiobuccal cusp of the lower second molar with
Fig. 8- 49. Mandibular first molar in balancing contact, buccal view.
Fig. 8-51. Mandibular second molar in centric occlusion, lingual
view .
Fig. 8- 53. Mandibular second molar in working occlusion, lingual
view.
Arranging and articulating artificial teeth 241
the distal slope of the cusp of the upper first molar. The
buccal cusps of the upper and lower second molars are
in contact with each other.
Fig. 8-53 illustrates a lingual view of the relationship
of the second molar in working occlusion , and a buccal
view of their relationship in balancing contact is seen in
-
Fig. 8 54.
Fig. 8-50. Mandibular second molar in centric occlusion, buccal
view .
Fig. 8- 52. Mandibular second molar in working occlusion, buccal
view.
Fig. 8- 54. Mandibular second molar in balancing contact, buccal
view.
242 Dental laboratory procedures: complete dentures
Fig. 8-55. Mandibular second premolar in centric occlusion, buccal
view.
Fig. 8- 57. Mandibular second premolar in working occlusion, buccal
view.
Articulation of mandibular second premolar
The lower second premolar buccal cusp rests be-
tween the upper first and second premolars. The tip of
the buccal cusp contacts the mesial marginal ridge of
the upper second premolar ( Fig. 8-55). The lingual as-
pect of the lower second premolar in centric occlusion
shows its lingual cusp between the upper first and sec-
ond premolars. The mesiolingual ridge of the lower sec-
ond premolar engages the distal slope of the lingual
cusp of the upper first premolar (Fig. 8-56).
In working occlusion , the distobuccal slope of the
lower second premolar contacts the mesiobuccal slope
of the upper second premolar. The mesiobuccal slope
of the lower second premolar contacts the distobuccal
slope of the upper first premolar ( Fig . 8-57). The lin -
gual cusp of the lower second premolar contacts the
distolingual area of the upper first premolar and the
mesiolingual area of the upper second premolar in
working occlusion ( Fig. 8-58). The mesial slope of the
Fig. 8-56. Mandibular second premolar in centric occlusion, lingual
view.
Fig. 8-58. Mandibular second premolar in working occlusion, lingual
view.
buccal cusp of the lower second premolar is in contact
with the distal slope of the lingual cusp of the upper
first premolar in balancing occlusion ( Fig. 8-59).
Articulation of mandibular first premolar
In centric occlusion, the lower first premolar is posi -
tioned with the tip of the buccal cusp in contact with
the mesial marginal ridge of the upper first premolar
( Figs. 8-60 and 8-61) . The distobuccal slope of the lower
first premolar contacts and glides over the mesiobuccal
slope of the upper first premolar in working occlusion
( Figs . 8-62 and 8-63). The mandibular first premolar is
shown in balancing contact ( Fig. 8-64 ).
In some instances there may not be sufficient space
for the mandibular first premolar. For esthetic reasons
it is often advisable to grind the mandibular first pre-
molar rather than alter the anterior teeth . Therefore
many do not set the mandibular first premolar until the
mandibular anterior teeth are in position .
 Arranging and articulating artificial teeth 243

Fig. 8 59. Mandibular second premolar in balancing contact, buccal

- Fig. 8 60. Mandibular first premolar in centric occlusion, buccal
-
view. view .

- .
Fig. 8 61 Mandibular first premolar in centric occlusion, lingual -
Fig. 8 62. Mandibular first premolar in working occlusion, buccal
view. view .

Fig. 8 63. Mandibular first premolar in working occlusion, lingual

- Fig. 8 64. Mandibular first premolar in balancing contact , buccal
-
view. view.
 V.

244 Dental laboratory procedures: complete dentures

Fig. 8-65. Complete setup of 33-degree anatomic posteriors in cen -

tric occlusion, buccal view.

Fig. 8-66. Completed setup in centric occlusion, lingual view . Fig. 8-67. Completed setup in working occlusion, buccal view.

%
Fig. 8-68. Completed setup in working occlusion, lingual view. Fig. 8-69. Completed setup in balancing contact, buccal view .
 Arranging and articulating artificial teeth 245

Checking completed setup of 33-degree

anatomic posterior teeth
After completion of the setup of the 33-degree ana-
-
41
tomic posterior teeth , it is essential to check it in all
relationships: centric occlusion ( Figs. 8-65 and 8-66) ,
working occlusion ( Figs . 8-67 and 8-68), and balancing
contact Figs. 8-69 and 8-70 ). Fig. 8-71 provides an an -
terior view of the completed tooth arrangement, and a
view of it on the articulator is given in Fig. 8-72.

Alternate method of articulation of 33-degree

anatomic maxillary posteriors to mandibular
posteriors

.
Fig 8-70. Completed setup in balancing contact , lingual view. ' An alternate method of arranging and articulating
*

s/
teeth for complete dentures preferred by some is to re-
late the mandibular teeth to a predetermined occlusal
plane first , in a manner similar to that shown in Fig. 8-
125. Then it is necessary to articulate the maxillary
teeth with the mandibular teeth!* Articulation of 33-de-
gree anatomic maxillary posterior teeth to mandibular
posterior teeth is shown in a series of illustrations. Ar -
ticulation of the 33-degree anatomic maxillary first mo-
lar in its various positions is shown in Figs. 8-73 to 8-
78. Articulation of the 33-degree anatomic maxillary
second molar is shown in Figs. 8-79 to 8-84 . Articula-
tion of the 33-degree anatomic maxillary second pre -
molar is shown in F igs. 8-85 to 8-90. Articulation of the
maxillary first premolar is shown in Figs. 8-91 to 8-96 .

Fig. 8 71. Anterior view of completed setup.

-

Fig. 8 73. Upper 33-degree anatomic first molar in centric occlu-

-
sion, buccal view.

- .
Fig; 8 72 Completed tooth arrangement on articulator.
 246 Dental laboratory procedures: complete dentures

Fig. 8-74. Upper first molar in centric occlusion, lingual view . .

Fig. 8-75 Upper first molar in working occlusion, buccal view.

- .
Fig. 8 76 Upper first molar in working occlusion, lingual view . .
Fig. 8-77 Upper first molar in balancing contact, buccal view .

- .
Fig. 8 78 Upper first molar in balancing contact, lingual view. - .
Fig. 8 79 Upper second molar in centric occlusion, buccal view.

.s
 C2
Arranging and articulating artificial teeth 247

*
%-

.-
Fig 8 80. Upper second molar in centric occlusion, lingual view. - .
Fig. 8 81 Upper second molar in working occlusion, buccal view.

\
*

*
. -
Fig 8 82. Upper second molar in working occlusion, lingual view . .
Fig. 8-83 Upper second molar in balancing contact, buccal view.

i
9‘

-
Fig. 8 84. Upper second molar in balancing contact, lingual view . .
Fig. 8-85 Upper second premolar in centric occlusion, buccal view .
 I
248 Dental laboratory procedures: complete dentures

Fig. 8-86. Upper second premolar in centric occlusion, lingual view. Fig. 8-87. Upper second premolar in working occlusion, buccal
view.

Fig. 8-88. Upper second premolar in working occlusion, lingual Fig. 8-89. Upper second premolar in balancing contact, buccal
view. view .

Fig. 8-90. Upper second premolar in balancing contact, lingual .

Fig. 8-91 Upper first premolar in centric occlusion, buccal view.
view .

Fig. 8-92. Upper first premolar in centric occlusion, lingual view .
Fig. 8- 94. Upper first premolar in working occlusion, lingual view.
Fig. 8- 96. Upper first premolar in balancing contact , lingual view.
Arranging and articulating artificial teeth 249
Fig. 8-93. Upper first premolar in working occlusion, buccal view .
Fig. 8-95. Upper first premolar in balancing contact, buccal view.
Arranging 20-degree maxillary posterior teeth
PROCEDURE
1 . Place the maxillary first premolar with its long axis
at right angles to the occlusal plane. Place the buccal
and lingual cusps on the plane ( Fig. 8-97 ).
2. Place the maxillary second premolar in like man -
ner . Align the facial surfaces of the premolars and the
canine with a straightedge ( Fig. 8-98).
3. Have the mesiobuccal and mesiolingual cusps of
the upper first molar touch the occlusal plane. Raise the
distobuceal cusp approximately 0.5 mm and raise the
distolingual cusp accordingly ( Fig. 8-99 ).
4. Raise all cusps of the second molar from the lower
occlusal plane after positioning the first molar. Place
the mesiobuccal cusp approximately 1 min from the oc-
clusal plane ( Fig. 8-99 )
250 Dental laboratory procedures: complete dentures

A
X x
/< /
f X

First premolar Second premolar First molar Second molar

Distal view

Fig. 8- 97. Typical cusp relationships of 20- degree posterior teeth to flat occlusal plane.

Fig. 8- 98. Buccal ridges of molars are angled slightly inward from
line extending along facial surfaces of canine and two premolars.

$
Fig. 8- 99. Buccal view of the same cusp relation- /
* F

mi
ships as in Fig. 8-97 shows distal cusps of first \
molar raised approximately 0.5 mm. All cusps of \\
second molar are raised from occlusal plane after
positioning of first molar . Mesiobuccal cusp of sec -
ond molar should be approximately 1 mm from oc -
\ IV \ I
l ,
clusal plane.
First Second First Second
premolar premolar molar molar

Buccal view

5. Follow the same procedure in placing the posteri
ors on the opposite side.
6. As shown in Fig . 8-98, use a straightedge to align
the labial ridge of the canine, buccal ridges of the first
and second premolars, and mesiobuccal ridge of the
first molar . Align the buccal ridges of the molars simi -
larly , and angle them slightly inward ( palatallv ).
The maxillary arrangement is complete ( Fig. 8-100).
The buccal and lingual cusps of the upper first and sec-
- one! premolars should touch the occlusion rim . The me-
siobuccal and mesiolingual cusps of the first molar
should touch the occlusion rim . The distobuccal cusp
should be raised approximately 0.5 mm from the occlu -
sion rim , and the distolingual cusp raised accordingly.
All cusps of the second molar are raised from the occlu -
sal plane after positioning the first molar . The mesio-
buccal cusp should be approximately 1 mm from the
occlusal plane.
 Arranging and articulating artificial teeth 251

Fig. 8- 100. Completed maxillary setup of 20-degree posteriors. Fig. 8- 101. Mandibular 20-degree first molar in centric occlusion,
buccal view , NOTE: Camera angle exaggerates horizontal overlap of
maxillary anterior teeth in relation to mandibular residual ridge.

Fig. 8- 102. Mandibular first molar in centric occlusion, lingual view. Fig. 8- 103. Mandibular first molar in working occlusion, buccal view.

Articulation of 20-degree posterior

mandibular teeth
Articulation of first molar
The ridge of the mesiobuccal cusp of the upper first
molar rests in the anterior buccal groove of the lower
first molar in centric occlusion ( Fig. 8-101). The me *

siolingual cusp of the upper first molar fits into the cen -
tral fossa of the lower first molar ( Fig. 8- 102 ).
The buccal cusps of the lower molar are in contact
with the buccal cusps of the upper first molar and the
distal slope of the buccal cusp of the upper second pre-
molar in working occlusion ( Fig. 8-103). Also in working Fig. 8- 104. Mandibular first molar in working occlusion, lingual view .
occlusion , the mesiolingual cusp of the upper first mo-
lar is in contact with the ridges formed by the protru -
sive and retrusive lingual planes of the lower first molar
( Fig. 8- 104 ). When the teeth of the opposite side move c
cr \d
OBR 4 R y ) » i
 252 Dental laboratory procedures: complete dentures

into working position, the mesiolingual cusp of the up -

per first molar slides through the distobuccal groove of
the lower first molar. The lingual cusp of the upper sec -
ond premolar is in contact with the protrusive plane of
the mesiobuccal cusp of the lower first molar ( Figs. 8 -
105 and 8- 106 ).
Articulation of mandibular second premolar
In centric occlusion , the tip of the lower buccal cusp
contacts the mesial marginal ridge of the upper second
premolar as well as the distal marginal ridge of the up - Fig. 8-105. Mandibular first molar in balancing contact, buccal view.
per first premolar (Fig. 8-107). Also in centric occlu -
sion , the lingual cusp is at the embrasure between the
upper first and second premolars. The mesiolingual
ridge contacts the distal slope of the lingual cusp of the
upper first premolar ( Fig. 8 108).-
In working occlusion, the distobuccal slope of the
lower premolar contacts the mesiobuccal slope of the up-
per second premolar. The mesiobuccal slope of the lower
second premolar. The mesiobuccal slope of the lower sec -
ond premolar contacts the distobuccal slope of the up-
per first premolar ( Fig. 8- 109). Also in working occlu -
sion , the lingual cusp of the lower second premolar
closes the embrasure formed by the upper first and sec-
ond premolars ( Fig. 8-110). In balancing contact, the
Fig. 8- 106. Mandibular first molar in balancing contact, lingual view .
mesial slope of the buccal cusp of the lower second pre-
molar is in contact with the distal slope of the lingual
cusp of the upper first premolar ( Figs. 8-111 and 8-112).
Articulation of mandibular second molar
In centric occlusion, the ridge of the mesiobuccal
•
cusp of the upper second molar rests in the buccal
groove of the lower second molar ( Fig. 8-113). Also in
centric occlusion , the mesiolingual cusp of the upper
second molar fits squarely into the central fossa of the
lower second molar ( Fig. 8-114).
In working occlusion , the buccal cusps of the lower
second molar arc in contact with the buccal cusps of the
upper second molar and with the distal slope of the up- Fig. 8- 107. Mandibular second premolar in centric occlusion, buccal
per first molar ( Fig 8-115). Also in working occlusion . view .

Fig. 8- 108. Mandibular second premolar in centric occlusion, lingual Fig. 8- 109. Mandibular second premolar in working occlusion, buc-
view . cal view.
 Arranging and articulating artificia l teeth 253
V

Fig. 8-110. Mandibular second premolar in working occlusion, lin- - .

Fig. 8 111 Mandibular second premolar in balancing contact , buc-
gual view . cal view.

.
Fig. 8-112 Mandibular second premolar in balancing contact, lin- Fig. 8 113. Mandibular second molar in centric occlusion, buccal
view.
-
gual view.

- .
Fig. 8 114 Mandibular second molar in centric occlusion, lingual Fig. 8-115. Mandibular second molar in working occlusion, buccal
view . view .
254 Dental laboratory procedures: complete dentures

ilUM
Fig. 8-116. Mandibular second molar in working occlusion, lingual Fig. 8 117. Mandibular second molar in balancing contact , buccal
-
view . view .

-
Fig. 8 118. Mandibular second molar in balancing contact, lingual Fig. 8 119. Mandibular first premolar in centric occlusion, buccal
-
view. view.

*4

Fig. 8-120. Mandibular first premolar in centric occlusion, lingual - .

Fig. 8 121 Mandibular first premolar in working occlusion, buccal
view . view .
 Arranging and articulating artificial teeth 255

Fig. 8- 122. Mandibular first premolar in working occlusion, lingual

view .

Fig. 8- 125. Mandibular 20-degree posterior teeth have been posi-

tioned in relation to predetermined occlusal plane.

the mesiolingual cusp of the upper second molar is in

contact with the ridges formed by the protrusive and
retrusive lingual planes of the lower second molar . The
mesiolingual slope of the lower second molar touches
the distolingual cusp of the upper first molar ( Fig. 8-
116
Fig. 8- 123. Mandibular first premolar in balancing relation, buccal
In balancing contact , the mesiolingual cusp of the up-
view .
per second molar slides through the distobuccal groove
of the lower second molar. The distolingual cusp of the
upper first molar contacts the mesiobuccal protrusive
plane of the lower second molar ( Fig. 8- 1 IT and 8- 118).
Articulation of mandibular first premolar
The relationships of the mandibular first premolar in
centric occlusion , working occlusion , and balancing po-
sition are shown in Figs. 8-119 to 8- 124.

Alternate method of articulation of 20-degree

maxillary posterior teeth to mandibular
posterior teeth
As noted previously ( p. 245) ' a method of arranging
and articulating artificial teeth preferred by some is to
v
complete the mandibular setup first . In this instance,
Fig. 8- 124. Mandibular first premolar in balancing relation, lingual
^ position the mandibular teeth in relation to a predeter -
view . > mined occlusal plane ( Fig. 8-125).' As shown in Fig. 8-
125, it may consist of a carefully formed maxillary oc-
clusion rim .
The buccal and lingual cusps of the lower first and
second premolars should touch the maxillary occlusion
256 Dental laboratory procedures : complete dentures
rim. The inesiobuccal and mesiolingual cusps of the
lower first molar touch the occlusion rim . and the distal
cusps fall slightly below the rim . Elevating the mesio-
buccal cusp of the lower second molar slightly places
the mesial slope in alignment with the protrusive incli -
4
nation of the distal cusp of the lower first molar. After
the mandibular teeth are in position , articulate the
maxillary teeth with them .
1
Articulation of maxillary first molar
In centric occlusion , ' the ridges of the inesiobuccal
cusp of the upper first molar rests in the anterior buccal
groove of the lower first molar. ' The distal inclined
plane of the upper first molar touches the inesiobuccal
cusp of the lower second molar ( Fig. 8- 126). Also in
centric occlusion , the mesiolingual cusp of the upper
first molar fits squarely into the central fossa of the*
lower first molars The distolingual cusp of the upper
first molar touches the mesial ridge of the lower second
-
molar ( Fig. 8 127).
In working occlusion , the buccal cusps of the upper
first molar are in contact with the buccal cusps of the
lower first molar and the mesial slope of the lower sec
ond molar ( Fig. 8-128). Also in working occlusion , the
mesiolingual cusp of the upper first molar is in contact
Fig. 8-126. Maxillary 20-degree first molar in centric occlusion, buc-
cal view.
Fig. 8-128. Maxillary first molar in working occlusion, buccal view.
with ridges formed by protrusive and retrusive lingual
planes of the lower first molar . The distal slope of the
upper distolingual cusp touches the mesial slope of the
mesiolingual cusp of the lower second molar ( Fig. 8-
129 ).
When the teeth of the opposite side go into working
occlusion , the mesiolingual cusp of the upper first mo-
lar slides through the distobuccal groove of the lower
first molar ( Fig. 8rl 30). The distolingual cusp of the up-
per first molar contacts the inesiobuccal cusp of the
lower second molar ( Fig. 8-131 ).
Articulation of maxillary second premolar •
+
In centric occlusion , the tip of the buccal cusp of the
upper second premolar contacts the inesiobuccal ridge
of the buccal cusp of the lower first molar and the dis -
tobuccal ridge of the lower second premolar ( Fig. 8-
132). Also in centric occlusion , the lingual cusp of the
upper second premolar is at the embrasure between
the lower first molar and lower second premolar. The
distal ridge contacts the mesiolingual cusp of the lower
first molar , and the mesial ridge contacts the distal
- slope of the lower second premolar ( Fig. 8- 133).
In working occlusion , the distobuccal slope of the up-
per second premolar contacts the inesiobuccal slope of
Fig. 8- 127. Maxillary first molar in centric occlusion, lingual view .
Fig. 8- 129. Maxillary first molar in working occlusion, lingual view .
 Arranging and articulating artificial teeth 257
tin * lower first molar. The mesiolmccal slope of the up-
per second premolar contacts the distobuccal slope of
the lower second premolar ( Fig. 8- 134 ). Also in working
occlusion , the lingual cusp of the upper second premo-
lar closes the embrasure formed by the lower first mo-
lar and lower second premolar ( Fig. 8-135).
In balancing contact , the lingual cusp of the upper
second premolar contacts the mesiobuccal cusp of the
lower first molar ( Figs. 8- 136 and 8-137).

.
Fig 8-130. Maxillary first molar in balancing contact, buccal view.

-
Fig. 8 131. Maxillary first molar in balancing contact , lingual view . Fig. 8-132. Maxillary second premolar in centric occlusion, buccal
view .

- .
Fig. 8 133 Maxillary second premolar in centric occlusion, lingual Fig. 8 134. Maxillary second premolar in working occlusion, buccal
view .
-
view .

.
Fig. 8-135 Maxillary second premolar in working occlusion, lingual Fig. 8-136. Maxillary second premolar in balancing contact, buccal
view . view .
258 Dental laboratory procedures: complete dentures

Fig. 8- 137. Maxillary second premolar in balancing contact, lingual Fig. 8- 138. Maxillary second molar in centric occlusion, buccal
view. view.

Fig. 8- 139. Maxillary second molar in centric occlusion, lingual Fig. 8- 140. Maxillary second molar in working occlusion, buccal
view. view.

Fig. 8- 141. Maxillary second molar in working occlusion, lingual Fig. 8- 142. Maxillary second molar in balancing contact, buccal
view. view .

!'
fry .

'

Fig. 8- 143. Maxillary second molar in balancing contact, lingual Fig. 8- 144. Maxillary first premolar in centric occlusion, buccal view
view .
 Arranging and articulating artificial teeth 259

Articulation of maxillary second molar

4
In centric occlusion , the ridge of the mesiobuccal
cusp of the upper second molar rests in the buccal
i -
groove of the lower second molar ( Fig. 8 138 ). Also in
centric occlusion , the mesiolingual cusp of the upper
second molar fits squarely into the central fossa of the
lower second molar ( Fig. 8-139)."'
In working occlusion , the buccal cusps of the upper
second molar arc in contact with the buccal cusps of the
lower second molar ( Fig. 8 140). Also in working occlu
- -
sion . the mesiolingual cusp of the upper second molar
contacts ridges formed by the protrusive and retrusive - .
Fig. 8 145 Maxillary first premolar in centric occlusion, lingual view .
lingual cusp planes of the lower second molar ( Fig. 8-
141).
In balancing contact , the mesiolingual cusp of the up-
per second molar slides through the distobuccal groove
of the lower second molar ( Figs. 8-142 and 8- 143).
Articulation of maxillary first premolar
In centric occlusion, the tip of the buccal cusp of the
•

upper first premolar contacts the distobuccal ridge of

the lower first premolar and the mesiobuccal ridge of
the lower second premolar ( Fig. 8-144 ). Also in centric
occlusion , the lingual cusp of the upper first premolar
is at the embrasure between the lower first and second
premolars.1 The mesial ridge of the upper first premolar Fig. 8-146. Maxillary first premolar in working occlusion, buccal
view.
contacts the distal slope of the lower first premolar , and
the distal ridge contacts the mesial slope of the lower
second premolar ( Fig. 8-145).
In working occlusion , the distobuccal slope of the up-
„ per first premolar contacts the mesiobuccal slope of the
lower second premolar. The mesiobuccal slope of the
upper first premolar contacts the distobuccal slope of
the lower first premolar ( Fig. 8-146). Also in working
occlusion , the lingual cusp of the upper first premolar
closes the embrasure formed by the lower first and sec-
ond molars ( Fig. 8- 147).
In balancing contact , the lingual cusp of the upper
first premolar contacts the buccal cusp of the lower sec-
ond premolar ( f igs. 8- 148 and 8-149). Fig. 8-147. Maxillary first premolar in working occlusion, lingual
view .

. - .
Fig 8 148 Maxillary first premolar in balancing contact , buccal Fig. 8 149. Maxillary first premolar in balancing contact, lingual
-
view. • view.
Checking completed setup of 20-degree
posterior teeth
After completion of the setup of the 20-degree pos-
terior teeth , it . is essential to check it in all relation -
ships: centric occlusion ( Figs. 8-150 and 8-151), working
. -
occlusion ( Figs 8 152 and 8-153), and balancing contact
( Figs. 8-154 and 8- 155). An anterior view of the com -
pleted tooth arrangement is shown in Fig. 8-156.
Arranging Pilkington-Turner 30-degree
posterior teeth
Fig. 8-150. Completed setup of 20- degree posteriors in centric oc-
The individual relationship of each Pilkington-Turner clusion, buccal view.
maxillary posterior tooth to an occlusal plane is shown
in Fig. 8-157. Note that the lingual cusp of the first and
second premolars should touch the occlusal plane. The
buccal cusps are raised approximately 0.5 mm .
NOTE: Diagrams can exaggerate the positions of teeth
in relation to a flat plane. Average’ dentures do not
"

normally require a distance of more than 2 mm from

the distobuccal cusp of the second molar to the occlusal
plane. The arrangement of posterior teeth in this man -
ner forms a compensating curve ( the counterpart of the
curve of Spec in natural dentitions).
NOTE: This positioning of the maxillary teeth is an
"
average positioning. The ridge relations, condylar
guidance, and incisal guidance may make it necessary Fig. 8- 151. Completed setup in centric occlusion, lingual view.
to increase or decrease the degree of the compensating
cur\ e to effect a balanced occlusion .

A
The long axes of the premolars should be right angles
to the occlusal plane, whereas the molars may incline
slightly toward the mesial surface ( Fig. 8-158). The me-
siobuccal cusp of the first molar is raised approximately
0.5 mm to place it out of contact with the occlusal
plane. The mesiolingual cusp touches the plane, and
the distobuccal cusp is raised approximately 1 mm . The
mesiobuccal cusp of the second molar is raised approx -
imately 1 mm; the distobuccal cusp approximately 1.5
mm. An occlusal view of the setting of these maxillary
posteriors is shown in Fig. 8- 159.
Fig. 8-152. Completed setup in working occlusion, buccal view .

Fig. 8- 153. Completed setup in working occlusion, lingual view . Fig. 8- 154. Completed setup in balancing contact, buccal view .
 Arranging and articulating artificial teeth 261

\s

Fig. 8- 155. Completed setup in balancing contact , lingual view. Fig. 8- 156. Anterior view of completed tooth arrangement.

i i
A
H/

Fig. 8- 157. Cusps of Pilkington-Turner posterior teeth are shown in relation to flat occlusal plane.
Lingual cusps of premolars touch, and buccal cusps are approximately 0.5 mm from plane. Mesiolin-
gual cusp of first molar touches plane. Second molar follows alignment of first molar. Distobuccal
cusp of second molar normally is not more than 2 mm from plane.

* r

Fig. 8- 158. From buccal view, premolars are vertical to plane. Cer - Fig. 8- 159. Positioning of Pilkington-Turner molars in relation to line
vical area of molars incline slightly toward mesial line. along facial surface of canine and premolars.

*
 262 Dental laboratory procedures: complete dentures

The mandibular tooth arrangement is completed and
checked in a manner similar to that shown in the sec-
tion on the 33-degree anatomic posterior teeth (see
Figs. 8-45 to 8-72).
Arranging Rational O-degree posterior teeth
Rational O-degree posterior teeth may be used for
complete denture construction when a preference for a
Hat occlusal form or conditions indicate their use. The
purpose of this chapter is not to discuss indications or
contraindications of flat teeth in comparison with teeth
that have cusps of varying degrees of steepness.
However, some consider Hat tooth forms useful in so-
*.• called problem cases, such as those with * malrelation of
the jaws;1 crossbites,'’* Hat or heavily resorbed ridges,
making denture bases less stable; and those persons
with uncoordinated jaw movements^ for whom it is dif-
ficult to obtain a valid centric relation record.
It is possible to set Hat teeth to a curve or to a flat
*
plane /' This chapter will describe latter procedure,
which is * more common .1
NOTE: Set the anterior teeth so that the degree of
vertical overlap (overbite) is 0 degrees or nearly so. Af-
ter positioning the maxillary and mandibular anterior
' surface relationship / or even a crossbite.* As mentioned
teeth , shape the lower wax occlusion rim to form a Hat
occlusal plane extending from the tips of the lower ca-
nines through the centers of the retromolar pads. Make
the right and left sides the same height and have them
parallel laterally and anteroposteriorly. This plane also
should he roughly parallel to the mean foundation plane
of the mandibular ridge / as viewed from the side. Mark
the center of the mandibular ridge on the top of the
lower wax occlusion rim by surveying the mandibular
cast and marking the rim , as shown in Figs. 8-39 to 8-
41.
-
Rational O degree posterior teeth are available as sin -
gle teeth, or inSolid quadrant blocks of four teeth each
for setting up as a unit .' The principles of positioning
both ty pes are the same. Set the maxillary teeth so that
their centers (from anterior to posterior ) lie approxi-
mately over the line scribed on the mandibular wax
rim . This position can vary as individual situations in -
dicate. The teeth , as viewed from the side, form a Hat
surface against this plane ( Fig. 8-160). Then set the
mandibular teeth to occlude with the maxillary teeth .
In a normal jaw-relation situation, there will be a
buccal overjet of the upper teeth ( Fig. 8- 161 ).
However, in some situations in which there is a small
upper arch and a large lower arch , it is possible to po-
- -
sition the posterior teeth in an “ end to end occlusal
previously, some believe that Hat posteriors are prefer-
able in such situations. Additionally, if the upper and
lower space available for setting teeth anteroposteriorly

Table 8- 1. Arrangement and articulation of artificial teeth

Problem Probable cause Solution

Lack of vertical space to
set anterior teeth
Lack of space to set pos-
terior teeth
Lack of space ( anteropos-
terior) to set mandibular
first premolar
Movement of teeth e-
^
cause of wax shrinkage
Recent extractions with large unre- Grind ridge lap area of teeth carefully (do not impinge
sorbed ridges present on pins in porcelain teeth)
Use plastic teeth if heavy ridge-lap reduction required;
leave labial collar if possible
Small interridge space Grind ridge lap carefully (do not grind away vent holes
on porcelain teeth), leave off second molar, or use
shorter posterior mold
Often a Class II (retrusive) jaw rela- Leave 1 mm diastema between upper canine and first
tion premolar (giving more space for lower), or grind
lower premolar carefully on mesial and distal sur -
faces to narrow it: or leave out lower central or lat-
*4
eral (in extreme conditions)
and/or wax -up 9
^ ^-
Excess heat applied di ri g setup Do not overheat wax

Chipping of porcelain teeth
Undue time elapsed before investing
Thermal shock during wax -up
Too much pressure during packing of
compression-mold denture- base
resin
Undue leverage during deflasking pro-
cedures
Leave ground porcelain tooth surfaces
unpolished
Invest for processing as soon as practical after wax -up
Avoid direct flame on teeth
Avoid excess pressure when using compression-
molded denture-base materials
Deflask carefully
Polish teeth carefully after grinding Jh
 Arranging and articulating artificial teeth 263

is mismatched , it is possible to set premolars to oppose

molars, since there is no interdigitation of cusps ( Fig.
8-162).
-
It is advisable when using O degree posterior teeth to
select or modify the canines, so that they tend to have
a blunt incisal edge rather than a pointed one. Usually
optimal contact and/or embrasure between a canine and
Fig. 8-160. Rational O-degree posterior teeth are set contacting flat
a O-degree premolar can be obtained more readily with
plane.
a somewhat blunted canine than with a pointed one.
The proper setting of flat teeth requires attention to
detail comparable to that used in arranging cusp teeth .
It is important to pay special attention to see that there
is good occlusal contact in the setup when viewed from
different sides, especially the lingual aspect .
Arranging Anatoline posteriors
in a linear occlusion
1 . Place the maxillary premolars and molars with
their long axes at right angles to the occlusal plane ( Fig.
8-163). The buccal and lingual cusps should touch the
plane ( P igs. 8- 163 and 8- 164 ).
2. Use a straightedge to align the lingual cusps of all
four posteriors to a straight line ( Fig. 8- 165). When this
is done, a proper degree of buccal curvature results
( Fig. 8-166). This also in effect aligns the lingual cusps
to form a lingual knife for exceptional cutting effi -
“

Fig. 8-161. Buccal overjet of upper Rational O-degree teeth in “ nor-
mal" jaw relation.
ciency.
3. Follow the same procedure in placing the posteri -
ors on the opposite side.
4. Then occlude the mandibular teeth to the maxil -
lary teeth as shown in Figs. 8- 167 to 8- 172. This ar-
rangement was done with a 30-degree condylar incli -
nation , and a O-degree incisal inclination . Other
guidance factors may be used as individual conditions
indicate.

S'
v
1 *
7
t I % if S\ \Y !
FC£
Fig. 8 162. Premolars can be set to oppose molars if needed be-
-
cause there is no interdigitation of cusps. ^ 163. Teeth positioned with long axe» at right angles to the
occlusal plane.

-
Fig. 8 164. Buccal and lingual cusps touch the plane.
I

1st premolar 2nd premolar 1st molar 2nd molar

Checking completed setup of 20-degree
posterior teeth
After completion of the setup of the 20-degree pos-
terior teeth, it . is essential to check it in all relation -
-
ships: centric occlusion ( Figs. 8- 150 and 8 151), working
-
occlusion ( Figs. 8-152 and 8 153), and balancing contact
-
( Figs. 8- 154 and 8 155). An anterior view of the com -
pleted tooth arrangement is shown in Fig. 8 156. -
Arranging Pilkington-Turner 30-degree
posterior teeth
Fig. 8-150. Completed setup of 20-degree posteriors in centric oc -
The individual relationship of each Pilkington -Turner clusion, buccal view .
maxillary posterior tooth to an occlusal plane is shown
in Fig. 8- 157. Note that the lingual cusp of the first and
second premolars should touch the occlusal plane. The
buccal cusps are raised approximately 0.5 mm.
NOTE: Diagrams can exaggerate the positions of teeth
in relation to a Hat plane. “ Average” dentures do not
normally require a distance of more than 2 mm from
the distobuccal cusp of the second molar to the occlusal
plane. The arrangement of posterior teeth in this man -
ner forms a compensating curve ( the counterpart of the
curve of Spee in natural dentitions).
NOTE: This positioning of the maxillary teeth is an
“ average” positioning. The ridge relations, condylar

guidance, and incisal guidance may make it necessary Fig. 8- 151. Completed setup in centric occlusion, lingual view .
to increase or decrease the degree of the compensating
curve to effect a balanced occlusion .
The long axes of the premolars should be right angles
to the occlusal plane, whereas the molars may incline
slightly toward the mesial surface ( Fig. 8- 158 ). The me-
siobuccal cusp of the first molar is raised approximately
0.5 mm to place it out of contact with the occlusal
plane, 'flic mesiolingual cusp touches the plane, and
the distobuccal cusp is raised approximately 1 mm. The
mesiobuccal cusp of the second molar is raised approx-
imately 1 mm ; the distobuccal cusp approximately 1.5
mm . An occlusal view of the setting of these maxillary
posteriors is shown in Fig. 8-159.
Fig. 8- 152. Completed setup in working occlusion, buccal view.

1
%

*
Fig. 8- 153. Completed setup in working occlusion, lingual view. Fig. 8- 154. Completed setup in balancing contact, buccal view .
 Arranging and articulating artificial teeth 261

-
Fig. 8 155. Completed setup in balancing contact, lingual view . Fig. 8- 156. Anterior view of completed tooth arrangement.

Fig. 8- 157. Cusps of Pilkington-Turner posterior teeth are shown in relation to flat occlusal plane.
Lingual cusps of premolars touch, and buccal cusps are approximately 0.5 mm from plane. Mesiolin-
gual cusp of first molar touches plane. Second molar follows alignment of first molar. Distobuccal
cusp of second molar normally is not more than 2 mm from plane.

Fig. 8- 158. From buccal view, premolars are vertical to plane. Cer- Fig. 8- 159. Positioning of Pilkington-Turner molars in relation to line
vical area of molars incline slightly toward mesial line. along facial surface of canine and premolars.

*4
 262 Dental laboratory procedures: complete dentures

The mandibular tooth arrangement is completed and
checked in a manner similar to that shown in the sec-
tion on the 33-degree anatomic posterior teeth (see
Figs. 8-45 to 8-72).
Arranging Rational 0-degree posterior teeth
/
Rational 0-degree posterior teeth may be used for
complete denture construction when a preference for a
Hat occlusal form or conditions indicate their use. The
purpose of this chapter is not to discuss indications or
contraindications of Hat teeth in comparison with teeth
that have cusps of varying degrees of steepness.
the right and left sides the same height and have them
parallel laterally and anteroposteriorly. This plane also
should be roughly parallel to the mean foundation plane
of the mandibular ridge,* as viewed from the side. Mark
the center of the mandibular ridge on the top ol the
lower wax occlusion rim by surveying the mandibular
cast and marking the rim , as shown in Figs. 8-39 to 8-
41.
Rational 0-degree posterior teeth are available as sin -
gle teeth , or inSolid quadrant blocks of four teeth each
for setting up as a unit.* The principles of positioning
both types are the same. Set the maxillary teeth so that

- However, some consider Hat tooth forms useful in so-

called problem cases, such as those with * malrelation of
the jaws;1 brossbites?' flat or heavily resorbed ridges,
making denture bases less stable; and those persons
with * uncoordinated jaw movements* for whom it is dif-
'
ficult to obtain a valid centric relation record.
It is possible to set flat teeth * to a curve or to a Hat
planed This chapter will describe latter procedure,
which is * more common . *
NOTE : Set the anterior teeth so that the degree of
vertical overlap (overbite ) is 0 degrees or nearly so. Af-
ter positioning the maxillary and mandibular anterior
teeth, shape the lower wax occlusion rim to form a Hat
occlusal plane extending from the tips of the lower ca-
nines through the centers of the retromolar pads. Make
their centers (from anterior to posterior) lie approxi-
mately over the line scribed on the mandibular wax
rim . Tins position can vary as individual situations in -
dicate. The teeth , as viewed from the side , form a Hat
surface against this plane ( Fig. 8-160). Then set the
mandibular teeth to occlude with the maxillary teeth .
In a "normal jaw-relation situation, there will be a
buccal overjet of the upper teeth ( Fig. 8- 161 ).
However, in some situations in which there is a small
upper arch and a large lower arch , it is possible to po-
sition the posterior teeth in an "end - to-end occlusal
surface relationship, or even a crossbite.? As mentioned
previously, some believe that Hat posteriors are prefer-
able in such situations. Additionally, if the upper and
lower space available for setting teeth anteroposteriorly

Table 8- 1. Arrangement and articulation of artificial teeth

Problem Probable cause Solution

Lack of vertical space to Recent extractions with large unre- Grind ridge lap area of teeth carefully (do not impinge
set anterior teeth sorbed ridges present on pins in porcelain teeth)
Use plastic teeth if heavy ridge-lap reduction required;
leave labial collar if possible
Lack of space to set pos- Small interridge space Grind ridge lap carefully (do not grind away vent holes
terior teeth on porcelain teeth), leave off second molar, or use
shorter posterior mold
Lack of space ( anteropos- Often a Class II (retrusive) jaw rela- Leave 1 mm diastema between upper canine and first
terior) to set mandibular tion premolar (giving more space for lower), or grind
first premolar lower premolar carefully on mesial and distal sur -
-
faces to narrow it? or leave out lower central or lat

Movement of teeth«be- Excess heat applied

cause of wax shrinkage
Chipping of porcelain teeth
-a
diftfig
setup
eral (in extreme conditions)
Do not overheat wax
and/or wax-up r'*
Undue time elapsed before investing Invest for processing as soon as practical after wax -up
Thermal shock during wax -up Avoid direct flame on teeth
Too much pressure during packing of Avoid excess pressure when using compression-
compression-mold denture-base molded denture-base materials
resin
Undue leverage during deflasking pro- Deflask carefully
cedures
Leave ground porcelain tooth surfaces Polish teeth carefully after grinding
unpolished

Fig. 8- 160. Rational 0-degree posterior teeth are set contacting flat
plane.
Fig. 8- 161. Buccal overjet of upper Rational 0-degree teeth in "nor-
mal" jaw relation.
> lary teeth as shown in Figs. 8-167 to 8-172. This ar-
f $v
Fig. 8-162. Premolars can be set to oppose molars if needed be-
cause there is no interdigitation of cusps.
Fig. 8- 164. Buccal and lingual cusps touch the plane.
1st premolar
Arranging and articulating artificial teeth 263
is mismatched , it is possible to set premolars to oppose
molars, since there is no interdigitation of cusps ( Fig.
8-162).
It is advisable when using 0-degrce posterior teeth to
^
select or modify the canines, so that they tend to have
a blunt incisal edge rather than a pointed one. Usually
optimal contact and/or embrasure between a canine and
a ( )-degree premolar can be obtained more readily with
a somewhat blunted canine than with a pointed one.
The proper setting of flat teeth requires attention to
detail comparable to that used in arranging cusp teeth.
It is important to pay special attention to see that there
is good occlusal contact in the setup when viewed from
different sides, especially tin * lingual aspect .
Arranging Anatoline posteriors
in a linear occlusion
1. Place the maxillary premolars and molars with
their long axes at right angles to the occlusal plane ( Fig.
8-163). The buccal and lingual cusps should touch the
plane ( Figs. 8-163 and 8- 164 ).
2. Use a straightedge to align the lingual cusps of all
four posteriors to a straight line ( Fig. 8-165). When this
is done, a proper degree of buccal curvature results
( Fig. 8- 1 (56). This also in effect aligns the lingual cusps
to form a lingual knife ” for exceptional cutting effi -
ciency.
3. Follow the same procedure in placing the posteri -
ors on the opposite side.
4. Then occlude the mandibular teeth to the maxil-
rangement was done with a 30-degree condylar incli -
nation , and a O-degree incisal inclination. Other
guidance factors may be used as individual conditions
indicate.
S'
S v Ss
I, s1
V
I )Y M ¥ I
^5 *
^
* 163. Teeth positioned with long axes at right angles to the
occlusal plane.
I
2nd premolar 1st molar 2nd molar
 264 Dental laboratory procedures: complete dentures

«r I

Fig. 8- 165. A straight edge is used to align the lingual cusps.

>

Fig. 8- 166. Buccal curvature is established when

lingual cusps are aligned.
ft

Fig. 8- 167. Anatoline linear tooth arrangement in centric occlusion, Fig. 8- 168. The linear arrangement in centric occlusion, lingual
buccal view . view . r
 - n

Arranging and artindating artificial teeth 265

-6

Fig. 8- 169. The linear arrangement in working occlusion, buccal Fig. 8-170. The linear arrangement in working occlusion, lingual
view . view .

>

t Fig. 8-171. The linear arrangement in balancing position, buccal Fig. 8-172. The linear arrangement in balancing position, lingual
view. view .

.
L
266 Dental laboratory procedures: complete dentures
Arranging Anatoline posteriors
in a bilateral balance
5. The same procedure is followed in placing the pos -
terior teeth on the opposite side.
1. Place the maxillary premolars with their long axes 6. Then mandibular teeth are occluded to the maxil-
at right angles to the occlusal plane ( Fig. 8- 173). The lary teeth ( Figs. 8-175 to 8-180 ). A 30-degree condylar %

lingual cusps should touch the plane and the buccal inclination and a 10-degree incisal inclination is recom -
cusps should be raised approximately 0.5 mm above the mended . However, other guidance factors may be used
-
plane ( Figs. 8- 172 to 8 174 ). A straightedge may be as individual conditions indicate.
used to align the lingual cusps as shown previously
-
( Figs. 8 165 and 8-166).
2. The first and second molars may be set with their
long axes inclined slightly mesially ( Fig. 8- 173).
3. The mesiolingual cusp of the first molar touches
the plane, and the mesiobuccal cusp is approximately
0.5 mm above the plane. The distolingual cusp is
slightly above the plane, and the distobuccal cusp is
approximately 1 mm above the plane ( Figs. 8 173 and
8-174 ).
4. The second molar is set to follow the position of
-
WI V a\
%

the first molar. The distolingual cusp is approximately. Fig. 8- 173. Maxillary premolars are placed with long axes at right
1.5 mm above the plane, and the distobuccal cusp is angles to the occlusal plane. Lingual cusps should touch the plane.
approximately 2 mm above the plane ( Figs . 8-173 and
8-174 ).

Fig. 8- 174. Buccal cusps are raised approximately

0.5 mm above the occlusal plane. as?.

1st premolar 2nd premolar 1st molar 2nd molar

ft

Fig. 8- 175. The balancing arrangement in centric occlusion, buccal Fig. 8- 176. The balancing arrangement in centric occlusion, lingual
view. view .
 Arranging and articulating artificial teeth 267

A
*

Fig. 8-177. The balancing arrangement in working occlusion, buc- -

Fig. 8 178. The balancing arrangement in working occlusion, lin-
cal view . gual view .

M
S

Fig. 8-179. The balancing arrangement in balancing position, buc - Fig. 8 180. The balancing arrangement in balancing position, lin-
-
\X cal view . gual view.
t

o
268 Dental laboratory procedures: complete dentures

ft
Fig. 8- 181. Posterior teeth are placed with long axes at right angles
f to the occlusal plane.

m/ R T Ctf
I)

i
i i
l
n f i

V J&r ) Vi
Fig. 8- 182. Buccal and lingual cusp areas should touch the occlusal plane.

UMaaiisi i

i
Fig. 8- 184 . Straight lingual alignment provides proper buccal cur -
vature.

Fig. 8- 183. Use a straight edge to align lingual cusps.

Arranging Monoline posteriors in a flat linear
type occlusion
1. Place the maxillary premolars and molars with
their long axes at right angles to the occlusal plane ( Fig.
8-181 ) . The buccal and lingual cusp areas should touch
the plane ( Fig. 8- 181 and 8- 182).
2. A straightedge may he used to align the lingual
cusps of all four posteriors to a straight line ( Figs. 8- 183
and 8- 184 ). When this is done, a proper buccal contour
results .
3. Follow the same procedure in placing the posteri -
ors on the opposite side.
4 . Then occlude the mandibular teeth to the maxil -
lary teeth ( Figs . 8-186 to 8-191). There should be ap- VJ
proximately 1.5 mm of buccal overjet by the maxillary
teeth, as shown in Fig. 8-185. The arrangement illus -
trated here was done with a 30-degree condylar incli -
nation and a — -
10 degree incisal inclination. Other
A
guidance factors may be used as individual conditions
indicate. In this type occlusion with Monoline posteri-
 Arranging, and articulating artificial teeth 269

. .
Fig 8-185 Provide approximately 1.5 mm of horizontal overlap by
the maxillary teeth.

v Fig. 8-186. Flat linear tooth arrangement in centric occlusion, buc Fig. 8 187. Centric occlusion, lingual view.
-
cal view .

k
.
Fig. 8-188 Working occlusion, buccal view. - .
Fig. 8 189 Working occlusion, lingual view.
270 Dental laboratory procedures: complete dentures
- .
Fig. 8 190 Balancing position , buccal view.
.
Fig . 8-192 Posterior teeth set “ end to end ."
ors there will normally be no contact in balancing po
sitions. NOTE: The maxillary and mandibular teeth do
not have to be interdigitated . ” They may be set “ end
to end , ” as shown in Fig. 8- 192. It is possible to posi -
tion premolars to oppose molars because there is no
interdigitation of the cusps.
Arranging Monoline posteriors in a
bilateral balance
1. Place the maxillary premolars with their long axes
at right angles to the occlusal plane ( Fig. 8-193). The
lingual cusp areas should touch the plane, and the buc
cal cusp areas of the premolars should be raised approx
imately 0.5 mm above the plane ( Figs. 8 193 and 8 -
194 ). A straightedge may be used to align the lingual
tooth surfaces, as shown previously ( Figs. 8-183 and 8
184).
2. Set the first and second molars with their long axes
inclined very slightly toward the mesial ( Fig. 8-193).
3. Position the first molar with the mesiolingual cusp
area touching the plane, and the mesiobuccal cusp area
- .
Fig. 8 191 Balancing position , lingual view .
- -
Fig . 8 193. Lingual cusp areas of premolar teeth touch plane . Buc
cal cusp areas are raised approximately 0.5 mm.
- approximately 0.5 nun above the plane. NOTE: Both
types of tooth arrangement shown above are average.
Modifications can be made as needed for a given situa-
tion . The distobuccal cusp area should be approxi -
mately 1 mm above the plane ( Fig. 8-193 and 8-194 ).
4. The second molar is set to follow the position of
the first molar. The mesiolingual cusp should be about
1 mm above the plane, and the mesiobuccal distolin -
gual cusp areas approximately 2 mm off the plane.
5. Follow the same procedure in placing the poste-
rior teeth on the opposite side.
- 6. Then occlude the mandibular teeth to the maxil -
- lary teeth ( Figs. 8- 195 to 8- 200 ). A 30-degree condylar
- —
inclination and a 10-degree incisal inclination were
used in this arrangement . Other guidance factors may
- be used as individual conditions indicate. When using
Monoline posteriors, it is advisable to modify the ca-
nines so that the incisal edges tend toward bluntness
rather than a sharp point. A somewhat blunted canine
enhances the appearance of the contact area and em - **
brasure between the canine and the first premolar. To
 Arranging and articulating artificial teeth 271

Fig. 8 194. The first molar ’s mesiolingual cusp area contacts the
-
occlusal plane. Note position of the second molar.

.
Fig 8-195. Monoline balancing arrangement in centric occlusion, - .
Fig. 8 196 Centric occlusion, lingual view.
buccal view.
^

.
Fig. 8-197 Working occlusion, buccal view . .
Fig. 8 198 Working occlusion, lingual view .
-
*
272 Dental laboratory procedures: complete dentures
Fig . 8- 199. Balancing position, buccal view.
} j
IV - I v n\
' Y y/ V 'it
1st premolar
Fig . 8- 202. Note position of cusps in relation to the occlusal plane.
ensure the best occlusal efficiency , there should IK *
close contact of the occlusal surfaces when viewed from
the lingual as well as the buccal .
Arranging Monoline mandibular posteriors with
Anatoline maxillary posteriors in a lingualized,
balanced occlusion
1 . Place the Anatoline maxillary premolars with their
long axes at right angles to the occlusal plane ( Fig. 8
201). The lingual cusps should touch the plane, and the
buccal cusps should be raised approximately 0.5 mm
above the plane ( Figs. 8-201 and 8-202 ). A straightedge
Fig . 8- 200. Balancing position, lingual view.
Fig . 8-201 . Anatoline maxillary premolars are set with their long
axes at right angles to the occlusal plane. Note position of buccal
cusps.
2nd premolar 1st molar 2nd molar
may be used to align the lingual cusps, as shown pre-
viously for the Vlonoline posteriors (see Figs. 8- 183 and
8- 184 ).
2. The first and second molars may he set with their
long axes inclined slightly mesiallv ( Fig. 8 201). -
3. The mesiolingual cusp of the first molar touches
the plane, and the mesiobuccal cusp is approximately
0.5 mm above the plane. The distolingual cusp is
- slightly above the plane, and the distobuccal cusp is
-
approximately 1 mm above ( Figs. 8 201 and 8 202). -
4 . The second molar is set to follow the position of
the first molar. The distolingual cusp is approximately
^

.
Fig 8- 203. Note relationship of maxillary lingual cusp with central
fossa area of mandibular tooth .
rrr 4
Fig. 8-205. Centric occlusion, lingual view.
1.5 mm above the plane, and the distobuccal cusp is
approximately 2 mm above the plane ( Figs. 8-201 and
8-202 ) .
5. The same procedure is followed in placing the pos-
terior teeth on the opposite side.
6. The central fossae area of the mandibular Mono-
line teeth is occluded to the lingual cusps of the
maxillary Anatoline teeth . A typical relationship of
-
upper to lower is illustrated in Fig. 8 203. The rela -
tionships of the completed arrangement are shown in
Figs. 8-204 to 8-209. A 30-degree condylar inclina
tion and an approximate —
10-degree incisal guidance
Arranging and articulating artificial teeth 273
. .
Fig. 8-204 Monoline/ Anatoline lingualized balanced tooth arrange-
ment in centric occlusion, buccal view.
ri V V
i i
.
Fig. 8- 206 Working occlusion, buccal view.
inclination were used for this arrangement. Other
guidance factors may be used as individual condi -
tions indicate. The molds used in this arrangement
are Anatoline 334 and Monoline 433. If a “ deeper”
or “ tighter occlusion is desired, some slight grind -
ing modification in the developmental groove areas
of the Monoline lower posteriors will permit a more
intense lingualized relationship with the lingual cusps
of the upper Anatoline posteriors. The modification
may he done with small , mounted points and will
- permit deeper penetration of the upper lingual
cusps.
274 Dental laboratory procedures: complete dentures

Fig. 8- 207. Working occlusion, lingual view .

Fig. 8- 208. Balancing position, buccal view .

Fig. 8- 209. Balancing position, lingual view.


TRY-IN
The try-in is the time for the dentist to determine
the esthetics of the restoration and to write the final
instructions to the dental laboratory about these consid -
erations. The tooth arrangement should be carefully
waxed to produce a natural anatomic form and appear-
ance, and rough or sharp edges should be removed
from the baseplates. The color of the wax should be
pleasing, and it should approximate the color of the fin -
ished dentures.
The dentist may wish to check the following aspects
at the time of try-in:
1. Midline harmony
2. Relation of anterior teeth to lips
3. Prominence of cervical area of canines
4. Anteroposterior position of anterior teeth
5. Occlusal plane
6. All original esthetic considerations, such as
shape, size, and color of teeth
7. Phonetic acceptability
8. Vertical dimension
9. Occlusal relations
10. Overall patient comfort and acceptance
GRINDING PORCELAIN TEETH
After processing, remounting, and modifying the
tooth form by selective grinding procedures, it is
strongly recommended that ground surfaces of porce-
lain teeth be repolished. Rough surfaces, which may
tend to collect stain and debris, are a major cause of
* chipping and flaking. Smooth porcelain surfaces glide
‘
smoothly over each other however
; , rough , unpolished
surfaces catch and “ trip, thereby causing discomfort
and ultimately resulting in chipping and flaking of the
porcelain . A few moments of polishing at this time can
Arranging and articulating artificial teeth 275
prevent potential problems and later embarrassment .
In addition , it is necessary to polish porcelain teeth
highly if they occlude with plastic teeth and grinding
has penetrated the glaze of the porcelain teeth . Prosth-
odontic authorities recognize the need in some in-
stances to give consideration to the advisability of oc-
cluding porcelain teeth against plastic teeth . In this
instance , porcelain teeth must present a smooth surface
to avoid undue wear of the resin teeth. When feasible,
avoid grinding porcelain when it opposes plastic teeth .
Four easy steps are essential in reshaping and polish -
ing porcelain teeth:
1 . Grind and reshape porcelain with fairly soft , fine,
uniform grit stones.
2. Smooth ground surfaces with a rubber wheel to
remove stone marks and to round sharp or square cor-
ners .
3. Pumice the rubber-wheeled areas to smooth the
porcelain even more and to impact an initial polish .
4 . Apply a commercially available porcelain polish *
to develop a final polish with a high luster.
SUMMARY
This chapter has described methods of arranging and
articulating anterior teeth , 33-degrec* anatomic poste-
rior teeth , 20-degree posterior teeth . Pilkington-Tumer
.
30-degree posterior teeth Rational 0-degree posterior
teeth , IPN Anatoline posterior teeth , and IPN Mono-
line posterior teeth . These methods may be used to
produce optimal treatment results for edentulous and
partially edentulous patients.
*Trii|X » lish or Dentsply Porcelain Tooth Finishing Kit . Dentsply In -
.
ternational , Inc., York Pa.

CHAPTER 9
WAXING AND PROCESSING
. . .
KENNETH D. RUDD, ROBERT M MORROW EARL E FELDMANN, AMBROCIO V. ESPINOZA,
and CHARLOTTE GORNEY
waxing ( wax-up) The contouring of a wax pattern or the wax base
of a trial denture into the desired form,
flasking The act of investing a pattern in a flask. The process of
investing the cast and a wax denture in a flask preparatory to
molding the denture base material into the form of the denture
,
processing The procedure of bringing about polymerization of ap-
pliances; processing of dentures.
denture processing The conversion of a wax pattern of a denture,
or trial denture, into a denture with a base made of another ma-
terial, such as acrylic resin.
WAXING FOR TRY-IN
The wax try-in is an important appointment for the
dentist and patient . Preparation of the trial denture for
try-in involves contouring the wax on the trial denture
to produce a denture base form that reproduces the
contours of the original tissues in the dentulous mouth .
If carving and contouring are accomplished skillfully , it
is much easier to evaluate the appearance and speech
of the patient during the try- in appointment .
Waxing the maxillary trial denture
PROCEDURE
1 . Adapt a softened roll of baseplate wax about 6 mm
wide and 5 cm long to the facial surface of one side of
the trial denture, and contour with the fingers while
the wax is soft ( Fig. 9- 1).
2. Adapt the wax to cover the necks of the teeth , and
extend it on the flanges of the trial denture ( Fig. 9-2).
3. Contour the baseplate wax immediately above the
necks of the anterior teeth to produce a gingival bulge ,
or fullness, simulating the attached gingiva ( Fig. 9-3).
276
A
4. Contour the wax above the canine tooth to simu -
late the canine eminence found in the dentulous
mouth . The waxed canine eminence should blend into
the peripheral border without producing additional
thickness of that border ( Fig. 9-4 ).
5. Develop a slight root prominence over the maxil-
lary central incisors, flic prominence should not he as
definite as the canine eminence and should fade out C\
before the border is reached .
6. Carve a slight depression , or fossa, between the
root of the central incisor and the canine eminence
( Fig. 9-5). This should be a very slight depression and
not hollowed out to any extent .
7. Contour the anterior flange of the trial denture to
produce a slightly convex effect overall .
8. Wax a gingival bulge immediately above the necks
of posterior teeth . This convexity should resemble the
gingival bulge placed in the anterior region , although
in the case of the posterior teeth it may be somewhat
more accentuated. The gingival bulge area should he
almost nonexistent in the first premolar area, becoming
progressively more prominent in the second premolar
and molar region ( Fig. 9-6). Vertically the gingival
bulge should be approximately 5 to 6 mm wide over the
second molar.
9. Extend the gingival bulge distal to the second mo-
lar, and blend it in with the wax , forming the maxillary
tuberosity distal to the second molar .
10. Carve a slight depression above the premolar
teeth , extending it from the canine eminence posteri -
orly to the molar process ( Fig. 9-7). This depression is
 Waxing and processing 277

-.
Fig. 9 1 A, Roll of baseplate wax is softened. B, Softened wax is adapted to flange of baseplate.

v/
•4

*
.
Fig. 9-2 A, Necks of teeth are covered with softened wax. B, Adapted wax extends over most of
buccal surface.

w.
Fig. 9 3. Wax is contoured to form fullness or convexity above an-
- .
Fig. 9 4. Canine eminence should not extend to border
-
terior teeth.
278 Dental laboratory procedures: complete dentures
/ the canine fossa and is important if normal facial expres-
Fig. 9-5. Slight depression is created between roots of central inci-
sor and canine tooth (arrow ).
Fig. 9-6. Buccal gingival bulge becomes progressively more prom-
inent in second premolar and molar region.
Fig. 9-7. Slight depression is carved above premolars.
sion is to he obtained.
11 . Carve the area above the posterior gingival bulge
to produce a slightly concave surface ( Fig. 9-8 ). This
extends from the peripheral roll superiorly, to the gin -
gival bulge inferiorly.
12. After adapting and contouring wax on the facial
surfaces of the trial denture, seal the baseplate wax
around the necks of each tooth with a wax spatula ( Fig.
9-9).
13. Use a roach carver, or a No. 7 spatula, to remove
excess wax from the facial surfaces of the denture teeth
until the finish lines on the necks of the teeth are barely
exposed ( Fig. 9-10).
14. Use a roach carver, or a No. 7 spatula, held at
-
approximately a 60 degree angle, to carve the gingival
margin around the anterior teeth ( Fig. 9- 11 ).
15. Carve the gingival margin around the posterior
teeth with a roach carver, or No. 7 spatula , held at a
-
45 degree angle. Follow the finish lines around the
necks of the teeth , removing all wax remaining on the
teeth above the finish line ( Fig. 9-12).
16. Carve the wax to produce a convex gingiva pa -
pilla . The gingival papilla of the denture should be con -
vex , both occlusogingivally and mesiodistallv ( Fig.
9-13).
17. Carve the width of the gingival margin around all
teeth until it is approximately 0.5 mm in width .
18. Use an alcohol torch to ( lame the wax surface,
taking care to not overheat the wax, thereby obliterat -
ing the carved contours. Xl
19. As an option , a subtle gingival roll may be carved
above the anterior teeth ( Fig. 9-14). Use a roach carver ,
a Woodson No. 1 plastic instrument , or small Kingsley
scraper, to remove approximately 0.5 mm of wax about
1 to 1.5 mm above the necks of the teeth following the
contour of the gingival margin . Use care when flaming
the gingival roll, otherwise, the wax will be melted , and
the roll destroyed. Polish this area with a piece of damp
nylon stocking.
:
20. Use the tip of a No. 23 explorer, held perpendic-
ular to the tooth, and carefully follow the gingival mar-
gin outline around each tooth , without creating an un -
dercut , to remove any wax ( Fig. 9-15). The explorer
produces a clear separation between the wax and tooth
and will result in a more esthetic denture.
21. If desired, the wax denture may be stippled at
this time with a modified bristle brush or toothbrush
( Fig. 9- 16, A and B ). Stipple the region of the attached
gingiva . It is usually more effective if the stippling is
confined to the interproximal areas of the teeth ( Fig.
-
9 16).
% IT
22. Flame the stippling very lightly, taking care to
not melt the wax ( Fig. 9- 17).
 Waxing and processing 279

Fig. 9-8. Region above gingival roll is slightly concave (arrows). Fig. 9-9. Hot wax spatula is used to seal around neck of each tooth.

>4»

Fig. 9- 10. A . Finish line on denture tooth is indicated by roach carver. B, Wax is removed from
denture teeth at level of finish line.

Fig. 9- 11. Carver should be held at approximately 60-degree angle

when trimming around anterior teeth.

*r
.
 280 Dental laboratory procedures: complete dentures

Fig. 9- 12. A , Carver is held at 45- degree angle when carving around necks of posterior teeth. B,
Wax is removed at level of finish line.

Fig. 9- 13. Gingival papillae are carved so that they will be convex Fig. 9- 14. Subtle gingival roll can be placed above anterior teeth
mesiodistally and occlusogingivally in completed denture. .
( arrow )

r
*

Fig. 9-15. There should be sharp delineation between denture tooth

and wax . i

*
%
 Waxing and processing 281

i
l

A f M B

-*r .
w
w

••
k

%
•\

r
-
Fig. 9 16. A, Used lathe brush wheel is broken into sections, and small section used for stippling
wax. B, Toothbrush, modified by removing all except one row of bristles, makes excellent stippling
brush. C, Stippling is placed in region of attached gingiva and is usually more prominent between
teeth rather than directly over roots.

A B

1/

- . .
Fig. 9 17 A, Do not overflame stippling B, Light flaming imparts realism to stippling.

4
y«9
282 Dental laboratory procedures: complete dentures
- .
Fig. 9 18 Wax on palatal side is trimmed from teeth at obtuse an-
gle (20 degrees below horizontal plane, arrows ) .
23. Seal the baseplate wax of the palate to the lingual
surfaces of the denture teeth .
24. When the wax is cool , use a roach carver, or No.
7 spatula , in a vertical position to remove a sufficient
amount of wax in a vertical direction . This will expose
the finish line on the lingual surfaces of the teeth.
25. Trim the wax around the necks of the teeth with
a No. 7 spatula from a palatal direction at approximately
-
a 20 degree angle below the horizontal ( Fig. 9-18). In
this manner, the wax is carved to form a slight obtuse
angle, and a smooth junction with the lingual surfaces
of the teeth at the finish line is assured .
26. Flame the wax lightly with an alcohol torch, and
again trim around the necks of the teeth to remove all
traces of wax .
27. Polish the wax with a piece of damp nylon stock-
ing until it presents a smooth shiny surface. Check the
entire maxillary denture carefully, flame it lightly, and
polish any rough areas with a piece of damp nylon
stocking. Check the waxed denture carefully for pits.
These must be filled with wax using a spatula rather
than flaming with a torch . The maxillary waxed denture
is now ready for trv-in .
Waxing the mandibular trial denture
PROCEDURE
1 . Flow wax on the lingual surfaces of the lower trial
denture and carve the gingival margins to produce a
gingival margin angle of approximately 20 degrees be-
low the horizontal ( Fig. 9-19).
2. Wax the lingual flanges of the lower denture from
the posterior teeth to the peripheral roll to produce an
inclined plane that slopes toward the tongue. The con -
Fig. 9 19. Lingual gingival margins of mandibular denture are
-
carved similar to maxillary denture.
tour of the posterior lingual flange should not be con -
vex , hut in some instances may be slightly concave. The
concavity should not be deep, or the tongue can fill the
concavity and dislodge the denture during tongue
movement ( Fig. 9-20).
3. Contour and wax the distal lingual area of the lin -
gual flange so that it blends into the retromylohyoid
- .
space ( Fig. 9 20)
4 . Wax the peripheral roll to completely fill the pe-
ripheral roll outline on the cast . The wax should he
contoured to produce a rounded border as will be re - -
C *
quired in the finished denture ( Fig. 9-21).
5. On the labial surface, wax a small gingival bulge
just below the gingival margins of the four incisor teeth ,
similar to that in the maxillary teeth .
6. Develop a canine eminence below each canine
tooth .
7. The gingival bulge should be convex in shape;
however, no extreme root prominences should be pres-
ent .
8. Contour the area between the gingival bulge and
the peripheral roll to produce the concavity . As in the
case of the maxillary denture, carve the canine emi -
nences so that they blend with the contour of the pe-
ripheral border.
9. Carve the interproximal papilla to completely fill
the interproximal space. It should be full bodied and
convex mesiodistally and incisogingivallv .
10. The free gingival margin, gingival bulge, and in -
terproximal papilla are contoured similarly to that of the
maxillary trial denture.
11 . Contour the space between the posterior gingival
bulge and the peripheral border so that it is slightly
concave ( Fig. 9-22 ). Overcarving this area , producing a
 Waxing and processing 283

Fig. 9- 20. Lingual surfaces of posterior flanges should not be con - Fig. 9-21. Peripheral roll of wax denture completely fills cast border
vex. They may be slightly concave, though not too deep (arrows ). .
(arrows )

Fig. 9- 22. Area between posterior gingival bulge and denture bor-
der should be slightly concave.

?•

Table 9- 1. Waxing the trial denture

Problem Probable cause Solution

Denture teeth not exposed to cervical
finish line
Denture too thick, not contoured to
simulate dentulous mouth
Denture wax -up unsightly because of
discoloration
Wax placed above finish line and not
carved properly
Too much wax added during wax-up
Failure to carve anatomic contour in
wax
Wax was overflamed
Wax in waxing tray is old and discolored
Incorrect type of alcohol used in torch,
causing smoke discoloration
Use roach carver and trim wax to ex-
pose denture tooth
Do not overwax
Carve anatomic contours in wax -up
Do not overheat wax when flaming with
torch
Use fresh wax in waxing tray to preserve
color
Use proper alcohol in torch

*
284 Dental laboratory procedures: complete dentures
pronounced concavity, could cause food to lx* retained
on the finished denture.
12. Carve around the individual teeth to produce a
slight gingival crevice between the wax and denture
teeth .
13. Before the trial dentures are tried in the mouth ,
check the occlusion on the articulator to he sure that
the teeth have not moved during the waxing procedure.
PROBLEM AREAS
The principal problems associated with waxing a trial
denture for try-in are related to covering up too much
of the denture teeth with too much wax, failure to de-
velop anatomic contours, and using wax that may be
discolored from overheating (Table 9-1). All of these er -
rors contribute to a trial denture that is not esthetic and
should be avoided . Add only enough wax to develop
the desired contours, and carefully trim excess wax
from the trial denture. Be sure that the denture teeth
are exposed properly by trimming the wax to the level
ol the gingival margin on the denture teeth . On the
trial dentures, carefully establish anatomic contours
that simulate those of a normal dentulous mouth. Avoid
overcontouring that can be garish and unrealistic. Use
new wax when waxing the denture, and do not overheat
the wax when flaming it , because it will produce un -
sightly discolorations. The trial denture should simulate
the appearance of the finished denture as closely as
possible.
WAXING FOR FLASKING
A plastic palate form can be * used to replace the
smooth palate of the baseplate. It will provide anatomic
detail for the palate of the maxillary denture and permit
better control of palate thickness. The baseplate itself
may not have a uniform thickness and , as a result the
completed denture, will require additional finishing
time. An anatomic palate may be freehand waxed , in
which case the plastic palate form is omitted. In this
case, baseplate wax is adapted to the cast in place of
the baseplate palate and carved to the desired contour.
Adding a plastic palate form
PROCEDURE
1 . Remove the maxillary trial denture from the cast ,
and cut out the palate section using a No. 701 or 702
fissure bur in a handpiece ( Fig. 9-23). Cut the palate
approximately 5 to 6 mm from the denture teeth , in -
clining the cut to produce an upward-facing bevel on
the resin baseplate. The bevel may be smoothed and
perfected by using an acrylic bur ( Fig. 9-24 ). A shellac
baseplate palate may be removed with a hot spatula or
a bur and should be beveled in the same manner.
2. Brush away all resin debris from the cutting pro-
cedure, and replace tlx maxillary denture on the cast .
*
3. Wax the trial denture to the casLaround the entire
border of the trial denture ( Fig. 9-25). Check the thick -
ness of the palate form with a Boley gauge before
adapting it to the cast . It is important that the finished
denture have an approximate palate thickness of 2 mm .
Since some plastic palate forms may not be this thick ,
additional wax can be flowed onto the cast before adapt -
ing the palate form to produce the desired thickness
( Fig. 9-26).
4 . Place the palate form on the cast to check the
overall fit . Shape the palate form with scissors, or a
sharp No. 25 blade in a Bard- Parker handle, so that it
closely conforms to the outline of the resin section re-
moved from tlx baseplate.
*
5. Beginning in the anterior portion , adapt the plastic -
palate to the cast , aligning the incisive papilla area in
position behind the maxillary central incisor teeth .
Continue the adaptation posteriorly, taking care to
avoid entrapment of air, which produces air bubbles
beneath the palate and creates localized thickened areas
in the denture ( Fig. 9-27).
6. Use care when adapting the palate to avoid wrin -
kles. Trim tlx * palate form posteriorly so that it ends at
the posterior extent of the maxillary denture.
7. Add wax to the bevel to produce a smooth junction
between the wax overlying the resin baseplate and the
plastic palate form ( Fig. 9-28, A ). There should be no
sharp ledge or thick border between the palate form
and wax ( Fig. 9- 28, B ) . Smooth the wax junction with a
piece of damp nylon stocking material .
8. Add wax to the tuberosity area to produce a slight
convexity lingual to the second molars. This convexity
Fig. 9- 23. Palate is removed from resin baseplate with handpiece-
mounted fissure bur.
 Waxing and processing 285

.
Fig. 9- 24 Bevel can be smoothed and perfected with large acrylic - .
Fig. 9 25 Trial denture sealed to cast with baseplate wax .
.
bur

» -

Fig. 9-26. Baseplate wax is flowed onto cast to thicken resultant .

Fig. 9-27 Plastic form is adapted to cast using care to avoid wrin-
denture palate. kles or air bubbles.

A B

t
- .
Fig. 9 28 A, Palate form is waxed to trial denture. B, There should be no sharp ledge at junction
between palate form and wax . •V

1
 284 Dental laboratory
Woreflu r » o. ~ /

286 Dental laboratory procedures: complete dentures

Fig. 9-29. Tuberosities should be convex and taper anteriorly , end- Fig. 9- 30. Smooth palate can be obtained by adapting sheet of base-
ing in region of second premolar ( arrows ) . plate wax to cast . Additions of wax beneath baseplate wax may be T
necessary to achieve adequate palate thickness.

Pi

should taper anteriorly and end in the area of the firs

Fig. 9-31. Rugae can be waxed on baseplate wax palate if desired.
or second premolar. Viewed from above, the narrowest P
part of the maxillary arch should be in the first premo-»
lar region , and it should widen progressively posteriori)
( Fig. 9-29).
9. Seal the posterior border of the palate form to the
cast with a spatula and baseplate wax , Smooth the wax
to produce a smooth junction between the palate form
and wax. Optionally, a smooth palate can be obtain* Flasl
by adapting a sheet of baseplate wax to the cast ( Fig. 9
30). A layer of baseplate wax forming the palate give PR
good palate thickness control , and if rugae or other anj 1.
atomic forms are desired , they can be waxed in at tl it . fill i,
- .
time ( Fig. 9 31) The waxed denture should exhibit
those contours desired in the finished denture ( Fig. 9-32)
comp
over!
2.
PROBLEM AREAS
tape i
The principal problems associated with placing a pa tion,
ate form are related to failure to establish a proper bef cast
el , failure to align the palate form correctly, and traj recte
ping air beneath the palate form during adaptatii 3.
(Table 9-2 ). Placing an upward-facing bevel on the pb rocki
tic baseplate with a bur , correctly aligning the pah luhri
form so that the rugae are in proper position , and cat
fully adapting the palate form with finger pressure '
usually prevent these problems. * Vfas<
 Waxing and processing 287
293

ent to

Fig. 9- 32. A , Waxed denture should simulate contours desired in complete denture. B , Note smooth
borders of palate wax -up.

Table 9-2. Adding a plastic palate form

Problem Probable cause Solution

Palate of finished denture has thick
ledge at junction of palate form and
baseplate
Midline of palate form, or rugae, not in
correct position
Palate of finished denture has thick
areas not evenly distributed
Baseplate not beveled when palate form
was adapted
Palate form not aligned properly when
adapted
Air bubbles trapped under palate form
during adaptation
Bevel baseplate to make smooth junction
between palate form and baseplate
Position palate form so that rugae, inci-
sive papilla, midline are located in
area of natural counterpart
Use care when adapting to minimize air
entrapment
Puncture air bubbles with sharp instru-
ment; express air

Flasking the denture 4. Remove the waxed denture and cast from the ar- > ra-
ticulator , and paint the cast with a separating mediumt on
PROCEDURE
.
(Fig 9-37). B ).
1 . Check the seal of the trial denture to the cast , and 5. Place the dentures and casts in the flask to check to-
fill in deficient areas with baseplate wax. Take care to the height of denture teeth in the flask .
completely fill the peripheral border; however, do not 6. Soak the wax dentures on their casts in clear slurry lch
overflow wax onto the cast borders (Fig. 9-33). water for a few minutes. The casts will take up slurry me
2. Check the occlusion with tissue paper or plastic water and , as a result , remove less water from the in - 5 th
-
tape ( Fig. 9 34). Adding wax, cutting out the palate sec- vesting stone mix ( Fig. 9-38). B ).
tion , and removing and replacing the denture on the 7. Proportion artificial stone by weight (usually 200 me
cast may produce occlusion errors that should be cor- gm is adequate for half-flasking a denture), and mix it
rected before flasking the denture. with the recommended volume of water . Artificial stone ) le
3. Select flasks that fit together accurately without is recommended for flashing because of its superior mt
-
rocking ( Fig. 9 35). Lubricate the flasks with silicone compression strength . llv
lubricant* to facilitate cleanup after processing ( Fig. 9-36 ). 8. Place the stone mix in the flask , and settle the wax g-
denture and cast into the mix ( Fig. 9-39 ). Center the ct
us
.
*Masque, The Harry J . Bosworth Co , Chicago, HI . -
tSuper Sep, Kerr Manufacturing Co., Romulus, Mich . e-
288 Dental laboratory procedures: complete dentures

Fig. 9 33. Wax extending onto cast border is removed before flask -
-
ing.

Fig. 9 34. Occlusion is checked before removing casts for flasking.

-

Fig. 9 35. A, Flasks should fit together without rocking. Be certain that numbers match. B, Flasks
-
should be clean and free of plaster. r
 Waxing and processing 289

Fig. 9 36. A, Interior of flask is lubricated with silicone lubricant. B and C, Exterior and joining sur-
-
faces are coated with silicone lubricant.

.
Fig. 9-37 Wax denture and cast are removed from mounting stone. .
Fig. 9-38 Waxed denture and cast are soaked in clear slurry water
for few minutes.
 290 Dental laboratory procedures: complete dentures
/

- .
Fig. 9 39 Denture and cast are settled into stone mix.

.
Fig. 9-40 Cast is centered in flask , keeping occlusal surfaces par-
allel to bench top.

cast in the flask , keeping the occlusal plane approxi-

mately parallel to the base of the flask ( Fig. 9-40).
9. Smooth the stone around the cast with a spatula
( Fig. 9-41 ). Remove stone as necessary, and fill any de-
ficient areas ( Fig. 9-42 ).
10. Allow the stone to complete the initial set , and
trim and smooth it with a sharp plaster knife ( Fig. 9-
43). A blade with a curved end is recommended to pre-
vent damage to the wax denture.
11 . Remove all stone undercuts that would prevent
-
Fig. 9 41. Stone is smoothed with spatula.
separation of the flask halves ( Fig. 9-44 ). Undercuts oc-
cur commonly in the posterior lingual region of man -
dibular dentures. Undercuts can be blocked out with
wax before pouring the upper half of the flask to pre-
vent heel breakage on opening of the flask ( Fig. 9-45).
12. Place the top half of the flask into position on the
lower half to determine that no stone remains on the
rim to prevent complete seating ( Fig . 9-46).
13. Paint all stone surfaces in the lower half of the
flask with a separating medium* ( Fig. 9-47, A ). Take
care not to place the separating medium on the wax
denture or teeth . This is particularly true if the denture
teeth are plastic, since some separating media can stain
resin denture teeth . Soak the lower half of the flask and
invested cast in clear slurry water before pouring stone
into the top half of the flask ( Fig. 9-47, B ).

-
Fig. 9 42. Areas are filled where needed to eliminate undercuts. *Super-Sep, Kerr Manufacturing Co., Romulus. Mich .
 Waxing and processing 291

7*01

>di

»
_
cl
i-

-
Fig. 9 43. A, Stone is trimmed with sharp plaster knife. B, All stone is removed on flask rims. C,
t Avoid gouging or cutting wax denture. Note curved blade, which is recommended for trimming task -
ing stone.

0
a

Fig. 9-44. Flasking stone is examined for undercuts, which must be

removed or filled in before top half of flask is poured.
292 Dental laboratory procedures: complete dentures

Fig. 9-45. A, Heel undercuts are blocked out with baseplate wax . B, Distolingual region is frequently
undercut and should be blocked out.
*

Fig. 9- 46. Flask halves are assembled and checked for stone that
could prevent accurate seating.

A B

Fig. 9- 47. A, All stone surfaces are painted with separating medium. B, Flask is soaked in clear
slurry water for few minutes before second pour is added.
*

n
4
A B
Hr Fig. 9-49. A, Stone is painted on occlusal surfaces with stiff brush . B, Stone is painted on wax
surfaces to minimize voids.
14. With the upper half of the flask in position , make
a mix of artificial stone as previously described . Mixing
the stone in a mechanical spatulator under reduced at -
mospheric pressure results in minimal air inclusion and
fewer nodules on the processed denture, materially re-
ducing the finishing time.
15. Paint the wax surface with a surface tension re-
ducer * ( Fig. 9-48 ) , and place stone on the occlusal sur-
faces of the denture teeth and into the interproxiinal
areas with a stiff bristle brush or finger ( Fig. 9- 49). This
procedure reduces voids or bubbles and materially re-
I duces the amount of time required to finish the den -
ture. It can be done while the flask is being held on a
vibrator operating at low speed .
16. Pour stone into the flask , allowing time for the
stone to flow over the denture and in the lower hall ol
the flask , lake care to avoid air entrapment , which can
’ Ddnibblizer, .
Kerr Manufacturing Co , Romulus, Midi .
Waxing and processing 293
Fig. 9- 48. Wax is painted with surface tension-reducing agent to
minimize bubbles.
produce voids ( Fig. 9-50, A ). In the absence of a v ibra-
tor , the stone may be settled by bouncing the flask on
a bench covered with a folded towel ( Fig. 9-50, B ) .
Care must be taken to hold the flask halves firmly to-
gether.
17. Fill the flask to within approximately V\ inch
(0.64 cm ) of the top ( Fig. 9-51 , A ). Remove the stone
with a finger to expose the occlusal surfaces of the teeth
in preparation for pouring a stone cap later ( Fig. 9-51. B ).
18. Permit the stone to set before pouring the stone
cap.
19. After the stone has set , it is sometimes desirable
to cut small retentive grooves in the stone to prevent
premature separation of the cap ( Fig. 9-52). Carefully
paint the stone surface with a separating medium ( Fig.
- .
9 53) Do not allow the separating medium to contact
the occlusal surfaces of the incisal edges of teeth . This
is particularly important when resin teeth are used , be-
cause they may become stained .
 Fig. 9- 50. A, Stone is poured into flask slowly while on vibrator to reduce air entrapment. B, If vibrator
.
is not available, flask can be tapped against towel on bench top using care to hold flask halves
together.

A B

A
J

Fig. 9- 51. A, Flask is filled to within VA inch (0.64 cm) of top. B, Stone is removed from occlusal
surfaces of teeth.

Fig. 9- 52. Small retentive grooves are placed in set stone to main - Fig. 9- 53. Stone surface is painted with separating medium. Do not
tain cap in position. perit separating medium to contact resin denture teeth.
 Waxing and processing 295

]
•

*
Fig. 9-54. Clear slurry water is poured on stone and allowed to
remain while stone for cap is mixed.

. r I

)i

44

Fig. 9- 55. A , Slurry water is poured off , and flask is filled with stone. B , Flask is completely filled with
stone.

r
Fig. 9-56. Lid is placed on flask and tapped to determine that flask
is filled.
296 Denial laboratory procedures: complete dentures

.
Table 9-3 Flasking the denture
Problem
Flask halves cannot be separated
after removal from boiling water
Heel broken on mandibular cast
on flask separation
Denture has many nodules of
acrylic attached when removed
from flask
Probable cause
Undercuts exist in flasking stone
or on casts
Separating medium not painted
on stone in lower half of flask
Undercut on cast not blocked out
with wax
Investing stone not painted on
denture during flasking
Investing stone not vacuum spat-
ulated
Solution r
Examine casts and flasking stone carefully to locate
and block out undercuts
Paint separating medium on stone in lower half of
flask before pouring upper half
Check heel area of mandibular denture after half
flasked to locate and block out undercuts
Paint investing stone on teeth; wax denture with
stiff brush «
Mix investing stone in mechanical spatulator under
reduced atmospheric pressure

20 . Pour clear slurry water onto the stone surface ,
and allow it to remain while the stone is being mixed
for the stone cap ( P ig . 9-54).
21 . Pour the slurry water off, and vibrate the stone
onto the surface, filling the flask ( Fig. 9-55) .
22 . Place the lid on the filled flask , and tap it gently
to be sure that the flask has been completely filled ( Fig .
9-56) .
23. Allow the stone to set before the wax is elimi -
nated .
PROBLEM AREAS
Problems associated with flasking are related to fail -
ure to identify and block out undercuts in the flasking
stone; incorporating air inclusions in the investing
stone, resulting in nodules on the denture; and failure
to paint a separating medium on the investing stone
(Table 9- 3) . Undercuts on the flasking stone should be
identified and eliminated by trimming it with a knife or
by filling it in with baseplate wax . Failure to do this
may result in a broken cast when separating the flask
halves . Investing stone should be brushed on the den -
ture during flasking to reduce air inclusions . Better yet ,
the investing stone should be mixed in a mechanical
spatulator under reduced atmospheric pressure . * A
separating medium should be painted on the stone in
the lower half of the flask before pouring the upper half;
otherwise, separation will be difficult , if not impossible .
--
^Combination Vac U Vester Power Mixer, Whip- Mix Corp., Louis
.
ville Ky.
Wax elimination
After the stone has set , the flask is placed in boiling
water to soften the wax .
PROCEDURE
1 . The flask , in a suitable holder, is placed in boiling
water for approximately 5 minutes ( Fig . 9-57, A ) . A
suitable flask holder can be made from a potato masher 4
( Fig . 9-57 , B ) . It is essential that a timer be used to
prevent liquefying the wax ( Fig. 9-57, £).
2. Remove the flask , and pry it open with a plaster
knife . Be sure to pry on the side opposite any potential
undercuts ( Fig . 9-58 ).
3. Discard the softened wax and plastic denture base ,
and check that no denture teeth have been dislodged
on opening the flask (Fig. 9-59 ) .
4. Place half of the flask in a holder , and flow clean
boiling water, to which detergent has been added , over
the surface of the teeth , cast , and stone to eliminate all
traces of wax ( Fig . 9-60) .
5. A brush and soap, or detergent solution , can be
used to clean the cast and stone, followed with a clean
boiling water flush ( Fig . 9-61 ) . Place the flask aside to
cool .
6 . Flush the flask with clean boiling water to remove
all traces of detergent water ( Fig . 9-62) .
7 . Place the half flask in an upright position , and al -
low it to drain and cool ( Fig. 9-63).
- 8. The lower half of the flask is treated in the same
manner . >
 Waxing and processing 297

*
*

>

t
E

fl
Fig. 9-57. A, Flask immersed in boiling water. B, Suitable flask holder can be made from potato
masher. C, Wires added to potato masher prevent flask from slipping. D, Flask in modified potato
masher. E, Timer is used to assure adequate wax softening.
* C
Yv
or ) t
(
(
LIBRARY . </> I

i 4
 298 Dental laboratory procedures: complete dentures

- .
Fig. 9 58 Flask halves separated.

Fig. 9 59. Baseplate and softened wax are removed. Check for dis-
-
lodged denture teeth at this time.

Fig. 9 60. Mold is flushed with hot water to which detergent has
-
been added.

*
 Waxing and processing 299

i .
t

jsl

I *

i Fig. 9-61. A , Worn-out lathe brush wheel can be

used to scrub cast to eliminate all traces of wax . B
and C, Molds should be thoroughly cleansed.

MW

ft

OcCm— i' i

i Fig. 9-63. Flasks are allowed to drain and cool in upright position.
Note grooved plastic holder used to hold casts upright.

Fig. 9-62. Detergent solution is removed with final flush of clean

boiling water.
300 Dental laboratory procedures: complete dentures
Painting the tinfoil substitute Fresh tinfoil substitute should be used , and the apply-
Tinfoil substitute is applied to all stone surfaces of the ing brush never dipped in the principal storage bottle.
cast after the flasks have cooled so that they can be han - A sufficient volume of 4infoil substitute should be
dled comfortably. poured into a secondary container for use. Some tinfoil V
substitutes are viscous and difficult to paint . The thick
PROCEDURE material can usually be diluted with water to a more
1. Pour enough tinfoil substitute into a small con - usable consistency; however, it should not be overdi-
tainer for use on the flasks at hand ( Fig. 9-64 ). Never luted , or a poor separating effect will result. Ridge laps
dip a brush into the main container because it is very of resin denture teeth should not be coated with tinfoil
easily contaminated and its effectiveness destroyed . substitute. If tinfoil substitute is painted on the ridge
2. Carefully paint the tinfoil substitute on the stone laps it should be removed , or the bond between the
surfaces in the flask ( Fig. 9-65). Do not paint tinfoil tooth and denture base may be compromised .
substitute on the ridge laps of the teeth.
3. Certain tinfoil substitutes are quite thick and can
be diluted by adding water. Take care, however, to not
overdilute, since the effectiveness of the tinfoil substi -
tute may be compromised .
4 . After the stone in the flask has been coated with
tinfoil substitute, place it aside, and allow it to dry ( Fig.
9-66 ) . Be sure that all areas of stone have been painted
with tinfoil substitute, or the denture base resin will
adhere to the stone, making a difficult finishing prob-
lem .
PROBLEM AREAS
Principal problems associated with applying tinfoil
substitute to the Basking stone and cast are related to
omitting the tinfoil substitute, using contaminated tin -
foil substitute, overdiluting the tilfoil substitute, and in -
advertently coating the ridge laps of resin teeth with
tinfoil substitute when applying it to the stone (Table 9- Fig. 9-64. Tinfoil substitute is poured in small container for imme-
4). Tinfoil substitute should be carefully painted on the diate use. Any tinfoil substitute remaining after using should be dis-
Basking stone and cast , leaving no areas uncoated. carded and not returned to storage container.

Table 9- 4. Painting the tinfoil substitute

Problem Probable cause Solution

Flasking stone sticks tenaciously
to cured denture surface
Resin teeth fail to bond to den-
ture base resin
Tinfoil substitute not applied to cast
or flasking stone
Tinfoil substitute contaminated with
stone
Tinfoil substitute too diluted as a
result of thinning
Wax elimination not completed dur-
ing boilout, rendering tinfoil sub-
stitute ineffective
Tinfoil substitute painted on ridge
laps of denture teeth
Wax residue remains on ridge laps
of denture teeth
Paint stone and cast with tinfoil substitute
Pour fresh tinfoil substitute in small container for im-
mediate use; do not dip brush in principal storage
container
Do not add too much water to thin tinfoil substitute
Cleanse interior of mold and cast surface thoroughly
with boiling water to which detergent has been
added; flush with clean boiling water
Remove any tinfoil substitute that contacts ridge
laps of resin teeth
Cleanse interior of mold, denture teeth, and cast
thoroughly with boiling water to which detergent
has been added; flush with clean boiling water
 Waxing and processing 301

I
n
Fig. 9-65. A , Tinfoil substitute is carefully painted on stone. B, Do not allow tinfoil substitute to puddle
in interproximal areas. C, Do not place tinfoil substitute on ridge laps of teeth .

4 f

I
Fig. 9-66. Coated flasks are allowed to drain and dry. Fig. 9-67. Small recesses placed in ridge laps of resin denture teeth
facilitate stronger attachment between teeth and denture base.
r.
 302 Dental laboratory procedures: complete dentures

Fig. 9-68. A, Resin is mixed in clean mixing jar with stainless steel spatula. B, Resin is allowed to
set in closed jar until dough stage is reached. C, Mixing jar lid should form tight seal when in place.
.
D, Lid does not provide good seal, thus plastic sheet is placed over jar before lid is screwed on E, &
Plastic serves as gasket, forming tight seal.
. Preparing ridge laps
When resin teeth are used in the denture, it is advis-
able to roughen the ridge laps or make diatories in
these teeth with a bur to provide additional area for
bonding between the denture base resin and denture
tooth . This is particularly true when highly cross-linked
denture base resins are used. A No. 4 or 6 round bur
can be used to place indentations in anterior teeth .
( Grooves or indentations can be placed in resin posterior
teeth in order to materially improve the attachment be-
tween the denture teeth and denture base resin ( Fig.
Waxing and processing

5. Place plastic sheets over tin resin , place the flask

*

halves in position, and close it slowly in a bench com -

press ( Fig. 9-71 ) to permit the flow of acrylic resin into
the minute intricacies of the mold .
6. Open the denture flask , and cut away excess resin
flash , replace the plastic sheets, and trial pack the flask
again ( Fig. 9-72).
7. Continue trial packing until no more flash is ap-
parent on opening the flask ( Fig. 9-73).
8. At this time , when the flask is opened, the resin
should exhibit a shiny surface ( Fig. 9-74 ).
303

9-67). After the indentations have been placed , be sure

to remove all traces of acrylic grindings from the flask .

Packing the denture

PROCEDURE
1. Choose an appropriate shade denture base resin to
J meet the needs oi the patient , and proportion it accord -
ing to the manufacturer’s instructions.
2. Mix the resin in a clean mixing jar with a stainless
steel spatula (Fig. 9-68, A ). Place it aside until tlu* resin
reaches the proper stage ( dough ) for packing ( Fig. 9-68,
B ). It is important that the mixing jar be airtight to pre-
vent evaporation of the acrylic monomer, which will
cause the mix to be grainy ( Fig. 9-68, C). If the lid does
not seal well , a sheet of thin plastic can be used to gain
a seal ( Fig. 9-68, D and E ).
3. Handle the resin with plastic gloves to prevent
contaminating the resin with skin oils and to prevent
possible development of contact dermatitis through re-
^ peated contacts with the resin ( Fig. 9-69).
4. After the resin has reached the dough stage, re- Fig. 9-69. Resin is handled with plastic gloves to prevent contami-
move it from the jar , form it into a roll , and adapt it to nation.
the flask ( Fig. 9-70 ).

I
I

I
Fig. 9-70. A, Resin dough is removed and formed into roll. B, Resin adapted in flask .

I
304 Dental laboratory procedures : complete dentures

i•

- .
Fig. 9 71 Flask is closed slowly in compress. Fig. 9-72. A, Plastic sheet removed, and resin flash trimmed. B,

^
Dull spatula is used to trim flash, knife can cut stone, allowing stone •
particles to be incorporated in resin.

-
Fig. 9 73. Trial packing is continued until no flash is apparent on .
Fig. 9-74 Resin surface is glossy when flask is opened; however,
opening flask. it dulls rapidly .
 Waxing and processing 305

Fig. 9-75. Tissue paper absorbs acrylic resin monomer. Name

should be placed where subsequent adjustment of denture is un-
likely. Name placed on facial surfaces might be objectionable to
patient.

Fig. 9-76. A , Clear acrylic resin polymer is sifted over name. B, Resin is saturated with monomer. C,
Name is completely covered with clear resin and is ready for trial packing.

+
Denture identification
It is important to employ some method for identify -
ing denture prostheses. Identification can help reduce
losses and could facilitate identification of the patient in r *

the event of a catastrophic accident or illness.

PROCEDURE
NOVACK , EL
1. Type the patient s name and initial on absorbent
tissue paper. The name can also be typed on the stain -
tA
less steel strip material if desired . Cut the name out 4
with scissors.
2. Place the cut -out name strip on the internal sur -
face of the denture and saturate it with acrylic resin
-
monomer ( Fig. 9 75). Fig. 9-77. Trial pack further embeds name in denture base, yet
transparent overlying resin permits it to be easily read.
3. Sift clear acrylic resin polymer over the name strip
and wet with monomer ( Fig. 9-76 ) .
4. Trial pack the denture again , open the flask , and
make certain that the name strip is completely covered » .
with resin ( Fig. 9-77. )
When cured , the embedded name is readillv visible
and permanently identifies the prosthesis ( Fig. 9-78). If
the patient ’s name is long and space is a problem , the
typed name can be reduced in size in a reducing copy
machine.
5. After the final trial pack, repaint the cast portion
of the flask with tinfoil substitute, and allow it to dry
( Fig. 9-79). Place a sheet of plastic over the denture
base resin to minimize monomer evaporation .
6. Assemble the Hask , and close it until metal-to-
metal contact between the flask rims is achieved ( Fig. A
9-80). L1
7. Place the denture in a compress, and bench cure Fig. 9-78. After processing, embedded name is readily visible.
it , if specified by the manufacturer, before curing it in
a curing unit.

Fig. 9- 79. Cast is again coated with tinfoil substitute and allowed to Fig. 9- 80. Flask rims contact, indicating flask is closed.
dry before final closure.
T

PROBLEM AREAS
Principal problems associated with packing the den -
ture are related to failure to adequately fill the mold
H with resin , packing the resin at the wrong stage, failure
to bench cure the packed denture prior to curing, and
failure to achieve metal - to- metal contact of the flask
(Table 9-5). The mold should be completely filled and
flash extruded during initial trial packing. Failure to fill
the mold , or underpacking, can result in a denture with
.
porosity Attempting to pack the denture resin too soon
may result in the resin being too sticky to handle prop-
erly. Resin should be packed at the dough stage. Pack
ing the resin at a late stage , such as the rubbery stage ,
can require excessive force to close the mold . This can
produce tooth movement in the mold and increase pro-
cessing error . Thick dentures should be bench cured
before being subjected to increased temperature. The
long curing cycle, starting at room temperature and ris-
i ing to 165° F ( 74' ( ’ ) is recommended for thick dentures
> 7. Place the lid in the flask , and tap to determine that
to prevent porosity . In any instance the manufacturer’s
instructions should be closely followed . Failure to
achieve metal-to- metal contact of the flask rims during
packing can also contribute to increased processing error.
ALTERNATE FLASKING PROCEDURE
Various silicone mold , or investment coating, mate-
rials have been used to flask complete dentures. The
resultant flexible mold facilitates rapid retrieval of the
cured denture from the flask , reduces the finishing time
required to remove investing plaster or stone from the
denture, serves as a moisture barrier, and does not re-
^ quire application of tinfoil substitute to the mold mate-
rial . Disadvantages include cost of material and the ten -
dency for denture teeth to be occasionally dislodged
from the flexible mold.
Table 9-5. Packing the denture
Problem Probable cause
Cured denture has porosity Flask underpacked with
resin
Thick denture base heated
too rapidly
Cured denture has increased Denture resin packed at
processing error late, or rubbery, stage
Flask not properly closed
prior to curing
Waxing and processing 307
PROCEDURE
1 . Dentures, waxed in the usual manner , are half
flasked in stone ( Fig. 9-81).
2. Paint a separating medium on the investing stone
in the lower half of the flask from the denture border
to the flask rim ( Fig. 9-82 ).
3. Proportion the investment coating material* ac-
cording to the manufacturer's recommendations ( Fig. 9-
83).
4. Paint the mixed mold material over the waxed
denture with a spatula ( Fig. 9-84 ), using care to thor -
- oughly coat the entire denture surface and teeth.
5. Place the upper half of the flask in position on the
lower half ( Fig. 9-85). Remove any mold material from
between the flask rims that could prevent accurate
seating.
6. Add stone to fill the flask while the surface of the
investment coating is still tacky ( Fig. 9-86).
the flask is completely filled ( Fig. 9-87).
8. After the stone has set , immerse the flask in boil -
ing water for 5 minutes to soften the wax . The mold is
then flushed with a detergent solution and clean boiling
water ( Fig. 9-88).
9. Place small recesses in the ridge laps of plastic
denture teeth to facilitate a stronger union between the
denture tooth and denture base ( Fig. 9-89).
10. Mix the denture base resin according to the man -
ufacturer’s recommendations, and pack the mold in the
usual manner. The denture is then cured and polished
( Fig. 9-90).
*Vescote, Teledyne Dental Products Co., Getz-Opotow Division . Elk
*
Grove Village , III.
Solution
Fill mold completely before curing; properly packed resin should
exhibit flossy surface when flask is first opened
Bench cure, followed by long curing cycle
Pack resin during dough stage
-
Make certain metal to-metal contact of flask rims is achieved
before curing
308 Dental laboratory procedures: complete dentures r
1
A

*
*

Fig. 9-81. Waxed dentures are half - flasked in usual manner . Fig. 9-82. Separating medium is painted on investing stone from
denture border to flask rim.
4
1

•I
!
i
Fig. 9-83. A, Investment coating material is proportioned according to size of denture: 5 ml of base
.
for small dentures 10 ml for larger dentures. B, Catalyst is added to base: 1 drop for each 5 ml of
base. C, Catalyst is thoroughly mixed with base for 15 to 20 seconds.
 Waxing and processing 309

1
%

Fig. 9-84. A . Silicone investment coating is painted on dry denture. Avoid entrapment of air, which
results in resin nodules on cured denture. B, Entire denture is covered with investment coating. Air
bubble (arrow ) in material should be punctured. C, Investment coating extends onto investing stone
surface.

Fig. 9-85. Upper half of flask is placed in position. Make certain

that flask rims contact.
310 Dental laboratory procedures: complete dentures

vj

'
'

.
Fig. 9-86. A, Stone mix is vibrated into flask. Investment coating should have tacky surface B, Flask
is tilted while vibrating to allow stone to flow into all portions of flask. Large void produced by air
entrapment could change contour of denture surface.

Fig. 9-87. Stone extrudes through holes in flask lid, indicating that
flask is full.

Fig. 9-88. A, All traces of wax are removed from upper flask. Note smooth, bubblefree surface of
mold. B, Lower mold is also bubble free and ready for packing. «
 Waxing and processing 311

*
t

Fig. 9-89. A , Grinding ridge laps of plastic denture teeth can contribute to stronger attachment be-
tween teeth and denture base . B, Flexibility of mold allows removal of denture tooth for ridge- lap
preparation . Tooth is then easily replaced in indentation. Same flexibility , however , can also lead to
inadvertent dislodgment of teeth during boilout and packing .

Deflasking the denture

After the denture has been cured , it is removed from
the curing unit and allowed to bench cool . The denture
is then ready for deflasking, finishing, and polishing.

Fig. 9- 90. Denture resin is packed in mold and trial packed in usual
manner .
Curing the denture
After bench curing the denture for 1 or more hours,
place the denture in water at room temperature, and
program the curing temperatures according to the man -
ufacturer’s recommendations. It is helpful to place a
small hall of excess resiu around the handle of the com -
press if the dentures are to be cured overnight in the
SUMMARY
Waxing, Hashing, and processing procedures for
complete dentures have been described in this chapter .
These are important steps in complete denture con -
struction . Esthetics, function , and patient satisfaction
depend on a skillfully waxed and properly process-
ed prosthesis . As is the case with most dental labora-
tory procedures, careful attention to detail and skill
achieved through experience invariably contribute to a
superior prosthesis.
BIBLIOGRAPHY
Feldmann, E . E . , and Caloineni , A . A . : Complete denture laboratory
manual , San Antonio, Tex . , 1977 , The University of Texas Health
Science Center .
Hickey , J . C. , and Zarb, G . A . : Boucher’s prosthodontic treatment for
edentulous patients ed. 9 . St . Louis . 1984 . The C. V . Mosby Co.
,

laboratory. The resin hall is checked the next morning
to assure that the power has not been inadvertently
I Sharry, J . J . : Complete denture prosthodontics, ed . 3. New York .
turned off during the night , leaving the denture under-
cured . Cured resin on the handle of the compress,
though not infallible, is an indicator that the curing unit
* performed its function .
*
Martinelli , N . , and Spinella , S . C . : Dental laboratory technology , ed .
3, St . Louis, 1981 . The C. V. Mosby Co.
1974 . McGraw- Hill Book Co .
Sowter. J . B . : Dental laboratory technology: prosthodontic technique.
Chapel Hill , N . C. , 1968, The University of North Carolina Press ,
pp. 88-95.

CHAPTER 10
FINISHING AND POLISHING
KENNETH D. RUDD, ROBERT M. MORROW , AMBROCIO V. ESPINOZA, and JESSE S. LEACHMAN
finishing and polishing Removal of excess restoration material
from the margins and contours of a restoration and polishing of
the restoration.
polishing (noun) The art or process of making a denture or casting
smooth and glossy .
polishing ( verb) Making smooth and glossy usually by friction: to
give luster .
After the complete dentures have been cured , they
are removed from the curing unit and bench cooled to
room temperature. Then the dentures are removed
from the flask and remounted in the articulator. Occlu -
-
sion errors are corrected , a face bow index is made
when indicated , and the dentures are removed from
the cast and finished and polished . Methods of deflask -
ing complete, dentures, constructing a face- bow index ,
and polishing complete dentures will be described in
this chapter.
DEFLASKING
When deflasking complete dentures, it is best to use
a deflasker, * which allows retrieval from the flask with -
out damage to the dentures or flask ( Fig. 10-1). De-
flasking w ith a hammer can damage the flask and result
in unnecessary breakage of the dentures ( Fig. 10-2 ) .
PROCEDURE
1. Remove the lid from the flask containing the
bench cooled denture ( Fig. 10 3).
- -
‘Teledyne Dental Products Co.. Ilanau Division , Buffalo, N . Y.
312
A
2. Place the flask , bottom side up, in the deflasker,
and tighten the thumbscrew until it contacts the bottom
plate ( Fig. 10-4 ).
3. Place the pry bars through the slots in the side of
the deflasker, and engage the slots in the flask between
both halves of the flask ( Fig. 10-5).
4. Press down on the engaged pry bars first ( Fig. 10-
*
6), and then pry up ( Fig. 10-7). These movements read -
ily separate the flask from the stone enclosed denture.
5. Place a knife-blade in contact with the junction *
between the stone cap and the rest of the stone enclos-
ing the denture. Tap the back of the knife blade with a
plastic mallet to separate the stone cap and to expose
the cusp tips and incisal edges of the denture teeth
( Fig. 10-8).
6. Use care in separating the stone cap from dentures
with porcelain teeth ( Fig. 10-9).
7. With a saw and a spiral blade, cut through the
stone that encloses the denture opposite the central in -
cisor teeth ( Fig. 10- 10 ). Take care to avoid sawing into
the teeth or denture base.
8. Place more saw cuts at the distobuccal corners of
the flasked denture ( Fig. 10- 11 ), so that the stone en -
closing the denture has three cuts ( Fig. 10-12).
9. Place a knife in the anterior saw cut, and pry
gently to separate the stone from the buccal and ante-
rior flanges of the denture ( Fig. 10-13).
10. Place a knife in the posterior cut , and pry later-
ally to separate any posterior section of stone that may
have adhered to the buccal flange of the denture ( Fig.
10- 14 ).
11 . Remove stone from the palate or tongue area of
the mandibular dentures by first relieving the stone ad -
 Finishing and polishing 313

Fig. 10-1. Deflasker and pry bars facilitate quick removal of stone .
Fig. 10-2 Hammering stone from flask with plastic hammer or
and dentures from flasks without damage to denture or flask. metal L wrench eventually ruins flask and often breaks denture
base or teeth.

-.
Fig. 10 3 A, Blade of heavy -bladed laboratory knife is placed in slot between top and upper half of
flask, and top is lifted off. B, Top is removed from flask with knife in position shown.

-»
Fig. 10 4. Flask is placed bottom side up in deflasker, and thumb-
- . -
Fig 10 5. Pry bars inserted through slots in sides of deflasker to
screw is tightened. engage slots in flask .
t

Fig. 10-6. With pry bars engaged, pry down on them to separate Fig. 10-7. Pry bars are lifted up to separate top half of flask. Note
.
bottom half of flask Thumbscrew contacting bottom circular plate that top half is on bottom, since flask is in deflasker, bottom side
holds stone in position. up.

*
r

Fig. 10-8. A , Tap back of knife blade with plastic mallet to separate stone cap. B, Separating medium
properly applied facilitates separation of stone cap, exposing cusp tips of denture teeth.

Fig. 10-9. Solid tap with knife held in this position can fracture one
or more porcelain anterior teeth. Place knife at side as shown in
n n
Fig. 10- 10. Saw through investing stone, using spiral blade.

t
 Fig. 10 11. Additional saw cuts are made at distobuccal corners of
- .
Fig. 10-12 Three saw cuts are made in investing stone.
flasked denture.

.
Fig 10-13. A, Plaster knife blade is placed in anterior saw cut , and stone is pried from buccal con-
tours of denture. B, After one section is removed, remaining buccal section is separated.

Fig. 10 14. If it is difficult to separate second section, pry in poste -

- Fig. 10-15. Stone is cut away from lingual surfaces of teeth before
nor saw cut to break it loose . attempting to remove it from palate of upper dentures or lingual
region of lower dentures. Otherwise, these teeth can be fractured
C* when stone is removed. Shell blaster can be used to expose teeth
316 Dental laboratory procedures: complete dentures

jacent to the lingual surfaces of the denture teeth with 16. Use a toothbrush to clean out the index grooves
a knife (Fig. 10- 15). Take care to avoid cutting the teeth on the base of the cast ( Fig. 10-20). This cleansing
or denture base. makes it possible to position the cast accurately on the I
12. After relieving the stone adjacent to the lingual mounting stone for correction of any processing error. -> »

surfaces of the denture teeth , gently pry the stone in
the lingual area of the mandibular denture or the palate
of the maxillary denture, and lift it away from the den -
ture ( Fig. 10-16).
13. Make more cuts lingual to the heel area of the
mandibular dentures if necessary ( Fig. 10- 17 ).
14 . Remove the denture from the investing stone ex-
cept where it encloses the cast ( Fig. 10- 18).
15. Protect the teeth with the hand and , with a plas-
tic mallet , carefully tap away the stone enclosing the
cast . Exercise care to avoid damaging the teeth by
striking them with the mallet ( Fig. 10-19).
17. After retrieval from the stone, the dentures are
ready for remounting on the articulator ( Fig . 10-21).
PROBLEM AREAS
Problems that occur during deflasking are ( 1 ) break -
ing of the denture, (2) breaking of the cast , or (3) break - I
ing of both . A secondary problem is damage to the flask
as a result of using a hammer to tap the stone from the
flask . Attention to the details of Basking to eliminate
undercuts, proper use of tinfoil substitute, and careful
deflasking procedures minimize breakage of the den -
tures and facilitate rapid retrieval (Table 10- 1 ).

Fig. 10- 16. Lift palatal section of stone from denture. Note that lin-
gual surfaces of teeth are cleared first.

.
Fig. 10- 17. A , It may be necessary to take out more wedges of stone before removing lingual section
of stone from mandibular dentures. B, Remaining lingual section of stone is pried from denture gently -
after other wedges are removed. Removal of small wedges can prevent fracturing of mandibular cast .
 Finishing and polishing 317

. - .
Fig 10 18 Investing stone was removed except around base of

Fig. 10 19. A, Protect denture teeth with hand before tapping away remaining stone. B, In this man
- -
ner, rest of stone is separated from cast, and denture teeth are not struck with mallet inadvertently .

-
Fig. 10 20. Brush index grooves with toothbrush to remove parti-
cles of stone that prevent accurate replacement in articulator.
.
Fig. 10-21 Dentures ready for remounting in articulator to correct
any processing error. Some dentists prefer to make this correction
after making new jaw relation record and remounting.

4
318 Dental laboratory procedures: complete dentures

Table 10- 1. Deflasking

- A
i
Problem Probable cause Solution

Denture base or denture
teeth broken during de-
flasking
Stone adhering to surface of
denture
Casts cr ked and distorted
^
and unable to fit together
with mounting stone accu-
rately.
Deflasker not used to deflask den-
ture
Knife blade hit teeth when removing
stone cap
Hammer used to tap denture out of
flask
Failure to place tinfoil substitute on
stone prior to packing
Tinfoil substitute contaminated with
stone
Tinfoil substitute diluted too much
prior to painting on stone
Casts distorted by hammering on
them when retrieving dentures
from flask
Use deflasker to remove flask from enclosed stone
Place knife blade on side of investing stone, not on
anterior side; control depth of penetration
Do not use hammer to tap stone away from den -
ture
Paint tinfoil substitute on stone prior to packing
denture base resin
Use fresh tinfoil substitute poured into small con-
tainer from storage jar; do not dip directly into
storage jar
Do not overdilute tinfoil substitute to achieve work-
able consistency
Use deflasker to remove flask from stone
I

REMOUNTING DENTURES right - and left-lateral and protrusive positions. Gener-

After the index grooves or notches are cleaned , the
dentures and casts are sealed to the mounting stone
with sticky wax ( Fig. 10-22).
PROCEDURE
1. After remounting the dentures in the articulator,
check the relationship of the incisal guide pin to the
incisal guide table ( Fig. 10-23). Often the incisal guide
pin does not contact the incisal guide table because of
changes during processing. A processing error of 1 mm ,
though not insignificant , is correctable. However, an
error of more than 1 mm , which often requires consid -
erable reduction on the occlusal surfaces of the denture
teeth to regain the vertical dimension of occlusion , is
undesirable.
2. Check contacts between the heel of mandibular
dentures and the tuberosity region of maxillary den -
tures to make certain that the increase in vertical di-
mension is not the result of an overly thick denture
base resin in these areas ( Fig. 10- 24 ).
3. Place articulating paper between the teeth , and
gently tap the articulator together to indicate deflective
occlusal contacts ( Fig. 10-25).
ally , reduction results in grinding of the fossae rather
than the cusp tips. When adjusting the working posi-
tion , adjust the buccal cusps of the upper teeth and the
lingual cusps of the mandibular teeth to eliminate de- l
flective contacts. On the nonworking, or balancing side,
deflective contacts are usually on centric holding cusps,
and grinding requires a compromise. We prefer to
grind the inclines of the maxillary lingual cusps rather
than the buccal cusps of the mandibular dentures.
5. Move the articulator into a working position, and
examine the relationship of the working cusps ( Fig. 10-
27). Mark the deflective contacts with articulating pa-
per , and examine the resulting pattern ( Fig. 10-28).
Eliminate deflective contacts on porcelain teeth by ad - *
justing the buccal cusps of the maxillary teeth and the
r
lingual cusps of the mandibular teeth with a stone.
6. Examine the balancing contacts in a similar man -
ner, and adjust the lingual cusps of the maxillary teeth
or the buccal cusps of the mandibular teeth to correct
deflective contacts ( Fig. 10-29 ).
7. After completing the selective grinding, move the
articulator into the various positions, and check the oc-

4. Adjust these contacts with a stone if the teeth are
porcelain or a bur if the teeth are resin ( Fig. 10-26).
Continue to adjust the occlusion in the centric relation
position and in the eccentric positions, according to the
rules of selective grinding. Do not adjust the cusps in
the centric relation position unless they are high not
only in the centric relation position , but also in the
1
clusion with tissue paper strips. Now the incisal guide
pin should contact the incisal guide table and , thereby,
indicate reestablishment of the original vertical dimen -
sion of occlusion ( Fig. 10-30). Do not complete defini -
tive polishing of the occlusal surfaces of the teeth at this
time because the dentist usually remounts the dentures
on the day of insertion .
8. Recheck the occlusion on the articulator in the
 Finishing and polishing 319

Fig. 10- 22. A , Maxillary cast is sealed to mounting stone with sticky wax. Make certain that cast and
mounting stone fit together accurately before sealing. B . Mandibular cast is sealed to mounting stone
in similar manner.

Fig. 10- 23. Close articulator, and check incisal pin to determine Fig. 10- 24. Denture base is too thick as indicated by articulating
amount of processing error ( arrow ). paper marks (arrows ). This problem usually results from removing
dentures from articulator for final waxing and not replacing them to
check occlusion.

Fig. 10- 25. Articulating paper is used to indicate teeth with deflec -
tive occlusal contacts. Articulator condylar elements are locked se-
curely in centric position for this check .
320 Dental laboratory procedures: complete dentures

~ *

A A
f

(
I
Fig. 10- 27. Articulator is moved into working position, and cuspal
%
Fig. 10- 26. Each mark is analyzed before any decision is made
about grinding. In centric relation position, opposing fossa is deep - relationship between maxillary and mandibular teeth is examined.
ened unless offending cusp is high not only in that position, but also
in eccentric positions. Application of this rule usually results in
deepening of sulci, rather than reduction of cusps when correcting
centric relation position. Fine stone is used to modify porcelain
teeth, and bur or stone is used for resin teeth.

Fig. 10- 28. Working contacts are marked with articulating paper
and adjusted if necessary. Inclines of buccal cusps of maxillary
teeth and inclines of lingual cusps of mandibular teeth are adjusted
to provide smooth lateral movements without cuspal interference
Lingual cusps of mandibular molars, indicating heavier contact , will
. Fig. 10- 29. Maxillary lingual cusps were marked by articulating pa-
per as articulator was moved into balancing position for this side.
l
be reduced (arrow ). Heavy contacts on lingual cusps were reduced. #

Fig. 10-31. A, Occlusal surfaces of maxillary teeth show numerous contacts with similar pressure
marks. B, Mandibular occlusal surfaces have similar marks.
centric relation position, using articulator paper, and
evaluate the pattern of contacts. Equalize the contacts
on the right and left sides to assure a uniform distribu -
tion ( Fig. 10-31).
MAKING A FACE- BOW INDEX
After adjusting the occlusion on the articulator, mak-
ing a face-bow index preserves the face-bow mounting
of the maxillary denture. Unless a face-bow transfer was
used for the original mounting, it is unnecessary to
make a face- bow index at this time.
PROCEDURE
1. Remove the mandibular denture and cast from the
mounting stone, and scrape off any sticky wax used in
securing the lower cast to the mounting stone ( Fig.
10-32).
2. Box the lower mounting stone with boxing wax
( Fig. 10-33). Extend the upper edge of the boxing wax
Finishing and polishing 321
Fig. 10-30. After vertical dimension of occlusion is reestablished,
tissue paper strips are used to determine whether contact is equal-
1 or 2 mm above the level of the occlusal surfaces of
the maxillary teeth ( Fig. 10-34).
3. Seal the boxing wax to the stone to make it water -
-
tight ( Fig. 10 35).
4. Pour water into the boxed stone to soak it and
facilitate joining of the next pour of stone ( Fig. 10-36).
5. Paint the occlusal surfaces of the maxillary teeth
with a microfilm* separating medium ( Fig. 10-37).
6. Mix the stone, and fill the boxed area ( Fig. 10-38).
7. Place additional stone on the occlusal surfaces of
the maxillary teeth ( Fig. 10-39).
8. Close the articulator to create an indentation in
stone of the occlusal surfaces of the maxillary teeth ( Fig.
10-40 ).
9. Allow the stone to set ; then remove the boxing
-
wax, and trim it . The face bow index is complete ( Fig.
10-41).
* Kerr Microfilm. Kerr Manufacturing Co., Romulus, Mich.
322 Dental laboratory procedures: complete dentures

^v
•

Fig. 10-32. A, Scrape sticky wax from sides of stone mounting. B, Sticky wax was removed from
lower mounting.

* \
5

Fig. 10-33. Lower mounting stone is boxed with strip of boxing wax. Fig. 10- 34. Upper edge of boxing wax is extended 1 or 2 mm above
In other instances, two strips may be required for sufficient height . level of occlusal surfaces of teeth to assure adequate imprint.

>

Fig. 10- 35. A , Hot spatula is used to seal boxing wax to mounting stone. B, Wax is sealed on exterior
of boxed mounting to make it watertight.
 Finishing and polishing 323

Fig. 10-36. Water poured into boxed mounting will show leaks. Fig. 10- 37. Separating medium assures clean separation of teeth
Soak mounting stone to assure better sticking of stone to be added. from stone.

Fig. 10- 38. A , Boxed enclosure is filled with stone. B, Stone surface is smoothed with spatula.

Fig. 10-39. Stone is placed on occlusal surfaces of teeth to mini- Fig. 10-40. Articulator is closed, pressing occlusal surfaces of den -
mize voids. ture teeth into stone. Tap articulator until incisal guide pin touches
incisal guide table.
324 Dental laboratory procedures: complete dentures
Fig. 10- 42. Thickness of cast is reduced on cast trimmer to facilitate
recovery of denture .
REMOVING DENTURES FROM CAST
After correction of the processing error and construc-
tion of a face-bow index if required , the dentures are
ready for removal from the cast and finishing and pol -
ishing.
PROCEDURE
1 . Using a cast trimmer, thin the casts with the den -
tures seated on them , but avoid trimming the denture
base ( Fig. 10-42).
2. Remove the stone from the denture in small sec-
tions ( Fig. 10-43, A ) . Use a bur or a saw judiciously in
removing the stone in sections without damaging the
denture ( Fig. 10-43. B and C ).
Fig. 10- 41. Boxing wax is removed, and articulator opened after
stone is set . Trim stone if any imprints are too deep. Face-bow
index is complete .
3. A shell blaster also is useful in removing stone
from the interior of the denture ( Fig. 10-44 ).
4. A pneumatic chisel aids in removing stone from
the denture; however , great care is essential to prevent
damage to the denture , particularly to the denture
teeth ( Fig. 10-45). Do not attempt to pry the denture
from the cast because it can result in fracturing the
denture. After removal from the cast , the dentures are
ready for finishing and polishing.
POLISHING THE COMPLETE DENTURE
Two methods of polishing complete dentures will be
presented.
 Finishing and polishing 325

Fig. 10- 43. A, Stone cast should be removed from denture in small sections. Numbers indicate usual
sequence. B, Saw or bur can be used to section stone. Care must be taken to not damage denture
base. C, Freed section of stone is removed.

A
Fig. 10- 44. Laboratory shell blaster is very effective for removing Fig. 10- 45. Pneumatic chisel can be used to remove stone.
stone. Use care to not burn resin.
326 Dental laboratory procedures: complete dentures
PROCEDURE FOR METHOD ONE
1 . After taking the complete denture from the cast ,
use a shell blaster to remove any stone that adheres to
the denture, lake care to avoid burning the surface of
the acrylic resin when shell blasting.
2. Trim the Hash from the complete denture with an
arbor band or a large bur mounted on a laboratory lathe
( Fig. 10- 46 ) .
3. Finish the frenum attachments with a small car
bide bur to create the desired freedom ( Fig. 10-47).
4. With a chisel carefully remove stone adhering to
the gingival margins ( Fig. 10-48). Make a chisel by
grinding a broken instrument to form a sharp triangular
edge, which facilitates the removal of stone from the
gingival margin .
5. Check the interior of the denture carefully with a
finger to locate any nodules of acrylic resin , and remove
them with a round bur ( Fig. 10-49).
6. Complete the relief for the frenum attachments by
using a No. 558 or a No. 701 bur to do the final finish -
ing and to open the frenum attachment .
7. Finish the lingual border area of the mandibular
complete denture with a handpiece- mounted small car-
- bide bur ( Fig. 10-50 ). Frequently, a standard size arbor
band is too large for this area ( Fig. 10-51).
8. Thin the palate if necessary . Take care to avoid
producing grooves when using an arbor band ( Fig. 10-
52). A large lathe- mounted laboratory bur also is useful
for this procedure ( Fig. 10-53).
9. Pumice the dentures with a prepared rag wheel .

Fig. 10- 46. A , Lathe-mounted arbor band is used to trim borders. B, Laboratory - size carbide bur is
used for trimming borders.

/*
Fig. 10i47. A , Fissure bur mounted in handpiece or lathe is used to deepen frena notches. B, Do not
make frena relief too deep for proper retention of dentures.
 Finishing and polishing 327

Fig. 10-48. A , Pointed chisel is made by sharpening broken dental instrument or fissure bur, then it
is placed in wooden handle. B, Chisel is used to remove stone from between teeth or to remove
acrylic resin nodules from denture.

//

Fig. 10-49. A , Finger is used to check for nodules or sharp feather edges on denture resin. B,
Nodules are removed with handpiece or lathe-mounted bur.

-
*J Fig. 10- 50. Small handpiece-mounted or lathe-mounted carbide bur
is used to finish lingual border of denture.
328 Dental laboratory procedures: complete dentures
Fig. 10-51. A , Arbor band is too large for finishing this area. If used here, borders of denture can be
overthinned. B, Laboratory bur of correct diameter for finishing border.
Fig. 10- 52. Grooves in palate (arrow ) produced by incorrect use of
arbor band are difficult to remove.
Preparing rag wheel
Special preparation of a rag wheel makes it more ef-
fective for pumicing and polishing. The procedure de-
scribed also reconditions used rag wheels by giving
them the flexibility and fluffiness necessary to achieve a
* *
smooth finish ( Fig. 10-54).
PROCEDURE
1 . Place the rag wheel on a spiral chuck, run the
lathe at low speed , and use a knife to cut the threads
holding the rag-wheel plies together. Hold the knife
firmly while cutting the threads ( Fig. 10-55).
2. Stop the lathe, separate the plies of the rag wheel ,
and makecertain tocut the thread completely ( Fig. 10-56).
Fig. 10- 53. Production of grooves is minimized by using large egg-
shaped bur to reduce thickness of palate.
3. With the rag wheel on the spiral chuck , rotate the
lathe at low speed , and hold a stainless steel plaster
spatula against the rag wheel to remove the cut threads
and make the wheel fluffy ( Fig. 10-57).
4. Singe the frayed threads with a lighted match to
make the wheel uniform ( Fig. 10-58). Place a metal pan
beneath the wheel , and have the lathe anti any suction
device in the nonoperating position . Have a bowl of wa-
ter available to douse the wheel if it flares.
5. After placing the rag wheel in water, return it to
the lathe, and start the lathe at low speed . Rotate the
singed wheel against the stainless steel spatula again to
Huff it and remove any remaining threads ( Fig. 10-59).
6. The modified rag wheel is ready for use ( Fig. 10-60).
 fl
*
Finishing and polishing 329

t Fig. 10 54. Badly worn rag wheel in need or renovation (left ), and
-
fluffy wheel after reconditioning (right ).
r

•
i 4

Fig. 10-55. Rotate lathe slowly, and use knife to cut threads holding
cloth plies together.

"S

- .
Fig. 10 56 Plies of cloth are separated.

.V
'
.

Fig. 10- 57. A, Stainless steel plaster spatula or

dull dinner knife is held against wheel while
C running lathe at low speed. B, Cloth plies are
separated by knife. C, Wheel after fluffing on
lathe.

Fig. 10- 58. Match used to singe off protruding threads. Do not
singe threads while suction device is in operation , because this
will produce draft. Singe rag wheel in metal pan after removing all
flammable material. Have water available to douse wheel. After
singeing, place rag wheel in water.

i
A B

/•>

Fin 1CWKQ A Fluff QinnpH whppl nn lathp as dpsrrihpd nrpvinu&lv B Rpr.onditinnpd ran whpp| is
 Finishing and polishing 331

lr
JU

r V
Fig. 10-60. Old rag wheel (left) was rehabilitated, and new rag
wheel (right ) was fluffed to improve efficiency.

>
ft
*

Fig. 10-61. Generous amount of flour of pumice slurry is used for

polishing resin. Fine pumice polishes almost as fast as coarser
grades and produces smoother surface.

Y'
Pumicing denture hold it in light contact with the surface of the denture
to be stippled , that is , the area of the attached gingiva
PROCEDURE
.
-( Fig. 10-65) Use light random circular movements of

1' Make a slurry of fine flour of pumice witn water
( Fig. 10-61). Using copious amounts of the slurry , wet
the rag wheel , and polish the denture at low speed .
Move the denture throughout the polishing to prevent
formation of plane surfaces. Use a brush or prophy cup
with the slurry to polish areas less accessible to the rag
wheel ( Fig. 10-62).
2. Polish the palate and areas of the denture not
readily accessible to the rag wheel by using a prophy
cup or a Dixon brush with slurry of flour of pumice.
Smooth the denture in this manner because a larger
polishing instrument would obliterate anatomic details
( Fig. 10-63;. After completing the pumicing, wash the
denture thoroughly in water, dry it , and examine it for
scratches. If any scratches are visible on the pumiced
surface, repeat the pumicing, and postpone the high
polishing until after removing all scratches.
* 3. Stipple the denture with a No. 200 finishing bur
( Fig. 10-64 ). Rotate this bur slowly in a handpiece, and
the bur against the resin surface to produce an eggshell ,
or stippled , effect that breaks up light reflections and
corrects minor imperfections in the resin ( Fig. 10-66).
4. Go over the stippled area lightly with a rubber
prophy cup and a slurry of flour of pumice ( Fig. 10-67 ).
5. Put a high shine on the denturewith No. 341
TiGleam *, or prepared chalk slurry , and a modified rag
wheel ( Fig. 10-68). Do not use this rag wheel with any
other polishing material . Examine the denture carefully
for scratches, and polish out any missed previously
( Fig. 10-69). Take care when polishing or pumicing the
denture to keep from abrading the anatomic details of
the plastic teeth .
6. Brush the denture with green soap to remove all
traces of polishing material , and examine the denture
carefully. Rinse the denture in water, and store it in a
plastic container of water until needed ( Fig. 10-70 ).
No. 341 TiGleam, Ticonium , Albany, N . Y. , or equivalent.
Fig. 10-62. A , Where larger rag wheel might eliminate anatomic details, polish denture with hand-
piece-mounted rubber prophy cup and flour of pumice slurry. B, Use medium bristle brush in same
manner as prophy cup.

Fig. 10-63. A, Scratches deep in vault of palate are difficult to remove with rag wheel. B, Handpiece-
mounted brush safely removes scratches or grooves in vault.

Fig. 10-64 . No. 200 finishing bur (center ), rubber prophy cup (left ),
and handpiece-mounted brush (right ) are used to place stippled or
eggshell surface on denture.
 Finishing and polishing 333

>

Fig. 10-65. A, Area of denture to be stippled is outlined with felt -tip pen. Stippling or peened surface
is confined to area occupied by attached gingiva. B, Areas on maxillary and mandibular dentures are
outlined for stippling.

1
Ir

Fig. 10-66. Random circular movements at slow speed with light Fig. 10-67. Pumice stippling with flour of pumice slurry and hand-
pressure are used to create stippled surface. Position of denture is piece -mounted rubber prophy cup. Pumice lightly to avoid polishing
changed to facilitate making random swirls. away stippled surface.

Fig. 10-68. Denture is buffed to high luster. Prepared chalk slurry,

.
No 341 TiGleam, Shur-shine, rouge, or other high- shine materials
can be used to create highly polishing surface.

r
r
334 Dental laboratory procedures: complete dentures

1 . V “
Fig. 10-69. A , Dentures are examined carefully for scratches, and high shine is restored after
scratches are removed. B , Note effect of stippling.

Fig . 10-70. Denture is cleaned thoroughly with brush and soap so-
lution to remove all traces of polishing materials. Completed den-
ture is rinsed and stored in water until needed.

PROCEDURE FOR METHOD TWO

1 . Remove the denture from the cast as described
previously.
2. Remove the stone that adheres to the gingival -
margin area of the denture with a Bard - Parker handle
and a No. 25 blade ( Fig. 10-71 ). Trim away excess flash
with a laboratory lathe- mounted carbide bur ( Fig. 10-
72 ). Place the denture in an ultrasonic cleaner, contain -
ing a solution for removal of gypsum products ( Fig. 10-
73). Adjust for frenum clearance with a No. 558 bur
mounted in a laboratory lathe ( Fig. 10-74).
3. Use a rubber point* mounted on a mandrel and a
dental lathe to remove scratches from the denture base
in areas inaccessible to the larger pumice wheel ( Fig.
10-75). Pumice the denture using Hour of pumice or
.
*No. 255 clasp polishers Ticonium , Albany, N . Y .
fine pumice mixed with water and a modified rag
wheel , as described previously ( Fig. 10-76).
4. Polish areas between the teeth with a bristle brush
and pumice slurry ( Fig. 10-77).
5. Put the initial high shine on the denture with a
soft rag wheel and prepared chalk mixed with water
( Fig. 10-78).
6. Put the final high shine on the denture with a soft
chamois wheel and gold rouge ( Fig. 10-79).
7. Stipple the denture with a straight handpiece No.
4 round bur bent slightly to rotate eccentrically ( Fig.
10-80).
8. Place the bur in a lathe and , with the lathe run -
ning at slow speed , stipple the surface of the denture
base in a random motion ( Fig. 10-81). Apply a high pol -
ish to the dentures again, scrub them with soap and
water, and place them in a container of water until
ready for use by the dentist ( Fig. 10-82 ).
T Finishing and polishing 335

- .
Fig. 10 71 Optional method of removing plaster or stone from den-
ture is to qse No. 25 blade in Bard-Parker handle. When using
blade, exercise care to avoid cutting fingers or plastic teeth.

-
Fig. 10 72. A, Carbide burs for laboratory use are excellent for removing resin flash. Lower bur can
.
be used in lathe or handpiece. B Flash is removed from buccal border. C, Flash on posterior border
is removed, and area is thinned.

f-

i
336 Dental laboratory procedures : complete dentures

- .
Fig. 10 73 Dentures can be placed in ultrasonic cleaner containing Fig. 10-74. Adjust for frenum clearance with lathe-mounted fissure
-
appropriate solution before or after flash is removed. Stone remain bur.
ing around teeth is removed quickly and easily.

Fig. 10-75. Rubber points can be shaped for particular area to be

smoothed. Care is required to avoid damage to plastic teeth.

Fig. 10-76. Flour of pumice mixed with water and modified rag Fig. 10-77. Polish interproximal areas with lathe- mounted brush
wheel are used to polish denture. wheel and flour of pumice slurry. Caution is advised if plastic teeth f
are used, since anatomic details can be polished away.
 Finishing and polishing 337

- .
Fig. 10 78 Rag wheel and prepared chalk mixed with water are
.
Fig. 10-79. Soft chamois wheel and gold rouge are used for final
high shine .
used for initial high shine This rag wheel should not be used with
other polishing materials.

Fig. 10 80. Straight handpiece No. 4 round bur bent slightly for use
-
in stippling.

#•

Fig. 10-81. Modified bur produces stippled surface. Do not bend Fig. 10 82. Dentures are examined carefully, touched up wherever
-
bur too much or. use excessive pressure when stippling to avoid necessary, scrubbed thoroughly, and stored in water until needed.
creating rough surface.

4
338 Dental laboratory procedures: complete dentures
POLISHING TEETH
Acrylic resin teeth are polished by the same method
as the denture base material . A rubber prophv cup and
fine pumice or flour of pumice are used to restore the
surface luster of acrylic teeth after modification . A high
luster is restored to the surface of these teeth with a
soft rag wheel and a high -shine material such as rouge
, wheel and a slurry of Hour of pumice.
.
or prepared chalk slurry Care should be taken when
polishing resin teeth to avoid removing too much ma - rag wheel and a slurry of porcelain finishing polish , t
terial from the occlusal surfaces and , thereby , affecting
the occlusion . One disadvantage of using plastic teeth
is the possibility of altering them during the polishing
by inadvertent contact between the teeth and polishing
wheel.
Polishing porcelain teeth
Since it is more difficult to polish ground porcelain
teeth than acry lic teeth , restoring a satisfactory surface
requires more effort.
PROCEDURE
1. Smooth the surface of ground porcelain teeth with
a medium polishing wheel. *
2. Smooth the surface again with a fine polishing
wheel , t
-
3. Polish in two directions with a lathe mounted rag
4. Do the final polishing with a clean lathe-mounted
The procedure described restores an acceptable sur-
face to porcelain teeth , although it is not as smooth as
the original glaze.
SUMMARY
Methods for deflasking, finishing, and polishing com -
plete dentures have been described in this chapter.
The success of the restoration is often directly related
to the quality of the technical procedures involved .
*Super-polish wheel No. 37, Vs x 'A inch ( 1.6 x 0.32 cm ), medium
grit .
Dental Development and Manufacturing Co., Brooklyn , \ V.
tSuperpolish wheel No. 37, Vs x >A inch ( 1.6 x 0.32 cm ), fine grit .
Dental Development and Manufacturing Co. , Brooklyn , N Y .
$Tru -polish No. 3. Dentsply International, Inc., York , Pa .
*
 CHAPTER 11
DUPLICATE DENTURES
KENNETH D. RUDD and ROBERT M. MORROW
duplicate denture A second denture intended to be a copy of the
first denture
A spare or backup denture is a definite advantage for
the patient whose original denture requires repair or
modification . The literature contains reports of several
methods of duplicating dentures with heat -curing and
’
autopolymerizing resin (Geiger, 1955; Adam , 1958;
^ Shaw, 1962; Manoli and Griffin , 19(59; Azarmehr and
Azarmehr, 1970; Zoeller and Beetar, 1970; Wagner,
1970; Boos and Carpenter, 1974 ; Brewer and Morrow .
1975; Singer. 1975).
METHODS
This chapter presents three methods of duplicating
dentures with pour-type autopolymerizing resin . * The
methods differ principally in the type of flask and the
investing medium used . They are ( 1 ) the modified-
denture flask method ( Brewer and Morrow, 1975), ( 2 )
-
the pour resin-flask method ( Boos and Carpenter,
1974), and (3) the cup- flask method ( Wagner, 1970;
Singer, 1975).
Modified-denture flask method
This method requires the use of a modified denture
flask and alginate irreversible hydrocolloid to flask the
denture to be duplicated.
•Pronto II , Vernon - BenshofT Co. ,
Inc., Albany. N . Y.: Pour- N -Cure,
Coe Laboratories Inc., Chicago, III. ; or Moxum Fluid Denture base
system, Dentsply, York Div . , York, Pa .
PROCEDURE
1. Modify the denture flask by removing a rectangu -
lar section from the upper part ( Fig. 11- 1 ). This open -
ing will allow access for the sprues. Although it is un -
necessary to have a new flask the parts should fit
,
together accurately without rocking.
2. If the denture to be duplicated has thin areas, add
wax to the exterior surface of the denture to thicken
these areas before flasking ( Fig. 11-2 ).
3. Roll utility wax to form a sprue approximately 75
mm long and 15 mm in diameter ( Fig. 11 -3).
4. Attach the sprues to the lingual surface of the
heels of mandibular dentures and to the palatal surface
of the tuberosity region of maxillary dentures ( Fig. 11-4 ).
5. Paint the round plate from the lower part of the
flask with an adhesive, * and insert it from the exterior
surface, rather than from the interior ( Fig. 11-5). This
insertion prevents distortion of the alginate mold by in -
advertent displacement of the plate while handling the
flask .
6. Apply the same adhesive* to the interior surface
of the flask to facilitate retention of the alginate ( Fig.
11 -6) .
7. Mix eight scoops of regular setting alginate with
the recommended volume of water for the first pour.
Cooling the water will allow additional working time.
8. Mix the alginate with a mechanical spatulatort un -
•Hold, Teledyne Dental Products Co., Getz/Opotow Division . Elk
Grove Village, Ill .
-
tCombination Vac U - Vestor Power Mixer, Whip- Mix Corp. , Louis-
ville, Ky.
339
 -
340 Dental laboratory procedures: complete dentures

or upper part of upper flask or, B,

Fig. 11-1. A, Rectangular section ( arrows ) is removed from cope
part of lower flask . C, Wax sprues will extend through opening.
from drag or lower

Fig. 11-3. Sprues of utility wax or orthodontic tray wax should be

Fig. 11 2 Wax is added to exterior surface of denture where thin-
-. approximately 75 mm long and 15 mm in diameter.
.
ness can result in miscast
 Duplicate dent tires 341

* %

Fig. 11- 4. A, Sprues should be added to lingual surfaces of mandibular heel region. Portions of
denture should not extend above sprue attachment when held vertically to prevent entrapment of air
during pouring of resin and resultant void. B , Sprues are attached to tuberosity regions of maxillary
dentures. Seal sprues to denture with wax spatula.

B
A

Fig. 11-5. A, Edges of round plate are painted with adhesive ( Hold). B, Plate is inserted from exterior
surface rather than interior.

Fig. 11-6. Interior of flask is painted with adhesive ( Hold) to main-

tain alginate in flask when halves are separated.
342 Dental laboratory procedures: complete dentures

der reduced atmospheric pressure to minimize air in - 18. Place the lower part of the flask , that is , the east
clusions in the material ( Fig. 11-7). Hand spatulate side, in a humidor or under a wet towel .
thoroughly if a power mixer is unavailable. 19. Dry the tooth indentations in the alginate care-
9. After mixing, place alginate into the interior of the fully . Use a gentle stream of air or a strip of cleansing
denture with a finger or a brush , taking care to avoid tissue to remove water from the tooth imprints ( Fig. 11 -
the entrapment of air and resultant voids ( Fig. 11-8). 18).
Fill the denture completely ( Fig. 11-9). 20. Add autopolymerizing tooth -colored resin of the
10. Place the remainder of the alginate mix in the proper shade to the tooth indentations by the sprinkle-
lower part of the flask ( Fig. 11-10). on or paint -on method ( Fig. 11-19 ) .
11 . Settle the filled denture into the mix , as during a
routine Basking procedure ( Fig. 11 -11). The wax sprues
can support the denture, thereby preventing it from
sinking into the alginate ( Fig. 11- 12 ). The alginate
should extend approximately 3 mm onto the exterior
surface of the denture.
12. After the alginate has set , trim away any excess
that flows over the edges of the flask ( Fig. 11-13).
13. Place the upper part of the flask in position , and
adapt the wax sprues to seal the rectangular opening
( Fig. 11-14 ).
14. Mix six scoops of alginate with three times the
recommended volume of water to make a pourable con -
sistency.
15. Pour the alginate into the flask slowly. Use a fin -
ger or brush to wipe alginate onto the teeth of the den -
ture to minimize voids ( Fig. 11 - 15). The second pour
will not stick to the first one.
16. Completely fill the flask , and place the top in po-
sition ( Fig. 11-16). Allow the alginate to set approxi -
mately 15 minutes or longer if using cold water. v *

17. After the alginate has set , open the flask , and re-
move the denture and sprues ( Fig. 11- 17).

Fig. 11-7. Alginate mixed under reduced atmospheric pressure has

fewer air inclusions.

Fig. 11-8. Alginate is painted into interior of denture; care is exer -

cised to minimize voids. Fig. 11- 9. Interior of denture is filled with alginate.

'
 >, Duplicate dentures 343

Fig. 11- 10. A, Remaining alginate is placed in flask. B, Flask half filled with alginate.

Fig. 11 11. Filled denture is settled into alginate- filled flask .

- Fig. 11- 12. Wax sprues are pressed into back side of flask to sup-
port denture and prevent sinking.

Fig. 11- 13. Any alginate extending onto edges of flask is removed.

<
tlQf *fr
•

n
( LIBRARY .
n •

\
344 Dental laboratory procedures: complete dentures

Fig. 11-14. A, Flask halves assembled. B, Fingers are used to mold wax sprues to make watertight
seal. Here lower flask is being used.

Fig. 11 15. Teeth are coated with alginate using brush, finger, or
-
spatula. Lower flask is shown here. Hence alginate is poured
through round plate opening.

Fig. 11 16. A, Upper flask is filled completely with alginate, and lid is replaced. B, Lid is tapped to
-
assure complete seating. If upper flask is used, pour through open top.
 Duplicate dentures 345

.
Fig. 11-17. A, Spatula is used to separate flask halves B, Denture and wax sprues are removed
from investing alginate. Gentle stream of air will often lift denture from alginate.

Fig. 11- 18. A, Moisture is removed with gentle stream of air. B, Strip of absorbent tissue also can be
used to remove moisture from tooth indentations.

Fig. 11- 19. Tooth shade-autopolymerizing resin is sprinkled or

.
Fig. 11- 20. Resin is painted or sifted to conform to cervical line Do
painted into indentation. not overfill.
*
— 346 Dental laboratory procedures: complete dentures
Fig. 11- 21. A , Sprue hole. B, Resin is poured into one sprue hole only . C and D, Gently rock flask
to left and right to minimize voids.
21 . Carefully add the tooth -colored resin in incre-
ments, and fill the indentations to the cervical line ( Fig.
11 -20). Exercise care to improve materially the resul -
tant duplicate denture. It is possible to add incisal ,
body, and gingival shading, but it requires considerable
skill to achieve good results.
-
22. Allow the tooth shade resin to set for a few min -
utes before assembling the flask .
23. Carefully dry the alginate in the lower flask ; then
assemble the flask halves, and clamp or secure them
with rubber bands .
24. Mix a pour- type resin * according to the manufac-
turer’s recommendations , and pour it into one sprue
hole ( Fig. 11 - 21 , A and B ).
25. Rock the flask gently while pouring to minimize
the entrapment of air ( Fig. 11-21, C and D ).
26. Fill one sprue until the resin fills the other sprue,
thereby indicating that the mold is full .
* Pronto . - . -
II Vernon Benshoff Co. , Albany, N.Y ; Pour N-Cure, Coe
laboratories Inc. , Chicago, III . ; Maxnrn Fluid Denture Base System ,
.
Dcntsply York Div.
(l '
27. Attach modeling clay to the filled flask , place it
sprues upward in warm water in a pressure container ,
and cure the denture at 20 psi for 30 minutes ( Fig. 11-22 ).
28. Remove the cured denture, and examine it for
nodules and voids ( Fig. 11-23).
29. Cut off the sprues, and finish and polish the den -
ture ( Fig. 11-24), as described previously .
PROBLEM AREAS
The principal problems associated with this method
are the inability to obtain a bubble-free voidless mold ,
failure to achieve an accurate duplication of denture
teeth without rounded incisal angles, and difficulty in
producing an accurate alginate mold and resultant du-
plicate denture (Table 11 - 1 ). Mixing the alginate in a
mechanical spatulator under reduced atmospheric pres-
sure helps to minimize voids. Painting the alginate into
the denture with a finger or brush also results in fewer
voids. Making acceptable autopolymerizing resin teeth
in the denture requires skill and practice. Make certain *-
that the tooth indentations in the alginate are dry to
minimize the possibility of rounded incisal angles in the
 Duplicate dentures 347

Fig. 11- 22. Small pellets of modeling clay attached to flask permit it to remain with sprues upright in
pressure container .

i
Fig. 11-23. Denture is examined carefully for voids or nodules.

resin teeth ( Fig. 11-25). Add the resin in increments,

and tilt the flask while pouring. This procedure results
in a controlled flow of resin . If tooth -shade resin does
not fill the indentations completely, pink resin will fill
the remaining portion and produce an unsatisfactory re-
sult . Adding too much tooth-colored resin may cause
part of the gingival portion of the denture base to be
tooth shade rather than pink and therefore undesirable.
A small brush is helpful in adding resin to specific areas
of the indentation , and practice assures more uniform
and acceptable results.
It appears, at least clinically , that the duplicate den -
—
ture made by the alginate mold pour resin system does
not exhibit the same adaptation to the tissues as the
original denture. Therefore the duplicate may require
Fig. 11-24. Sprues are removed, and denture is polished.
more adjustment by the dentist. It is best to consider
the duplicate denture a spare one for emergency use
only.
348 Dental laboratory procedures: complete dentures

Table 11-1. Modified-double flask method

ZH J
Problem Probable cause Solution '

Many bubbles and voids in
alginate mold
Duplicate denture incomplete
because of voids
Rounded incisal edges on
teeth in duplicate dentures
Teeth on duplicate denture
pink in gingival third
Tooth-shaded resin on gingi-
val papillae of denture
base
Duplicate denture porous
Alginate not painted on denture with
finger or brush
Alginate not mixed in mechanical
spatulator contains excess air
Thin areas in original denture
Sprues improperly attached
Resin poured down both sprue holes
Flask not rocked while pouring resin
Tooth indentations in alginate mold
not dried before pouring resin
Moisture trapped in indentation, pre-
venting sharp reproduction
Tooth indentations in alginate mold
not completely filled with tooth
resin
Tooth resin applied improperly, per -
mitting tooth- shaded resin to ex -
tend into papillae
Wrong type of resin used
Mixing instructions of manufacturer
not followed
Minimize voids by painting alginate onto denture
Use mechanical spatulator to mix alginate under re -
duced atmospheric pressure
Thicken thin areas of original denture with wax to im-
prove castability
Attach sprues correctly to preclude entrapment of air
Pour resin into one sprue hole ; use other as vent
Rock flask gently during pouring to reduce possibility of
entrapment of air and resultant voids in duplicate
denture
Dry tooth indentations in alginate mold with gentle
stream of air or strip of absorbent tissue to remove
moisture
Fill mold indentations completely to gingival margin with
tooth resin 1
Take care to confine resin to tooth indentation by using
brush if necessary
Use pour-type autopolymerizing resin
Follow mixing instructions of manufacturer

-v
Pour-resin-flask method
It is possible to make satisfactory duplicate dentures
by using autopolymerizing pour- tvpe resin , a special
flask for these resins ( Fig. 11-26 ), and reversible hydro-
colloid . Boos and Carpenter ( 1974 ) have described an
excellent method , and the follow ing technique is an ad -
aptation of theirs.

PROCEDURE
1. Mount the denture to be duplicated on the lower
plate of a pour-resin flask , using heat -stable clay. Adapt
the clay to form a base approximately 6 nun thick , and
develop a land area around the denture border 4 to 5
mm wide and perpendicular to the denture flanges
( Fig. 11-27).
2. Assemble the pour- resin flask , * and fill it with re-
versible hydrocolloidt ( Fig. 11-28).
Fig. 11 25. Excess moisture is removed to reduce rounding of in-
- 3. Cool the filled flask in water ( Fig. 11-29). i
f.
cisal angles (arrows ). 4 . After the reversible hydrocolloid has gelled, disas-
semble the flask , and remove the denture and clay ( Fig.
11-30).

* Pour- N -Cure * Flask , Cot Laboratories Inc. , Chicago, Ill

*

t Reversil >le hydrocolloid .

. -
 Duplicate dentures 349

r
^4

\
V1
f

. -
Fig 11 26. Several types of pour resin flasks are available. Flask Fig. 11-27. Clay base simulating cast is formed around denture.
shown here is manufactured by Coe Laboratories Inc., Chicago, III. Borders made 4 to 5 mm wide and 2 to 3 mm above denture bor-
ders.

Fig. 11- 28. A, Flask is assembled. B and C, Plates are slipped into position. D , Flask is filled
with
reversible hydrocolloid.
350 Dental laboratory procedures: complete dentures

'a

Fig. 11- 29. Flask is placed in water to cool hydrocolloid.

\

Fig. 11- 30. A, Opened flask . B, Clay is removed.

5. Cleanse the denture, and reposition it in the mold 12 . Paint tooth shade-autopoly meriting resin into
( Fig. 11-31). the tooth indentations with a brush , and exercise care
6. Switch the bottom plate of the flask to pour the to avoid the entrapment of air ( Fig. 11 -37 ).
.
tissue side of the denture ( Fig 11-32) . 13. Fill the tooth indentations with the resin care-
7. Fill the flask with the hydrocolloid , and cool it in fully , and pay special attention to maintain the gingival
the same manner as before ( Fig. 11 33). - outline. Do not remove the resin teeth from the
8. After the hydrocolloid has gelled , remove it from mold .
the cooling hath , and place it in water at 115° F ( 46° C ) 14. Using a cork borer, cut sprue holes through the
for 5 minutes prior to removing the denture . hydrocolloid resin ( Fig. 11 -38).
9. Open ( he mold , and use a gentle stream of air to 15. Assemble the mold , mix and pour the resin into
facilitate separation of the hydrocolloid pours ( Fig. 11-34)
10. Dry the tooth indentations in the mold with a
. one sprue only ( Fig. 11-39) , and gently rock the flask to
minimize the entrapment of air within the mold.
'
gentle stream of air, or use a thin slip of absorbent tis- 16. Place the mold with the sprue holes upright in a n
-
sue to blot the moisture ( Fig. 11 35). pressure container of water at 120c F ( 45.5° C ) , and
11 . Place the cast portion of the hydrocolloid mold in cure at 20 psi for 30 minutes ( Fig. 11 -40 ).
a humidor or cover it with a damp towel to minimize 17. Remove the cured duplicate, and trim it , and pol -
- .
dehydration ( Fig. 11 36) isli it ( Fig. 11 -41 ).
Text continued on p. 356

¥
 Duplicate dentures 351

* 4»

.
Fig. 11 31 A, Clay is removed from denture, and denture is replaced in mold. B and C, Undercuts
-
in hydrocolloid are trimmed with knife to facilitate separation later.

Fig. 11 32. Bottom plate of flask is switched.

-
 - .
Fig. 11 33 A . Reversible hydrocolloid is poured
in flask. Flask should be filled completely B Flask
is cooled in water.

Fig. 11-35. Tooth indentations are dried with, A, air or, B,

absorbent tissue to minimize roundinq of
incisal angles.
 Duplicate dentures 353

9
\

l *

Fig. 11-36. Hydrocolloid mold is covered with damp towel to pre-

vent drying and resultant shrinkage of mold.

.
Fig . 11-37. Tooth-shade resin is placed in indentations Gingival
outline is maintained while adding tooth resin.

Fig. 11-38. A, Small cork borer is used first to achieve proper approach to denture, then
larger cork
borer is used to trace path of small borer. B, Small cork borer can be used to create vent
in midline
of posterior border of upper denture.
354 Dental laboratory procedures: complete dentures

Fig. 11 39. A, Mold is assembled. B, Resin is poured into mold while rocking gently to minimize
-
voids. C, Resin is added until sprue holes are filled.

A B

- .
Fig. 11 40 A, Resin-filled flask is placed upright in warm water in pressure container. B, Flask is
cured at 15 to 20 psi for 30 minutes.
 Duplicate dentures 355

\ " Wmm mmrnmmrnmm.

t
C

- .
Fig. 11 41 A and B, Cured denture removed from flask . C, Sprues are cut from dentures and dupli-
cate dentures are polished.

Table 11-2. Pour resin— flask method

Problem Probable cause Solution

Voids along posterior borders
of duplicate denture
Incisal edges of teeth on dupli-
cate denture rounded
»
:
Sprues improperly attached
Resin poured into both sprue holes,
entrapping air
Flask not rocked during pouring
Water not removed from mold
Mold not warmed in water at 115° F
( 46° C) for 5 minutes to reduce
Attach sprues to denture so that denture does not
extend above sprue feed
Pour resin into one sprue only
Rock flask gently from side to side while pouring
Blot moisture from tooth indentations with absor -
bent tissue
Minimize sweating by placing mold in water at
115° F (46 C) for 5 minutes prior to pouring
L

sweating
Teeth on duplicate denture pink Mold indentations not completely Fill tooth indentations carefully to level of gingival
in gingival third filled with tooth-shade resin margin
Gingival papillae on duplicate Tooth indentations overfilled with Do not overfill tooth indentations with tooth-shade
denture blanched tooth- shade resin, resulting in resin
blanching of papillae
%
356 Dental laboratory procedures : complete dentures
PROBLEM AREAS
Obtaining a duplicate denture free of voids is the
principal problem of the pour-resin-flask method (Ta-
ble 11-2 ). Correct spruing procedures and careful pour-
ing techniques will minimize voids. In addition , a spe-
cial flask and the equipment for liquefying reversible
hydrocolloids are essential.
Cup- flask method
Wagner ( 1970) has described a method of duplicating
complete dentures by using reversible or irreversible
hydrocolloid and a cup as a flask . Singer (1975 ) has
modified the method by introducing a particularly con -
venient zipper technique that uses dental floss to sec-
tion an alginate irreversible hydrocolloid mold poured
in a 12-ounce ceramic cup. This zipper method is
equally effective for reversible and irreversible hydro-
colloid molds.
The methods described are adapted from those of
Wagner and Singer. Although reversible hydrocolloid
or irreversible hvdrocolloid is usable for making molds,
we prefer reversible hvdrocolloid because of the resul -
tant smoother resin surfaces.
4. Make soft utility wax or caulking compound sprues
approximately 75 mm long and 12 min thick , and adapt
them to the maxillary and mandibular dentures as de-
scribed previously (Fig. 11 -45). An optional vent sprue
that extends from the center of the maxillary denture is
useful, but it is unnecessary if care is exercised when
pouring.
5. For the maxillary denture, press the remainder of
the loop into the inner and outer surfaces of one sprue.
6. Press the (loss loop from the lingual flange of the
lower into the inner surface of the wax sprue and the
floss from the buccal surfaces into the outer surface of
the wax sprue ( Fig. 11-46).
7. Attach the wax sprues between two Winch (6 mm )
wood dowel rods approximately 6 inches ( 15.2 cm ) long
to suspend the denture in a 12-ounce ceramic cup with -
out contacting the bottom of the cup ( Fig. 11 - 47).

PROCEDURE
1 . Slowly pull 16-inch (40-cm ) lengths of dental floss
through liquefied orthodontic tray wax ( Fig. 11 -42).
This soft wax will enable the floss to adhere to the den -
ture flanges readily.
2. Tie the floss into a loop, and adapt it to the den -
ture flanges 2 to 3 mm from the borders and across the
posterior border of the maxillary denture ( Fig. 11 -43).
3. Use two loops for the mandibular denture. Adapt
one loop to the lingual flange approximately 4 mm from Fig. 11- 42. Orthodontic tray wax is melted and dental floss pulled
the border ( Fig. 11 -44 ), and adapt the other loop to the through it to make the floss tacky. Dental floss also can be made
buccal flanges of the denture. tacky by rubbing it with orthodontic tray wax.

Fig. 11- 43. A, Floss is adapted to flanges approximately 2 to 3 mm below borders (arrows ). B, Floss
is attached to posterior border also (arrows).
 V

Duplicate dentures 357

. -
Fig 11 44. One length of floss is adapted to lingual flanges of den- Fig. 11- 45. Wax sprues approximately 75 mm in length and 12 mm
ture and another to outer or buccal flanges (arrows ). in diameter are attached to denture.

.
Fig 11-46. Floss loop from lingual flanges is attached to inside of Fig. 11- 47. Denture should not touch cup when suspended in it .
one sprue (upper arrows), and floss loop from buccal flanges is
attached to outside of sprue (lower arrows ).

Fig. 11- 48. Wedge of molding clay is attached to inner surface of

1 cup opposite handle (arrow ).

7>
358 Dental laboratory procedures: complete dentures

8. Place a modeling clay wedge in the cup opposite 18. Assemble the mold in the cup in the original po-
the handle to facilitate removal of the mold after pour- sition . Mix pour-type resin , and pour it into one sprue,
ing ( Fig. 11-48). as described earlier ( Fig. 11 -59).
9. Suspend the sprued denture in the cup ( Fig. 11 -49 ). 19. Cure the duplicate denture in warm water in a
10. Fill the mold with a pourable mix of alginate ( Fig. pressure container for 30 minutes at 20 psi.
11-50) or reversible hydrocolloid ( Fig. 11-51). Alginate 20. Retrieve the denture, and examine it for voids or
mixed with approximately three times the recom - nodules ( Fig. 11 -60 ).
mended volume of water makes a pourable mix. A mix 21 . Polish the duplicate denture.
of six scoops of alginate and three times the recom - The mandibular denture is handled in much the
mended amount of water will fill the 12-ounce cup ap- same way; the main difference is in the placement of
proximately. A smoother bubble-free mix results from the waxed dental floss loops.
mixing in a mechanical spatulator under reduced at -
mospheric pressure.* An 800-gm mixing bowl is rec-
ommended . An optional pouring technique involves
filling the cup first , then settling the denture into the
mix, though there is greater risk of touching the cup
with the denture.
11 . Allow the irreversible hydrocolloid to set on the
bench ( Fig. 11 -52, A ). Place the reversible hydrocolloid
in cool water until gelation occurs ( Fig. 11-52, B ).
12. Remove the dowel rods from the mold and the
clay wedge from the hydrocolloid ( Fig. 11 -53).
13. Remove the mold containing the upper denture
from the cup. A gentle stream of air directed at the
kcvway will aid in removal ( Fig. 11-54).
14 . Pull the dental floss across the posterior border
and around the flanges of the upper denture ( Fig. 11-55).
15. Open the mold , and retrieve the denture ( Fig.
11-56 ). Fig. 11-49. Sprued denture is suspended in cup. Two dowel rods
16. Dry the tooth indentations with a stream of air make it possible to stabilize denture without rocking.
and with absorbent tissue ( Fig. 11-57).
17. Paint autopolymerizing resin of the proper shade
into the tooth indentations as described previously ( Fig.
11-58).
"Combination Vac- U -Vester Power Mixer. Whip- Mix Corp. , Louis-
ville, Ky.

. .
Fig. 11-50 Cup is filled with alginate irreversible hydrocolloid - .
Fig. 11 51 Reversible hydrocolloid also can be used to obtain bet-
ter denture surface.

•V
 Duplicate dentures 359

A B

Fig. 11- 52. A, Alginate is allowed to set on bench. B, Reversible hydrocolloid is placed in cool water
A to gel.

A
Fig. 11-53. Dowel rods are removed from mold. Clay wedge is re-

* 't
moved from hydrocolloid.

Fig. 11- 54. Air is blown into keyway formed by clay wedge to re-
move mold from cup.
I
356 Dental laboratory procedures: complete dentures
PROBLEM AREAS 4. Make soft utility wax or caulking compound sprues
Obtaining a duplicate denture free of voids is the approximately 75 mm long and 12 mm thick , and adapt
—
principal problem of the pour-resin flask method (Ta-
ble 11-2). Correct spming procedures and careful pour-
them to the maxillary and mandibular dentures as de-
scribed previously ( Fig. 11-45). An optional vent sprue
ing techniques will minimize voids. In addition , a spe- that extends from the center of the maxillary denture is
cial flask and the equipment for liquefying reversible useful , but it is unnecessary if care is exercised when
hvdrocolloids are essential. pouring.
5. For the maxillary denture, press the remainder of
Cup- flask method the loop into the inner and outer surfaces of one sprue.
Wagner ( 1970 ) has described a method of duplicating 6. Press the floss loop from the lingual flange of the
complete dentures by using reversible or irreversible lower into the inner surface of the wax sprue and the
hydrocolloid and a cup as a flask. Singer ( 1975) has floss from the buccal surfaces into the outer surface of
modified the method by introducing a particularly con - the wax sprue ( Fig. 11 -46 ).
venient zipper technique that uses dental floss to sec- 7. Attach the wax sprues between two Vi-inch ( 6 mm )
tion an alginate irreversible hydrocolloid mold poured wood dowel rods approximately 6 inches ( 15.2 cm ) long
in a 12-ounce ceramic cup. This zipper method is to suspend the denture in a 12-ounce ceramic cup with -
equally effective for reversible and irreversible hvdro- out contacting the bottom of the cup ( Fig. 11 -47).
colloid molds.
The methods described are adapted from those of
Wagner and Singer . Although reversible hydrocolloid
or irreversible hydrocolloid is usable for making molds ,
we prefer reversible hvdrocolloid because of the resul -
tant smoother resin surfaces.
PROCEDURE
1 . Slowly pull 16-inch (40-cm ) lengths of dental floss
through liquefied orthodontic tray wax ( Fig. 11-42).
This soft wax will enable the floss to adhere to the den -
ture flanges readily .
2. Tie the floss into a loop , and adapt it to the den -
ture flanges 2 to 3 mm from the borders and across the
posterior border of the maxillary denture ( Fig. 11 -43).
3. Use two loops for the mandibular denture. Adapt
one loop to the lingual flange approximately 4 mm from Fig. 11- 42. Orthodontic tray wax is melted and dental floss pulled
the border ( Fig. 11 -44 ), and adapt the other loop to the through it to make the floss tacky. Dental floss also can be made
buccal flanges of the denture. tacky by rubbing it with orthodontic tray wax .

Fig. 11- 43. A , Floss is adapted to flanges approximately 2 to 3 mm below borders (arrows ). B, Floss
is attached to posterior border also (arrows ).
 Duplicate dentures 357

.
Fig 11-44. One length of floss is adapted to lingual flanges of den- Fig. 11- 45. Wax sprues approximately 75 mm in length and 12 mm
ture and another to outer or buccal flanges (arrows ). in diameter are attached to denture.

1 ^
.
Fig 11-46. Floss loop from lingual flanges is attached to inside of Fig. 11- 47. Denture should not touch cup when suspended in it .
one sprue (upper arrows ), and floss loop from buccal flanges is
attached to outside of sprue (lower arrows ).

1 Fig. 11- 48. Wedge of molding clay is attached to inner surface of

cup opposite handle (arrow ).

I
T
358 Dental laboratory procedures: complete dentures

8. Place a modeling clay wedge in the cup opposite 18. Assemble the mold in the cup in the original po-
the handle to facilitate removal of the mold after pour- -
sition . Mix pour type resin, and pour it into one sprue,
ing ( Fig. 11-48). as described earlier ( Fig. 11 -59).
9. Suspend the sprued denture in the cup ( Fig. 11 -49). 19. Cure the duplicate denture in warm water in a
10. Fill the mold with a pourable mix of alginate ( Fig. pressure container for 30 minutes at 20 psi .
-
11 50) or reversible hydrocolloid ( Fig. 11-51). Alginate 20. Retrieve the denture, and examine it for voids or
mixed with approximately three times the recom - nodules ( Fig. 11-60).
mended volume of water makes a pourable mix . A mix 21 . Polish the duplicate denture.
of six scoops of alginate and three times the recom - The mandibular denture is handled in much the
mended amount of water will fill the 12 ounce cup ap- - same way; the main difference is in the placement of
-
proximately . A smoother bubble free mix results from the waxed dental floss loops.
mixing in a mechanical spatulator under reduced at -
mospheric pressure.* An 800-gm mixing bowl is rec-
ommended . An optional pouring technique involves
filling the cup first , then settling the denture into the
mix, though there is greater risk of touching the cup
with the denture.
11 . Allow the irreversible hvdrocolloid to set on the
bench ( Fig. 11 -52, A ). Place the reversible hydrocolloid
in cool water until gelation occurs ( Fig. 11 -52 , B ) .
12 . Remove the dowel rods from the mold and the
clay wedge from the hydrocolloid ( f ig. 11-53).
13. Remove the mold containing the upper denture
from the cup. A gentle stream of air directed at the
keywav will aid in removal ( Fig. 11 -54 ).
14 . Pull the dental floss across the posterior border
and around the flanges of the upper denture ( Fig. 1 1 -55).
15. Open the mold , and retrieve the denture ( Fig.
-
11 56). Fig. 11- 49. Sprued denture is suspended in cup. Two dowel rods

-
16. Dry the tooth indentations with a stream of air make it possible to stabilize denture with'out rocking.
and with absorbent tissue ( Fig. 11 -57).
17. Paint autopolymerizing resin of the proper shade
into the tooth indentations as described previously ( Fig.
-
11 58).
* Combination Vac- U- \ ester Power Mixer, Whip- Mix Corp. , Dniis-
ville, Ky.

Fig. 11- 50. Cup is filled with alginate irreversible hydrocolloid . Fig. 11-51. Reversible hydrocolloid also can be used to obtain bet -
ter denture surface .
 Duplicate dentures 359

A B

Fig. 11 52. A, Alginate is allowed to set on bench. B, Reversible hydrocolloid is placed in cool water
-
to gel.

Fig. 11-53. Dowel rods are removed from mold. Clay wedge is re-

h * moved from hydrocolloid.

f
Fig. 11-54. Air is blown into keyway formed by clay wedge to re-
move mold from cup.
i
 —
360 Dental laboratory procedures: complete dentures

Fig. 11-55. Zipper floss is pulled across posterior border and around flanges.

Fig. 11-56. Zippered mold is opened, and denture and sprues re-
moved. Sprues can be removed earlier if desired.

Fig. 11-57. Mold is dried with air or absorbent tissue.

e-
 Duplicate dentures 361

f
•

v
or sifted into mold, as described in Fig. 11-37.
- Fig. 11- 58. Tooth-shade resin is painted carefully

*
362 Dental laboratory procedures: complete dentures

Fig. 11- 59. Resin is poured into one sprue hole only. Mold is com- Fig. 11 - 60. Cured denture is checked for voids or nodules.
pletely filled.

Fig. 11-61. Lingual flange zipper is pulled first .

Fig. 11-62. Zipper floss is pulled around labial and buccal flanges.
 Duplicate dentures 363

Table 11-3. Cup- flask method

Problem Probable cause Solution

Bubbles in mold, producing
nodules on denture
Voids in posterior border region
of denture
Rounded incisal angles on den-
ture teeth
Denture teeth pink in gingival
third
Alginate not mixed with mechanical
spatulator
Sprues improperly attached
Mold not rocked during pouring of
resin
Resin poured down both sprues .
resulting in entrapment of air
Mold not dry before resin added
Tooth indentation not filled com -
pletely with tooth resin
Mix alginate in mechanical spatulator under reduced
atmospheric pressure
Attach sprues so that denture does not extend
above attachment
Rock mold gently during pouring of resin to pre-
clude entrapment of air
Pour resin into only one sprue
Dry mold with air or absorbent tissue before adding
resin
Fill tooth indentation completely when adding tooth
resin

PROCEDURE drocolloid is not as easy to use as alginate , since it must

1. Cross the inner (lingual flange ) dental floss loop,
i and pull it through the alginate or the reversible hvdro-
colloid before removing the mold from the cup ( Fig. 11-
61).
2. Remove the mold from the cup, and pull the floss
around the labial and buccal flanges ( Fig. 11-62 ).
3. Complete the mandibular denture in the manner
described for the maxillary denture.
PROBLEM AREAS
The problems associated with the cup-flask method
* , for duplicating dentures are the difficulty in obtaining a
bubble-free mold , particularly with alginate, the round -
ing of incisal angles caused hv improper drying of the
tooth indentations in the hydrocolloid , and the diffi-
culty of painting in the tooth -shade resin to make an
esthetic duplicate (Table 11-3).
Mixing alginate materials in a mechanical spatulator
under reduced atmospheric pressure minimizes bub-
bles in the mold . Drying the mold with a stream of air
and absorbent tissue reduces rounding of the incisal an -
gles. Practice and experience contribute to the im -
proved skill that is required to apply the tooth -shade
resin to the mold and significantly improve the quality
of the duplicate denture. . Prosthet. Dent. 21:104-107, 1969.
^
SUMMARY
This chapter has presented three methods ol con -
structing duplicate dentures. All ol the methods use re-
versible or irreversible hydrocolloid for the mold and a
be liquefied first . However, we believe that the results
with reversible hydrocolloid are clearly superior. Du -
plicate dentures constructed by these methods can be
esthetically acceptable with proper attention to the in -
dividual steps.
Painting tooth shade resin in the mold is particularly
important , and it requires extreme care for the best es-
thetic results. Duplicate dentures can be useful substi-
tutes for the original dentures during necessary repair
or modification . However, they should serve only as
spare or backup prostheses.
REFERENCES
Adam. C. E.: Technique for duplicating an acrylic resin denture. J .
Prosthet . Dent. 8:406-410, 19.58.
Azarmehr, P., and Azarmehr, H. Y.: Duplicate dentures, j . Prosthet.
Dent. 24:339-345, 1970.
Boss, R . H . , and Carpenter, ll . O. , Jr.: Technique for duplicating a
denture, J . Prosthet. Dent . 31:329-334 , 1974. 1/
Boucher , C . O. : Clinical dental terminology : a glossary of accepted
terms in all disciplines of dentistry , St . Dm is, 1974 . The C. W
Mosby Co.
Brewer, A . A . , and Morrow, R. M .: Overdentures, ed . 2, St . Louis,
1980, The C. V. Mosby Co., pp. 209-213.
? Gieger, E.C. K.: Duplication of the esthetics of an existing immediate
denture, J . Prosthet. Dent. 5:179-185, 1955.
Manoli , S . G . , and Griffin , T. P.: Duplicate denture technique, J .
.
Shaw, D. R .: Duplicate immediate dentures J . Prosthet . Dent . 12:47-
57, 1962.
Singer, I. L.: The zipper technique for duplicating dentures; final
impressions, replica dentures, and a complete denture splint , J .
Prosthet. Dent . 33:582-590, 1975.
7 Wagner , A . G . : Making duplicate dentures for use as final impression <j

pour- type resin for the duplicate denture. Reversible trays, J . Prosthet. Dent. 24:111-113, 1970.
hvdrocolloid molds produce a far better surface on the Zoeller, G . N . , and Beetar , R . F.: Duplicating dentures, J . Prosthet.
denture and are preferable to alginate. Reversible by- Dent. 23:346-353, 1970.
¥
CHAPTER 12
RELINING AND REBASING
KENNETH D. RUDD, ROBERT M. MORROW, R. NEAL EDWARDS,
and AMBROCIO V. ESPINOZA
reline To resurface the tissue side (basal surface) of a denture with
new base material to provide a more accurate fit .
rebase A process of refitting a denture by replacing the denture
base material without changing the occlusal relations of the
teeth
Relining a complete denture to improve its fit is a
frequently used procedure in dental practice and has
been referred to as one of the most difficult procedures
in dentistry'. This is reflected in the relining procedures
advocated , which vary from relatively simple to com -
plex. The clinical phase of relining involves making an
impression in the denture to improve fit without incor -
porating errors in the occlusion . Thus the laboratory
phase begins with the denture readapted to the den -
ture-supporting tissues with a suitable impression ma-
terial and correctly related to the opposing teeth .
ARTICULATOR METHOD
PROCEDURE
1 . Box the denture with impression material before
pouring a cast in artificial stone ( Fig. 12- 1 ).
2. Pour artificial stone into the boxed denture
impression to form a cast ( Fig. 12-2 ).
3. After the stone has set . remove the cast with the
denture in place, and index the base. Paint the base
with a separating medium ( Fig. 12-3).
4 . Fill the palatal section of maxillary dentures and
the lingual region of mandibular dentures with clay .
Adapt clay to the facial surfaces of the teeth and den -
ture, exposing the occlusal third of the denture teeth
364
( Fig. 12-4 ). This blockout of clay will prevent the index
stone from engaging undercuts on the denture teeth.
5. Mix artificial stone , and place a patty of stone on
the lower member of the articulator ( Fig. 12-5).
6. Smooth the stone with a spatula , and seat the den -
ture into the stone ( Fig. 12-6 ). The clay will prevent
the denture from being placed too deep into the stone
( Fig. 12-7).
7. After the stone on the lower member has set, close
the articulator to estimate the volume of stone needed
to attach the cast ( Fig. 12-8).
8. Mix the artificial stone, and place it on the cast,
taking care to fill the index grooves ( Fig. 12-9).
9. Place additional stone on the upper member of the
articulator, and close the articulator ( Fig. 12-10). Tap
the articulator to determine that it is fully closed ( Fig.
12-11).
10. Allow the stone to set , and remove the modeling
clay from the denture ( Fig. 12-12 ).
11. Separate the denture from the cast , and remove
all traces of impression material from the denture ( Fig.
12-13).
f 2. With an acrylic bur in a handpiece, remove a thin
layer of resin from the interior of the denture to freshen
the surface ( Fig. 12- 14).
13. Reduce the borders 2 to 3 mm with a bur ( Fig.
12-15).
14 . Deepen frena notches wifcfo a handpiece-mounted
tapered fissure bur ( Fig. 12-16).
15. Blow off acrylic-resin grindings with a stream ol r
air ( Fig. 12- 17 ). Be sure the compressed air does not
 Relining and rebasing 365

contain an aerosol of oil , which could compromise the 22. After curing the relined denture, remove from
i bond between old denture resin and the autopolymer-
izing resin to be added.
the cast, and finish and polish it ( Fig. 12-24 ).

16. Place the posterior palatal seal in the maxillary
*
casts ( Fig. 12-18).
17. Paint the cast with tinfoil substitute ( Fig. 12-19).
18. Mix autopolymerizing resin in accordance with
the manufacturer’s recommendations, and add resin to
f
the interior of the denture with a spatula ( Fig. 12-20) .
19. Place additional resin on the cast, taking care to
fill the borders of the cast ( Fig. 12-21).
l 20. Seat the denture into the indentations, and close
the articulator , expressing the excess resin ( Fig. 12-22 ).
21. Cure the relined denture in a pressure container
to minimize porosity ( Kig. 12-23).
PROBLEM AREAS
The principal problem associated with this relining
method is related to failure to eliminate voids when
adding the autopolymerizing resin to the denture and
cast . The resultant voids in the relined denture must
be repaired. If the relined denture is not cured in a
pressure container, the resin may develop porosity (Ta-
ble 12-1). Carefully adding the resin with a spatula to
preclude air inclusions and curing the relined denture
in a pressure container will contribute to a relined den -
ture of acceptable quality
Text continued on p. 372.

i
Fig. 124 . A , Impression is made in complete denture that is to be relined. B , Beading wax placed
and sealed to impression, keeping wax 2 to 3 mm below denture border. C, Boxing wax is adapted
* around beaded impression and sealed to beading wax with hot spatula. D, Boxed denture impression
ready for pouring.

A
366 Dental laboratory procedures: complete dentures

Ffg /12 2. A, Artificial stone is mixed and poured into denture impression. B, Stone is added, taking
-
care to avoid air inclusions or voids. C, Poured denture impression placed aside to set.

Fig. 12 3. Separating medium is painted on base of cast, using

-
care to coat index grooves.
m.y .
N
*-
OUHCM

-
sv. '-.
CO
 Refining and rebasing 367

'l

Fig. 12-4. A , Modeling clay is adapted to denture, blocking out all denture surfaces, except occlusal
surfaces of teeth. B, Clay prevents stone extensions into undercuts on denture base and teeth, which
would make separation difficult .

Fig. 12- 5. Artificial stone is mixed and placed on lower member of

articulator. Simple but sturdy hinge- type articulator is adequate.
X

t
I

n
L

A B

-
J 2-6. A , Stone surface is smoothed with spatula. Bt Denture is settled in stone mix. Stone can
ce placed on occlusal surfaces of denture teeth with finger before seating in stone. Position denture
in stone so that occlusal surfaces are approximately parallel to bench top.

i
 —
368 Dental laboratory procedures: complete dentures

-.
Fig. 12 7 Modeling clay will prevent denture from settling too deep Fig. 12-8. Articulator is closed to estimate volume of stone required
in stone. to attach cast.

Fig. 12- 9. Stone is placed on cast base, using care to fill index Fig. 12- 10. Additional stone is placed on upper member of articu-
grooves. lator.
/

Fig. 12-11. Articulator is closed, and upper member tapped, making

certain that articulator is closed to its stop.

\
 Relining and rebasing 369

A B

Fig. 12-12. A , Mounting stone is allowed to set. B, Modeling clay has been removed from denture
surface. Note depth of index was controlled by clay.

Fig. 12-13 All impression material must be removed from denture. Fig. 12- 1 ... ^apiece or lathe-mounted acrylic bur is used to re-
Scraper or bur can be used to remove impression materials. move thin layer of resin from interior of denture.

r,
Fig. 12-15 Borders are reduced 2 to 3 mm with bur. Fig. 12-16. Frena notches are deepened with No. 557 cross-cut
fissure bur.
370 Dental laboratory procedures: complete dentures

Fig. 12- 17. Resin grindings are removed with stream of air. Air Fig. 12- 18. Posterior palatal seal is placed in cast, unless provided
must not be contaminated with compressor oil or water , or bonding for in impression.
may be compromised.

Fig. 12-19. Cast is coated with tinfoil substitute.

Fig. 12-20. Autopolymerizing resin is mixed according to manufac-

turer’s recommendations and placed in denture, taking care to
avoid air entrapment.
 Helining and rebasing 371

. 12-21. Resin is placed on cast and in border reflections.

ij .
Fig. 12- 22 Denture is seated in indentations, and articulator
Closed. Resin can be added to deficient areas if needed.

-
Fig. 12 23. Relined denture is cured in pressure container at 15 to
20 psi for 30 minutes. ( Method and time of curing will vary with
resin used. )

A B

.
Fig. 12- 24 A, Relined denture is removed and examined for voids and nodules of resin. B, Denture
i is finished, polished, and stored in water until needed.
372 Dental laboratory procedures: complete dentures
RELINING JIG METHOD 12. Cure the relined denture in a pressure container
PROCEDURE of warm water at 15 psi for 30 minutes.
13. Separate the jig, remove the relined denture, and
1. Box the denture and impression , and pour a cast
as described for the articulator method ( Fig. 12- 25 ). finish and polish it as described for the articulator
2. Use modeling clay to block out the denture, and method ( Fig. 12-37 ).
seat the denture in a stone patty on the lower member PROBLEM AREAS
of the reline jig* ( Fig. 12-26).
3. After the stone index has set , paint the indexed Problems associated with the relining jig method are
cast with a separating medium , and mount the cast to
similar to those for the articulator method (Table 12- 1 ) .
the upper member of the reline jig ( Fig. 12-27).
4 . After the stone has set , remove the modeling day ,
open the jig, and separate the denture from the index
( Fig. 12-28).
5. Carefully lift the denture oil the cast ( Fig. 12-29 ).
A stream of air can sometimes be used to remove the
denture ( Fig. 12-30).
6. Remove all impression material from the denture ,
and prepare the surface as described for the articulator
method ( Fig. 12-31).
7. Seat the denture in the stone index ( Fig. 12-32 ).
8. Paint the cast with tinfoil substitute ( Fig. 12-33).
9. Moisten the resin surface of the denture with an
autopolvmerizing monomer ( Fig. 12 34). -
10. Mix the autopolymerizing resin , and place it on
the cast and in the denture ( Fig. 12 35). -
11. Assemble the reline jig and secure it with lock -
nuts ( Fig. 12-36 ).

Reline jig. Howmedica. Inc. . Chicago, 111. ; Ilooi ^ r Duplicator, Te- Fig. 12-25. Denture and impression are boxed before pouring cast .
ledyne Dental Products Co., Ilanau Division , Buffalo, N Y.: or Caulking compound was used to bead impression in this case .
equivalent.

Table 12- 1. Relining procedures

Problem Probable cause Solution

Voids in resin of relined denture
Completed reline shows line
between denture base and
added resin
Relined denture is porous
Relined denture not retentive
Autopolymerizing resin not placed
throughout the interior of den-
ture or into border reflections of
cast
Denture resin not freshened or
thoroughly cleaned prior to
adding autopolymerizing resin
Aerosol of oil in compressed air;
coated denture resin
Autopolymerizing resin mix too
dry when placed in denture
Relined denture not cured in
pressure pot
Posterior palatal seal not placed
in cast
Initial impression not adequate
Place resin over entire tissue surface of denture
and cast ; take care to minimize voids, using ad-
equate volume of material
Grind surface of denture to receive new resin;
thoroughly remove all traces of impression ma-
terial; wet denture with a brush and monomer
prior to adding resin
Do not use air blasts to remove resin grindings if
air source contaminated with oil or water
Pack resin at proper stage before it begins to set
Cure relined denture in pressure pot for 30 min-
utes at 15 to 20 psi
Scrape posterior palatal seal in cast prior to add-
ing resin
Examine reline impression carefully for damage in
transit
 Relining and rehasing 373

.
-
V

-
Fig. 12 26. Blocked out denture is seated on stone on lower mem-
ber of relining jig.

»
*

Fig. 12-27. A, Stone is placed on cast base and relining jig assembled. Tap jig with spatula handle
to make certain that it is seated. B, Mounting stone is smoothed with spatula. C, Excess stone
-
extruding through top of jig is removed. Locknuts are screwed down to secure upper member while
stone sets.
. t.
 374 Dental laboratory procedures: complete dentures

A B

.
Fig. 12 28. A, Locknuts and modeling clay are removed B, Jig is opened exposing occlusal inden-
-
tations.

%
- .
Fig. 12 29 Denture is carefully lifted off cast by prying gently at .
Fig. 12-30 Blowing air under denture will often lift it from cast.
borders.

- .
Fig. 12 31 Denture basal surface is prepared. - .
Fig. 12 32 Clean prepared denture is seated in stone index, mak-
ing certain that it is completely seated. *1
 Relining and rebasing 375

Fig. 12-33. Cast is painted with tinfoil substitute. Fig. 12- 34. Resin surface is moistened with autopolymerizing
monomer.

0
*
Fig. 12- 35. A, Resin is mixed and placed on cast, using care to minimize voids. Bt Resin is placed
in denture .

Fig. 12- 36. Jig is assembled and locknuts tightened.

*
 376 Dental laboratory procedures: complete dentures

A B

Fig. 12-37. A, Relining jig is separated and relined denture examined for voids. B, Relined denture
is polished.

A B

C D
<

Fig. 12-38. A, Stone index is formed on lower member of duplicator. B , Denture to be rebased is
seated in index in Hooper Duplicator. C, Cast is attached to upper member with stone and locknuts
secured. D, Stone is allowed to set.
*

.

REBASING
Rehasing may be necessary when the existing den -
ture base is discolored or if the denture base resin is
too light or dark in color for the patient. Rebasing may
also be required in the laboratory if a newly processed
denture exhibits porosity. Denture rebasing in which
all of the denture base is replaced can be accomplished
using a reline jig, articulator, or denture flask.
Jig method
PROCEDURE
1. Mount the denture on its cast in a reline jig* or
articulator as described for the articulator method and
reliniqg jig method ( Fig. 12-38).
•Hooper Duplicator. Teledyne Dental Products Co. , Hanau Divi-
.
sion . Buffalo N . Y.
v» . -
Fig 12 39. Porcelain denture teeth can be removed from denture by heating carefully with alcohol
torch or with hot spatula.
Relining and rehasing 377
2. Open the jig, or articulator, and carefully remove
the denture from the cast .
3. If the teeth are porcelain, heat each tooth with a
hot spatula, and remove it from the denture ( Fig. 12-39).
4. Place each denture tooth in its corresponding in -
dentation ( Fig. 12-40).
5. If the denture teeth are resin , cut them from the
denture base in units with a bur, and seat them in their
indentations.
6. Adapt a layer of baseplate wax to the cast , assem -
ble the jig or close the articulator, and wax the denture
teeth to the wax ( Fig. 12-41).
7. Complete the wax-up on the jig, or articulator, re-
move the cast , and flask and process it ( Fig. 12-42).
8. Replace the cured denture on the jig, or articula-
tor ; check and correct the occlusion ; then finish and pol -
ish the denture ( Fig. 12-43).
378 Dental laboratory procedures: complete dentures

Fig. 12- 40. Each porcelain tooth is replaced in its indentation in

stone index.

A B
I

.
Fig. 12- 41. A, Layer of baseplate wax is adapted to cast B, Baseplate wax is removed if insufficient
space exists between ridge lap of tooth and cast ( arrow ). C, Add additional thicknesses, or pieces,
of baseplate wax where space is large (arrow ) to help prevent occlusal changes as result of wax
shrinkage
 Relining and rchasing 379

i **

-
Fig. 12- 42. A and B. Wax -up is completed on jig. C, Waxed denture is removed and flaskeci. Heat-
curing denture base resin will be used for rebasing procedure.

Fig. 12- 43. Rebased denture is replaced on jig.

ated with waxing, flask ing, packing, and curing a com -

PROBLEM AREAS
Principal problems associated with this procedure are
related to separating the denture from the cast without
breaking either the cast or denture; shrinkage of wax
when the denture teeth are waxed to the cast, produc-
r ing errors in occlusion ; and the usual problems associ -
plete denture (Table 12-2). Undercuts must be
removed from the interior of the denture before the
rebase impression is made. Failure to remove under-
cuts will make removal of the denture from the cast
difficult and can damage both the denture and cast . II
considerable space exists between the denture teeth

4
 380 Dental laboratory procedures : complete dentures

Table 12- 2. Jig or articulator rebasing method

Problem
Denture cannot be separated
from cast without breaking
cast or denture
Rebased denture occlusion
is in error
Probable cause
Undercuts in denture not re-
moved before making impres-
sion
Denture teeth not seated properly
in indentations
Wax shrinkage withdrew teeth
from indentations, resulting in
lack of occlusal contact
Occlusion not properly related by
rebase impression
Flask halves fit together poorly
Solution
.
Remove undercuts from denture with bur prior to mak-
ing rebase impression
Seat denture teeth firmly in indentations
Add chips of cooled wax to space between tooth ridge
laps and cast to minimize wax shrinkage
Make rebase impression at proper occlusal relation-
ship
Use flasks that fit together accurately without rocking

Fig. 12- 44. Denture is half - flasked using standard procedure.

and the baseplate wax on the cast add chips of cooled

, 6. Remove the porcelain or resin teeth from the den -
wax to minimize wax contraction . The use of melted
wax alone can produce significant occlusal changes as a
result of shrinkage. Careful attention during waxing and
processing procedures will contribute to a better resto-
ration .
Flask method
PROCEDURE
1 . Pour a cast in the denture as described earlier.
2. Half- flask the denture in an accurate denture flask
( Fig. 12-44 ).
3. Paint silicone mold material* over the denture its
described in Chapter 9 ( Fig. 12-45).
4 . Complete flashing the denture.
ture as described for the jig method .
7. Replace the teeth in the silicone mold ( Fig. 12 -
47 ).
8. Place a posterior palatal seal in the maxillary cast .
9. Paint the cast and investing stone with tinfoil sub-
stitute ( Fig. 12-48).
10. Pack denture resin in the mold , and cure, finish ,
and polish the denture ( Fig. 12-49).
11 . Correct processing errors after the remounting
procedure.
PROBLEM AREAS
Principal problems associated with this method are
incorporating air inclusions in the silicone material ,

5. Open the flask after the flashing stone has set . The
resilient silicone will allow the denture to be withdrawn
without damage ( Fig. 12-46 ).
.
*Vescotc, Dentsply International, Inc*. York . Pa.
producing resin nodules on the rebased denture; the
possibility of occlusal errors if the flasks do not fit to-
gether accurately; and the potential for dislodging a
' j
denture tooth from the flexible silicone mold when
packing the resin (Table 12-3).

i
 Relining and rebasing 381

Fig. 12-45. Silicone mold material is painted on denture and teeth. Fig. 12- 46. Flask is opened. Here denture remained in upper half
Making coat too thin would not provide sufficient flexibility to re- of flask.
move denture.
\

Fig. 12- 47. A, Porcelain denture teeth are removed and placed in silicone mold. B, Resin teeth are
cut from denture base and placed in mold.

> -
Fig. 12-48. Cast and investing stone are painted with tinfoil substi Fig. 12-49. Cured denture is ready for finishing and polishing.
tute.
382 Dental laboratory procedures: complete dentures

Table 12- 3. Flask rebasing method

Problem
Rebased denture has nodules of
resin that require additional
finishing time
Rebased denture occlusion is in-
correct
Probable cause
Air incorporated in silicone
mold material during mixing
Silicone material not painted
on denture with stiff brush
or spatula
Flasks do not fit properly
Resin not trial packed ade-
quately
Initial impression not related to
proper jaw position
Solution -
V
Mix material carefully; do not whip air into mix
Painting silicone over denture to preclude voids
Use accurately fitting flasks that do not rock
Trial pack resin until flash is eliminated
Make certain that impression is related to proper occlusal
position (clinical ); examine impression for damage that
may have occurred in transit to laboratory

SUMMARY Friedman, S.: Rebasing the complete maxillary denture, N Y. State

Methods for relining and rebasing complete dentures Dent . J . 40:19-22. 1974.
were discussed in this chapter. Each of the described Cillis. K . R.: A relining technique for mandibular dentures, J .
Prosthet, Dent. 10:405-410. 1960.
methods can produce a satisfactory result . The relining .
Hardy, I . R .: Rehasing the maxillary denture Dent. Digest 55:23-27.
procedures involved the use of autopolymerizing resin , 1949.
which is cured in a pressure container . The rebasing Hooper , B. B.: Rebasing or duplicating dentures: a method of restor-
procedure described used conventional heat -curing ing facial contour and correct faulty retention. Dent. Digest 38:206-
213, 1932.
resin to rebase the denture. Whereas the laboratory
phases of relining and rebasing methods are critical to
.
Jordan L. G.: Relining the complete maxillary denture, J . Prosthet .
Dent . 28:637 641 . 1972. -
success the completed restoration will not be success-
,
.
Ostrem . C T.: Relining complete dentures, J . Prosthet. Dent.
ful unless the prerequisite clinical procedures were 11:204-213 1961. .
completed properly. Payne, S. H .: Denture base materials and the refitting ol dentures. J .
\ m Dent. fcssoe. 49:5( > 2 566, 1954.
BIBLIOGRAPHY Sears. V. II . : Functional impressions lor rebasing lull dentures, J .
Body . L. II .: Relining immediate dentures utilizing cephalometries, Am . Dent. Assoc. 23:1031 1035 1936. - .
|. Prosthet . Dent . 11:864-872, 1961. Shaffer , F. W .: Relining complete dentures with a minimum of error.
Boucher. C .O.: The relining of complete dentures, J . Prosthet. Dent. .
J . Prosthet . Dent 25:366-370. 1971.
30:521-526, 1973. .
Smith, D. E., I >ord, J. L., and Bolender, C L.: Complete denture re-
Braver , F. M . , White , E. E. , Burns, C. L . , and Woelfel, J . B.: Denture lines with autopolymerizing acrylic resin processed in IDO under
—
59:270-283, 1959.
-
reliners direct , hard, self curing resin , J . Am. Dent. Assoc. air pressure, J . Prosthet. Dent . 18:103 115, 1967. -
Smith , R. V.: Rebasing technique for full dentures, Iowa Dent . Bull .
Buchman , J : Relining full upper and lower dentures, J . Prosthet. 39&40 1953
Dent . 2:703-710, 1952. .
Stout , C J.: Rebasing complete dentures using infrared heat , J
Christensen, F T.: The wing relining technique, J . Prosthet. Dent . Prosthet . Dent . 11:665-667, 1961.
22:268-270. 1969. .
Terrell, W . H . : Relines, rebases, or transfers and repairs J . Prosthet .
Christensen , F T.: Relining techniques for complete dentures, J . Dent . 1:244 253. 1951. -
Prosthet. Dent. 26:373-381, 1971. Tucker. K . M .: Relining complete dentures with the use of a func -
Christie. D. R.: Relining acrylic dentures without distortion. J . Can. .
tional impression J . Prosthet. Dent . 16:1054 1057, 1966. -
Dent . Assoc. 17:374-377, 1951 . Wolfe, H E , : Denture relining or rebasing with a fluid resin , J
Fcldmann. E . E . , Morrow, R . M . , and Jamison, W.S.: Relining com - .
Prosthet Dent. 31:460 465 1974 . - .
plete dentures with an oral cure silicone elastomer and a duplicate
.
denture J . Prosthet . Dent. 23:387-393, 1970.
 '
I f
CHAPTER 13
REPAIRS
KENNETH D. RUDD , ROBERT M. MORROW , and ALEXANDER R . HALPERIN
Unfortunately, complete dentures occasionally break
when in function or when dropped onto a hard surface.
Often the fractured denture can be repaired; several
repair methods will be described in this chapter.
REPAIRING DENTURE WITH FRACTURED TEETH
Fracturing or chipping a denture tooth is not an un -
common problem . Although porcelain teeth are more
prone to breakage , particularly when dropped onto a
hard surface, either porcelain or plastic denture teeth
may he fractured . The method used to replace these
teeth depends on the tooth material .
Plastic anterior tooth replacement
Replacement of plastic teeth requires the fractured
tooth to first be removed by grinding. Occasionally, a
lack of bonding between the denture base resin and
tooth allows a plastic tooth to be dislodged from the
denture. This can occur if wax elimination is not thor -
ough or if tinfoil substitute inadvertently placed on the
ridge laps of the teeth is not removed prior to packing.
PROCEDURE
1 . Remove the fractured tooth by grinding it with a
No. 8 round bur ( Fig. 13- 1).
2. Do not grind the labial gingival margin ( Fig. 13- 2).
3. Remove denture base resin from the denture lin -
gual surface adjacent to the tooth to be replaced. Do
not perforate the base ( Fig. 13-3).
4. Select a plastic tooth of the appropriate size and
shade, and custom grind its ridge lap to facilitate cor-
* rect positioning on the denture ( Fig. 13-4 ) .
5. Check the replacement - tooth position from front
and above views. Sticky wax may be used to secure it
in position ( Fig. 13-5) .
6. When .the tooth position is acceptable, pour a plas-
ter index onto the labial surface of the tooth to be re-
placed and on the labial surfaces of adjoining teeth on
each side ( Fig. 13-6).
7. After the plaster sets, separate the index and tooth
from the denture, and remove all traces of sticky wax
( Fig. 13-7 ).
8. With a No. 6 bur, place shallow indentations in
the denture- tooth ridge lap to provide an additional
bonding area ( Fig. 13-8).
9. Replace the index and tooth on the denture, and
carefully paint in autopolymerizing resin from the lin -
gual or palatal side ( Fig. 13-9).
10. Continue to add resin , taking care to minimize
voids, build it up to the desired contour ( Fig. 13-10).
11 . Place repaired denture in a pressure pot of warm
water, and cure it at 20 psi for 30 minutes ( Fig. 13-11 ).
12. Remove the denture, and polish the autopoly-
merizing resin with flour of pumice and either a rag
wheel ( Fig. 13-12) or rubber prophy cup on a standard
handpiece that reduces the likelihood of overreducing
the denture surfaces ( Fig. 13-13).
PROBLEM AREAS
Principal problems that occur with replacing anterior
denture teeth are related to failure to duplicate the po-
sition of the original denture tooth; failure to control
the flow of autopolymerizing resin when painting it on
the denture and permitting the autopolymerizing resin
surface to dry, thus producing porosity in the cured
resin (Table 13- 1 )•
Text continued on p . 389.
383
rr-
384 Dental laboratory procedures: complete dentures

A B

.
Fig. 13-1 A, Fractured plastic tooth to be replaced is removed by, B, grinding. Care must be taken
to not perforate denture base.

: -2. Labial margin (arrow ) is left intact to preserve esthetics.

!

.
F j*. 13-3 Resin is removed from lingual aspect to provide for ad-
-

dition of repair resin.

 Repairs 385

A B

'1

- f

I Fig. 13-4. A, Resin tooth of same shade and mold as tooth on denture is selected. B, Ridge lap of
tooth is ground so that it can be placed on denture in same position as original. Small indentation
can be placed in ridge lap at this time to improve attachment strength. C, Modified tooth is positioned.

t
-.
Fig. 13 5 After tooth position has been verified, it is sticky waxed
into position.

i
C'
V \ N
*

if Qf •
Cfl { 8 i,
LIBRARY. )
\
A
i•
f '"
386 Dental laboratory procedures : complete dentures

A B

.
Fig. 13- 6. A, Tooth position is checked again and B, if acceptable, plaster index is poured.

Fig. 13-7. Index is separated, and sticky wax removed.

Fig. 13-8. If not done earlier, shallow indentations should

now be placed in ridge laps of tooth to ensure stronger re-
pair.
 Repairs 387

Fig. 13 9. A, Prepared region is moistened with monomer, and autopolymerizing resin is painted
-
\ carefully to lingual prepared area, allowing resin to flow between ridge lap and denture base. B, Care
must be taken to not entrap air, thus producing voids. C, Palatal surface is built up to desired contour.

Fig. 13-10. Resin is added to build up slight excess, which will be

finished to original contour after polymerizing.
f

7T
 9

- .
Fig. 13 11 Denture cured in pressure pot.

- .
Fig. 13 12 A, Excess bulk is reduced with hand*
piece-mounted No. 8 bur. B, Resin is smoothed with
mounted rubber point . C, Repair is polished with
slurry of flour of pumice and handpiece-mounted
prophy cup. Df High polish is achieved with prophy
cup and prepared chalk. E, Repaired denture is pol-
.
ished using care to not overpolish, thus obliterating
contours of plastic replacement tooth.
 Repairs 389

Fig. 13- 13. Rubber prophy cup mounted in laboratory handpiece

will reduce likelihood of overpolishing.

3
* Table 13- 1. Replacing anterior denture teeth

i Problem

Replacement tooth too long, too

short , or incorrectly positioned
Probable cause

Tooth not modified to permit

correct placement
Solution

Grind replacement tooth ridge lap to facilitate proper

placement
buccolingually Check position carefully prior to pouring index
Replacement tooth wrong shade Shade selection in error Check shade under variety of lighting conditions to assure
proper shade
Repair resin on polished den- Too much resin added during Paint resin on in increments to avoid overfilling
ture surface paint-on procedure
Too much monomer resulted Use only enough monomer to assure proper wetting
in fluid resin mix
Porous repair resin Repair-resin surface mono- Keep surface of repair resin moistenpd with monomer; do
mer evaporated not permit monomer to flow onto polished surface of
denture
\ Place repaired denture in pressure container for curing
i Use good-quality repair resin

Porcelain anterior tooth replacement
The procedure for replacing porcelain denture teeth
differs from that for plastic teeth in the manner of re-
moving the fractured tooth from the denture base.
PROCEDURE
1. Heat the end of a roach carver or wax spatula in a
flame, and press it against the fractured porcelain tooth
(Fig. 13-14 ). Several applications may be necessary to
1 heat the tooth sufficiently .
2. Gently pry the porcelain tooth from the denture
base ( Fig. 13-15). The tooth should separate cleanly
from the base.
3. Examine the ridge lap of the tooth for mold iden -
tification marks ( Fig. 13-16). See Chapter 7 on artificial
teeth .
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 ( Fig. 13- 17).
6. Try the tooth in position , and adjust it if required
( Fig. 13- 18). A fine-cut wheel * is good for reducing por-
celain .
7. Wax the tooth in position with two droplets of
sticky wax on the incisal edge, and check its position
carefully ( Fig. 13-19).
8. Pour a plaster index as described previously for
plastic teeth (steps 6 to 8).
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 ( Fig. 13-20) .
-
* Fine cut wheel No. 328, VH X VH inch ( 2.2 x 0.32 cm ), Dental De-
.
velopment and Manufacturing Co , Brooklyn , N.Y.

1
 390 Dental laboratory procedures : complete dentures
\s

Fig. 13- 14. A , Fractured tooth. B, Heated instrument is held against fractured tooth to soften adjacent
denture base resin. Do not overheat, and check softening repeatedly by prying on tooth.

Fig. 13-15. Porcelain tooth is pried from denture base resin.

-
Sr

Fig. 13-16. Depending on type of tooth used, it may be possible to

see mold number impressed in denture resin socket (arrow ) if ridge
lap of original tooth was not ground.
 A He pairs 391

. - .
Fig 13 17 Resin is removed from lingual surface (arrows ) to ac- Fig. 13-18. Ridge lap of replacement tooth is shaped to permit re-
commodate retention pins on replacement tooth. placement in same position as original.

.
Fig. 13-19 Tooth sticky waxed into position, and position verified.

Fig. 13 20. Prepared resin is moistened with monomer. Plaster in-

-
dex is replaced, if used, and autopolymerizing resin is painted. No
voids should remain around retention pins.

A

392 Dental laboratory procedures: complete dentures
Fig. 13-21. Repaired denture is polished with flour of pumice and
handpiece-mounted rubber prophy cup.
Fig. 13- 22. Denture mounted in simple articulator.
Fig. 13- 23. Fractured plastic tooth is ground away with No. 8 round bur , preserving facial margin,
and using care to not perforate base.
—
10. Cure the repaired denture in a pressure con -
tainer at 20 psi for 30 minutes.
11. Polish the repaired denture with Hour of pumice
and a rag wheel or a rubber prophy cup ( Fig. 13-21).
PROBLEM AREAS
Principal problems are similar to those for plastic
teeth (See Table 13-1).
Plastic posterior tooth replacement
The method for replacing fractured plastic and por-
celain 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 correc-
tion . 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 occlu-
sal contour. A possible exception would occur if the
plastic posterior tooth was fractured during deflasking
or while the denture was being constructed. In this sit -
uation the new tooth would be added , and the occlu -
sion adjusted in the articulator when the processing er-
ror was corrected .
PROCEDURE
1. Mount the denture in an articulator to facilitate
correcting the occlusion ( Fig. 13-22 ).
2. Remove the fractured resin posterior tooth by
.
grinding it with a No. 8 round bur ( Fig. 13-23), 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 .
4. Grind the ridge lap of the replacement tooth to
allow correct placement on the denture ( Fig. 13-24 ).
The tooth can be occluded and sealed to the opposing
denture tooth during this procedure ( Fig. 13-25).
 Repairs 393

Fig. 13 24. A, Ridge-lap area of denture is hollow ground to permit placement of replacement tooth.
-
B, Ridge lap of replacement tooth is modifed as needed.

A B

.
Fig. 13-25. A, Articulator is closed, and occlusion checked B and C, If correct, replacement tooth is
sealed to opposing tooth or index with sticky wax.
r

Fig. 13-26. A, Denture indentation and ridge lap of tooth

are moistened with monomer. B and C, While tooth is
secured with sticky wax, autopolymerizing resin is first
painted into indentation on denture base and then be-
tween tooth and denture base, using care to avoid air
entrapment.

A B

C D

Fig. 13-27. A, Occlusion is checked and repair polished. B, Bur and, C,pumice-impregnated rubber
rpnair
 ..

5. Paint autopolymerizing resin into the ridge lap
area to seal the tooth to the denture base ( Fig. 13-26 ).
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 ( Fig.
13-27).
Porcelain posterior tooth replacement
PROCEDURE
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 ( Fig. 13-28).
Grind away the denture base resin extending into the
retentive recess of the denture tooth .
3. Check the indentation in the denture base to de-
termine if the mold number is discernible ( Fig. 13-29 ).
An impression of the indentation can be made in inlay
wax: then the impressed mold number can be read in
the wax ( Fig. 13-30).
Repairs 395
^
4. Select a replacement tooth, and grind the ridge lap
il necessary to achieve the correct position ( Fig.
13-31).
5. Occlude the replacement tooth, and seal it with
sticky wax to the opposing tooth or index ( Fig. 13 32). -
6. With the tooth secured in this position , paint au -
topolymerizing resin into its retention recess and into
the denture base indentation ( Fig. 13-33). Close the ar-
ticulator.
7. Place the denture in a pressure container of warm
water at 20 psi for 30 minutes.
8. Kemove the denture, polish it , and adjust the oc-
clusion ( Fig. 13-34).
If the occlusal surface of a fractured tooth is not af -
fected . 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 occlu -
sion adjustment, use the index instead of the opposing
occlusion.

A B

) *

C D

j
Fig. 13- 28. A, Fractured porcelain tooth. B, Spatula is heated in flame. C, Hot spatula is held against
fractured porcelain tooth. D, Broken tooth can often be removed after heating carefully with alcohol
torch.

r
 396 Dental laboratory procedures: complete dentures

<5
l

Fig. 13- 29. A, Indentation in denture base (arrow ) is checked to determine if mold number is read-
able. B, Dots (arrow ) indicate that tooth is second bicuspid. Dots are on mesial ridge lap. (Teeth
.
made by Dentsply York Division) .

Fig. 13- 30. A, Blue inlay wax impression of indentation is often more easily read. B and C, Wax
impression may be readable, thus identifying original mold. All wax must be completely removed
before adding resin. D, Baseplate wax can be used in same manner. Mold number is visible in wax
(arrow ).
 Repairs 397

r*
I

- .
Fig. 13 31 Ridge lap is ground, if necessary, to place tooth cor-
rectly. Be sure to check occlusion.

A B

» r Fig. 13 32. A, Replacement tooth is sealed to opposing tooth with sticky wax ( arrow ). Resin is
-
painted into retention recess of tooth and indentation in denture base before closing articulator. In
this instance, lower first molar is being replaced. B, Stone index can also be used to check occlusion
if occlusal surface of fractured tooth was intact. Index would be made before removal of fractured
tooth.

.
Fig. 13 33 Additional resin is painted into deficient areas as
- Fig. 13 34. Repair is polished, and occlusion adjusted to opposing
-
needed. teeth or index.

4
WJ
398 Dental laboratory procedures: complete dentures
PROBLEM AREAS
The principal problems with posterior tooth replace-
ment are similar to those for anterior teeth (Tables 13-
1 and 13-2 ). An additional problem exists, however,
—
2. If the fractured denture is self-approximating, pour
plaster into the denture to form a repair cast ( Fig. 13-
36). Depending on the size of the fracture, pouring the
denture completely may not be necessary; instead , %

with the occlusion. The posterior replacement tooth pour a cast incorporating the fracture and extending ap-
must harmonize with the existing occlusion to avoid de- proximately 10 mm to either side of the fracture line *

flective contacts. Careful placement of the tooth and ( Fig. 13-37).

correction of the occlusion after the repair resin has set
will reduce occlusion problems.
REPAIRING FRACTURED DENTURE
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 .
4>
PROCEDURE
1 . Carefully examine the denture to determine the
extent of the fracture ( Fig. 13-35). Gently flexing the
denture, but taking care to prevent breakage, will aid
this determination .
3. If the denture is undercut in the region of the re-
pair , place a mix of silicone mold release into the un -
dercut area to facilitate removing and replacing the
denture after the cast has set ( Fig. 13-38 ).
4 . Remove the denture from the set cast , and use a
No. 558 bur to grind out the fracture line from begin -
ning to end ( Fig. 13-39). Bevel the cut outward to in -
crease the bonding surface ( Fig. 13- 40 ). In the palate of
maxillary dentures, place dovetails to strengthen t!i
repair joint ( Fig. 13-41 ).
^
5. Paint the stone cast with tinfoil substitute, and al -
low it to dry ( Fig. 13-42 ). 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 .

Table 13-2. Replacing posterior denture teeth

Problem Probable cause Solution

Posterior replacement is too
high or too short , produc-
ing error in occlusion
Replacement tooth wrong
shade
Repair resin on polished
denture surface
Porous repair resin
Dentures not mounted prior to frac-
tured- tooth replacement
Replacement- tooth ridge lap not modi-
fied properly
Occlusion not adjusted after repair
Shade selection made in wrong light ,
Too much resin used during paint-on
procedure
Repair not cured in pressure container
Mount denture in articulator prior to repair or con-
struct occlusal index
Prepare ridge lap to assure correct positioning
With articulating paper , adjust denture occlusion after
repairing
Check shade under variety of lighting conditions
Use only enough resin to fill in between tooth and
denture base resin
Cure denture in pressure container

Fig. 13- 35. Denture is examined to determine extent of fracture

line. Gently flexing denture will aid this determination, but use care
to prevent breakage. Fracture originating at labial notch and pro-
gressing alongside tooth is common ( arrows ) .

v't:
 Repairs 399

If fractured denture self - approximates, undercuts are Fig. 13- 37. Full cast is not necessary if fracture is small.
blocked out with clay, and repair cast poured. Stone cast poured in
.
denture

A B

Fig. 13-38. A , Silicone mold material can be placed in undercut, resulting in flexible cast permitting
removal of denture, yet maintaining tissue contours essential for repair. B, Repair cast of silicone
mold release that can be withdrawn from undercuts.

-*
•

558 bur.
- .
Fig. 13 39 Fracture line is widened from beginning to end with No. Fig. 13- 40: Widened cut is beveled outward ( arrow ) to increase
bonding area.
400 Dental laboratory procedures: complete dentures

Fig. 13-41. Widened trough can be dovetailed ( arrow ) on palatal

surface to further strengthen repair. Beveled margin is moistened
with monomer before repair resin is added.

Fig. 13-42. Stone cast is painted with tinfoil substitute and allowed
to dry. If denture is placed on cast before tinfoil substitute is thor-
.
oughly dry resin may be coated, reducing repair strength.

Fig. 13-43. Denture is replaced on cast. Moisten prepared surfaces

with monomer before adding resin.
 Revairs 401
V
6. Replace the denture carefully on the cast ( Fig. 13-
43).
7. Paint autopolymerizing resin into the groove, tak -
/» ing care to avoid air entrapment ( Fig. 13-44 ).
8. Build up the repair resin slightly above the surface
of the denture ( Fig. 13-45).
9. Secure the denture to the cast with a rubber band ,
and cure it for 30 minutes in a pressure container ( Fig.
13-46).
10. Remove the cured denture from the cast , then
finish and polish it ( Fig. 13-47).
Denture fractured into two or more
parts (components)
A denture fractured into two or more parts (compo-
nents) often occurs when the denture is dropped on a
hard surface. This type of breakage requires care to as- - .
Fig. 13 44 Repair resin is painted in groove, using care to not cre-
sure that the components are accurately oriented before ate voids.
a cast is poured ( Fig. 13-48).

. - .
Fig 13 45 Excess is built up (arrows ) for finishing. .
Fig. 13-46 Denture is cured in pressure container for 30 minutes.

t
Fig. 13 47. Cured repair is removed, finished, and polished.
-
402 Dental laboratory procedures: complete dentures
PROCEDURE
1. Examine the denture to determine that all pieces
are present ( Fig. 13-49 ).
2. Assemble the individual pieces carefully and lute
them together with sticky wax ( Fig. 13-50). 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 ( Figs. 13-51 and 13-52).
3. Pour a stone cast into the reassembled denture
( Fig. 13-53). Undercut relief may not be required , de-
pending on the degree of fragmentation . When needed ,
a silicone mold release or alginate irreversible hvdro-
colloid can be placed in denture undercuts to facilitate
removal and replacement ( Fig . 13-54 ).
Fig. 13- 48. Fragmented dentures require cast after assembly.
Fig. 13- 50. Sticky wax can be used to lute sections together.
4. After the cast has set , remove the denture, and
groove and dovetail the various pieces as previously de-
scribed: use wire reinforcement to strengthen the re-
pair if desired ( Fig. 13-55). Moisten the margin with M
monomer before painting the repair resin .
5. Paint tinfoil substitute on the cast, and allow it to
dry. It is not necessary' to paint the alginate with tinfoil
substitute.
6. Replace the denture on the cast, and carefully
paint autopolymerizing resin into each groove and dove-
tail ( Fig. 13-56). Use autopolymerizing resin that is
compatible in color and fiber content to the original
denture. Build up the repair resin as previously de-
scribed .
.
Fig. 13-49 Denture is assembled, noting whether all fragments are
1
present.
Fig. 13-51. Modeling clay used as scaffold can aid reassembly
when assistance is not available.
 Repairs 403

Fig. 13- 52. Assembled denture is reinforced with sticky wax and orange wood sticks before removing
from clay.

Fig. 13- 53. Cast is poured in assembled denture. Undercut relief

may not be required depending on degree of fragmentation. Mold
release material or alginate can be used if needed.
 /
404 Dental laboratory procedures: complete dentures
/
</
/
V

Fig. 13- 54. A, Alginate irreversible hydrocolloid can be used because of pronounced undercut in this
mandibular denture. B, Denture is blocked out with clay similar to method used for constructing
mounting casts. Undercut midline fracture region is not blocked out. C, Alginate is mixed and painted
into denture. D, Paper clip is bent to form figure eight retentive wire. E, Wire is placed in alginate and
held in position until set. F, Stone cast is poured. G, Flexible alginate permits denture removal, yet
preserves contour of undercut hdge. H, Cast is removed after denture. Note alginate ridge duplicates
tissue surface.
FI
Repairs 405

A B

C D

E F

- .
i »g 13-55. A, Margin of each fragment is beveled with bur. B, Handpiece-mounted inverted cone
acrylic bur can be used to place bevel. C, Mandibular denture labial bevel (arrows ). D, Mandibular
.
denture lingual bevel (arrows ) E, Beveled maxillary denture on repair cast. F, Wire or screen mesh
reinforcement can be incorporated in repair to gain additional strength.

j
fir

406 Dental laboratory procedures: complete dentures

.
Fig. 13-56 Margins are moistened with monomer before painting repair resin. Autopolymenzmg resin
is painted in each groove and dovetail, building up excess.

7. Secure the denture to the cast with plaster or rub-
ber bands, and cure it in a pressure container of warm
water for 30 minutes at 20 psi ( Fig. 13-57).
8. Remove the repaired denture from the cast, and
finish and polish it ( Fig. 13-58).
Fractured denture with section( s) missing
A fractured denture with a section missing will usu -
ally 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 sev-
eral 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 por -
tion . The repair is very similar to constructing a resin
baseplate.
PROBLEM AREAS
When repairing complete dentures , the principal
problems are associated with correctly aligning the den -
ture sections and achieving a strong break-resistant re-
pair (Table 13-3). Alignment problems can be mini -
mized if proper relationship of the various parts is
assured as the broken denture is assembled. A high -
quality denture repair resin and pressure-container cur-
ing will improve the physical properties of the repair!
 w^m

Repairs 407

Fig. 13-57. A . Mix of quick - setting plaster can be used to hold denture and cast together. B, Repair
is cured in pressure container for 30 minutes.

Fig. 13 58. Repaired dentures are polished.

-
r.
408 Dental laboratory procedures: complete dentures

Table 13-3. Repairing complete denture

Problem Probable cause Solution

Repaired denture does Denture sections not aligned properly
not fit properly
Sticky- wax seal broken or distorted when
pouring cast
Denture repair not allowed adequate setting
time
Denture did not fit well before breakage
Porous denture repair Denture not cured in pressure container
Denture repair-resin surface not kept moist-
ened when painting on additional resin
Denture repair not rigid Monomer contaminated
Wrong monomer (heat -curing) used
Wire reinforcement not used
Denture repair fails Prepared edges of denture contaminated
with tinfoil substitute
Wire reinforcement not used
Denture fits poorly; occlusion errors present
Align parts accurately ; lute together accurately
Use adequate, good- quality sticky wax on dry
surface
Allow repaired denture to set at least 30 min-
utes in pressure container before polishing
Do not repair ill-fitting denture
Cure denture in warm water in pressure pot
Keep surface of repair resin moistened with
monomer throughout adding resin proce-
dure
Use noncontaminated monomer; pour mono-
mer from main container into small dappen
dish; paint from that
Do not substitute heat -curing monomer for au-
topolymerizing monomer
Use wire reinforcement to add rigidity to repair
Avoid getting tinfoil substitute on denture
edges adjacent to repair
Embed reinforcing wire in denture for addi-
tional strength
Refit denture by relining or remounting to ad-
just occlusion

Fig. 13- 59. A, Denture with wax posterior palatal

seal. B, Anterior portion of denture is sealed off
with clay. C, Cast is constructed to extend 4 to 6
C mm beyond posterior border of denture. Denture
can be blocked out, since complete cast is not re-
quired.

*

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 .
PROCEDURE
1. Pour an artificial stone cast into the denture. The
cast must include all of the posterior palatal seal addi -
tion and extend 4 to 6 mm beyond it posteriorly ( Fig.
13-59).
2. After the cast has set , remove the denture ( Fig.
-
13 60). 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 ( Fig. 13-61 ).
4 . Check the fit of the denture to the cast .
5. Paint the cast with tinfoil substitute ( Fig. 13-62).
6. With autopolymerizing monomer , moisten the
A B
Fig. 13-61. A, All traces of impression compound or wax are removed from denture and cast . B,
Anterior finish line ( arrow ) is made with No. 2 round bur .
i
V
Repairs 409
denture surface that is to receive the resin ( Fig. 13-63).
7. Add autopolymerizing resin to the cast , and paint
additional resin on the denture surface ( Fig. 13-64 ).
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 ( Fig. 13-65).
10. Remove the cast after curing, and finish and pol -
ish it ( Fig. 13-66).
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 (Table 13-4 ). 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 re -
moval. Too little resin will result in undesirable voids
in the posterior palatal seal , which will have to be filled
with resin .
Fig. 13-60. Denture removed from cast .
410 Dental laboratory procedures: complete dentures

A B

Fig. 13-62. A, Fit of denture is checked on cast . B, Cast is painted with tinfoil substitute and allowed
to dry.

Fig. 13-63. Surface of denture to receive resin is moistened with Fig. 13-64. Autopolymerizing resin is mixed and placed on cast,
monomer. and additional resin is placed on denture.

Fig. 13-65. Denture is placed on cast, and firm finger pressure is

used to squeeze out excess resin posteriorly. Rubber bands are
used to hold denture against cast during curing.

4
 Repairs 411

- .
Fig. 13 66 A, After curing, denture is removed from cast . Minimal resin flash extending anteriorly
must be removed (arrow ). B, Surface of added resin is smooth, glossy, and devoid of porosity . C,
.
Over-extensions are removed with lathe-mounted bur D, Resin nodules or rough edges are
smoothed with handpiece-mounted bur. E, Posterior border is lightly pumiced to produce smooth
.
surface
412 Dental laboratory procedures: complete dentures

Table 13- 4. Adding posterior palatal seal

Problem Probable cause Solution

Resin flash extends forward onto
denture
Posterior palatal seal has voids
Too much resin used
Denture not seated firmly against
cast to express excess resin
posteriorly
Inadequate resin used
Denture not held firmly against
cast
Control amount of resin added
Seat denture firmly with finger pressure to express
excess resin posteriorly
Use enough resin to assure complete fill
Maintain pressure once denture is seated and resin
expressed

SUMMARY
Several methods for repairing dentures with auto-
polymerizing resin have been described in this chapter ,
as well as a method for adding a posterior palatal seal
to an existing denture . Successful denture repairs , pro-
viding adequate strength and minimal distortion , result
only from painstaking attention to detail .
BIBLIOGRAPHY
Air Force Mammal 160-29: Dental Laboratory Technicians' Manual,
Washington , D C. , 1959, U . S. Government Printing Office.
Boone, M . E.: Denture repairs involving midline fracture, J .
Prosthet. Dent. 13:676-678, 1963.
Hickey, C., and Zarb. G . A .: Boucher's prosthodontic treatment for
.
edentulous patients, ed . 9. St . Louis 1981, The C. V. Mosbv Co.
Martinelli , N . , and Spinella, S.C.: Dental laboratory technolog) , ed .
'

3, St . I /mis, 1981 , The C. V. Mosby Co.

Molner , E. J . , and Rice, W. S.: Bonding ( repairing) acrylates with self -
—
polymerizing acrylates advantages and disadvantages ( abstract ),
Int. Assoc. Dent . Res. 34:87, 1956.
Sharry, J . J . : Complete denture prosthodontics, ed . 3, New York ,
1974 , McGraw- Hill Book Co.
Sowter, J . B.: Dental laboratory technology, prosthodontic tech -
niques, Chapel Hill . N . C., 1968, The University of North Carolina
Press.

«
 5

CHAPTER 14

IMMEDIATE DENTURES
KENNETH D. RUDD and ROBERT M. MORROW

CONSTRUCTING IMMEDIATE DENTURES

immediate denture A removable dental prosthesis constructed for
placement immediately after removal of the remaining natural
teeth •
Many patients receive an immediate denture for
their initial complete denture prosthesis. Immediate
dentures offer several advantages. Since the patient re-
ceives the denture immediately after the last hopeless
teeth are removed, the patient is spared the needless
^ embarrassment of having to appear without teeth . The
immediate denture can protect the surgical site , and its
appearance is usually excellent , because the natural
teeth serve as guides for positioning of the denture
teeth .
Laboratory procedures for constructing immediate
dentures are similar to conventional complete dentures,
except for the method of setting teeth . Preliminary im -
mediate procedures, such as inipression - trav and base-
plate construction , were described in Chapters 3 and 5.
PROCEDURE
If casts are not received mounted in the articulator,
they should be mounted in the laboratory using the
centric jaw relation record furnished by the dentist
( Fig. 14-1). The procedure for constructing a maxillary
immediate denture is as follows:
1. The dentist may wish to try in the posterior teeth 1
1
to verify tooth shade, position , and accuracy of the jaw

A B

; Fig. 14- 1. A , Casts may be received mounted in articulator. B, Usually only anterior teeth remain on
casts. This immediate maxillary denture will oppose interim removable partial denture in lower arch.

413
w*
414 Dental laboratory procedures: complete dentures

Fig. 14- 3. Pencil line placed on labial surfaces of lower anterior teeth indicates vertical overlap in
natural dentition and;is guide for setting denture teeth /
 Immediate dentures 415

-.
Fig. 14 4 A and B,' Line indicates gingival margin of tooth to be removed.' Tooth is removed from the
. .
cast using a C,' saw, D, bur, or E knife.

i
416 Dental laboratory procedures: complete dentures

relation record . If this is desired /set the posterior teeth
on the baseplate, and wax them for try- in ( Fig. 14-2 ) . 4
2. Draw a line on the lower anterior teeth at the level
of the upper anterior teeth incisal edges ( Fig. 14-3).
3. With a sharp pencil indicate the gingival margin of
the upper anterior teeth before removing one tooth
from the cast with a knife or saw ( Fig. 14-4 ).
4. Carve a small depression on the ridge portion of
the cast to make a shallow socket ( Fig. 14-5).
5. Select a denture tooth of the proper size, shape ,
and shade , and wax it in the position formerly occupied
by the cast tooth ( Fig. 14-6). It may be necessary to
grind the denture tooth, or change its position , if the
natural tooth was malpositioned ( Fig. 14-7 ).
6. Remove alternating teeth on the cast, and set the
corresponding denture teeth ( Fig. 14-8). In this manner
the cast teeth serve as guides for the shape and position
of the denture teeth ( Fig. 14-9).
7. Complete the wax - up as previously described ( Fig.
14- 10).
8. Flask the immediate denture.
9. Eliminate the wax, and allow the llask to cool ( Fig. 4
14-11).
10. Trim the cast according to the instructions of the
dentist , or have the dentist trim the cast ( Fig. 14- 12).
11 . Wet the cast in slurry water to prevent sticking,
and make an impression of the cast in the flask ( Fig. 14-
13).
12. Separate the impression , and pour stone in the
impression to form a cast ( Fig. 14-14). This cast will be
used to make a transparent resin surgical template ( Fig.
14-15).
13. Paint the stone in the flask with tinfoil substitute
( Fig. 14-16, A ). Indentations placed in ridge laps of
resin denture teeth can improve the attachment of
teeth to the denture base ( Fig. 14 - 16, /1).
Text continued on />. / 22

.
Fig. 14-5 A, Shallow socket is scraped in cast inside pencil mark, indicating gingival margin. B,
Scraper can be used to taper depression from zero depth lingually to approximately 2 mm in depth
.
facially. C, Handpiece-mounted No 6 bur works well when creating facial depth.
 Fig. 14-6. Denture tooth positioned on cast and sealed with base- Fig. 14- 7. It may be necessary to modify denture tooth by grinding
plate wax .

" Fig. 14-8. Teeth set in alternating sequence to assure proper posi- Fig. 14-9. Cast tooth adjacent to denture tooth is guide for proper
tion. positioning. v
*

Fig. 14- 10. Denture waxed in usual manner. Posterior palatal seal
may be placed in cast before waxing palate, but must be placed Fig. 14- 11. Denture is flasked in artificial stoi x boiled out, and
before processing denture . flask cooled.
418 Dental laboratory procedures: complete dentures

Fig. 14-12. A, Cast trimming must be specifically prescribed by dentist, or better yet, completed by
dentist . B and C, Trim only as specified because overtrimming results in ill-fitting denture.
 Immediate dentures 419

A B

C D

Fig. 14- 13. A, Cast is wet with clear slurry water to prevent alginate from sticking. B. Alginate placed
on cast with finger to minimize voids. C, Filled tray is placed in position, and impression made of
flasked cast . D, Alginate is allowed to set.

«v
*
420 Dental laboratory procedures: complete dentures

V
*

Fig. 14 14. A, Impression is separated by directing stream of air between impression and cast. B,
-
Impression is examined to determine if it is acceptable. C, Stone is poured in impression to make
cast. Cast will be used to construct transparent surgical template.

«
Fig. 14-15. A, Transparent surgical template made quickly by vacuum-forming sheet of clear resin
over cast. Cast poured in alginate impression is one used for template. B, Heated resin sheet has
been formed over cast. Careful finger molding at this stage can improve adaptation. C, After cooling,
lathe-mounted laboratory bur is used to trim around borders of cast. D, Template is removed and
examined. E, Borders are trimmed and smoothed with lathe-mounted laboratory bur. F, Template is
stored on cast.
 422 Dental laboratory procedures: complete dentures

Fig. 14- 16. A , Cast and stone are painted with tinfoil substitute, using care to not place tinfoil substi-
.
tute on ridge laps of teeth B, Indentations placed in ridge laps of resin teeth improve bonding to
denture base.

Fig. 14- 17. Denture base resin is mixed according to manufactur - Fig. 14- 18. After processing and recovering denture from mold, it is
er’s recommendations, and denture is trial packed to assure mini- examined for resin nodules or sharp fins.
mum flash.

* 14 . Mix the denture base resin , and pack the imme-
diate denture ( Fig. 14-17 ).
15. Cure the immediate denture as recommended by
the resin manufacturer.
16. After curing, cool it to room temperature, and
recover the denture as described in Chapter 10.
17. Remount the denture in the articulator , and cor -
rect processing errors as previously described.
18. Construct a face-bow index to permit remounting
of the maxillary denture later (see Chapter 10).
19. Remove the denture from the cast , and then ex-
amine it carefully ( Fig. 14-18). Sharp fins , resin projec-
tions formed by the sockets, and nodules can be re-
moved from the interior of the denture with a bur ( Fig.
-
14 19).
20. Polish the immediate denture ( Fig. 14 20). -
21. Scrub the denture thoroughly with soap and wa-
ter and store it in water or diluted sodium hypochlorite
( Fig. 14-21). r
 Immediate dentures 423

Fig. 14- 19. Sharp projections on denture are smoothed with bur.
Remove resin projections that were formed by sockets carved into
cast .

A B

Fig. 14- 20. A, Carefully pumice denture, paying particular attention to borders. B, High shine
achieved with soft rag wheel and slurry of prepared powdered chalk.

A B

Fig. 14-21. A, Denture is scrubbed to remove polishing agent. B, Store denture in water or 1 : 10
y dilution of 5% to 6% sodium hypochlorite and water. Dentures with teeth that have metal occlusal
surfaces should not be stored in sodium hypochlorite solution.

§
424 Dental laboratory procedures: complete dent tires

Table 14-1. Constructing immediate dentures

Problem Probable cause Solution

Esthetics of immediate denture not
acceptable because of drastic
change in appearance of patient
Immediate denture and surgical
template do not demonstrate
good adaptation on insertion
Denture teeth not placed in position of
natural teeth
Position of denture teeth differs signif -
icantly from position of natural teeth
because of overcorrection
Cast overtrimmed prior to packing im-
mediate denture
Place denture teeth in same position as natural
teeth where acceptable
Avoid drastic correction, which may produce
poor esthetic results, when compensating for
malpositioned natural teeth
Trim cast only as prescribed by dentist or dentist
can trim cast

PROBLEM AREAS Denture teeth can be positioned on the cast to im-

Principal problems associated with construction of
immediate dentures are similar to those for conven -
tional complete dentures (Chapters 9 and 10). Problems
unique to immediate dentures are related to failure to
duplicate the position of natural teeth (Table 14- 1 ). This
can occur when attempting to correct the positions of
natural teeth with the denture teeth and overtrimming
the cast prior to packing.
prove the esthetics of the completed denture. This is
particularly true when the natural teeth are malposi -
tioned with unsightly diastemas and overlap. The cast
should not be overtrimmed prior to packing the den-
ture, and this procedure should be prescribed or ac-
complished by the dentist .
SUMMARY
This chapter described procedures used during the
construction of an immediate denture that differ from
comparable procedures for conventional complete den -
tures.

•i
*
CHAPTER 15
FLUID RESIN COMPLETE DENTURES
WALTER L. SHEPARD
festooning Carving of the denture base material to simulate the
contours of the natural tissues that are to be replaced by the
denture.
fluid resin (pour resin) An autopolymerizing or lower tempera-
ture-curing resin that can be introduced into a mold in a liquid
state.
Denture base processing with
a hydrocolloid investment
l Traditionally, methods of denture base formation
consisted of carving, casting, or forming the base under
varying degrees of pressure. Dentists hand carved early
dentures from various organic materials, such as ivory,
wood , or animal horn , and usually fitted them directly
to the oral tissues. After the advent of techniques for
making impressions of the mouth , they devised meth -
ods of making denture bases of swaged gold , tin , alu -
minum , and porcelain. Vulcanization probably brought
to dentistry the first relatively inexpensive method of
producing a denture base that was accurate and dur-
able. Although in the late 1930s vulcanite lost its popu -
larity as a primary means of processing denture bases,
dentists continue to find the occasional patient who still
wears vulcanite dentures.
The methyl methacrylate denture, which possessed
superior esthetic characteristics and offered other ad -
vantages over denture bases of vulcanite and other ma-
terials, primarily condensites, first appeared in 1937 .
The inherent properties of methyl methacrylate cause
it to remain the denture base material of choice today .
No other denture base materials have proved equal to
t methyl methacrylate denture base materials, in spite of
other claims of superiority.
Mirza ( 1961 ) described a method of producing a den -
ture base that used a pourable methyl methyacrylate
resin and a hydrocolloid investing medium . Thereafter,
numerous reports about this type of denture base pro-
cessing appeared , and several manufacturers produced
resins that dentists could introduce into a mold in a
liquid state. Winkler (1967) described a technique, and
Shepard (1968) reported the results of producing more
-
than 14 , 000 dentures in a 2 year period , using a hydro-
colloid investment and a liquid resin .
The substitution of hydrocolloid for gy psum as an in -
vesting medium offered several advantages. It consid -
erably reduced the working time required for flasking
and deflasking. Tooth breakage was less likely to occur
during deflasking, hydrocolloid material was both
cleaner to handle and reusable curing was faster, and
it was possible for the dentist ^ to receive the finished
denture sooner . Axinn et al . ( 1975) reported that the
results obtained with this method compared favorably
with conventional packing techniques.
As in almost all procedures in dentistry', disadvan -
tages offset some advantages. Usually , a slight loss in
the vertical dimension of the occlusion occurred , but it
was possible to compensate for it when making jaw rec-
ords or setting teeth . Increasing the interocclusal dis-
tance 0.5 mm in the incisal guide-pin area of the artic-
ulator offset curing shrinkage. Occasionally, individual
tooth movement occurred , particularly if it was neces-
sary to reduce excessively the length of the denture
tooth to accommodate the lack of interocclusal space.
The denture base contouring phase of the waxing pro-
cedures required more attention to detail .
425
426 Dental laboratory procedures: complete dentures
REQUIREMENTS FOR DENTAL RESIN methacrylate, as well as the resins described in this
Phillips (1973) stated the properties of an ideal resin technique, have essentially all of these properties.
as follows:
SYNOPSIS OF METHOD
1. The material should exhibit a translucency or transpar
-
ent } that would make it possible to duplicate esthetic ally the
*
- 1 . Place the waxed denture in a modified duplicating
oral tissues that it was to replace . flask . * and surround it with a hvdrocolloid .
2. No change should occur in the color or appearance of 2. Chill the hydrocolloid.
the material alter fabrication , whether accomplished inside or 3. Remove the waxed denture from the mold , and
outside of the mouth. sprue the mold .
3. It should not expand contract , or warp during process
,
- 4 . Remove the teeth and wax from the cast , clean
ing or subsequent use by the patient. them , and replace them in the mold.
4 . It should possess adequate strength , resilience and ,
5. Reassemble the flask.
abrasion resistance to withstand all normal use. 6. Mix the resin , and pour it into the mold .
5. It should be sufficiently impermeable to oral fluids so 7. Cure the denture.
that it would remain sanitan and not acquire a disagreeable
8. Deflask the denture, and finish and polish it In
taste or odor.
6. It should be completely insoluble in the oral fluids or the conventional method .
any substances taken into the mouth , show no evidence of
MATERIALS AND EQUIPMENT REQUIRED
corrosive attack , and not absorb these fluids.
7. It should be tasteless , odorless, nontoxic, and nonirritat - 1. Pourable methyl methacrylate resin
ing to the oral tissues. 2. Suitable flask ( Fig. 15- 1 ).
8. It should have a low specific gravity . 3. Reversible hvdrocolloid
-
0

9. Its softening temperature should be well above the tem 4. Hvdrocolloid conditioner
perature of any hot foods or liquids taken into the mouth . 5. No. 4 and No. 5 cork borers
10. In case of unavoidable breakage, it should be possible 6. Tinfoil substitute
to repair easily and efficiently. 7. Wax detergent
11 . It should be easy to make the material into a dental
8. Compartmentalized strainer for cleaning teeth!
appliance with only simple equipment
9. Pneumatic curing unit
Although no known dental resin would satisfy all of
these requirements, acrylic resins, such as methyl - -
V 102 Flask, Vernon Bonshofl Co., Inc. Albany, X. Y.
tHowmedica, Inc., Chicago. 111.

-.
Fig. 15 1 Flask disassembled. Inner ring ( I ) has large opening to permit cutting of sprues and vents.
Split outer ring ( O ) confines hydrocolloid within flask. Reservoir ( R) is tapered to fit snugly into lid ( L ).
Metal base ( B ) is held securely in position by flexible metal retaining clips ( C ). No. 5 cork borer fSj i
is used for spruing. No. 4 cork borer (V ) is used for venting.

PREPARATION OF CAST AND WAX PATTERN
PROCEDURE
1. Make the cast so that it has an adequate shelf or
% land area, 3 to 5 mm , to support the cast in the mold
after dewaxing.
2. Taper the sides of the cast so that they will con -
verge slightly toward the occlusal aspect , thereby facil -
itating removal from the chilled hydrocolloid ( Fig. 15-
2). The base should be flat , and the cast should be free
of contaminants.
3. Contour the wax in exactly the same manner as
-
desired in the finished denture ( Fig. 15 3). The ability
of the hydrocolloid to duplicate minute details makes it
worthwhile to spend additional time on festooning. Ex-
ercising care with this procedure will espedite finishing
and polishing.
4. It is extremely important to have no wax residue
left on the artificial teeth prior to investing. Careless-
ness at this point not only increases finishing time, but
it also can result in dislodging the teeth during pouring
procedures. It is essential to remember that the hvdro-
colloid will duplicate accurately any wax remaining on
the teeth as well as the waxed denture. Any wax left on
the tooth surface will result in a void between the tooth
and hydrocolloid after dewaxing and repositioning the
tooth in the mold. A resin flash will occur on the tooth
surface during the pouring of the denture.
Fig. 15-2. Cast should be tapered so that it will have adequate land
area .
I of wax residue.
Fluid resin complete dentures 427
5. It is necessary to take advantage of existing under -
cuts on the teeth by trimming the wax down to the
collar. This gives the teeth better retention in the mold
and reduces the likelihood of tooth movement during
pouring.
6. When using a preformed palatal pattern, it is es-
sential to seal the cast with a thin coating of wax before
adapting it . Firm adaptation of the pattern in position
is necessary to prevent any lifting away from the cast
when pouring the hydrocolloid .
PREPARATION OF HYDROCOLLOID
PROCEDURE
1. Break down the hvdrocolloid in a simple double
boiler or conditioning machine ( Fig. 15-4 ). Bring it to a
temperature that produces a fluid without lumps, and
then cool it to a temperature between 120 and 125° F
(50° to 53° C ). Hydrocolloids that contain glycerin or
those that are water thinned are satisfactory investment
media. The glvcerin - type hvdrocolloid appears to be
tougher and have a longer life as well as a desirable
tacky surface. However, it is impossible to use it in du -
plicating casts because it adversely affects the setting of
gypsum products. Reuse of either material is satisfac-
tory until it no longer cuts sharply with a sprue former.
2. W ash the hvdrocolloid free of all debris after use ,
and store it in a moist atmosphere.
Fig. 15- 3. Waxed denture should be made to conform to desired
finished contours and be well sealed to cast . Teeth should be free
 Ah

428 Dental laboratory procedures: complete dentures

Fig. 15- 4. Double boiler may be used to break down hydrocolloid. Fig. 15- 5. Waxed dentures are soaked in slurry water to displace
Use of aluminum utensils should be avoided because of adverse air in casts. Note bubbles being released.
effect on hydrocolloid.

Fig. 15-6. Waxed denture is centered in ring with distal aspect to-
ward large opening of inner ring.

Fig. 15-7. Hydrocolloid is poured so that flask is

filled from base upward.
 Fluid resin complete dentures 429

Fig. 15-8. Flasks should remain in cool circulating water until hydro- Fig. 15- 9. Hydrocolloid is removed from areas in which cast has
colloid has gelled . been keyed and beveled to gain access to base. All torn fragments
of hydrocolloid must be cleared away carefully after removal of cast
and waxed denture .
INVESTMENT
PROCEDURE
1. Soak the cast with the waxed denture in slurry
water at room temperature for 10 minutes prior to in -
vesting ( Fig. 15-5) to displace any air within the cast
and prevent bubble formation in the hydrocolloid in -
vestment .
2. Assemble the flask without the top, and center the
waxed denture in the flask . It is important to center the
waxed denture so that an equal amount of hydrocolloid
* surrounds it and thereby prevent distortion . The distal
aspect of the denture should face the large opening of
the inner ring ( Fig. 15-6 ) to allow access to areas of the
denture base through which sprues and vents can be
cut .
3. Pour the hydrocolloid into the side of the ring to
fill it from the base upward ( Fig. 15-7). After covering
the teeth , assemble the top of the flask , position the Fig. 15-10. Mold should be inspected carefully for any loose pieces
retaining clips , and add the reservoir. Continue pour - of hydrocolloid.
ing through the reservoir until it is full.
4 . Place the flask in cool circulating water no deeper 2. Remove the base of the flask and any hvdrocolloid
-
than hall the height of the flask ( Fig. 15 8). The metal from the areas used in keying the cast .
base will conduct the heat from the mold so that the 3. Bevel the hydrocolloid around the base of the cast
hydrocolloid will gel and shrink toward the base, re- slightly to permit access with a knife blade on each side
sulting in a more accurate mold . Allow the flask to re- of the cast to facilitate removal of the cast and waxed
main in the water for 45 minutes to assure complete denture.
gelation . 4. Grip the knive blades firmly at each side of the
DEWAXING base of the cast , and apply downward leverage with the
knife handles to remove the waxed denture from the
PROCEDURE mold ( Fig. 15-9 ).
1. Remove the retaining clips and reservoir after ge- 5. Remove any torn fragments of hydrocolloid care-
* lation , and trim the hvdrocolloid reservoir flush with fully from the beveled surface to keep them from falling
the lid of the flask . into the mold ( Fig. 15- 10 ).
 430 Dental laboratory procedures: complete dentures

6. Dislodge the denture teeth from the wax, and

place them in the compartmentalized strainer in proper
sequence ( Fig. 15-11).
7. Clean the teeth with detergent to remove all wax
residue , and rinse them in clear, hot water ( Fig. 15- 12).
8. Remove the waxed denture base, clean the * cast
with detergent , and rinse it with hot water.
9. Apply a thin coat of separating medium ( tinfoil
substitute ) evenly over the impression surface of the
cast while it is still hot (Fig. 15- 13). Set the cast aside,
and permit it to cool .
10. Exercise care to avoid pooling the separating me-
dium on any part of the cast . Since the resin is fluid , it
does not require any packing pressure and will not dis-
place thick areas of separating medium during process-
ing . Therefore voids can occur on the impression sur-
face and border areas of the finished denture. The
paintbrush can carry small stone particles back into the
separating medium , contaminate it , and cause it to Fig. 15- 11. Denture teeth are removed and placed in proper com-
partments of strainer.
thicken . Pour a small amount of fresh separating me-
dium into a clean container , and discard any unused
portion at the end of the working period.

Fig. 15- 12. Teeth must be cleaned thoroughly of all wax residue.

>

Fig. 15- 13. Thin coating of uncontaminated separating medium is

applied to clean cast . Care is taken to prevent pooling of medium.

SPRUING AND VENTING
PROCEDURE
1. Remove the outer ring of the flask to expose the
^ area designated for the vents and sprues.
2. Position the No. 4 cork borer so that it will cut
through the hydrocolloid to the most distal area of the
mold to provide a vent. Usually these areas are the dis-
tolingual flange area of the lower denture and the ham
ular notch area of the upper denture. After cutting the
vents and removing the hydrocolloid plugs, make the
main pouring sprue.
3. Make the slightly larger pouring sprue with a No.
5 cork borer. Position it so that it will make contact
with the denture base in the distal midline area of the
upper denture and distolingual midline area of the
lower denture ( Fig. 15-14 ).
4. The principal consideration when spruing is hav ing
the fluid resin reach the most central anterior area of
the denture as quickly as possible and permitting it to
travel up the lateral aspects of the denture and force air
out ahead of it .
Fig. 15-15. Teeth are replaced in their respective posi-
tions in mold .
Fluid resin complete dentures 431
5. Some assistance with a sharp blade may be neces -
sary to release the hydrocolloid ping from the mold af -
ter the cork borer has cut into the denture base por -
tion .
6. Scrutinize the mold carefully for any loose frag -
ments of hydrocolloid , and remove them to prevent
their incorporation in the resin.
- REPLACING TEETH IN MOLD
PROCEDURE
I . Remove the thoroughly cleaned teeth from the
strainer with cotton pliers , and replace them in their
respective positions in the mold ( Fig. 15- 15). When us -
ing resin teeth , grind the ridge - lap area lightly prior to
replacing the teeth in the mold . Civjan et al . ( 1972)
reported that removal of the glaze will result in a
stronger bond at the denture base and tooth interface.
It is more expedient to grind resin teeth lightly during
setup procedures . When using porcelain teeth , remove
any water remaining in the diatoric portion of the tooth
with a blast of air.
Fig. 15- 14. Main pouring sprue is cut after vents are made. Vents
and pouring sprue should be as close to parallel as possible.
V
-
* |

432 Dental laboratory procedures: complete dentures

2. After repositioning the teeth in the mold, invert

the flask, and shake it gently to make certain that the
teeth remain in position.
3. II any tooth becomes dislodged at this point, use a
small amount of petroleum jelly on the occlusal or in-
cisal surface to hold it in place. Eastman 910 adhesive*
also works well for this purpose. Exercise care to pre-
vent contact between either of these materials and the
ridge-lap area of the teeth because the result will be a
poor bond between the tooth and resin.

MIXING AND POURING RESIN

PROCEDURE

1. Replace the cast in the mold ( big. 15- 16), and re-
position the base of the Mask and retaining clips Make .
certain that the cast is not warm at this point.
2. Measure the powder and liquid accurately to as -
sure proper color, dimensional stability, and curing and
pouring of the resin. Follow the manufacturer’s direc -
tions accurately because mixing procedures vary be -
tween Iiurnu fact 11rers.
3. Use resins with a higher percentage of polymer in
relation to monomer to produce the best results be-
cause less curing shrinkage is likely to occur Winkler.
( 1972) states some resins use two volumes o! polymer
to one volume ol monomer, and at least one resin uses Fig. 15- 16. Cool cast is replaced carefully in mold.
three volumes of polymer to one volume of monomer .
Though more viscous in its pouring state, the lattert
produces excellent results, similar to resins using a
.
2.5 : 1$ or an 8: 3§ ratio Therefore, the higher polymer
ratio resins an* preferable.
4. All of the currently available fluid resins allow suf-
ficient working time for pouring two dentures from the
same mix . Clean the mixing equipment thoroughly
(Fig. 15- 17).
5. Add the polymer to the monomer, and stir slowly
for 15 to 30 seconds until the mixture has a uniform
consistency (Fig. 15- 18). A glass or polyethylene mixing A

beaker is suitable for the purpose. Overspatulation can

cause the undesirable incorporation of air in the resin. I
6. Rotate the beaker slow ly for 10 to 15 seconds to
assure homogeneity before pouring. I A
7. Handle the flask carefully to avoid dropping or jar -
ring it . If either occurs, discard the mix, and disassem -
ble the flask to make certain that there has been no
'7
tooth movement.
8. Pour the resin slowly through the main pouring Fig. 15- 17. Proportions must be accurate, and mixing utensils m
sprue only (Fig. 15- 19). Do not add any resin in the be clean.

•Buffalo Dental Manufacturing Co., Inc., Brooklyn, V Y.

tFlow, Cosmos Dental Products, Mt. Vernon, N.Y.
tFronto II Vernon- Benshofl Co., Inc., Albany, N. Y.
,

.
CMyerson’s Pont, Mverson Tooth Corp , Cambridge, Mass.

vents. Adding resin through the vents could produce
voids. Continue pouring until the resin overflows
through the vents.
9. Rock the flask gently from side to side for 10 to 15
seconds to displace any air bubbles that may have be
come trapped during pouring. It is possible to add
more* material if the sprue level drops as a result of
overflow through the vents, but add it only to the main
pouring sprue. Then the dentures are ready for curing.
Fig. 15- 19. Resin is poured slowly through pouring sprue only .
^ tial air input from disturbing resin.
Fluid resin complete dentures 433
CURING DENTURES
PROCEDURE
1 . The curing procedure varies slightly from one
resin to another. Some are autopolymerizing, whereas
- others require low curing temperatures. A tempera-
ture-controlled pneumatic curing unit is helpful, but
not absolutely necessary. Follow the manufacturer’s di -
rections as to the temperature and depth of the water
in the curing unit . The temperatures vary from 100° to
125° F (38° to 51.5° C ). One resin requires a starting
temperature of 120° F (49° C ) in a curing unit.
2. Position the flasks carefully in the curing unit so
that the sprues or vents are not directly beneath the air
inlet ( Fig. 15-20). This precaution will prevent an initial
intake of air in the curing unit from disturbing the fluid
resin .
Fig. 15- 18. Mixing is done slowly for 15 to 30 seconds.
Fig. 15- 20. Flasks are placed in curing unit carefully to prevent ini-
j
434 Dental laboratory procedures: complete dentures

3. Position the top of the curing unit securely, and FINISHING AND POLISHING
add 20 to 30 psi air pressure ( Fig. 15-21 ) . PROCEDURE
4 . Monitor the pressure gauge to make certain that 1 . If the sprues or vents interfere with remounting,
the unit does not lose pressure. remove them with a separating disk at this time ( Fig.
5. After 30 minutes in the curing unit at 20 to 30 psi , 15-23). If it is possible to remount the dentures without
release the pressure, and remove the flasks. The den - interference, remove the sprues and vents later ( Fig.
tures are cured . 15-24 ).
DEFLASKING 2. Equilibrate the occlusion , remove the casts, and
finish and polish the dentures in the conventional man -
PROCEDURE ner ( Fig. 15- 25).
1 . A major advantage of this method of processing is
the ease with which it is possible to recover the den -
tures after curing. To recover the dentures after curing
disassemble the flask , and eject the dentures with fin -
ger pressure ( Fig. 15- 22 ).
2. Wash the hydrocolloid clean of any debris, and
store it for further use.

Fig. 15- 21. Air pressure at 20 to 30 psi is maintained for 30 min-

utes. Pressure must be monitored .

Fig. 15-22. Cured denture is ejected from mold with finger pres-
sure.
 Fluid resin complete dentures 435

X
'

-
Fig. 15 23. Sprues are removed when interfering with remounting procedures.

. -
Fig 15 24. Dentures are remounted before equilibration. Note - .
Fig. 15 25 Dentures after occlusal equilibration.
slight loss in vertical dimension, indicated by opening between
maxillary cast and mounting.
436 Dental laboratory procedures: complete dentures
REMOVABLE PARTIAL DENTURES
PROCEDURE
1. Spruing procedures vary when processing partial
dentures, according to the type and position of the den -
ture base areas. The principle is the same as for com -
plete dentures, that is , having the sprue connect the
most anterior accessible denture base area and making
the vents at the most distal aspect of the denture base.
2. Block out gross undercuts of the cast with quick-
setting plaster of Paris to prevent tearing of the hydro-
colloid when removing the cast from the mold . Do not
use modeling clay in this procedure because it can
change shape during handling in the dewaxing proce-
dures and prevent proper reseating of the cast back in
the mold . The areas requiring blockout are generally
the labial aspect of the anterior teeth and beneath the
lingual major connector of the lower partial dentures
( Fig. 15- 26 ). Block out any other severe undercut areas,
but do not extend the plaster over the clasp arms as the
framework is removed from the cast during dewaxing
procedures ( Fig. 15-27).
3. Bilateral and unilateral free-end partial dentures
require no modifications prior to investing other than Fig. 15- 26. Processed bilateral free-end partial denture showing
plaster blockout . In instances when a distal abutment sprue and vent positions. Area beneath lingual bar has been
tooth prevents access for a vent, attach a roll of wax of blocked out with quick -setting plaster of Paris.
approximately the size of the vent to the most distal
aspect of the denture base, and bring it back to an ac-
cessible area of the cast . Cut the vent to the space in
the mold formed by the roll of wax ( Fig. 15-28).

v v

/\
f-
A
/S

Fig. 15- 27. Anterior undercut area also is blocked out with plaster Fig. 15- 28. Bilateral partial denture with distal abutments. Sprues
of Paris. Plaster should not cover clasp arms. ( S ) are cut to most anterior lingual segment. Rolls of wax (W ) were
connected to denture base and brought distally to accessible vent
(V ) area before investment

4. For partial dentures containing only an anterior
denture base, attach a roll of wax to the labial aspect of
the denture base in the buccal fold area , and continue
it posteriorly to an accessible venting area.
^ 5. Cut the pouring sprue through the denture base
at the lingual aspect of the anterior teeth, and vent it
where the roll of wax ended ( Fig. 15-29 ).
6. When there are both an anterior denture base and
a unilateral posterior denture base, attach one roll of
wax to the buccal fold area from the anterior base to
the posterior base on one side; also attach another roll
to the other side , and bring it back to the most distal
accessible area of the cast . Cut the pouring sprue to the
most anterior area of the denture base and the vents to
the most posterior areas.
. -
Fig 15 30. Unilateral free-end partial denture with additional ante-
rior and posterior denture base area. Sprue ( S ) is cut to lingual
aspect of anterior teeth. Rolls of wax ( W ) were connected to pos-
terior denture base areas before investment . Vent (V ) on left side is
cut into denture base area. Vent ( V ) on right side is cut into what
was extension of roll of wax (W ).
Fluid resin complete dentures 437
7. When there are bilateral posterior edentulous
areas and an anterior area , treat each side as in the uni -
lateral situation ( Fig. 15-30).
8. Remove the framework from the cast during de-
waxing.
9. Clean the cast and framework of all wax , and coat
the cast with a separating medium .
10. Sprue , vent , and clean the teeth , and replace
them in the mold .
11 . Replace the framework on the cast , and replace
the cast in the mold .
12. Accomplish the remaining steps in the same man -
ner as for complete dentures.
13. Pouring generally takes longer with partial den -
tures because the retentive meshwork impedes the
resin flow to some extent . Less restrictive meshwork
Fig. 15-29. Partial denture with only anterior edentulous area.
Sprue fSj is cut to lingual area. Rolls of wax (W ) were connected
to most distal area of denture base and continued to accessible
vent ( V ) area before investment.
438 Dental laboratory procedures: complete dentures
patterns are best to use when making the metal frame-
work . The screen -type retentive meshwork pattern is
not satisfactory because it impedes the How of resin too
much and can cause voids in the denture base.
14 . A major advantage of a fluid resin method of pro-
cessing, in the instance where the denture base has a
free-end extension , is the absence of packing pressure
on the retentive meshwork of the partial denture. Pack -
ing pressures frequently causing warping of the mesh -
work during processing. The release of stresses after re-
moval of the partial denture from the cast causes the
meshwork to resume its original position . When the
pressure- packed free-end extension partial denture is
inserted in the mouth of the patient , the dentist often
finds that the denture has an anteroposterior displace-
ment . It becomes evident when finger pressure is ap-
plied to the occlusal surface of the posterior denture
teeth and metallic portions of the partial denture ante-
rior to the most distal rest move upward out of proper
position . The fluid resin processing method eliminates
the warping effect because it requires no application of
pressure.
15. Another advantage is the ability to recover the
partial denture from the mold without damage to the
cast . This situation greatly facilitates remounting pro-
cedures for occlusal correction after processing.
REBASING
PROCEDURE
1 . It is impossible to reline dentures properly by this
method of processing. It is essential to rebase instead
of reline dentures.
2. All undercuts should have been removed from the
basal surface of the denture prior to making the impres-
sion to permit removal of the denture from the cast
without damage.
3. After the impression has been made, box the den -
ture, and make a cast of improved stone.
4. Taper the cast on sides, and make the base flat .
5. Remove carefully any impression material from the
polished surface of the denture up to the peripheral roll
without removing the denture from the cast .
6. Do the investment , cooling, removal, spruing, cast
cleaning, and painting with a separating medium in the
same manner as when the denture is an original.
7. If the denture has porcelain teeth , remove them
from the denture base , clean them , and replace them
in the hydrocolloid mold individually . If the denture
has resin teeth , cut the denture base away up to the
teeth , clean the entire arch , and replace it in the mold
as a unit.
8. The remaining procedures for processing are the
same as those for original dentures.
REPAIRING
PROCEDURE
1 . Make repairs with autopolvmerizing or low-heat
resin , using the pneumatic curing unit to avoid poros-
ity . Any fluid resins can be used for repair if they are
autopolymerizing or low-temperature polymerizing.
2. Repair any denture made originally of fluid resin
with the same resin if possible. Then the repair area is
undetectible.
PROBLEM AREAS
Some problems can arise in this method of process-
ing, but generally they result from carelessness or lack
of attention to detail (Table 15-1).
It is essential to handle the cast with care. Contami-
nation with silicone or acrylic spray, talcum , and oils;
failure to clean the cast properly before pouring; or per-
mitting the separating medium to form pools will affect
the impression surface of the denture adversely. These
resins are autopoly merizing, and some contaminants
will prevent proper curing. Exercising care when using
impression materials that contain eugenol is essential.
W hen it is necessary to soften a zinc-oxide-eugenol
wash impression that has been border molded with
modeling plastic before separating the cast from the
impression tray, heat it quickly and moderately. It is
necessary to avoid placing the impression in an oven or
under an infrared lamp to soften it , since either type of
heat tends to make the stone cast take up the eugenol .
An adequate land area , proper tapering, arid a flat base
are essential for the cast .
Festooning should conform exactly to what is desired
in the denture after minimal finishing. The teeth must
be entirely free of wax prior to investing. If one is un -
able or unwilling to remove all of the wax, it is prefer-
able to use some other method of processing.
Spruing and venting correctly and understanding the
basic concepts of the technique are essential for suc-
cess. Some partial dentures require rather complicated
spruing and venting procedures, but pouring works
well when the resin reaches the most anterior area first
and is able to escape through the most distal area with -
out interruption. Voids result when air is trapped any-
where along the route. The mold must be free of loose
pieces of hydrocolloid because they become incorpo-
rated in the denture base.
Only precise mixing of the resin according to the pro-
portions specified by the manufacturer assures the best
results. Higher polymer-ratio resins are recommended.
Cleanliness of mixing utensils is critical for consistent
results. It is impractical to use the monomer of one
manufacturer with the polymer of another because this
combination can result in unpredictable polymerization

Table 15- 1. Denture base processing with a hydrocolloid investment
Problem
Voids in denture base
Hydrocolloid particles in den-
ture base
Palatal form of improper con-
tour or excessively thick
Blebs on denture surface
Tooth movement
Porous denture base
% pressure is maintained at 20 to 30 psi during curing
Irregularities on impression sur-
face of denture
Tooth detachment from denture
base during finishing or after
delivery to patient
Denture base acrylic on tooth
surface
* •$v
Probable cause
Air trapped within mold as result
of improper spruing and venting
Air trapped within mold as result
of improper pouring
Air trapped with mold because of
too viscous mixture
Loose pieces of hydrocolloid left
in mold
Preformed palatal pattern lifted
away from cast during investing
Bubble formation in hydrocolloid
mold
Tooth not held in position properly
by hydrocolloid during pouring
Tooth out of position prior to
pouring
Inadequate air pressure
Denture placed in curing unit after
polymerization begun
Accelerated polymerization
Improper treatment of cast prior
to pouring resin
Inadequate treatment of resin
tooth at denture interface
Wax left on tooth surface prior to
investing
Fluid resin complete dentures 439
Solution
Follow spruing and venting procedures properly
Pour slowly through pouring sprue only; gently rock
flask from side to side to displace bubbles
Follow manufacturer ’s recommendations exactly as to
proportioning monomer and polymer; pour within
prescribed time limitations
Inspect mold carefully before reassembling; remove
any loose hydrocolloid particles
Seal palatal area of cast with wax; firmly adapt pattern
Soak cast in slurry water prior to investing to displace
air contained in cast; exercise care in pouring hy-
drocolloid
Trim wax down to collar of tooth surface during fes-
tooning; use adhesive to hold tooth in position when
ridge lap ground excessively
Exercise care in handling flask after reassembly; place
correct tooth in proper position in mold
Monitor pneumatic curing unit to make certain that
cycle
Avoid excessive delay in placing flask in unit after
pouring
Make certain that water temperature in curing unit is
not too high and that cast is cool before placing it in
mold
Avoid contamination of cast with oils, sprays, talcum;
do not permit separating medium to pool or use
contaminated separating medium; clean cast prop-
erly prior to coating, reassembly, pouring
Clean teeth properly to remove wax residue; grind
ridge-lap area to assure proper bond
Clean teeth of wax meticulously during festooning
or I
I
(•
-
** ( LIBRARY. )
u
440 Dental laboratory procedures: complete dentures

of the resin. Inverting the measuring graduate contain - . .

Dutton D.A. Swoopp, C. C. , and Moffa, J . P.: A comparison of ver-
ing the monomer after use is essential for complete tical changes in dentures processed by two methods Int . Assoc..
drainage, or the polymerized monomer can build up Dent . Res. Abst. No. 236, March , 1968
n . r .
,
i
* , , , Fairchild . J M .: The fluid resin technique ol denture base formation.
gradually in the bottom ol the graduate and render it
f Caljf Assoc 43:l 27- 138. 1967
inaccurate. Since the monomer is lelatively deal , and Goodkind , R . J . , and Schulte, R. C.: Dimensional accuracy of pour
all ol it does not drain out during decanting tor mixing, acrylic resin and conventional processing of cold -curing acrylic
it may he impossible to detect a buildup. If ambient ,
res n bases* J Prosthet . Dent. 24:662-668, 1970.
Crant’ A. A., and Atkinson , H. F.: Comparison between dimensional
..
. . .
temperatures are high, refrigeration of the monomer
Will increase the working .time.
. . accuracy of dentures produced with pour - tvpe resin and with heat -
pressed materials, J . Prosthet . Dent . 26:296-301. 1971.
Pouring slowly and only through the pouring sprue i Inge, W. A., Jr. , and Taylor , D. F.: Dimensional changes in dentures
essential because pouring through the vents will result ^ \ processed by the fluid resin technique, Int . Assoc. Dent . Res.
in voids. Pouring too rapidly can cause entrapment of Abst. No. 273. March , 1970.
air. Careful handling of the llask w i l l avoid tpotll dis- .
K«blitz, F. F., Smith . R . A , and Wolfe , H E .: Fluid denture resin
. , .i
lodgment . Itf the
ii . . . .
/
1 r .
resin is too viscous as a result ot some v 7 . „. . ; . -
processing in a rigid mold. J. Prosthet. Dent. 30:339 346, 1973.
. . . r. .
kraut , R . A.: A comparison ot denture ha.se accuracy. J . Am . Dent
.

delay after mixing it , there should be pt > attempt to

pour it .
/ -
ASSOC. 83:352 357. 1971.
Mirza, F. D.: Dimensional stability of acrylic resin dentures, J .
For good results, it is necessary to do the curing with Prosthet. Dent. 11:848-857, 1961.
adequate air pressure , and at specific temperature if ad - bver. L.17,, Smith , R . A. , Wolfe , H E . , and Kohlitz, I . P . : Imme-
/ ° _
y .
. i
li
vocated Otherwise 0 . , porosity
.. otf .the
i j . | .
denture base or nn *
diate denture *processing with a fluid resin , J . Prosthet . Dent .
• . . . *
i
Q lr
"HSAID'MU,
propel polymerization Will le Cllt .
ii
Phillips, R. W.: Skinners science of dental materials, ed. 7. Philadel-

SUMMARY
^ phia . 1973, W. B. Saunders Co. , pp. 158- 159.
This section of the chapter described a method for
producing dentures from resins that do not require a
gy psum investment . Considerable processing time cgn
he saved when this method is used . Consistent results
depend on attention to detail . Attempts to circumvent
certain procedures will result in less than satisfactory
results. / 28:580-584, 1972.
REFERENCES
. . -
Axinn S. , Kopp, E . N . , anti Hansen , J . G : Trouble shooting the pour
-
resins, J . Prosthet. Dent . 33:689 691 , 1975.
Civjan , S. , Gardner, T. V. , Worthen , D. F., and de Simon , L. B.:
Evaluation of a “ fluid ” denture base resin , Int . Assoc. Dent . Res.
Abst . No. 233, March , 1968.
Civjan , S. , Huget . E. F., and de Simon , L. B. : Modifications of the
.
fluid resin technique, J . Am . Dent. Assoc 85:109- 112, 1972.
Shepard , W.L.: Denture bases processed from a fluid resin, J .
.
Prosthet . Dent 19:561-572, 1968.
Stanford, J . W., editor: Cuide to dental materials and devices, ed . 6,
Chicago, 1972- 1973, American Dental Association, pp. 98-99
Weaver, R . G., arid Ryge, G.: Advancements in processing tech -
niques, J . Ala. Dent. Assoc. 53:22-27, 1969.
Winkler, S. : Pour technique for denture base processing Dent . Di- .
-
gest 73:200 203, 1967.
Winkler , S.: The current status of pour resins , J . Prosthet. Dent .
.
Winkler, S. , \ lorris, II . F. , Thongthamraachat, S . and Shorr. J . H .:
Investing mediums for poyr resins, J . Am. Dent . Assoc. 83:848-
851, 1971.
Winkler , S., Ortman, 11. R. , Morris, H . F., and Plezia. R . A . : Process-
ing changes in complete dentures constructed from pour resins, J .
Am. Dent . Assoc. 82:349-353, 1971 .
Wolfe, H. E., Smith , R . A . , and kohlitz, F. F.: Denture relining or
rebasing with a fluid resin , J . Prosthet. Dent. 31:460-465, 1974.
?
CHAPTER 16
SOFT LINERS
MICHAEL J. MAGINNIS and GERALD T. GAUBERT
resilient denture base liner A layer of compressible material that
separates the hard denture base material from the oral mucosa
of the residual ridge
Resilient denture base liners
The indications for use of a resilient liner are exis
tence of thin , nonresilient mucosal coverage of the resid -
ual ridge, poor ridge morphology , persistent denture
4 sore mouth, and acquired or congenital oral defects .
Stoner ( 1962) states that the rationale for using a soft
lining material is that part of the energy transferred
from it to the denture aids in deforming the denture
elastically and consequently reduces the direct load of
mastication on the atrophied area. In addition , the soft
lining produces an equal amount of pressure over the
bone of the ridge and thereby avoids resistance from
the prominent spicules to a larger amount of applied
force.
Ortman and Ortman (1975) have described the ideal
properties of a resilient liner and recommended that
these liners serve merely as aids in solving the problem
and not as the total solution .
REQUIREMENTS OF RESILIENT DENTURE
BASE LINERS
The requirements of soft liners are as follows:
1. They should be of a biologically inert material that
is compatible with the oral tissues and does not support
hacterial or fungal growth .
2. They should be resilient and capable of maintain -
* ing this characteristic. Dentists agree that the average
period of satisfactory service for a denture is 7 years;
however, patients that need this resilient lining have
special problems that often require more frequent ser-
vice. For them , a reasonable period of service expected
from such a material may be 2 vears.
¥ ¥
3. After curing, they should be dimensionally stable
and insoluble in oral fluids to maintain proper tissue
- contact .
4. They should be color stable throughout their use-
- ful life, resistant to staining, and impervious to odors.
5. Even though flexible, they should resist abrasion
and thereby allow the practice of proper hygiene of the
surface.
6. On curing, they should maintain their bond to the
denture base without damaging it .
7. It should be relatively easy to work with them ,
including during fabrication of the lining and its subse-
quent adjustment ; however, it is not essential for the
liner to be a chairside material .
RESILIENT LINER MATERIALS
Materials available for use as resilient liners are nat -
ural rubber, soft acrylic materials, vinyls, and silicone
rubbers (Table 16-1). Natural rubber has only a limited
service period because of deterioration , fouling, and
poor dimensional stability .
Plasticized resin materials are the largest group of re-
silient liners; they are either cold-cure or heat-cure sys-
tems, and frequently they depend on the addition of
plasticizer for their resilience. A plasticizer eventually
leaches out , leaving the material hard and often fis-
sured , thereby promoting staining. Vinyls have short -
comings similar to those of resins because they may
harden in service gradually. Lower resistance to abra-
441
442 Dental laboratory procedures: complete dentures

Table 16-1. Materials and manufacturers

Material Manufacturer

Silicone rubber materials

Flexibase Flexico Developments Ltd., London, England
Simpa A . Kettenback, West Germany
Cardex - Stabon Cardex, Austria
*
Molloplast -B .
Kostner and Co. Germany
Primasoft Buffalo Dental Manufacturing Co., Inc., Brooklyn, New York
Prolastic Young Dental, Maryland Heights, Missouri
Silastic 382 Dow Corning, Co. Midland, Michigan
Soft acrylic materials
Coe- soft Coe Laboratories, Inc., Chicago, Illinois
Soft Oryl . .
Teledyne Dental Products Co. Getz / Opotow Division, Elk Grove Village Illinois
Coe-Super Soft Coe Laboratories, Inc., Chicago, Illinois
Palasiv 62 Kulzer and Co., Germany
Soft Nobiltone Nobilium, Chicago, Illinois
Softie 49 Kerr Sybrow Corp., Romulus, Michigan
Virina Virina Dental Products, Ltd., Canada
Verno Soft Vernon- Benshoff Co., Inc., Albany, New York
Other materials
Hydrocryl Soft Liner Hydro Dent, Los Angeles, California
Cole Polymers R .H. Cole and Co., Ltd., London, England
Natural rubber .
The Malaysian Rubber Producer’s Research Association Malaysia

sion also is a problem and may contribute to the poor
fit of dentures (Ortman and Ortman , 1975).
Silicone rubbers probably are closest to being the
ideal material . Achieving a satisfactory bond strength
between the silicone lining and denture base resin for
a reasonable service life has been a problem. Use of
newer bonding agents seems to have increased the ser-
vice life. Although silicone rubber is a suitable medium
for the growth of fungus, proper denture hygiene min -
imizes this problem . In this chapter methods for using
silicone material will be described .
Silicone rubber materials
Having no natural adhesion to polymethyl methacry-
late, silicone rubbers depend on an adhesive or a bond-
ing agent , such as a silicone polymer in a volatile sol -
vent , for adherence of the lining to the denture base ,
'
fhe molecules of the polymer penetrate the acrylic of
the denture base and anchor in it after evaporation of
the solvent. As the resilient lining material cures, it ad -
heres to the denture base by cross-linkage with the sil -
icone polymer (Wright, 1976).
Bates and Smith (1965) have suggested that the rate
of diffusion and total water absorption of ideal resilient
lining materials should be similar to that of polymethyl
methacrylate, approximately 2.2 % . Persumably, this
rate is sufficient to reduce the likelihood of a break -
down of the bond to the denture base.
Wright ( 1976 ) has investigated fifteen resilient liner
materials and analyzed them for water absorption , wa -
ter solubility, viscoelastic properties, and the effect of
bonding these materials to polymethvl methacrylate.
He notes that silicone rubbers are well established re- vi *
silient lining materials. They have 10 % to 35% inor-
ganic silicates that determine their water absorption
characteristics. The results of his study indicate that
Molloplast- B* has a lasting softness and an especially
low water absorption rate similar to that of the acrylic
of the denture base.
Suehatlampong et al . ( 1976 ) have determined that sil -
icone rubber materials are most satisfactory with regard
to compressibility. They produce a stress-relieving ac-
tion that is adequate if they are at least 2 mm thick.
The study indicates that a 2 to 3 mm thick section of
Molloplast - B has superior compressibility. Wright
(1976) has found that silicone rubber 3 min thick is
eight times as soft as one that is 1 mm thick .
Lining denture bases
A silicone rubber liner can be added to a previously
processed denture base as a reline procedure or, more
conveniently, can be included in the process of initial
fabrication of the denture base.
-
* Molloplast B, Kostner and Co. , Germany . Marketed by Buffalo
Dental Manufacturing Co. , Inc. , Brooklyn. N . Y .
 Soft liners 443

RELINE PROCEDURE
1. Complete the denture to be lined with the resil -
ient liner in the conventional manner using a high -im -
f pact denture base resin , * return it to the patient, re-
mount it , and adjust the occlusion . Remove
approximately 2 mm of the denture base material from
the tissue side and borders of the denture, and replace
it with a tissue conditionert During a 1-week period ,
adjust the tissue surface and borders to relieve overex-
tensions and impingements, as well as to make the final
thickness of the tissue conditioner 2 to 3 mm immedi -
ately prior to processing ( Fig. 16- 1 ).
2. Place the denture with the tissue conditioner liner
in the lower half of a conventional denture flask in such
a manner that the impression surface is upright. Also Fig. 16- 1. Denture with soft tissue-conditioner preparatory to task -
make certain to embed the teeth in a vacuum spatulated ing and processing with Molloplast-B.
-
mix of one- half dental stone and one half dental plas-
ter. Have the border rolls of the denture above the rim
of the flask and the stone-plaster surface slope down
and away from the denture borders ( Figs. 16-2 to 16- 4 ).
-
3. Before the stone plaster mix reaches its final set ,
remove the excess with a plaster knife to expose fully
the tissue rolls of the denture borders ( Fig. 16-5). This
action assures inclusion of all of the border rolls in the
upper half of the flask and prevents damage during re-
moval of the impression material. Contour the remain -
der of the stone- plaster mix with a wet finger, and sand
it smooth with No. 320 grit wet or dry sandpaper; ex-
ercise care to avoid touching or distoring the impres-
sion material ( Figs . 16-6 and 16-7).
'i . 4. After the stone- plaster mix has reached its final
set , coat the surface with a thin layer of petroleum jelly,
and place the upper half of the flask in position ( Fig. Fig. 16- 2. Stone-plaster mix is spatulated onto outer surface of
16-8). Fill the flask with water that is at room temper- denture so as to avoid trapping air and to assure filling interproximal
ature, and allow it to stand while mixing dental stone spaces.
for the second pour ( Fig. 16-9). The water wets the sur -
face of the impression material and prevents air bubbles
from clinging to it during the second pour.
5. Pour the water out of the flask , vibrate the vac-
uum -spatulated mix of dental stone into the top half of
the flask , and make certain to avoid trapping any air
bubbles ( Fig. 16- 10). Fill the Mask to the top with the
second pour, and position the flask lid .
6. After the stone has reached its final set , immerse
the flask in hot , 130° F (54° C ), tap water for approxi -
mately 5 minutes ( Fig. 16- 11 ). Gently pry the Hask
apart , and separate the halves of the Hask carefully to
avoid fracturing the stone. The top half of the flask
should contain an accurate replication of the impression
surface of the denture, including the full rolls of the
denture borders ( Fig. 16- 12 ).
Fig. 16- 3. Denture is inverted into lower half of denture flask filled
^ .
* Lucitone 199 L.D. Caulk Co., Milford. Del . , or equivalent. with stone-plaster mix. Position denture above rim of flask to con-
tCoe-soft, Coe Laboratories, Inc., Chicago, Ill . , or equivalent . tain border rolls in upper half of flask.
444 Dental laboratory procedures : complete dentures
Fig. 16- 4. Stone-plaster surface should slant down and away from
border rolls to avoid creating undercut in lower half of flask.
Fig. 16-6. No. 320 grit wet or dry sandpaper is used to put smooth
finish on stone-plaster surface and to facilitate separation of halves
of flask before removal of tissue conditioner. Also care is exercised
to avoid touching or distorting soft material.
Fig. 16- 8. When stone-plaster mix has reached its final set , thin
coat of petroleum jelly is painted on surface to act as separator .
Second half of flask has been placed in position.
Fig. 16-5. Entire denture border rolls are exposed with plaster knife
while stone-plaster mix is still soft. Care is exercised to avoid touch-
ing border roll of tissue conditioner.
*
Fig. 16- 7. Fully exposed denture border roll will be contained in top
half of flask when second pour is made to assure accurate replica-
tion and prevent any change in shape of border contours during
subsequent removal of tissue conditioner.
Fig. 16-9. Upper half of flask is positioned, and flask is filled with
water at room temperature to wet surface of tissue conditioner and
to prevent air bubbles from clinging to material during second pour.
Water remaining in flask while mix of dental stone is made for sec-
ond pour is emptied immediately before addition of stone.

Fig. 16-10. Vacuum- spatulated mix of dental stone is vibrated care-
fully into upper half of flask to complete flasking. After flask is filled,
lid is positioned.
Fig. 16-12. Full rolls of denture border are reproduced accurately in stone investing medium of sec-
ond half of denture flask. Rolls are unaffected during removal of impression material from lower half
of flask and preparation of denture base before addition of soft liner. Any manipulation of stone
surface or denture base is done in lower half of flask.
7. Remove the hulk of the tissue conditioner with a
sharp vulcanite scraper ( Fig. 16-13), and use a large
carbide bur mounted in a bench lathe to remove the
remainder of this material ( Fig. 16-14 ). With a sharp
blade ( Fig. 16-15), remove the tissue conditioner from
the sides of the denture below the stone surface. Also
take out small pieces of stone Hash to prevent their in -
clusion in the Molloplast- B during the trial packing.
8. Prepare the denture base with a carbide bur to
roughen the acrylic surface ( Fig. 16- 16). If necessary,
remove additional acrylic to make the Molloplast- B 2 to
3 mm thick in all areas of the denture base. At the same
time, maintain at least a 3 mm thickness of acrylic base
material over the crest of the ridge to reduce the pos-
4 sibility of producing a fracture site. Flatten the denture
borders to make a butt joint and to remove any sharp
angles in the denture base material ( Fig. 16- 17).
Soft liners 445
.
Fig. 16-11 After stone of second pour of denture flask has reached
its final set, flask is immersed in hot water, 130 F (54° C), for ap-
L
proximately 5 minutes to soften tissue conditioner and facilitate
separation of halves of flask. Boiling out is unnecessary. Halves of
flask are pried apart gently to avoid fracturing stone investing me-
dium.
9. Apply a tinfoil substitute* to all gypsum surfaces
of both halves of the flask ( Fig. 16-18), and allow them
to dry thoroughly (approximately 5 minutes).
10. Coat all exposed resin surfaces thoroughly with a
bonding agent ( Fig. 16-19) immediately prior to trial
packing with Molloplast - B . It is essential to use a bond -
ing agent to assure adhesion of the Molloplast - B to the
denture base. Primot and Primabondt are silicon *
polymer bonding agents in a volatile solvent . After ap
plication to the resin surfaces and evaporation of the
solvent , the silicone polymer becomes anchored to the
denture base and serves as sites for attaching the Mol -
loplast - B by cross-linkage.
. .
* Al-cote, L. D Caulk , Co., Milford , Del. , or equivalent
tPrimo, Cuthapfel and Co., Switzerland.
.
iPrimabond , Buifalo Dental Manufacturing Co., Inc., Brooklyn N . Y.
 Fig. 16- 13. Bulk of tissue conditioner can be removed quickly and Fig. 16- 14. After bulk of tissue conditioner has been removed with
easily with sharp vulcanite scraper. vulcanite scraper, remainder of material can be removed with car -
bide bur mounted in bench lathe.

Fig. 16- 15. Portion of tissue conditioner that forms sides of border Fig. 16- 16. Resin of denture base is roughened with carbide bur
rolls can be removed from between denture base and stone invest - and , if necessary , part of it is removed to provide 2 to 3 mm thick-
ing medium with sharp blade. Small pieces of stone flash that might ness of Molloplast - B in all areas of denture base. Denture base
be included in Molloplast-B during trial packing later also can be material should be maintained at thickness of at least 3 mm over
removed. crest of ridge to reduce possibility of producing fracture site.

Denture base
Rounded internal surfaces

Butt joint
Resilient liner

Fig. 16- 17. Borders of denture base are flattened to provide butt joint for finishing Molloplast-B on
external surface of denture . All surfaces of inner aspect of denture base are rounded to remove sharp
angles.

Fig. 16- 19. Bonding agent is applied to all exposed surfaces of resin denture base. Bonding agent is
applied immediately before trial packing, and 1- to 5-minute wait before trial packing is recommenced
3 by some manufacturers.
11 . The pregelled Molloplast - B is ready to use di-
rectly from the container because it requires no extra
catalyst or mixing ( Fig. 16-20). Roll the puttylike Mol -
loplast - B into the shape of a hot dog, place it on the
4
denture base ( Fig. 16-21), and cover it with a thin plas-
tic sheet . * Position the top half of the flask , and trial
pack it with minimal packing pressure to produce an
even distribution of material ( Fig. 16-22).
12. Open the flask, and remove the flash with a sharp
blade. Trial pack at least twice more until only a mini-
mal amount of flash is produced (T ig. 16-23). Generally,
the addition of more material after the first trial pack is
unnecessary unless there is no flash .
13. Remove the plastic sheet prior to final closure,
and achieve metal-to- metal contact between the halves
t
of the flask before placing them in the flask press for
processing. The manufacturer stresses the importance
of maintaining sufficient pressure at all times to prevent
the escape of the oxygen catalyst from the Molloplast -
A B; otherwise , bubbles can form , and subsequently the
acrylic and silicone rubber liner can separate .
Plastipac, Yates Dental Products, Chicago, III . , or equivalent.
Soft liners 447
Fig. 16- 18. Tinfoil substitute is applied to all gypsum surfaces of
both halves of flask to facilitate separation after processing. After
approximately 5 minutes material is thoroughly dry and ready for
trial packing of Molloplast- B .
14. Insert the flask in cold water in a Hanau curing
the temperature of the water to 160° F (71
unit , * bring
C ) within 30 minutes, and maintain this temperature
for 30 minutes . During the next 30 minutes bring the
water to a boil , and then boil it for 2 hours. The total
curing time is 314 hours.
15. Bench cool and deflask the denture ( Fig. 16- 24 ) .
Clean it ultrasonically in a plaster and stone remover
solution .
16. Trim the bulk of the flash from the denture bor -
ders with a sharp scissors ( Fig. 16- 25). Reduce and con -
tour the remainder of the flash with a No. 60 LG grind -
ing wheel. t Make certain that the direction of the
rotation of the stone is from the soft material to the
hard denture base ( Fig. 16-26 ). Silicone rubber resilient
liners are always difficult to trim and polish . The man -
ufacturer recommends trimming them at slow speeds
* Hanau curing unit, Telcdyne Dental Products, Hanau Division ,
Buffalo, N . Y.
tJ . F. Jelenko 6c Co., LC Division , Chicago, III .
I
'JF

448 Dental laboratory procedures: complete dent tires

Fig. 16- 20. Pregelled Molloplast -B is ready to use directly from its Fig. 16- 21. Putty -like Molloplast -B is formed into roll and placed o
container and requires no additional catalyst. denture base. If excessive amount is used at this stage, no mor
material will be required during trial packing.

i i *

Fig. 16-22. Trial packing with minimal packing pressure should pro - Fig. 16- 23. Minimum of three trial packs usually is required to prc
duce even distribution of material. Flash can be removed with sharp duce minimal amount of flash before final closure of flask.
blade.
 Soft liners 449

Fig. 16- 24. Processed denture is deflasked. Stone of investing me- Fig. 16- 25. Molloplast -B flash is trimmed with sharp scissors.
dium that clings to surface of denture can be removed ultrasonically
in plaster and stone remover solution .

Fig. 16-26. Bulk of excess Molloplast-B can be removed with No.

60 LG grinding wheel. This wheel also can be used to reduce and
contour excess material. Direction of rotation of wheel ( arrow )
should be from soft material to hard denture base.

with disks and rubber wheels. However, experience

has shown that coarse stones revolving at high speeds
produce the best finish .
17. Do the final finishing and smoothing with a No.
228 barrel -shaped or a No. 230 tapered LG mounted
point * ( Fig. 16-27 ). Mount the wheels and points in a
high-speed lathe or handpiece that will reach speeds of
at least 25, (XX) revolutions per minute ( rpm ). No further
finishing or polishing of the Molloplast - B is necessary.
18. Use a carbide bur to smooth any areas on the
denture base that are nicked or scarred during process-
ing and finishing ( Fig. 16-28).
19. Pumice and polish the acrylic, but exercise care
to avoid separating the resilient liner from the denture
base ( Fig. 16-29).
20. Clean the denture ultrasonically in an all - purpose
solution. Then the completed denture with the resilient
Fig. 16- 27. No. 228 barrel-shaped LG mounted point can be used
liner is ready for delivery to the patient ( Fig. 16-30 ).
for final finishing and smoothing of Molloplast -B resilient liner.
*
*J . F. Jelenko 6c Co. , LG Division , Chicago, 111.
 Fig. 16- 28. Any areas of denture base that were nicked or scarred
during processing and finishing should be smoothed and contoured
with carbide bur.

Fig. 16-29. Denture base material is pumiced and then brought to high shine with mounted rag
wheels that rotate in direction from soft liner to hard denture base (arrows ). CarQ is exercised to
avoid separating resilient liner from denture base.

V
A B

Fig. 16- 30. A, Completed denture with resilient

Molloplast-B liner. Tissue rolls have been repro-
duced and carried onto external surface of den-
ture. B. Butt joint placed in denture base ( arrows )
makes smooth finishing line. C, LG wheels and
points mounted in high-speed lathe produce ex -
cellent finish.

PROBLEM AREAS
In the past , the major problems associated with the
use of resilient liners have been inadequate bonding of
•v the liner to the denture base, color instability , loss of
resiliency , and support of bacterial growth .
Use of the newer silicone rubber liners has overcome
the problem of loss of resiliency . Although the material
may become lighter in color with age , it should have
no effect on the performance of the material . Bacterial
growth is only an infrequent problem, controllable with
proper denture hygiene and use of an antibacterial
agent.* Use of the newer bonding agents appears to
have improved the bond strength between silicone rub-
ber liners and the denture base. A discussion of the
other problems encountered with processing resilient
denture base liners, their causes, and solutions follows
(Table 16-2).
•Zephiran , Winthrop Corp., New York. N . Y.
Soft liners 451
1. Large subsurface voids that occur during the initial
stages of ( tasking fill with Molloplast - B later and be-
come a problem during finishing ( Fig. 16-31). Failure
-
to apply the stone plaster mix carefully to the external
surface of the denture before inserting it in the bottom
half of the flask causes voids. Therefore spread the vac-
uum -spatulated stone- plaster mix on the external sur -
face of the denture, and exercise care to fill the inter-
proximal embrasures of the teeth , and cover their
occlusal surfaces without trapping air bubbles ( Fig. 16-
2).
2. Improper flashing can result in inadequate dupli-
cation of the denture border rolls, overfinished borders ,
and loss of accuracy in the rolls of soft -tissue condi -
tioner. To assure accurate replication of the denture
borders, it is essential to trim the stone- plaster mix
prior to its final set ( Fig. 16-5). This trimming makes it
possible to contain the border rolls of tissue conditioner
in the top half of the flask . Later, during removal of the
tissue conditioner and preparation of the denture base .

Table 16-2. Resilient denture base liners ( silicone)

Problem Probable cause Solution

Subsurface voids during initial
flasking stages
Inadequate duplication of den-
» ture border rolls
Adherence of tissue conditioner
to stone surface
Chalky, rough, pitited stone sur -
face
Voids in top half of flask
Denture base visible through
resilient liner on adjustment
Fracture of denture base during
usage
Separation of resilient liner from
denture base material
Small yellowish plaques on re-
silient liner surface
1
Improper application of stone-plas-
ter mix to surface of denture
Improper flasking
Too much free liquid remaining in
tissue conditioner
See above
Dry surface of tissue conditioner
Improper flasking
Resilient liner too thin
Inadequate removal of denture base
material
Weak denture base material
Denture base material too thin
No bonding agent used
All surfaces not coated with bonding
agent
Yeast organisms
Carefully apply stone-plaster mix to assure filling
interproximal areas and avoid trapping air
Vacuum spatulate stone-plaster mix in mechani-
cal spatulator
Flask so as to assure inclusion of border rolls of
impression in top half of the* flask
Fully expose border rolls prior to final set of
stone -plaster mix
Alter powder -liquid ratio
Prolong wearing time of tissue conditioner until
flasking
See above
Wet surface of tissue conditioner with water be-
fore pouring second half of flask
Use mechanical vibration to avoid entrapment of
air bubbles
Use vacuum-mixed dental stone
Remove adequate amount of denture base mate-
rial to assure resilient liner 2 to 3 mm thick prior
to packing and processing
Use high-impact resin
Leave minimum of 3 mm of denture base material
over crest of ridge
Use bonding agent recommended by manufac-
turer
Apply bonding agent thoroughly to all surfaces to
be covered with resilient liner
Soak for 30 minutes in solution of 1 Vfe oz of Ze-
phiran and 8 oz of water; scrub well with mild
soap and water
*
452 Dental laboratory procedures: complete dentures

*
.
Fig. 16-31 During first half of flasking procedure, care is taken to
avoid trapping any air bubbles on surface of denture and creating
voids that will fill with Molloplast-B (arrows ) later during trial pack-
ing. Generally, it is easy to remove these bubbles of resilient liner
during finishing, but they can make border roll inaccurate.

Fig. 16 32. Stone from around denture base in lower half of flask
- Fig. 16 33. Removal of stone from bottom half of flask to provide
-
can be removed (arrows ) to provide access to denture base without access to denture base during removal of tissue conditioner often ^
v
affecting shape and accuracy of denture border roll. Resultant produces excessive amount of Molloplast -B above denture border
thickness of Molloplast -B above border roll can be removed during roll (arrows ). Excess can be removed easily during finishing without
finishing. affecting shape or accuracy of denture border roll.

Fig. 16 34. Chalky and pitted stone surface (arrows) in top half of
- Fig. 16 35. Too much free liquid in tissue conditioner will produce
-
flask results when tissue conditioner adheres to cast and resists chalky and pitted stone surface in top half of flask (arrows ) and
easy removal. This problem is caused by presence of too much free result in roughened surface on resilient liner.
liquid in tissue conditioner.

*
Fig. 16-37. Inadequate removal of denture base material during ap-
plication of tissue conditioner or during preparation of denture base
before trial packing will result in thin section of resilient liner (ar -
rows ) that can be removed during adjustment of denture base to
provide tissue relief. This problem is avoided by removing adequate
amount of denture base to provide 2 to 3 mm thickness of resilient
liner. Area like this can reduce effectiveness of resilient liner and
weaken bond between liner and denture base.
it is possible to remove stone from around the denture
base in the lower half of the flask for access to the
acrylic base without affecting either the shape or accu -
racy of the denture borders ( Fig. 16-32). The resultant
thickness of Molloplast - B is produced above the border
rolls ( Fig. 16-33) and permits removal during finishing.
3. The tissue conditioner adheres to the cast , resists
easy removal, and produces a chalky and pitted stone
surface ( Figs. 16-34 and 16-35). This problem results
from the presence of too much free liquid in the tissue
conditioner. The dentist can rectify the problem most
effectively by altering the powder-liquid ratio or by in -
creasing the amount of time that the patient wears the
appliance with the soft - tissue conditioner prior to re-
moval from the mouth and flasking.
4. Voids in the top half of the flask ( Fig. 16-36) that
later fill with Molloplast - B produce inaccuracies in the
^ borders of the finished denture . Pouring the second
half of the flask without first wetting the surface of the
Soft liners 453
.
Fig. 16-36 Voids in top half of denture flask will produce inaccuracy
in border roll of resilient liner (arrows ). Voids result from clinging of
air bubbles to surface of tissue conditioner during second pour of
denture flasking procedure and can be eliminated by filling flask
with water and wetting surface of tissue conditioner before making
second pour.
tissue conditioner traps air bubbles, which produces
voids . It is necessary to fill the flask with water at room
temperature , allow it to stand while mixing dental stone
for the second pour, and then pour the water out of the
flask immediately prior to filling it with the vacuum -
spatulated mix of dental stone.
5. The denture base shows through the resilient liner
on adjustment to provide tissue relief ( Fig. 16-37). The
cause is the inadequate removal of the denture base
material during the initial stages of applying the tissue
conditioner or during preparation of the denture base
prior to packing the Molloplast - B. It is necessary to re-
move 2 to 3 mm of resin from all areas of the tissue
surface of the denture to provide for adequate thickness
of the resilient liner. Although an area of resin like that
shown in Fig. 16-37 does not produce a poor result nec-
essarily , it can reduce the effectiveness of the resilient
liner and weaken the bond between the liner and den -
ture base.
 454 Dental laboratory procedures: complete dentures
Fig . 16-39. Separation of resilient liner from denture base material
( arrows ) is caused by improper or inadequate use of bonding
agent . All surfaces of denture base to be covered by resilient liner
must be coated with bonding agent.
\ *
-
6. The resilient lined denture base fractures during
usage ( Fig. 16-38). The primary cause is use of an in
adequate amount of denture base material over the
crest of the ridge in the fracture site or failure to use a
high-impact resin for the base material . Preparation of
the denture base for a resilient liner more than 3 mm
thick can leave an inadequate amount of base material
(less than 3 mm ) and produce a possible fracture site.
When it is necessary to reduce the thickness of the
denture base to less than 3 mm to allow for a 2 to 3
mm thickness of the resilient liner , use of such a liner
is questionable; probably the height and thickness of
the residual ridge permits use of a conventional denture
base. If the resilient liner is still intact , it is possible to
repair the denture base. However, this denture base is
Fig. 16-38. Fracture in denture base ( arrows ) during use generally
results from inadequate amount of denture base material over crest
of ridge. If resilient liner is still intact, repair can be attempted. Use
-
of high impact resin and leaving thickness of at least 3 mm over
crest of ridge can prevent problems of this type .
not dependable, inasmuch as the initial cause of the
fracture still exists, and the denture base is even
weaker after repair. If the liner tears, no repair is fea-
sible , and it is necessary to reline the denture base.
7. The resilient liner separates from the denture base
material ( Fig. 6-39 ). Improper use of the bonding agent
results in an inadequate bond between the resilient
liner and denture base. It is essential to apply a coat of
bonding agent to all surfaces to be covered by the re-
silient liner and to follow the manufacturer s instruc-
tions as to when to apply the agent and how long to
wait before packing the resilient liner.
Initial processing procedure .
.
1. Flask denture in a Hanau flask in conventional
manner, as described in Chapter 9.
2. Boil out and apply tinfoil substitute to all gypsum
surfaces of both halves of flask and allow them to dry
,
thoroughly (approximately 5 minutes ).
3. To control the thickness of the Molloplast- B liner,
a silicone putty* spacer is constructed on the master
cast in the lower half of the flask ( Fig. 16-40). Mix putty
following manufacturer’s directions and mold onto mas-
- ter cast maintaining at least a 3 mm thickness ( Fig. 16-
41 ). When set , trim borders with scissors ( Fig. 16-42 ).
Reduce excess thickness with a coarse stone mounted
in a high -speed lathe ( Fig. 16-43).
4. Trial pack high -impact denture base resin in Hask
with silicone putty spacer.
5. Place flask in cold water in a Hanau curing unit,
and set curing cycle and temperatures according to
manufacturer’s recommendations.
6. Bench cool and open flask . Halves of the Hask will
separate easily, as soft spacer does not engage under-
cuts in master cast ( Fig. 16-44 ).
-
* Insta Mold Putty System , Nobilium , Chicago, III . , or equivalent
 Soft liners 455

.
Fig 16-40. Silicone putty spacer on master cast in lower half of - .
Fig. 16 41 After mixing to manufacturer's specifications, silicone
flask. Thickness of spacer is 2 to 3 mm. putty is molded onto master cast in flask .

Fig. 16-42. Borders of silicone putty spacer can be trimmed with

scissors.

. .
Fig 16-43 Borders of silicone putty spacer can be contoured to
desired shape and excess thickness reduced, using coarse stone
mounted in high-speed lathe.
-
Fig. 16 44. After processing, flask can be easily separated as sili-
cone putty spacer does not engage undercuts in master cast.

I
 456 Dental laboratory procedures: complete dentures
Fig. 16- 45. After spacer is removed, resin borders of denture base
are flattened ( arrows ) to provide butt joint.
/
Fig. 16- 46. Finished denture with processed Molloplast- B liner . Use
of silicone putty spacer during processing controls thickness of soft
liner and provides for formation of smooth junction ( arrows ) be-
tween processed liner and denture base .
Fig. 16- 47. Two thicknesses of extra-hard baseplate wax adapted
on master cast in lower half of flask provide adequate space in
mold for processed soft liner .
7. Remove spacer and flatten resin borders with a
carbide bur to provide a butt joint ( Fig. 16-45).
8. Reapply tinfoil substitute to gypsum surfaces of
master cast and lower half of flask . Coat all exposed snr-
faces of resin with bonding agent. Trial pack , process,
and finish Molloplast - B liner ( Fig. 16-46). Use method
^
described earlier on p. 449.
Alternate spacer procedure
Baseplate wax may be used for spacer construction . 2
to 3 mm of extra hard baseplate wax adapted over the
surface of the master cast will provide adequate space
for the Molloplast - B liner. The use of wax as a spacer
requires a change in the processing technique of the
denture base resin and the Molloplast - B liner.
PROCEDURE
1 . Flask denture in conventional manner. Boil out
and apply tinfoil substitute to all gypsum surfaces.
2. Adapt two thicknesses of extra hard baseplate wax
over surface of master cast in lower half of flask ( Figs.
16-47 and 16-48 ).
3. Mix denture base resin according to manufactur -
ers recommendations. Pack into mold and cover with
plastic sheets. Trial pack against wax spacer.
4. After bench curing 2 hours in compress with plas-
tic sheets in place, open Hask and remove wax spacer.
Flush lower half of flask with clean boiling water. Re-
coat all gypsum surfaces with tinfoil substitute.
5. Coat surface of resin with bonding agent . Trial
pack Molloplast-B.
6. Curing must proceed in a slower manner at a
lower temperature to prevent escape of resin monomer.
Rapid volatilization of monomer will produce bubbles
in the silicone rubber liner. Close flask and process un -
der pressure in water bath at 150° F ( 65 C ) for 6 hours,
then at 185° F (85° C ) for 8 hours.*
.
Smith , l). E .: Personal communication University of Washington
School of Dentistry, Seattle, Wash.
279- 281
V
 Soft liners 457
PROBLEM AREAS
Problems associated with silicone rubber liners used
during the initial fabrication of the denture base are
i surface voids and bubbles (Table 16-3). Occurrence of a
void in the impression surface of the processed liner is
related to improper application of tinfoil substitute ( Fig.
-
16 49). Wax residue from inadequate mold cleansing
following initial boil-out or removal of a wax spacer will
prevent prenetration of tinfoil substitute into the stone
surface of the master cast . Voids mav also occur when
w

the silicone rubber liner pulls away from the surface of

the master cast following trial packing in a cold flask .
Warm the master cast and its half of the flask under a
.
Fig. 16-48 Two thicknesses of extra-hard baseplate wax used as
heat lamp for several minutes just before trial packing
a spacer before trial, packing flask with denture base resin.
( Fig. 16-50 ).
Bubbles in the body of the resilient liner will com -
promise its longevity and serviceability ( Fig. 16-51 ).
These voids can be introduced during packaging by the
manufacturer ( Fig. 16-52), by inadequate trial packing,
or by too rapid volatilization of the monomer of the
denture base resin .

Fig. 16- 49. Void (arrows ) in impression surface of heat-processed

soft liner. Improper application of tinfoil substitute or wax residue in
mold will cause such voids.

Table 16-3. Resilient denture base liners

Problem Probable cause Solution

Surface voids Improper application of tinfoil Flush mold surface with boiling water to eliminate any
substitute traces of wax.
Packing in cold mold Warm mold under heat lamp.
Subsurface voids (bubbles) Packaging Precompress soft liner in specially prepared flask.
Trial pack three times
Underpacking Trial pack three times
Rapid monomer volatilization Reduce temperature and increase time of initial stage of
cure cycle (150° F, 6 hours).
Completely cure resin against silicone putty spacer before
packing and processing soft liner
f
 458 Dental laboratory procedures: complete dentures

Fig. 16-50. Warm the master cast under a heat lamp just before
trial packing the Molloplast -B. A warm mold surface will reduce the
likelihood of the silicone rubber liner pulling away from the surface
of the master cast during trial packing.

- .
Fig. 16 51 Bubbles (arrows ) in the processed silicone rubber liner
introduced during the manufacturing process or during the process-
ing technique.

Fig. 16 52. Bubbles (arrows ) in the packaged Molloplast -B introduced during the manufacturing pro-
-
cess.
 r

Soft liners 459

SUMMARY Ohashi, M., Woelfel, J . B. , and Paflen (larger, G.C.: Pressures exerted
Since 1942, dentistry lias sought to find a resilient on complete dentures during swallowing, J . Am. Dent. Assoc.
denture lining material that would exhibit ideal clinical 73:625-630, 1966.
Ortman , II . R . : Factors of bone resorption of residual ridge, J .
4 and laboratory qualities. To date , silicone materials .
have been considered the material of choice.
Prosthet. Dent 12:429 440. 1962. -
Ortman . II . K . : Discussion of impact reduction in complete and par-
REFERENCES tial dentures, J . Prosthet. Dent. 16:246-250. 1966.
Ortman. II . R. . and Ortman. L. F.: Denture refitting with today s con -
Barnhart , C. W.: Silicone materials for lining dentures. Dent . Prog- .
cepts and materials Dent . Clin. North Am. 19:269-290, 1975.
ress 3:246-252. 1963. Robinson , J . E .: Clinical experiments and experiences with silicone
Basconi. P. W.: Resilient denture base materials, J . Prosthet . Dent. rubber in dental prosthetics, J . Prosthet . Dent . 13:669-675 1963. .
16:646-649, 1966. Robinson , J . E . . and Barnhart , G. W.: Silicone rubber soft denture
.
Bates J . F., and Smith , D.C.: Evaluation of indirect resilient liners base material: technique and clinical applications Dent . Digest .
for dentures: laboratory and clinical test , J . Am . Dent . Assoc. 70:362-369. 1964.
70:344-353, 1965. Rudd. K. D.: Processing complete dentures without tooth movement.
.
.
Ger Dent. 4:2 4, Jan., 1969.-
—
Boone M E . : Three R ’s resilient, resistance, research . J . Am . Soc. Dent. Clin. North Am. pp. 675-691, 1964.
Sauer, J . L. , Jr . : Relining dentures with silicone rubber. J . Mich .
.
Braden M - , and Clarke. R . L.: Viscoelastic properties of soft lining Dent. Assoc. 46:101 106. April . 1964. -
.
materials, J . Dent Res. 81:1525 1528. 1972. - Sauer, J . L., Jr.: A clinical evaluation of Silastic 390 as a lining mate-
Cawson, R . A.: Symposium on denture sore mouth . II . The role ol rial for dentures, J . Prosthet. Dent . 16:650-660. 1966.
.
Candida Dent. Pract . (Bristol) 16:138 142, Dec. 1965. - Schmidt, W. F., and Smith , D . E.: A six - year retrospective study of
Craig, R . G. , and Gibbons, P. : Properties of resilient denture liners,
J . Am. Dent. Assoc. 63:382 390, 1961 . -
Gibbons, P.: Clinical and bacteriological findings in patients wearing
Dent. 50:308 313. 1983.
—-
Molloplast -B lined dentures. I . Patient response, J . prosthet.

Schmidt , W. F., and Smith . D. E.: A six -year retrospective study of

.
Silastic 390 soft liner J . Mich . Dent Assoc 47:65-67, March, . . Molloplast-B-lined dentures. II. Liner serviceability, J . Prosthet.
1967. Dent. 50:459-465, 1983.
Gonzales, J . B . , and Lancy, W. R.: Resilient materials for denture Storer , R .: Resilient denture base materials. I . Introduction and lab-
prostheses, J . Prosthet . Dent. 16:438 444 , 1966. - oratory evaluation , Br. Dent . J . 113:195 203, Sept . , 1962. -
Griem, M . L. , Robinson , J . E., and Barnhart , G. W.: The use of a soft Storer, R . : Resilient denture base materials. II. Clinical trial . Br .
denture base material in the management of post radiation denture
.
problem Radiology 82:320-321, 1964.
Dent. J 113:231 238, Oct. 1962. -
Suchatlampong, C.. Davies, E. H., and von Fraunhofer, J . A.: Some
Gruber, R.G., Lucatorto, F. M . , and Molnar, E . J .: Fungus growth on physical properties of four resilient lining materials, J . Dent.
tissue conditioners and soft denture liners, J . Am. Dent. Assoc. .
4( 1 ):19-27 1976.
73:641-643, 1966.
Guide to dental materials and devices, ed . 6, Chicago, 1972 1973, -
.
Sweeney W.T. : Acrylic resins in prosthetic dentistry Dent. Clin . .
American Dental Association , p. 106.
North Am. pp. 593 601, 1958. - .
.
Travaglini E . A., Gibbons, P. , and Craig, R . G : Resilient liners for
Harris , E .: Plea for more research on denture- base materials, J . dentures, J . Prosthet . Dent . 10:664 672, 1960. -
^ Prosthet . Dent. 11:673 676, 1961 . - West , W . H.: RTV silicone rubbers in prosthetic dentistry . Dent .
.
Lammie, C. A , and Storer, R.: A preliminary report on resilient den - Progress 3:125-126, Jan . 1963.
ture plastics, J . Prosthet . Dent. 8:411 -424 . 1958. Williamson , J . J . : The effect of denture lining materials on the growth
.
Laney, W. R : Processed resilient denture liners Dent . Clin North . . of Candida albicans, Br . Dent. J . 125:106-110. 1968.
Am . 14:531-551, 1970. .
Wilson , II . J . and Tomlin , II . R . : Soft lining materials: some relevant
Larsen , II . D., McDonald , G . T. , and Purcell. J . P.: Resilient denture properties and their determination, J . Prosthet. Dent . 21:244-250.
linings, J . La . Dent. Assoc. 35(2):9 ll , 1977. -
Lytle, R . B. : Management of abused oral tissues iu complete denture
1969.
Woelfel , J . B. , and Palfenbarger , C . C.: Evaluation of complete den -
.
construction J . Prosthet. Dent. 7:27-42, Jan 1957. . tures lined with resilient silicone rubber, J . Am . Dent. Assoc.
Makila . E . : Soft lining to relieve soreness beneath dentures. J . Oral 76:582-590. 1968.
Rehabil. 3:145 150, 1976. - .
Woelfel, J. B., and Paffcnbarger , G C.: Method of evaluating the clin -
Makila, E . , and llouka , ( ).: Clinical study of a heat cured silicone
soft lining material , J . Oral Rchahil. 6: 199-204 , 1979.
- ical effect of warping a denture: a report of a case, J . Am . Dent .
Assoc. 59:250-260, 1959.
-
Makila. E . , and IIopsu Havu, V. K .: Mycotic growth and soft denture .
Woelfel. J . B . , Paffcnbarger G . C. , and Sweeney, W.T.: Clinical eval -
.
lining materials Acta Odontol. Stand 35:197 205, 1977. . - uation of complete dentures made of 11 different types of denture
Mason , II . J . : Extreme warpage of resin dentures in routine grinding base materials, J . Am. Dent . Assoc. 70:1170 1188, 1965. -
ami polishing, North - West Dent . 43:97 99. March April, 1964. -
Morrow, R . M ., Reiner, P. R . , Feldman , E . E . , et ah : Metal rein -
- Wright . P. S.: Soft lining materials: their status and prospects. J .

.
Dent. 4247 256, 1976. -
-
forced silicone lined dentures, J . Prosthet . Dent 19:219 229, 1968. - Young, G. , Resca, H . G., and Sullivan , M . T.: Yeasts of the normal
.
Mowrey, W. E , Burns, C . L. , Dickson, G., and Sweeney, W . T.: Di - mouth and their relation to salivary acidity J . Dent . Res. 30:426 . -
mensional stability of denture base resins, J . Am. Dent. Assoc. 430, June. 1951.
-
57:345 353, 1958.

r
'
CHAPTER 17
METAL BASES
JAMES S. BRUDVIK
metal base The metallic portion of a denture base, forming a part
of all of the basal surface of the denture. It serves as a base for
the attachment of the plastic (resin) part of the denture and
teeth . positive fit on the master cast without rocking; and (4)
References to metal bases for complete dentures can
be found in antiquity. Certainly their use was well un -
derstood by the time dentistry entered its modern era .
In 1867, Bean received a patient on a device for cast -
ing aluminum bases. Descriptions of swaged aluminum
bases appeared in the dental literature of the late
18( X )s. More recently, Campbell ( 1923) described alu -
minum casting techniques that are still applicable in
part .
Cast gold alloys, and later cast chrome base alloys,
completed the armamentarium for complete denture
metal bases . Grunewald's classic article ( 1964 ) defined
the advantages of gold alloy bases, whereas Bell et al .
( 1977 ) discussed chrome alloy bases and Lundquist
(1963), aluminum alloy bases.
The three alloys mentioned here have a place in the
current practice of prosthodontics. Faber (1957) has
given the following advantages of metal bases: ( 1 ) pre-
vention of acrylic warpage , ( 2) more strength, (3) in -
creased accuracy, (4) less tissue change under the base,
(5) less porosity and therefore easier to clean and keep
clean, (6) thermal conductivity, and (7) less deformation
in function . Me also has given the following disadvan -
tages: ( 1) cost, (2) difficulty of refitting (relining), and (3)
-
time consuming construction .
REQUIREMENTS FOR CAST METAL BASES
The requirements for acceptable cast metal bases
mirror the advantages. The bases should be ( 1 ) as thin
460
r_
as possible, and at the same time rigid , depending on
the alloy used; ( 2) dense; (3) accurate, that is , having a
of a biologically acceptable alloy .
DESIGN PRINCIPLES
Although some aspects of construction of cast metal
bases depend entirely on the alloy chosen , the princi -
ples of design remain essentially the same. The design
of the cast metal base always must be a clinical deci- *
sion . A prescription of pencil drawing on the master
V
cast must determine the amount of coverage, place -
ment of finishing lines, and type of resin retention
used .
Maxillary bases
The maxillary base can cover ( 1 ) only the palate, ( 2)
the palate and the ridge crest , or (3) the entire denture-
bearing area ( Figs . 17-1 to 17-3). The most satisfactory
design covers the complete palate and ridge crest , hut
leaves the denture borders in resin . An acceptable
variation of this design also places the posterior palatal
seal area in metal and begins the resin periphery at the
pterygomaxillary notch area ( Fig. 17-4 ).
If the posterior palatal seal is to be in metal , it is
essential that the dentist establish this critical area ac-
curately . Scraping of the cast by the technician to es-
tablish the seal area is inadvisable.
Mandibular bases
The mandibular cast base is of only two types: (1)
with crest of the ridge coverage and (2) with complete
coverage of the mandibular denture space ( Figs. 17-5
 Metal bases 461

-
Fig. 17 1. Maxillary base covering only center palate area with re- -.
Fig. 17 2 Maxillary coverage of palate and ridge crest. Posterior
lieved retention mesh. This design has been used to aid patient palatal seal area will be in resin to facilitate adjustments.
with history of repeated midline fractures of maxillary denture. It is
inferior design because it places thin, porous resin over ridge crest.

Fig. 17-3. Entire denture-bearing area is covered with metal. This .

Fig. 17-4 When posterior palatal seal area is well defined on mab-
design is seldom used because weight of metal is excessive. .
ter cast , posterior border can be placed in metal This design re-
duces bulk of denture base in posterior area.

-.
Fig. 17 5 Mandibular cast bases that are short of peripheries are
simple to make and adjust. Base outline is drawn to follow heights
of contour without entering any prominent undercuts.

1
462 Dental laboratory procedures: complete dentures
Fig. 17-6. If considerable weight is desired in mandibular casting, it
can be cast of gold alloy extended to cover complete denture
space. Careful determination of peripheries during final impression
is essential with this type of base.
Fig. 17-8. Retentive beads provide excellent resin retention if they
are No. 14 or larger and space between them is twice their diame -
ter.
m.
and 17-6). Since exact determination and registration of
the mandibular denture space is difficult clinically, the
crest of the ridge coverage with resin peripheries is
preferable, especially when using chrome base alloys f
because adjustment and subsequent repolishing are
much more difficult than when using resin peripheries.
Resin retention
Resin retention for inaxillarv or mandibular bases is
0
of four types: ( 1 ) raised ( relieved) retention mesh , ( 2)
nonrelieved retention of beads, (3) nailheads. ” and (4)
loops ( Figs. 17-7 to 17-10 ). Since relieved retention
places thin resin adjacent to denture-bearing tissues, it
is inferior to nonrelieved types, which permit a butt
joint of thicker resin . In addition, nonrelieved retention
uses less interridge space and thereby facilitates posi-
tioning of the denture teeth .
-.
Fig. 17 7 Relieved retention mesh should allow at least 1 mm for
resin beneath it.
Fig. 17 9. Nailhead retention is made by blunting piece of 18-gauge
-
wax and attaching it to stipple sheet with tacky liquid.
.

Biockout and relief
Aspects of concern in both maxillary and mandibular
bases are the biockout of soft -tissue undercuts under
the bases and placement of arbitrary relief areas. These
* two steps require clinical observation and judgment and
normal!) are completed by the dentist. Placement of
relief chambers cannot be arbitrary. However, it is pos-
sible to block out extremely sharp soft -tissue folds and
crevices as well as pronounced rugae contours arbitrar -
ily to eliminate problems in seating the casting back on
the master cast ( Fig. 17- 11 ). This biockout also reduces
the number of sharp metal projections on the tissue
surface to be removed during finishing.
Materials for cast metal bases
Three groups of alloys are used to construct cast
metal bases for complete dentures. They have had clin -
ical evaluation , and many references to their use appear
in the literature.
. - .
Fig 17 11 Biockout of soft tissue undercuts should be guided by
clinical judgment, as indicated on prescription form. If casting is to
.
enter undercuts without biockout adjustments must be made on
master cast to allow seating of cast base.
1
Metal bases 463
Gold alloys
Gold alloys of Types III and IV are sufficiently rigid
for use as cast metal bases. Casting in gypsum - bound
investments with a uniform thickness as thin as 2S
gauge is easy. The gold alloys are most frequently cast
in 20 to 24 gauge. They contain copper, silver, palla -
dium , platinum , and some trace elements, and differ
slightly in content with the various manufacturers, but
all that satisfy the American Dental Association specifi -
cations will be acceptable.
Chrome base alloys
All of the commonly used removable partial denture
alloys are equally acceptable for cast metal bases for
complete dentures. Casting at a 26-gauge thickness is
dependable, but chrome base alloys generally are at 22
to 24 gauge to be sufficiently rigid . The low-heat
chrome alloy offers only one advantage: casting in gvp-
sum - boimd investments with a 1300 F (704.5° C)
burnout.
Fig. 17-10. Retentive loops made of 18- or 20- gauge round wax
can be adapted to base wax -up for effective retention. They have
disadvantage of intruding into denture space more than bead or
nailhead retention.
v
464 Dental laboratory procedures: complete dentures
Aluminum alloys MOU »IWt < NlKWTfla

•» ,

——
1

Unlike the gold and chrome base alloys, aluminum is . CAST .. DetJTune /3 Ai£
usable in its pure state. However , its use as an alloy
«
nii
• *
* <Cfmm M r »*
-
» « »>

with 2 % to 4 % magnesium and slight amounts of silicon

is more common. The casting temperature of aluminum
in gypsum - bound investment alloys is between 1300° F
(704.5° C ) and 1500° F (815.5° C ). It is possible to an -
odize aluminum , although this practice is not essential .
Aluminum oxidizes easily and can become pitted .
Therefore no commercial resin denture base cleansers wOTH< MMli

should be used when soaking it overnight. Warm water

and soap used after each meal are adequate for main - Fig. 17- 12. Design as seen on two-dimensional prescription must
taining a clean surface. be transferred to master cast before blockout procedures are be-
gun.
Gold alloy cast base
PROCEDURE
1. Ideally, the master cast arrives at the laboratory
with the base outlined in pencil. When this is impossi -
ble , the technician transfers the design to the master
cast from the information obtained from the prescrip-
tion ( Fig. 17-12). l
2. The technician holds the designed master cast in
front of a suction outlet , and sprays it lightly with a
model spray.* This prevents the design from being
washed away in subsequent procedures. It also fills
minute pores in the cast and strengthens chalky areas
against abrasion.
3. Blockout of the master casts consists of two sepa-
rate stages. First, with any standard blockout wax ,
block out the areas within the outline of the cast base
requiring relief or recontouring, as indicated by the
prescription . Next , the undercut areas outside of the
outline are blocked out with clay or caulking compound Fig. 17- 13. Clay or mortite ( window caulking) is used to block out
'( Fig. 17-13). The standard outline of a maxillary cast *
undercuts on peripheries of master cast.

base extends barely over the crest of the ridge; there-

iore place this material along the buccal and facial ridge
surfaces and into any other cast undercuts or discrep-
ancies that may distort the duplicating material and
make the refractory cast inaccurate (Table 17- 1 ). The
mandibular cast usually requires blockout in the retro-
molar area as well as the sharp, soft-tissue folds ( Fig.
17-14 ). II raised retention mesh is desired , relief pads
must be placed at this point . The minimum acceptable
thickness is equal to approximately that of one sheet of
standard baseplate wax. SeaJ this wax completely at the
periphery to prevent it from raising up and becoming
distorted during the duplicating process ( Fig. 17-15).
4 . Place the master cast in slurry water preheated to
100° F (38° C) for 20 minutes. This procedure prepares
the cast for accurate duplication by warming it to the
approximate temperature of the duplicating material.

*Jelrnko Model Spray, J. F. Jelcnko 6c Co., New Rochelle, N . Y . , or Fig. 17-14. Mandibular cast, properly blocked out, is ready for du-
equivalent. plication .

Table 17-1. Metal bases
Ar Problem Probable cause
Incomplete casting Inadequate amount of metal
cast
Stipple sheet possibly
stretched during applica-
tion, causing wax -up to be
too thin
Mold too cold at casting
I follow instructions of manufacturer exactly; preferably have
Porosity in casting Metal too hot at casting
Pits and inclusions in Investment particles incorpo-
casting rated in molten mass
Metal blebs on com - Voids ( air pockets ) during
pleted casting paint -on stage
Failure to fit master cast Inadequate blockout of un-
dercuts
Distortion during duplication
Breakdown of refractory
Change in powder -water ratio
Plastic pattern ( stipple sheet )
1 pulled from refractory cast
•The Wilkinson Co. . Westlake Village . Calif .
*
Metal bases 465
Solution
Reevaluate amount of metal to be used in casting (Table
17-2).
Add flash of wax (0.5 mm) to refractory cast before applying
stipple sheet in prominent areas or sharp contours where
distortion of plastic sheet is liable to occur
Check burnout furnace temperature control; do not bring mold
from furnace until metal is ready to cast (30- second interval,
maximum allowed); recalibrate induction casting machines;
manufacturer 's representative demonstrate calibration proce-
dure first time
Practice hot and cold casting of metal bases with torch to train
eye (practice castings can be made to simulate dimensions
of desired metal bases by using stipple sheets)
Same as when metal too cold
Round all angles in wax -up and spruing stage to avoid having
sharp areas of refractory cast liable to be broken off by
force of molten metal
Apply paint-on layer in smaller increments
Identify interferences with disclosing medium (spray powder,
Liqua-Mark,’ or similar product) ; relieve metal with fine-cut
stones; return casting for clinical try-in and if acceptable, re-
lieve master cast under casting for soft-tissue undercuts
when necessary for complete seat
Check time and temperature for entire duplication process
Verify manufacturer 's expiration date on investment
Verify powder - water ratio; check measuring devices (scales
and graduates)
Apply tacky liquid carefully; apply small amounts of hot wax at
stipple- sheet margin to seal patterns to cast
.
Fig. 17-15 Relief pad wax is sealed to master cast with hot spatula.
In addition to periphery, wax is sealed by crosshatching entire pad
area to prevent pad from becoming displaced during duplication.
466 Dental laboratory procedures: complete dentures
Slurry water is essential to prevent leaching action on
the master cast .
5. Use any duplicating colloid , but follow the manu -
facturer s directions as to time and temperature because
of slight differences in the materials. For example, it is
essential to boil and spatulate Nobilloid* to break it
down , to pour it at 125 to 130° F (51.5° to 54° C ), and
to let it set at 65° to 75° F ( 18.5 to 24° C ) for at least
30 minutes. A variety of duplicating flasks are available,
and they consist of a base and a cover. Usually, the base
is of metal , so that cooling in cold water will pull the
solidifying material toward the base and down onto the
master cast. Center the cast in the flask and, after the
duplicating material reaches the recommended temper -
ature , direct it in a small finger-size stream to the high -
est portion of the cast ( Fig. 17- 10, A ). The material
flows down the sides of the cast and fills it without en -
trapping air. Bench set the filled flask for 5 minutes ,
and then place it in the cooling tank for 30 minutes to
an hour ( Fig. 17- 10, B ) . Have the water no deeper than
the depth of the flask base to “ puli’ the colloid toward
the cast .
0. After the colloid has set . remove the base. Cut
away excess material around the cast base, and remove
the master cast by forcing a blast of air gently along the
walls of the cast , or by snapping out the cast with two
knives ( Figs. 17-17 to 17- 19 ). Carefully inspect tlu
mold under magnification for tears and distortions in
the colloid .
7. Although the manufacturer recommends pouring
the refractory material immediately , frequently it is im -
practical when doing a series of units at the same time.
In the event of any delay, place the colloid mold in a
•Nobillium Products, Chicago, 111.
A B
Fig. 17- 16. A , Duplicating colloid is directed to highest point on master cast . B, Filled flask is put into
cooling tank with water covering only base.
humidor or at least cover it with a damp towel . Use any
gympsum -bound refractory material for gold castings,
hut follow the manufacturer’s directions. Investic,* the
investment for Ticonium , * is a good example of a gen -
eral-purpose gympsum -bound refractory' material. Mix
100 gm of investment with 29 ml of distilled water. As
with any gyps uni - bound refractory material, more wa-
ter decreases the expansion , and less water increases
the expansion . It may be necessary' to use 30 ml of dis-
tilled water for extra-large castings . When mixing these
investments in small amounts, such as for a single cast ,
use of a syringe in measuring the water is essential. The
possible error in reading the meniscus of a standard
graduate is too great to risk . When mixing larger
amounts, such as for many casts in large commercial
laboratories, the meniscus error has less effect on the
overall powder-water ratio.
The manufacturer states that Investic should be
spatnlated not more than 30 seconds mechanically , or 1
minute by hand . Remove any excess moisture from the
mold with a gentle blast of air, and vibrate the refrac-
tory investment directly into the mold. Do not vibrate
longer than is necessary to cover the surface of the
mold.
8. Allow 1 hour to complete the set before removing
the cast from the colloid . Leaving the cast in the mold
* longer is detrimental because the water- based colloids
can dry up and affect the refractory surface. Glycerin-
based colloids, used with some chrome base alloys, do
not exhibit this desiccation.
After breaking the colloid from the set refractory ma-
terial , rince it to remove the stone debris ( Fig. 17-20 ).
Then cut or break it into small pieces, and reboil it for
*Ticonium , Albany . \ V
 Metal bases 467

. -
Fig 17 17. Dull laboratory knife is used to trim colloid around base .
Fig. 17-18 Blast of compressed air directed along base of cast will
of cast . free it from duplicating material.
f

. .
Fig 17-19 Master cast also can be removed by prying on base of Fig. 17-20. Duplicating material is broken off from refractory cast
cast with two knives. and must be rinsed to remove stone particles before breaking it
down for reuse.
468 Dental laboratory procedures: complete dentures
Fig. 17- 21. Cast base must be trimmed to thickness of % inch (0.64
cm) in thinnest portion to assure having pattern close to outside of
investment mold.
Table 17-2. Alloy, pattern gauge, and amount used for cast metal bases
Alloy
Gold
Type IV
Chrome base alloys
Ticonium, Vitallium, Nobillium, etc.
Aluminum
Alcoa D214
future use, or store it in 1 ( K ) % humidity. Do not store
it immersed in water because the material will absorb
water and lose both strength and accuracy.
9. Trim the refractory cast with a model trimmer to
within V2 inch (1.3 cm ) of tin* desired base coverage.
Then reduce it in height until the cast is VA inch (0.64
cm ) thick at its thinnest vertical dimension ( Fig. 17-21).
Uniformity in thickness of the refractory cast is es-
sential to position the wax pattern properly in the flask
ring during the investing. Make it no more than V2 inch
(1.3 cm ) thick from the pattern to the outside of the
refractory mold , and standardize this procedure for all
castings.
Rinse the trimmed refractory casts quickly under
running water to remove all slurry from the trimming.
Any slurry allowed to remain on the refractory cast will
set and distort it . Dry the cast with a blast of air, and
place it in a drying oven at 200 F (93.5° C ) for 1 hour . *
* Model 105-SS, Modern Laboratory Equipment Co., New York ,
.
N . Y. , or equivalent
i
Fig. 17-22. Black pencil is used to indicate critical areas of design.
Since plastic stipple sheet patterns are translucent, it is possible to
trim exactly to line by using black pencil marks visible through
sheet.
Pattern gauge Average amount by type of cast
20 to 24 24 dwt, mandibular
30 dwt. maxillary
24 16 dwt. mandibular
19.5 dwt , maxillary
22 25 ingots, mandibular
30 ingots, maxillary
0
10. Close or fill all the pores in the refractory' cast
before waxing the base. Use a model spray,* or dip the
hot cast in beeswax, t Usually, commercial deep fat
fryers are used to heat the beeswax to 300° F ( 149° C).
Remove the refractory cast from the drying oven and
submerge it in the hot beeswax. Soon it begins to bub-
ble and foam ; keep the cast in the wax for 15 seconds
more before removing it and placing it on a paper towel
to absorb the excess wax. When the cast is cool, it is
ready for transfer of the design and waxing.
11 . Transfer the outline showing the extent of the
base coverage and the position of the finishing lines
from the master cast to the refractory cast. It is unnec-
essary to draw the complete outline on the refractory
cast , which is much softer than dental stone ( Fig. 17-
22 ). Any damage caused by excessive drawing will be
reproduced in the metal.
•Jelenko Model Spray. J. F. Jelenko ami Co. , New Rochelle, N. Y., or
equivalent .
tModem Material Manufacturing Co., St . Louis, Mo., or equivalent.

Fig. 17- 23. Pattern adapter facilitates adaptation of plastic stipple
sheets to refractory and minimizes risk of tearing or excessive thin-
ning.
12. Selection of the size of the plastic pattern is a
clinical decision. In general, mandibular gold bases are
strong enough if they are 1 min thick ( 18 gauge). It is
possible to make them from 0.75- mm ( 21-gauge) pat -
tern sheets by reinforcing the peripheries. Maxillary
bases are strong enough in their thinner dimensions be-
cause their geometric form makes them more rigid than
mandibular bases. The average thickness of a maxillary
cast base is 0.61 mm (22 gauge ) (Table 17-2).
13. For a maxillary cast gold base, make a “ tacky liq -
* uid ” by mixing 18 ml of acetone and enough plastic pat-
tern material to raise the volume to 20 ml . This ratio
makes it have the consistency of a thin syrup . Occasion -
ally, it will be necessary to add more acetone to main -
tain this consistency. Paint this liquid on the refractory
cast within the confines of the proposed base. Take one
thickness of a stipple sheet that is half the final thick -
ness desired, and lay it down to the outlined base ex-
tension . A stipple sheet is a plastic pattern form avail -
able from any of the major manufacturers of removable
partial denture alloys. It is available in 21 to 30 gauge
and in both a stippled surface and a smooth one. Using
a moistened finger or a pattern adapter, * adapt the
stipple sheet to the refractory cast ( Fig. 17-23). Begin
the adaptation in the center of the palate, and work the
material out to the peripheries to prevent the sheet
from folding over on itself. After making certain that
the sheet is in place and well adapted, cut off the excess
back exactly to the line with a No. 11 blade warmed
over a Bunsen burner ( Fig. 17-24 ).
14. Adapt a second sheet of stipple, also half the
thickness of the final casting, to the first sheet with the
* ations, the base requires more structural support in the
* Howmcdica, Inc. , Chicago, III.
Metal bases 469
Fig. 17-24. If blade has been heated , pattern can be cut without
distortion.
aid of the tacky liquid. Trim this second sheet quite
short of the first so that its border forms the external
finishing line on the palate and allows a smooth transi -
tion from the metal to the resin lingual to the denture
teeth ( Fig. 17-25). Cut the second sheet at a 90-degree
angle to the palatal surface so that the resin can have a
butt joint with the metal.
15. Add retention beads for the resin to the ridge
crest area. The beads should be 14 gauge or larger to
retain the resin adequately. Form nailheads from 18-
gauge round wax and retention loops from 18- or 21-
gauge round wax . Place tacky liquid on the ridge crest
area , and use cotton forceps to apply the beads or nail -
heads ( Fig. 17-26). Place them in a regular pattern, and
make the distance between them two and a half times
their diameter. Exercise care to avoid setting the beads
too deep in the tacky liquid because the retentive effect
relies on having the maxium surface below the height
of the contour.
16. Make a final inspection of the entire periphery at
this point to make certain that the borders are sealed
completely to the refractory' cast ( Fig. 17-27). Failure to
seal any portions may allow it to rise slightly before in -
vesting and result in inaccuracies in the adaptation of
the base.
17. Except for using a different gauge of stipple sheet
and almost always making the base short of all borders,
the techniques for waxing the mandibular cast are the
same as for the maxillary cast . Since ridge loss often
causes constriction ol the labiolingual dimension of the
mandibular base area, the mandibular cast base must
be thicker than the maxillary. In some severe situ -
form of an I - beam addition to the stipple sheet ( Fig. 17-
470 Dental laboratory procedures: complete dentures

Fig. 17-25. Finishing line for junction of resin and metal is estab -
lished when second sheet of plastic pattern is laid to cover first
sheet partially.

Fig. 17- 26. Retentive beads can be placed on tacky liquid with cot- Fig. 17- 27. Addition of small amount of blue wax to periphery witt *

ton forceps. Fine brush also can be used to pick up and deposit extremely hot spatula will assure having sheet in contact with cas
beads if tip is moistened. throughout investing procedure.

Fig. 17- 28. Addition of half round strip of wax slightly to lingual area
of ridge crest greatly strengthens thin mandibular casting without
interfering with placement of denture teeth.

4 joint of resin. The outlined base should allow for a 3 to
Fig. 17 29. Gold bases require four 8-gauge sprues curved slightly
- verely acute angles where sprues join the appliances.
to reach ridge at almost 90-degree angle. This approach eliminates
thin angle of investment that would result from acute angle and
possible breakoff during casting.
* refractory mold ; they may break off during casting and
. -
Fig 17 30. Sprue cone formed from half circle of wax 2 Vs inch (6.4
1 cm) in diameter.
* * Debubblizer, Kerr Manufacturing Co. , Homulus, Mich . , or equiva -
I
Metal bases 471
28) . Generally, form a mandibular cast gold base from
a 22-gauge plastic pattern sheet . Cut it at a 90-degree
angle to the refractory cast surface to allow for a butt
5 mm extension of resin at all peripheries.
18. Sprue gold alloy cast bases from above by placing
8-gauge sprues in the cuspid and first molar areas. Join
the sprues with a wax-cone sprue form centered above
the base ( Fig. 17- 29). It is possible to construct the wax
cone by cutting a circle of regular baseplate wax that
has a diameter of 2 '/2 inches (6.4 cm ). Cut this circle of
wax into two pieces, and roll each one to form an ideal
sprue cone ( Fig. 17-30). Round the tip of the cone by •
adding more wax by hand , and place the cone so that
the sprue leads join it 3 to 5 mm up from the tip. Place
the tip of the cone approximately 30 mm from the
deepest portion of the palate or the center portion of
the mandibular refractory cast ( Fig. 17-31). This dis-
tance varies with the height of the ridge and palatal
contour. It is essential that the sprue leads be inclined
until they form an angle of approximately 135 degrees
with the long axis of the sprue cone. Sometimes it is
necessary to curve the sprues slightly to eliminate se-
The sprue leads join the waxed appliance in the resin
retention area. Add wax at this junction to make a
smooth transition into the stipple sheet ( Fig. 17-32).
Establish a similar smooth joint where the leads join
the wax cone. Elimination of sharp angles in the wax in
these areas is essential to preclude sharp edges in the
become entrapped in the molten mass.
19. After properly spruing the completed wax-up,
prepare it for investing by dipping it in a surface ten -
sion-reducing agent * and carefully blowing oft the ex-
-
cess. Prepare the paint on layer according to the pow-
der-water ratio of the manufacturer ( Investic, 100 gm:
30 ml ). A 50-gin mixture is sufficient for the paint on -
layer. Spatulate the material for 30 seconds mechani-
cally or 1 minute by hand, and then vibrate it gently
onto the waxed base ( Fig. 17-33). Exercise care to avoid
entrapping air bubbles or dislodging retentive beads or
loops. The entire layer should be not more than l/s inch
( 0.32 cm ) thick . This uniformly thin layer within the
larger investment mold allows the gas to escape. It also
increases the liklihood of complete castings by reducing
the possibility of trapping air on the wax-up and by pro-
tecting the mold if the investment cracks during the
burnout . When the paint -on layer has reached its initial
set ( in approximately 10 minutes ), continue the invest -
ing. Select a flask ring that will allow a clearance of at
lent.
472 Dental laboratory procedures : complete dentures

Fig. 17-31. Sprue cone tip needs to be approximately 30 mm from

deepest portion of wax - up to allow space for curving sprue leads to
approach cast at 90- degree angle and to maintain approximately
135-degree angle with long axis of sprue cone.

Fig. 17- 32. More blue wax must be added to eliminate sharp edges
in junction of sprue lead and wax -up.

Fig. 17-33. Hand with brush is placed on vibrator table, and refrac- Fig. 17- 34. Flask rings must allow clearance of at least Vfc inch (1.3
tory is brought to brush tip . Paint - on layer is added in small cm) from paint-on layer to give adequate strength in final mold.
amounts to prevent entrapment of air.
 Metal bases 473

. .
Fig 17-35 Refractory is wiggled or twisted into partially filled ring. Fig. 17 36. Polyvinyl ( PVC ) pipe, available from plumbing supply
-
When cast touches bottom, it is twisted back up approximately 14 store, makes durable investing ring when sectioned with cutoff disk .
inch (0.64 cm). Sprue cone must be positioned near center of ring
to complete investing properly.

least Vi inch (1.3 cm) around the refractory model and

its paint -on layer ( Fig. 17-34 ). Measure the rest of the
refractory investment , and spatulate it in the same ratio
and manner as the paint-on layer . Do not vacuum spa-
tulate investment layers because the mold must be po-
rous to eliminate gas. Place the Hask ring on a flat
bench surface and fill it three fourths full . Hold the cast
by the sprue cone , and dip it in water to wet the paint-
on layer and keep it from dehydrating the fresh mix of
* investment . Wiggle the cast into the investment flask
ring until it touches the bottom , and then bring it V-\
inch (0.64 cm ) back up toward the top ( Fig. 17-35). The
investment should be firm enough to support the cast
in this position as the initial set begins . The final set
requires approximately 15 minutes.
20. The investment flask rings can be of metal , Plex -
iglas, or polyvinyl chloride ( PVC) pipe; a 4-inch (10.16-
cm ) diameter pipe split lengthwise with a 1 Vi-inch (3.8- - .
Fig. 17 37 Investing ring of proper size for this cast denture base.
cm ) cutoff disk makes an excellent homemade Hask
( Fig. 17-36). A larger diameter pipe is suitable for es-
pecially large castings. Split all rings to permit expan - tronic timers to regulate the rate at which the temper-
sion and removal from the mold before placing it in the ature increases.
.
furnace The flask ring chosen for the case must have 22. Always place the mold in the furnace with the
enough vertical height for the sprue cone tip to be Vi sprue opening down and in such a position that the
to % inch (1.3 to 1.9 cm ) below the top of the ring ( F ig. mold touches neither the furnace walls nor other
17-37 ). This position will allow the recessed sprue lead molds. Burnout eliminates the plastic and wax patterns,
to be at least !4 inch (0.64 cm ) in the completed mold . and allows the thermal expansion inherent in the par-
21. Burnout cycles (time and temperature) vary with ticular refractory material to occur.
the refractory material used . Normallv, a burnout time 23. It is possible to cast the gold denture base in the
frame of 2 to 3 hours during which the furnace reaches conventional broken -arm machine with a gas-air or a
13( H) to 1350° F (704.5° to 732° C ) is used with a heat -
0
gas-oxygen torch to melt the metal . However, use of an
* soak period of 1 to 2 hours at the maximum tempera- induction casting machine assures more repeatable re-
ture . Most large, modern burnout furnaces have elee- sults. Although every technician has a technique for

i
474 Dental laboratory procedures: complete dentures

torch castings, the essential aspects are: to use a cruci - -

heads ( Fig. 17 38). Square off the peripheries of the
ble not contaminated from use with other alloys, to bal - casting with a disk or wheel until they are at an angle
ance the casting arm for the weight of the mold , to of 90 degrees to the palatal surface, and no flash re-
clean and flux the metal properly, to bring the metal to mains. The finished casting must fit the master cast *
j
the required temperature evenly and avoid overheat - without rocking. It is permissible to blunt sharp inter -
ing, to position the mold in the cradle as close as pos- nal ridges with finishing stones before the first attempt
sible to the actual moment of casting to prevent exces- at seating the casting. On the first indication of contact,
sive cooling of the mold , and to use a reducing flame use no more force. A powdered deodorant spray is an
on the torch . excellent disclosing material to demonstrate primary
24. Induction casting eliminates most of the human -
contact areas ( Fig. 17 39). Continue to adjust the cast-
error from the process. Specific instructions accompany ing with finishing stones until the casting is fully seated .
each induction casting machine. For example, with Je- Finish those areas not to be covered by resin with fine
lenko s Thermotrol 2500, the casting temperature is set stones, followed by rubber points and lathe polishing.
on the pyrometer, and the metal is placed in the cru - At this time, a high shine on these areas offers little
cible in the muffle at approximately 400° F (204.5° C ) advantage. The casting will receive considerable han -
below the casting temperature. The arm is wound with dling before completion of the denture , and the final
two turns and locked into position . A buzzer sounds polishing will be done at that time.
when the casting temperature is reached. It may be
-
necessary to heat soak the metal and visually verify that
the mass of metal is truly molten . The ring is removed
from the oven and placed in the cradle. With the metal
at the desired temperature, the arm is unlocked by
freeing it from the locking pin. At the drop of the pin ,
the arm can be released , and the casting completed.
Ilowmedica’s Electromatic Casting Machine is even
more sophisticated. It releases the casting arm auto-
matically when the radiation pyrometer indicates that
the desired metal temperature has been reached. Since
the arm is driven by a motor instead of a spring, the
rpm of the arm can be set, and a constant rate estab-
lished. Gold castings require a rate of 380 rpm . Other
settings for the Electromatic are as follows: range
switch , gold ; temperature controller, approximately
150° F (65.1° C ) above the midpoint of the alloy melting
range; soak timer, 45 seconds, centrifuge, 380 rpm ; Fig. 17- 38. Since upper halves of beads have no retentive value,
centrifuge acceleration: large melts ( more than 1 ounce they are removed with stone.
[ 28 gm ]), 40 to 50 and small melts ( less than 1 ounce
[ 28 gm ]) , 0 to 10; powder -selector switch : small melts ,
low and large melts, medium ; and pyrometer angle,
forward.
25. Remove the casting from the cradle, and allow it
to bench cool . Tap the mold with a wood or hard rub-
ber mallet to break away the refractory material easily
down to the paint-on layer. Do not break away the re-
maining layer of investment with blows from a hammer.
Since damage to the casting is too great a possibility ,
remove the final material with sand or walnut shell
blasting.
26. Remove the sprue leads with a large cutoff disk
mounted in a high-speed lathe. Do not attempt to cut
the sprue right down to the casting, but remove it at a
safe distance. Continue further reduction with a wheel
or three disks mounted on the same mandrel. Stop the
sprue reduction at the level of the middle of the reten -
tive beads. Then remove the upper half of the retentive Fig. 17-39. Indicator spray identifies areas of initial contact.

Chrome alloy cast base
PROCEDURE
1. The techniques for chrome alloys differ from those
*
for nolcl alloys, primarily in the investing and casting
procedures. If Ticonium is the chrome alloy, the refrae
tory material and investing and spruing techniques can
lx * identical to those for the gold alloys. Only the cast -
ing temperature differs. With chrome alloys , a thinner
cast base has enough rigidity, and often a 24-gauge stip-
-
ple sheet is adequate. For high heat chrome base al -
loys, such as \ itallium and Nobillium , it is essential to
use a phosphate or silica- bound investment, different
-
paint on and investing techniques, and a much higher
temperature burnout , 1800° to 2( )0()° F (982° to 1093°
C ). Cast all chrome base alloys in automatic induction
casting machines. Torch casting of alloys that melt
I During spruing, form a single wax lead from the sprue
Fig. 17- 40. Posterior sprue for Ticonium denture bases.
«r
Fig. 17-41. Multiple sprue leads for Vitallium denture base castings.
Insufficient metal was used in this casting.
Metal bases 475
above 2400° F (1315.5° C ) is a demanding technique
that requires considerable experience.
2. Master alternative techniques for spruing chrome
alloy bases. These techniques are for specific alloys, and
- complete instructions are available from each manufac-
turer of an alloy. For example , it is possible to sprue
and cast accurately Ticonium maxillary cast bases by us-
ing a single large sprue attached at the posterior border
and parallel to the hard palate ( Fig. 17-40 ). A mold for
making these large sprues is availalbe from the manu-
facturer . * On the other hand , it is best to sprue Vital-
lium from above by adding a fifth lead , or even a sixth ,
for exceptionally large casts ( Fig. 17-41).
3. Sprue Ticonium mandibular cast bases through the
base of the refractory cast like all Ticonium mandibular
removable partial denture castings ( Fig. 17-42 ). I bis
type of spruing requires special preparation of the mold
during the pouring of the refractory cast ( Fig. 17-43).
hole to the base of the casting at the lingual frenum
area. Make this lead of 8-gauge round wax, and flare it
at the junction point with additional wax to avoid form -
ing sharp angles ( Fig. 17-44 ). Wax the Ticonium sprue
cone in place for the paint -on layer and final investing,
and remove it before placing the ring in the furnace.
Mark the mold to indicate the desired direction of
metal flow during casting by aligning the single sprue
lead toward the seam in the flask ring ( Fig. 17-45).
.
Ticonium Albany, N . V.
Fig. 17-42. Mandibular base sprued through refractory cast.
476 Dental laboratory procedures : complete dentures
Fig. 17-43. Sprue hole former is placed in duplicating material to
precisely locate sprue hole in relation to ridge.
Fig. 17-45. Position of mold for casting mandibular base is marked
on mold with jeweler ’s rouge.
Aluminum alloy cast base
PROCEDURE
1. Aluminum differs considerably from gold and
chrome alloys. Being such a light metal , aluminum re-
quires a modification of the spruing, burnout , and cast -
ing techniques to achieve repeatedly acceptable results.
It is possible to cast Alcoa 1 )214 aluminum alloy as thin
as 26 gauge, but it is too fragile. A 22-gauge sheet is
dependable for casting and rigidity in the maxillary cast
bast . Mandibular castings normally should have two
* to the Howmedica Electromatic Casting Machine:*
thicknesses of 24-gauge aluminum alloy and additional
reinforcement provided by hand waxing and an I-beam
in the anterior area for special situations.
Fig. 17 44. Wax - up and sprue are connected by 8 - gauge round
-
wax lead that is flared where it is joined to wax - up.
2. The remainder of the wax-up is identical to that
for old or chrome base castings. Sprue the cast bases
^
with three 8-gauge round wax leads, one to the anterior
midline and the other two to the second molar areas.
Join these three leads over the center of the casting to
the wax cone. Have the cone 1 inch ( 2.54 cm ) above
the ridge crests. Add another 8-gauge round wax lead
to the crest of the ridge at the position of the right cus-
pid , and run it straight up to the side of the wax cone.
Sprue the maxillary and mandibular bases in the same
manner ( Fig. 17-46 ).
3. The refractory material used for aluminum alloys
is the same gypsum - bound investment used for gold or
Ticonium. The powder-water ratios are identical ; the
refractory cast , paint-on layer, and final investing also
are the same.
4. Place the mold in the burnout furnace at 1350° F
(732° C ). The burnout time is 1 hour at this tempera-
ture. At the end of this time, reduce the furnace control
to 650° F (343.5° C ). When the furnace reaches this
temperature the mold is ready for casting.
5. Since 1 )214 alloy melts at 15( K )° F (819 C ) and
solidifies at 650° F (343.5° C ), keep the casting arm
turning until the alloy has solidified. During this vital
phase, an induction casting machine is essential for a
casting technique to be dependable. The large induc-
tion machines used in routine chrome base alloy cast-
ings have belt -driven casting arms able to be set to de-
liver a specific rpm . Activated electrically, the arm runs
until switched off. The following settings are applicable
centrifugal accelerator, 30; melt , medium ; multisoak, 0;
•Howmedica. Inc., Chicago. III.

0 . -
Fig 17 46. Maxillary aluminum base wax -up properly sprued and
ready for paint - on layer of investment.
and rpm of casting arm , 300. Other induction machines
have similar settings, but it is essential to consult the
manuals of each manufacturer for specific information .
The lowest temperature setting for the Electromatic
* the finishing with a slow-speed lathe ( Red Wing or a
Casting Machine is 1600° F (871° C ). The Ticomatic
Machine* does not have a temperature-control reading
in degrees F; it is necessary to cast the metal by visual
reference.
6. With the mold in the furnace at 650° F (343.5° C ),
^ place the aluminum ingots in the induction crucible of
the Electromatic Casting Machine. Use this crucible for
aluminum only . Turn on the melt switch , and probe the
ingots with a quartz rod as they melt. When it is pos-
sible to push the top ingots into the mass, turn off the
melt switch , and allow the metal to cool until it turns
gray. .
7. Remove the mold from the furnace, and place it
in the cradle. Turn on the melt switch, and watch the
metal until it takes on the orange color of a harvest
moon . At that point , throw the automatic cast switch ,
and complete the casting. Keep the arm rotating for a
full 3 minutes.
8. Remove the cast and allow it to bench cool for 10
minutes before quenching it in running water. Remove
the hulk of the refractory material with a wax spatula or
a similar hand instrument under running water. Do the
final cleansing of the refractory cast by blasting it care-
fully with walnut-shell abrasives. Do not use a sand
blaster or a liquid hone under any conditions because
either one will pit and dull the aluminum alloy .
*Ticonium. Albany, N . Y.
Metal bases 477
.
Fig. 17-47 Resin added to periphery of cast denture base.
9. Since the aluminum allov is soft, exercise consid-
erable care in fitting and finishing the casting. Cut off
the sprue leads with a high -speed lathe. Do the rest of
similar lathe), or with a laboratory handpiece, finishing
stones, and burs. On a properly executed casting, the
metal will have a clean , shiny surface and require no
polishing.
Conversion of cast base to redord base
1. flic addition of autopolymerizing resin to the per-
ipheries on the master cast is the most reliable method
of converting the cast base to a record base. The resin
need only engage the outer retention on the periphery
of the casting ( Fig. 17-47). This will facilitate removal of
the resin during the boilout phase of packing and pro-
cessing the completed denture. (See Chapter 4 for the
technique used in adding this resin . )
2. Pack and process complete dentures with cast
metal bases in the same manner as conventional com -
plete dentures. There appears to be some advantage in
a resin system that does not require trial packing be-
cause it is easy to displace the cast base when opening
the flask . Myerson’s Duraflow* or any fluid resin will
serve this purpose. After boiling out the denture , re-
move the cast base, and burn off the peripheral resin
by heating it with an alcohol torch until it softens, and
remove it with cotton forceps, or a similar tool. Cleanse
the metal carefully of all debris, and seat it back on the
master cast immediately after painting it with tinfoil
* Mycrson Tooth Corp.. Cambridge, Mass., or similar material .
 478 Dental laboratory procedures: complete dentures
substitute. If the cast is warm and the separator is new,
the casting will be fully seated and retained in place by
the set separating medium .
3. If the casting fits the master cast accurately , no
Hash of cured resin should show on the tissue side. Anv w
imperfection in this adaptation will result in a thin Hash
that is readily removable with a finishing bur or a stone
run at slow speed ( Fig. 17 -48). An aluminum alloy base
demands care in finishing to avoid cutting into the
metal because it is much softer than a gold or chrome
alloy base.
SUMMARY
Cast metal bases for complete dentures must be con -
sidered an adjunct to routine care for the dentulous pa-
tient . Fortunately, they are not complicated to con -
struct , and when made of nonprecious alloys, they
should not prove to be so costly as to eliminate them
from consideration as an alternative to the conventional
denture.
/ Cast metal bases are indicated as the treatment of
choice under certain conditions: allergic reactions to
-
dental resins, fracture prone dentures, instances where
additional weight is required in the mandibular den -
ture, and similar special situations . For these reasons
the master dental technician must be prepared to offer
them as a treatment modality .
L
1
*
Fig. 17- 48. Internal resin flash is removed with slow- speed round
bur.
REFERENCES
Bell. D ll . , Finnegan , F. J ., and Ward. J . E .: Pros and cons of hard
and resilient denture base materials. J . Am. Dent . Assoc. 94:511,
1977
DeFurio, A . , and Geld , I ).: Clinical study of the retention of maxil -
lary complete dentures with different base materials. J . Prosthet .
-
Dent 23:374 380, 1870,
Faber, B. L.: Lower case metal denture, J . Prosthet. Dent . 7:51-54,
1957
Crunewald , A. II.: Gold base lower dentures, J . Prosthet. Dent.
14:432-441 , 1964.
Hansen, C.: Phonetic considerations of chromium alloy palates for
complete dentures, J . Prosthet . Dent . 34:620-624, 1975.
Jha. M .: A study of tissue response to metallic ( aluminum ) denture
base, J . Indian Dent. Assoc. 44:122- 126, 1972. #
Lang, B. R.: The use of gold in construction of mandibular denture
. -
bases J . Prosthet . Dent . 32:398 404 , 1974 .
Lundquist , D.O.: Aluminum alloy as a denture base material, J .
Prosthet. Dent . 13:102-110, 1963.
Moore, F. D.: Organic or metal bases for denture. J . Prosthet . Dent .
17:227-231 , 1967.
Regli , C . P. , and Kvdd, W. L.: Preliminary study (if the lateral defor-
mation of metal base dentures in relation to plastic base dentures,
-
J . Prosthet . Dent. 3:326 330, 1953.
-
Sizeland Coe. J . W.: Superpurity aluminum in dental prosthesis , Br
Dent. J . 91:263-268, 1951.
 CHAPTER 18
MAXILLOFACIAL PROCEDURES
FREDRICK M. MATVIAS
obturator A prosthetic substitute that restores a defect by occupy-
ing a space created as the result of loss or absence of tissue,
generally in the maxillary arch. An obturator should be light in
weight, stable, nonirritating, comfortable, simple in design, read-
ily removable, and capable of restoring both contour and physi-
ologic function, such as speech and swallowing ( Appleman,
1951 ). The total restoration of function, as well as anatomic con-
tour, may be impossible.
immediate ( surgical) obturator An obturator that is placed imme-
diately after surgical removal of tissue, generally after tissue is
taken from the hard or the soft palate.
J
In general terms, maxillofacial prosthetics is the art
and science of anatomic, cosmetic, and /or functional re-
construction and rehabilitation of missing or defective
body areas by means of prosthetic substitutes ( Hahn and
Boucher, 1970 ). The defects are acquired or congenital
in nature.
All laboratory techniques should use proper and ac-
ceptable prosthodontic principles. Since success de-
pends on the correct application of materials, it is es-
sential to follow accurately all instructions of the
manufacturer. A knowledge of basic head and neck
anatomy is important . Training should include exposure
to the many problems that challenge the imagination
and lead to the development of many approaches that
produce similar results. The purpose of this chapter is
to present some of these approaches.
IMMEDIATE OBTURATORS
Requirements
Immediate obturators should restore the contours of
the hard palate and , il possible, portions of the soft pal -
r\ ate immediately after their loss , which has tremendous
psychologic benefit for the patient . Although it may be
impossible to restore complete function at this time,
food contamination and unfavorable scarring will be
minimized .
Materials
Immediate obturators generally are of either chemi-
cally or thermally activated acrylic resin that is pink or
clear. The use of metal is rarelv feasible at this time.
The impression can be of any material, but usually it is
of irreversible hydrocolloid .
PROCEDURE
1 . Pour the impression with artificial stone using the
proper method designated by the clinician , and then
trim it carefully to avoid loss of deliberate posterior and
lateral extensions ( Fig. 18- 1 ).
2. Return tin * cast for outlining of the area to be re-
moved surgically.
3. After completion of the outlining, duplicate the
cast , cut oft any teeth to be removed in a manner sim -
ilar to that used in immediate denture fabrication , and
prepare the cast to maintain or form a typical palatal
contour.
4. Deepen the sulcus in the area of the defect , and
round it to provide a smooth , round , slightly overex-
tended peripheral roll, thereby avoiding trauma to the
soft-tissue cut edges.
5. If the patient has any natural teeth left , block out
unnecessary undercuts; however , if the patient is eden -
tulous. block out severe undercuts minimally, and only
il requested .
ft. Duplicate this prepared cast , and adapt wire clasps
at this time if desired ( Fig. 18-2 ).
479
F 480 Dental laboratory procedures : complete dentures

Fig. 18- 1. Properly poured and trimmed cast used as pretreatment Fig. 18- 2. Teeth are removed in area of surgery, cast is smoothed,
record. clasps are adapted with tooth undercut blockout if needed, and pe-
ripheral vestibule is contoured to achieve smooth roll.

> t

Fig. 18-3. Properly fabricated immediate obturator with smooth pe- Fig. 18- 4. Lateral hole placement for possible postoperative zygo-
ripheral roll and interproximal holes for fixation. matic wire fixation.
 Maxillofacial procedures 481
Clinically activated resin obturator
PROCEDURE
l
1. Make a chemically activated resin obturator in a
k manner quite similar to a record base . NOTE: soft resin
from other methods of stabilization used in making rec-
ord bases is not satisfactory for obturators initiated on
properly prepared casts.
2. After completion of processing, chip away the
working cast to avoid warping the resin .
3. Trim the acrylic resin , and polish it in a manner
that does not result in loss of the desired form or con -
tour.
4 . Fit the obturator to the duplicate prepared cast to
assure accuracy ( Fig. 18-3).
5. If it is necessary to have retentive holes for wire
or pin fixation , use a No. 6 round bur for the correct
diameter. Place these holes approximately between the
second premolar and first molar areas bilaterally and in
the area lateral to the anterior frenum or in the middle
of the palate where it is possible to use orthopedic - Fig. 18- 5. Immediate obturator without loss of any teeth for hard
screws ( Fig. 18-4). palate resection only.
6. When natural teeth remain , use interproximal
holes for wire fixation to the remaining teeth. The in -
clusion of artificial teeth is rare; they must be anterior Materials
teeth only. Chemically activated or thermally activated acrylic
resin or metal with either of the two resins are the ma-
Thermally activated resin obturator terials of choice.
PROCEDURE
Chemically activated resin interim obturator
1. Allow the prepared cast to dry, and then adapt
PROCEDURE
baseplate wax to a uniform thickness over the cast , usu -
* ally approximately 2 mm . 1. Pour the impression correctly with artificial stone.
2 . Flame the wax smooth , and invest and separate The impression can include the surgical obturator. Dis-
the flask in the usual manner. card the obturator if it has served as a tray , but not if it
3. Mix and compression - mold the acrylic resin , and is necessary to add an extension to the original obtura-
use a short or long cure. tor .
4 . Recover and polish the obturator. 2. After obtaining the master cast , prepare it as when
5. Do not warp the obturator by trying to salvage the making a record base, but do not block out any under -
working cast . cuts .
f 6. Place the retentive holes as described previously . 3. If natural teeth are present , survey and block out
the undercuts, adapt clasps, and use lug rests if not us-
INTERIM OBTURATORS ing a metal frame.
An interim obturator is a transitional obturator fabri - 4. Apply resin by the method of choice.
cated after the surgical removal of tissue but before 5. Add teeth when a bite registration and an oppos-
complete healing. It may be the first obturator or a ing cast are available.
modification of the surgical obturator. Usually only an - 6. Avoid warping the master cast during recovery .
terior teeth are replaced , if any. 7. If the defect is particularly large , make the bulb
hollow to minimize the weight , as described later in
Requirements this chapter.
Requirements of interim obturators include those of 8. Pumice and buff lightly the bulb portion of the
the immediate obturators. It is necessarv to restore obturator to preserve the surface detail .
function , that is , speech and swallowing, to some extent 9. Use tape to protect the teeth present from damage
at this point ( Fig. 18-5). during polishing.
n.
wrr/
482 Dental laboratory procedures : complete dentures

Fig. 18-6. Transitional obturator that provides some restoration of Fig. 18- 7. Maxillary cast after pouring and proper trimming to pre-
soft palate defect is made quickly from chemically activated resin. serve necessary structures, including defect area.

10. Wlii'ii adding a hull ) to a previously fabricated

surgical appliance , clean the old resin , free it of wax
and other contaminants and . if needed , freshen it by
roughening with a bur.
11 . Provide mechanical retention if the previous ap-
pliance has been ot thermally activated resin . T he cre-
ation of dovetails is adequate, and a tapering or beveled
finish is more acceptable than a butt-joint finish line
( Fig . 18-6).
Thermally activated resin interim obturator
PROCEDURE
1 . Dry the master cast , and trim it so that it will be
conducive to flashing.
2. Reduce the severe undercuts by flowing wax into
these areas.
3. Soften additional baseplate wax , and adapt it to Fig. 18-8. Surveyed, blocked out cast with defect are recontoured
form a base approximately 2 mm thick . before framework wax -up.
4. If the defect area is particularly large, use a hollow
bulb to reduce the weight.
5. In setting artificial teeth on a cast mounted by Metal framework with resin interim obturator
means of an intermediate record base , arrange them for
the best esthetic effect . Often a try- in aids in obtaining PROCEDURE
the best results. I . Survey and design a master cast to provide reten -
6. Survey the natural teeth , and block them out with tive areas that resist displacement forces . This retention
appropriate clasp adaptation. consists of lingual retention with buccal reciprocation ,
7. Invest the waxed obturator with the clasps held in alternate buccal and lingual retention , or possibly a
place by stone. -
well designed latch or swing lock .
8. Process the case according to an established rou- ‘2. Follow the design accurately in blocking out . du - .*
tine. plicating, and waxing.
 Maxillofacial procedures 483

.
Fig. 18-9 Completed wax pattern for maxillary resection frame- - .
Fig . 18 10 Maxillary framework completed.
work.

3. Fill the defect with clay or wax, carve it to simti-

late normal palatal contour, and allow space for the
resin to he retained by the metal ( Figs. 18-7 and 18-8).
4. Place an internal finish line to allow the resin to
flow in the area of the surgical cut on the hard palate,
thereby facilitating relief in this area if needed.
5. The external finish line can simulate a median pal -
atine fissure when appropriate, or it can be slightly
lower in the defect, thereby resulting in a relatively
smooth palatal contour ( Fig. 18-9 ).
6. If the surgical excision involves the anterior labial
frenum area, design the metal to allow ease of adjust-
ment and to avoid metal impingement or overextension
into the soft tissues.
7. Invest the cast as if it were a removable partial
denture framework; cast , recover, and polish it ( Fig.
18- 10).
8. After try-in , return the framework for addition of
resin to the defect using the original cast or a modified - .
Fig. 18 11 Completed interim-type obturator with metal framework.
altered cast if needed to redefine the defect.
n 9. Add resin of either the chemically or thermally
activated type ( Fig. 18- 11 ).

t
484 Dental laboratory procedures: complete dentures
DEFINITIVE OBTURATORS set for 10 minutes to permit redissolving of trace gases
A definitive obturator is for patients whose healing into the polymer.
after surgical management of a tumor or after trauma is 8. Pour the mixture into the defect area ( Fig. 18-19).
complete. All healing changes have stabilized , and the Place the stone core , and hold the halves to allow cur-
patient has minimal discomfort . The patient can be to- ing ( Fig. 18-20). A cure of about 24 hours at 23° C is
^
tally edentulous, partially edentulous, or dentulous. required. At 40° C, a 5-hour cure is noted. The material
The defect can involve the hard palate, the soft palate, is cured in 5 minutes at 150° C , 15 minutes at 100° C ,
or a combination of both . 30 minutes at 75° C , and 2 hours at 55° C.
9. Separate and save the key and cast ( Fig. 18-21).
Requirements 10. Duplicate the silicone bulb and cast with hydro-
These obturators satisfy all requirements for surgical colloid to obtain a working stone cast ( Fig. 18-22 ).
and interim obturators and provide a maximum seal 11. Remove the silicone bulb; it will be mechanically
during function to allow refinement of swallowing and retained on the finished acrylic prosthesis ( Fig. 18-23).
speech . The addition of artificial teeth will restore es-
thetics and contours.
Materials
The prosthesis can be resin , metal , resin and metal ,
or resin and silicone. It is possible to attach the bulb of
the defect portion of the obturator to the rest of the
prosthesis or keep it separate.
Impressions can be of any type, but it is necessary to
box them to make the stone of an adequate, uniform
thickness throughout the defect area. Record bases or
processed bases are used to obtain proper centric rec-
ords. Set artificial teeth conventionally, according to
the occlusal scheme selected by the clinician.
A hollow bulb reduces weight and increases the com -
fort of the patient . The bulb can be of silicone or acrylic
resin , made in one piece or several pieces. The best
approach is to simplify the design as much as possible. Fig. 18- 12. Defect area before wax shim adaptation.
Silicone bulb
PROCEDURE
1 . Duplicate the master cast to form a working cast.
2. Outline the extension of the bulb. It usually fol -
lows the palatal contour ( Fig. 18- 12).
3. Adapt a uniformly thick wax shim .
4 . Index or key the lip of the waxed bulb to provide
mechanical retention ( Figs. 18-13 and 18- 14 ).
5. Pour a stone cap into the wax bulb with stops after
applying silicone release or foil ( Fig. 18-15) .
6. Boil out, separate, and dry the mold . It is critical
to remove the foil at this time. Apply silicone release
or liquid-soap separator to the cast and stone cap ( Figs .
18- 16 and 18- 17).
7. Mix the Dow Corning MDX 4-4210* thoroughly
(one part curing agent to each ten parts by weight of
the base material ) ( Fig. 18-18 ). Entrapped air can be
removed by exposure to a vacuum of 28 inches (71.1
cm ) of mercury for 30 minutes. Allow the material to

*
* Dow Coming Corp., Midland , Mich. Fig. 18-13. Waxed obturator with blocked undercuts.
 MaxilIofacid I p rocedu res 485

- .
Fig. 18 14 Completed wax shim with lip and mechanical undercuts.

-
Fig. 18 15. Stone cap.

; §
A *

f «1

<

J
1
. -
Fig 18 16. Side view of cap showing mechanical retention bulb .

I
 486 Dental laboratory procedures: complete dentures

Fig. 18- 17. Stone cap and defect areas devoid of wax . Foil is removed, and silicone release is
applied.

Fig. 18- 18. Dow Corning MDX 4- 4210 curing agent, left , and base
silicone, right.

i c*

Fig. 18- 19. Mixture poured into defect.

 >

Fig. 18-20. Cap in place to allow curing. Fig. 18- 21. Silicone bulb .

Fig. 18- 22. Working (processing) cast.

Fig. 18- 23. Removal of silicone bulb.

}
488 Dental laboratory procedures: complete dentures
Hollow acrylic bulb
TWO- PIECE PROCEDURE
1 . Use two flasks with interchangeable upper halves.
2. Invest the bulb in the bottom half (drag) of the
flask . No. 1, and the remaining portion of the prosthesis
in the top half (cope).
3. Separate, boil out . and allow it to dry .
4 . Line the bulb form with a single thickness of base-
plate wax after blocking out the undercuts. Avoid any
mechanical lock, thereby preventing the stone core
from drawing.
5. Press the top half of the first flask , and hold it in
position relative to the bottom half of the flask to form
a key or contact with the remaining prosthesis, or carve
a key in the wax.
6. Remove the top half of flask No. 1 .
7. Place the top flask No. 2 with the bottom flask
No. 1 , invest and complete the boilout procedure.
8. Compression - mold the bulb, and process it in a
conventional manner .
9. Fill the bulb with stone up to the previously des-
ignated key , but do not interfere with the key . Place
tinfoil substitute over the stone core and acrylic resin.
Discard the upper half of flask No. 2.
10. Return the upper half of flask No. 1 , pack and
process.
11 . Recover the obturator bulb, and trim the two
pieces.
12. Use the previously established keys, and lute the
two pieces together with chemically activated resin.
13. Verily the continuity of the seal by placing the
bulb in a bowl of water , and check it for water seepage.
Fig. 18- 24. Processed bulb with split master cast.
If there is a leak , drain the bulb, and place a new seal.
14. Do not place the bulb in any pressurized con-
tainer, such as a pressure pot , until after curing the seal
to prevent perforation and seepage ( Malson , 1955).
In a variation of the procedure, make the following
changes:
1 . Four the final impression with the appropriate ar-
tificial stone, and then duplicate the cast .
2. Wax the bulb portion , invest it , process it . and
recover it from the investment.
3. Split the master cast by sawing through the stone
partially , and then break the cast carefully. This proce-
dure makes it possible to reorient the bulb to the re-
maining tissues ( Figs. 18- 24 and 18-25).
4. Hold the bulb in position with a rubber band , and
then fill it with clav or blockout wax, but leave the kev
9 9
exposed .
5. Duplicate the cast , and use it to fabricate record
bases.
6. Set the teeth where indicated ( Fig. 18-26).
7. Process the obturator against the keyed , duplica-
ted cast ( Fig. 18- 27).
8. Process the halves separately, and lute them to-
gether with chemically activated resin ( Fig. 18-28 ).
In another variation of the procedure, the following
changes are made:
1 . Make record bases on the master cast in the usual
manner with the defect area blocked as needed .
2. Complete all final setups.
3. Wax, and prepare it for finishing.
4. Wax the bulb solid.
5. Complete the investing* and processing proce-
dures.
Fig. 18-25. Bulb repositioned in master cast.
 Maxillofacial procedures 489

6. Recover, and hollow the bulb by grinding the
resin with burs. Maintain approximately 2 mm for ad
justments to the exterior surface of the bulb. Initiate
the grinding from a noncritical area, and create a step
* or a key around the lip of the hole.
7. Use clay to fill the bulb, and form a proper contour
- for the external surface of the cap.
8. Adapt foil to the clay and the key , and make a
chemically activated resin cover.
9. Seal the lid or cap to the bulb with chemically
activated resin ( Fig. 18-29) (Chalian and Drane, 1972).

Fig. 18 26. Teeth can be set on master cast with previously pro-
- - .
Fig. 18 27 Processed obturator.

> . cessed bulb.

t Fig. 18 28. Completed large acrylic resin hollow bulb obturator.

- Fig. 18 29. Hollow bulb obturator was fabricated by grinding from
-
superior surface and capping with chemically activated resin.
I
Fig. 18-31. Palatal view of obturator shown in Fig. 18 -30.
Table 18- 1. Immediate obturators
Problem
Loss of lateral and posterior
extension
Improper fit
Fracture of acrylic
Table 18-2. Interim obturators
Problem
Loss of labial tooth form
Failure of new resin to bond
to previous resin
Fig. 18- 30. Hollow bulb obturator from tissue side was fabricated in
'
one-step procedure.
Probable cause Solution
Improper trimming and polishing Refer to outlined cast after processing
Warpage during removal from working cast Reduplicate prepared cast; review removal
procedure
Improper storage, polishing, processing Review method for record base fabrication
Uneven placement of resin Review method for record base fabrication
Probable cause Solution
Overpolishing Cover teeth with tape prior to polishing; use rubber cup with
pumice
Contamination Use proper boilout with clear water
Lack of mechanical retention Provide mechanical retention, especially when adding
chemical resin to thermally activated resin
r
 Maxillofacial procedures 491
ONE- PIECE PROCEDURE MANDIBULAR RESECTION DEVICES
1. Invest the waxed and festooned obturator in a den - A mandibular resection device is any appliance or de-
ture flask in the usual manner. vice used to retrain the muscles so that the remaining
* 2. Separate the obturator, clean it , and allow it to mandibular segment functions in a more physiologic
drv. manner. It provides a degree of functional ability and
3. Block out severe undercuts, and adapt a wax shim restores esthetics by replacing teeth and improving fa -
in the defect areas in the upper and lower halves of the cial profiles and contour in patients in whom a portion
flask . of the mandible has been removed to control cancer.
4 . Press together the halves of the flasks to key the Mandibular resection devices are of two ty pes, eden -
halves of the wax shim . tulous and dentulous. An edentulous patient uses a re -
5. Cut a tripod system of stops to the stone in each movable maxillary appliance with a guide ramp located
half of the wax shim. in the palatal side of the maxillary teeth to guide the
6. Mix chemically activated resin , and pour it in each motion of the mandible to a relatively correct relation -
half after placing tinfoil substitute in the stops. ship. Maxillary and mandibular loops and guide bars of
7. Put the halves together, and rotate the cases dur- metal or acrylic resin attached to removable partial
ing the curing cycle of the resin . dentures also can provide a hingelike action .
8. Separate the flask , thereby producing a hollow An edentulous patient requires a specifically de-
resin bulb core. signed occlusal scheme to provide function and possible
9. Mix the thermally activated resin , and compres- correction of mandibular deviation.
sion - mold with the hollow core in place.
10. Complete the processing, and recover the obtur- Requirements
ator ( Figs. 18-30 and 18-31) ( Chalian and Barnett, The appliance should be comfortable and nonirritat -
1972). ing, compatible with the oral environment , stable, and
easy to clean . Restoration of function and esthetic con -
PROBLEM AREAS FOR OBTURATORS
tours may be secondary or obtainable only in part, but
Some of the potential problems are noted in Tables they are essential aspects to consider.
18-1 to 18-4. Most are caused by improper procedure
sequence. Materials
Mandibular resection devices can be of metal, acrylic,
or acrylic and metal combined. Establishing a proper
s occlusal scheme is the major difficulty from the labora-
tory standpoint .
Table 18- 3. Definitive obturators
Problem Probable cause Solution Edentulous mandibular resection device
PROCEDURE
Loose record Overrelief ( blockout ) Minimize blockout
bases 1 . Mount the maxillary and mandibular record bases,
Improper use of soft Review technique or key them in a position acceptable to the clinician .
resin
Warpage during re- Review technique
2. Set the maxillary anterior teeth in a conventional
covery manner.

Table 18-4. Hollow bulb obturators

Problem Probable cause Solution

Fluid leakage Inadequate seal Redesign keys; avoid rushing; do not use pressure pot ; use
adequate amount of chemically activated resin; use of
adequate cementation ( silicone bulb)
Perforation after adjustment Improperly relating bulb to remain- Wax patch with baseplate wax; form stone key ; repair hole
der of case with chemically activated resin
Inadequate thickness of bulb walls Walls should be uniform in thickness
*
 I
492 Dental laboratory procedures: complete dentures
3. Set the maxillary posterior teeth in an ideal posi -
tion mediolaterallv, but rotate them about their axes so
that the lingual cusps are lower or more inferior to the
buccal cusps on the nondefect side.
4. Place a piece of plastic or compound in the region
of the second premolar to the second molar on the non -
defect side, and lute it to the record base with hard wax
or a compound such as modeling plastic. This ramp has
its most medial margin ( relative to the midline) inferior
to the maxillary occlusal plane, and its lateral margin is
continuous with the maxillary posterior rationale teeth .
5. Set the posterior teeth on the defect side conven -
tionally if there are no opposing teeth or in a manner
harmonious to the inclination of the ramp if there are
teeth in the opposing arch .
6. Then position the mandibular anterior teeth with
Fig. 18-32. Tentative placement of mandibular teeth
Fig. 18- 33. Ridges are not parallel, and initial tooth placement
should allow rotation of defect side superiorly .
i
the niidline corresponding to the maxillary anterior
teeth and slightly anterior to the crest of the ridge.
*
7. Position the mandibular posterior teeth mediolat -
erally with the cusp or the central groove over the crest *
of the ridge ( Fig. 18-32).
8. Determine the height by the level of the maxillary
teeth or halfway up the retromolar pad . The inclination
of the posterior teeth harmonizes with the maxillary
ramp. The interarch relationship may or may not ap-
pear conventional at this point . If the arches appear
parallel anteroposteriorly, have the teeth on the defect
side touch on complete closure. If the mandibular arch
is not parallel, that is, usually open on the defect side,
leave a space between the teeth ( Fig. 18-33).
9. The patient returns for a try-in , and one of the
following approaches is used: (a ) wax of a functional na-
ture is added to the ramp, and a functionally generated
occlusion is established; ( b ) the ramp is adjusted in a
mediolateral and an anteroposterior position and angle
of inclination to guide the mandible smoothly to a more
correct vertical and lateral relationship ( Figs. 18-34 to
18-36). A new centric record is made at this time.
The resection appliance will be returned and re-
mounted in the revised position . The teeth should be
reset. If the mandibular position falls short of ideal, a
double row of teeth , one for esthetics and contour and
one for function , may be set ( Fig. 18-37 ). The functional
row will establish an occlusal surface or table more sat -
isfactory for mastication at the deviated position . The
ramp should be smooth and continuous so that the
mandibular teeth do not trip'or catch during the closing ^
cycle ( Figs. 18-38 to 18-41).
10. Process in resin any functionally generated occlu -
sal pattern developed on the ramp .
Fig. 18-34. Functionally generated occlusal surface of ramp .
 Maxillofacial procedures 493

. -
Fig 18 35. Adjustment of ramp and posterior teeth with compound Fig. 18 36. Anteroposterior and mesiolateral positions are adjusted
-
to allow mandibular movement . to provide proper initial contact and smooth sliding mechanism.

- .
Fig. 18 37 Two rows of teeth have been set — one for appearance Fig. 18 38. Completed maxillary component of mandibular resec-
-
and one for function. tion device.

-r
V"
494 Dental laboratory procedures: complete dentures
Fig. 18-40. Completed appliance inserted with patient's teeth
open position.
Dentulous mandibular resection device
Two approaches to use for patients with teeth are as
follows: ( 1 ) make a maxillary removable appliance with
a guide ramp or ( 2 ) make a mandibular guide prosthesis
with or without the maxillary component . In both in -
stances, the objective is to provide a method to correct
the mandibular deviation on completion of closure.
PROCEDURE
1 . Survey the cast to determine favorable undercuts.
2. Achieve appropriate blockout.
3. Duplicate the master cast .
Fig. 18-39. Posterior view showing necessary angulation
of ramp and teeth.
in Fig. 18-41. Patient s teeth in closed position.
4. Adapt clasps of choice, usually from orthodontic-
type wire.
5. Add thermallv or chemieallv activated resin to the
* #
palatal aspect of the maxillary cast .
6. Add a plastic ramp to the nondefect side with com -
pound until the lingual cusps tips arc* Hush with the
surface of the ramp, so that the mandibular cusps will
glide smoothly to the proper occlusal contact.
7. Return the appliance for ramp angulation and
overall dimension determination .
8. Make a stone core.
9. Construct the ramp by adding more resin ( Figs.
18-42 to 18-46).
 Maxillofacial procedures 495

.
Fig. 18- 42. Acrylic resin maxillary guide ramp Fig. 18- 43. Lateral view of acrylic ramp showing initial contact of
mandibular teeth .

Fig. 18- 44. Closure of patient’s teeth without aid of guide ramp. Fig. 18- 45. Initial closure of patient 's teeth with ramp placed on left .
Note deviation of mandibular toward defect side. Note lack of closure on right .

Fig. 18- 46. Closure after adaptation to guide ramp.

r
496 Dental laboratory procedures: complete dentures

Mandibular guide prosthesis 5. Solder the loop

PROCEDURE
1 . Design a removable partial denture framework
that has lingual retention on the nondefect side and
buccal retention on the defect side.
2. Cast a rigid metal loop. Design it for soldering to
the buccal aspect of the mandibular framework .
3. Try in the partial denture, adjust it , and return it
with a centric record for accurate mounting.
4 . Position the loop so that it will contact the maxil -
lary teeth during function . The vertical dimension is
slightly less than the maximum opening to allow place-
ment by the patient.
6. Set the artificial teeth ( Fig. 18-47 ).
Following is an alternate approach to making a mai
dihnlar guide prosthesis:
1 . Design a maxillary framework and cast with hucc
retention on the nondefect side and lingual retention <
the defect side.
2. Solder a bar to the buccal clasps on the nondefe
side of the buccal arms approximately the length of tv
teeth ( Fig. 18-48).
3. Make the mandibular framework as described pr
viously for mandibular guide prostheses, but have tl
loop glide over the maxillary bar rather than over tl
teeth .

Fig. 18- 47. Mandibular guide prosthesis with wire loop soldered to
framework to guide mandible in hinge-like opening and closing.
-
Fig. 18- 48. Maxillary removable partial denture with guide bar s
dered to clasps.

Table 18- 5. Mandibular resection device

Problem Probable cause Solution

Uneven ramp surface
Loss of posterior teeth during
processing
Inadequate framework reten-
tion
Inadequate loop height
Failure to fill spaces between rows Give proper attention to waxing detail
of teeth
Overmodification of esthetic row of Reduce excessive modification; cement teeth to stone
teeth prior to application of tinfoil substitute
Poor design Review design principals
Poor loop positioning Obtain record of maximum opening
 Maxillofacial procedures 497

Acrylic resin guide flange

PROCEDURE
1. Design the mandibular framework as described
f earlier.
2. Add an acrylic resin guide to the buccal aspect ol
the teeth on the nondefect side rather than on the
metal loop (Ackerman. 1955).
PROBLEM AREAS FOR MANDIBULAR
RESECTION DEVICES
The more common problem areas for mandibular re-
dev ices are summarized in fable 18-5.
section

SPEECH AIDS
A speech aid is a prosthesis or an appliance used to
help produce or improve the quality of speech in the Fig. 18- 49. Maxillary speech bulb for patients with edentulous cleft
patient for whom surgical correction of this problem is palates.
impossible, generally a patient with a congenital cleft
palate. The aid can consist of an obturator-like bulb
( Fig. 1S--49 ) or a maxillary palatal midline extension
known as a palatal lift ( Fig. 18-50). A speech bulb com -
pensates for a congenitally or surgieallv shortened soft
palate. A lift raises the soft palate structures physically ,
and thereby promotes palatal function . It can serve as a
diagnostic tool to determine whether surgical reposi-
tioning of the palate would be beneficial.

Requirements
A speech aid should improve the quality of speech ,
and it must be easy to clean , lightweight , comfortable,
• and retained adequately.
Materials
Speech aids can be entirely acrylic or metal with an
acrylic lift or bulb portion .
Acrylic resin palatal lift Fig. 18- 50. Maxillary palatal lift with connector (i.e . , partial denture
PROCEDURE framework ).

1. Pour the impression with stone, and trim it , leav-

ing the posterior extension intact .
2 Adapt wire clasps with distal undercuts. Adams
.
clasps often are ideal .
3. Survey the teeth and block them out .
,
4 . Duplicate the cast.
5. Position the clasps.
6. Add acrylic resin , usually orthodontic type, with a
midline posterior extension . Wherever indicated , initi -
ate soft - palate relief.
7. As an alternative to chemically activated resin ,
process with thermally activated resin .
8. Polish the lift , and return it with wax or compound
f added to the tissue side when corrections are needed.
9. Use an altered cast technique or a stone core fab-
ricated with the necessary corrections made of resin .
Make the posterior extension thin, but not thin enough
to fracture under stress.
Metal framework with reenforced acrylic
posterior extension
PROCEDURE
1. Block out a master cast according to the designated
design.
2. Use distal retention generally.
3. Duplicate the cast in a refractory model, and com -
plete the wax - up.
498 Dental laboratory procedures : complete dentures
Fig. 18- 51. Posterior extension is added to provide support for
acrylic component of lift .
Fig. 18- 53. Casting of separate tailpiece to be soldered later.
Fig. 18- 52. Different design possibility for posterior extension.
4. Make a metal extension posteriorly. Use a pattern
for a mandibular lingual bar with retention placed in
the posterior segment ( Figs. 18-51 and 18-52).
5. Provide relief for the resin to encompass the distal
extension retentive area.
6. Cast the distal extension separately , and solder it 4
to the palatal major connector ( Fig. 18-53).
7. Cast and finish the framework .
8. Return it for try in . -
9. Compound or wax is added for the appropriate
amount of lift action .
10. Make an altered cast .
11. Section the tailpiece, and resolder it ii necessary.
12. Add wax , and process the lift as if it were a partial
denture.
Edentulous and dentulous maxillary speech bulb
A maxillary speech bulb uses many of the techniques
associated with a maxillary obturator. Speech bulbs ob-
turate, and thereby improve velopharyngeal valving
and facilitate speech . They can be dentulous or eden -
tulous.
PROCEDURE
1. Make and design the major connector or denture
like * any other complete denture or removable partial
denture.
2. Place the clasp retention to the distal side.
3. Make the connector between the bulb and base of
the denture of metal or acrylic.
 Maxillofacial procedures 499

Fig. 18-54. Posterior connector or tailpiece should dip into defect .

Finish lines and relief should be provided .

Fig. 18-55. Maxillary speech aid with distal retention, maxillary ob-
turator for palatal defect , and hollow posterior speech bulb.

Table 18-6. Speech aids

Problem Probable cause Solution

Inadequate prostheses retention
Soft-palate irritation
t Fracture of posterior extension
Inferior placement of tailpiece
Exposure of retention mesh
Displacement forces not considered in design
Inadequate tailpiece relief
Inadequate metal or resin thickness
Failure to use altared cast
Failure to place retention mesh superiorly
Distal undercuts required
Make sure resin or metal does not contact
soft palate at rest
Reenforce resin with metal or use mandibular
lingual bar pattern for adequate thickness
Cut and resolder metal ; modify acrylic resin
Section and resolder tailpiece using new
stone cast

4. Indicate relief in the range of 30-gauge wax to pre-
vent the connector from impinging on the soft palate.
Incorporate a finish line in the design of the connector
for both the bulb and the palatal portions.
5. Have the most posterior extension of the bulb con -
nector dip into the defect, so that the acrylic bulb can
begin at the soft palate and extend superiorly. Consid -
erable inferior extension will result in impingement of
the tongue during function ( Fig. 18 54 ). -
6. Return the frame with the bulb connector for an
impression . Make an altered cast , that is , trim the pos-
terior of the cast , seat the denture or metal base, and
pour stone around the bulb impression.
7. Make the bulb hollow as for hollow maxillary bulb
obturators ( Fig. 18-55) . clean, capable of accepting makeup and intrinsic and
8. Process the denture and bulb portions simulta
neously.
PROBLEM AREAS
Five problem areas in reference to speech aids are
discussed in Table 18-6.
FACIAL PROSTHESES
A facial prosthesis is an extraoral removable pros -
thesis used to restore a missing or defective area of the
body . The restoration is usually anatomic, functional,
and esthetic. It may be a nasal , orbital , ocular, or auri -
cular (ear ) prosthesis, or some other type.
Requirements
Facial prostheses should be comfortable, nontoxic,
nonallergenic, reasonably esthetic, translucent , easy to
- extrinsic coloration , flexible and natural to touch , easy
to make, inexpensive, retentive of fine detail for a long
 500 Dental laboratory procedures: complete dentures

Fig. 18- 56. Three nasal prostheses: polyurethane , left ; s

cone , center; and polyvinyl chloride , right .

time, mechanically retentive or receptive to adhesive

with a fine line marginal contact , and easy to duplicate.
Maximum esthetics depend on matching shades and re-
producing details by sculpting ( Fonseca , 1966;.
#

Materials
The most popularly used materials are vinyl chloride
polymers and copolymers; types of acrylic material ,
such as methyl methacrylate; and heat -vulcanizing and
room temperature-vulcanizing silicones and polyure-
thanes. Each has favorable and unfavorable charac ter-
istics. The material of choice depends on the needs of
the particular patient and the preference of the clini-
cian . All materials require a mold , generally of metal ,
stone, or epoxy resins. The working characteristics of
each brand of material may be different . Exact and
close adherence to the manufacturer’s suggestions is es-
sential ( Fig. 18-56).
Laboratory facility requirements
The following items are necessary' for making facial
prostheses: a heating unit for reversible hydrocolloid;
large investment rings , usually of galvanized sheet
metal; gray, or other high -heat , investment material ; a Fig. 18- 57. Reversible hydrocolloid impression of face and def
large dry-heat oven; and other routine laboratory sup- area of patient.

* plies.
Metal mold fabrication
PROCEDURE
1 . Pour an impression of the defect , and separate it
( Figs. 18-57 to 18-59).
2. Prepare a sculptured , extremely detailed clay or
wax prosthesis pattern on the cast . Return it for trial
placement by the clinician . Then seal the margins of
the pattern to the cast , and place keys in the peripheral
area ( Figs. 18-60 and 18-61 ) .
3. Box the pattern and keyed areas with wax , and
pour alginate into the boxed area. Mix it with approxi -
mately twice as much water as required. Pour a stone
or plaster core over the alginate for support after pi;
ing wire mechanical retention mesh.
4. Remove the impression , box it , and pour it w
gray investment .
5. Block out the defect area not to he used for ret <
tion by drilling a hole through the back of the mas
cast and vibrating stone through the hole with the p
tern in place. The effect is to minimize the thickness
the facial prosthesis. Thin the pattern as much as p<
sible prior to this blockout procedure. Avoid creati
mechanical undercuts that prevent the molds from se
ing. In making an orbital prosthesis allow an unden

Fig. 18-58. Pouring the impression with artificial stone.
.
Fig 18-60. Master cast separated and prepared for fabrication of
clay pattern.
under the ocular area, and key the ocular prosthesis,
that is , the artificial eye , to relate it to the master cast
prior to making an impression for the tissue side of the
mold and to form a retentive lip in the final prosthesis
to maintain the eye.
6. Remove the clay pattern , replace the ocular pros-
thesis, and make a boxed impression in the manner de-
scribed previously for the other half of the mold .
Maxillofacial procedures 501
. - .
Fig 18 59 Properly poured and reinforced impression of facial de-
fect.
ft
- .
Fig. 18 61 Clay pattern positioned on cast.
7. Box the impression , make another impression of
the first impression , and back the latter with stone.
8. Discard the first impression . Use gentle com -
pressed air to facilitate separation of the two impres-
sions.
9. Box the second impression, and pour it with gray
investment .
10. Check both patterns for detail. It is possible to
502 Dental laboratory procedures: complete dentures
Fig. 18- 62. Metal molds before fitting and adjustment by spot grind-
ing.
make minor surface detail changes to the tissue side at
this time.
11 . Wax the pattemns with approximately 3 mm of
baseplate wax . Add a strip of beading wax to the pe-
riphery of the pattern to aid in later retention of the
clasp.
12. Attach sprues to the patterns at the lowest points
on the periphery of the mold .
13. Place several vents at the highest points on the
pattern.
14. Invest the waxed patterns with more investment
by using large rings screwed or clamped together at one
point to permit removal prior to elimination of the wax.
The main sprue is 1 inch ( 2.54 cm ) from the wall of the
ring.
15. Invest the pattern and boil it out with hot water
or burn it out in an oven .
16. Dry the molds thoroughly to prevent fracture
from vaporization of retained moisture during the intro-
duction of molten metal . Place them in a dry- heat oven
at .56.5° F (70° C ).
17. Melt linotype metal used in newspaper printing
with a torch , at approximately 500° F ( 260° C ).
18. Pour the metal into a vent , and use a torch to
keep the metal molten . Hold the flame over the main
sprue, and pass it down the sprue adjacent to the pe
riphery of the mold .
19. Cool it for approximately 30 minutes, then im -
merse it in water , and brush if clean .
20. Cut the vents and sprues evenly to form a stand
for the molds.
21. Fit the molds if necessary by spot grinding with
articulating paper ( Figs. 18-62 and 18-63).
Fig. 18-63. Metal molds fitted properly with sprues and vents
trimmed to form stand for molds.
Fabrication of three - piece auricular metal mold <
PROCEDURE
For patterns with multiple undercuts, make the up-
per or external portion of the mold in two pieces.
2. Kev the master cast .
¥
3. Mark the crest of the helix around the periphery
to beneath the lobe.
4 . Box the area posterior to the helix and behind the
ear ( Figs. 18-64 and 18-65).
5. Make a separate boxing keyed to the posterior seg-
ment ( Fig. 18-66 ).
6. Mix the alginate, pour it behind the helix, and key
it ( Fig. 18-67).
7. Place the remaining boxing, and pour the alginate
( Fig. 18-68).
- -
8. Back both boxings with stone ( f ig. 18 69).
9. Remove the posterior crescent, box it , and pour it
with gray investment ( Fig. 18 70).
-
10. Box the remaining external segment , and pour it
-
( Fig. 18 71).
11. Make the defect side in the same manner as the
-
two piece mold .
12. Make metal molds ( Fig. 18-72 ) .
 «

Maxillofacial procedures 503

. .
Fig 18-64 Auricular pattern with boxed posterior segment and
keyed master cast.

Fig. 18 65. Mechanical retention is provided with wire loops.

-

. .
Fig 18-66 Segmented boxing pattern is fabricated. .
Fig. 18-67 Poured alginate with keys.

1
504 Dental laboratory procedures: complete dentures

.
Fig. 18-68 Remaining boxing is placed for upper half of mold.

.
Fig. 18-69 Both segments are backed with stone to reinforce algi-
nate.

- .
Fig. 18 70 Posterior crescent is removed and boxed.
 Maxillofacial procedures 505

Direct wax method of metal mold fabrication

An alternative to the metal mold procedure is a di -
rect wax method of metal mold fabrication advocated by
%
Yini et al . (1975).

PROCEDURE
1. Carefully paint molten baseplate wax directly onto
the clay pattern and the master cast.
2. After proper cooling, remove the wax mold , and
place the sculptured pattern into the wax form .
3. Fabricate the tissue side of the mold by painting
wax to the wax mold with the pattern in place.
4. Then invest and cast both .
Stone mold fabrication
PROCEDURE
1 . Position the clay pattern with the margins sealed
and detail maintained .
2. Key the stone, and box it .
Fig. 18- 71. Both segments of upper half of mold are ready for pour-
ing with gray investment . 3. Apply a separator, such as soapy water or silicone,
to the stone.
. 4 . Vibrate additional stone into the mold .
5. Separate the molds.
6. If the mold is small enough, invest it in a denture
flask , and then remove it from the flask for storage.
PROBLEM AREAS
Metal mold fabrication is technique critical, if maxi -
mum mold accuracy is desired. Refer to Table 18-7 for
some common problems and solutions.
*
RADIATION APPLIANCE
Radiation therapy is a useful treatment modality for
the control and management of cancer. Damage to nor-
mal tissues is a frequent side effect because many le-
sions are accessible only by radiating through normal
structures. It is possible sometimes to minimize dam -
age to the oral and paraoral structures by using various
appliances that permit direct access to a lesion with a
radiation source or a beam directed from a radiation
source.
Fig. 18- 72. Completed three-piece metal molds.

Table 18-7. Metal mold

Problem Probable cause Solution

Discarding incorrect impression Improper labeling of impression Label impressions; review concept of mold fabrication
Lack of detail Improper handling of soft investment Modify investment to improve surface detail
Mold porosity Improper sprue location Place vents at highest pattern points and sprues at
lowest
Investment fracture during pouring Moisture retention Use dry- heat oven for adequate time period
Improper fit of molds Distortion of alginate Fabricate proper stone core; pour gray investment as
* soon as possible to minimize alginate distortion

4
 506 Dental laboratory procedures: complete dentures
Requirements
The design must allow the therapist to achieve treat -
ment plan goals for the particular tumor. It should hi
easy to place, relatively comfortable, able to he reposi -
tioned accurately with repeated application , light , easy
to clean , rigid and stable, non irritating, and durable
with use. It is essential to consider the requirements of
each patient prior to establishing a design ( Delclos,
1965).
Materials
The material of choice depends on the requirements
of the patient , hut generally, chemically or thermally
activated methyl methacrylate is preferable. Time is an
important consideration when selecting the material. If
there is need for a radiation source, a mockup of the
source, such as rods or seeds, and a method of locating
the source precisely within the appliance in relation to
the lesion are essential . Regular laboratory processing
and flashing equipment are important.
Fabrication of locator
A locator (cone locator and radiation source locator )
is usually of acrylic resin and helps to position the cone
or the tip of the machine with repeated accuracy in re
lation to the lesion.
PROCEDURE FOR CONE LOCATOR
1 . Use maxillary and mandibular casts w ith a wax oc-
clusal registration , preferably in the open position .
2. Mount the case on a simple hinge. The degree of
opening depends on the vertical height of the bone.
'
Fig. 18-73. Comfortable , completed one- piece intraoral cone locator that satisfies needs of particular
treatment modality.
3. Adapt baseplate wax over the ridge, but short of
the peripheral roll. Overextension is undesirable.
* 4. If the lesion extends close to or over the ridge,
keep the wax short of these areas.
5. Form a cylinder of wax slightly larger than the ^
cone tip from the machine. Foil can be applied to the
cone to prevent the wax from sticking. Place a wax stop
in the tumor or tissue end of the cylinder so that the
cone will not slip through .
6. Process the bases and cone positioner by investing
them in a stone flask and compression - molding them.
Trim the flash , and finish polishing it .
7. Return the case so that the clinician can position
the cone support to the bases in relation to the position
of the lesion .
8. Attach the three pieces with chemically activated
resin , and polish them ( Fig. 18-73). As an alternative,
fabricate the cone locator from chemically activated
resin .
Radiation source carrier
A radiation source carrier is an appliance that posi -
tions and holds a source of radiation in close proximity
to a lesion for a specified period of time. An impression
- of the tumor and surrounding area must be obtained.
Invest it in the appropriate manner. The design of the
carrier depends on the anatomic location and size of the
tumor.
Fabrication of nasopharyngeal carrier
It is impossible to reach the nasopharynx with exter- t
nally applied radiation without producing side effects

on normal tissues. If indicated , a nasopharyngeal carrier
will minimize these effects.
PROCEDURE
* 1. Invest in stone an impression of the nasopharynx
as advocated by Rudd et al. (1966) ( Fig. 18-74 ).
2. Make an acrylic model that includes the area of
the tumor ( Fig. 18-75).
3. Determine the position of the source to find out
whether to split the final appliance for ease and proper
placement.
Fig. 18-74. Impression of nasopharynx made by using tongue blade
* with wire-reinforced compound and rubber base wash. This impres-
sion is invested in stone.
Fig. 18- 76. Sources positioned appropriately in relation to tumor
can be maintained securely by means of screw.
Maxillofacial procedures 507
4. Reinvest the acrylic model, and split - pack it with
clear resin if indicated , process it , recover it. and polish
it .
5. Achieve final positioning of the source by using
mockups ( Fig. 18-76).
6. Fit the halves together easily, and secure them
with a screw.
7. Place umbilical tape through the external nares for
retention ( Fig. 18-77 ).
Fig. 18-75. Acrylic model formed from processed clear resin to de-
termine position of radiation source.
Fig. 18-77. Completed nasopharyngeal carrier with umbilical tape
used for retention with nasopharynx .
508 Dental laboratory procedures : complete dentures
Fabrication of palatal carrier
Some lesions of the palate may require radiation
therapy. A removable appliance , such as a palatal car -
rier. may be used to place a source near these lesions.
PROCEDURE
CRANIAL IMPLANTS
A cranial implant is positioned surgically and secured
into a skull defect . The two principal indications for cra-
nial implants are for defects secondary to trauma or in -
fection. The implants are made of metal, such as stain - ^
less steel and acrvlic resin .
9

1 . Make casts of the lesion and corresponding arches.

2. Mount these casts on a hinge articulator in an open
position to keep the normal tissues as far away from the
radiation as possible . ics, as well as protect the brain from injury resulting
3. Make a split resin base over the site of the lesion
and hold it together with screws or by some other
method .
4. Place the source between the two bases, and hold
it securely ( Fig. 18-78).
5. Key or attach the base of the opposite arch to the
other rim by acrylic bite blocks ( Fig. 18-79 ).
6. Insert the case, and have the patient close against
the rim for comfort .
PROBLEM AREAS
Proper radiation source positioning is very important
for successful treatment. Table 18-8 reviews two prob-
lems.
Requirements
A cranial implant should restore contour and esthet -
, from trauma. It should be stable, nontoxic, and nonir-
ritating . Methyl methacrylate implants are the most
common .
Materials
Clear, thermally activated acrylic resin is the material
of choice. However, it is possible to use chemically ac-
tivated acrylic resin for a rapid result.
PROCEDURE FOR IMMEDIATE CRANIAL IMPLANT
1. Duplicate a bone fragment in resin after adding
wax to the periphery to compensate for loss of tissue,
resulting from cutting the segment ( Fig. 18-80 ).
2. This implant is reinserted on completion of a
lengthy procedure.

Fig. 18-78. Master cast with lesion circumscribed might be treated Fig. 18-79. Two-piece acrylic maxillary stents are secured together,
by placing radiation source in acrylic stent as shown. and appliance is inserted with mandible of patient positioned by
acrylic struts.

Table 18-8. Radiation appliance

Problem Probable cause Solution

Inaccurate cone position Improper fit of cylinder Use minimal relief and cone stop
Inaccurate base- to-cone relationship Reattach with chemically activated resin
Inaccurate source position Improper split-packing or mold- sectioning Refer to dosimetry chart to verify source placement

* 2. Outline the defect with an indelible pencil and
Fig. 18-80. Bone fragment with wax added to periphery ready to be
duplicated in resin by investing it in stone , recovering the bone seg-
ment. and compression-molding an acrylic resin implant.
Fig. 18-81. Finished cranial implant before perforation and place-
ment of retention holes. Note slight flange- like overextension
around periphery to allow adjustments.
Maxillofacial procedures 509
PROCEDURE FOR DELAYED IMPLANT
1. Make an impression of the skull defect area, and
pour it with stone. Have the hair short or shave that
part of the head .
transfer this outline to the cast.
3. Relieve the cast to compensate for the approximate
thickness of the soft tissues and skull plate. Generally,
the skull is thicker toward the superior midline. The
clinician who palpated the defect should perform the
relief .
4 . Make a wax or clay sculpting to restore the ana -
tomic contour. Add a bevel or flange to the implant to
compensate for any deficiencies in marginal extension.
5. Invest the implant , and process it . Frequently, a
large Hask may be essential .
6. After finishing the implant , perforate it only on
request of the clinician ( f ig. 18-81 ).
7. Retentive holes are placed at the time of surgery ,
and the implant is fixed with stainless steel or tantalum
wire, braided wire, or silk suture ( Fig. 18-82 ) (Sabin ,
1975).
SILASTIC IMPLANT
A Silastic implant is a surgically implanted prosthesis
that restores or modifies body contour.
Requirements
Silastic implants should be nontoxic, tissue compati -
ble, stable , durable, easy to fabricate, and able to be
adapted accurately .
Materials
The material used for a Silastic implant is Dow Corn -
ing Silastic 382 medical -grade silicone ( Fig. 18-83). It is
room - temperature vulcanizing and easy to use.
PROCEDURE
1. Make an impression of the patient , and fabricate a
-
cast ( Fig. 18 84 ).
2. Make a clay pattern directly on the cast .
3. Return the pattern for trial positioning. Make any
changes required directly on the patient .
4. Return the pattern , and make a stone mold by
pouring stone over the pattern and on the periphery of
the cast .
5. Mix the Silastic, and press it into place using the
mold.
6. Perforate the inferior border with holes approxi -
mately the size of a No. 8 round bur for retention after
trimming and smoothing ( Fig. 18-85).
PROBLEM AREAS
This type of silicone is relatively simple to use when
the proper technique is followed. ( See Table 18-9).
M
510 Dental laboratory procedures: complete dentures

Fig. 18 82. Cast of patient 's head before surgery, left, and af -
-
ter surgery, right.

- .
Fig. 18 83 Dow Corning Silastic 382 Medical Grade Elastomer .

Fig. 18-84. Cast of chest made from reversible hydrocolloid impres- .

Fig. 18-85 Finished silicone implant before placement of retention
sion to be used to fabricate Silastic implant to correct pectus exca- holes and surgical implantation.
vatum defect.
 Maxillofacial procedures 511

Table 18- 9. Silastic implants

Problem Probable cause Solution
*
Silicone with embedded Sticking during curing Lubricate stone properly with soapy water
stone particles
Porosity Delayed packing Pack and mold prosthesis before initiation of final set
Thick prosthesis Improper compression Do not place too much material in mold; use adequate compression
force; do not delay too much during processing, thus allowing ini -
tial set

SUMMARY
This chapter presents some approaches useful to the
technician who is involved in maxillofacial prosthetics.
It is not all -inclusive; its purpose is primarily to stimu -
late imaginative and innovative ideas. Additional refer-
ences listed contain information about other tech -
niques.
REFERENCES
Ackerman , A. J .: The prosthetic management of oral and facial defects
-
following cancer surgery, J . Prosthet . Dent: 5:413 432, 1955.
Ampil. J . . Ellingcr , C., and Rahn. A . : A temporary prosthesis for an
edentulous patient following maxillary resection , J . Prosthet. Dent.
17:88-91 , 1967.
Appleman , R . M .: The prosthetic repair of defects of the maxilla re-
sulting from surgery , J . Prosthet. Dent. 1:424-437, 1951.
Aramany , M . , Drane, J . , and Anderson , K . : Radiation protection
.
prostheses for edentulous patients, J . Prosthet Dent . 22:292-296.
9 1972.
Boucher. L. J .: Prosthetic restoration of a maxilla and associated struc-
-
tures. J . Prosthet . Dent. 16:154 168, 1966.
Brown. K . E.: Fabrication of orbital prosthesis, J . Prosthet. Dent .
21:592-597. 1968.
Brown , K . E.: Fabrication of ear prosthesis, J. Prosthet. Dent . 21:670 -
676. 1969.
Brown. K . E . : Fabrication of an ulloplastic cranioimplant . J . Prosthet.
Dent. 24:213- 224. 1970.
Canario, C.: A two-section metal mold for an ear prosthesis, J .
Prosthet. Dent. 31:343-348, 1974.
Carl , W : Preoperative and immediate postoperative obturators. J .
Prosthet. Dent. 36:298-305, 1976.
C 'halian , J . , and Barnet, M . : A new technique for constructing a one-
piece hollow obturator after partial maxillectomy, J . Prosthet .
Dent. 28:448-453, 1972.
Chalian, J . , Drane, J ., and Standish , M .: Maxillofacial prosthetics,
multidiscipline practice, Baltimore. 1972, The Williams 6c Wilkins
Co.
Delclos, L.: Radiotherapy for bead and neck cancer, J . Prosthet .
.
Dent. 15:157- 167 1965.
Fine, L., Robinson , J . E., Sharett. T. , et al.: Fabrication of a pros-
thesis for guiding and fixing radioactive sources in treatment of can -
cer of the floor of the mouth , J . Prosthet. Dent . 30:349-353. 1973.
.
Firtell D. N .: Maxillofacial prosthesis: reproducible fabrication , J .
-
Prosthet. Dent. 22:247 252, 1969.
I
Fonseca, E.: The importance of form , characterization and retention
in facial prosthesis, J . Prosthet. Dent. 16:338-343, 1966.
Hahn , G . W., A comfortable silicone bulb obturator with or without
-
dentures, J . Prosthet . Dent . 28:313 317. 1972.
Hawkinson , R.T.: Development of skin surface texture in maxillofa-
cial prosthetics, J . Prosthet. Dent. 15:929-937, 1965.
Malson . T. S. : Complete denture for the congenital cleft palate pa -
tient . J . Prosthet . Dent. 5:567-578, 1955.
Matalon , V.: A simplified method for making a hollow obturator. J .
Prosthet . Dent. 36:580-582, 1976.
Moore, D. , and Mitchell. D.: Rehabilitating dentulous hemimandib -
-
ulectomy patients, J . Prosthet. Dent . 35:202 206, 1976.
Ohyama, T. . Cold . H., and Pruzansky, S.: Maxillary obturator with
silicone lined hollow extension , J . Prosthet . Dent . 34:336-341,
1975
Ouellette, J. R.: Spray coloring of silicone elastomer maxillofacial
prostheses. J . Prosthet. Dent. 22:271 -275. 1969.
Parel , S. , and Drane, J .: Reproducing the vertical lateral defect space
in obturator construction , J . Prosthet. Dent . 35:314-318, 1976.
Halm , A., and Boucher, L.: Maxillofacial prosthetics, principles and
concepts, Philadelphia. 1970. The W. B. Saunders Co.
Robinson . J . E . . and Rubright . W.C.: Use of a guide plane for main -
taining the residual fragment in partial or hcmimandibulectomy , J .
Prosthet. Dent. 14:992-999, 1964.
.
Rudd , K. D . , Green , A. E., Jr. Morrow, R . M . , et ah : Radium source
appliance for treatment of nasopharyngeal cancer. J . Am. Dent.
Assoc. 72:862-866, 1966.
-
Sabin , II . : Cranial implant problems, J . Prosthet. Dent. 34:659 665,
1975.
Santiago , A . :Fabrication of an intraoral radiotherapy prosthesis. J
Prosthet. Dent. 33:212-215, 1975.
Schaaf, \ .: Oral reconstruction for edentulous patients after partial
mandibulectoinies, J . Prosthet. Dent. 36:292-297, 1976.
Schuppe. N .: Cranioplasty prostheses for replacement of cranial
Inme , J . Prosthet. Dent. 19:594-597, 1965.
Swoope, C.: Prosthetic management of resected edentulous mandi -
-
bles, J . Prosthet . Dent. 21:197 202, 1969.
Tanaka. V . , Gold. H . . and Pruzansky. S . : A simplified technique for
fabricating a lightweight obturator , J . Prosthet. Dent. 38:638-642,
1977.
Vini, R. , Krill. R . , and Aramany , M.: Direct wax method for fabri -
-
cation of metallic facial mold . J . Prosthet . Dent. 33:85 88, 1975.
Wood , R . , and Carl , VV.: Hollow silicone obturators for patients after
total maxillectomy, J . Prosthet . Dent. 38:643-651, 1977.

CHAPTER 19
LABORATORY PROCEDURES FOR
IMMEDIATE OVERDENTURES
ROBERT M. MORROW
overdenture A complete denture constructed for placement over
some remaining natural teeth and the residual ridges,
immediate overdenture An overdenture constructed for placement
immediately after removal of the last hopeless teeth.
Interest in overdenture treatment procedures has
continued to gain momentum and has resulted in more
practitioners providing overdentures for their patients
then ever before. As a result , it is appropriate that the
laboratory procedures for immediate overdentures be
described in detail . Construction of impression trays,
baseplates, occlusion rims, and the procedures for set-
ting teeth and constructing the immediate overdenture
will be presented in this chapter. Most overdenture
procedures are similar to those for conventional imme-
diate dentures; however, certain procedures are unique
to overdentures and will be described in detail.
CONSTRUCTING IMPRESSION TRAYS
Making impressions for immediate overdenture is
similar to that for conventional immediate dentures .
One method found to be effective involves first making
an impression of the posterior edentulous arch in a suit -
able impression material , using an autopolymerizing
resin tray. The posterior impression is examined and
replaced in the mouth, and an overall alginate impres-
sion made over the posterior edentulous impression
and the anterior teeth ( Fig. 19- 1 ) .
512
*
PROCEDURE
1. Stone casts of the involved arches are required .
Examine the casts for undercuts, which should he
blocked out with baseplate wax prior to constructing
the impression tray. This will permit the completed
impression tray to be removed from the cast without
breaking either the cast or the tray . J
2. Draw the impression tray outline on the cast . The
tray extension should be approximately 2 mm short of
the vestibular reflection on the cast ( Fig. 19-2). The
tray should extend posteriorly to the vibrating line .
3. Soften a sheet of baseplate wax, and adapt it to the
cast ( Fig. 19 3). Take care to avoid entrapment of air
-
beneath the baseplate wax, and then trim the baseplate
wax to the tray outline ( Fig. 19-4 ).
4. Flow baseplate wax onto the lingual surfaces of the
anterior teeth and into any spaces that exist between
the teeth ( Fig. 19-5). This provides relief and prevents
the tray resin from extending into the spaces. If resin
extends into the spaces, the teeth may be broken when
the impression tray is removed from the cast .
5. Paint tinfoil substitute on the stone cast and over
the baseplate wax ( Fig. 19-6). Painting tinfoil substitute
on the baseplate wax facilitates removal of the baseplate
wax later when the dentist makes the final impression.
6. Proportion the autopolymerizing tray resin accord -
ing to the manufacturer s recommendations, and mix it ,
and roll it to form a thin resin wafer ( Fig. 19-7).
7. Place the resin wafer on the cast , and adapt it with
finger pressure ( Fig. 19-8). Take care when finger
 Laboratory procedures for immediate overdentures 513

Fig. 19- 1. A, Impression is made of posterior edentulous arch. B, Alginate impression is made over
first impression and remaining natural teeth.

A B

Fig. 19-2. A, Draw outline of impression tray on cast . Tray extensions should be approximately 2 mm
short of borders of overdenture. B, Tray outlines have been drawn on maxillary and mandibular casts.

* »
.
Fig. 19-3 Adapt sheets of baseplate wax to casts. Fig. 19- 4. Trim to tray outline.
514 Dental laboratory procedures: complete dentures

Fig. 19- 5. Wax can extend onto and between anterior teeth (ar- Fig. 19-6. Paint baseplate wax and cast with tinfoil substitute .
rows,) to provide relief .

Fig. 19- 7. A , Mix autopolymerizing tray resin . B, Roll resin into wafer before adapting it to cast .

adapting to not overthin the tray material over the con -

Fig. 19-8. Adapt resin to cast .
vex portions of the cast ( Fig. 19-9). Continue to adapt
the tray resin to the cast until the resin sets.
.
8. After the tray resin has set remove the tray from
the cast, and trim and smooth the impression tray with
arbor bands and burs ( Fig. 19-10). The tray borders
should be finished even with the baseplate wax relief
( Fig. 19-11 ). Be sure that no sharp or rough edges exist
on the tray borders. The completed impression tray is
stored on the cast until needed ( Fig. 19-12 ) .
PROBLEM AREAS
Principal problems associated with making an
impression tray are failure to maintain uniform thick -
ness of the impression tray during finger adaptation;
making the impression tray too thick or too thin ; allow-
 Laboratory procedures for immediate overdentures 515

i* *
zs

-.
Fig. 19 9 Do not overthin at convex portions of ridges. Fig. 19-10. Trim tray borders to level of relief wax ( arrows ). Space
for compound will be made later by removing strip of wax from bor-
ders.

Fig. 19 11. Trim impression trays with lathe-mounted arbor band

- Fig. 19-12. Store trays on casts until needed at next appointment .
Strip of wax 3 mm wide has been removed to create space for
border molding compound.

Table 19- 1. Impression trays

Problem Probable cause Solution

Impression tray too thick
Impression tray too thin
over residual ridges
Teeth broken off cast during
removal of impression
tray
0
Tray resin not rolled into thin wafer Roll resin into thin wafer before adapting to cast
before adapting to cast
Tray resin thinned over convex Use care when adapting resin to prevent overthinning
portion of cast during adaptation
Tray resin contacted teeth on cast Block out spaces between teeth to provide relief
or projected into spaces be-
tween teeth
516 Dental laboratory procedures: complete dentures

ing the tray resin to extend into spaces between the
teeth , resulting in a broken east ; and failure to finish
and smooth the borders of the completed tray (Table
19- 1 ). Rolling the tray resin into a wafer with a roller
will help achieve an impression tray of uniform thick-
ness. Careful finger adaptation will minimize the ten -
dency to overthin the tray over convex portions of the
cast. Spaces between the teeth should be blocked out
with wax prior to adapting the resin to prevent extru -
sion of the tray resin between the teeth . The tray bor -
der should be smoothed and finished with arbor bands
and acrylic burs to remove sharp ridges or fins that
might prove uncomfortable for the patient .
4. Warm the baseplate , and continue to adapt it to
the cast with wet fingers ( Fig. 19-16). Remove the base-
plate, and soften areas of the baseplate that extend into
undercuts so that the baseplate can be removed and
replaced on the cast without damaging the cast . ^
5. Add a wax occlusion rim , and seal it to the base-
plate ( Fig. 19- 17). The maxillary and mandibular base -
plates are complete ( Fig. 19-18).
6. The mandibular shellac baseplate can be strength -
ened by embedding a heavy paper-clip wire into the
lingual material from premolar to premolar area , The
wire improves the rigidity of the baseplate.

CONSTRUCTING BASEPLATES
Baseplates for immediate overdentures can be con -
structed of shellac baseplate material or autopolymer -
izing resin . Shellac baseplates can be constructed more
(juickh than resin baseplates; however, the dimensional
stability of shellac baseplates is not as good as resin
baseplates. The procedure for adapting shellac base-
plates for immediate overdentures is similar to that for
constructing baseplates for conventional immediate
dentures (Chapter 5).
Shellac baseplates
PROCEDURE

1 Soak the cast in clear slurry water for a few min -

utes prior to adapting the shellac baseplate ( Fig. 19-13).
2. Wilt the shellac baseplate onto the wet cast with a
flame (Fig. 19-14).
3. Fold the edges of the shellac material over , and Fig. 19 13. Cast is soaked in slurry water for few minutes before
-
blend them into the shellac baseplate material ( Fig. adapting shellac baseplate.
19- 15).

- .
Fig. 19 14 Shellac baseplate is wilted onto wet cast with flame. - .
Fig. 19 15 Edges are folded over and blended into shellac mate- t
rial.
 Laboratory procedures for immediate overdentures 517

Fig. 19- 16. Baseplate is warmed and adapted with wet fingers. Fig. 19- 17. Wax occlusion rims are added and sealed to baseplate.

*
*

Fig. 19- 18. A, Completed maxillary shellac baseplate. B, Completed mandibular shellac baseplate.
This baseplate can be strengthened by embedding heavy paper-clip wire in lingual area from pre-
molar area to premolar area (arrows ).

Table 19- 2. Shellac baseplates

Problem Probable cause Solution

Shellac baseplate sticks to Cast not wet before base- Soak cast in clear slurry water before adapting shellac baseplate
cast plate adapted
Shellac baseplate does not fit Baseplate distorted during Replace baseplate on cast; readapt it
cast removal from cast
Baseplate not properly Adapt baseplate to cast with finger pressure
adapted to cast
• 4

i
518 Dental laboratory procedures: complete dentures
PROBLEM AREAS
The principal problem associated with making shellac
baseplates is related to maintaining dimensional stabil -
ity of the baseplate once it is constructed . Shellac base-
plate materials also tend to stick to dry casts during drv-
heat adaptation (Table 19-2). It is important to wet the
cast prior to adapting the baseplate material onto the
cast with heat . Careful adaptation of the shellac base-
plate to the wet cast will result in an excellent fit of the
completed baseplate and minimize the tendency of the
material to stick to the cast.
Resin baseplates
Autopolymerizing resin baseplates are preferred for
immediate overdentures. Resin baseplates can be made
thin over residual ridges, yet are reasonably rigid and
dimensionally stable. This is an important considera-
tion , since the baseplates will be used for setting teeth .
In the procedure described , two types of autopolymer-
izing resins are used in constructing baseplates. A soft -
setting autopolymerizing resin * is first placed in under-
cut areas, and conventional hard -setting autopolymer-
izing resint is sprinkled over the soft resin to provide
rigidity ( Fig. 19- 19 ). Soft resin in the undercuts be-
comes an integral part of the baseplate and will permit
the baseplate to be removed from moderate cast under-
cuts without damage to the cast or baseplate. However,
severe undercuts require block-out with baseplate wax
prior to the addition of soft resin .
PROCEDURE
1. Check the master cast carefully for undercuts. Un -
dercuts are usually found on the buccal slope of residual
ridges just posterior to canine abutments, in the tuber -
osity region of the maxillary cast , and in the posterior
lingual region of mandibular casts ( Fig. 19-20 ).
2. Undercuts should be blocked out with baseplate
wax it they are severe. Soft-setting autopolymerizing
resin is placed in minor to moderate undercuts; how-
ever , the soft resin will not compensate for severe un -
dercuts.
3. Block out spaces existing between the teeth on the
cast to prevent autopolymerizing resin from flowing be-
tween these teeth during baseplate construction ( Fig.
19-21 ). As in the case of the impression tray, if resin
extends into these spaces, the teeth may be fractured
from the cast during baseplate separation .
4 . Soak the master cast for a few minutes in clear
slurry water ( Fig. 19-22).
5. Paint tinfoil substitute onto the cast and over the
previously placed blockout ( Fig. 19-23).
Coe-soft , Coe Laboratories, Inc., Chicago, III.
.
tCaulk repair resin The L. I ) . Caulk Co. , Milford, Del.
r0E- soft
OCHTV
UN0
**
*
sawogg
L I w*
Cto
mini*
A
»ir « ri«** cum*
iHUi Will
INK
_
1* 1
Fig. 19- 19. Two types of autopolymerizing resin are used for base-
plate construction. Soft - setting resin ( Coe- soft) is placed in under-
cuts , and conventional hard- setting resin (Caulk Repair Resin)
forms baseplate.
6. Mix soft -setting resin monomer and polymer in a
dappen dish, and apply the mixed resin to the previ -
ously identified undercuts ( Fig. 19-24 ).
7. Completely fill the undercuts with the soft resin .
8. Warm the tip of a chip blower in a flame, and blow
a gentle stream of warm air onto the soft - resin surface
( Fig. 19-25). The warm airstream w ill produce a surface
hardening effect , which will prevent the soft resin from
flowing out of the undercut and into the cast border ±
area where it is of no benefit ( Fig. 19-26). In this man -
ner, fill all undercuts with soft resin .
9. Using the sift -on technique , apply conventional
hard-setting autopolymerizing resin polymer to the
cast , and wet it with monomer ( Fig. 19- 27).
10. Add liquid and pow der alternately to build up the
desired baseplate thickness.
11 . l ilt the cast to one side when sprinkling on the
polymer to minimize pooling of the resin in the palate
of maxillary’ casts, resulting in an overthick baseplate
.
( Fig 19-28) .
12. Allow the resin to extend onto the lingual sur -
faces of anterior teeth. This resin can be removed later
if it interferes with the occlusion ( Fig. 19- 29 ).
13. Completely fill the border area of the cast to du -
plicate the thickness of the impression border. Be cer-
tain that the baseplate is adequately thick over the re-
sidual ridges to be sifficiently rigid . The mandibular
baseplate can be strengthened , as with the shellac base-
plate, by incorporating an adapted wire in the resin
( Fig. 19-30).
14. Cure the baseplate under an inverted plaster 1
bowel to reduce porosity ( Fig. 19-31).
 Laboratory procedures for immediate overdentures 519

A B

I 1 Fig. 19- 20. A, Cast undercuts are commonly encountered distal to canine abutment teeth. B, Under -
cuts are often found lateral to tuberosity region. C, Undercuts commonly exist in posterior lingual
region of mandibular casts. Failure to compensate for these undercuts can result in broken cast,
fractuced baseplate, or both.

15. Alter hardening, remove the baseplate carefully

from the cast , and examine it ( Fig. 19-32 ).
16. After examining the baseplate, reduce overly
thick areas with a bur or arbor band ( Fig. 19-33).
17. The borders should be trimmed to form smooth
rounded contours to prevent sharp edges that would
abuse the patient s tissue ( Fig. 19-34 ).
18. Pumice the border if required . However, a high
polish is not desired. The finished baseplate should be
approximately 2 to 3 mm thick , except over the ridges
where it should not be thicker than 1 mm . The base-
plate should be smooth , relatively rigid , and capable of Fig. 19-21. Flow baseplate wax around and between teeth on cast
r being easily placed on or removed from the cast ( Fig. .
(arrows ) This will prevent resin from flowing into these areas, min-
19-35). imizing cast tooth breakage when baseplate is removed.

4
520 Dental laboratory procedures: complete dentures

Fig. 19- 22. Soak casts in clear slurry water for few minutes before coating with tinfoil substitute.

Fig. 19- 23. Paint tinfoil substitute over cast and blockout wax. Be Fig. 19- 24. Fill in cast undercuts with soft - setting autopolymerizing
.
sure to cover teeth resin.

\ Fig. 19- 25. Warm tip of chip blower over flame

 Laboratory procedures for immediate overdentures 521

Fig. 19- 26. Gently blow warmed air onto soft resin. This will pro- Fig. 19- 27. Conventional autopolymerizing resin powder is sifted
duce surface '‘set" that retains soft resin in position in undercut. If onto cast and over soft resin in undercuts. Polymer is wetted with
not treated in this manner, soft resin tends to flow out of undercut monomer, and desired thickness of baseplate is built up in this
into border area where it is of no benefit. manner.

Fig. 19- 28. Tilt cast to side when adding resin. Add powder and Fig. 19- 29. Build up baseplate thickness in increments. Do not per-
liquid to two upward-facing surfaces (arrows ), then tilt cast in op- mit resin to pool in palate of maxillary casts, which will result in
posite direction and add to remaining surfaces. overly thick palate that will need to be thinned later.
4
522 Dental laboratory procedures : complete dentures

Fig. 19 30. Reinforcing wire will add strength and rigidity to com-
- .
Fig. 19-31 Cure baseplate under inverted plaster bowl or in pres-
pleted baseplate. sure pot to control porosity.

A B

Fig. 19 32. A, Cured baseplate can sometimes be lifted off cast by directing stream of air under it.
-
Be careful when prying baseplate from cast to prevent cast and baseplate breakage. B, Maxillary
baseplate is separated and ready for trimming.

- .
Fig. 19 33 Thick areas should be thinned with lathe-mounted arbor
band. Note how band is positioned on chuck (arrow ). Band exten -
sion will flex during trimming, reducing tendency to groove base-
plate.

« -
 Laboratory procedures for immediate overdentures 523

Fig. 19- 34 . Baseplate borders should be finished to contours dictated by impressions. A and B, Arbor
bands and, C, can be used to contour and smooth baseplate.

Fig. 19- 35. Test baseplates for ease of placement and removal
from cast. Adjust baseplate if necessary to facilitate placement on
cast without undue flexing.

r \
524 Dental laboratory procedures : complete dentures
Occlusion rims
PROCEDURE
1 . Soften a sheet of baseplate wax , form it into a roll ,
and adapt it onto the baseplate to make an occlusion f
rim ( Fig. 19-36). Seal the wax rim to the baseplate with
a hot spatula ( Fig . 19-37). The rim should be adapted
over the residual ridges, be somewhat higher than the
proposed occlusal plane, and be approximately 8 mm
wide. It should extend posteriorly to the region of the
second molar.
2. Smooth the wax of the occlusion rim , and replace
the completed baseplate on the cast ( Fig. 19-38 ).
PROBLEM AREAS
Principal problems associated with constructing base-
plates of autopoK merizing resin art related to the dif-
4

- .
Fig. 19 36 Adapt baseplate wax to form occlusion rim .
ficulty in achieving a baseplate that is not too thick in
some areas and too thin in others (Table 19-3). Porosity
can also be a problem , and failure to block out the un -
dercuts adequately can result in a broken cast and base-
plate. Tilting the cast when sifting the resin powder
minimizes pooling of the resin in the palate of maxillary
casts. Examining the cast carefully prior to constructing

« '

- .
Fig. 19 37 Seal wax rim to baseplate with hot spatula. .
Fig. 19-38 Completed baseplates and occlusion rims are stored on
casts until needed.

Table 19-3. Resin baseplates

Problem Probable cause Solution

Baseplate difficult to remove
or fractures on removal from
cast
Maxillary baseplate too thick in
palate and too thin over
ridges
Cured baseplate porous
Undercuts not identified and blocked
out
Tinfoil substitute not painted on cast
Soft resin used to block out severe
undercuts
Soft resin flowed out of undercut
Cast not tilted when sifting resin,
permitting resin to pool in palate
Baseplate not cured in pressure pot
or under inverted plaster bowl
Identify and block out undercuts before sifting
resin on cast
Paint tinfoil substitute on cast
Block out severe undercuts with baseplate wax
Warm surface of soft resin to produce surface set
Tilt cast to one side; sift resin on upward facing
surfaces, then tilt to other side in similar man-
ner
Cure baseplate in pressure pot or under inverted
plaster bowl
 Laboratory procedures for immediate overdentures 525

the baseplate will identify severe undercuts that should

be blocked out with baseplate wax. Baseplate resin po-
rosity can be controlled by curing the baseplate in a
pressure pot or beneath an inverted plaster bowl.
*
SETTING THE TEETH
After thejaw relation recording procedures are com -
pleted , the master casts are mounted in an articulator
( Fig. 19-39). Anterior and posterior teeth are selected
for the proposed overdenture, using the teeth on the
cast as a guide for size and mold selection .

PROCEDURE

Fig. 19-39. Master casts mounted in articulator .
-
1 . Measure the width and length of the central inci
sor and any other anterior teeth present on the cast
( Fig. 19-40).
2. Check the shape of the natural teeth on the cast
to determine the tooth form ; square, tapering, ovoid ,
or combination . Based on these measurements and ob -
servations select resin anterior teeth that will closely
approximate the size and shape of the patient 's natural

A B

C D

Fig. 19- 40. A, Measure width of central incisor on cast and on patient. B, Meausure length of central
incisor . C, Measure combined width of maxillary anterior teeth using flexible plastic rule . Remember
* to allow for spaces between teeth. D, Measure mandibular anterior teeth.
'S

526 Dental laboratory procedures: complete dentures

-
w
I
n iiii|iiii|iiii|il(
10 20
ijiiiiB
30 40 5
I BlCiDlf
^
H
-
O AT MARK
f
m
j
READ MOULO U
RIGHT CUSi
I
r
LEFT CUSPIf

- .
^
Fig. 19 41 Measure posterior arch length to determine size of pos- Fig. 19 42. Height of posterior tooth is determined by space avail-
-
terior denture teeth. able for teeth (arrows ). Tooth length should be as long as possible.

A B

.
Fig. 19-43 A, Set posterior teeth on baseplate. B, Grind ridge laps if necessary when setting teeth.

teeth . It is important to use resin teeth in an immediate
overdenture, since they contribute to a stronger over-
denture.
3. Select the posterior teeth using a millimeter rule
to measure from the distal surface of the canine on the
cast to a point where the posterior occlusion would nor-
mally terminate ( Fig. 19-41). In this manner the appro-
priate combined mesiodistal widths of the four posterior
teeth can be selected .
4 . Take the posterior shade from the anterior teeth
so that the shade will be compatible.
5. Select the posterior tooth length by closing the
articulator and observing the available denture space
( Fig. 19- 42 ). Select resin posterior teeth to provide a
strong unitized overdenture that will resist breakage in
service. The occlusal pattern of posterior teeth will de-
pend on the preference of the dentist; however, ana-
tomic or nonanatomic forms can he used. Anterior and
posterior molds , shade, and type of tooth and material
should be recorded in the laboratory records for future
reference in the event of a fracture.
Setting the posterior teeth
If a try-in of the posterior teeth is desired , the pos-
terior teeth art* set on the baseplate before the anterior
teeth are positioned.
PROCEDURE
1 . Set the posterior teeth on the baseplate ( Fig. 19-
43, A ). Often the space is minimal , and it is necessary
to modify the teeth by grinding the ridge laps ( Fig. 19-
43, /1).
-
 Laboratory procedures for immediate overdentures 527

A B

Fig. 19- 44. A, Center posterior teeth over ridge. B, Posterior height of occlusal plane should be one
half to two thirds height of pear - shaped pad.

Fig. 19- 45. Incorporate horizontal overlap in setup to minimize

cheek biting.

l Fig. 19-46. Posterior setup. No opposing tooth was provided for lower left premolar because of extru-
* *
sion. It will be removed when overdenture is inserted.
 528 Dental laboratory procedures: complete dentures
2. Center the mandibular posterior teeth over the re-
sidual ridge buccolingually and establish the posterior
occlusal plane so that it is no higher than one half to
two thirds the distance up the pear-shaped pad ( Fig.
19-44 ).
3. Adjust each individual tooth position to develop
the desired occlusion. Incorporate sufficient horizontal
overlap to minimize the tendency for cheek biting ( Fig.
19-45). After the posterior setup is complete, wax the
posterior teeth securely to the baseplate, and wax the
-
teeth for try in ( Fig. 19-46 ).
4. Check the occlusion with thin tissue or plastic tape
l
after waxing, and adjust it if necessary before tri -in.
Store the baseplate and wax-up on the cast in the artic-
ulator until needed .
'
Fig. 19- 47. Use incisal edges of maxillary teeth as guide; draw line
on lower anterior teeth to indicate vertical overlap.
Fig. 19- 48. Mark midline and contacts between maxillary teeth on
lower teeth ( arrows ).
*
Setting anterior teeth
PROCEDURE
1. Resin anterior teeth should be selected because,
as previously stated, they bond to the overdenture base j
and result in a stronger overdenture. Selected teeth
should approximate the size and shape of the natural
teeth they are to replace.
2. With casts in the occluded position , use the incisal
edges of the maxillary teeth as a guide and draw a line
on the labial surface of the lower anterior teeth ( Fig.
19-47 ). This line indicates the vertical overlap and is a
guide for setting the maxillary teeth ( Fig. 19-48 ).
3. Remove one anterior tooth, the central incisor if
present , from the cast with a bur or saw ( Fig. 19-49).
Remove only one tooth at a time so that the adjacent
tooth on the cast senes as a guide for positioning the
denture tooth .
4 . Contour the ridge of the cast so that it has a
^
smooth rounded contour ( Fig. 19-50). Do not , however,
inlet the cast .
5. Position the denture tooth on the space formed by
the removal of the tooth on the cast ( Fig. 19-51). Usu -
ally the ridge lap of the denture tooth will require
grinding to assure proper placement ( Fig. 19-52). The
ridge lap can be adjusted with an arbor band or a bur
until the tooth can be placed in the same position as
the natural tooth.
6. Duplicate the positions of the natural teeth if ap-
propriate. However, overdenture patients may have
malpositioned, extruded teeth, in which case duplica-
tion of these abnormal tooth positions may not be de-
sirable. In these situations, modify the tooth position to
improve esthetics and meet functional requirements
^
( Fig. 19-53).
.
Fig. 19-49. One anterior tooth is removed from cast. Saw, bur or
knife can be used for this procedure.
 #
•
Laboratory procedures for immediate overdentures 529

A B

Fig. 19- 50. A, Smooth ridge where tooth was removed but do not inlet cast. B, If tooth was severely
periodontally involved with deep periodontal pockets, cast may be reduced slightly to compensate.
This should be done by dentist. 9

Fig. 19- 51. Set denture tooth in position and grind if necessary.
Fig. 19-52. Lathe-mounted arbor band can be used to grind tooth
ridge lap. use care and do not overshorten, which will compromise
esthetics. Note position of band on chuck, which increases its flex -
.
ibility

A B

» * Fig. 19- 53. A, Malpositioned teeth may be corrected in setup if desired. In this situation lateral incisor
is extruded. B, Lateral incisor position has been corrected in setup.
530 Dental laboratory procedures: complete dentures

*
Fig. 19-54. Wax tooth to cast. Be sure to check occlusion and ad-
just tooth position as required.

Fig. 19- 55. A , Sequentially remove tooth from cast, B, Replace with corresponding denture tooth,
using cast tooth as guide.

- .
Fig. 19 56 All anterior teeth are set except abutment teeth. Fig. 19-57. Mark abutment tooth ( arrow ) to indicate amount of oc- '» 4
clusogingival reduction.

s.

Fig. 19- 58. Cut cast tooth with saw or No . 558 bur.
7. After tin * denture tooth has been modified so that
it can he positioned properly , wax it to the cast ( Fig.
19-54 .»
*8. Remove another tooth from the cast , and replace
it with a denture tooth as previously described . The
sequence of removal and replacement should allow an
adjacent tooth on the cast to serve as a guide for posi -
tioning the denture tooth ( Fig. 19 55). - over the cast abutment . The basic purpose ol the pre-
9. In this manner all anterior teeth , except the abut
* ments, are set on the cast ( Fig. 19-56). If maxillary and
mandibular overdentures are being constructed maxil -
larv and mandibular anterior teeth are set .
Preparing cast abutments
PROCEDURE
1 . The dentist should mark the cast abutment indi -
to be reduced ( Fig. HI-
cating tlu * amount the tooth is
.
ST ) Shorten the cast abutment with a bur or saw ( Fig.
19-58). The abutment should be shortened so that a
minimum space of 2 to 3 mm exists between the abut
ment preparation and an opposing tooth ( Fig. 19-59 ). A
space of less than 2 to 3 mm will result in a resin thick -
ness that will not be adequate to prevent breakage.
Strength requirements for an overdenture exceed those
for most conventional complete dentures . The presence
of supporting natural teeth permits increased functional
forces to be placed on the overdenture , and the inden -
tations in the overdenture base to accommodate the
abutment teeth can have a weakening effect on the
overall structure. As a result , an overdenture needs to
r he stronger than a conventional complete denture to
^ prevent breakage.
1
Laboratory procedures for immediate overdentures 531
Fig. 19- 59. Check occlusion to determine that 2- to 3- mm space
exists between abutment and opposing teeth .
2. Prepare the abutment on the cast , removing stone
from the facial , proximal and lingual surfaces ( Fig. I 9-
,
60). If faciolingual reduction of the cast abutment is
represented as a percentage , approximately 60 % of the
reduction should come from the facial surface, and
about 40% from the lingual surface ( Fig. 19-61). This
reduction facilitates positioning of the denture tooth
- pared cast abutment is to form an indentation in the
overdenture that will be occupied by the natural abut-
,
ment tooth . Thus it is very important when removing
teeth from the cast and setting the denture teeth that
the abutment teeth are not inadvertently removed from
the cast . To prevent removal of the abutments, the
teeth can be identified on the cast by writing save' on
the abutment tooth .
3. Hollow a resin denture tooth with a bur so that it
can be positioned over the cast abutment . Use a large
acrylic bur for gross reduction , and make refinements
- with a No. 8 round bur ( Fig. 19-62). Usually the den -
ture tooth should be modified so that it can be placed
in the position of the natural tooth ( Fig. 19-63).
4. Occasionally, because of drifting, abutment teeth
may not be in a position compatible with an esthetic
result ( Fig. 19-64 ) . In this instance the denture tooth
can be modified so that it can be positioned either me-
sial or distal to the cast abutment and not directly over
-
it ( Fig. 19 65). The cast abutment is then positioned
between two teeth on the overdenture. This is accept -
able; however, sufficient wax must be placed over the
interproximal area to provide at least a 2 mm thickness
of denture base resin to prevent breakage.
532 Dental laboratory procedures: complete dentures

A B

Fig. 19-60. A, Prepare cast abutment using bur for proximal reduction. B, Sharp knife can be used
.
to shape abutment preparation on cast C, Completed cast preparation. A

Fig. 19-61. When preparing cast abutment, remove more stone Fig. 19-62. Large acrylic bur is used for gross reduction.
from facial surface than from lingual surface. This reduction (arrow ) M
will facilitate placing denture tooth in correct position faciolingually.
 Laboratory procedures for immediate overdentures 533

*
*:

\
.
Fig. 19-63 Denture tooth is positioned over cast abutment .

Fig. 19-64. if abutment tooth has drifted out of position, it may not
desirable to place denture tooth directly over it. In this situation,
denture teeth may be positioned anterior and posterior to cast abut -
ment . There is too much space mesial to cast abutment in this illus -
tration.

A B

r t Fig. 19 65. A, Canine and premolar denture teeth have been positioned over canine cast abutment .
-
B, Wax in interproximal area ( arrow ) in this situation should not be less than 2 mm thick.
534 Dental laboratory procedures: complete dentures

Fig. 19-66. Carve wax to simulate anatomic contours.

WAXING THE IMMEDIATE OVERDENTURE

Waxing the immediate overdent lire is similar to wax -
ing a conventional immediate complete denture. Ana -
tomic contours should l )e stimulated as discussed in
Chapter 9, although overcharacterization is to he
-
avoided . After the posterior teeth have been tried in
and returned to the laboratory , the overdenture can be
waxed for flashing, or the denture teeth may be re-
moved from the baseplates, and the baseplates dis-
carded . This is usually done when an anatomic palate
form is to be used. In this situation the baseplates are
no longer needed , and their presence on the cast can
interfere with waxing. This is an optional procedure.
Waxing of the overdenture is done in a conventional
manner, and prior to flashing, the occlusion is checked
with tape ( Figs. 19-66 and 19-67). Waxing of the over-
denture can cause teeth to move, resulting in occlusion Fig. 19-67. Occlusion of wax denture should be checked with thin
error that should lx corrected prior to flashing the ov -
*
tissue before removing wax - up for processing. Be certain to check
erdenture. contact of incisal guide pin and incisal table at this time .
'
 Continued .

Fig. 19-68. A, Place casts and wax -ups in lower half of flasks and place upper halves of flask in
position. Be sure that there is enough space above incisal edges of teeth for stone cap. B, Invest
casts and wax denture in lower part of flask using artificial stone. C, Check half -flasked overdentures
for undercuts. Flasked maxillary overdenture is undercut (arrow ). Note particularly heel region of
mandibular cast, since undercuts are commonly encountered in this area. D, Undercuts can be ob-
turated by flowing baseplate wax into undercut. Failure to do this may result in broken cast when
separating flask halves after boilout procedures. E, Coat artificial stone in lower half of flask with
separating medium. F, Brush artificial stone onto wax denture, using stiff brush to help prevent voids.
G, When painting separating medium on stone surface in preparation for pouring stone cap. do not
coat occlusal surfaces of teeth with separating medium. Certain separating media may stain resin
teeth if they come in contact with teeth. H, Flasked overdentures are ready for caps. I, Lid is placed
on flask and tapped into place. Stone is then allowed to set before being placed in boiling water to
eliminate wax.

r %
%7

536 Dental laboratory procedures: complete dentures

\

Fig. 19-68, cont’d. For legend see p. 535.

FLASKING THE IMMEDIATE OVERDENTURE

Select denture flasks that do not rock when assem-
bled , and flask the overdenture as described in Chapter
9 (Fig. 19-68). After the dentures have been flashed ,
eliminate the wax by placing the denture in boiling wa -
ter for 5 minutes. After the wax has been eliminated ,
the molds are thoroughly Hushed , and a final flush is
completed with clean boiling water. The flasks are then
placed upright to drain and cool .

Making an impression of the overdenture cast

It is a definite advantage for the dentist to have a cast
of the abutment preparations to serve as a guide when
the abutments are prepared in the mouth . This cast is
easily obtained at this time.
PROCEDURE

1 . Dip the lower half of the flask containing the over-

denture cast in water to wet the cast .
2. Select an oversize rim lock tray ( Fig. 19-69). Mix
fast-setting alginate, and make an impression of the
Masked cast ( Fig. 19-70). Fig. 19-69. Select oversize rim-lock tray.

Fig. 19-70. Make impression of flasked cast using fast- setting algi-
nate.
Fig. 19-72. Adapt sheet of clear resin over cast, using vacuum-
adapting device to form surgical template.
3. After the alginate has set , separate the impression ,
and pour it in artificial stone ( Fig. 19-71). The resultant
cast can then be used to fabricate a surgical template
and can also serve as a guide for the dentist to ensure
that the abutment preparation in the mouth of the pa
tient will be slightly smaller than the abutment prepa -
ration on the cast .
Making a surgical template
A clear resin template is often requested by the den -
tist and can be made using the above cast . The tem -
r plate is made by adapting a sheet of clear resin over the
* -
flask with a vacuum adapter device as discussed in
Chapter 5 ( Fig. 19-72).
Laboratory procedures for immediate overdentures 537
Fig. 19- 71. Pour artificial stone into alginate impression. This cast
will be used as guide for tooth preparation later .
Fig. 19-73. Using No. 558 bur or No. 37 inverted cone bur, place
grooves approximately 2 mm wide and 2 mm deep across mesio-
distal width of resin posterior denture teeth .
Preparing ridge laps
A stronger break -resistant overdenture can be ob-
tained if the ridge laps of the resin posterior teeth are
grooved mesiodistally with an inverted cone or cross-
- cut fissure bur to produce diatorics in these teeth .
PROCEDURE
1. Grooves, approximately 2 mm wide and where
possible 2 mm deep, are cut in the ridge lap of the
resin posterior teeth ( Fig. 19-73). They should extend
across the full widths of the denture teeth . II minimal
denture space necessitated shortening of the teeth for
the setup, the teeth may be too thin to permit place-
ment of the grooves. However, where space is avail-
538 Dental laboratory procedures: complete dentures
able, grooves are placed to increase the bonding area,
and the ridge oi high-impact resin extending into the
grooves imparts additional strength and rigidity to the
overdenture.
2. Prepare the ridge laps after the wax has been elim -
inated from the mold , but before the tinfoil subsitute
has been applied. Be sure that the posterior palatal seal
has been placed on the maxillary cast before the over -
den t ure is packed .
3. Do not place grooves in the anterior teeth ridge
laps, since grooves in these teeth can modify the shade.
Pink denture base resin ridges may be visible through
the relatively thin anterior tooth . Three to four shallow
indentations made in the ridge laps of these teeth with
a No. 6 round bur will improve attachment to the den -
ture base resin .
4 . Remove the glazed surface on the ridge laps of
anterior teeth to facilitate bonding between the tooth
and denture base resin . Ridge-lap modificaiton , careful
boilout procedures to assure complete wax removal ,
and tin use of high-impact denture base resin will sig-
*
nificantly reduce overdenture breakage.
Applying tinfoil substitute
Painting the mold with tinfoil substitute is an impor -
tant step in achieving a successful overdenture.
PROCEDURE
1 . Pour fresh tinfoil substitute in a paper cup, and
carefully paint the stone mold .
Fig. 19- 74. Carefully paint tinfoil substitute over stone mold and
cast. Take care to not get tinfoil substitute onto ridge laps of teeth.
If tinfoil is inadvertently placed on hdge laps of teeth, it must be
removed before denture base resin is added, or bond strength be
tween denture base resin and denture tooth will be severely com-
promised.
2. Do not coat the ridge laps of the teeth with tinfoil
substitute. If this is done inadvertently, remove it with
a cotton swab ( Fig. 19-74). If tinfoil substitute is al-
lowed to remain on the ridge laps of the resin teeth , a
significant reduction of bond strength will occur. This
reduced strength compromises overall overdenture
strength and should be avoided . Be certain that all
stone surfaces are coated with tinfoil substitute, and
place the flask aside to dry .
3. Paint tooth -shade heat -curing resin into the hol-
lowed -out denture teeth over the abutments, and wet
it with monomer ( Fig. 19-75).
PACKING THE OVERDENTURE
PROCEDURE
1 . Pack the overdenture with a high-impact denture
base resin . * Proportion the powder and liquid , and mix
it according to the manufacturers recommendations
( Fig. 19-76).
2. After the resin has reached the dough stage, re -
move it from the mixing jar , and adapt it to the mold .
Use plastic gloves, or plastic sheets, to avoid contacting
the resin with the hands ( Fig. 19-77). Place a plastic
sheet over the resin , assemble the flask, and close it
slowly in a bench compress as in the case of the con -
ventional complete denture. Be sure to allow adequate
*Lucitone 199. The L. D. Caulk Co. , Milford , Del . : Hireoe, Coe lab-
oratories, .
Inc., Chicago, III ; or equivalent.
r
Fig. 19-75. Paint heat -curing tooth- shade resin into all abutment
teeth. Dip brush first in monomer and then polymer, and transfer to
abutment tooth. Do not overfill. Note indentations in anterior teeth
- .
( arrow )
 Laboratory procedures for immediate overdentures 539

time for the resin to flow throughout the mold . Do not

attempt to obtain metal - to- mctal flask contact on the
initial closing.
3. Remove the flask from the bench press, open it ,
and trim the excess resin flash with a No. 25 blade in a
-
Bard Parker handle ( Fig. 19-78). Take care to not incor -
porate stone particles in the resin as a result of trim -
ming. Replace the plastic sheet , and make another trial
closure. Remove the flask , separate the halves, and
trim the excess as before. In this manner, make addi -
tional trial packs until resin flash within the mold no
longer occurs , and metal - to- metal closure of the flask is
obtained .
4. Place the packed dentures in a hand compress,
and cure them according to the manufacturer s recom -
mendations.
Fig. 19 76. Use high-impact denture base resin and proportion
-
powder and liquid according to manufacturer’s recommendations.

Fig. 19 77. Use plastic gloves or plastic sheet to handle resin and
-
place resin into mold. Use of gloves prevents contamination of resin
with skin oils and, more important, may prevent contact dermatitis
as a result of repeated contacts with resin.

Fig. 19-78. Remove flask from bench press, open it, and trim ex -
cess resin flash with sharp No. 25 blade. Take care to not incor-
.
porate any stone particles from trimming into resin
540 Dental laboratory procedures: complete dentures

*
Fig. 19-79. Remount overdentures on casts in articulator, and de-
termine amount of processing error.

.
Fig. 19-80. A , Be certain that indicated p ocessing error is not caused by contact of posterior exten-
sions of overdenture. These areas are frequently waxed more heavily immediately before flasking
and, as result, produce interferences once overdentures are remounted in articulator. B. In centric
relation position, grind fossa of tooth unless opposing cusp is high not only in centric relation position
but also in eccentric positions. C, Adjust inclines of buccal cusps of maxillary teeth (arrow ) and lingual
cusps of mandibular teeth to eliminate working side interferences.
 Laboratory procedures for immediate overdentures 541

A B

Fig. 19- 81. A , Trim overdenture borders with arbor band mounted on lathe. B, Anterior flange of
overdenture usually requires thinning, since portion of impression is not border molded . Do not over-
thin before dentist adjusts for undercuts.

POLISHING THE OVERDENTURE

* 2. Trim overdenture borders with a lathe- mounted
Fig. 19-82. Polish accessible areas of overdenture with lathe-
mounted rag wheel in slurry of flour of pumice . ( Arrow denotes di-
rection of rotation. )
CORRECTING PROCESSING ERROR
After the overdentures have been retrieved from the
flask, they are remounted in the articulator, and the
amount o! pin opening is determined ( Fig. 19-79 ). t se
articulating paper to indicate the deflective contacts on
the occlusal surfaces of the teeth , and adjust the deflec-
tive contacts ( Fig. 19-80). Some dentists may prefer to
make corrections after the remounting procedure. After
the occlusion has been adjusted , an occlusal index of
the maxillary overdenture can be made to preserve the
face- bow record if a face- bow record was used to mount
i the maxillarv cast .
PROCEDURE
1 . Remove the overdentures carefully from the cast
as previously discussed . A laboratory shell blaster can
be used to remove stone from the interior of the over -
denture. Otherwise , remove the stone in small sec-
tions, and do not attempt to pry the overdenture from
the cast .
arbor band ( Fig. 19-81 ).
3. Smooth accessible exterior surfaces of the over -
-
denture with a lathe mounted rag wheel and a slurry of
flour of pumice ( Fig. 19-82 ).
4 . Smooth the palate and the region adjacent to the
teeth with a handpiece- mounted brush and rubber pro -
-
phy cup and flour of pumice ( Fig. 19 83). The smaller
rubber cup allows smoothing areas of the overdenture
base without obliterating contours.
5. Stipple , or place an eggshell surface on the pol -
ished anterior and buccal surface of the overdenture
with a finishing bur if desired ( Fig. 19-84 ).
6. Buff the polished surface to a high luster with a
lathe-mounted rag wheel and polishing medium * ( Fig.
19-85).
7. Examine the interior of the overdenture, and re-
move any nodules or sharp fins that might prove un -
comfortable for the patient .
*Ti-gleam No. 341, Ticonitim Company, Albany, N . Y., or prepared
chalk or equivalent polishing agent.
542 Dental laboratory procedures: complete dentures

Fig. 19-83. A . Use handpiece-mounted brush, B and C, rubber prophy cup and flour of pumice to
polish areas of overdenture where access is limited. Use of larger wheel in these areas will obliterate
anatomic contour.

Fig. 19-84. A, Eggshell finish placed on overdenture is frequently esthetic because it breaks up light
reflections. This finish is accomplished by first outlining finish area on overdenture with eyebrow
.
pencil. In this overdenture canine is over abutment (arrow ) B, No. 200 finishing bur is rotated against
.
resin to create desired surface Bur should be randomly moved over surface within outlined area with
light pressure.
 Laboratory procedures for immediate overdentures 543

1 *

A B

Fig. 19- 85. Buff overdenture to produce high-luster surface. Note effect of finishing bur on surface .

8. Scrub the polished overdenture with soap and wa-

ter to remove all traces of polishing compound . Rinse
and store the overdenture in water , or seal it in a plas -
tic bag containing water ( Fig. 19-86 ).

PROBLEM AREAS
Principal problems associated with constructing an
immediate overdenture are related to failure to use a
-
high impact resin for construction of the overdenture;
failure to use resin denture teeth ; and failure to place
retention grooves in the ridge laps of resin denture
teeth , which will contribute to a weaker overdenture
(Table 19-4 ). Using a high -impact resin , such as Luci-
tone 199 or Hircoe, using resin teeth in the overden -
ture, and the placement of retentive grooves in the
ridge laps of the posterior teeth and retentive indenta-
Fig. 19- 86. Scrub polished all- resin overdenture with soap and wa- tions in the anterior teeth , will contribute significantly
r • ter and store in water . to a stronger overdenture.
544 Dental laboratory procedures: complete dentures

Table 19-4. Immediate overdentures

Problem
Immediate overdenture breaks
repeatedly in service
Resin teeth did not bond to
denture base resin
Probable cause Solution 1
High-impact resin not used Use high-resin to pack the immediate overden-
ture
Resin teeth not used Use resin teeth on overdenture
Wax not completely removed during Use boiling water, to which detergent has been
boilout added, to flush mold; follow with clean
boiling- water flush
Tinfoil substitute inadvertently painted Take care to not paint tinfoil substitute on ridge
on ridge laps of teeth laps of resin teeth; remove any placed inad-
vertently
Ridge laps not groved before packing Place grooves in ridge laps of resin posterior
resin teeth; place indentations in ridge laps of an-
terior teeth

SUMMARY
Laboratory procedures incident to constructing im -
mediate overdentures were discussed in this chapter.
The procedures are similar to those for conventional
immediate overdentures. Significant differences exist ,
however, and these relate to the method in which the
teeth are set on the cast, the use of resin teeth for the
denture , the method in which the resin teeth are
grooved to provide additional bonding area, and the use
of a high-impact resin to construct the denture. When
constructing an immediate overdenture, it is important
to remember to not remove all the teeth from the cast .
Abutment teeth are prepared on the cast , and prepa-
ration can be accomplished by the dentist. Immediate
overdentures are finding widespread acceptance
throughout the dental profession , and it is axiomatic
that those involved in constructing immediate overden -
tures be knowledgeable in the procedures involved.
BIBLIOGRAPHY
.
Brewer A . A., and Morrow, K . M . : Overdentures, ed. 2, St. Ixniis.
. .
1980, The C V Moshy Co.
Morrow, R . M .: Handbook of immediate overdentures, St . Louis,
1978, The C. V . Moshy Co.

r
 M
CHAPTER 20
DENTURE BASE TINTING
KENNETH D. RUDD, ROBERT M. MORROW , and MEADE VAN PUTTEN
tinted denture base A denture base that simulates the coloring
and shading of natural oral tissues.
TINTING THE DENTURE BASE
Several methods have been used to tint denture base
resins to achieve a more natural appearance. Usually
-
heat curing or autopolymerizing resins of various
shades or colors are painted on the denture base or are
shifted onto the mold during denture construction to
obtain a tinted denture. Skillful tinting procedures can
produce excellent results, but it is equally true that
poorly executed tinting can produce garish results,
much worse than no tinting at all . Recently more den -
ture base resins are available in different shades to
meet individual patient needs . Denture base resins can
be obtained in a range of colors and shades from deep
pink brown to light pink ( Fig. 20- 1 ). * Denture base res-
ins are also fibered or nonfibered and range in translu-
cency from relatively translucent to moderately opaque.
A major indication for special denture base shades and
individualized tinting is pigmented oral tissues ( Plate
1 ). Methods for tinting the denture bases for these pa-
tients are described by Choudhary et al. (1975).
Two methods for tinting the denture base using heat -
curing tinting resins will be described in this chapter.
The methods are based on the sift - in technique of
Pound (1951). A simple method for gaining experience
and developing skill in tinting will also be described .
* Natural C< *e- Lor Denture Kesin , Coe Laboratories, Inc., Chicago,
III.
PROCEDURE
Usually, five stains or tinting resins are adequate to
characterize most dentures ( Fig. 20-2 )*.
H , basic color ( light pink as in attached gingiva)
F, light red
A, medium red , use cautiously
E , purple, use sparingly in most dentures
B, brown , used for patients with heavy gingival pig-
mentation .
I. When waxing the denture, use care in carving ap-
propriate contours on the denture base. Skillful con-
touring is probably more important for esthetics than
tinting. Application of stains is related to carved con -
tours ( Fig. 20-3).
2. Flask and boil out the denture, paint it with tinfoil
substitute, and allow to dry .
3. Modify a glass dropper by heating and drawing to
create a smaller orifice and better monomer control
( Fig. 20-4 ). Use heat -curing monomer to wet the resin .
4. Sift H resin over the facial aspect of the flashing
stone in the region occupied by the attached gingiva ,
and saturate it with monomer ( Figs. 20-3 and 20-5).
l int half the denture, then tint the other half.
5. Sift a light coat of F over the 11, and extend the F
higher on the flange ( Fig. 20-6 ).
6. Sift E sparingly on the area of the attached gingiva/
mucosa junction, and saturate it with monomer. Do not
overwet the resin , or it may pool in the lower gingival
areas.
Mo.
-
* Kayon Denture Stains, Kay See Manufacturing Co. , Kansas City,
545
 %

546 Dental laboratory procedures: complete dentures

*
1

.
Fig. 20-1 Natural Coe-Lor denture resin. ( Courtesy Coe Laboratories, Inc., Chicago. III.).

-. .
Fig. 20 2 Kayon stains: H, F. A. E and Brown.

.
Fig. 20-3 Drawing indicates appropriate areas for each stain.
 Denture hose tinting 547

Fig. 20- 4. A . Lower dropper has been modified to produce smaller orifice and better flow control. B,
Large dropper orifice releases too much monomer. C, Smaller orifice permits excellent monomer flow
control.

Fig. 20- 5. Stain H has been applied and is wetted with monomer Fig. 20- 6. Stain F is sifted over stain H and extended higher on
from small dropper. flange.
548 Dental laboratory procedures: complete dentures

.
Fig. 20 7. A Stain A is sifted over stain F and extends to denture border. B, Resin is wetted with
-
monomer.

Fig. 20 8. Tinted dentures before removing from casts.

-

Table 20-1. Denture base tinting

Problem Probable cause Solution

Denture tinting too red and gaudy
Denture has horizontal streaks of
color
Stone adhered to tinted resin
when deflasked
Tinted surface is porous on de-
flasking
Tinting resin squeezed out during
trial packing
Too much A applied
Tinting resins not blended or over-
lapped
No coating of tinfoil substitute ap-
plied
No coating of tinfoil substitute in
spots or small areas because of
retained wax on mold
Too much monomer added, permit-
ting resin to penetrate investing
stone
Tinting resin monomer evaporated
before denture was packed
Resin not allowed to set for 15 to 20
minutes before packing
Apply less A
Overlap resins with each application to produce
gradual color change
Paint cast ; flask stone with tinfoil substitute
Clean mold thoroughly with detergent during
boilout to permit tinfoil substitute to react with
gypsum mold
Control flow of monomer
Keep previously tinted surface slightly wet; cover
tinting resin with sheet of plastic after applica-
tion to reduce evaporation of monomer
Permit resin to set for 15 to 20 minutes before
packing i

7. Silt A higher on the flanges to the borders of the
denture. Use care, since A is red ( Fig. 20-7).
8. After tinting one side of the denture , complete the
r H other side iu the same manner. Continually refer to the*
tinted side for comparison to avoid a pronounced differ -
ence in color and distribution of the tinting resin .
9. Place a plastic sheet over the tinted flask , and al -
low it to set for 15 to 20 minutes before packing the
denture l #ise. If the denture is packed too soon , the
tinting resin can be squeezed out of the mold , or the
distribution modified .
10. Cure the denture, and finish and polish it in the
usual manner ( Fig. 20-8 and Plate 2 ).
The second method involves the use of brown and
purple resins for those with pigmented oral tissues.
PROCEDURE
1. Sift F resin over necks of teeth and saturate with
monomer. This should be a very thin layer ( Plate 3, A ).
2. Sift a layer of brown resin over the F resin ( Plate
3, B ). Take care to correlate the thickness of the layer
to obtain desired intensity of the brown tint.
¥ *
%
Fig. 20-9. Flexible silicone mold makes excellent practice mold. Autopolymerizing tooth-colored resin
can be sifted into the mold first to simulate denture teeth.
Denture base tinting 549
3. Place red fibers above the mueogingival junction
on attached mucosal regions and sift A resin over the
fibers ( Plate 3, C ).
4. Add F resin to mucosal areas to create a mottled
or scattered pattern. A slight amount of yellow can be
used as a highlighter over the root eminences. Saturate
with monomer ( Plate 3, D ) .
5. Completed denture simulates color and texture of
natural tissue ( Plate 3, E ).
PROBLEM AREAS
The principal problem with this technique is related
to poor results because of improper application of the
tinting resin (Table 20-1). It is important to note that
the brown gingival colors can be made more or less in -
tense with a variation of the thickness of the applica-
tion . The procedure must not be done hastily or in a
slipshod manner. 11 is important to overlay each addi -
tion of tinting resin to produce a gradual color change,
rather than a striped appearance. Experience is very
important in achieving an acceptable result.
550 Dental laboratory procedures: complete dentures

*1 ^

Fig. 20- 10. Resin veneer can be easily removed for evaluation and study.

USE OF PRACTICE MOLD REFERENCES

In Chapter 9, methods for using a flexible silicone Choudhary, S . ( .‘. Craig, J . F. , and Suls, F. J .: Characterizing the den -
t

mold material were discussed ( Fig. 20-9). After the .

ture base for non -Caucasian patients J . Prosthet . Dent. 33:73-79.
1975.
dentures are processed in the mold , the mold can be .
Johnson II . B .: Techniques for packing and staining complete or par-
used for practice to improve tinting skills. The flexible tial denture bases. J . Prosthet. Dent . 6:154-159, 1956.
silicone permits the tinting veneer to be removed from Kemnitzer , D . F . : Esthetics and the denture base, J . Prosthet. Dent.
6:603-615, 1956.
the mold and evaluated ( Fig. 20- 10). Thus the techni - Pound . E. : Esthetic dentures and their phonetic values, J . Prosthet.
cian can see immediate results of the tinting proce- Dent. 1:98- 111, 1951.
dures. Different combinations of resins and the appli - Powers. J . L.: Brush -on technique in natural coloring of cured cross-
cation sequence can be studied and practiced to linked plastic artificial denture materials, J . Prosthet. Dent . 3:350-
improve skills. .
353 1953.
Proctor, 11. II .: Characterization of dentures, J . Prosthet. Dent.
SUMMARY -
3:339 349, 1953.
#

A method for characterizing the denture base by tint - *

ing was described in this chapter. It is important to re-
member that proper contouring of the denture base is
even more critical to achieving an esthetic denture .
Poorly executed tinting is usually worse than no tinting.
Practice will usually result in vastly improved skills.

I
 *
CHAPTER 21
CUSTOM MOUTHGUARDS
ROBERT M. MORROW, WILLIAM KUEBKER . and RICHARD SEALS
mouthguard (mouth protector ) A device or appliance placed in-
side the mouth (or inside and out ) to reduce mouth injuries , par-
ticularly to teeth and surrounding structures.
Mouthguards have proved to be particularly effective
in reducing injuries to teeth and surrounding structures
in contact sports participants. In certain sports such
as football their use is mandated by rules implemented
^ by the sport’s governing bodies. The sports participant
has three types of mouthguards to choose from ( Fig. 21-
1 ). They include:
chased over the counter and ready for use.
—
Type I (stock mouthguard ) a mouthguard pur-
—
Type II ( mouth molded ) Purchased over the
counter but fitted to the athletes mouth , usually by
softening in hot water, then by adapting over the teeth .
Most are the heat-softening type, but a few are adapted
to the teeth with a fast -setting soft resin .
—
Type III (custom ) the custom mouthguard is con -
structed on a cast obtained from an impression of the
player's mouth . Custom mouthguards have been con -
structed from rubber, silicone materials, and various
resins. A popular method is to heat a sheet of thermo-
plastic mouthguard material and then vacuum -adapt it
over the dental cast . Custom mouthguards have several
advantages over the other types, including better fit
and adaptation , improved comfort , and less interfer-
ence with breathing and speech . Interference with
speech can be a serious problem for those players
whose positions require clear , understandable speech .
r The methods described are for custom mouthguards
with and without a faceguard attachment strap and with
modification to improve speech clarity.
PROCEDURE
As in the case of most dental procedures, accurate
casts are required . Casts should he poured in artificial
stone and should accurately reproduce all anatomic
structures to be contacted by the mouthguard. The
casts should be free of voids , distortions, and stone
nodules. Maxillary and mandibular casts will be needed
if occlusion is to be provided. If custom mouthguards
are to be made for an entire team , care should be taken
to identify each cast to prevent subsequent mix- ups
( Fig. 21-2 ).
CAST PREPARATION
1. Trim the maxillary cast laterally to the depths of
the vestibular extension. Trim the base to produce
approximately 5 mm thickness in the palate ( Fig.
21-3).
2. Draw outline of the mouthguard on the cast with
a pencil ( Fig. 21 -4 ). Keep buccal and labial borders 2
to 3 mm short of the vestibule and frenae ( Fig. 21-5).
Palatal extensions can vary from 2 to 10 mm from gin -
gival margins of the teeth ( Fig. 21-6 ). Shorter palate
extensions are used when maximum speech clarity is
required.
3. Place a hole through the palate of the maxillary
cast with a No. 8 round bur ( Fig. 21 -7 A and B ) . The
hole facilitates intimate adaptation of the mouthguard
material to the cast .
551
k \
552 Dental laboratory procedures: complete dentures

-.
Fig. 21 1 Three types of mouthguards are available. Stock, mouthformed (center two), and custom ( L ).

Fig. 21-2. Cast should be marked to prevent possibility of misiderv

tification.

Trim to depth of
vestibular extension
-.
Fig. 21 3 Base of cast should be no thicker than 5 mm in palate.
Vestibular recesses are trimmed away. \ /
\ / ft -
\ 5 mm /

CROSS SECTION
A
*

Plate 1. Many patients present with pigmented oral tissues. It is axiomatic that complete denture
restorations for these patients be appropriately tinted to facilitate acceptable esthetics.

r r

Plate 2. Contouring and tinting the denture base can

contribute to a lifelike appearance. A poorly executed
tinting procedure may, however, ruin an otherwise ac-
ceptable denture.

r '
 4

A
0

*
,-v

** »

Plate 3. A, Shade F polymer is sifted over necks of the denture teeth. B, Brown resin is sifted over
F layer. Thickness of the brown layer should be controlled to produce desired result. C, Red nylon
.
fibers are placed above the mucogingival junction in the attached mucosa areas The A resin is sifted
over the fibers. D, E resin is added to mucosal areas to produce a mottled or scattered pattern.
Saturate with monomer. E, Complete denture tinted to conform with patient's pigmented tissues.
 Custom mouthguards 553

is

Fig. 21- 4. Mouthguard is outlined on cast with pencil. Do not bead Fig. 21- 5. Mouthguard border should be 2 to 3 mm short of maxi-
cast. mum extension and provide adequate frenae relief .

Fig. 21-6. Palatal extensions can be modified to fit needs of athlete.

Line closer to teeth generally provides better speech. Outer line is
typical or usual extension.

Mouthgard outline 0

2 10 mm
*
xHole placed in palate

C \ Fig. 21-7. A , Maxillary cast is perforated with No. 8 round bur. B , Hole is centrally located in cast .
 554 Dental laboratory procedures: complete dentures

*
Fig. 21-8. Mouthguard material ( L), %2 inside diameter vinyl tubing
( top ), and wood dowel ( R ) are used to form attachment core.

12 mm

A 15 mm
Scrap mouthguard material
B

Q
Wood dowel
)
m 5
) Vinyl tubyig 7/32 " outside diameter

/32 " inside diameter

Fig. 21-9. A, Tubing with enclosed dowel is attached to mouthguard material. B, Wood dowel pre-
vents collapse of tube lumen during vaccuum adaptation.

Identification

\ # 30 \ \
~
\ Seals \

Wood dowel
$ Logo

Fig. 21- 10. Typed name is lightly pressed on softened surface of Fig. 21- 11. Team logo can be placed on large vinyl tubing *
core.
 Custom mouthguards 555

* !*

Adapt and attach to cast

B

Fig. 21-12. A, Attachment core must extend vertically above teeth. B, Attachment core overlaps
lingual and labial surfaces of anterior teeth approximately 2 mm .

Mouthguard with faceguard attachment

Many football players prefer a mouthguard with a
strap for attaching the mouthguard to the helmet face-
guard. Attaching a strap to a custom mouthguard has
been a problem , but the method described , which is a
modification of that described by Greco (1977) has
proved successful. Our method uses flexible vinyl tub-
ing to attach the mouthguard ( Kuebker and Morrow,
B 1984 ).
PREPARING THE ATTACHMENT CORE
er
y l .Cut a 12 X 15 mm rectangular piece of mouth -
* guard material * ( Fig. 21-8). Scrap material may be used
since full - thickness, 0.150-inch , is not required.
2. Cut a 12 mm length of 5/32- inch inside diameter,
7/32- inch outside diameter vinyl tubing, t
3. Cut a 12-mm length of orange wood stick or wood
dowel approximately 5/32- inch in diameter, lubricate ,t Fig. 21-13. Chill cast in freezer before adapting mouthguard.
and insert into the vinyl tubing.
4 . Heat one end of the rectangular section of mouth -
guard material with an alcohol torch and attach to the
-
vinyl tubing ( Fig. 21 9 A and B ). The athlete’s name 8. Heat the opposite end of the attachment core, and
and number and the team logo can be placed on the adapt over the incisal edges of the maxillary central in -
attachment core to permanently identify the mouth - cisors. Overlap the incisal edges on the labial and lin -
guard . gual approximately 2 mm . The attachment core must
5. Type the name and/or number and cut out , mini - extend vertically above the teeth ( Fig. 21- 12).
mizing margin around name. The typed names can be
VACUUM ADAPTATION
reduced on a reducing copy machine if desired .
6. Lightly flame the attachment core and gently press 1. Place the cast with attached core in a freezer for 2
the name onto its surface ( Fig. 21-10). to 3 minutes ( Fig. 21-13). Chilling the cast helps to pre-
7. A team logo can be cemented on the vinyl tubing vent excessive thinning of the mouthguard material
as an option ( Fig. 21-11). when vacuum adapting.
2. Place a sheet of 0.150- inch thick mouthguard ma-
r (
-
.
iacturing Co. , Inc , Brooklyn , N . Y.
-
*Sta Cuard Mouthguard Material 0.150 inch, buffalo Dental Manu - terial in the vacuum adapter and turn on heating ele-
tCadillac Plastics, San Antonio, Tex. ment . Heat until material sags 3/ 4-inch below frame
^Masque-silicone lubricant , Henry Bosworth Co, Skokie, III . holder.
556 Dental laboratory procedures: complete dentures

3. Remove chilled cast from freezer and place on ad -

aptation table; lower frame until the mouthguard ma-
terial contacts the occlusal surfaces of the teeth ( Fig.
21 - 14 ). Maintain this position 15 to 20 seconds.
i
4 . Lower frame to its lowest point and turn on vac-
uum for 10 seconds ( Fig. 21-15).
5. Remove cast and adapted material , and chill in ice
water.
6. Trim excess mouthguard material from the base of
the cast with shears.
7. Meat material around junction of strap attachment
core with an alcohol torch ( Fig. 21 - 16).
8. Hold the cast under a warm water faucet , and
carefully bend the core forward into a near horizontal
position ( Fig. 21-17). The core should have a slight
downward tilt . Fig. 21- 14. Permitting mouthguard material to contact occlusal sur-
faces of teeth 15 to 20 seconds before adapting helps to prevent
overthinning of mouthguard in critical areas.

Fig. 21- 15. Material has adapted over attachment core and cast. Fig. 21- 16. Use torch to soften core just above incisal edges of
Vertical position of core before adaptation helps prevent folds of .
teeth Soften all surfaces but do not char material.
material in labial flange.

A B

Fig. 21-17. A, Mold core under hot water faucet. Be careful to not burn fingers. B, Core is now in
near horizontal position. Slight downward tilt from lip is desirable.
r
Custom mouthguards 557

9. Trim mouthguard to pencil outline on the cast

with a heated No. 25 blade in a Bard Parker handle.
Pull away excess material ( Fig. 21-18).
%
10. Smooth the mouthguard borders on the cast with
I
a coarse tapered stone* or acrylic bur ( Fig. 21 - 19).
Carefully remove the mouthguard from the cast and ,

further contour and smooth the borders ( Fig. 21-20 ) .

Soaking the cast in water and directing an airstream at
the border often facilitates mouthguard removal from
the cast and helps prevent broken teeth on the cast .
11. Replace the mouthguard on the cast , flame the
borders lightly with an alcohol torch, and smooth with
a lubricated finger.

DEVELOPING OCCLUSION

Fig. 21-18. Heated blade works well to cut out mouthguard . How -
ever, care must be taken to prevent finger lacerations.
+ tical stop previously set will prevent overclosure and
Fig. 21-19. Mouthguard border is beveled and contoured with a
violet stone while on the cast .
A mandibular cast will be needed if occlusion is to be
provided . A jaw relation record may also be needed if
there are insufficient teeth to accurately hand articulate
the casts.
12. Mount the casts in a plasterless articulatort ( Fig.
21 -21 ).
13. Increase the vertical dimension of the articulator
approximately 3 mm in the bicuspid region ( Fig. 21-22 ).
14. Lubricate the opposing mandibular occlusal sur-
faces with a silicone lubricant (Fig. 21-23).
^
15. Place the mouthguard on the maxillary cast and
close the articulator. Initial contacts will usually occur
in the molar region ( Fig. 21- 24 ).
16. Soften the occlusal surface of the mouthguard
with an alcohoPtorch and close the articulator. The ver-
tooth penetration ( Fig. 21-25). Several heatings and clo-
sures mav *
be necessarv^ to achieve the selected vertical
dimension.
* Violet stone, Braeseller Manufacturing Co., Savannah . Ga.
fGalette, Rocky Mountain Orthodontics, Denver, Colo, /
t Masque. \

e %
Fig. 21-20. Removing mouthguard from cast permits access for Fig. 21- 21. Plasterless articulator saves time.
contouring.
558 Dental laboratory procedures: complete dentures

Ik

Fig. 21 22. Increasing vertical dimension on articulator controls

- .
Fig. 21- 23 Lubricated teeth will not stick to mouthguard material.
mouthguard thickness .

Fig. 21 24. Initial contact is with molar tooth.

- Fig. 21 25. All teeth now contact mouthguard occlusal surface.
- i

\
 Custom mouthguards 559

A B

Fig. 21- 26. A, Stone is used to remove material covering ends of dowel rod . B. Lubricated dowel is
pushed out of vinyl tube , leaving open lumen for attachment tubing.

17. Resoften the mouthguard occlusal surface and

carefully move the articulator in right and left lateral
and protrusive positions. Always end with a closure in
the centric occlusion position .
18. Deep indentations in the mouthguard are not de -
sirable and should lx * trimmed and smoothed . Trimmed
areas should be ( lamed with an alcohol torch to produce
a smooth surface. The objective of this procedure is to
permit maximum tooth contact with the mouthguard
when the player closes in the centric occlusion position .
\ V The occlusion should not lock the teeth in one position .
COMPLETING THE ATTACHMENT STRAP
1. Open into each end of the large vinyl tubing with
a stone or bur , and push the wood dowel out ( Fig. 21-
26). Fig. 21- 27. Typed name is visible through transparent tubing.
2. Cut a piece of vinyl tubing* 1/8-inch outside di -
ameter , 1/16-inch inside diameter. 13 inches long. This
external tubing, used to attach the mouthguard to the
helmet , may be dyed to the school s colors with house-
hold fabric dye. Do not dye the mouthguard . If the
tubing is dyed , it must be rinsed thoroughly in tap wa-
ter for 60 minutes.
3. The player s name can be placed in the vinyl tub-
ing by curling the typed name around the shaft of a
handpiece bur , then inserting the name into the lumen
-
( Fig. 21 27).
-
4 . Cut a piece of 0.08 inch diameter nylon monofila-
ment 3/4- inch long ( Fig. 21-28 ) .
5. Round each end of the monofilament with a coarse
stone. Then insert half its length into the lumen of the
small vinyl tubing ( Fig. 21- 29).
* Cadillac Plastics. San Antonio, Tex. Fig. 21- 28. Hot No. 25 blade can be used to cut monofilament.
560 Dental laboratory procedures: complete dentures

*
A B

Fig. 21- 29. A, Ends of monofilament are rounded to make insertion easier. B, Pliers grip monofila-
ment as it is inserted into vinyl tubing.

i
diameter tubing .
- -
Fig. 21-30. Tubing Vfe inch is threaded through larger V32 inch inside

'
4
!

Strap attachment core

\

Strap attachment core

vinyl tubing — 5/32 " inside diameter

3
Vinyl tubing — % " outside diameter
13 " long

§ea / sT fe&s&m
> ^
Identification in tubing ^3330.080 " nylon cord 3
—
/ " long
*
cemented into tube lumen

Fig. 21-31. Nylon monofilament joins tubing to make loop. *

\

*
Fig. 21 33. Mouthguard on left has shortened palatal extensions
-
and is design preferred by quarterbacks. Mouthguard on right has
conventional extensions. Partially erupted third molars were not
covered (left ).
V K
6. Thread the 13-inch length of tubing through the
larger tubing ( Fig. 21-30). Join the small tubing by
placing the nylon monafilament into the remaining
open end, forming a loop ( Fig. 21-31).
7. The nvlon monofilament may be cemented into
the tubing, but quicker release will occur if not ce-
mented . The tubing is looped over a horizontal bar of
the helmet faceguard ( Fig. 21-32).
Custom mouthguard without attachment
The procedures for constructing a custom mouth -
guard without an attachment strap are similar to those
already presented. The absence of the attachment strap
and the need for a different method for identifying the
mouthguard are the principal technical differences.
Typically this design is preferred by players who must
call signals in football and by those participating in a
S multitude of other contact sports where a helmet or
* faceguard are not worn .
Custom mouthguards 561
- .
Fig. 21 32 Vinyl tubing can be looped over horizontal bar of helmet
faceguara. NOTE: Cast and mouthguard identification.
Mouthguard outline
The palatal extension for a mouthguard to he worn
by a quarterback can be somewhat shortened ( Fig. 21-
33) . A conventional palatal extension is used for other
players who do not call signals. The shortened palatal
extension permits greater speech clarity and as a result
is preferred .
Mouthguard identification
Since an attachment strap is not used , the player’s
name is embedded in a buccal Hange of the mouth -
guard .
PROCEDURE
1 . The name and /or number is typed on paper and
cut with minimal borders.
2. A buccal Hange of the mouthguard is softened by
flaming with an alcohol torch , and the typed name is
pressed into the softened material with a plugger ( Fig.
21-34 ).
562 Dental laboratory procedures: complete dentures

Fig. 21 34. Typed name should be pressed into resin to depth of 1

-
to 2 mm.

A B

Fig. 21 35. A, Heated piece of mouthguard material is placed over typed name. B, Lubricated finger
-
can press material firmly over typed name.

- .
Fig. 21 36 Excess material is removed with stone to reduce need-
less bulk.
 Custom mouthguards 563

3. Cut a small rectangular piece of scrap mouthguard

material slightly smaller than the typed name. Hold the
material with cotton pliers and soften in a flame. Place
over the typed name and adapt with a lubricated finger
( Fig. 21-35) .
4. Cool the mouthguard in water and remove excess
material over the embedded name with a violet stone
( Fig. 21-36).
5. Flame the resin over the name to improve trans-
parency and to restore a smooth polished surface ( Fig.
21-37). The name is completely embedded in mouth -
guard resin and helps prevent loss and resultant need
for remakes ( Fig. 21 -38).
MOUTHGUARD OCCLUSION
Occlusion is particularly important for improved Fig. 21- 37. Flaming mouthguard material permits smoothing and
speech . Occlusion is developed as described previously enhances transparency.
(Fig. 21-39 ).

Fig. 21- 38. Name is completely embedded in mouthguard material

yet is clearly visible. #

A B

Fig. 21-39. A, If occlusion is not provided, molar teeth will usually contact mouthguard first. B, Mouth-
* * guard permitting equalized contacts of opposing teeth is more comfortable to wear. Partially erupted
third molars are not covered.
Table 21-1. Troubleshooting chart for custom mouthguard construction
Problem
Mouthguard too thin to af -
ford protection
Mouthguard material did
not adapt initially to cast
Mouthguard does not fit
cast
Mouthguard blackened and
unsightly
Mouthguard too thick and
not well adapted to cast
Attachment loop separates
too easily
Folds of mouthguard mate-
rial develop in labial
area when adapting over
attachment strap core
Attachment core collapses
during adaptation
Mouthguard material too
thin or perforated on lin-
gual aspect of anterior
teeth
Perforation of occlusal sur
face of mouthguard
Teeth or cusps break off
cast when removing
mouthguard
Cannot thread vinyl tubing
through attachment core
Probable cause
Mouthguard material too hot when
adapted
Cast not chilled
Mouthguard material not permitted to
contact occlusal surfaces of teeth for
15-20 seconds before lowering frame
Cast too thick, resulting in overthinning of
material ( tent effect )
Cast not trimmed properly
Hole not placed in palate of cast
Material not hot enough for adaptation
Cast is wet, inhibiting vacuum adaptation
Was not adapted properly, no hole in pal-
ate, material too cool
Mouthguard distorted during flaming pro-
cedure
Mouthguard removed from cast while
warm
Mouthguard rinsed in hot water
Mouthguard stretched and distorted when
removed from cast
Mouthguard material overheated and
charred during construction
Material was too cool when adapted
Material permitted to contact occlusal
surfaces of teeth too long before adap-
tation
Nylon monofilament section too short
Wrong size of monofilament used
Attachment core inclined to labial when
adapting softened mouthguard material
End of attachment core not securely
luted to incisal edges of teeth, or luting
is attempted on chilled cast
Attachment strap core softened before
adaptation
Molding attachment strap while mouth-
guard is warm
- Insufficient separation of teeth before de-
veloping occlusion
Tooth contacts when developing occlu - Check relationship of teeth in excursion movements to
sion in lateral excursions
Perforations occur while grinding away
deep indentations
Removal of mouthguard from dry cast
Water powder ratio of stone mix wrong
Inside diameter of tubing in attachment
core too small
Tubing of attachment strap core col-
lapsed during adaptation
Solution
-
Adapt when material sags 3/4 inch below frame 9
Chill cast in freezer immediately before adaptation
Permit material to remain in contact with occlusal sur-
faces of teeth 15-20 seconds before proceeding
with adaptation
Trim cast so base is approximately 5 mm thick in pal-
ate
Trim away deep vistibular extensions, which may
cause bridging during vacuum adaptation
Place a hole with a No. 8 bur in the palate to vent air
and ensure adaptation in this area
Let material develop 3 4 -inch sag before adaptation
Do not use a cast saturated with water; permit it to
dry
Place hole in cast palate; have proper sag before
adapting
Cool mouthguard after flaming
Chill mouthguard before removing from cast ; do not
force removal
Rinse mouthguard in cool water
Trim to border outline with hot blade before initial re-
moval from cast
Use care when flaming; move flame to prevent char -
ring
Be sure of 3 4-inch sag before adapting
Permit contact between material and occlusal surfaces
of teeth for 15- 20 seconds before adapting
0
Use 3/ 4 -inch length of monofilament
Use 0.08-inch diameter monofilament to ensure snug
fit
*
Place attachment strap core in vertical position (per-
pendicular to base of vacuum adapter )
Soften end of attachment core thoroughly and adapt
labial and lingual to incisal edges of teeth before r
chilling cast
Lute attachment core to teeth before chilling cast and p
do not soften core before adaptation
Chill mouthguard on cast ; then flame neck of attach -
ment core only, avoiding softening of resin over
teeth
Increase vertical dimension at least 3 mm in bicuspid
area to allow sufficient thickness in molar area
to
determine positions in which tooth contact occurs; i
limit movements so perforations do not occur
Remove deep indentations with a coarse stone with-
out attempting to flatten occlusal surface «
Immerse mouthguard and cast in cold water before
removal of mouthguard; keep in water until wetting
of teeth is evident
Use correct water powder ratio to assure maximum
cast strength
Use tubing for attachment core that is slightly larger
than outside diameter of vinyl tubing
Place lubricated piece of orangewood stick or dowel in
lumen before adaptation
i
 Custom mouthguards 565

PROBLEM AREAS REFERENCES

Principal problems associated with custom mouth - Greco, E.A.: Technique for a mouthguard with an attachment tab,
guard construction include failure to control mouth - Ontario Dent. 54:8, Aug. 1977.
Kuebker, W . A . , and Morrow, R. M .: Custom mouthguards: clinical
* guard thickness, distorting the mouthguard during con - and laboratory procedures. In Clark . J. W.: Clinical dentistry, vol.
struction . and burning or charring the mouthguard 2. New York , 1984. Harper & Row, Publishers, Inc.
material when flaming the borders (Table 21-1). Careful
attention to construction details will minimize most
problems and contribute to the achievement of a com -
fortable, well - fitting protective device.

* *
 c
// /
4y b
or
vi ( ,S
LIBRARY.
u
VL ^
<?
*
_^^ - V

> •. '* •

Index

A
Abrasive blasting equipment, 2:228, 292,
—
Acrylic resin cont’d
soft , denture base liner of, 1:442
323. 327, 451- 453 Acrylic teeth , 2:373, 3:345
Airbrush Workstation , 2:452 Acrylic veneer, labiogingival tissue; see
Blastmate Non - Recycling Abrasive Labiogingival tissue acrylic veneer
*4
Blasting Unit. 2:452-453 Adams clasp , 3:286-287, 634-636
Combilador CL- FSC, 2:452 Additive color mixing, 2:267
Micro Pencil Air Abrasive Unit, 2:453 Agar , 2:3, 3:1
Mini Max Blaster , 2:453 Agar reversible hydrocolloid
Abutment liquefication of, 2:4
in multiple splint or large bridge, repair packaged , 2:3 5 -
Agar reversible hydrocolloid impression ,
of, 2:418-420
1
with recurrent caries, repair of, 2:420- 421 2:3-9, 3:1. 23-26
% Abutment facing, fractured , repair of, 2:415- -
tare of , 3:23 24
pouring of, 2:7-8, 3:24-26
116
Accounts, soliciting of, by technician , 1:2 Agar reversible hvdrocolloid mold , 3:209-
Accralastic, 2:15 220
Accudrill, 2:469 Air blasting, 2:327
Accu -Therm II HXX ) furnace , 2:472 Airbrush, 2:293
Acetate sheet matrix , for provisional Airbrush Workstation , 2:452
-
restorations, 2:388 391 Akers clasp , 3:143
Ackermann clip. 3:581 , 608 Al-cote, 1:445, 3:380
Aekermann rider, 3:610 Alborinm , 3:319
Acral ite 88, 1:91 Alcoa 1)214 aluminum alloy, 1:468, 476
-
Acri Dense Pneumatic Curing Unit, 1:92, -
Alginate, 1:10, 2:7 9, 3:1
3>78 packaged, 2:9
Acrylic bulb , in definitive obturator, 1:488- Alginate adhesive , 3:504
491 Alginate foil substitute, 2:392. 394
Acrylic bur , 1:284 - 285, 364 , 369, 405, 531 - Alginate irreversible hydrocolloid
532, 557, 2:437-438, 441 -
in duplicating dentures, 1:339 348. 356
M elite. 2:430 .363
Acry lic index . 2:48-51 model construction from , 3:680-684
Acrylic insert, 3:496 in repair of fractured denture, 1:402, 404 .
Acrylic resin; see also Fluid resin complete 106
denture Alginate irreversible hydrocolloid
die of, 2:42-43
*
-
denture base of. 3:156 157 impression , 2:7-11. 3:1-23, 504-505
artificial stone in , 3:7- 17
impression tray of, 3:60-68 care of, 3:4 - 11
mixing and pouring of. 1:432 433- over framework and relined bases. 3:413
obturator of, 1:479-481 pouring the stone in , 3:12 18 -
preliminary', 1:10-22
Boldface numbers indicate volumes ol Dental
trimming of, 3:19 23 -
Alginate irreversible hydrocolloid mold .
Laboratory Procedures series: I , Complete 1:356, 3:209
dentures ; 2, fixed partial dentures; 3, Re- -
Alginate substitute silicone impression
movable partial dentures. system , 2:11-12
Alloy, 2:220-228
base metal; see Alloy, nonprecious
ceramic; see Ceramic alloy
-
ccramometal; see Metal ceramic alloy
- -
cobalt chromium , 3:220 221, 275, 327,
515
gold ; see Gold alloy
hardness of. 2:224
heat hardening of, 3:321
heat softening of*3:321
high -fusing, 2:214
magnetizable 3:597
IIHHIUIC of elasticity. 2:224
-
nickel chromium. 2:223, 233 235. 3:275
nonprecious, 2:223, 233-235, 3:275
-
- -
palladium cobalt nickel, 3:597
percent of elongation , 2:224
physical property charts for. 2:224
-
platinum gold - palladium . 3:274
-
porcelain bonding, 2:214
precious, 2:221-223, 3:274 275 -
semiprecious, 2:223- 224 , 233 2)5 -
-
silver palladium , 2:223
yield strength of. 2:224
Altered cast . 3:30
Aluminous porcelain , 2:284 285 -
Aluminous porcelain jacket crown , 2:305-314
Aluminum alloy base, 1:460. 464. 468, 476 -
477
- Aluminum crown , 2:381-384
Aluminum oxide abrasive blasting. 2:249,
.
292 451-453
Alveolar lione, loss of, 2:367-368, 371
Amalgam repair , 2:420
American Tooth Manufacturing Company,
teeth manufactured by, l :199-2( X)
Analyzing rod , 3:165
Anatoline posterior teeth. 1:200 201, 263 - -
.
267 272-274
arranging in bilateral balance, 1:266 267 -
arranging in linear occlusion 1:263 265 . -
Anatomic crown , 1:6
Anatomic model , mounting of. 2:58-64
on fully adjustable articulator, 2:63-64
on nonadjustable articulator, 2:58 61 -
on semiadjustable articulator, 2:61 63 -
1
2 / ndex

Anatomic teeth , 1:6, 1 ST Denar Track II . 2:458-459 Attachment — emit d

Anatomy, occlusal, 2:153 156
Anchor hand . 1:96
- Dentatus AKA . 2:457-458
Dentatus ARH , 1 :148. 157-162 2:45(3457 .
stress-director. 2:333
stud; see Stud attachment
.
Ancrofix attachment 3:581. 589 590, 603- - in fabrication of occlusion , 2:157-158 Swing/ Lock ; see Swing/ Lock (S/ L) partial
604 fully adjustable , 2:63-64 denture
Annealed orthodontic wire. 3:617-618 llanau 158, 2: ISO Ultra- M , 2:359-360
Anterior edentulous area removable partial Hanau 96112. 1:149 Attachment casting of Swing/ Lock partial
denture, 3:138
Anterior guided posterior occlusion , 2: 179
llanau 130-1, 1:148
llanau 154-1. 1:148
dentures, 3:506 509
Attrition 1:6 .
-
Interior pontk - ; -111 201
maxillary . 2:279
- Hanau 130-28, 1:149. 163 171
llanau 112 A icon , 1:149, 171 - 176
- Auricular metal mold, 1:502-505
-
Auto Klutch drive, 2:412. 417
Anterior teeth , 3:350 351 - Hanau LTD 147-3, 2:455-456 Autocast Induction Casting Unit , 2:466-467
arrangement
1:236
of, overall evaluation of, Hanau Radial Shift , 1:149 150, 2:455
llanau University Model 130-22, 2:45- 4
- AutopoKmeri / ing resin
acrylic
m immediate overdenture, 1:528 531 - Hanau Wide-Vue, 1:149-150, 2:454-455 impression tray of. 1:26 40, 44 56 - -
mandibular. 2:92-93
arrangement of / 1:235- 236
Hanau - Mate 165 1, 2:455-456
nonadjustable, 2:58-61
- in orthodontic appliances , 3:641-644
for relines, 3:417-419
metal-ceramic restoration of, 2:277-278 and pantographic record , 2:156 157 - sifter for. 1:94
maxillary , 2:92-93 Plainline, 1:151 in addition of palatal seal , 1:409 412 -
anterioposterior placement of, 1:223-237
arrangement of. 1:232-233
plasterless, 1:557 559
semiadjustable, 2:61 -63
- in clasp attachment . 3:288
in duplicating dentures, 1:339-363
asymmetry of, 1:229 230 - TMJ Deluxe, 2:460 model construction from . 3:680-684
.
crowding of, 1:231 -232 TMJ Mini, 2:460-461 -
pour type, in duplicating dentures 1:348 -
lapping of. 1:231-232 Whip- Mix , 1:151, 177-181 . 2:61 -62. 457 - 356
-
metal ceramic restoration of , 2:276- 277
placement and positioning of, 1:226-229
458
Whip- Mix quick -mount , 2:78-81
record base stabilized with . 1:121 -123,
3:113-117
relationship of arch form to tooth Articulator method in relining, 1:364 376 - i
arrangement . 1:225- 227
.
of re basing. 1:377 380 - repair , 3:451
spacing of 1:230 231 -
over- the- ridge position of. 1:223-224
of relining, 1:364-371
Artificial teeth . 1:187- 222; .see also Denture
in repair of fractured denture teeth ,
1:383-389
replacement of, 1:383-392, 3:158- 161 teeth Autopolymerizing resin record base. 1:91 -
representative artificial . 1:199
Antiflux, 3:469. 471
arranging. 1:223 275 - 111, 3:77-100
confined dough method , 1:103-112
articulating, 1:223 275 -
Appliance
bruxism, 2:428-431
components of, 1:189
.
materials for 1:187- 188 wax, 3:95-100
-
stone mold, 1:103-108

.
diagnostic 2:428-449
orthopedic, 2:432-449
with metal occlusal , 1:188
mold identification , 1 :191 -201
-
wax confined , 1:108- 112
finger-adapted dough method 1:99-103, .
repositioning; see Repositioning appliance
temporary occlusal, 2:429
shade identification. 1:191 201
Asbestos substitute, 3:300, 316
- 3*90 95
-
-
sprinkle on method, 1:91 -99, 3:78 90 -
temporomandibular joint 2:428- 431 . A SC-52 attachment. 2:332. 354-357, 361 with framework. 3:84 ^90 i

treatment . 2:428-449 Asymmetry in tooth arrangement , 1:229-230 Axial contouring, 2:184-191

Aqueous impression material . 3:1 .
\ ttachmerit 2:331 366
Arl >or band . 1:31, 44. 112- 113, 127, 326, -
A SC 52 , 2:332, 354-357, 361
- faciolingual surface, 2:185-189 *
I
interproximal surface. 2:189-191

Arch
328. 514 -515. 522 523 .541, 3:398 - . auxiliary. 3:581
liar; see Bar attachment
Axis, 2:143. 151
Axle. 2:143
ovoid , tooth arrangement in . 1:225-227 Rival , 2:332, 347, 352-354 , 361
relationship of arch form to tooth Dalbo; see Dalbo attachment B
arrangement , 1:225- 227 EM . 3:582 Bach man n Parallelometer. 3:579
square, tooth arrangement in , 1:225-226 extracoronal; see Extracoronal attachment Bachmann Parallelor and Precision Milling
square tapering, tooth arrangement in . flat-back lock. 3:504-510, 513 instrument 2:477 . I
1:226-227 H-tvpe frictional , 2:331 Back pressure porosity, 2:207, 215
tapering, tooth arrangement in . 1:225-226 Interlock, 2:334. 337-338 Backing, metal: see Metal backing
«
Aristocrat HTC. 2:386 intracoronal . 2:331. 337-347 Baer attachment, 3:589-590, 601
Arrowhead claps 3:6134 . intracoronal -extracoronal combined ; see fricative. 3:582
Arti - Fol Plastic, 2:437, 441 Schat / mann attachment retentive 3:582 .
-
Artic U- Locs, 3:466 M -S. 2:337 Balance , electronic, 2:453-454
Articulating foil, 2:438
Articulating paper. 1:320, 541. 2:300. 302,
magnet. 3:597 600, 603 -
male , framework and , 3:484-490
Ball clasp, 2:434-435, 440-441, 3:285- 286,
632-633
3: m McCollum 2:338-342 . Bar attachment , 3:581, 605-616
.
Articulating ribbon 2:446 3:354 355, 358 . - . Mini- Rest , 2:362 .
C M i Ider, 3:610 613 -
.
367 546-547 -
Mortice Rest , 2:362-363 Dolder, 3:605-608, 613
Articulation , 2:140-158
-
Articulator , 1:147 186, 318 321; 2:142. 454 - -
Ney . 2:362
Omega; see Interlock
-
Hader, 3:607 608, 613-615
Bar clast , 3:174. 249. 401; see also
l
461 , 3:363-364 393 394 . - for overdentures, 3:577-616 Infrabulge clasp
anatomic relationship to skull . 2:55
BufTalo Dental No. 9 1:151 .
P. D . , 2:362 365
precast, 3:506
- Bar joint , 3:581
Dolder 3:607 608.3 581 - I
Denar Automark , 2:458 459 - precision ; see Precision attachment Bar unit, :
Denar D5A 2:458-459 . for removable partial denture, 2:247 249 - Dolder, 3:605-606
Bard - Parker knife. 1:334-335. 2:253-254 .
Denar fully adjustable, 2:63 64 - requirements < »1 2:333-334
Denar Gnathornatic, 2:458 459 - Schatzmann ; see ,£chatzmunn attachment 442. 3:226, 231-233
Denar Mark II , 1:147 156 - s« * i n ipreeisioii. 2:362-366 Barrel-shaped point, 1:449 *
Denar Omni , 2:459 Sholder- Dalbo. 2:357 -
Barrier to dentist technician communication .
Denar SE , 2:458-459 Stern JMS, 2:342-347 1: 1 2

*
i
 Index 3

Base
denture; see Denture base
record ; see Record base
Bracing arm , 1:6
.
-
Boxing wax, 1:57 67. 3:26- 28, 30-41

lingual , 2:334 347 349 -

Baseplate; see Record base
Baseplate wax, 1 :28, 33. 92, 143
Baseplate wax spacer, 1:456
Basic materials checklist , 1:4
Bead( ing), 3:187, 200-201, 206-207
and boxing corrected cast impression with
wax, 3:36-41
for closed horseshoe connector, 3:206
corrected east impression with wax and
two-stage pour, 3:42-49
for full palatal bar, 3:206
for full palate* connector, 3:206
lor horseshoe connector 3:206 .
lor palatal bar , 3:206
retention . 3:240- 241. 553
—
Cast(ing) cont’d
definition of, 3:299
diagnostic; see Diagnostic east
Bridge, repair of, 2:416-420 for Dicor castable ceramic crown, 2:322-
Bristle brush , 2:257. 403 323
Broken Arm Casting Machine, 2:465 duplication of, preparation for , 3:194 - 208
Brush equipment for, 2:465-468
.
bristle 2:256. 403 examining fit on master cast. 3:343
fiberglass, 2:344 fitting to die, 2:249-252
handpiece- mounted . 1:332 for fluid resin complete denture, 1:427
Robinson , 2:257 framework , materials lor , 3:140
syringe cleaning. 2:27 of gold alloy, low-fusing, 2:225-232
Brush wheel , 1:334 , 336 indexing of, 1:80-85
Bruxism appliance, 2:428-431 induction, 2:233
Buflalo Dental No. 9 articulator , 1:151 investment , 3:220-233
.
Buffing, 1:331, 333, 541 , 543 mandibular, waxing of. 3:255-259
Buffing Bar Compound, 2:257 master; see Master cast
Bulk grinding wheel , 2:300 materials for. 2:42-45 #

Beading wax , 1:57-58, 60

-
Beading Grip Wax, 1:57 58, 3:36. 39 Bur , 3:396, 4 ( H ) ; see also specific kinds of
burs
maxillary; see Maxillary cast
metal
Beavertail burnisher, 2:275
Beeswax, 1:468, 3:232
Burnisher, 1:116- 117
beavertail , 2:275
cleaning of. 2:226-228, 235 237
finishing of. 2:249-259
-
Bell jar. 3:673 orangewood. 2:292 fitting to working cast , 2:252- 257
Bench press, 3:384 toothbrush handle, 1:116- 117 multiple adjacent, 2:257
Bending of orthodontic wire. 3:618-624
closed end loop, 3:620 621 -
Burnout, 2:219-220, 3:299. 314-319. 482-483
of Swing/Lock partial dentures, 3:511-512,
of metal-ceramic alloy, high-fusing, 2:233
235
-
deflection, 3:622 515-516 mounting: see Mounting cast
helical, 3:619-620
right -angle , 3:621
Burnout furnace, 2:220. 470 472
Accu-Therm II 1000, 2:472
- for mouthguard. 1:551-553
orientation of, 3:166
semicircular , 3:619 Combilador CL-VS 2< X )2, 2:471 pickling of. 3:324-325
smooth curve, 3:624 Dual-Temp, 2:471-472 of plastic patterns in metal. 3:506-507
.
zigzag 3:623 Midi Model BOD 7S, 2:471 - 472 pouring of, 1:64-66, 71 -74 . 76-82
Bennett Blade, 2:370 NEYMATIC-101, 2:471 preliminary. 1:9
Bennett movement , 2:146- 148 Busch bud finishing bur, 2:249-251 procedures for, 2:219- 220
Bilateral balanced posterior occlusion , 2:175- BZ-75 screw system , 3:612-613 rebase , 3:423-435
176 rec< >n struction, 3:435-436
Bilateral distal extension removable partial .
recovering of 3:321-322
-
denture, 3:136 137
Biocry1 II , 2:434, 436-437, 440- 441
C
C & B Flask Liner. 3:300
refractory ; see Refractory cast
reline, 3:410*123
Biolon , 2:399, 407, 3:496 C & B Kit , 2:386 remount; .vee.Remount cast
Biostar unit , 2:436, 440- 441 CM. rider, 3:610-613 removing dentures from. 1:324-325
Biostar Universal Pressure Molding Calcining, 2:32 repair , 1:398-408. 3:453
Machine , 2:429-430 Canine requisites for , 3:1-2
Bird - beak pliers, 3:435, 618 mandibular selection of, for Dicor castable ceramic
Bite plane , anterior, 2:438-439, 449 metal -ceramic restoration of. 2:277 crown, 2:316-317
Bite plate, anterior. 2:428- 429 morphology of, 2:112-113 stabilization of, 2:59-60
Bite Rim Former, 1:143, 3:130 position of, 1:235- 236 for Swing/Lock partial dentures, 3:506-
.
Bite-fork record 2:77-78 maxillary 507, 511-512, 515 516 -
Rival attachment . 2:332, 347, 352-354, 361 metal-ceramic restoration of. 2:277 tilting of, 3:166 175 -
Blastmate Non -Recycling Abrasive Blasting
Unit , 2:452-453
morphology of. 2:98-99
position of, 1:225-236
- .
torch. 1:473 474 2:225, 233-235
tripoding of, 3:174-175
Blind vent , 1:6 Cantilever fixed partial denture, 1:6 working; see Working cast
Blockout , 3:187, 194-208, 513 -
Carbide bur. 1:326-327, 334 335, 445-446, Casting investment, 3:299
arbitrary. 3:196-197
flame. 2:350
-
449 4.50. 2:236, 327 416 . -
gypsum bonded, 3:299
metal base and , 1:463 -
phosphate lxmded , 3:299
parallel . 3:194-195 fluted, 2:193 Casting machine, 1:473-477, 3:315 325 -
shaped, 3: 196- 197, 202 203
tools for, 3:194- 195
- trimming , 2:191-192
Carbon marker, 3:165
Autocast Induction, 2:466-467
Broken Arm , 2:465
Blockout wax , 2:365, 3:200-201 Carbon rod . 2:374-375 centrifugal 2:226-227, 233
preparation of. 3:2( X )- 202 Carborundum disk. 2:191-192, 3:440 Combilador Vacuum Pressure, 2:466-468
Blowpipe , orthodontic, 3:637
. .
Blue wax 1:470 472
-
Cardex Stabon, 1:442
Carpules, 2:5
Dicor, 2:322 323
electric, 2:225 226
-
-
Body porcelain , 2:282-283, .309-310
Body shade, 2:408
Cartri -loids. 2:5
Carver , Hollenback, 2:192-193
Electromatic, 1:474 , 476 477
Emesco Senior, 2:465-466
-
Body-shade resin , 1:211
Boilout, 3:378-380, 386-387
Cast abutment , preparation of, 1:531 533
Cast base, conversion to record base, 1:477-
- Enterprise, 2:468
.
pressure 2:226
Boley gauge, 3:94 , 536-537 478 Production Caster , 2:465- 466
Boxing of impression Cast clasp , repair with, 3:444- 447 Casting ring, liner for, 2:212
caulking compound and paddle method , Cast trimmer. 1:324 Casting wax, 2:348
s 1:74-79
plaster of Paris and pumice method, 1:67- 483 ^ -
Cast ( ing ), 2:170-259. 3: 29, 319 325, 482- Caulk Repair Resin , 1:27, 91, 518
Caulking compound , 1:356
.
74 3:30-35 cleaning of, 3:322-323 Caulking compound and paddle l >oxing
wax method, 1:57-67 corrected, 3:30 method , 1:74 79 -
r
4 / ndex

Ceka attachment , 3:583-584, 603-604

resilient. 3:593-597
—
Clasp cont’d
ball . 2:434-435, 440-441. 3:285-286, 632-
Combilador CL- VS 2002 furnace, 2:471
Combilador inductively heated vacuum -
rigid. 3:593-597 633 pressure casting machine, 2:467-468
Celluloid crown, 2:382. 384 bar ; see Bar clasp Combilador CL-VMR Mixing Unit. 2:480-
Cement case. 3:444 447 - 481 r
provisional . 2:404-405
shaded , 2:329
circlet. 3:144-145, 203, 249
circumferential, 3:143, 273-274, 276-279,
-
Combilador CL DA Steam Cleaning Unit,
2 : ITS
Cementation
of Dicor castable ceramic crown , 2:329
443-444 , 631 632 -
construction techniques for, 3:276-297
Combilador CL-1 Ultrasonic Cleaner , 2:478
479
-
of prov isional restoration , 2:403- 405 contouring of , 3:276-287 Combilador Vacuum Pressure Casting
Central incisor double, 3:149- 150 Apparatus, 2: i < >» > - 167
mandibular E, 3:149-150 Combilador CL- H Vibrator, 2:482
morphology of , 2:108- 109 embrasure, 3:146-147, 284-285, 292, 443 Combilador CL-EW Waxing Unit, 2:483
position of, 1:235- 236 half and half, 3:149-150 Combination Mixing Unit , 2:481
maxillary .
1- bar , 3:148-149 185, 280-281 Communication
morphology of. 2:94-95 .
infrabulge, 3:141, 147-150. 276 279-284 , dentist- technician . 1:1-8
position of. 1:224 - 236
size of , 2:123 125-
443-444
materials for. 3:274-276
-
third party. 1:7
Communication troubleshooting chart . 1:8
morphology of, 2:92 93 - mesiodistal, 3:150 151 - Compensating curve, 2:150 «
size of. 2:135 136-
spacing IK* tween , 1:230-231
modified T: see T clasp, modified
multiple circlet, 3:145
in sagittal plane study, 2:150
Complementary colors, 2:267
supernumerary 2:134 . onlay , 3:145 Complete denture
Centric relation , 2:81 , 146 orthodontic; see Orthodontic clasp fluid resin ; see Fluid resin complete
Centric relation record, 2:58, 62-63 repair of. 3:292-297, 443 denture
Ceram ax 1 , 3:594 requirements of. 3:142 fractured
Ceramic, color in . 2:2(50-268 reverse approach circlet, 3:144 nonseparated. 1:398-401
Ceramic alloy, preparing for porcelain , ring. 3:150 repair of. 1:398-408
2:290-292 simple circlet , 3:143 with section(s) missing, 1:406-408
Ceramic crucible, 2:322 suprabulge, 3:141- 147 into two or more parts 1:401 407 . -
Ceramic embedment material , 2:323-324 T; see T clasp -
Swing/ IaK k , 3:525-526
Ceramic metal- bonding conditioner , 2:286- -
U , 3:149 150 Composite resin
288 wire selection for , 3:276 -
heat cured , 3:556
Ceramic restoration , adjusting color of ,
2:266-268
-
wrought wire, 3:149 150, 185, 273- 297
Clasp polisher, 1:334
light -cured small particle, 3:556-557
Compression forming method for thin resin
Ceramic rod . 2:299-3< X )
Ceramic-bound white stone , 2:236-237
Class I clasp; see Simple circlet clasp
Class II clasp; see Intrabulge clasp
matrices &388 390
Compression strength of dental stone,
-
Ceramicor, 2:350. 357 Cleaning 2:33
Ccramigold Investment. 2:350 of metal casting, 2:235-237 Condylar path
Ceramming for Dicor castable ceramic ultrasonic; see Ultrasonic cleaner orbiting; see ( fc- biting condylar path
crown . 2:324-325 Cleft palate, 1:497, 3:526-528 pantographic records and occlusal
Ceramming furnace, 2:324 Clinical crown, 1:6 anatomy. 2K 153-156
Ceramogold . 3:597 Clip, Aekemiann , 3:581, 608 protrusive, see Protrusive condylar path
Cerestore , 2:165 Closed end loop of orthodontic wire , 3:620- rotating; see Hotating condylar path
Ccrobend. 3:470 621 Condyle
Chalk Closed Kennedy bar; see Lingual plate orbiting. 2:146
colored , 2:406 Cloth wheel; see Bag wheel rotating, 2:146, 151
prepared slurry, 1:334. 337 338, 423 -
Chamois wheel , 1:334. 337, 3:339, .'341
Coarse stone, 1:454-456
Cobalt -chromium alloy, 3:220-221, 275, 515
( ’one locator, 1:506
Confined dough method for construction of
Characterization of provisional restoration , finishing of, 3:327 autopolymerizing resin record base,
2:406-410 Coe 'fray Plastic, 3:62, 92 1 : 103- 112
Checklist Coe- Flex, 3:111 stone- mold , 1:103-108
basic materials. 1:4
procedures, 1:4
Coe- Flo, 1:118, 3:106, 468, 472
Coe-Soft , 1:91-92, 442-443. 518, 3:77-78
-
wax confined, 1:108-112
Congenital defect. 1:479, 2:367, 3:528
Chill vent , 2:212 Coe-Super Soft. 1:442 Connector, 3:150 155 -
Chip blower, 2:182- 184 Cole Polymers, 1:442 Crismani , 2: 134- 135
.
Chisel. 1:21 326-327 Color incisal loop, 2:134 135 -
pneumatic, 1:324-325 applied to inner surface crown , 2:406 interproximal. for metal ceramic
Chloroform. 3:369, 373 in ceramics, 2:260- 268 restoration. 2:199
Chroma, 2:262-285 complementary, 2:267 major, 3:150-152
identification of, 2:266 in dentistry, 2:261 labial bar, 3:152- 153
Chrome alloy base, 1:460, 483, 468. 475-476 development of concepts of, 2:260-261 lingual bar; see Lingual bar
Chromium alloy. 3:140 of Dicor castable ceramic crown , 2:327- lingual plate, 3:1.50- 152, 185. 256-257,
Cingulum rest preparation , 3:140 329 448-450
Circlet clasp. 3:144-145, 203, 249 in everyday life, 2:261 plastic, 3:568
.
Circumferential clasp, 3:143 273-274 . 276- mixing of. laws of , 2:267-268 repair of, 3:440- 441
279, 443-444 , 831-832 tooth , 2:126- 128 maxillary major , 3:152-154
Citricon , 2:21 Color modifier, 2:268, 296-298 closed horseshoe , 3:154-155
Clasp , 3:141- 1.50 addition of. to polymer powders before full palate , 3:154- 155
Adams, 3:286-287, 834-836 mixing, 2:406-408 horseshoe, 3:154
adjustment of, 3:292-293 Color Order System , Munsell , 2:261-266 palatal bar ; see Palatal bar
arrowhead , 3:834 Colored modifying porcelain , 2:283-284 minor, 3:154 155 -
attachment of, to removable partial Combilador CL- FSG abrasive blasting unit, repair of. 3:441- 442
denture. 3:288-297 2:452 semirigid , 2:331 366 -

—
Coi 11lector con t d
solder, 2: 134
spring- loaded pawl , 3:581
Contour
crown , 2: 167- 169
height of, 1 :6
labial , 2:167
lingual . 2: 168
protective , 2: 184
stimulating . 2: 184
of teeth, 2: 122- 139
Contouring, axial; see Axial contouring
Contouring pliers, 2:384
Coping. 2: 165- 169
Coping material , 3:579
Copper in gold alloys, 2: 221 - 222
Copper band -modeling plastic impression,
2:42
Copper tube impression , 2: 1 -2
Cork borer, 1 :350. 353, 426. 431
Coronal plane, 2:143
Coronal plane study , 2: 151 - 153
Corrected cast, 3:30
Corrected cast impression
beading and boxing with wax , 3:36-41
beading with wax and two-stage pour ,
3:42-49
boxing with plaster/pumice mix and wax .
3:30-35
pouring of, 3:30-57
North Carolina technique of, 3:49-57
Cosmetic restoration, 2: 164- 165
Cranial implant , 1 :508-509
delayed , 1 :509
immediate , 1:508-509
Craniomandihular orthopedic appliance ,
instructions for care of, 2:443-444
Creshine, 3:520
Crismani connector, 2:333
Crismani resilient joint , 2:333
Cristobalite model investment . 2:214, 3:222.
476-477, 481 -482
Critique card , 1 :6- 7
Crowding of anterior teeth , 1:231-232
Crown , 2:206
aluminum , 2:381-384
anatomic , 1 :6
celluloid , 2:382. 384
cleansing of, 2:186
clinical , 1 :6
construction of. under existing partial
denture , 2:421 -422
contour of, 2: 167 - 169
Dicor castable ceramic, 2:315-329
double, 3:580
full veneer; see Full veneer crown
jacket ; see Jacket crown
length of, 2: 128- 129
metal-ceramic; see Metal -ceramic crown
partial veneer, 2: 160- 163
polycarbonate, 2:382. 385, 406
preformed , 2:282-285
preparation design for, 2: 159- 169
provisional . 2:381 - 410
repair of. 2:420-421
separated from tooth , readaptation of,
2:422-425
single . 3:577-580
telescope , 3:577-580 -
three-quarter; see Crown , partial veneer
tin -silver , 2:382-383
Crucible , ceramic, 2:322
Crystal retention, 3:553
Cup- flask method of duplicating dentures,
1:356-363
Curing, 1:307 , 311 , 433-434, 3:386-387
Curing unit , 1:433-434, 3:386-387
visible light ; see Triad Light Curing Unit
Curve
reverse , 1 :6
of Spec, 1:6, 2:90 92 ,
of Wilson, 2:91 -92. 153
Cusp tip contact , placement of, 2: 179- 181
Cusp-to-fossa waxing, 2:173- 175
Cuspless teeth , 1 : 187
Custom impression tray ; see Impression
tray, custom
Cutback technique for fabrication of wax-up
of metal-ceramic restoration , 2:271 -
276
Cutting bur , 2:436 , 441 - 442 '
Cyanoacrylate cement, 2:305-306
D fixed partial ; see Fixed partial denture
Dalbo attachment , 2:357 -361
rebasing of, 2:359
Dalbo- Fix attachment, 2:332
Dalbo- M attachment , 2:359- 360
Dalbo-S attachment , 2:357
Dalla Bona attachment , 3:583, 602-604
DAP Hope Caulk , 1 :74-75, 3:90
Debubblizer, 1 :214, 293, 471 , 2:213. 218.
3:28, 376
Debubblizer- Wax Painting Solution, 3:302
Dedeco Koolies, 3:440
Dedeco NM thin disk , 3:486
Deflasker. 1:312-314
Deflaskmg. 1:311 -318, 434 . 3:369-408
Deflection, 2: 161
of orthodontic wire , 3:622
Degassing of eeramometal casting, 2:237
20- Degree maxillary posterior teeth, 1:249-
260
33- Degree maxillarv posterior teeth, 1 :238-
239
Denar D31 AB Face-bow/Ear-bow, 2:461
Denar Automark articulator, 2:458-459
Denar D5A articulator, 2:458-459
Denar fully adjustable articulator, 2:63-64
Denar Gnathomatic articulator, 2:458-459
Denar Mark II articulator and ear- bow
record, 1 : 147- 1.56
Denar Mini - Recorder, 2:464-465
Denar Occlusal Analyzer, 2: 144
Denar Omni articulator, 2:459
Denar Pantronic recording system, 2:464 -
165
Denar SE articulator, 2:458-459
Denar Track II articulator, 2:458-459
Densite, 2:32-33
Dental floss , zipper. 1 :356-363
Dental laboratory
agreements with dentist by , 1:3-4
equipment for . 2:451 -485
evaluation of, 1 :7 -8
selection of, by dentist , 1 :2-3
visit to , by dentist, 1:5
Den till plaster. 2:56-57
Dental porcelain; see Porcelain
Dental stone , 2:42
compression strength of, 2:33
physical and chemical properties of, 2:32-
33
setting expansion of , 2:32
setting time of, 2:32-33
Dental technician ; see Technician
Index 5
Den talon, 2:386-387
Dentatus AHA Articulator, 2:457-458
Dentatus ARH Articulator, 1:148 , 157- 162,
2:456-457
face-bow registration , 1 : 157- 162
Dentin buildup in metal -ceramic crown with
porcelain margin . 2:298-299
Dentist
agreements with dental laboratory . 1 :3-4
communication troubleshooting chart , 1:8
communication with technician , 1 : 1 -8
legal obligation of , 1:5
selection of dental laboratory by, 1 :2-3
visit to dental laboratory by . 1:5
Dentsply International teeth manufactured
,
by , 1:190- 191 , 200- 201
Dentsply Porcelain Tooth Finishing Kit ,
1 :275
Denture
duplicate ; see Duplicate denture
fractured . 1:454
identification of. 1:305-307
immediate; see Immediate denture
personalization of, by selective grinding,
1:233-235
trial; see Trial denture
Denture base . 3: 156-157, 369-371
acrylic resin , 3:156-157
additions to, 3:455-456
fracture of 1:398-408
,
complex , 3:453- 454
repair of . 3:451 -454
simple , 3:451-453
simple, involving teeth . 3:453
metal ; see Metal base
processing with hydrocolloid investment ,
1:425440
resin , 3:156- 157
retention , 3:156
tinting of, 1:545-549
Denture base liner resilient . 1 :441 - 459
,
materials for , 1:441-459
requirements of, 1:441
silicone rubber , 1 :442-459
Denture processing, 1: 276
Denture teeth
additions of , 3:455-456
adjusting occlusion to a functionally
generated path occlusion . 3:364-368
anterior, 3: 160- 161
arrangement of, 3:350 351 -
airangenient of. 3:536-537
in fixed-removable partial denture , 2:373
fractured, 3:454-455
in immediate overdenture. 1:525-533
metal backings for, 3:535-561
metal occlusal , 1 :214-222
missing. 3:454-455
posterior
arrangement of, 3:352-360
setting to a functionally generated path
template, 3*360-364
repair of, 1:383-398, 3:454-455
replacement of. 3:454-455
selection of, 3:345-349, 516-537
Deodorant spray as disclosing material .
U474
Design , 3: 136- 186
preliminary, for Sw ing/ Lock partial
denture , 3:503-504
preparation; see Preparation design
Design transfer . 3:187- 193, 234-235
6 Index

Dewaxing of fluid resin complete denture . Dumbbell spring, 3:628-629 Emergence profile, 2:167
1:429-430 Duplicate cast. 3:506 Emesco Electric Micro motor handpiece,
Diagnostic appliance. 2:428 449 - Duplicate denture, 1:339-363 2:474 475-
Diagnostic cast . 2:383. 3:76. 187, 460. 656- cup- flask method , 1:356 363 - Emesco Senior Casting Machine. 2:465 466 -
663
.
modified -denture flask method. 1:339 348 - Enterprise Casting Unit , 2:468 r
design of, for removable partial dentures -
pour resin -flask method , 1:348-356 Epiminc resin lor provisional restorations,
3:176 185 - Duplicate master cast, 3:404 - 405 2 : ;s7
mounting of. 2:77 82 - Duplicating colloid, 3:480- 481 Epoxy die material . 2:1
occlusal adjustment on , 2:88 89 - Duplicating flask . 3:209- 219 Epoxy rosin
preparation of, 2:72-77, 3:656 663 - Duplication, 3:194-233 die of. 2:42 43 -
lor S \ ung Lock partial denture. 3:503 504 - agar reversible hvdroeolloid mold for, .
ivory 3:675 680 -
use of. 2:82 87
Diagnostic preparation , 2:82 87
-
-
3:209 220 -
definition of. 3:209
model ol , 3:675-680
Equipment, laboratory 2:451-485 .
Diagnostic procedure(s ) 2:72 89 3:644 . - . Duraflow . 1:477 Ethical obligations of dentist and technician.
Diagnostic waxing, 2:82-87 , .383 .
Dura Lay 1:214, 216. 2:339. 348, 365, 375, 1:5
Diamond disk . 2:297 298 300 303. 436. 441 - . . 421-426, 3:464-465. 488-490. 493 495, - Evaluation of dental laboratory', 1:7-8
Diamond point , 2:304
-
double sided, 2:325-326 580
Dura Lay Temporary, 2:386
Expansion
of dental stone, 2:32
-
barrel shaped 2:300 303 . . Dykem , 3:474 . 483- 484 hygroscopic, 2:214 4
.
fine 2:300, 303 327 . Dymo labeling tape . 3:667 setting. 2:214
short , tapered , 2:300. 303 Dvmon - Hue teeth 1:199 200 . - thermal , 2:214
ultraflne, 2:325-326 Explorer tip, 3:396-397 400 .
.
Diastema 2:132 133, 135 - E Extracoronal attachment , 2:331
Dicor add -on ceramic porcelain , 2:327-328 E clasp, 3:149-150 combined . 2:352 362 -
Dicor castable ceramic crown , 2:315 329 - Eagle drawing lead . 3:173
Dicor casting machine , 2:322 323 - Ear- bow record. 1:147- 156, 171- 176 F
Dictating unit , 2:85-86 Early side-shift . 2:147 Fabulustre Polish. 2:437, 442
.
Die 2:32 54 - Edentulous ridge, mandibular. 2:195 Face-bow, 1:147, 2:56-57, 61-64 , 77, 460-
electroplated 2:1 . 43 45 . - Edentulous space 165
fitting cast to 2:249- 252 . mandibular posterior , 2:194 Denar D31 AB, 2:461
materials for, 2:42 45 - maxillary posterior , 2:194 Hanau 132-2SM . 2:461, 463
preparation of , for Dicor castable ceramic Eggshell finish , 1:541 -542 llanau 153-16, 2:461 -462
crown, 2:316-317 Eggshell technique for fabrication of Hanau Twirl- Bow, 2:461- 462
preparation of working casts with , 2:34 42 - provisional restoration , 2:395 398 - hinge-axis , 2:56
removable, problem areas in . 2:51 54 - Elasticity, module of. of alloy, 2:224 index. 1:321-324
trimming of, 2: 191 - 192 Elasticor wire, 2:377 quick-mount , 1:177- 181
for aluminous porcelain jacket crown, Elastomer, silicone, 3:664-674 registration , 1:157-162. 167-171 , 2:57
2:305-309 Elastomeric impression , 3:26-30 Slidematic, 2:461
Die * Lube 3:244 . Elastomeric impression material, 1:57, 2:2 - TMJ Kinematic, 2:464 -465
Die lubricant . 2:170, 182. 212 213. 289. 317 - 31, 3:1, 77 Whip Mix Quick Mount, 2:461 , 463
Die pin . 2:38 40 - mixing of , 2:28 29 - Face-l >ow fork . 2:61 -63
Die pinning equipment , 2:468- 470 problem areas of. 2:31 Faceguard attachment, mouthguard with .
Accndrill. 2:469
Microdrill. 2:469 470 -
record base stabilized with . 1:121- 122,
3:110- 113
-
1:555 561
Facial core, 2:271 - 272
Pin Drill. 2:470 syringe for transfer of , 2:25- 29 Facial prosthesis. 1:499-505
Pindex system, 2:469
.
trays for , 2:23 25 - laboratory facility requirements for. 1:500-
.505
Router 2:470
Die sealer . 2:317
Electric soldering. 3:438 440, 488 489- -
Electric soldering machine, 3:488 materials for , 1:500
Die sinker file, 3:48 4 - Electric welding unit, 3:6, 8 requirements of. 1:499-500
-
Die spacing. 2:41 42 317 - . Electrochemical equipment , 2:475 476
.
- Facing
.
Disclosing material, 1:474 Electroformer 143-1C 2:475 for anterior tooth replacement 3:158 159 -
wax . 3:483
Distributed side-shift . 2:1.47
Electrolytic Polisher, 2:475 476
-
Multi plater, 2:475
- politic, 2:198-199
-
flat back , 3:535 536. 550-552
Divesting -
Oxy Etch . 2:476 porcelain , 2:198-199
for Dicor castable ceramic crown , 2:323 -
Electroformer 143 1C electroplating unit. reinforced, 3:535 561 -
.
postcoram for Dicor castable ceramic 2:475 -
reverse pin . 3:536 550 -
crown , 2:325 Electrolytic Polisher , 2:475- 476 Faciolingual surface in axial contouring,
Dividers, 3:567
Dolder bar attachment, 3:613
Electromatic casting machine, 1:474 . 476- -
2:185 189
41 i Fast Tray, 3:50-1
Dolder bar joint , 3:607 608
Dolder bar unit . 3:605-607
- Electronic balance. 2:453 454
Precision Scale CL- W. 2:454
- Fast-cut stone, 1:112
Fastcure, 3:77
Double clasp , 3:149 150 - Electroplated die, 2:43-45 Feedback between dentist and technician ,
Dowel pin , 2:34 37 56 - . Electroplating equipment 2:43- 44, 475-476. 1:2 , 6-7
Drawing lead, 3:173 Editor. 2:350. 357 3:610 Felt wheel, 3:336-338. 400. 402
-
Drom Flux, 3:290
Dry- pinning technique for preparation of
Elongation , percent of, of alloy , 2:224 Festooning, 1:425. 427, 438, 2:430-431
EM attachment , 3:582 Fiberglass brush , 2:344
working casts with removable dies, EM Attachment Selector, 2:333, 363 File, 3:484
2:38 41 - EM Parallelometer , 2:477 Filling device, 2:27
Drying oven . 1:468 Embedding for Dicor castable ceramic Final impression , boxing and |K )iiring of,
Dual-Temp furnace, 2:471-472 crown , 2:323 324 - 1:57-79
Dual path of insertion for removable Embrasure clasp, 3:146-147, 284-285, 292. Fine solder, 2:241 , 247 r
denture 3:562-568 . 443 Fine-cur wheel, 1:389

-
Finger adapted dough method
lor construction of autopolymerizing resin
-
impression tray, 1:32 37. 44 - 47, 49 56
for construction of autopolymerizing resin
A -
record base, 1:99 103, 3:90 95 - Fluid resin, 1:425
Finishing, 1 :312, 3:369- 408. 433
of Dicor castable ceramic crown , 2:325
327
of fluid resin complete denture, 1:434- 435
of framework , 3:327-344
metal . 2:235-236
of metal casting. 2:249-259
of metal occlusal , 1:219, 221
of provisional restoration . 2:401 - 403
/ of Swing/ lx >ck partial dentures. 3:516, 519
.
Finishing bur 1:331-332. 541 -542. 2:375
Finishing polish . 1:338
First molar
mandibular
articulation of, 1:240-241, 251-252
morphology of. 2:118-119
maxillary
articulation of, 1:256-257
morphology of, 2:104-105
* position of, 1:238-239, 249- 250
First prernolar
mandibular
articulation of, 1:242 249, 254-255
morphology of. 2:114- 115
- Food deflection ridge, 2:186- 187
maxillary
articulation of. 1:258-259
morphology of. 2:100-101
position of , 1:238-239, 249- 250
Fisher’s angle, 2:151
Fissure bur, 1:326. 336. 364. 369. 2:204,
3:399
straight, 3:428
Fitting of Dicor castable ceramic crown.
2:329
Fixed partial denture, 2:270-281
cantilever, 1:6
provisional. 2:381- 410
Fixed removable partial denture, 2:367 380
advantages of. 2:377-379
description of. 2:371-372
disadvantages of. 2:379-380
history of, 2:367-371
limitations of. 2:379
McCollum attachment for , 2:340
F. D. attachment for 2:364 . prosthesis, 3:458-499
substructure bar, fabrication of. 2:372-375
suprastrueture of. fabrication of, 2:375-377
Flagship furnace, 2:427-473
Flange , acrylic resin guide. 1:497
Flask
lubrication of, 1:287. 289
selection of , 1:287-288
Flask ejector, 3:388-389
-
Flask holder, 1:296 297, 299
Flask method of rebasing, 1:380-382
-
Flask ring. 1:472 473
Flashing, 1:276. 287-296. 307-311, 426.
3:369-408
of immediate overdenture, 1:535-538
waxing for. 1:284-311
Flaskless method for processing denture
Flat -back hinge, 3:501
-
hose, 3:405 408
Flat - back lock attachment, 3:504 . 506-508.
P 510. 513
Flat hack facing, 3:550-552
Flex-skins, 2:3
Flexibase. 1 :442
Flour of pumice, 1:67-74. 331-334. 336. 541 .
- 3:400-401, 421
Flow, 1:432
Fluid resin complete denture, 1:425 440
- casting of. 1:427
curing of. 1:433-434
dellasking of, 1:434
dewaxing of. 1:429-430
finishing of. 1 :434 -435
investment of. 1:428- 429
materials and equipment for, 1:426
method for, 1:426
mixing and pouring resin for. 1:432-433
polishing of, 1:434 435 - Gold alloy base, 1:46«. 463-474
preparation of hydrocolloid for, 1:427-428
repair of, 1:438- 440
replacing teeth in mold. 1 :431 - 432
spruing of, 1:431
venting of. 1:431
wax pattern for , 1:427
Fluid resin record base , 1:136- 142
Fluid resin removable partial denture.
1:436- 438
Flux , 3:290, 438, 638
Flux II , 2:238, 243
Food - flow pattern, 2:185-186
Formatray , 1:26. 3:504
Framework
attachment of clasp to , 3:288-289
and bases with reline impression , 3:410-
412
cast , materials for, 3:140
design
for mandibular partial denture, 2:334-
336
for maxillary partial denture, 2:336
finishing of. 3:327-344
-
fitting ot . 3:483 484
and male attachment assembly , 3:484- 490
- metal , soldering to porcelain 2:242-243.
-
for metal ceramic restoration . 2:276- 281
fabrication of. 2:270-271
oi Swing/ Lock partial dentures , 3:513.
-
516 519
-
waxing of, 3:236 238, 182 513 . Hammer , plastic, 1:312-313
Frictional wall precision attachment partial
Full palate connector, 3:154 155
heading for. 3:206
- Hanau 130- 1 articulator, 1:148
Full veneer crown , 2:163- 164
cosmetic. 2:289-314
Full-arch impression tray, 1 :44 -49
Functional core, waxing to 2:175 185
Furnace
. -
burnout; see Burnout furnace
cerainming, 2:324
porcelain ; see Porcelain furnace
G
Gacrny cylinder milling bur . 2:348 349
Gate method of spruing, 2:209 211 - Hanau LTD 147-3 articulator, 2:455-456
.
Gerber attachment 3:589 591 - Hanau Radial Shift articulator, 1:149-150,
.
resilient 3:602-603
rigid . 3:602, 604
( killings magnet , 3:597
Gingival margin
-
repair of , 2:420 421
surgical repositioning of, 2:128 130
-
Gingival porcelain , 2:128 129, 283
Index 7
Gingival tissue, loss of . 2:131
*
Glaze, 2:284
Glazing for metal-ceramic crown with
porcelain margin, 2:304-305
Glenoid fossa, 2:178- 179
- Gloss Medium , 3:875
.
Gold alloy 2:233-2.34 , 3:14«, 22«. 275
classification of, 2:224
heat treatment of. 2:224- 225
high -fusing, 2:235
low-fusing, casting procedures for, 2:225-
232
physical and chemical properties of.
2:220-222
type III , soldering of. 2:239-242
Gold alloy inlay. 2:214
Gold casting
finishing of. 2:249-259
polishing of. 2:257
repair of , 2:247 - 249
Gold foil , repair with , 2:421
Gold occlusal . 1:187-222. 3:492-496; see also
Metal occlusal
construction of, 1:201-214
Gold powder. 2:285-286
Gold rouge, 1:334, 337
Gold saddle, 3:496
Gold supporting wire , 2:434- 435
Gothic arch record . 2:148- 149
Gray investment. 3:221
Green Line lathe wheel , 1:8«
Green soap, 1:331 , 2:212-213, 3:403
Green stone wheel , 3:540-541
Grinding
for personalization of denture , 1:233-235
of porcelain teeth. 1:275
Grinding wh£el , 1:447 . 2:300
Grove indexing method , 1:80-85
Guide flange, acrylic resin. 1:497
Gypsum, 2:3£
Gypsum -bonded casting investment, 3:299
H
H -type frictional attachment. 2:331
-
Hader attachment, 3:608 610, 613 615
.
-
Half and half clasp 3:149-150
Hanau H 2 Arcon articulator. 1:149
and ear-bow record , 1:171-176
Hanau 96112 articulator. 1:149
Hanau 130-28 articulator , 1:149
and arbitrary mounting, 1:163-167
and face-bow registration , 1:167- 171
Hanau 154- 1 articulator , 1:48
Hanau 158 articulator , 2:180
Hanau 153-16 face- bow, 2:461- 462
Hanau 132-2SM fascia bow, 2:461 463 .
Hanau Condyle Repositioner , 2:456-457
Hanau curing unit , 1:447, 454 , 3:386-388
Hanau Flask Ejector , 3:388-389
- Hanau laboratory technical device, 1:149
2:455
Hanau Twin -Stage Occluder. 2:66-70. 456
Hanau Twirl- Bow face-bow 2:461- 462.
Hanau University Model 130- 22 articulator,
2:454
- Hanau VVide-Vue articulator, 1:149- 1.50.
-
2:454 455
/
8 Index

-496
Hanau Mate articulator. 1:149- 150, 2:455-

Handpiece. 2:474 - 475

Kmesco Electric Micro motor , 2:474 - 475
Immediate overden hire cont’d
record base lor, 1:516 524
setting teeth lor , 1:525-533
waxing of, 1:534 536 -
—
-
Impression tray cont d
requirements for 1:26, 3:58
—
stock , 1:26. 2:24-25 3:58 75
mandibular, 3:59
.
. -
Laboratory' Hand Engineer, 2:474
Handpiece holder. 3:542 Imperial teeth . 1:195
-
Immediate side shift. 2:147- 148 maxillary . 3:59
perforated metal. 2:24 25 -
Handpiece- mounted brush . 1:332. 541 542 - Implant perforated metal rim -lock , 3:58 59 -
-
11and piece mounted bur, 1:411 cranial; see Cranial implant plastic, 2:24 25, 3:60 -
Handy Sandy sandblaster, 3:323 Silastic, 1:509 511 - -
rim lock . 2:24- 25
I lardness of alloy 2:224 Impregum , 2:22- 23, 27. 350, 3:587, 592 solid metal rim lock, 3:58 59 - -
Harmony pin politic, 2:412
Hawley appliance. 3:645, 65-1-656
Impression
agar reversible hydrocolloid; see Agar
-
water cooled 2:24- 25, 3:59
storage of, 1:514-515
.
Heat treatment of gold alloys, 2:224-225 reversible hydrocolloid impression -
two piece 1:51 .56 . -
- base 1 132- 135
Heat cured compression - molded record
. :
alginate irreversible hydrocolloid ; see
Alginate irreversible hydrocolloid
Incisal application to aluminous porcelain
jacket crown , 2:309-311
Heat -cured provisional restoration , 2:399 - impression Incisal area ol provisional crown ,
401 boxing of, 1:57-79 translucence of. 2:408
Heatless stone. 3:328-330
Helical bend of orthodontic wire. 3:619-620
care of. 3:1-29
copper tube, 2: 1 - 2
Incisal buildup in metal ceramic crown with
porcelain margin , 2:298-299
-
Helical finger spring. 3:625-626
Hi- Heat Soldering Investment , 2:242
corrected cast ; see Corrected cast
impression
-
Incisal cutback in metal ceramic crown with
porcelain margin . 2:299-304
llircoe. 1:538
.
Hold 1:339, 341 . 3:504
definition of, 3:58
318-319,
-
Incisal guide pin, 1: 157 162 , 171, 179- ISO.
elastomeric: see Elastomeric impression 2:78. SO. 3:355. 358 359 - ,
Hollenback carver . 2:192- 193
Hollow bulb obturator , 1:488-491
electroplates , 2:43 45
final ; see Final impression
- - 364 368
Incisal guide table. 1 :153. 157-164. 171 ,
Hooper Duplicator, 1:376-377, 3:413 metallic paste, 3:42 178-179. 181 318-319 3:350 .354. , , ,
Horizontal axis. 2:151 modeling plastic, 1:22 24 - 358-359 368 ,
Horizontal plane, 2:143 -
mnscostatie. 3:468 469 custom . 2:65-67
Horizontal plane record , 2:155- 156 of overdenture cast , 1:536-537 mechanical. 2:65
Horizontal plane study, 2:146-149 lor partial denture. 3:1 Incisal loop connector, 2:134 135 -
Horseshoe connector, 3:154 . 185
beading for, 3:206
plaster, 3:36, 42, 468 469
polyether, 2:20-23
- Incisal
Incisal
pin, 2:62-63
porcelain. 2:283-28-1
closed, 3:154- 155 polysiloxane , 2:20- 24
polysulfide, 2:13-17
Incisal rest preparation 3:140 .
Howmedica Reline and Repair Resin , 3:683 Incisal shade, 1:211 , 2:408
Hue, 2:262-265 pouring of. 2:33-34 Incisor
identification of, 2:265 preliminary ; see Preliminary impression central; see Central incisor
Humidor , 2:72-73, 219-220 rebase, 3:423 lateral ; see Lateral incisor
Hydrocal , 2:1 , 32-33, 3:374, 412 , 414 -415 reconstruction , 3:435 mandibular, metal -ceramic restoration of,
Hydrocolloid , 3:1 reline, 3:410 412 - 2: 277
irreversible; see Alginate irreversible rubber base, 1:57, 3:30 -
maxillary . metal ceramic restoration of.
hydrocolloid silicone; see Silicone impression 2: 276- 277 * A
preparation of. 1 :427 -428 for Swing/ Lock partial denture, 3:504 -
Index, facc tmw 1:321 -324 .
reversible; see Agar reversible zinc oxide-eugennl paste; see Zinc oxide- Indexing of cast , 1:80 85 -
hydrocolloid eugenol paste impression groove method, 1 :80 85 -
Hydrocolloid compound technique for Impression cement, 3:468 notch method, 1:84-85
fabrication of remount cast 2: 16- 48 . Impression compound . 1:10 2: 1 -2 . requirements for, 1 :80
Hydrocolloid impression , combination Impression material , 2:1 31. 42 - using split remounting plates , 1 :85-88
technique, 2:11 13 -
Hydrocolloid investment , denture base
aqueous, 3:1
elastic, 2:1-31
Indium in gold alloys. 2:221-222
Induction casting 2:233 .
processing with, 1:425 440
Hydrocry I Soft Liner, 1:442
- syringe lor transfer of. 2:25- 29
tray carrier for, 2:23-25
Inlrabulge clasp, 3: 1 II 147 150 276. 279
284, 443-444
. - . -
HvdroFlame. 3:637 -638 elastomeric 3: 1 . .
Inlay 2:206
Hygiene device, mechanical 2:186
Hygroscopic expansion in gypsum -bonded
inelastic. 2:1 2
selection of 2: 1
- Inlay technique, indirect, 1:6
Inlay wax, 2:348 399 .
investment, 2:214 Impression plaster , 2:2 , 239-240. 392 lunovadent , 3:597
Hygroscopic technique of investing . 2:217 Impression tray, 1:26 56. 3:468 -
custom . 1:26, 2: 14 - 16, 3:58-75
-
Insta Mold Putty System , 1:454
llyrax wire expansion screw, 3:650-651 -
Inter penetrating polymer network tooth
autopolymerizing acrylic resin 1:26-40, . material 1:201 .
I
- .
44 56 3:60 68
posterior, 1:44-45. 49-51
- Interarch relationship, 2:82, 84-87
Interceptive orthodontic appliance 3:617- .
-
I bar clasp, 3:148-149, 185. 280-281 shellac baseplate material, 1:40- 44 663
Identification thermoset vinyl , 3:68 71 - components of, 3:617-644
of denture, 1:305-307
-.
-
vacuum adapted thermoplastic resin. fabrication of, 3:644 656 -
of mouthguard 1:554 555, 559. 561 563 - 1:37-40, 47-49 fixed , 3:617
Immediate denture
construction of. 1:413-424
-
visible light cured , 3:71 -74 Hawley, 3:645, 6.54 656 -
definition of, 3:58 lingual arch , 3:645 647 -
impression tray for. 1:44-56 for elastic materials. 2:23-25 modified Nance, 3:645, 618 650 -
Immediate overdenture, 1:512-544 , 3:577 full-arch , 1 :44 -49 prescription for, 3:644
correcting processing error in 1:541 . handles lor , 1:29-30, 35-36, 39-40, 42 rapid palatal expansion 3:645, 6.50 652 . -
Masking of, 1:535-538 holder for. 1:10-12 removable , 3:617
impression tray for, 1:512 516 - for immediate dentures, 1:44-56 transpalatal , 3:645, 647 648 -
packing of, 1:538-539 for immediate overdenture , 1:512-516 .
W-arch 3:645. 652 653 -
polishing of. 1:541 543 - .
materials for 1:26- 41 working cast for . 3:644

Interdental papilla. 2:168, 190
porcelain , 2:131 132 - denture, 3:136- 139
1 Interim partial denture, 3:568
.
Interlock 2:334, 337 338 - Key attachment; see Precision attachment
* lit Internal attachment ; see Precision
attachment
Interproxinial surface , 2:168-169
in axial contouring, 2:189- 191
Intra -arch relationship. 2:82-81
Intracoronal attachment , 2:331, 337-347
Intracoronal-extracoronal combined
attachment; see Schatzinann
attachment
Inverted cone bur, 1:537
In vest ic. 1:217, 466. 471
Investing. 2:213-219, 3:482 483, 490-493
definition of , 3:299
lor Dicor castable ceramic crown , 2:320-
322
of Huid resin complete denture, 1:428-429
217
-
with gypsuin bonded investment. 2:215-
hygroscopic technique of. 2:217
mechanical vacuum technique of, 2:215.
217
-
paint on technique of. 2:215- 216
2:217 219 -
-
with phosphate bonded investment ,
of sprued pattern . 3:299-318
of Swing/ Lock partial dentures, 3:511-512,
514
vacuum investing equipment, 2:480-481
Investment, 3:221 223 -
casting; see Casting investment
-
gypsum bonded 2:214 217 . -
hydrocolloid , denture base processed
with . 1:425-410
- .
paint on 3:3( K ) 303 - Lateral incisor
-
phosphate lxmded. 2:213-219
in preweighed packages, 2:218
7 4 .
soldering, 2:238 241 242 3:490 - .
Investment cast , 3:220- 233
Iris scissors , 3:472 473 -
Irreversible hvdrocolloid ; problems areas of.
2:31; see also Alginate irreversible
hvdrocolloid
Isosit composite resin kit . 3:556. 561
Ivomat processing unit . 3:556-557
Ivory epoxy resin , 3:675-680
J Legal obligations of dentist and technician
Jacket crown
aluminous porcelain . 2:284-285, 305-314
porcelain , 2:123, 126. 164-165, 305 314
Jaw relation. 1:90-91
Jel- Pac. 3:324
Jelenko alloy. 3:220-221
Jelenko surveyor. 3:164-165
J citrate, 3:504
Jet Acrylic, 2:386. 399. 3:682
Jeweler’s broach . 2:374
Jeweler s rouge , 1:333. 338, 476, 3:308, 334
355. 339-341, 403
Jeweler 's saw, 2:37, 41
Jig. 3:464 , 475, 479. 578
. -
'
reline , 1:372 , 3:413 423
Jo Dandy wheel 2:191 - 192
Johnson’s Baby Powder, 3:100, 123
K Lingual hladed teeth. 1:188
\ Kaoliner casting ring liner, 3:68
Kaolinite lining material , 2:320
Kayon stain . 1:546
Index 9
Kennedv classification of removable partial Lingua ) plate, 3:150-152. 1S5, 256 257 448 - . -
4.50
.
Kerr Permlastic, 3:77 Lingual retentive arm 2:347 349 -
milled , 2:334-335
Keyway attachment ; see Precision
attachment
Lingual section , 3:501
Lip extension , maximum , 3:501
Kind Radiopaque, 2:386-387 Lip line 1:90 91 . -
Kiwi white liquid shoe polish 3:470- 471 . -
Lip support wax index, 3:501, 526
Knife-edge wheel. 3:333 337 . Liquitex Acrylic Gloss Medium and Varnish
Konomctcr , 3:579 3:675
Kurer Press-Stud , 3:584, 589-590. 602 LOA ; see Libia! opening arc ( LOA )
.
Kurer screw system 3:612-613 Locator, fabrication of. 1:506
L
-
Low fusing porcelain, 2:282 285 -
LPI ; see Lingual path of insertion ( LPI)
L- bar clasp; see T clasp, modified LRG; see Latch recessed groove ( LRG)
- Labeling tape, plastic, 3:667 .
Lucitone 1:443, 538, 3:382
Libial bar. 3:152-153. 501 528 . .
Luralite 1:118, 3:106
double, 3:526 533-
opening of, in Swing/ Lock partial
Luting , 1:402. 2:59, 3:418, 425. 428
Luxene Vinyl Denture Base Separator .
dentures, 3:516 3:520
Libia! bow spring, 3:626-628
Labial contour, 2:167
Lihial gingival acrylic veneer, 3:526-527 M
Libia! opening arc (LOA), 3:501 502 - -
M S attachment, 2:337
-
Labial veneer; see Labiogingival tissue Magne Dent , 3:597 600 -
acrylic veneer Magnet attachment, 3:597-600, 603
-
Libia! veneer wax trv in , 3:501
Labiogingival tissue acrylic veneer, 3:501,
Mallet , plastic, 1:316 317
Mandibular east
-
-
519 522, 528 diagnostic, 2:73-75
laboratory bur, 1:326. 328, 2:402 dimensions for, 1:9 10 -
Laboratory equipment, 2:451 485 - orienting to maxillary east 2:57 58 . - »
index to manufacturers of. 2:485 489
Laboratory Hand Engineer, 2:474
- surveying of, 1:237 238
Mandibular denture, Swing/ Lock, 3:525
-
Laboratory plaster, 1:67, 3:32 Mandibular guide prosthesis, 1:496
Lacquer, 1:216 Mandibular metal base 1:460-462 .
Lipping of anterior teeth, 1:231 232 - Mandibular (Movement , 2:142 153 -
Litcb recessed groove ( LRG ), 3:506, 508 a x e s ol r o t a t i o n . 2: 143- 144
classification of 2:143 .
mandibular
morphology of. 2:110- 111
studies of, 2:144 153
Mandibular occlusion run , 1:144 - 145
-
position of, 1:235-236 Mandibular recording equipment, 2:460-465
maxillary Mandibular resection device, 1:491-497
morphology of, 2:96-97
position of , 1:225-236
dentitions, 1:494-495
edentulous, 1:491-494
supernumerary, 2:134 materials for. 1:491
morphology' of, 2:92-93 requirements of, 1:491
-
Lathe, high speed. 3:327-328 Mandibular strut . 3:522-524
latticework . 3:345 347
Leader Tape, 2:340
- Mandibular teeth; see Anterior teeth ,
mandibular; Posterior teeth ,
Ledging; see Blockout, shaped mandibular
. Mandrel, 2:355. 3:328 329 -
1:5 Manufacturer s index, 2:485-489
Length of tooth , 2:128- 132 Margin , adaptation of
- Lentulo spiral, 3:548-549 to die. 2:191- 193
Lever, class II. 2:176. 178 to wax pattern , 2:192-193
Light and visual perception , 2:122- 123 Mark IV digital furnace, 2:341
Light -cured resin Masque, 1:53, 163, 167. 287. 555, 3:92, 131
provisional restoration of, 2:405-406 Master cast . 3:187
small particle composite, 3:556-557 blockout of, 3:513
Lincoln Dental Supply Company, teejh duplicate, 3:404 405 -
.
marketed by 1:191-192 examining of, 3:505 506 -
- Line angle. 1:6
Liner
mounting of 2:54 71
preparation for, 2:54 58
. -
-
denture base; see Denture base liner pouring of. 3:505
soft ; see Soft liner rebase 3:423 435 . -
.
Lingual arch appliance 3:645-647 reline, 3:410-423
-
Lingual bar. 3:150 151. 255-257, 440. 450- requirements for, 3:504
lor Swing/ Lock partial denture, 3:504-506.
451
double. 3:152-153. 256-257 513
Mastication , muscles of, 2:178
Lingual bracing arm . 2:334 , 347 349 - Maxillary cast
Lingual contour. 2:168 diagnostic 2:73-74 .
Lingual path of insertion ( LPI ). 3:501 dimensions for , 1:9- 10
10 Index
Maxillary cast contd —
orienting of. 2:56-58
.
waxing of 3:239-255
Maxillary coping overdenture. 3:526-528
Maxillary metal base. 1:460-461
Maxillary occlusion rim, 1:143- 144
Maxillary orthopedic stabilizing appliance,
2x444 448 -
Maxillary teeth; see Anterior teeth,
maxillary; Posterior teeth , maxillary
Maxillofacial procedures, 1:479-511
Maxillofacial prosthesis, Swing/ Lock. 3:524
M AM M Fluid Denture base system , 1:339,
346
McCollum attachment. 2:338-342
MDS Adhesive, 2:436. 441
Mechanical vacuum technique of investing,
2:215. 217
Mediuin (a ) , communication , 1:1
Melite acrylic bur, 2:430
Nlelotte's metal , 2:47 - 48
Mercaptan; see Polysulfide impression
Mesiodistal clasp. 3:150-151
Metal
Mellotte s, 2:47-48
in metal -ceramic restoration , choice of.
2:280
surface conditioning of. 2:285-288
Metal backing
for denture teeth, 3:535-561
indications for, 3:535
techniques for. 3:535- 561
Metal base. 1:460-478 3:156-157 .
advantages of. 1:460
alloy, pattern gauge, and amount used.
1:468
design principles of. 1:460-478
mandibular. 1:460-462
materials for. 1:463-477
.
maxillary 1:460-461
requirements for. 1:460
Metal design for metal-ceramic crown with
porcelain margin , 2:291-293
Metal mold
auricular, three-piece, 1:502-505
fabrication of
direct wax method , 1:505
for facial prosthesis, 1:500-505
Metal occlusal, 1:188. 3:162- 163
construction of. 1 :201 -214
finishing of. 1:219. 221
polishing of, 1:219 221 . metal; see Metal mold
Metal occlusal denture teeth , fabrication of,
1:214 - 222
Metal politic , 2:198, 3:163
Metal record base, 1:143
Metal repair , 3:437 451 -
Metal-ceramic alloy , 2:221 -237
high fusing, casting of, 2:233- 235
Metal -ceramic casting, degassing of. 2:237
Metal -ceramic crown, 2:270-281
with porcelain margin , 2:289-305, 313
Metal-ceramic politic, 2:198-199. 202-203
Metal -ceramic repair, 2:411 -413
Metal-ceramic restoration
alloys for, 2:221-237
framework of, 2:276-281
fabrication of , 2:270-271
metal in , choice of, 2:280
multiple, 2:278-279
polishing of. 2:257-259
spruing for , 2:210-213
Metal-insert teeth , 1:187-188
'
T-
Metallic paste impression . 3:42
Micro Pencil Air Abrasive Unit , 2:453
Mounting
— contd
of functionally generated occlusal path
-
Micro Matic Waxing Unit , 2:483 record 2:66 70 -
Microdrill, 2:469 470 - of master cast , 2:54-71
Microfilm separating medium , 1:321 . 323
Midi Model BOD 7S burnout furnace .
Mounting cast , 1:147 186
construction of, 1:136-138
- 8
2:471-472 Denar Mark 11 articulator and ear bow -
Midline, 1:90 91 - record, 1:147-156
Milled lingual bracing arm , 2:334 Dentatus AHH articulator and face - bow
Milled lingual retentive arm . 2:334 335 - registration , 1:157 162 -
Milling, 2:374-375 -
Ilanau 130 28 articulator
equipment lor , 2:375. 476- 177 and arbitrary mounting, 1:163-167
.
Milling bur 2:348 349 3:579 - . -
and face bow registration , 1:167 - 171
Milling platform , 2:373 Ilanau 112 articulator and ear-l >ow record.
Mini Max Blaster, 2:453 1:171-178
-
Mini Bk attachment , 3:582
-
Mini hinge, 3:501, 506-509, 513
Whip-Mix articulator and quick mount
face- bow , 1:177-181
-
-
Mini hinge plastic pattern , 3:503
.
Mounting media, 2:56-57
-
Mini Lah Vacuum Adaptor 1:37 Mounting plate, retrieving, 1:184- 186
- -
Mini Presso Matie, 3:581 Mounting plate ejector, 1:184- 185
Mini - Best attachment, 2:362 Mounting stone , requirements for. 1:147
Minute Stain , 2:406. 408-409 Mouth protector; see Mouthguard
Model Mouthguard. 1:551
anatomic; see Anatomic model custom, 1:551-565
epoxy resin , 3:675 680 - cast preparation for , 1:551-553
Model gloss, 3:666 with faceguard attachment , 1:555-561
Model investment , 3:221-223 without faceguard attachment , 1:561-
Model release agent , 3:405, 572 565
Model spray . 1:464, 468 identification of. 1:554-555, 559. 561-563
treatment of refractors- cast with , 3:229- mouth molded. 1:551-552
230 speech and, 1:561
Model trimmer , 2:477 - 478 stock , 1:551-552
Toothmaster Discomat, 2:477-478 Mouthguard material . 2:430
Modeling plastic Movement 2:142.
2:42
-
copper band modeling plastic impression. mandibular; see Mandibular movement
planes of, 2:143 0
impression of. 1:22-24 .
rotary 2: 142
occlusal index of , 2:46 translatory , 2:142
occlusion rim of, 1:145. 3:134 types of, 2:142
Modern foil , 1:92, 3:80, 520 and visual perception , 2:123
-
Modified denture flask method of
duplicating dentures, 1:339-348
Mueostatic impression , 3:468-469
Multi - plater , 2:475
Molar Multiple adjacent casting. 2:257
first; see First molar Multiple circlet clasp. 3:145
second: see Second molar Muusell Color Order System , 2:261 -260
Mold Muscle(s ) of mastication . 2:178
agar reversible hydrocolloid 3:209- 220
alginate irreversible hvdrocolloid , 1:356,
. Myerson Special teeth. 1:191
Mverson Tooth Corporation , teeth
3:209 manufactured by , 1:191, 193
conditioning of, for Dicor castable ceramic M verson s Porit. 1:432
crown , 2:322 Mylar film leader tape. 3:579
Mylar strip. 2:255
posterior tooth , selection of. 1:237
practice, 1:550 N
reversible hydrocolloid . 1:136-142 Nance appliance , modified, 3:645, 648-650
silicone, for multiple waxing of similar Nasal prosthesis 1:500 .
tooth contours, 1:222
tooth , numbering system for , 1:191-201
Nasopharyngeal radiation source carrier.
1:.506-507
Molloplast - B , 1:442-458 Natural Coe- Lor Denture Resin, 1:545-546
Monoject , 3:504 Ney attachment , 2:362
Monoline posterior teeth , 1:200-201, 268- Ney surveyor. 3:164- 165. 579
274 Ney undercut wax 3:200 .
arranging in bilateral balance, 1:270-272 .
Nev’s antiflux 3:469, 471
arranging in fiat linear type occlusion , NEYMATIC-101 furnace, 2:471
1:268-270 .
Nickel-chromium alloy 2:223, 2.33- 235.
Morphology, occlusal 2:140 158 . - 3x275
Mortice- Rest attachment, 2:3(52-363 Nickel-cohalt-chromium wire, 3:448
Mortite , 1:464 . 3:470-471 Nohilliuiu , 1:468, 475
Mounted stone, 3:398-399 Nobilloid , 1:466
Mounting, 1:147, 3:76 Nonanatomic teeth , 1:187
of anatomic model, 2:55-64 North Carolina technique for pouring
arbitrary, 1:163- 167, 2:77-82 corrected cast impression. 3:49-57
ol diagnostic cast , 2:77-82 Notch indexing method , 1:84-85

O -
Obturator, 1:479
definitive
f hollow acrylic bulb, 1 :488- 491
.
materials for 1:484- 491
problem areas for. 1:491
requirements of, 1:484
silicone bulb, 1:484-487
immediate, 1:479
chemically activated resin , 1:480-481
materials for. 1:479-481
problem areas for . 1 :490
requirements of, 1:479
thermally activated resin , 1:481
interim
chemically activated resin , 1:481 482
materials for , 1:481 - 483
metal framework with resin , 1 :482- 483
problem areas for. 1:490
requirements of. 1:481
thermally activated resin , 1:482
surgical; see Obturator , immediate
Occlude, 3:580
Occluder, twin -stage, 2:180- 181 . 456
Occlusal
gold ; see Gold occlusal
metal ; see Metal occlusal
wax, 3:493
-
Occlusal anatomy, 2:153 156
Occlusal appliance , temporary, 2:429
Occlusal contact
relationship of . to temporomandibular
joint, 2:180
.
number of contact points in 2:180
Occlusal index
modeling plastic, 2:46
plastic, 2:48-51
Occlusal morphology . 2:140-158
Occlusal path record , functionally
generated , 2:175- 185
?. .
mounting of 2:66-70
Occlusal plane, anterior tooth placement
and , 1:226-227
Occlusal rest preparation , 3:140
Occlusal splint , 2:429
-
Occlusion , 3:369 370, 372
anterior guided posterior , 2:179
bilateral balanced posterior, 2:175- 176
checking with plastic strips , 2:255 257
functionally generated path , 2:66 70.
-
3:264 268
mouthguard . 1:557. 563
optimal , specifications for , 2:140- 141
unilateral balanced posterior , 2:176
179
. .
Occlusion rim 1:6 90. 3:76
for immediate overdenture , 1:524
.
mandibular 1:144 - 145
-
maxillary. 1:143 144
.
modeling plastic 1:145. 3:134
.
wax , 1:143- 145, 516-517 3:130 134 - attachments for, 3:577-616
Omega attachment ; see Interlock
Omnidental blockout compound, 1:125,
3:118
Omnidental coping material , 3:609
Omnilube Spray Silicone, 3:118
.
Omnivac 1:37, 2:339, 348, 3:68 69 - Oxy- Etch , 2:476
Omnivac baseplate material, 1:125, 3:118
Omnivac coping material . 3:579-580
% Omnivac Precision Vacuum Adapter 1:125,
- .
2:388 389 429
Onlay, 2:206
Onlay clasp, 3:145
4
Opaque porcelain , 2:282 283. 286 288, 293-
298
-
Opaquing, 2:293 298
Opotow Standard ZOE impression paste .
1: 1 IS. 3:77. 106
Optosil blockout material , 2:271 , 434 440-
441
Orange - .
solvent , 2:430 431 438, 442
Orangewood burnishing tool , 2:292
Orangewood stick adaptor. 2:306-307
Orax 1 , 3:594
Orbital prosthesis, 1:500 501 -
Orbiting condylar path , 2:146
in coronal plane study, 2: 152
in horizontal plane record , 2:155 156
- • in horizontal plane study, 2:146- 148
in sagittal plane record , 2:154 155
in sagittal plane study, 2:150 151
Orbiting condyle, 2:146
Orthociasp wire , 2:377
Orthodontic appliance , interceptive; see
Interceptive orthodontic appliance
Orthodontic blowpipe, 3:637
Orthodontic clasp, 3:285-287. 631-636
Adams, 3:634-636
arrowhead, 3:634
ball, 3:632-633
CIRCII mferen tial, 3:631-632
Orthodontic pliers , 3:618
Orthodontic procedure. 3:617-663
Orthodontic Resin , 2:408
Orthodontic spring. 3:624-631
dumbbell . 3:628-629
helical finger. 3:625-626
labial bow. 3:626-628
simple finger, 3:624-625
-
slingshot , 3:629 631
Orthodontic tray wax, 1:57, 61, 340, 356
Orthodontic wire, 3:617-618
annealed, 3:617-618
bending of; see Bending of orthodontic
wire
preactivated , 3:617
Orthopedic appliance. 2:432- 449
Orthopedic screw, 1 :481
Orthopedic stabilization , 2:443-448
Orthopedic stabilizing appliance, maxillarv,
2:444-448
- .
Orthosit denture teeth 1:195, 198 199
- Outline form
.
facial 2:122-123
tooth, 2:123-125
square-ovoid, 2:123-125
- -
square tapering, 2:123- 125
Oven soldering. 2:244-247
Overbite, 1:235
Overcasting
-
metal ceramic repair using, 2:411 412
in repair of abutment facing, 2:415- 416
Overdenture, 1:512, 2:166 167 - Pascal Occluder, 2:349
immediate; see Immediate overdenture
maxillary coping. 3:526 528 -
remote, 3:577
Overimpression, 2:387
-
Oxy Micro Ten furnace , 2:472 473 - lead. 3:176
P Periodontal splint, 3:526-527
. Paasche Air Eraser, 2:349
Packing, 1:302-304, 307, 3:382-387
of immediate overdenture, 1:538-539
split - packing technique, 3:382
Index 11
- Paddle boxing method 1:74 79 . -
-
Paint on technique of investing. 2:215 216 -
Palasiv 62, 1:442
- .
Palatal bar. 3:152 153 185. 440 528 .
.
-
anterior posterior, 3:1.53 1.54
beading for. 3:206
-
beading for. 3:206
double; see Palatal bar, anterior posterior
Palatal lift , acrylic resin . 1:497
-
Palatal radiation source carrier 1:508 .
Palatal seal, posterior, 1:6
addition of, 1:409-412
Palatal strap: see Palatal bar
Palate
- defect in . 1:482
-
resection of. 1:481
Palate form , plastic, 1:284-287
- Palladium in gold alloys, 2:221-222
Palladium-cobalt- nickel alloy 3:597 .
Pallax I , 3:594
Pantograph , 2:144- 145
application of. 2:156-157
Pantographic record , 2:144-146. 153-156,
460, 464-465
clinical signifiance of. 2:156-157
Paper, articulating, 1:320, 541 , 2:300, 302.
3:394
Paper clip in spniing, 2.206
.
Paperclip wire 1:113-114 , 404 , 516-517.
3:77-78, 102-103, 123
"
Papilla, interdental; see Interdental papilla
Parallel attachment; see Precision
attachment
Paralleling equipment. 2:476-477
Bachmann garallelor and Precision
Milling instrument . 2:477
EM Parallelometer, 2:477
Parallelism , verifying. 3:479-481
Parallelometer, 2:348, 477, 3:579
Parked C. I . Kit , 2:422
Parked Trim Bur , 2:430
Partial denture
bounded , 2:333
cantilever fixed , 1:6
construction of crown under existing,
2:421 422 -
free-end, 2:333
interim , 3:568
- mandibular , framework design for , 2:334-
336
maxillary, framework design for. 2:336
plastic, 3:568-573
removable; see Removable partial denture
transitional . 3:568
Partial denture impression , 3: 1
Partial prosthesis, frictional wad precision
attachment , 3:458-499
- Partial veneer crown , 2:1(50- 163
Partitive color mixing, 2:267-2(58
Pattern adapter. 1:469
P. D. attachment . 2:362-365
Pectus excavation defect , 1:510
Pencil
-
crayon type, 3:176
-
Pencil erasei adaptor. 1:116 117, 3:104 -105,
204
Permalastic, 1:91 , 3:111
Personalization of denture, 1:233 235 -
-
PGP alloy ; see Platinum gold palladium -
( PGP) alloy
12 Index

-
——
Phosphate bonded casting investment, 3:299 Polysulfide impression, 2:13-17 Posterior teeth cont’d
Pickling. 2:226-228, 3:324-325 Polyvinyl matrix for provisional restorations. mandibular cont cl

1:260-262
-
Pilkington Tumer 30-degree posterior teeth . 2:388-391
Polyvinyl pipe, investment flask ring of, 1:473
articulation of 33-degree anatomic.
1 :240-249
.
Pin Drill 2:470 Pontic, 2:279 metal-ceramic restoration of, 2:278 t
Pin politic. 2:412- 415 -
anterior, 2:203 204, 279 maxillary, 2:92-94
Pindex drilling apparatus. 2:39 design of, 2:194-206 arranging 20-degree, 1:249-251
Pindex system 2:469 . fixed removable, 2:335 33-degree anatomic, 1:238- 239
Pink Opaque. 3:520 .
materials for 2:196- 198 metal-ceramic restoration of. 2:278
Plainline articulator. 1:151 metal. 2:198. 3:163 Monoline; see Monoline posterior teeth
Plane, 2:143 - . -
metal ceramic 2:198 199. 202-203 replacement of. 1:392-398, 3:161 - 163
coronal, 2:143 modified sanitary; see Sanitary politic. representative artificial . 1:195, 198
horizontal , 2:143 modified Postsoldering in vacuum oven, 2:244- 245
sagittal. 2:143 -
pin , 2:412 415 Potassium sulfate bath , 2:5. 7
Plaster posterior Potato masher , flask holder made from ,
dental , 2:56-57 mandibular. 2:194- 199 1:296-297
-
impression, 2:2. 239 240, 392. 3:36, 42. maxillary , 2:199-203 Pour resin ; see Fluid resin
468 469 - reinforced acrylic; see Reinforced acrylic - .
Pour- N Cure 1:339. 346
Plaster spatula 3:672. pontic Pour- N-Cure flask, 1:138, 348-349
.
Plasterless articulator 1:557-559 repair of. 2:411 415 - Ponr- N -Cure resin , 1: 138
Plaster/pumice mix. boxing impression with , -
ridge lap, 2:200 Pour-resin flask. 1:348-349
- .
1:67 74 3:30 35 -
Plastic matrix former. 2:306
saddle; see Saddle pontic
sanitary ; see Sanitary pontic
- -
Pour resin flask method of duplicating
dentures, 1:348-356
Plastic occlusal matrix procedure for -
Porcelain , 2:282 288. 3:220 Powder
-
fabrication of remount cast , 2:48 51 aluminous; see Aluminous porcelain gold, 2:285-286
Plastic partial denture, 3:568-573
-
Plastic teeth. 3:569 570
-
application of. in metal ceramic crown
with porcelain margin , 2:293- 298
porcelain, 2:286-288
wax, 3:544, 546-547
damaged , replacement of body, 2:282-283. 309-310 Practice mold , 1:5.50
anterior. 1:383-389 gingival, 2:128-129 283 . Preactivated orthodontic wire, 3:617
posterior. 1:392-395 incisal , 2:283-284 Precision attachment , 2:331-.366
grinding of, 3:394
Plastic vacuum mixing bowl, 3:678
-
low fusing, 2:282-285
for metal veneering, 2:282-283
classification of. 3:458
definition of, 3:458
Plasticine, 3:212 opaque, 2:282-283, 286-288, 293- 298 frictional wall . 3:458-499
Plasticized resin material , 1:441 preparing ceramic alloys for, 2:290- 292 soldering of, 2:247-249
Plasticizer, 1:441, 2:20
Plastopaste impression corrective , 3:468, 472
soldering to metal framework. 2:242-243
Porcelain facing. 2:198- 199
Precision Scale CL
2: r> I
# -
VV electronic balance.

Platinum in gold alloys. 2:221-222 Porcelain furnace, 2:472-474 Preformed crown, 2:382-385
Platinum foil , 2:292-293 Flagship, 2:472-473 Preliminary cast , 1:9
Platinum foil matrix , tools for forming, 2:306 Oxy Micro-Ten , 2:472-473 Preliminary' impression . 1:9-25, 3:1, 58
-
Platinum gold - palladium ( PCP ) alloy, 3:274 Ultra- Mat CDF, 2.472-473 -
alginate irreversible hydrocolloid , 1:10 22
modeling plastio. 1:22-24
Pliers
bird -beak , 2:435, 3:618
Porcelain grinding wheel , 2:300, 302
Porcelain powder, 2:286-288 Premolar *v-
contouring, 2:384. 3:275 Porcelain teeth . 1:187, 189. 2:373, 3:345. first ; see First premolar
orthodontic, 3:618 454 , 493. 496. 536 maxillarv, metal-ceramic restoration of.
soldering, 3:586 damaged , replacement of 2:278

---
three prong, 3:275. 618 anterior , 1:389-392 second ; see Second premolar
wire bending, 3:275 posterior, 1:39.5-398 Preoperative cast ; see Diagnostic cast
wire cutter with vinyl inserts, 3:275 grinding of. 1:275, 3:394 Preoperative procedures for frictional wall
Pneumatic press , 3:384
Polishing, 1:312, 3:327-344, 396-403. 421,
.
polishing of 1:275, .'338 precision attachment partial
in posterior tooth replacement, 3:162 prosthesis, 3:464- 468
433, 492-493. 516 tooth shade comparison chart , 1:196 Preparation , 2:159
of complete denture. 1:324-337 visual perception of, 2:122 Preparation design
of fluid resin complete denture , 1:434 435
of gold casting, 2:257
- Position of teeth. 2:137-139
Poster board. 3:666
classification of restorations by , 2:161-164
for crowns, 2: 159-169
of immediate overdenture. 1:541-543 Posterior custom impression trav. 1:44-45, aluminous porcelain jacket . 2:305-314
of metal -ceramic restoration , 2:257-259
of metal occlusal . 1:219, 221
49-51
Posterior mold , selection of, 1:237
-
general considerations in , 2:159 161
for retainers, 2:159-169
of provisional restoration, 2:401-403 Posterior pontic Prescription. 1:5
of teeth , 1:338 mandibular, 2:194-199 for interceptive orthodontic appliance,
porcelain 1:275 . maxillary, 2:199-203, 279 3:644
of wax pattern , 2:192-193 Posterior reference points. 2:151 President , 2:23-24
Polishing wheel , 1:338
Poly tube, 2:3, 5
Posterior teeth. 3:352 360 -
Anatoline; see Anatoline posterior teeth
- 602
-
Press Stud attachment. 3:583-584. 589 593,

Polycarlx>n ate crown , 2:382, 385, 406 arrangement of. 1:237-275 Pressure Indicator Paste. 2:346. 3:517-518.
Polvether impression , 2:20-23
Polyethvl methacrylate for provisional 1:260-262
-
arranging Pilkington Tumer 30-degree, 580
Pressure pot , 2:394, 3:78, 99
restorations. 2:386 arranging Rational O-degree. 1:262-263 electric, 2:436
Polyjel, 2:22
Polymethyl methacrylate for provisional
-
checking setup of 20 degree, 1:260-261
checking setup of 33-degree anatomic,
Primabond, 1:445
Primasoft , 1:442
restorations, 2:385-386 1:244- 245 Primo, 1:445
Polypropylene matrix for provisional in immediate overdenture. 1:526-528 Prisma. 3:556 *
restorations, 2:388-391 mandibular, 2:92-94 Pro- temp. 2:386-387
Polysiloxane impression , 2:20-24 -
articulation of 20 degree, 1:251-260 Procedures checklist, 1:4

I

Processing, 1:276 3:.369-408 .
flaskless method for. 3:405 408
remounting and correcting errors in .
3:393 395 -
A Production Caster, 2:465-466
Profile, emergence 2:167 . Schatzmanii attachment, 2:352
Prolast ic, 1:442
-
Progressive side shift . 2:147-148
Pronto 11 , 1:339, 346. 432 2:394
.
Prophy cup, 1:331-333 338. 383. 389. 392.
541-542
Prosthesis, frictional wall precision
attachment , partial , 3:458-499
ProTem . 2:340. 342. 3:579, 586
Protor 3 alloy, 3:610
Protrusive condylar path. 2:146
in coronal plane study , 2:152
in sagittal plane record. 2:154-155
in sagittal plane study , 2:150
Provisional crown. 2:381 -410
Provisional restoration, 2:381-410
cementation of. 2:403- 405
characterization of. 2:406-410
custom - made, 2:391-398
as diagnostic aid . 2:382 383
finishing of , 2:401-403
heat-cured , 2:399- 401
of light -cured resin. 2:405-406
.
materials for 2:385-387
matrices for , 2:387-391
shade modification of, 2:406-410
techniques for, 2:391-398
types of, 2:382-385
Proximal surface, 1:6
Pumice, 2:403, 405. 437, 442. 3:400, 4:13;
see also Flour of pumice
Pumice/ plaster mix; see Plaster/ pumice mix
-
. - .
Pumicing 1:331 $34 336, 3:400 403
Push type clasp; see infrabulge clasp
Pyroceram ceramic, 2:315
Q
Quad -skins, 2:3
Quartz, 2:214
Quickstone, 1:80
R Red rouge, 2:257
R & R Soldering Investment, 2:241
Radiation appliance , 1:505-508
materials for , 1:506
requirements of. 1:506
Radiation source carrier. 1:506-508
nasopharyngeal, 1:506-507
palatal , 1:508
Radiation source locator, fabrication of.
1:506
.
Rag wheel 1:326, 334, 337-538, 383, 388,
392. 423. 450, .541, 2:403. 437, 442,
3:338-342, 400-403, 421, 453, 643
preparation of. 1:328-531
reconditioning of. 1:328-331
RAP; see Reinforced acrylic pontic ( RAP )
Rapid palatal expansion appliance, 3:645,
650 652 -
Rational O-dcgree posterior teeth , 1:262- 263
435
- .
Rebasing, 1:364. 377 382 438, 3:410, 423-
articulator method, 1:377-380
Ceka overdentures, 3:595-597
C. M . rider, 3:613
Jr Dalho attachment , 2:359
Dolder bar joint, 3:607-608
Dolder bar unit, 3:606
a
/ ndex 13
- —
Rebasing contd
flask method , 1:380 382 -
Remount cast , fabrication
of, 2:45-51
hydrocolloid compound technique, 2:46-
liader bar, 3:609-610 48
jig method, 1:377 380 - plastic occlusal matrix , 2:48 51 -
Rothennann attachment. 3:587 Remounting immediate overdenture, 1:540 -
541
- -
Reciprocal arm , 1:6
Reconstruction of removable partial
Remounting dentures, 1:318 321 , 434 435,
3:393 395 -
. den tu res. 3:435-436 Remounting plates 1:80-82 .
Reconstruction cast , 3:435-436 .
split 1:85-88, 181 184 -
Record base. 1:90 Removable partial denture
autopolymerizing resin : see * all-plastic, with and without clasps. 3:568-
Autopolymerizing resin record base 573
clinical application of. 3:76-77 anterior edentulous area , 3:138
conversion of cast base to. 1:477-478 attachment in , 2:247-249
damage to teeth during removal of. 3:95, bilateral distal extension , 3:136-137
117. 123 classification of , 3:136-139
definition of. 3:76 components of , 3:140-163
failure to fit cast , 3:89-90. 95, 117, 127 dual path of insertion , 3:562-568
fluid resin , 1:136-142 fluid resin , 1:436-438
heat -cured compression- molded resin . immediate, with metal framework, 3:571-
1:132- 1 576
for immediate overdenture , 1:516 523 - McCollum attachment for, 2:340-341
materials for construction of. 1:90-91 3:77 . P. D. attachment for , 2:365
special purpose, 3:562-576
- metal , 1:143
porosity of, 3:89 90 - temporary, 3:568
unilateral distal extension, 3:137
removed from cast with difficulty, 3:123
.
requirements for 1:90, 3:76 77 - Repair
rigidity of. 3:89-90 117 .
separation of. from cast. 3:88-89, 95
of abutment facings , 2:415 418
of bridge, 2:416-420
-
shellac: see Shellac record base with cast clasp 3:444 447 . -
.
stabilized 1:6, 90. 113- 123, 3:76 of cast metal restoration , 2:247- 249
of clasp, 3:292 297 -
with autopolymerizing resin , 1:121 123, -
3:113- 117 of complete denture, 1:383 412 -
with elastomeric impression material , of denture, 1:398 408, 454 -
-
1:121 122. 3:110 113 - of denture base, 3:451 454 -
shellac, 3:10 1 - of denture teeth , 1:383 392. 3:454- 455 -
- —
with zinc oxide eugenol impression
paste, 1:115- 120. 3:104- 110
of fluid resin denture, 1:438 440
metal , 3:437 451
of pontic, 2:411-415
-
-
storage of. 1:96, 120, 131, 142
thickness of, 3:89-90, 95, 100. 117. 129 of removable partial denture. 3:437 457 -
vacuum -adapted thermoplastic resin . resin, 3:451 4.54 -
1:125-128. 3:117-123 resin retention, 3:447 451 -
visible-light cured. 3:128-129 of splint, 2:416-420
wax . 1:129- 131 , 3:123-127 with wrought alloys, 3:443-444
Record rim ; see Occlusion rim Repair cast , 1:398 408, 3:453 -
Repair resin , 1:26. 389-392, 395-398, 401-
Refractory cast . 3:209-235, 481 408
care of. 3:482 Replacement teeth. 3:492-495
definition of, 3:209 Repositioning appliance, 2:448
treatment of, 3:228-233 anterior, 2:432-438
model spray, 3:229-230 -
vacuum formed, 2:434-4.38
-
wax. 3:231 233
Regal Dental Corporation , teeth
orthopedic, 2:432-443
superior, 2:438- 443
manufactured by, 1:199- 201 -
vacu 11 m formed 2:440-443 .
Regal - D- Blend teeth , 1:199-201 Resection device, mandibular; see
Regal - D- Luxe teeth. 1:199-201 Mandibular resection device
Reinforced acrylic pontic ( RAP ) 3:553-555 . ReSete pin set , 2:417
in anterior tooth replacement 3:160- 161
Reinforced facing. 3:535-561
. Residual ridge, damage to, 2:367-368
Resin
Relief, 3:187, 198-200. 204-206 autopolymerizing; see Autopolymerizing
metal base and , 1:463 resin
Reline jig, 1:372. 3:413 -
body shade, 1:211
Reline jig method dental , requirements for, 1:426
of rebasing, 1:377 380 - fluid ; see Fluid resin
of relining, 1:372-376
Relining, 1:364-376, 3:410-423
repair with , 2:421, 3:451-454
tooth shade; see Tooth shade resin
addition of silicone rubber liner. 1:443- Resin record base for immediate
454 overdenture, 1:518-524
articulator method , 1:364-371 Resin retention , 1:462
reline jig method, 1:372-376, 3:413-423 Resin retention repair, 3:447 451 -
Rembrandt Surface Pigment, 2:408-410 -
Resin teeth, 1:187 189. 3:454 , 536
polishing of. 1:538
Remote overdenture, 3:577
 4
14 Index
Resin teeth
— cont 'd
in posterior tooth replacement 3:162
tooth shade* comparison chart, 1:197
i Resistance, 2:159 160 -
' Resistance form . 2:159
Rest , repair of. 3:441
Restoration
classification of. by preparation design ,
2:161 - 164
cosmetic, 2:164-165
dislodgment of, 2:159
esthetic, 2:261
metal-ceramic; see Metal ceramic
restoration
- Rugae , wax, 1:286
provisional; see Provisional restoration
Retainer
preparation design for , 2:159- 169
temporan indirect , 2:334-335
Retainer box , 2:430-431
Retention. 2:159-160
bead . 1:462, 469- 470. 3:240- 241. 252-253,
-
345 346, 553
crystal , 3:553 *
nailhead , 1:462. 469, 3:240- 241 , 254-255
onen , 3:240- 242
resin , 1:462
repair of. 3:447-451
wax *>ps, 1:462- 463. 469
Retention loop, 3:501
Retentive arm , lingual ; see Lingual retentive
arm
Retentive pin. 2:373 374 - Sandpaper disk . 2:349. 392. 402. 3:332 333
Reverse approach circlet clasp, 3:144
Reverse curve, 1:6
Reverse-pin facing, 3:536-550
Reversible hydrocolloid
agar ; see Agar reversible hydrocolloid
in duplicating dentures 1:348-353 . -
Reversible hydrocolloid impression; see also
Agar reversible hydrocolloid
impression • activation of, 2:351 -352
problem areas of. 2:30
Reversible hydrocolloid mold, 1:136-142
Ribbon, articulating. 2:446. 3:354-355, 358.
367, 536-547
Rider clip. 3:581
Ridge lap, preparation of, 1:301 , 303, 537-
538
Ridge resorption, 1:223-225
Ridge- lap pontic, 2:200
Right -angle bend of orthodontic wire, 3:621
Rim, occlusion ; see Occlusion rim
Rim - lock impression tray, 1:536, 2:9- 10
Ring clasp, 3:150
Robinson brush , 2:257
Rollette unit , 1:32, 34, 45, 100. 3:92
Rotating condylar path, 2:146
in coronal plane study. 2:152 153
in horizontal plane record, 2:155- 156
in horizontal plane study , 2:147- 149
in sagittal plane record , 2:154 -155
in sagittal plane study 2:151
Rotating condyle. 2:146
Rotation, 2:142
Rothermann attachment, 3:601
. position of. 1:238-239, 249- 250
resilient , 3:587-588
rigid . 3:582, 585-587
Rouge stick . 2:236
Round bur , 1:326-327. 234, 237, 531 , 2:204 .
v » 252, 444
Round-end cylinder bur, 2:348
Router , 2:470
.
Rubber
natural. 1:442
silicone; see Silicone rubber
Rubber abrasive wheel, 2:325. 327, 3:223-
. -
334 336 337, 399
Rubber base impression. 1:57. 3:30
Rubber cup, 2:403, 405
.
Rubber point 1:334, 336. 2:350
.
Rubber Sep 2:351-352. 338, 3:586, 588
.
Rubber wheel 1:112. 394, 2:247 249. 253.
255
-
green , knife edge, 2:257
Runner bar . 2:211
Rush case. 1:4
S
Saddle, gold . 3:496
Saddle pontic, 2: 194- 196, 199-200
modified. 2:199-200, 203
Sagittal axis in coronal plane study, 2:153
Sagittal displacement of rotating condyle.
2:151
Sagittal plane 2:143 . 1:545-549
anterior tooth placement and 1:227 228
Sagittal plane record, 2:154 155
Sagittal plane rotation of mandible, 2:143
Sagittal plane study, 2:148- 151
.
Sagittal plane translation of mandible 2:143
Sandblast • , 2£36 219 257 .3: i 22 > 2 > IS
Sandpaper , 1:443 444 -
Sandri attachment , 3:582, 589 591, 601. 603
Sanford’s Elephant ( due, 3:666
. .
Sanitary pontic 1:6 2:194 196. 203
.
modified 2:194. 196 197, 199 201 - -
Saw, jeweler’s , 2:37, 41
Scale forming reactions, 2:215
Schatzmann attachment , 2:332. .347, 349
352, 3:597
rebasing of, 2:352
Schubiger screw system , 3:612-613
Screw systems , 3:612 613
Scutan, 2:386
- matrix of, for professional restorations.
Second molar
mandibular
articulation of. 1:240-241 , 24.5-249, 252-
255
morphology of , 2:120- 121
maxillary
articulation of, 1:258-259
morphology of, 2:106 107
position of, 1:238-239, 249- 250
Second premolar
mandibular
articulation of, 1:242. 245-249. 252-2.53
- morphology of. 2:116- 117
maxillary
articulation of , 1:2.56-258
morphology of. 2:102-103
Semicircular l >cnd of orthodontic wire, 3:619
Semiprecision attachment , 2:362-366
Separating disk . 2:249-251, 402, 3:540-541
Sepcoat. 3:506
Septisol solution , 3:334
Setting expansion in gypsum - bonded
investment , 2:214
Setting time of dental stone, 2:32 33
Setup of Swing/ Lock partial denture, 3:519
Shade, tooth ; see Tooth shade
Shaped wheel, 1:328
Shellac, 1:112
Shellac baseplate material , construction of
r
-
impression tray from. 1:40 44
-
Shellac record base. 1:112- 113, 3:100 117
for immediate overdenture, 1:516-518
stabilized. 1:113-123, 3#104
S
with autopolymerizing resin , 1:121-123
with elastomeric impression material.
. 1:121- 122
with zinc oxide-eugenol impression
paste, 1:115-120
Shellblaster. 1:315, 324-326. 541, 3:322-323,
396-397
Shim stock , plastic. 3:394-395
Shofu rubber finishing points, 3:615
-
Sholder Dalbo attachment , 2:357
Shrinkage porosity, 2:206. 210, 229-230
Shur-shine, 1:333
Sichel explorer , 2:171-172
Side-shift , mandibular , 2:146-148
Side-shift plate, 2:78, 80
Silt - in technique of denture base tinting,
. - Silastic. 1:442. 509-511, 3:664
- Silastic elastomer mold. 3:664 -674
Silastic implant , 1:509-511
Silica, 2:214-215
. Silicone bulb in definitive obturator. 1:484-
. 487
Silicone carbide paper, 2:363
- Silicone grease. 2:404
- Silicone impression , 1:57, 2:18-22
alginate substitute-silicone impression
- .
system 2:11 -12
Silicone mold , 3:664-674
base and lxjxing of, 3:666-670
construction of, 3:664 -674
- lor multiple waxing of similar tooth
contours, 1:222
preparing for epoxy pour, 3:676
Silicone putty , 2:390
impression material of, 2:271
*
2:387-388
spacer of , 1:454-455
Silicone release agent , 2:390, 3:590. 599
Silicone rubber , resilient denture base liner
-
ni 1:442 459
Silver in gold alloys. 2:221-222
Silver plating. 2:43-45
Silver solder . 3:638
- Silver-palladium alloy. 2:223
Simpa , 1:442
Simple circ let clasp, 3:143
Simple finger spring, 3:624 -625
S/ L partial denture; see Swing/ Lock (S/ L )
partial denture
-
Slidematic Face bow. 2:461
Slingshot spring, 3:629-631
Slotted attachment; see Precision attachment
Slum concentrate. 1:104. 147
Slum water. 1:17-20. 3:14. 32-33. 38. 45
preparation of, 1:17, 96, 2:76
SMC-2 solder, 2:238
!
Smooth curve bend of orthodontic wire.
3:624
Snap. 2:386
Snow W hite Impression Plaster, 2:239,
- 3:468
Soft liner , 1 :441-459
materials for , 1:441-459
ft

: Soft liner
— tout’d
requirements of, 1:4 41
silicone rubber, 1:442- 459
Soft Nobiltone, 1:442
*
/?
\ Soft Oryl, 1:442
> Softie, 49, 1:442
Softness in arrangement, 1:228 229
Solder connector , 2:134
Solder joint configuration , 2:238-239
Solder joint gap, 2:239
Soldering. 2:238-249. 3:478, 490-493
in clasp attachment , 3:289-292
in clasp repair . 3:290- 297
electric; see Electric solder
of gold alloy, type III , 2:239-242
nonprecious metal , 3:438
oven . 2:244- 247
physical requirements for, 2:238-239
ol porcelain to metal framework. 2:242-
243
precious metal , 3:437-438
.
of precision attachment 2:247-249
silver, 3:038
stainless steel. 3:637-641
techniques of. 3:438-440
Soldering flux , 2:238, 3:638
.
Soldering investment 2:238. 241-242.
3:490
Soldering machine*, Torit Model 21- A.
3:275-276, 291
Soldering pliers, 3:586
Soldering stand , 2:241
Spatula
plaster , 3:672
wax ; see Wax spatula
Spatulatiou . mechanical . 2:8, 3:12, 24
Spear -shaped bur , 2:249
Special purpose partial denture. 3:562-576
Speech , mouthguard and. 1:561
S» >ecb lid . 1:497- 499
Z hds for . 1:497
*
r
^^metal framework with reenforced acrylic
posterior extension, 1:497-498
palatal lift . 1:497
» •quirements of. 1:497
speech bulb. 1:497-498
Speech bulb, maxillary, 1:497-498
Spiral drill , 2:374
.
Splint 2:381 -410
emergency. 2:429
periodontal. 3:526-527
repair of, 2:416-420
resilient . 2:448- 449
resilient occlusal . 2:429
- .
vacuum formed TMJ resilient 2:429-431
Splint line, 2:386
Split Kemounting Plate Assembly,
Complete. 1:57. 80
Split -cast technique
lor mounting master cast, 2:65-66
for politic repair . 2:412-415
Spot welder, orthodontic, 2:293. 295
Spring, orthodontic; see Orthodontic spring
Spring pin. 2:371-372, 376-377
Spring-loaded pawl connector. 3:581
Sprinkle-on method
for construction of autopolymerizing resin
.
impression tray 1:27-31
for construction of autopolymerizing resin
record base, 1:91 -99, 3:78 90 - Substructure bar, 2:368-371
i
Sprue cone , 1:471 - 472
Ticoniuin , 3:262-266
' Index 15
Sprue former, 2:200-211
prefabricated plastic, 2:207-209
Sprue hole cutter, 1:139- 140
Sprued pattern , investing, 3:299-318
-
Super Gel, 3:504
Super - polish wheel , 1:338
-
Super Sep separating fluid . 1:70-71, 153.
I hi 287 . 290. 366. 3:32 102, 369,
Spruing, 1:430-437, 471 , 475- 470. 2:206-213, .
373 377 , 424-425, 409. 471
233, 3:200- 272 Supernumerary teeth , 2:133 134 -
- definition of. 3:234 Supporting wire, gold , 2:434 435 -
ol Dicor castable ceramic crown. 2:318
320
- Suprahulge clasp, if:141-147
Surface conditioner for metal 2:285- 288 .
ol fluid resin complete denture, 1:431 .
Surface form t « x>th, 2:125- 127
of metal-ceramic unit, 2:210-213 Surgical template , preparation of. 1:537
removal of , 2:323 Surgident Multiform Impression Paste,
of Swing/ Lock partial denture, 3:511 -512 , 2:352
514, 528-529 Survey line 3:130.
of wax pattern , 2:200-210 Surveying. 3:130
Sta-Guard Mouthguard Material , 1:555 instruments for. 3:136, 164 - 166. 170. 460-
Sta - Vac. 1:26. 37. 3:118- 121 401. 479
Stabilizing appliance, 2:448 of mandibular cast . 1:237- 238
Stain , 2:266. 284 * principles of, 3:164-176
for denture base tinting, 1:545-549 Swing/ Lock (S / L ) complete denture. 3:525-
Stainless steel , 3:275, 597 526
Stainless steel pin, 2:375-376 Swing/Lock (S/L) hinge 3:501 .
Stainless steel soldering, 3:637 641
Stainless steel wire, 3:77
- Swing/Lock (S / L) latch . 3:502
Swing/ Lock (S/ L) lock . 3:501 ,
Stannous fluoride gel. 3:600 Swing/ Lock ( S / L ) maxillofacial prosthesis,
Starlite Endowed, 2:422- 423 3:521
Steam cleaning. 2:257 Swing/ Lock ( S/ L) partial denture, 3:501-534
equipment for. 2:478 adjustments to 3:518 .
Steam - Klean , 2:478 attachment castings for, 3:506-509
Steel bur , 2:249-251 attachments , placement of, 3:510-511
Steel’s antiflux, 3:409, 471 -
burnout of, 3:511 512, 515 516 - d
Steele’s flat back facing, 3:158-159
Steele’s 'I’rn - Pontic, 2:412-415
- -
castingd 3*511 512, 515 516
double casting technique , 3:515
Stern frictional wall precision attachment . single casting technique, 3:515
3:459- 460 casting plastic patterns into metal . 3:506 -
Stem JMS attachment . 2:342 347
Sticky wax , 3:480-487
- 507
.
diagnostic cast for 3:503 504 -
Stick wax clasp, 2:440 double labial l »ar in . 3:526 533 -
Sticky wax wire. 2:434 435
Stipple sheet , plastic. 1:409-470
- lilushing of . 3:516, 519
framework of, 3:516 517 -
Stippling, 1 :278, 281, 331-334, 337. 541 .
Stock impression tray; see Impression tray ,
stock
mounting of 3:519
-
framework try in, 3:518
impression for , 3:504
*
Stone; see also Dental stone -
investing of. 3:511 512 , 514
artificial jaw relation registration 3:519 .
in alginate irreversible hydrocolloid mandibular . 3:522-524
impression , 3:7 17 - .
master cast for 3:504-506. 513
mixing of , 1:80 metal for construction of. 3:515
storage of, 1:10- 11 14 15 3:9-11
weighing of, 1:14
. - . opening labial bar. 3:516
polishing of. 3:516
mounting, requirements for , 1:147 preliminary design for. 3:503-504
Stone mold , 1:32 setup of, 3:519
Stress director. 2:332 333
-
-
Stress d irector ’ attachment . 2:333
spruing of. 3:511-512, 514 , 528 529
waxing of. 3:511 -512
-
-
Strut . 2:59 60, 3:501; see also Connector, Swiss pattern file, 3:484
minor Syringe
mandibular , 3:522-524 cleaning brush for 2:27 .
try-in, 3:502 disposable, commercially available 2:26 . -
Stud attachment , 3:581-605 27
Anerofix. 3:581, 589-590. 003-604 parts of. 2:27
Baer, 3:582, 589-590, 601 reversible hydrocolloid reusable. 2:26 27 -
Ceka, 3:583-584 , 593-597. 603-604 small composite, 2:404
Dalla Bona, 3:583, 602-604 Teflon reusable, 2:27
.
Gerber 3:589-591, 602. 004 for transfer of elastic impression material ,
-
Mini BK . 3:582
.
Press-Stud 3:583 584, 591-593, 002
2:25 29 -
* for transfer of reversible hvdrocolloid , 2:5 -
Hothermann, 3:582, 585-588, 601 6
Sandri . 3:582, 589-591 , 601 , 603
T
Study cast ; see Diagnostic cast
T clasp, 3:147-148
fabrication of, 2:372 375
Subtractive color mixing, 2:207
- modified , 3:148. 282-283
T- Flux. 2:346
 16 / ndex
Tacky 1 pud . L 469, 3:240, 248 , 252, 255 .
482
Tang, retention , 3:580; see also Connector,
minor
Papered L‘ mounted point , 1 :449
'
Tapered stone , 1 :557
Tarnish . 3:437
Teaching aid . three-dimensional , 3:664 -685
Technician
communication troubleshooting chart , 1 :8
omm unication with dentist. 1 : 1 -8
igal obligations of, 1 :5
£ liciting new accounts, 1 :2
:cope crown , 3:577 -580
•plate functionally generated path
3:360-363
Teri. oorary base ; see Record base
Tern *rary bridge Resin , 2:386
^^
N 'rary coverage , 2: 123, 125
ary removable partial denture, 3:5(38
\ -omandibular joint , relationship to
< msal contacts, 2: 180
Temper* nandibular joint appliance, 2:428 -
Ul
..ml hinge axis . 2: 151
I ei ..
1 • >‘ogy , 1:5-6
Terminology calibration chart. 1 :6
—
Tooth cont ci
denture; see Denture teetli
length of, changes in , 2: 128- 132
metal- insert, 1 : 187- 188
morphology of, 2:91 - 121
movement of. 2:82-83
nonanatom it\ 1 : 187
outline form of. 2: 123- 125
plastic; see Plastic teeth
porcelain ; see Porcelain teeth
position of . changes in , 2:137- 139
posterior; see Posterior teeth
preparation for Dicor castable ceramic
crown , 2:315-316
, replacement , 3:492- 495
resin ; see Resin teeth
supernumerary', 2: 133- 134
surface form of . 2: 125- 127
texture of. 2: 125- 127
tipped , 2:82-84
tube; see Tube teeth
universal . 1 : 190
width of , changes in , 2:132- 137
zero-degree see Zero-degree teeth
,
Tooth shade, 1 :6 , 191 -201, 2:406-407
identification of, 1 : 191 -201
Tooth shade comparison chart
•
*
Try - in , 1 :275, 3:536
labial veneer wax , 3:501
waxing for . 1 :276-284
Try - in strut , 3:502
Tube teeth
for anterior tooth replacement , 3:158- 15v
for posterior tooth replacement , 3:162- lf
Twin -stage occluder, 2: 180- 181 , 456
Two-piece impression tray , 1:51-56
Two-stage pour . 3:42-49
U
U clasp . 3:149- 150
Ultrafine . 2: 11 - 12
Ultra - M attachment , 2:359-360
Ultra - Mat CDF, 2:472-473
Ultrasonic cleaner, 1:334. 336. 449, 2:237,
257. .351 , 478-480
Comhilador CL- 1 Ultrasonic Cleaner,
% 2:478-479
Transistor/ Ultrasonic Cleaning Unit .
2:478-480
Ultrathin , 2:438
Undercut , 3: 172- 174
Undercut gauge , 3:165, 176 , 182- 183
Unilateral balanced posterior occlusion ,
2: 175 179
-

Texture, tooth . 2: 125 - 127
Thermal expansion in gypsum - l »onded
\
^ investment, 2:214
Miopiastic resin record base , 1 : 125- 128
2- iimn -adapted , 3.117- 12.3
Tin i noplastic resin sheet . 2:389
% - niosi t vinyl impression tray , 3:68-71
1
V
Thermotro! 2500 1 :474
Thioko! rubber 2: 13
Third -party communication , 1:7
Thread Mate System, £:426
-
Thrce dinit nsional teaching aid , 3:664-68.5
Three-prong pliers . 3:275, 618
Thumb release groove ( TRG ), 3:501
! hun . b release projection ( TRP), 3:502
Ti-Seal , 3:240. 248
r jol , 1:27, 3:302
Ti - \ re , 3:448
YieoniatL Casting Machine , 1 :477
Tieonium , 1 :468, 475. 3:220
Ticoruum duplicating flask , 3:210
riconiuni sprue cone , 3:262- 266
TiGleam , 1:3-31 . 333. .541
I filing of cast , 3:166- 175
-
Hn silver crown, 2:382-3*33
Tinfoil . 1 : 116- 117 . 3: 104- 105, 110, 131 - 133
Tinfoil substitute , 1 :29. * t , 211 . 447 , 538 .
3:62-65. 80, 85. 91 , 96. 353-354, 380,
416. 432
painting on stone , 1 :300-301
Tinting of denture base , 1:545-549
lissue conditioner . 1:443. 451 -453
Tissue stop, 1:32-34
•
issue support, 3:486-487
TMJ Deluxe Articulator, 2:460
1 MJ Kinematic Face bow, 2:464-465 -
TMJ Mini Articulator. 2:460-461
Tooth; see also specific teeth
abutment , 1 :531-533
acry lic , 2:373, 3:345
anatomic, 1:6 , 187
anterior : see Anterior teeth
artificial; see Artificial teeth
color of. 2:126- 128
contour of. 2:122- 139
cuspless, 1 : 187
:
acrylic teeth, 1:197
porcelain teeth . 1:196
Tooth shade guide , 1 :6 , 2:263- 265
Tooth shade resin , 1:201 , 211 , 342, 345-346 ,
350 , 3-53. 358 , 361 , 363
Toothbrush handle burnisher, 1 : 116- 117
Toothmaster Discomat , 2:477-478
Toothmaster Investment Vibrator. 2:482
Toothy smile. 2: 137- 139
Torch casting, 1 :473-474 , 2:225, 233-235
Torch soldering, 2:239- 244
Torit Soldering Unit, 3:438-439
Transfer cast . 3:469-475. 481
Transfer ink . 3:483
Transfer tray , 3:472-473
Transistor/ Ultrasonic Cleaning Unit , 2:478-
480
Transitional partial denture , 3:568
Translation . 2:142
Transpalatal appliance, 3:645, 647-648
Trauma, 2:367-368, 371 . 378
fray , impression ; see Impression tray
Tray former . 3:62
Treatment appliance. 2:428-449
Treatment partial denture, 3:568
Treatment plan , 1 :5, 2:82
TRG ; see Thumb release groove (TRG )
Triad Light Curing Unit, 3:73, 405
Triad Visible Light Cured material . 3:71 .
73, 405-408. 571-572
Trial base; see Record base
Trial denture
mandibular, waxing of, 1 :282-284
maxillary , waxing of . 1:276-282
Trim , 2:386
Trimming
of individual die , 2:191 - 192
of provisional restoration , 2:401 -403
Triple beam balance , 3:222
Tripoding, preserving tilt through . 3: 174- 175
Tripoli . 2:236 , 3:334-340, 402-403
TRP; see Thumb release projection (TRP )
-
Tru Pontic, 2: 412 -415
Trubyte Bioform mold numbering system ,
1:190 - 191
Trupolish . 1 :275 . 338
Unilateral distill extension removable p;
denture, 3: 137
Unitek Corporation , teeth manufactured
1 : 191 - 195
Univac porcelain teeth , 1: 191 , 193
Universal Hardener, 2:434. 440
Universal teeth , 1 :191
Utility wax, 1 :340, 356-357
Utility Wax Strips . 1 :57
V
V- 102 Flask , 1 :426
Vac- U - Vestbr/ Power Mixer . 1: 11 , 62. 296,
339, 358. 3: 12, 678
Vacu - Press , 1:26. 37, 3:68-69
Vacuum investing equipment, 2:480-481
Comhilador CL- VMR Mixing Unit , 2:4*
481
Combination Mixing Unit, 2: 481
Vacuum Investor. 2:481
Vacuum Investor. 2:481
Vacuum machine, heated, 3:68-69
Vacuum oven , postsoldering in . 2:244- 24'
Vacuum power mixer , 3:678
Vacuum pump, 3:673
Vacuum -adapted thermoplastic resin
impression I ray of. 1:37-40. 47 -49
record base of . 1 :125- 128, 3: 117- 123
Vacuum -formed anterior repositioning
appliance , 2:434-438
Vacuum -formed superior repositioning '
appliance, 2:440-443
Vacuum -formed TMJ resilient splint, 2:4
431
Vacuum -forming apparatus , 2:388-389
Vacuum/pressure method , for thin plast>
matrices , 2:388
Value, color, 2:262-265
identification of, 2:265-266
Vel Mix , 1 :80, 3:32. 362
Veneering porcelain , 2:282-283
Venting. 1 :431 . 436-437
Ventriculator, 2:66-70
Verident plastic teeth. 1: 191. 193
Verno Soft , 1:442