1. Fabricating Removable Partial Denture Bases

2. (1) Factors Affecting Selection of Artificial Teeth (2) Altered Cast Technique (3) Procedures for Articulating and Restoring VDO (4) Procedures for Arranging Artificial Teeth and Waxing Up Denture Bases

3. (1)Factors Affecting Selection of Artificial Teeth (a)Criteria for common denture base and artificial tooth combinations 1Maxillomandibular space 2Esthetic values 3Absence of soft tissue undercuts 4Length of edentulous space 5Health of soft tissue and anticipated rate of bone resorption

4. (1)Factors Affecting Selection of Artificial Teeth 4 The choice of selecting acrylic or porcelain teeth are determined by the dentist

5. (b)Types of anterior tooth and tissue replacement 4 (Primary factor is esthetic acceptability) 1Commercial facings aPrefabricated facings retained on a metal backing with a cementing medium bIdentical replacement possible cMay be used when undesirable soft tissue undercuts are present dNo reline potential

6. (b)Types of anterior tooth and tissue replacement 2Reinforced Acrylic Pontics aDenture teeth ground to fit an edentulous space and retained on a metal base bVariety of shades and molds cAn advantage over commercial facings are the improved three dimensional effects, such as overlapping teeth dMay be used when undesirable soft tissue undercuts are present

9. Braided Post Used with stock denture teeth similar to RAP. Denture teeth not needed for wax-up

10. (b)Types of anterior tooth and tissue replacement 3Processed tooth-colored resin aWaxed to metal framework and processed with tooth- colored resin bMay be used when undesirable soft tissue undercuts are present cRequires stable ridge

11. (b)Types of anterior tooth and tissue replacement 4Acrylic denture teeth with resin base aAttached to metal retention grid or mesh bCompensates for gross ridge resorption cResin base provides support and bracing dResin can be relined eRequires significant vertical space f Not recommended when deep labial soft tissue undercuts are present

12. (c)Types of posterior tooth and tissue replacement 1Acrylic denture teeth with denture resin aAttached to metal retention grid or mesh bDenture base can be relined cEasy to modify dModerately esthetic

13. (c)Types of posterior tooth and tissue replacement 2Metal teeth integrated into framework aBetter tissue adaptation than processed acrylic bRequires least amount of space cLeast esthetic 3Tube tooth attached to metal denture base aLimited to short span, well healed areas bRequires 4 mm posts for adequate retention

15. (c)Types of posterior tooth and tissue replacement 4Processed tooth-colored resins with spiral post retention aShort span application bSubstitute for tube teeth cRequires slightly less interarch space than a tube tooth

17. (2)Altered Cast Technique (a)Definition - A corrected impression of the distal extension area(s) of the patient’s mouth, made after the fit of the framework is confirmed in the mouth and before artificial teeth are arranged (b)Purpose - This procedure is designed to ensure the best possible soft tissue support for a distal extension denture base

18. (c)Procedures for the Altered Cast Technique 1Dentist adjusts and fits the framework in the patient’s mouth 2Dentist designs outline of proposed impression tray 3Plastic tray will be constructed over the framework’s distal denture base retention 4Adapt a 26 gauge sheet wax spacer to the edentulous area, then adapt a second layer of 26 gauge sheet wax to the retromolar pad and blend it with the first sheet wax layer, trim wax to design line

20. (c)Procedures for the Altered Cast Technique 5Warm the distal extension grid of the framework over a flame and place the framework on the master cast aBe sure the rests are fully seated bRemove any wax that flowed over the metal capply separator to cast 6Mix self curing resin to a dough-like consistency 7Adapt resin over the edentulous area to form a tray that is firmly attached to the retention grid

22. (c)Procedures for the Altered Cast Technique 8After resin is cured, lift the framework with attached tray from the cast 9Trim the tray to the outline the spacer forms 10Remove wax spacer 11Disinfect IAW manufacturer’s directions 12Return framework to the dentist

23. (c)Procedures for the Altered Cast Technique 13Making the corrected impression aThe dentist makes the corrected impression bImpression material is placed in the tray(s), then the entire framework is seated in the patient’s mouth cDisinfect the completed impression

24. (c)Procedures for the Altered Cast Technique 14Altering the Master Cast aDraw design for saw cuts across the distal extension, from buccal to lingual, on a line that passes 1 mm behind the distal abutment bDraw another saw cut line that is parallel and lingual to the lingual sulcus to join with the first cut cCut along design lines dUsing a fissure bur or a saw, place multiple dovetail cuts in the cut surface of the cast to create mechanical retention for the corrected addition

26. (c)Procedures for the Altered Cast Technique ePlace the framework with corrected impression on the prepared master cast 1Be certain all rests are in complete contact with their respective seats 2Secure the framework in place with sticky wax

27. (c)Procedures for the Altered Cast Technique fBead and box around the borders of the impression 1Place utility wax around the outer border of the impression 3 mm below the peripheral roll and seal it to both the impression and the base of the cast at the ends of the wax 2Seal boxing wax in place even with the height of the base of the cast and along the outer border of the utility wax gSoak the base of the cast for about 5 minutes

29. (c)Procedures for the Altered Cast Technique hVacuum mix stone and pour impression 1Use manufacturer’s directions for water/powder ratio 2Remove wax after stone sets iSeparate Cast 1Remove framework and tray from the cast 2Completely clean debris from the cast 3Check the cast for voids 4Trim cast, preserving the land area

31. (c)Procedures for the Altered Cast Technique jRemove acrylic resin tray 1Flame tray until it softens 2Peel tray from the framework 3Clean framework thoroughly kSeat the framework back on the cast with all rests seated