The hollow maxillary complete
denture: A modified technique
MichaelO'SullivanBDentSci, MSc,
PhDaNancyHansenCDTbRobert JCroninDDS,
MScDavid RCagnaDMDd
PRESENTED BY
REHANA BANO
JR1(PROSTHODONTICS)
Introduction
The severely atrophic maxilla poses a clinical challenge
for fabrication of a successful complete denture. In
addition to this increased inter ridge distance often
results in heavy maxillary complete denture that
further reduces the retention of the prosthesis.
Clinical report
• A 56 year old male patient reported to the Department of
Prosthetic Dentistry of VSPM’s Dental College and Research
Centre, Nagpur for prosthetic rehabilitation of maxillary
and mandibular edentulous ridges.. Past dental history
revealed that patient was a denture wearer since 3–4 years
and the maxillary dentures were loose.
• Intraoral examination revealed severely resorbed maxillary
and mandibular edentulous ridges with increased inter
ridge distance. Hence, hollow maxillary complete denture
and conventional mandibular denture was planned for this
patient.
Technique 1
The maxillary denture was fabricated up to the trial
denture stage in the conventional manner.
The land area of the cast was indexed using a conical bur
and the trial denture was sealed to the definitive cast .
The trial denture was duplicated in reversible
hydrocolloid and poured in dental stone. A template of
the duplicated trial denture was made by adapting 0.5-
mm thermoplastic sheet on the recovered cast using
vacuum heat-pressed machine .
Trial maxillary denture sealed to
indexed definitive cast
Template adapted on duplicated trial
denture cast
• The trial denture was then processed in the
standard manner up to the wax elimination stage.
• Two layers of baseplate wax were adapted to the
definitive cast in the drag, conforming to the
border extensions .A second flask was used to
invest this baseplate wax and processed in
conventional manner.
• a Baseplate wax adapted on the stone cast.
b Processed heat cure record base
• After deflasking the clear matrix was placed
on the definitive cast using the indices in the
land area as seating guides. An endodontic file
with a rubber stop was used to measure the
space between the matrix and the processed
base .
File used to measure the space
between matrix and base
Vinyl polysiloxane putty was mixed and adapted on the base and
shaped to the approximate contours of the matrix . The
polymerized putty was shaped with a bur to leave 2–3 mm of
space between the putty and matrix. An additional 1 mm space
was provided over the tooth portion of the denture. The putty
was fixed to the base using cyanoacrylate .
• The original cope was reseated on the drag and verified for
complete closure of the flask. Then acrylic resin was packed
over putty and processed. The processed denture was
recovered in the usual manner.
• After finishing the denture two openings were cut with a
bur into the denture base distal to the most posterior
tooth. The silicone putty was removed using a sharp
instrument and thick orthodontic wire. The openings were
widened as necessary, to facilitate access . After complete
removal of putty, two covers were fabricated using clear
autopolymerizing resin. The clear resin covers were
attached using autopolymerizing resin.
Maxillary denture with openings
The denture was polished in the usual manner and the
seal was verified by immersing the denture in water.
(air bubbles should not be evident after immersing the
denture in water)
Hollow denture floating in jar
Technique 2
• For the second patient with resorbed maxillary and
mandibular ridges with increased interarch distance,
was treated with a lightweight maxillary hollow
denture, using thermocol, a common packing material,
as spacer.
Two split denture flasks with interchangeable counters
were used for the processing.
• The trial denture base was invested and the processing
was carried out till the wax elimination stage. Two
layers of hard base plate wax over the definitive cast in
the drag (base 1) conforming to the border extensions
was added .
Top half of the second split flask over
the wax shimmed
• A second flask (counter 2) was used to invest the
base plate wax till wax elimination stage and the
cope (upper half of the flask or cavity side) was
packed and processed with heat polymerizing
resin.
• The second flask (base 1) with the polymerized
acrylic resin shim of 2 mm attached with the drag
was separated. A denser thermocol was placed
over the bur roughened acrylic shim along the
ridge and luted with cyanoacrylate .
Thermocol adaptation
The spacer thickness is modified according to the calculation
done above, leaving 3 mm from the teeth to the denture base.
The original cope (base 1) over the drag (counter 1) was reseated
and complete closure of the flask was verified. The heat
polymerizing resin was then mixed, packed and processed . Pre-
insertion occlusal corrections were made and the denture was
inserted in the patient mouth .
Advantages of technique
Reduce leakage at the junction of the two portions of the denture.
Commonly used materials are used for its fabrication.
Reduces weight of the prosthesis which in turn enhances retention.
Disadvantages
Time consuming procedure.
Hollow denture is prone to fracture.
Removal of putty from the cavity is difficult.
Precautions
There should be adequate thickness of the resin
around the cavity.
Seal around the window should be perfect and should be
checked for any leakage.
Denture care instructions should be given to the patients.
Special instructions regarding handling of the denture
should be given as the dentures are prone to fracture.
conclusion
• Hollow maxillary complete denture considerably reduces the weight
of the prosthesis, which in turn prevents transmission of the
detrimental forces, which would otherwise be transmitted from a
conventional heavy prosthesis to the underlying tissue and bone.
Thus, it helps to preserve underlying tissue and bone. Also, the
clear matrix of the trial denture helps to facilitate the shaping of
putty spacer to ensure even the thickness of acrylic to resist
deformation and prevent seepage of saliva into the cavity.
• A simplified technique for fabricating light weight maxillary
dentures using Thermocol as spacer and putty as a spacer that can
be left in the denture without compromising denture strength has
been described.
THANK
YOU
