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REPAIR OF REMOVABLE PROSTHESIS

Terms in this set (75)

causes of fracture
denture related

patient related

technician related

facial trauma
causes of fracture

denture related
POOR FIT

ALVEOLAR RESORPTION

RELIEF AREA

POORLY BALANCED OCCLUSION

FAULTY DESIGN AND FABRICATION

INSUFFICIENT STRENGTH OF REPAIR MATERIAL

STRESS ON THE DENTURE BASE AFTER YEARS IN CLINICAL USE

INACCURATE IMPRESSION

POSITION OF THE TEETH
causes of fracture

patient related
cleaning

dropping

expelling the denture from the mouth
causes of fracture

technician related
lubricant contamination

processing

design/uniform thickness
REPAIRS OF COMPLETE DENTURES

classification
uniting one or more pieces

adding one or more teeth
REPAIRS OF COMPLETE DENTURES

classification

uniting one or more pieces
simple repair

complex repair
REPAIRS OF COMPLETE DENTURES

classification: uniting one or more pieces

SIMPLE REPAIR
uniting 2 pieces (ie: midline repair), come together easily
REPAIRS OF COMPLETE DENTURES

classification: uniting one or more pieces

COMPLEX REPAIR
fractures in multiple sites
REPAIRS OF COMPLETE DENTURES

classification:
adding one or more teeth
resin (IPN) teeth

porcelain teeth
REPAIRS OF PARTIAL DENTURES
uniting one or more pieces

adding one or more teeth

adding direct retainer(s)

welding procedures
REPAIRS OF PARTIAL DENTURES

uniting one or more pieces
simple or complex repair
REPAIRS OF PARTIAL DENTURES

adding one or more teeth
porcelain or resin teeth
A SATISFACTORY REPAIR
ADEQUATE STRENGTH

GOOD COLOR MATCH

BE EASY

QUICK

INEXPENSIVE

MAINTAIN DIMENSIONAL STABILITY
REPAIR OF MAXILLARY COMPLETE DENTURES
evaluate the accurate fit of fractured pieces

stabilize fractured pieces using sticky wax

block out undercuts

pour a stone model

remove fractured pieces from cast

prepare the fractured joint

apply a thin layer of separating medium

apply repair resin

place in pressure pot for adequate curing

finishing procedure

polished denture ready to be delivered
repair of maxillary complete dentures

pour a stone model
create a thick base for your cast, let it set fully
REPAIR OF MAXILLARY COMPLETE DENTURES

prepare the fractured joint
WITH ROUNDED INTERFACE SURFACES TO DECREASE STRESS CONCENTRATIONS AND ENHANCE JOINT STRENGTH

FRACTURED SURFACES SHOULD BE ROUNDED AND WIDE ENOUGH TO INCREASE SURFACE AREA.
REPAIR OF MAXILLARY COMPLETE DENTURES

apply repair resin
with sprinkle-on (salt and pepper) method

(make it bulkier)
REPAIR OF MAXILLARY COMPLETE DENTURES

place in pressure pot for adequate curing
-pressure?
-time?
-temperature?
30 PSI

20 mins

100 ºF
REPAIR OF MAXILLARY COMPLETE DENTURES

finishing procedure with
slow speed and resin burs
REPLACEMENT OF DENTURE TEETH
remove fractured tooth (from lingual) without damaging the denture

find best possible replacement tooth

remove denture base material lingual to socket, leave labial intact

grind tooth carefully and secure with sticky wax

prepare a matrix or index

apply repair resin (with brush) to attach new tooth to denture base

place in pressure pot curing unit

finishing procedure

polish and deliver

occlusal interferences must be checked intramurally
REPLACEMENT OF DENTURE TEETH

find best possible replacement tooth
USE SHADE AND MOLD GUIDE TO FIND THE BEST POSSIBLE REPLACEMENT TOOTH MATCHING TO THE FRACTURED ONE.
REPLACEMENT OF DENTURE TEETH

grind tooth carefully and secure with sticky wax
grind tooth carefully to obtain proper length and contour

sticky wax is used to secure tooth in correct position
REPLACEMENT OF DENTURE TEETH

prepare a matrix or index
PREPARE A MATRIX OR AN INDEX ON THE LABIAL SURFACES OF NEW AND THE ADJACENT TEETH BY USING A QUICK SETTING STONE OR A SILICONE PUTTY.

AFTER THE MATRIX SETS, REMOVE IT CAREFULLY AND COAT IT WITH A SEPARATING MEDIUM.
REPLACEMENT OF DENTURE TEETH

finishing procedure
use slow speed and resin burs to remove excess resin
REPAIR OF MANDIBULAR COMPLETE DENTURE
positively join fractured edges together

secure fractured parts with sticky wax

use modeling clay or PVS putty for extra stability

place additional sticky wax and block out the denture base undercuts

mix the stone and pour the cast

prepare the fractured joint

apply thin layer of separating medium and let it set

wet the repair area with monomer

apply repair resin over prepared fractured surfaces

place in pressure pot

finish and polish

deliver
REPAIR OF MANDIBULAR COMPLETE DENTURE

secure fractured parts with sticky wax
STICKY WAX CAN BE USED TO SECURE THE FRACTURED PARTS BY OLD BURS OR COTTON APPLICATOR STICKS.
REPAIR OF MANDIBULAR COMPLETE DENTURE

place additional sticky wax and block out the denture base undercuts
so the denture can be removed from the cast without breaking

(also block out lingual side with putty)
REPAIR OF MANDIBULAR COMPLETE DENTURE

prepare the fractured joint
WITH ROUNDED INTERFACE SURFACES TO DECREASE STRESS CONCENTRATIONS AND ENHANCE JOINT STRENGTH.
procedure code

repairs to complete dentures
D5500
procedure code

repairs to complete dentures: repair broken complete denture base, mandibular
D5511
procedure code

repairs to complete dentures: repair broken complete denture base, maxillary
D5512
procedure code

repairs to complete dentures: repair complete denture tooth
D5520
procedure code: repairs to partial dentures
D5600
procedure code: repairs to partial dentures

partial repair-base
D5610
procedure code: repairs to partial dentures

partial repair-framework
D5620
procedure code: repairs to partial dentures

repair/replace clasp
D5630
procedure code: repairs to partial dentures

partial repair teeth
D5640
procedure code: repairs to partial dentures

add tooth to existing partial
D5650
procedure code: repairs to partial dentures

add wire clasp to partial
D5660
procedure code: repairs to partial dentures

replace teeth and acrylic- maxilla
D5670
procedure code: repairs to partial dentures

replace teeth and acrylic-mandible
D5671
procedure code: denture rebase procedure
D5700
procedure code: denture reline procedure
D5725
procedure code: interim prothesis
D5800
procedure code: other removable pros. services
D5840

(ie: tissue conditioning)
REMOVABLE PARTIAL DENTURE REPAIR

repair by adding clasp assembly
take alginate pick-up impression

fabricate repair cast

wire added to resin base to act as retentive arm

repair resin added over extension of wire in denture base

wire cut to appropriate length

final activation should be performed with patient
REMOVABLE PARTIAL DENTURE REPAIR

welding procedures
clasp arm

occlusal rest

minor connector

major connector

(sent to lab)
TREATMENT PLANNING FOR REPAIR PROCEDURES

DISCUSS WITH YOUR PATIENT
THE CAUSES OF FAILURE.

POSSIBLE PROCEDURES BEFORE REPAIR

POSSIBLE ADDITIONAL PROCEDURES AFTER REPAIR.

REPAIR VS. REMAKE.

TIME MANAGEMENT.
TREATMENT PLANNING FOR REPAIR PROCEDURES

DISCUSS WITH YOUR PATIENT

possible procedures before repair
tissue conditioning/disease control, etc.
TREATMENT PLANNING FOR REPAIR PROCEDURES

DISCUSS WITH YOUR PATIENT

possible additional procedures after repair
reline/rebase/remounting, etc
flip
--
resin was unsupported by framework

extension of denture has to go all the way to hamular notch and cover the tuberosity area
repair of the acrylic flange of a maxillary RPD

why did this fracture?
---
flip back
REPAIR OF THE ACRYLIC FLANGE OF A MAXILLARY RPD

acrylic repair set up
PINK REPAIR ACRYLIC

DAPPEN DISHES

BRUSH

#6 STRAIGHT ROUND BUR

SLOW SPEED HAND-PIECE
REPAIR OF THE ACRYLIC FLANGE OF A MAXILLARY RPD

methods
create locking spaces in the acrylic (in house technique)

common alternative way: take alginate pick up impression (send to lab)
REPAIR OF THE ACRYLIC FLANGE OF A MAXILLARY RPD

create locking spaces in the acrylic
steps
create locking spaces in the acrylic with the #6 round bur

If pieces fit together then begin to add acrylic.

Place repaired RPD into hot water to accelerate the cure

Check the internal fit on the tissue with disclosing paste!

Check the occlusion !
REPAIR OF THE ACRYLIC FLANGE OF A MAXILLARY RPD

create locking spaces in the acrylic with the #6 round bur
Openings in the acrylic should be dumbbell shaped to create a locking affect
REPAIR OF THE ACRYLIC FLANGE OF A MAXILLARY RPD

common alternative way: take alginate pick up impression
place denture in mouth

take alginate pick-up impression in mouth

block out the undercuts

pour the cast

send to lab

do the repair on the cast
flip for cases
----
take alginate pick-up impression

pour cast and send to lab

they welded clasp and placed tooth and resin

try in patients mouth

if need: adjust clasp using ortho pliers
RPD BROKEN DIRECT RETAINER, TOOTH AND FLANGE REPAIR

75 YEAR OLD AA MALE PATIENT (RPD/RPD)

BROKEN WW DIRECT RETAINER ON LOWER LEFT TOOTH #22

#21 AND THE FLANGE WAS FRACTURED

PARTIALS DELIVERED 1 YEAR AGO

PATIENT REPORTS CHEWING ON ALMONDS WHEN THE PARTIAL BROKE.

NOT ENOUGH METAL FRAME SUPPORT FOR EDENTULOUS AREA (TOOTH #21 AND FLANGE)

FORCE OF OCCLUSION FRACTURE TOOTH AND ACRYLIC
take alginate impression of crown

use alike to fill tooth mold

approximate the fractured pieces (if pieces fit together accurately then complete the repair)

make openings in acrylic (dumbbell shaped) to create locking affect

use repair acrylic to add to interim denture

allow acrylic to cure in the mouth

carefully place interim in the mouth and check the fit and occlusion

add ortho wire to act as support for the tooth to be added
REPAIR OF A FRACTURED MAXILLARY INTERIM AND ADDITION OF TOOTH #12

patient has a wedding so need to do it in house
PLACE FORMED WIRE INTO THE INTERIM AND ADD REPAIR ACRYLIC TO RETAIN IT

PLACE THE PREVIOUSLY FORMED TOOTH #12 ON THE WIRE IN THE MOUTH AND ADD ALIKE TO LUTE IT TO THE MAXILLARY INTERIM
add ortho wire to act as support for the tooth to be added
-------
flip back
simple denture repair

you will need
slow speed and acrylic bur set

buffalo knife

.25 blade and red handle

extrude matrix putty

denture repair tub (acrylic and monomer)

mini mixing spatula and silicone dappen dish

pressure pot

bowl

1 packet of pumice

2 rag wheels

block of acryluster
simple denture repair

steps
1- make a base for your denture
2- adjust denture and replacement teeth
3- applying acrylic
4- cure the acrylic
5- clean up
6- smooth and polish
7- quality control
simple denture repair
step 1- make a base for your denture
use extrude putting to make a cast/base adapted to the intaglio surface of the denture

1 to 1 scoops of base and catalyst putty, mix well and quickly, no streaks

fill intaglio surface without voids
use extrude putting to make a cast/base adapted to the intaglio surface of the denture

why do we do this?
to ensure accuracy of tissue anatomy if we perforate the denture during adjustment and need to add new acrylic (so it is anatomically accurate)
simple denture repair
step 2- adjust denture and replacement teeth
remove old repair acrylic or ridges from repair site (avoid outer acrylic so there isn't a shade difference)

test replacement teeth to see if they fit and adjust as needed

for added retention and to prevent future failures, notch inside of denture base and teeth for acrylic to lock into place
simple denture repair
step 3- applying acrylic
add monomer into silicone dappen dish and mix (mixture should be thick and mobile, not runny)

apply to void in denture and set teeth into position (if multiple teeth, set and cure one at a time)

use excess monomer to smooth any rough acrylic areas after application

check for voids, bubbles, or other discrepancies

no acrylic should be on facial of denture tooth
why do we use glass or silicone dappen dishes
the chemistry of the monomer melts plastic and would cause acrylic mixed in a plastic dappen dish to set improperly!
simple denture repair
step 4- cure the acrylic
use a pressure pot to speed up the set time of cold cure acrylic

set in isolated area on flat surface

fill pot with water until the denture is just covered

lock the lid, apply desired PSI (approx 25)

let sit for 15 mins

(release pressure before opening the pot, pull on pin on lid until all air escapes)
simple denture repair
step 5- clean up
after denture is set, make adjustments to acrylic (clean up flash and add anatomy) using slow speed

don't hit the teeth
simple denture repair
step 6, part 1- smooth
set up lathe with new, damp rag wheel

wipe down splatter shield for visibility and lay down paper towel to collect debris

fill bowl with water and one packet of pumice (want thick paste), apply to areas you want to work on

set lathe on high

keep tight, 2 handed hold, gentle pressure
simple denture repair
step 6, part 2- polish
rinse denture (no pumice residue)

place new, dry rag wheel onto lathe

set lathe to high, apply block of acryluster (pink coat)

only contact wheel when coated in polish (high friction can burn or scorch the acrylic when there is no polish)
simple denture repair
step 7- quality control
check denture for areas that need improvement or adjustment

repeat any steps in adjustment and smoothing as needed

if none are found, disinfect and deliver to patient
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