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Hollow Denture & Artificial Saliva:Prosthodontic Management of Xerostomia & Resorbed Ridges - A Case Report
Introduction
Resorbed Ridges as well as Xerostomia are common clinical cases found.
The weight of a denture is often a dislodging factor . Hence, a light weight denture with salivary substitutes is required for better retention in such situations.
What is Xerostomia & Resorbed Ridge
Xerostomia is defined as dryness of the mouth due to the lack of normal secretion of saliva.
Resorbed Ridge is defined as the the diminished quality and quantity of bone that remains after the removal of the teeth.
O/E Decreased Salivary Flow Resorbed Mandibular
Ridge High Palatal Vault
Maxillary Ridge Increased inter-arch space Systemic Findings-
Nothing Relevant Reported
Steps in Fabrication of Hollow Denture with Salivary reservoir
Preliminary Impression
Final Impression Jaw Relation Wax Try In & Speech
Evaluation Insertion
Up to tryin routine Lab steps Palatal Index Formation Processing of maxillary denture Adaptation of sheet on palatal
index , flasking and processing in clear heat- polymerized resin
Palatal Window Creation Adaptation of soft liner on the
palatal window and processing Attachment of floor of the
reservoir to the palatal surface using auto polymerising resin
Drilling of hole in the reservoir
Clinical Steps Laboratory Steps
Maxillary & Mandibular Final Impression
Wax Try-In
Palatal Wax Up After Speech Evaluation
Measuring Depth Of reservoir
using endodontic file
Flasking and Fabrication Of Palatal Stone Index
Fabrication Of Roof of the Reservoir
Wax Spacer Adapted To Create Palatal window
Roof Of reservoir with Palatal Window
Roof Of Reservoir with resilient soft liner
Finished & polished denture with lid of reservoir attached using
auto-polymerizing resin.
FABRICATION OF HOLLOW DENTURE
LOWER TRIAL DENTURE FLASKEDINTERCHANGEAABLE FLASK
After Dewaxing
Wax up – adding one layer thickness of the wax over the cast & mold
POST FLASKING AND DEWAXING OF TEETH CONTAINING MOLD
POST FLASKING AND DEWAXING OF FLASK CONTAINING MASTER CAST USING INTERCHANGEABLE FLASKS
Processed – lower denture part containing teeth and denture base
mandibular hollow denture attaching two parts using auto -polymerising acrylic resin
Hollow Denture Floating in water
Injecting Artificial Saliva In the Reservoir
Artificial Saliva Coming out of the hole when applying pressure
Patient Instructions & Recall Visits
Demonstrate to the patient how to inject saliva substitute through the hole in both Maxillary and mandibular reservoir
by using a 5 Ml disposable syringe and needle. Provide a treatment record card and ask the patient to note
every time the reservoir is filled, the quantity of substitute, and the time till the reservoir is empty.
Patient is instructed to clean the denture using 2% sodium hypochlorite
Make a 24 hr. first recall appointment Make a 1-week recall appointment. After 1 week, evaluate the record and
calculate the average duration of flow. The duration of flow provided by artificial
saliva reservoirs should range from 2 to 5 hours.
Increase or reduce the size of the hole to adjust the flow rate.
Discussion Control Mechanism Speech Evaluation
DISADVANTAGES &LIMITATIONS Time Limit Patient Selection Regular Maintainance
CONCLUSION Functional Reservoir Ease and simplicity Cost effectivness
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