Technical Complete Denture Chapter XI

Study Notes

Causes of Denture Fracture: Construction Faults
- Posterior teeth, especially upper ones, positioned outside the ridge can lead to fractures.
- Unbalanced articulation creates abnormal stress, risking denture integrity.
- Excessive relief can diminish midline thickness, contributing to breaks.
- Incorrect dough consistency during packing, inadequate polymerization, and rapid cooling can weaken the denture base.
Causes of Teeth Dislodgement (Not Broken)
- Insufficient packing of acrylic resin can result in loose teeth.
- Presence of grease, separating mediums, or wax on resin teeth hampers adhesion.
- Packing acrylic resin too late in the dough stage reduces free monomer availability, affecting bonding strength.
Causes of Fractures Related to Oral Conditions
- Masticatory forces from chewing or teeth grinding can exert excessive pressure on the denture.
- Alveolar absorption leads to uneven denture support, increasing the risk of breaks.
- A high labial frenum on the ridge may require a deep frenal notch in the denture, which can be a fracture initiation point.

Denture fractures often stem from construction faults like improper positioning of posterior teeth, unbalanced articulation, and excessive relief reducing thickness.
Inadequate packing of acrylic resin, grease or wax interference, and improper dough consistency can lead to teeth detaching without breaking.
Mouth-related issues contributing to denture fractures include excessive forces from mastication or clenching, alveolar absorption leading to uneven support, and insufficient relief in the upper denture.
External causes of fractures include dropping or cleaning with excessive pressure.

Clean and align broken edges accurately for optimal fitting before reassembly with sticks and sticky wax.
Use plaster to create a cast of the denture after accurate alignment is confirmed.
For complete upper dentures, it is recommended to remove the entire palatal resin to prevent warping during repair.
Cold-curing resin minimizes warpage but may pose weaknesses at the union of new and old resin.
Heat-curing acrylic resin involves waxing up and flasking the denture and requires careful processing similar to a new denture.

Loosening an anterior tooth requires stabilizing it with sticky wax and creating a plaster index to ensure correct positioning.
Replacing broken or missing teeth involves preparing a dovetail for mechanical retention, positioning with an index, and filling gaps with repair acrylic.
The shade and position must closely match the original denture, considering occlusion during replacements.

Reline: resurfacing the tissue side to enhance fit.
Rebase: refitting by replacing the base material without altering occlusal teeth relations.
Objectives include improving retention, stabilizing occlusal plane, restoring vertical occlusion, alleviating pain, and ensuring even pressure distribution.
Indications for relining or rebasing include poor adaptation due to residual ridge resorption and instances when new dentures impose too much stress on patients.
Contraindications include significant ridge resorption, hyperplastic tissues, and unsatisfactory aesthetics or jaw relationships.

Denture preparations necessitate checking extensions, relieving undercuts, correcting occlusal disharmony, and ensuring a proper posterior palatal seal.
Accurate impressions should be taken in centric occlusion, maintaining occlusal integrity.
Distinctive methods:
- Flask Method: Involves embedding the cast in processing flasks, trimming, and packing with heat-polymerized resin, followed by processing and polishing.
- Articulator Method: Involves mounting dentures, applying plaster, and ensuring adequate contact for polymerization of new materials.

For relining, care must be taken when forming butt joints for new acrylic, particularly around the palatal regions.
During rebasing, nearly the entire denture base is removed, ensuring retention and proper alignment.
Holes may be drilled into the palate for easier material removal in maxillary dentures.

Consideration is given to minimizing errors during the impression process and finalizing with methods that promote efficiency and adhesion.
Consistent assessment and adjustment are vital to achieving optimal denture performance across repairs and modifications.

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