It is presumed that you have done the lab remount. (18) You have preserved the facebow record. (18) You have completely polished both dentures and have mounted (with a mounting model) the maxillary denture in its original facebow position. You have also made a mandibuler mounting model (18) so you can mount the mandibular denture. Do this before coming to the clinic.
Do not now put both dentures in the mouth. You first have to make sure each individual denture fits properly.
Pressure paste one denture making a thin layer in a definite pattern. (Use a disposable Q-tip rather than a brush.) A thin layer means the denture can show through between the grooves of paste . Gently insert the denture. After the denture is completely seated press firmly on the teeth. (If the denture doesn't go in completely, then keep adjusting the pressure spots until it finally seats. Don't force it in.) Remove the denture and look for isolated pressure spots.
To make sure that the spots are not arbitrary, pencil them in and re-cover them with paste. Reinsert and check for uncovered pencil marks. (Yes you can autoclave a pencil.) Reduce exposed areas then repaste and check again. You want large areas of pressure. Do the same with the other denture.
Don't be surprised if on the maxillary denture you don't get contact in the palatal area. That is expected. There is shrinkage when the denture is processed. The shrinkage causes the curved palate to "straighten" out, thus the acrylic is pulled away from the model in the palate area. It is a good idea you made a posterior palatal seal to compensate for this shrinkage. Thus you still have a seal despite the distortion in the denture. (That means you did get contact in palatal seal area.)
There may be undercuts on the disto-lingual of the mandibular denture. Since the mandible widens posteriorly, push the denture posteriorly - seat posterior portion - then slide the denture forward. This will allow you to utilize some of the undercut.
On very rare occasions the coronoid process (of the mandible) will define the thickness of the buccal flange of the maxillary denture in the 3rd molar-tuberosity area. If the patient has a problem opening and closing with the sensation of rubbing or pressure coming from outside the denture, then pressure paste the buccal flange. Thin the flange where the paste shows excessive contact.
Eventually remove all the paste with orange solvent.
|19. When the patient is satisfied, they may bake you a cake.|
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©1999 by Julius Rosen, D.D.S.