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1. Complete Denture Try-in Procedure
Comfort: During insertion of denture or application of occluasl and lateral
pressure patient should not experience any pain
- Pressure spots or sharp surfaces should be eliminated to make
denture comfortable.
Stability: Digital pressure on occlusal surfaces of teeth applied alternately on
right and left side should not cause any tilting or rocking.
Causes:
1. Fulcrum present due to the unusual displacibility of basal area tissues.
2. Teeth arranged at the crest buccal to the ridge
3. Denture base warped
4. Occlusal plane too for from the ridge.
Retention:
Denture should not dislodge when patient;
1. Carries out opening and closing movement of jaw or moves
tongue within normal limits:
2. Attempts to speak.
Causes:
1. Dental arc too narrow posteriorly
2. Anteriors placed too for forward or proclinated.
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2. 3. Occusal plane too high in mandibular denture.
4. Waxup too bulky.
It is presumed that causes of dislodgment due to the faulty impression of
denture base have been eliminated at the stage of jaw relation recordings.
Vertical dimension of occlusion to be checked as during stage of
recording by reference to
(i) Vertical dimension of rest (free way space)
(ii) Facial proportion and esthetics
(iii) Speech
Correction of decreased vertical dimension of occlusion
- A well softened roll of wax sheet is placed on the occlusal surfaces of
lower denture and sealed.
- The dentures are placed in the mouth and patient is made to close mouth
until mandible reaches the correct vertical dimension of occlusion. The
wax is concealed and the dentures are separated.
- The vertical dimension of occlusion is rechecked.
- The indentations are checked to establish and confirm.
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3. Correction of Increased vertical dimension of occlusion:
- If the error is about 2-3 mm. The mandibular teeth are removed from the
waxed denture and roll of wax is built up and procedure described for
decreased vertical dimension of occlusion is followed.
Centric occlusion:
- First observe the arrangement on articulator and note the relation of
posterior teeth and overbite and overjet of anterior teeth.
(a) Now place the denture in patients mouth and guide the patient to close
in centric relation.
(b) White patient applies gentle biting pressure place tip of wax knife
between occlusal surfaces and separate.
- Errors are observed ;
(a) At the initial contact of upper and lower arch in centric position
before any possible deflection at the mandible away from centric
relation position.
- In occlusion the mandibular arch appears shifted in relation to
maxillary in
1) Backward direction.
2) Forward direction.
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4. 3) Towards right.
4) Towards left.
Error observed (b) on occlusion spaces present between occlusal
surfaces.
1) Posteriorly on both sides
2) Posteriorly on right sides
3) Posteriorly on Left sides
4) Anteriorly
Causes of error observed
(a) Jaw relation was recorded
1) When mandible was anterior to centric relation position
2) When mandibular base has shifted from ridge posteriorly.
3) When mandibular is directed left or right during centric position.
Causes of errors observed
(b) Displacements of bases away from basal seat area recording
Jawrelation.
1. Maxillary or mandibular or both bases displaced posteriorly.
2. Maxillary or mandibular or both bases displaced anteriorly.
3. Maxillary or mandibular or both bases displaced right or left side.
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5. Correction of errors
- Re-recording centric relation for error observed in (a)
- Obtain souahs bite for error observed in (b)
Method of re-recording centric relation :
If vertical dimension of occlusion is correct.
- Remove posterior teeth from maxillary and mandibular base
soften the wax.
- Guide mandible to centric relation and recheck the centric relation.
- Method of obtaining souahs bite:
- First note the premature area of contact
- Prepare a roll of soften modeling wax. Place it on the occlusal surface of
premature contact.
- Guide mandible to centric relation.
- Remove excess wax.
- Recheck centric relation by reference to indentations in wax.
- Retransfer the relation on articulator
Aesthetics
First observe patient without dentures (try in) in mouth the following
i) Symmetry of face
ii) Contour in profile
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6. iii) Facial proportions
iv) Lip fullness
v) Fullness of cheeks
Next place dentures in mouth and ask patient to occlude teeth lightly and
check the points mentioned above.
- When lips are part gently and mouths opened slightly observe critically
the following :
1. Amount of teeth seen below lip line.
2. Width of arch and buccal corridor.
3. Symmetry of the dental arch and its midline.
4. Proclination, tilts and rotation of individual teeth.
5. Relation of individual teeth to occlusal plane.
6. Width and length of anterior teeth.
7. Location of gingiva.
8. Shape of anterior teeth.
9. Overlap, spacings and embrasures.
10. Contours of marginal gingiva and papilla.
Verification of vertical dimension of occlusion:
Factors:
1) Phonetics
2) Esthetics
3) Amount of interocclusal distance.
4) Lip length in relation to teeth.
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7. 5) Studies of facial dimension and facial expression
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