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 Table of Contents  
CASE REPORT
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 144-148

Hollow denture: A boon in increased interridge space in edentulous ridges


Department of Prosthodontics, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India

Date of Web Publication28-Dec-2017

Correspondence Address:
Dr. Priti Rahul Jaiswal
“Shree Ganesh“, Plot No. 8, South Ambazari Road, Laxmi Nagar, Nagpur - 440 022, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmd.ijmd_30_17

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  Abstract 


The success of complete denture relies on the principles of retention, stability, and support. Increased interridge space, long lip length, and resorbed ridges lead to a heavy-weighted prosthesis which transmits the leverage forces, hence affecting the retention, stability, and support. This article describes the case of a completely edentulous patient with increased interridge space, which was successfully rehabilitated with a hollow denture by simplified technique.

Keywords: Autopolymerizing resin; hollow denture; interarch space


How to cite this article:
Jaiswal PR, Pande N, Banerjee R, Radke U. Hollow denture: A boon in increased interridge space in edentulous ridges. Indian J Multidiscip Dent 2017;7:144-8

How to cite this URL:
Jaiswal PR, Pande N, Banerjee R, Radke U. Hollow denture: A boon in increased interridge space in edentulous ridges. Indian J Multidiscip Dent [serial online] 2017 [cited 2019 Jul 21];7:144-8. Available from: http://www.ijmdent.com/text.asp?2017/7/2/144/221762




  Introduction Top


Increased interridge distance would lead to the fabrication of heavy-weighted dentures which results in leverage forces affecting the principle of mechanics in the fabrication of complete dentures. Hence, to overcome this problem, fabrication of hollow denture was decided which improved the retention, stability, and support of the prosthesis.

Different weight reduction approaches have been achieved earlier using a solid three-dimensional spacer, including dental stone (Ackermen, 1955), cellophane-wrapped asbestos,[1] silicone putty,[2],[3] or modeling clay [4] during laboratory processing to exclude denture base material from the planned hollow cavity of the prosthesis. Holt processed a shim of indexed acrylic resin over the residual ridge and used a spacer which was then removed and the two halves and was luted with autopolymerized acrylic resin.[3]

Fattore et al.[5] used a variation of the double flask technique for obturator fabrication by adding heat-polymerized acrylic resin over the definitive cast and processing a minimal thickness of acrylic resin around the teeth using different drag. Both portions of resin were attached using a heat-polymerized resin.

O'Sullivan et al.[6] described a modified method for fabricating a hollow maxillary denture. A clear matrix of the trial denture base was made. The trial denture base was then invested in the conventional manner till the wax elimination. A 2-mm heat-polymerized acrylic shim was made on the master cast, using the second flask. Silicone putty was placed over the shim and its thickness was estimated using a clear template. The original flask with the teeth was then placed over the putty and the processing was done. The putty was later removed from the distal end of the denture and the openings were sealed with autopolymerizing resin. The technique was used in estimation of the spacer thickness, but the removal of the putty was found to be difficult, especially from the anterior portion of the denture. Moreover, the openings made on the distal end had to be sufficiently large to retrieve the hard putty.

Chaturvedi et al.[7] used dough of dental plaster – pumice and sugar syrup rolled and placed it over heat-cured base to act as a spacer. Heat polymerizing resin was then mixed, packed, and processed. Two small openings were made with bur into denture base distal to most posterior teeth. Dental plaster – pumice and sugar syrup was then removed by scraping and keeping it in water. The opening was then closed by autopolymerizing resin. Shetty et al.[8] used a denser thermocol and placed it over the roughened acrylic shim along the ridge and luted with cyanoacrylate.

This article describes the more convenient and easy method of the fabrication of a hollow denture using play dough and autopolymerizing acrylic resin.


  Case Report Top


A 76-year-old male patient reported to the Department of Prosthodontics, VSPM Dental College and Research Centre, with chief complain of inability to chew properly, due to heavy and ill-fitting dentures. The intraoral examination revealed well-formed rounded edentulous ridges [Figure 1] and [Figure 2] with increased interridge distance in class-1 relationship with firm and resilient mucosa. His upper lip was long, the interridge distance was more than normal and vertical dimension of occlusion and vertical dimension at rest were more than average. The previous denture of the patient was heavy with attrited teeth and was under extended. Hence, it was decided to fabricate a hollow maxillary denture and conventional mandibular.
Figure 1: Maxillary ridge

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Figure 2: Mandibular ridge

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Technique

Preliminary and final impressions were made in a conventional manner. Maxillary occlusal rims adjusted properly so as to provide proper esthetics to the patient with long upper lip. Jaw relation recorded. Teeth were selected and arranged in balanced occlusion and try-in was done first for anterior teeth and then for posterior teeth. The land area of the cast was indexed using a conical burr and trial denture was sealed to the definitive cast, and then, the trial denture was duplicated in irreversible hydrocolloid and was poured in dental stone.

Thermoplastic sheet of 1-mm thickness was adapted using vacuum heat pressed machine on the duplicated cast to form a template [Figure 3]. Two flasks with interchangeable counters were used for processing. The trial dentures were processed in the conventional manner up to the wax elimination stage in base 1 counter 1 flask. Base plate wax of 2 sheet thickness was adapted in the definitive cast, conforming to the border extensions in base 1 [Figure 4] for the fabrication of a heat cure acrylic resin denture base [Figure 5] with counter flask 2. On deflasking, the heat cure denture base resin was left undisturbed, and the clear matrix was placed on the definitive cast with heat cure denture base on base 1 using the indices in the land area as seating guides.
Figure 3: Template adapted on duplicate trial denture cast

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Figure 4: Base plate wax adapted on the stone cast

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Figure 5: Processed heat cure record base

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Play dough was placed on the base 1 and shaped to the approximate contours of the matrix [Figure 6]. A space of approximately 1.5 mm was created between the clear matrix and the play dough all over which was measured with endodontic files with a rubber stopper. Endodontic files with a rubber stopper measuring 1.5 mm were placed on the buccal and palatal side [Figure 7]. On the occlusal portion of the denture, 1-mm space was provided. Now, the putty was mixed and it was adapted on the measured play dough and the impression was made [Figure 8]. Now autopolymerizing acrylic resin was sprinkled over the putty index of the play dough to form a thin shell of approximately 1 mm [Figure 9] and [Figure 10]. Now the dough is removed from the heat cured base and cleaned.
Figure 6: Clay adapted and shaped to contours of matrix

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Figure 7: Endodontic files used to measure the space all around the clay matrix

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Figure 8: Putty index of the clay

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Figure 9: Cold-cure sprinkle to form a thin shell

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Figure 10: Finished cold-cure shell

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Now this autopolymerizing shell was placed on this heat cured denture base (base 1) and was sealed with cold cure acrylic resin and the original counter flask 1 was reseated and verified for complete closure of the flask [Figure 11]. Minor adjustment done to the shell if required for complete closure of the flask. Packing was done with heat cure denture base material (base 1 and counter 1) and was cured. Laboratory remounting, finishing, and polishing were done [Figure 12].
Figure 11: Shell sealed on heat cure denture base by autopolymerizing resin

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Figure 12: Hollow denture

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  Discussion Top


Rehabilitation of a patient with increased interridge distance and long lip length is a challenge to the dentist. Conventional denture leads to an extensive volume of the denture base material. To increase the retention and stability of heavy prosthesis, many methods have been tried such as utilizing the undercuts, modifying the impression techniques, use of magnets, and use of implants.

Reducing the weight of the maxillary prosthesis would be beneficial and it will also lead to less resorption of the residual alveolar ridge when compared with a conventional denture. The technique has the advantage of avoiding tedious effort to remove the spacer material from the denture.

In O'Sullivan et al.[6] technique, removal of putty was difficult, especially from the anterior portion and a large opening has to be made at the distal end to retrieve the hard putty. Chaturvedi et al.[7] used dough of dental plaster – pumice and sugar syrup which is very brittle and may break during compression technique. A large opening on the distal end is also made to remove the spacer later compromise the seal of the denture. Shetty et al.[8] used thermocol which may get displaced during compression molding.

Aggarwal et al.[9] used the lost salt technique. In this technique, uniformity of hollow part is not maintained, and the salt may react with heat cured acrylic resin which leads to porosity.

The current technique uses a clear matrix of the trial denture to facilitate shaping of dough spacer to ensure an even thickness of acrylic to resist deformation and prevent seepage of saliva into the cavity [10] making this technique more predictable.

The method described in this case report has advantages over previously described technique for the hollow denture fabrication.

  • Extra laboratory procedures are minimal
  • No efforts to remove the spacer material
  • No leakage
  • Autopolymerizing acrylic resin used to add strength
  • Color of autopolymerizing resin matches with the heat cured acrylic resin, thus esthetic is maintained
  • Method described provides even space all around
  • Ease of availability of material
  • Economical.



  Conclusion Top


The hollow denture is a boon to patients with increased interarch space and resorbed ridges. It considerably reduced the weight of the denture, thus enhancing the denture retention and stability of the denture. It prevents the transmission of leverage forces. The technique is simple to execute and it provides a healthy living to edentulous patients.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Worley JL, Kniejski ME. A method for controlling the thickness of hollow obturator prostheses. J Prosthet Dent 1983;50:227-9.  Back to cited text no. 1
    
2.
Holt RA Jr. A hollow complete lower denture. J Prosthet Dent 1981;45:452-4.  Back to cited text no. 2
    
3.
Jhanji A, Stevens ST. Fabrication of one-piece hollow obturators. J Prosthet Dent 1991;66:136-8.  Back to cited text no. 3
    
4.
DaBreo EL. A light-cured interim obturator prosthesis. A clinical report. J Prosthet Dent 1990;63:371-3.  Back to cited text no. 4
    
5.
Fattore LD, Fine L, Edmonds DC. The hollow denture: An alternative treatment for atrophic maxillae. J Prosthet Dent 1988;59:514-6.  Back to cited text no. 5
    
6.
O'Sullivan M, Hansen N, Cronin RJ, Cagna DR. The hollow maxillary complete denture: A modified technique. J Prosthet Dent 2004;91:591-4.  Back to cited text no. 6
    
7.
Chaturvedi S, Verma AK, Ali M, Vadhwani P. Hollow maxillary denture: A simplified approach. Peoples J Sci Res 2012;5:47-50.  Back to cited text no. 7
    
8.
Shetty V, Gali S, Avindram SR. Light weight maxillary complete denture: A case report using a simplified technique with thermocol. J Interdiscip Dent 2011;1:45-8.  Back to cited text no. 8
    
9.
Aggarwal H, Jurel SK, Singh RD, Chand P, Kumar P. Lost salt technique for severely resorbed alveolar ridges: An innovative approach. Contemp Clin Dent 2012;3:352-5.  Back to cited text no. 9
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10.
Kaira LS, Singh R, Jain M, Mishra R. Light weight hollow maxillary complete denture: A case series. J Orofac Sci 2012;4:143-7.  Back to cited text no. 10
  [Full text]  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12]



 

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Abstract
Introduction
Case Report
Discussion
Conclusion
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