PMC10361270_01
(a) Pretreatment intraoral view maxilla, (b) pretreatment intraoral view mandible.
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F1
Clinical examination revealed resorbed maxillary ridge with anterior flabby tissue, flat (atrophic) mandibular ridge, and increased interarch space [Figures 1 and 2].
(a) Marking of flabby tissue in maxillary arch, (b) marking of flabby tissue on primary cast.
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F2
Clinical examination revealed resorbed maxillary ridge with anterior flabby tissue, flat (atrophic) mandibular ridge, and increased interarch space [Figures 1 and 2].
(a) Secondary impression of maxillary ridge using regular body polyvinyl siloxane impression material, (b) window preparation and seating of impression in the patient's mouth, (c) impression of the flabby tissue using light body polyvinyl siloxane impression material.
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F3
Sticks). Spacer wax was removed and impression was made using medium-body polyvinyl siloxane impression material (Elite HD+, Zhermack, Germany) [Figure 3a]. Impression was then retrieved from the mouth and a window was created in the region of flabby tissue, the outline of which had been marked [Figure 3b]. Multiple relief holes were made in cut section of tray, the rest of the tray was seated in the patient's mouth, and light body polyvinyl siloxane impression material (Elite HD+, Zhermack, Germany) was loaded in the region of flabby tissue, following which the window section was replaced in its original position [Figure 3c].
(a) Secondary impression of mandibular ridge using regular body polyvinyl siloxane impression material, (b) removal of the material from the crest and making impression using light body polyvinyl siloxane impression material.
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F4
Mandibular impression was made using differential pressure impression technique wherein impression was made using medium body polyvinyl siloxane impression material after border molding (Elite HD+, Zhermack, Germany) [Figure 4a], 0.5 mm of the material was removed from the alveolar crest, and second impression was made using the light body polyvinyl siloxane impression material (Elite HD+, Zhermack, Germany) [Figure 4b].
(a) Flasking of teeth setting after trial, (b) dewaxing - teeth in cope, (c) indentations on the denture base in drag, (d) adaptation of wax on the teeth in cope, (e) fabrication of putty index.
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F5
After clinical try-in, trial denture was waxed-up, invested, and dewaxed using conventional laboratory procedures [Figure 5a and b]. Indentations of approximately 0.5-1 mm in depth and 5 mm in width were made on the processed acrylic denture base with acrylic burs in premolar and molar regions on both sides for orientation of the 3D spacer [Figure 5c]. It will model for the thickness of the resin obtained after processing [Figure 5d]. Putty consistency vinyl polysiloxane was mixed in equal proportions, molded into U shape, and placed over the wax adapted on the teeth [Figure 5e].
(a) DICOM File, (b) DICOM to STL conversion. DICOM: Digital Imaging and Communications in Medicine, STL: Standard Tessellation Language.
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F6
Standard Tessellation Language (STL) file [Figure 6b]. STL file thus obtained was uploaded into computer-aided design software.
(a) STL file of 3D spacer, (b) attachment of supports, (c) 3D printed spacer, (d) 3D printed spacer with holllow space. STL: Standard Tessellation Language, 3D: Three dimensional.
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F7
Design parameter of 1.25-mm wall thickness to create a hollow space within the solid STL file was set [Figure 7a]. Utilizing this modified file, a 3D hollow spacer with dental SG resin was obtained. [Figure 7b-d]. 3D spacer was oriented on the denture base utilizing the indentations created at premolar and molar regions on both sides.
(a) Securing of 3D spacer to denture base using cyanoacrylate, (b) 3D spacer incorporated in the hollow denture, (c) finished prosthesis, (d) float test for hollow denture. 3D: Three dimensional.
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F8
Subsequently, it was secured using the cyanoacrylates [Figure 8a]. After deflasking, finishing and polishing of the prosthesis were done [Figure 8b and c]. The resin spacer remained within the denture [Figure 8d].