| LIQUID SUPPORTED DENTURE - A CASE REPORT | 
| | Introduction:
The dimensions of the edentulous residual ridge are not stable because of bone resorption and mucosal changes from muscle dynamics or tissue irritation. Thus, complete dentures seldom remain in close adaptation to the adjacent mucosa. An ideal denture base would continuously adapt to the mucosa and thus flexible. However, it also has to support the teeth during function and thus should be rigid. Obviously, these properties cannot be combined in one material. Yet, with combinations of materials, the base can be rigid where it needs to be strong and flexible when in contact with the soft tissues. | | | | Indications:
? Flabby ridges
? Atrophic alveolar ridges
? Bruxism
? Allergic patients
Advantages
? This design acts as a continuous reline for the denture
? The close adaptation of the denture base to the soft tissue improves the retention
? Uniform distribution of masticatory load.
? Vertically directed forces will also be distributed in other directions by the liquid, which minimizes local stressing of the supporting tissues
? The spreading of pressure might also reduce problems at the mental foramen in a resorbed mandible.
? Slower and more even resorption of the residual ridges.
? Improved patient tolerance because of great comfort due to smooth flexible surfaces.
? Prevention of chronic soreness from rigid denture base | | | | Case report:
? A 65 year old male patient was referred to the department of prosthodontics, Bapuji dental college for prosthetic rehabilitation of the maxillary and mandibular ridges. The patient complained of ill fitting and loosen denture and he had been wearing dentures since the past 8 years even at night.
? On intra oral examination the mucosa over the anterior region of the maxillary ridge and the palatal rugae was flabby and compressible, maxillary and mandibular ridges were moderately resorbed.
? In order to reduce the stresses over the flabby tissue and to improve the retention maxillary liquid supported denture and mandibular conventional denture was planned. | | | | CONSTRUCTING A LIQUID-SUPPORTED DENTURE:
? Constructing a liquid-supported denture is largely similar to that of a normal acrylic resin denture with a few differences | | | | Primary impression:
Made by Mc cord’s technique
Custom tray:
o Relief was provided in the anterior maxillary ridge and mid palatine raphae , spacer was provided
? Custom tray was fabricated with self cure tray resin
? Border molding was done with addition silicone putty impression material and final impression was made with light body addition silicone.
? Master cast was obtained
? Denture base and occlusal rims were fabricated
? Jaw relation and mounting procedures were carried out in a conventional manner
? Try- in of waxed-up dentures was done
? The master casts were demounted from the articulator.
? A line was drawn on the master cast which was 2 mm short of the borders.
? A polythene foil of 0.5 mm thickness was adapted and heat pressed on the master cast and it was cut 2 mm short of the borders.
? Flasking and de waxing procedures were carried out in a conventional manner.
? At the time of packing o.5 mm thickness polythene sheet was adapted over the master cast.
? Packing was done with heat cure acrylic resin
? Curing, Finishing and polishing of the denture were done.
? The polythene foil is separated and removed from the denture - base
? The thickness of denture was reduced by 0.5 mm from the tissue surface of the denture- base 1 mm short of the junction between the foil and denture –base.
? Two inlets were made in the denture bucally in the molar region for injecting liquid.
? The foil was incorporated in the denture base with cyanoacrylate adhesive (used in surgery as an alternative to suturing) and sealed with light-cured dental varnish. (palaseal, kulzer) | | | | ? A viscous liquid (glycerin) was filled through the inlets and one inlet is sealed with cold cured acrylic resin. | | | | Conclusion:
Days and nights change, so do men, so do tissues, so do our treatments. Ultimately, Devan’s dictum holds true.
“Our objective should be perpetual preservation of what remains, rather than
meticulous replacement of what is lost ” | | | | References
1. Carel L, Davidson and Gert Boere. Liquid supported dentures, part 1: theoretical and technical considerations. J. Prosthet. Dent. 1990; 63: 303-6.
2. Gert Boere, Hans De koomen and Carel L , Davidson. Liquid supported dentures part 11: clinical study a preliminary report. . J. Prosthet. Dent. 1990; 63:434-6.
3. Verma , Dinesh,Ahluwalia , Tej pal singh. Cyanoacrylate tissue adhesives in oral and maxillofacial surgery. JIDA 2002; 73:171-4. | | | | | | | |
