EdenteV2, Istex, Corpus, bibRecord, 004767

An atypical chairside immediate denture: A clinical report

Identifieur interne : 004767 ( Istex/Corpus ); précédent : 004766; suivant : 004768

An atypical chairside immediate denture: A clinical report

Auteurs : Anton S. Gotlieb ; Samuel W. Askinas

Source :

The Journal of Prosthetic Dentistry [ 0022-3913 ] ; 2001.

RBID : ISTEX:8F9B1EAD320D61697060ECCDF4A7A4DAA8E0D5C1

English descriptors

KwdEn :
- Abutment, Abutment teeth, Abutment tooth, Acrylic resin, Chairside, Chairside fabrication, Clinical report, Complete denture, Dental arch, Dental stone, Dentistry, Denture, Gotlieb, Immediate denture, Maxillary, Maxillary cast, Maxillary denture, Maxillary impression, Maxillary right, Molar, Occlusal, Occlusal relationship, Partial denture, Prosthesis, Prosthet, Prosthet dent, Prosthetic, Prosthetic dentistry, Restorative dentistry.
Teeft :
- Abutment, Abutment teeth, Abutment tooth, Acrylic resin, Chairside, Chairside fabrication, Clinical report, Complete denture, Dental arch, Dental stone, Dentistry, Denture, Gotlieb, Immediate denture, Maxillary, Maxillary cast, Maxillary denture, Maxillary impression, Maxillary right, Molar, Occlusal, Occlusal relationship, Partial denture, Prosthesis, Prosthet, Prosthet dent, Prosthetic, Prosthetic dentistry, Restorative dentistry.

Abstract

Abstract: This clinical report describes the fabrication of an immediate complete denture for a patient with an extensive fixed prosthesis that was no longer serviceable because of major loss of integrity of the supporting abutment teeth. The procedure, which was performed chairside, replicated the existing fixed prosthesis as part of an immediate complete denture. (J Prosthet Dent 2001;86:241-3.)

Url:

https://api.istex.fr/document/8F9B1EAD320D61697060ECCDF4A7A4DAA8E0D5C1/fulltext/pdf

DOI: 10.1067/mpr.2001.117977

Links to Exploration step

ISTEX:8F9B1EAD320D61697060ECCDF4A7A4DAA8E0D5C1

Le document en format XML

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<front><div type="abstract" xml:lang="en">Abstract: This clinical report describes the fabrication of an immediate complete denture for a patient with an extensive fixed prosthesis that was no longer serviceable because of major loss of integrity of the supporting abutment teeth. The procedure, which was performed chairside, replicated the existing fixed prosthesis as part of an immediate complete denture. (J Prosthet Dent 2001;86:241-3.)</div>
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<notesStmt><note>aAssociate Professor, Department of Restorative Dentistry.</note>
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<note>Reprint requests to: Dr Anton S. Gotlieb, Department of Restorative Dentistry, Nova Southeastern University College of Dental Medicine, 3200 S University Dr, Ft. Lauderdale, FL 33328, Fax: (954)262-1782, E-mail: agotlieb@nova.edu</note>
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<abstract xml:lang="en"><p>This clinical report describes the fabrication of an immediate complete denture for a patient with an extensive fixed prosthesis that was no longer serviceable because of major loss of integrity of the supporting abutment teeth. The procedure, which was performed chairside, replicated the existing fixed prosthesis as part of an immediate complete denture. (J Prosthet Dent 2001;86:241-3.)</p>
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<head><ce:article-footnote><ce:label>☆</ce:label>
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Associate Professor, Department of Restorative Dentistry.</ce:note-para>
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<ce:article-footnote><ce:label>☆☆</ce:label>
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Professor and Chairperson, Department of Restorative Dentistry.</ce:note-para>
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<ce:article-footnote><ce:label>★</ce:label>
<ce:note-para>Reprint requests to: Dr Anton S. Gotlieb, Department of Restorative Dentistry, Nova Southeastern University College of Dental Medicine, 3200 S University Dr, Ft. Lauderdale, FL 33328, Fax: (954)262-1782, E-mail: agotlieb@nova.edu</ce:note-para>
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<ce:dochead><ce:textfn>Original Articles</ce:textfn>
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<ce:title>An atypical chairside immediate denture: A clinical report</ce:title>
<ce:author-group><ce:author><ce:given-name>Anton S.</ce:given-name>
<ce:surname>Gotlieb</ce:surname>
<ce:degrees>DDS<ce:sup>a</ce:sup>
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<ce:author><ce:given-name>Samuel W.</ce:given-name>
<ce:surname>Askinas</ce:surname>
<ce:degrees>DDS<ce:sup>b</ce:sup>
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<ce:affiliation><ce:textfn>College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, Fla</ce:textfn>
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<ce:abstract><ce:section-title id="st0010">Abstract</ce:section-title>
<ce:abstract-sec><ce:simple-para id="sp0030">This clinical report describes the fabrication of an immediate complete denture for a patient with an extensive fixed prosthesis that was no longer serviceable because of major loss of integrity of the supporting abutment teeth. The procedure, which was performed chairside, replicated the existing fixed prosthesis as part of an immediate complete denture. <ce:bold>(J Prosthet Dent 2001;86:241-3.)</ce:bold>
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<body><ce:sections><ce:para id="p0010">There are many advantages to immediate, as opposed to conventional, complete dentures.<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup>
</ce:cross-ref>
 From the patient's point of view, chief among these advantages is the preservation of the person's natural appearance and social mobility (loss of such mobility often results from the absence of anterior teeth). When a conventional complete denture is fabricated, there is normally a period of several weeks to months of edentulism for healing after extraction.<ce:cross-ref refid="bib2"><ce:sup>2</ce:sup>
</ce:cross-ref>
 This clinical report describes the chairside fabrication of an immediate maxillary complete denture.</ce:para>
<ce:section id="s0010"><ce:section-title id="st0015">Clinical report</ce:section-title>
<ce:para id="p0015">The patient was a 78-year-old woman with no significant medical history. She was first seen on referral with a multiunit ceramometal fixed partial denture extending from the maxillary right first molar to the maxillary left first molar (Fig. 1).<ce:display><ce:figure id="f0010"><ce:label>Fig. 1</ce:label>
<ce:caption><ce:simple-para id="sp0035">Patient at initial examination.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr1"></ce:link>
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The latter tooth was an attenuated pontic cantilevered distal to the maxillary left second premolar abutment tooth. The prosthesis had been placed several years previously. The crowns of all abutment teeth, except the maxillary right first molar, had completely decayed to the gingivae, and the prosthesis was extremely mobile because it was attached to only a single intact abutment tooth. The patient was adamant that she could not be edentulous for any length of time, however brief, as her employment required meeting the public every day.</ce:para>
<ce:para id="p0020">After radiographic and clinical examinations were completed, the patient was appointed for the chairside fabrication of a maxillary immediate complete denture (Fig. 2).<ce:display><ce:figure id="f0015"><ce:label>Fig. 2</ce:label>
<ce:caption><ce:simple-para id="sp0040">Panoramic radiograph.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr2"></ce:link>
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Consideration was given to incorporating the patient's 12-unit fixed partial denture in the immediate prosthesis.<ce:cross-ref refid="bib3"><ce:sup>3</ce:sup>
</ce:cross-ref>
 Because of the denture's weight and the associated problems of ensuring its attachment to the denture base, the decision was made to duplicate the denture with acrylic resin.</ce:para>
<ce:para id="p0025">The maxillary right first molar was anesthetized (Citanest Plain 4%, ASTRA, Westborough, Mass.) in anticipation of its possible odontectomy with its attached fixed prosthesis during the removal of the impression. Wax strips (Utility wax strips, Hygienic, Akron, Ohio) then were placed on the occlusal surface of the maxillary impression tray to maintain the mobile fixed prosthesis in position during the impression procedure. Maxillary and mandibular irreversible hydrocolloid impressions (Integra, Kerr, Orange, Calif.) were made with the use of stock trays (TRA Tens, Teledyne Water Pik, Ft. Collins, Colo.) (Fig. 3).<ce:display><ce:figure id="f0020"><ce:label>Fig. 3</ce:label>
<ce:caption><ce:simple-para id="sp0045">Maxillary impression with occlusal wax stops and vibrating line.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr3"></ce:link>
</ce:figure>
</ce:display>
The mandibular cast was poured in dental stone (Microstone, Whip Mix, Louisville, Ky.).</ce:para>
<ce:para id="p0030">A slurry of PMMA (Alike, GC America, Alsip, Ill.) was prepared in a shade that matched the patient's dentition and poured into the dental arch of the maxillary impression (Fig. 4).<ce:cross-ref refid="bib4"><ce:sup>4</ce:sup>
</ce:cross-ref>
<ce:display><ce:figure id="f0025"><ce:label>Fig. 4</ce:label>
<ce:caption><ce:simple-para id="sp0050">Maxillary impression with tooth-colored acrylic resin in dental arch.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr4"></ce:link>
</ce:figure>
</ce:display>
After polymerization, the acrylic resin was removed from the dental portion of the impression and trimmed to the gingival borders. Several retentive diatorics were prepared in the ridge laps of the acrylic resin dental arch to ensure accurate locking of the fixed prosthesis duplicate to the subsequent cast.<ce:cross-ref refid="bib5"><ce:sup>5</ce:sup>
</ce:cross-ref>
</ce:para>
<ce:para id="p0035">The acrylic resin arch was reseated in the impression, and the maxillary cast was poured in dental stone. This maxillary cast was retrieved from the impression with the acrylic resin dental arch in place (Fig. 5).<ce:display><ce:figure id="f0030"><ce:label>Fig. 5</ce:label>
<ce:caption><ce:simple-para id="sp0055">Maxillary cast with acrylic resin dental arch and posterior palatal seal area outlined.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr5"></ce:link>
</ce:figure>
</ce:display>
Both casts were hand articulated in maximum intercuspal position to verify the integrity of the occlusal relationship (Fig. 6).<ce:display><ce:figure id="f0035"><ce:label>Fig. 6</ce:label>
<ce:caption><ce:simple-para id="sp0060">Maxillary and mandibular casts hand articulated in maximum intercuspal position.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr6"></ce:link>
</ce:figure>
</ce:display>
</ce:para>
<ce:para id="p0040">The posterior border and posterior palatal seal were scored on the maxillary cast. Pink autopolymerizing PMMA resin (Acraweld, Schein, Philadelphia, Pa.) then was applied to the entire maxillary cast; PMMA polymer was alternately added and saturated with monomer to form the entire denture base. The maxillary cast and denture were placed in a pressure pot (Aquapress, Lang, Wheeling, Ill.) with warm water, and 20 psi of air pressure was applied during polymerization.</ce:para>
<ce:para id="p0045">The maxillary denture was separated from the cast, finished, and polished (Fig. 7).<ce:display><ce:figure id="f0040"><ce:label>Fig. 7</ce:label>
<ce:caption><ce:simple-para id="sp0065">Maxillary denture separated from cast.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr7"></ce:link>
</ce:figure>
</ce:display>
The patient was reanesthetized, and the maxillary right first molar with its attached fixed prosthesis was removed. The roots of 2 additional teeth were removed in the maxillary right quadrant, and 2 sutures were placed.</ce:para>
<ce:para id="p0050">Pressure-indicating paste (Mizzy, Cherry Hill, N.J.) was applied to the intaglio surface of the denture, which then was inserted and adjusted for impingements. This procedure was repeated until the denture was fully seated and the occlusion duplicated the patient's original maxillomandibular relationship. The denture was relined with tissue conditioner (Coe Soft, GC America, Alsip, Ill.) to enhance retention, patient comfort, and patient confidence. The patient was dismissed after she made an appointment for the removal of the remaining maxillary retained roots. She was seen after 24 hours and again after 1 week (Fig. 8) and was comfortable at all times.<ce:display><ce:figure id="f0045"><ce:label>Fig. 8</ce:label>
<ce:caption><ce:simple-para id="sp0070">Patient at 1 week after insertion.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr8"></ce:link>
</ce:figure>
</ce:display>
The definitive prosthesis was delivered 1 month after the placement of the immediate denture.</ce:para>
</ce:section>
<ce:section id="s0015"><ce:section-title id="st0020">Discussion</ce:section-title>
<ce:para id="p0055">Conventional immediate denture treatment requires a series of appointments. Replacement of the patient's remaining teeth is accomplished by placing denture teeth on the cast to duplicate or refine the patient's natural esthetics and establish an ideal maxillomandibular relationship. This conventional procedure may be difficult or impossible to accomplish when the remaining dentition in the arch includes extensive fixed prostheses linking anterior and posterior teeth.</ce:para>
<ce:para id="p0060">For the patient previously described, the esthetics and articulation of the immediate denture duplicated those of the preexisting maxillary fixed prosthesis. The patient was comfortable with both prostheses, although it was obvious that the occlusal relationship was less than ideal. This situation was ultimately resolved, as planned, when a new maxillary complete denture was fabricated after the maxilla had healed. It was delivered 1 month after the chairside immediate denture was placed.</ce:para>
</ce:section>
<ce:section id="s0020"><ce:section-title id="st0025">Summary</ce:section-title>
<ce:para id="p0065">The chairside fabrication of an immediate denture has been described. Conventional immediate denture procedures were not possible with this patient because the entire maxillary arch consisted of a fixed prosthesis attached to only 1 intact, but mobile, abutment tooth with a strong likelihood of spontaneously exfoliating. The patient, due to the requirements of her lifestyle and employment, emphasized the necessity for the most timely and efficacious restoration of the maxillary arch.</ce:para>
</ce:section>
<ce:section id="s0030" view="extended"><ce:section-title id="st0030">Supplementary Files</ce:section-title>
<ce:para id="p0070"><ce:float-anchor refid="mmc1"></ce:float-anchor>
<ce:float-anchor refid="mmc2"></ce:float-anchor>
</ce:para>
</ce:section>
</ce:sections>
</body>
<tail><ce:bibliography id="bi0010"><ce:section-title id="st0035">References</ce:section-title>
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</sb:author>
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<sb:title><sb:maintitle>Immediate dentures</sb:maintitle>
</sb:title>
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<sb:host><sb:edited-book><sb:edition>11th ed</sb:edition>
<sb:book-series><sb:editors><sb:editor><ce:given-name>GA</ce:given-name>
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<sb:date>1997</sb:date>
<sb:publisher><sb:name>: Mosby</sb:name>
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<sb:pages><sb:first-page>415</sb:first-page>
<sb:last-page>442</sb:last-page>
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</tail>
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<mods version="3.6"><titleInfo lang="en"><title>An atypical chairside immediate denture: A clinical report</title>
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<titleInfo type="alternative" lang="en" contentType="CDATA"><title>An atypical chairside immediate denture: A clinical report</title>
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<name type="personal"><namePart type="given">Anton S.</namePart>
<namePart type="family">Gotlieb</namePart>
<namePart type="termsOfAddress">DDSa</namePart>
<affiliation>College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, Fla</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Samuel W.</namePart>
<namePart type="family">Askinas</namePart>
<namePart type="termsOfAddress">DDSb</namePart>
<affiliation>College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, Fla</affiliation>
<role><roleTerm type="text">author</roleTerm>
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<typeOfResource>text</typeOfResource>
<genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre>
<originInfo><publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">2001</dateIssued>
<copyrightDate encoding="w3cdtf">2001</copyrightDate>
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<language><languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<abstract lang="en">Abstract: This clinical report describes the fabrication of an immediate complete denture for a patient with an extensive fixed prosthesis that was no longer serviceable because of major loss of integrity of the supporting abutment teeth. The procedure, which was performed chairside, replicated the existing fixed prosthesis as part of an immediate complete denture. (J Prosthet Dent 2001;86:241-3.)</abstract>
<note>aAssociate Professor, Department of Restorative Dentistry.</note>
<note>bProfessor and Chairperson, Department of Restorative Dentistry.</note>
<note>Reprint requests to: Dr Anton S. Gotlieb, Department of Restorative Dentistry, Nova Southeastern University College of Dental Medicine, 3200 S University Dr, Ft. Lauderdale, FL 33328, Fax: (954)262-1782, E-mail: agotlieb@nova.edu</note>
<note type="content">Section title: Original Articles</note>
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<dateIssued encoding="w3cdtf">200109</dateIssued>
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<identifier type="ISSN">0022-3913</identifier>
<identifier type="PII">S0022-3913(00)X0013-3</identifier>
<part><date>200109</date>
<detail type="volume"><number>86</number>
<caption>vol.</caption>
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<detail type="issue"><number>3</number>
<caption>no.</caption>
</detail>
<extent unit="issue-pages"><start>219</start>
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<extent unit="pages"><start>241</start>
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<identifier type="DOI">10.1067/mpr.2001.117977</identifier>
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An atypical chairside immediate denture: A clinical report

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