Wednesday, May 30, 2012

Mandibular Hybrid Prosthesis Denture Tooth Location Index and Tranfer to Metal Framework in Wax

The following photos depict the sequence and steps involved with transferring mandibular denture tooth position, determined previously with an intra-oral wax try-in, to mandibular hybrid prosthesis metal framework.

Fabricate a lab plaster occlusal index of the mandibular denture tooth position on  previously (correctly) mounted mandibular cast.  Maintain the same vertical dimension of occlusion with the articulator pin when fabricating the plaster index.  The index needs to cover the mandibular teeth to their height of contour.

Remove all wax from the mandibular denture teeth and re-insert into the plaster index.

Add sticky wax onto the facial/buccal surfaces of the denture teeth to secure their position in the plaster matrix.

Articulator closed with healing caps still present on implant abutment lab analogs.

Mandibular hybrid metal framework in place.  This photo shows properly adjusted mandibular denture teeth that allows closure of the articulator to the proper occlusal vertical dimension with the mandibular hybrid metal framework in place on the master cast.  In order to accomplish this, one must adjust the denture teeth until adequate space is present between the teeth and the metal frame when the articulator pin touches the articulator's pin table at the previously determined occlusal vertical dimension.  

Pre-opaqued mandibular hybrid metal framework.

Air abraded mandibular hybrid metal framework.
Opaqued framework on the master cast with indexed mandibular denture teeth in place.

Screw access holes blocked out with cotton prior to adding wax to secure mandibular denture teeth to hybrid framework.

PVS used to finish blocking out the screw access holes prior to securing teeth to the mandibular framework with wax.

Wax applied to the mandibular framework securing the mandibular denture teeth.

Screw access holes drilled through the wax and teeth providing access to the prosthetic screws of the hybrid. 

Festooned and polished mandibular hybrid prosthesis in wax.