PMC7591000_01
Frontal view, habitual occlusion.
CCIDE-12-437-g0001.jpg
PMC7591000_01_CCIDE-12-437-g0001.jpg
f0001
Clinical and radiographic examinations yielded the following findings: only the anterior teeth were in occlusion, and the occlusal vertical dimension was reduced (Figure 1).
Severe wear of the lower incisors.
CCIDE-12-437-g0002.jpg
PMC7591000_01_CCIDE-12-437-g0002.jpg
f0002
The mandibular anterior teeth had severe tooth wear and were non-vital (Figure 2).
Upper occlusal view (flipped mirror image).
CCIDE-12-437-g0003.jpg
PMC7591000_01_CCIDE-12-437-g0003.jpg
f0003
Multiple carious teeth, retained roots, over-contoured and splinted metal-ceramic crowns, and multiple missing teeth were found on the maxillary arch (Figure 3), whereas multiple missing teeth and teeth with severe wear were found on the mandibular arch (Figure 4).
Lower occlusal view (flipped mirror image).
CCIDE-12-437-g0004.jpg
PMC7591000_01_CCIDE-12-437-g0004.jpg
f0004
Multiple carious teeth, retained roots, over-contoured and splinted metal-ceramic crowns, and multiple missing teeth were found on the maxillary arch (Figure 3), whereas multiple missing teeth and teeth with severe wear were found on the mandibular arch (Figure 4).
Pretreatment orthopantogram.
CCIDE-12-437-g0005.jpg
PMC7591000_01_CCIDE-12-437-g0005.jpg
f0005
The radiographic examination showed caries on the teeth of both arches, as well as periodontal disease with generalized moderate to severe horizontal bone loss (Figure 5).
Spaced and perforated maxillary custom tray.
CCIDE-12-437-g0006.jpg
PMC7591000_01_CCIDE-12-437-g0006.jpg
f0006
In addition, spaced and perforated maxillary (Figure 6) and mandibular (Figure 7) custom trays for irreversible hydrocolloid impressions were constructed.
Spaced and perforated mandibular custom tray.
CCIDE-12-437-g0007.jpg
PMC7591000_01_CCIDE-12-437-g0007.jpg
f0007
In addition, spaced and perforated maxillary (Figure 6) and mandibular (Figure 7) custom trays for irreversible hydrocolloid impressions were constructed.
Maxillary irreversible hydrocolloid impression.
CCIDE-12-437-g0008.jpg
PMC7591000_01_CCIDE-12-437-g0008.jpg
f0008
The maxillary working impression recorded the entire denture-bearing area, which the buccal sulcus bordered anteriorly and laterally, and the vibrating line posteriorly (Figure 8).
Mandibular irreversible hydrocolloid impression.
CCIDE-12-437-g0009.jpg
PMC7591000_01_CCIDE-12-437-g0009.jpg
f0009
A mandibular study impression was also taken (Figure 9).
Maxillary occlusal rim.
CCIDE-12-437-g0010.jpg
PMC7591000_01_CCIDE-12-437-g0010.jpg
f0010
Self-cured acrylic temporary base was fabricated with a wax occlusal rim for its minimal distortion (Figure 10).
Mandibular occlusal rim.
CCIDE-12-437-g0011.jpg
PMC7591000_01_CCIDE-12-437-g0011.jpg
f0011
Stainless steel clasps were incorporated into the mandibular base for retention (Figure 11).
The wax-up denture try-in.
CCIDE-12-437-g0012.jpg
PMC7591000_01_CCIDE-12-437-g0012.jpg
f0012
The vertical and horizontal jaw relations, and appearance were verified and approved by the patient. (Figure 12).
The trimmed maxillary cast.
CCIDE-12-437-g0013.jpg
PMC7591000_01_CCIDE-12-437-g0013.jpg
f0013
The maxillary teeth on the model were removed, and the surrounding area was trimmed (Figure 13).
Sutures to assist haemostasis.
CCIDE-12-437-g0014.jpg
PMC7591000_01_CCIDE-12-437-g0014.jpg
f0014
In this situation, the sutures should not be under tension (Figure 14).
Area with excessive pressure disclosed with pressure indicating paste.
CCIDE-12-437-g0015.jpg
PMC7591000_01_CCIDE-12-437-g0015.jpg
f0015
Pressure-indicating paste was then applied to the fitting surface and border to identify the area with excessive pressure (Figure 15), and the denture was adjusted accordingly.