PROSTHETIC DENTISTRY

A TECHNIQUE FOR DUPLICATING COMPLETE DENTURES

Lt. Col. Mansour K. Assery* and Dr. Zaki Fakiha**

INTRODUCTION

here are a number of complete denture patients who ask the dentist to provide them with a duplicate denture. These patients cannot stand the embarrassment of being without a denture, even for a short period of time, due to denture fracture, especially when their own dentist cannot be reached1. Replacement dentures are similar in most respects to those that the patient is accustomed to2. Several techniques have been developed and described over the past 50 years3,5,6,7,8. Adam3 drew attention to the problem of replacing old dentures and the difficulties which so often ensued. Shaw4 emphasized the importance of duplicate immediate dentures in which these dentures were fabricated with the aid of pre extraction casts, jaw relation records and photographs. These factors help in the production of an aesthetically and functionally satisfactory denture composition. The following technique describes a simple, inexpensive procedure with which an existing complete denture can be duplicated for use in the fabrication of a new prosthesis.

ABSTRACT A technique is described whereby replica wax teeth are produced on special tray material base as the intermediate stage in the production of duplicate dentures. This concept is not new however, the present paper describes a method that uses equipment and materials which are normally available in the dental clinic and laboratory. Duplicate dentures are greatly appreciated by patients who fear the embarrassment of being without their denture.

* Chief of Dentistry, Consultant Prosthodontist. Al Hada Armed Forces Hospital, Taif, Saudi Arabia. ** Assistant Professor & Chairman, Department of Restorative Dental Sciences King Saud University College of Dentistry

DENTAL NEWS, VOLUME IV, NUMBER III, 1997

PROSTHETIC DENTISTRY
FIRST CLINIC VISIT
The new occlusion is recorded with a wax wafer using old dentures. The vertical dimension is increased by the desired amount if needed. The shade and mould for the new dentures should be selected at this stage. Most commonly these are matched as closely as possible to the old teeth. The first stage of this technique is the duplicating of the existing dentures in the clinic either by the dentist or the dental auxiliary. Two large upper impression stock trays for each denture can be used for this technique. The tray is loaded with alginate impression material and the polished surface of the denture is embedded in the alginate and seated until the material is almost level with the periphery of the denture (Fig. 1). When the alginate set, three locating grooves are cut, one anteriorly and one each buccally. A second upper tray is then loaded with alginate and inverted onto the fitting surface of the denture located in the first tray (Fig. 2). No separating medium is required as the mix of alginate do not adhere to each other. When set, the two trays are separated and the dentures removed (Fig. 3), and return to the patient who can be reappointed to come back for the second visit. This procedure is repeated for the other upper or lower denture.
Fig. 2: The two stock trays with the dentures inside the alginate.

Fig. 3: The lower denture have been removed from the alginate.

FIRST LABORATORY STAGE In the dental lab, the technician pours molten was into the impressions of the teeth (Fig. 4). It is important for the success of this technique that the gingival margins are covered by wax, otherwise the technician will have to trim away acrylic before new stock teeth can be fitted into place. This is then left to cool before pouring some

Fig. 1: Upper and Lower denture embedded in alginate. Notice the locating grooves.

Fig. 4: The wax have been poured into the impressions of the teeth both upper and lower.

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PROSTHETIC DENTISTRY
runny special acrylic resin tray material to fill the rest of the mould. The second half of the mould is then squeezed onto the first, and elastic bands are then used to secure them while setting. Once the acrylic resin has polymerized (Fig. 5), the duplicate denture is removed from the mould and excess material removed (Fig. 6,7). This procedure is repeated for the second mould. The two duplicate dentures are now articulated using the inter-occlusal record. Stock teeth that have been selected before are now set up on the duplicates by removing the wax teeth one by one and replacing them with acrylic teeth. The trial dentures are then waxed up and return to the dentist (Fig. 9).
Fig. 7: Occlusal view of the lower duplicate denture

Fig. 5: The special tray material has been added and cured.

Fig. 8: Upper and lower duplicate in occlusions ready for articulation.

Fig. 6: Occlusal view of the upper duplicate denture.

Fig. 9: The trial denture

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PROSTHETIC DENTISTRY
SECOND CLINICAL VISIT The try-in is carried out at this visit, and the usual checks are performed. Any over extended borders can be corrected on the trial dentures at this time. Final wash impressions are recorded for both upper and lower trial dentures using a light body material or on a soft reline material (Fig. 10). The upper impression is taken first, removed from the mouth and checked and then reinserted. In order to avoid introducing errors in the occlusion, the lower impression is taken with the teeth closed together. SECOND LABORATORY STAGE The technician can now pour the impressions in artificial stone and process the dentures for insertion at the next visit. It is important not to forget to prepare the posterior palatal seal in the upper cast before processing. Also is should be noted that there is no need for the technician to remove the trial dentures from the casts of the impressions prior to flasking. THIRD CLINICAL VISIT At this visit the processed dentures are inserted in the patients mouth and the usual examination checks are performed. patient. The completed duplicate dentures are produced in three visits instead of the usual five visits, and without loss of the opportunity to check all their features at the second visit, before finishing. In contrast, there are instances where the use of a copying technique is contra-indicated by errors or deficiencies in the existing dentures even if the latter have been considered satisfactory by the patient9. The technique described has several advantages: saving in clinical time, reduced material costs and less laboratory expenses. Despite the general similarity with the method described by Duthie et al.9 , the use of alginate for the impression stage is quick and convenient. Additionally, the special tray material bases are easier to apply, any undercuts can be adjusted later, does not warp while in the mouth, and can form a rigid tray for the wash impression10, 11. Another advantage of this technique is the use of stock teeth which have superior properties to those made in cold-curing resin12.

REFERENCES
1. P. Azarmehr, H.H. Azarmehr: Technique for duplicating a denture. J. Prosthet Dent 1974; 31: 329-334. 2. G.L. Polyzois, G.A. Staurakis, and P.P. Demertrou: Dimensional accuracy of duplicate dentures prepared by different methods. J. Prosthet Dent 1986; 55: 513-517. 3. C. E. Adam: Technique for duplicating an acrylic resin denture. J. Prosthet Dent 1958; 8: 406-410. 4. D. R. Shaw: Duplicate immediate dentures. J Prosthet Dent 1962; 12: 47-57. 5. S. G. Manoli, T.P. Griffin: Duplicate denture technique. J. Prosthet Dent 1969; 21: 104-107. 6. R. H. Boos, H.O. Carpenter, Jr.: Technique for duplicating a denture. J. Prosthet Dent 1974; 31: 329-334. 7. J. Nassif, R. Jumbelic : Duplicating maxillary complete dentures. J. Prosthet Dent 1984; 52: 755-759. 8. J. S. Cooper, A.C. Watkinson: Duplication of full dentures. Brit Dent J. 1976; 141: 344-348 9. N. Duthie, F. Lyon, K.C. Sturrock, and R. Yemm: A copying technique for replacement of complete dentures. Brit Dent J 1978 ;144: 248-252. 10. A. Wagner: Making duplicate dentures for use as final impression trays. J. Prosthet Dent 1970; 24: 111-113. 11. R. S. Krug: Ceramic flask technique for duplication a complete denture. J. Prosthet Dent 1984; 52: 698-899. 12. J. R. Heath, J.C. Davenport: A modification of the copy denture technique. Brit Dent J 1982; 153: 300-302.

Fig. 10: Upper and lower duplicate with a wash impression.

DISCUSSION
In making complete dentures by a copying technique, it is necessary to decide not only the changes / restorations to be built into the new dentures but also the degree of accuracy required in copying8. The technique described is designed to serve the majority of patients and to remain acceptable in terms of cost, technical services necessary and convenience to the

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DENTAL NEWS, VOLUME IV, NUMBER III, 1997