Technique for remounting removable partial dentures opposing maxillary complete dentures

Frank R. Lauciello, D. D. S. * Veterans Administration Medical Center, Buffalo, N.Y.

A final interocclusal centric relation record at the time of initial placement is necessary for both complete and removable partial dentures. The final remounting procedure allows for the elimination of processing changes and errors in initial records on the articulator. Intraoral occlusal adjustment is less desirable due to the movement of the bases on the residual ridges and to the presence of saliva.

A maxillary complete denture opposing a mandi- bular removable partial denture is a common clini- cal finding. Since the original master cast for the partial denture is usually destroyed after processing, the maxillary denture will oppose only the prosthetic teeth of the lower partial denture when the dentures

*Clinical .4ssistant Professor, State University of New York at

Buffalo, School of Dentistry, Buffalo, N.Y.

are remounted (Fig. 1). Therefore, after the occlusal equilibration on the articulator is completed, the maxillary denture must still be equilibrated to the lower natural teeth intraorally. The only exception to this is when all the lower posterior teeth are replaced by the partial denture.

Several techniques have been suggested to over- come the problem. Most texts“” suggest remounting the maxillary denture to a cast poured in an impres- sion of the remaining natural teeth with the remov- able partial denture in the mouth. However, inaccu- racies may result due to displacement of the denture while making the impression or upon removal from the mouth, especially if the partial denture has to be reseated into the impression. The additional time with the patient and the possible abutment breakage when removing the framework from the cast also add to the problems of this technique.

Fig. 1. Remounted processed maxillary complete denture and mandibular removable partial denture. Maxillary denture opposes only the prosthetic teeth of the lower partial denture.

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REMOUNTING REMOVABLE PARTIAL DENTURES

Fig. 2. Remounted processed maxillary complete denture.

Fig. 3. Centric interocclusal record.

Another suggested technique4 involves making a distal-extension removable partial denture remount cast in which the section of the master cast repre- senting the existing natural teeth is preserved after processing. The cured denture is reseated on this section, and a new cast is added after the undercuts in the denture base are relieved. Although this technique allows the denture to be easily removed from the cast and requires no additional time with the patient, it does depend on special consideration from the dental laboratory technician to properly

Fig. 4. Lower removable partial denture seated into cen- tric interocclusal record.

recover and prepare the removable partial denture remount cast.

This article describes a simple, accurate technique for fabricating a removable partial denture remount cast. The procedure requires no additional time with the patient and is easily accomplished in the office.

TECHNIQUE

1. Remount the processed maxillary denture using an occlusal index record fabricated after the try-in appointment (Fig. 2).

THE JOURNAL OF PROSTHETIC DENTLSTRY 337

LAUCIELLO

Fig. 5. Occlusal registration of natural teeth is boxed using soft peripheral wax.

Fig. 6. Undercuts in denture base are blocked out with moistened tissue paper.

2. Make a centric interocclusal record using Ram- itec* silicone registration material. A resilient mate- rial should be used to record more of the lower natural teeth without fracturing upon removal from the mouth. An attempt is made to record as much of the opposing natural occlusion as is possible (Fig. 3).

3. Seat the lower removable partial denture into the record (Fig. 4). Box the occlusal registration of

Fig. 7. The boxed area is poured in improved stone and dowel pins are imbedded into the area of the abutment teeth.

Fig. 8. Removable partial denture secured to lower member of articulator.

the natural teeth using a soft peripheral wax materi- al* (Fig. 5).

4. Blockout the undercuts in the denture base using pumice or tissue paper (Fig. 6).

5. Pour improved stone into the boxed area, and place pins in the impression to strengthen the abut- ment teeth and to help prevent breakage (Fig. 7). The pins are notched to aid in retaining the improved stone to the plaster.

*Premier Dental Products Co., Norristown, PA.

338

*Surgident periphery wax, Lactona Corp., Philadelphia, PA.

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REMOUNTING REMOVABLE PARTIAL DENTURES

Fig. 9A. Removable partial denture in place on remount Fig. 9B. Removable partial denture remount cast with- cast. out prosthesis.

Fig. 10. Cyanoacrylate cement added to occlusal surfaces of remount cast.

Fig. 11. Completed removable partial denture remount cast.

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6. Reseat the maxillary denture on the already mounted cast, and attach the lower partial denture to the lower member of the articulator with plaster (Fig. 8).

7. Remove the record after the stone has set, and trim the stone to allow easy removal of the lower partial denture (Fig. 9).

8. Add cyanoacrylate cement* to the stone teeth, making them more resistant to abrasion during the occlusal equilibration procedures (Fig. 10).

9. Equilibrate the occlusion according to the indi- vidual philosophy of balanced occlusion (Fig. 11).

SUMMARY

A technique for fabricating a removable partial denture remount cast has been described. This method requires no additional time with the patient and is easily accomplished in the office.

“Aron Alpha, Howmedica Inc., Chicago, IL.

LAUCIELLO

I would like to thank Miss Carol J. Payne, Medical Photogra- pher and the Medical Media Foundation Service/Photography

Section of the Veterans Administration Medical Center, Buffalo,

N.Y., for their assistance with the illustrations.

REFERENCES

Dykema, R. W., Cunningham, D. M., and Johnston, J. F.: Modern Practice in Removable Partial Prosthodontics, ed 1.

Philadelphia, 1969, W. B. Saunders Co., p 293. Miller, E. L.: Removable Partial Prosthodontics. Baltimore,

1972, The Williams & Wilkins Co.

Zarb, G. A., Bergman, B., Clayton, J. A., and Mackay, H. F.: Prosthodontic Treatment for Partially Edentulous Patients,

ed. 1. St. Louis, 1978, The C. V. Mosby Co., p 497. Ulmer, F. C., and Ward, J. E.: Simplified technique for

production of a distal-extension removable partial denture

remounting cast. J PROSTHET DENT 41:473, 1979.

Reprint requests to: DR. FRANK R. LAUCIELLO DENTAL SERVICE

VETERANS ADMINISTRATION MEDICAL CENTER 3495 BAILEY AVE.

BUFFALO, NY 14215

MARCH 1981 VOLUME 45 NUMBER 3