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| CASE REPORT |
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| Year : 2020 | Volume
: 15
| Issue : 2 | Page : 320-322 |
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Thermocol-filled hollow complete denture
Samidha Shailendra Pande, Seema Sathe Kambala, Ramnath Pradeep Revankar, Tanvi Rajesh Balwani
Department of Prosthodontics Crown and Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| Date of Submission | 01-May-2020 |
| Date of Decision | 15-May-2020 |
| Date of Acceptance | 20-May-2020 |
| Date of Web Publication | 21-Dec-2020 |
Correspondence Address:
Dr. Samidha Shailendra Pande
Q-15 Umalaxmi Apartments, Laxminagar, Nagpur - 440 022, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdmimsu.jdmimsu_131_20
A successful complete denture depends on the principles of retention, stability, and support. The skill here lies in the application of these principles proficiently in various difficult situations. Extremely resorbed maxillary edentulous ridges that show increased inter-ridge space provide lesser support, retention, and stability. The denture weighing more only compromises them further. This article discusses a case report of an edentulous patient having resorbed ridges where a simple yet effective technique of fabrication a lightweight maxillary complete denture effectively.
Keywords: Complete dentures, hollow maxillary denture, inter-ridge distance, lightweight dentures, residual ridge resorption
How to cite this article:
Pande SS, Kambala SS, Revankar RP, Balwani TR. Thermocol-filled hollow complete denture. J Datta Meghe Inst Med Sci Univ 2020;15:320-2 |
| Introduction | |  |
The maxillary ridge atrophy to an extreme level leads to a clinically challenging situation for the construction of a well-retained complete denture. The main reason for which being the increased inter-ridge distance which often results in a heavier maxillary complete denture that further causes decreased retention of the denture. Decreasing the weight of a maxillary prosthesis by using different means has been proven to be beneficial in decreasing the retention problems faced by the patient. This decrease in weight should be taken into consideration during the fabrication of maxillary complete denture for correction and restoration of a large maxillofacial defect.[1],[2]
Although not universally accepted, mandibular denture may show a better retention due to gravity and the addition of weight may also aid in in it. Maxillary denture faces more problems in such patients. Reducing the weight of a maxillary prosthesis, however, has been shown to be advantageous when fabricating an obturator for the restoration of a large maxillofacial defect. Considering the increased volume of the denture base material in prostheses provided to patients with larger maxillofacial defects or in cases of residual ridge resorption, reduction in the weight of the prosthesis can be achieved by making the denture base hollow.[3]
Literature suggests that various methods and materials have been used over the period to fabricate lightweight dentures. The various methods include using a solid three-dimensional spacer, cellophane-wrapped asbestos, silicone putty, modeling clay, thermocol, salt, and fabricating dentures in two halves. The advantage of a hollow maxillary denture is the decrease in excessive weight of the resin material, which replaces lost alveolar ridge in the inter-ridge space of the denture wearer.[4]
Holt processed a shim of indexed acrylic resin over the residual ridge and used a spacer which was then removed and the two halves were luted with autopolymerized acrylic resin.[5]
Fattore et al. used a variation of the double-flask technique for fabricating an obturator by adding heat polymerized acrylic resin over the definitive cast and processing a nominal thickness of acrylic resin around the teeth using different drag. Both portions of resin were attached using a heat polymerized resin.[6]
O'Sullivan et al. (2004) described a modified method for fabricating a hollow maxillary denture. A clear matrix of the trial denture base was made. The trial denture base was then invested in the conventional manner till the wax elimination. A 2-mm heat polymerized acrylic shim was made on the master cast, using a second flask. Silicone putty was placed over the shim and its thickness was estimated using a clear template. The original flask with the teeth was then placed over the putty and the processing was done. The putty was later removed from the distal end of the denture and the openings were sealed with auto polymerizing resin.
The technique was useful in the estimation of the spacer thickness, but removal of the putty was found to be difficult especially from the anterior portion of the denture. Moreover, the openings made on the distal end had to be sufficiently large to retrieve the hard putty.[3]
This clinical report describes a case report of edentulous patients with resorbed ridges by fabricating a lightweight hollow maxillary complete denture using thermocol.
| Case Report | | |
A 68-year-old male patient reported to the Department of Prosthodontics of Sharad Pawar Dental College, DMIMS, Sawangi, Wardha, with the chief complaint of loosening of denture, leading to difficulty in chewing food and wanted to get the denture replaced.
History revealed that the patient had been edentulous for the past 8 years.
Past medical history revealed no underlying systemic disorders.
Intraoral examination revealed resorbed maxillary and mandibular edentulous ridges with greater inter-ridge distance. Other intraoral structures were normal [Figure 1].
Hence, hollow maxillary complete denture and conventional mandibular denture was planned for this patient.
Technique
- The conventional method of fabrication of maxillary denture was carried out up to the trial insertion appointment
- The trial denture was then processed in the standard manner up to the wax elimination stage [Figure 2]
- After the wax elimination, the thermocol is cut into small pieces according to the space available. The thermocol is adjusted keeping in mind that 2 mm thickness of the denture base should be achieved. The thermocol is then removed and kept aside
- During the packing of the denture, a thin layer of heat cured acrylic resin is placed on the side of the flask with the tooth surfaces
- On this layer, the adjusted thermocol pieces are placed and another thin layer of heat cure acrylic resin is added and the flasks are closed and curing of the denture is carried out [Figure 3]
- After retrieval of the processed dentures, they were trimmed and polished and checked in the patient's mouth [Figure 4] and [Figure 5].
| Discussion | | |
Maxillary hollow complete denture reduces the weight of the prosthesis to a great extent, which in turn aids in better retention and lesser transmission of the unfavorable forces, which would otherwise be transmitted from a conventional prosthesis which is heavier onto the underlying tissue and bone. Thus, it helps to preventing any damage to the ridge (underlying tissue and bone).[7] The method described has advantages over the previously described techniques and gives a lesser technique sensitive option. Thermocol being a lightweight material can be left in the denture without causing any problem in the reliability of the denture, avoiding the tedious effort and difficulty to remove the spacer material when the denture is fabricated with other techniques. Moreover, the small window which is made in the cameo surface in other techniques may lead to fracture of the denture in due course. This technique is simple to execute as well as allows control of spacer thickness.[8]
| Conclusion | | |
Using thermocol to make a hollow denture is a simple technique for fabricating lightweight maxillary denture where thermocol can be left in the denture as a spacer without compromising any properties and with normal denture strength.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | El Mahdy AS. Processing a hollow obturator. J Prosthet Dent 1969;22:682-6.  |
| 2. | Brown KE. Fabrication of a hollow-bulb obturator. J Prosthet Dent 1969;21:97-103. |
| 3. | O'Sullivan M, Hansen N, Cronin RJ, Cagna DR. The hollow maxillary complete denture: A modified technique. J Prosthet Dent 2004;91:591-4. |
| 4. | Somasundaram P. The hollow maxillary complete denture-An alternative technique to remove the silicone putty. J Dent Oral Health 2016;2:38-40. |
| 5. | Holt RA Jr. A hollow complete lower denture. J Prosthet Dent 1981;45:452-4. |
| 6. | Fattore LD, Fine L, Edmonds DC. The hollow denture: An alternative treatment for atrophic maxillae. J Prosthet Dent 1988;59:514-6. |
| 7. | Kaira LS, Singh R, Jain M, Mishra R. Light weight hollow maxillary complete denture: A case series. J Orofac Sci 2012;4:143-7. [Full text] |
| 8. | Shetty V, Gali S, Ravindran S. Light weight maxillary complete denture: A case report using a simplified technique with thermocol. J Interdiscip Dent 2011;1:45-8. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
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