Repair

[DPS]

hi friends

I have a couple of questions around fracture repair of complete dentures. I'm still a student so excuse me if things I'm gonna ask are self- evident.

1.First of all , why do we need to pour a cast into the denture ( in cases that the base is broken ) ? can't we just sticky wax the pieces and apply acrylic ?

2.In the pictures below (D) the cast does not include all of the ridge areas . why is that ? why do we need to block out that much ? of course the purpose of blockout is to prevent fracture of the cast but this sounds too much .


3. in what cases of fracture do we need an impression ? what impression material ? is it always pick-up impression technique ?

4.what are the cases in which repair is impossible ?
5. in case of non-separated fracture , is there a way to fix without opening the crack ?

please also explain the type of repair that is done with flasking.

sorry too many questions

I would appreciate any tips and tricks, pictures ,… you recommend around this topic.

 

[JTG]

Please remember that in the end this is all about the patient. It is our job to repair an appliance so that is done in the best, most correct way. If we cut corners, then not only have we failed the patient, but we have also failed ourselves, the dentist, and this industry. It always takes less time to do it right than to do it twice. So let's begin...

1. If you sticky wax the pieces together, what are you using for an impression? You would just have a denture that you would be adding acrylic to, with nothing on the tissue side? You have to have some kind of impression to help control where the acrylic goes, to make sure it is only in the area you want it and not altering the tissue side of the denture. Also, putting wax in hot water in a pressure pot is not the best idea.

2. In the picture, there is no blockout in the area where the crack is not. All you are concerned with is the area where the crack is. It is so that it is easier for the denture to come off of the model you pour.

3. It would probably be correct to say you always need an impression, however, you don't always need one that the office took (as evidenced by your pics, the denture has become your impression). I request alginate for my impressions, and I request pick-up impressions. If they don't give you a pick-up impression, there is no way you will ever get the appliance to fit the model (it may come close, but won't be exact).

4. That would be a case by case scenario. Sometimes its better to remake than repair. Example, I had a repair come to me a few months ago (1st time to see it). The dr had told be that it had been repaired several times for cracks and teeth popping off, and that it was made by a lab I knew that went out of business last year. I told him I could repair it, but with all the problems they had already had, it would probably be best to go ahead and make a new one (it was really poorly made). However, to probably answer your question, if it comes to me and has been shattered into several pieces, that's usually where I draw the line.

5. If you don't fix the crack the whole way through, you'll just be waiting to get it back to repair it again.

Hope that helps, good luck!

 

[DPS]

Thanks a lot for taking time.

About the block out , in the text it says we block out using wet tissues , and in the picture B , most of the ridge has been blocked out . I thought they might have another reason for not recording the whole anatomic portion.

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[JTG]

No problem, good luck in your studies!

 

[JKraver]

Thanks a lot for taking time.

About the block out , in the text it says we block out using wet tissues , and in the picture B , most of the ridge has been blocked out . I thought they might have another reason for not recording the whole anatomic portion.

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Its acrylic, you can fix anything, Hell I could probably freehand acrylic and make a denture(wont be pretty or perfectly dense). Pouring a cast using wet tissues is pretty old school it was to prevent the stone from locking into any undercut and you having to break the denture out or the cast risking another break. There is something called putty that you can use as the cast I don't pour casts for fracture repairs anymore line up superglue press putty into intaglio and wait for it to set hard. grind away superglue along break, repair acrylic.

 

[JTG]

I do it the same way with the glue and putty, however, if you are doing this for school I would follow the parameters you are given by your instructor on how to do a repair, then try other things when you are out in the real world. FWIW

 

[JKraver]

I went to school 12' they teach you 1980's lab stuff. Your techniques will change dramatically in the real world.

 

[awhurst011]

+1 on the super glue and putty. Saves time and money. Almost anything acrylic can be repaired...Unless it is something that is just downright done for (You will know when you see it). You could use an impression for every repair but some simple fracture repairs don't need them. Most impressions are alginate if they are coming from the office straight to me. They must be poured before the alginate dries or your model will not be accurate. Wrap in a damp paper towel and put in a plastic bag if they are not going to be poured right away. If they are going to sit before pouring using poly vinyl material. Cracks have to be opened up completely. If your just coving the top with acrylic they will fracture completely and youll be doing another repair. Ive never flasked a repair (Im not familiar with a repair flasking technique if there is one.) Good luck with school. Like everyone says you will learn your technique the longer you are in the field.

 

[JMN]

They've nailed your questions so:
I'll take tips and tricks for $200 Alex.

1) The reline jig can be your best friend. If you have a case where the teeth and intaglio have broken from a cast rpd frame, assemble, superglue lightly and jig it. You can then replace all the metal mating acrylic without VDO change worries or tissue irritation concerns. So many other ways this tool can be helpful.

2) If you doubt the alignment of your pieces when you have a multipiece or even 2part fracture, look at the veining. The veins are like woodgrain in telling you if you're off 1/2mm or not. They are uniform in length and if you see one too short on either or both sides of a crack that hasn't been ground on something's not right....

3) verify before modify! Always be able to have a path backwards if your plan doesn't work.

4) get superglue unglue. ZAP Z-7 Debonder works well and didn't eat my acrylics over 30hrs I left some on them.

Get putty! most repairs can be done with it instead of stone. Get used to how it feels before it starts hardening or unlike stone you'll get impression echos moving it around when you shouldn't

Biggest thing, general problem solving mindset. Watch Macgyver reruns

Take a hint from Scotty on Star Trek. If it takes 1hr tell'em 2.5 hours. You'll be a hero somedays, and really need all that time other days.

Make it fun!

 

[JKraver]

Beam me up, I do it every day. Most the days I am a hero. Never been late on anything ever.

 

[JMN]

Beam me up, I do it every day. Most the days I am a hero. Never been late on anything ever.

Me neither, been there opening the door for the pt coming in as I leave once, but they we're pushyyyy and early. Doc warned me this one's always early.
Well, is it your appointment to be seen by them doc, or there appt to be seen by you? ok, de-rantified.

 

[nvarras]

Never deliver early. e that mistake once then they started asking for them early on the script. Never again. I don't need to be the hero. I just need to be paid.


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[JTG]

Biggest thing, general problem solving mindset.

BINGO!

 

[JMN]

Never deliver early. e that mistake once then they started asking for them early on the script. Never again. I don't need to be the hero. I just need to be paid.


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I tell'em they get it as soon as possible, whether 3hrs or 3days you'll always have it as fast as is possible because what is possible changes daily.

 

[nvarras]

I tell'em they get it as soon as possible, whether 3hrs or 3days you'll always have it as fast as is possible because what is possible changes daily.

Are you a politician? That sounds like a politician...[emoji23]


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[JTG]

Are you a politician? That sounds like a politician...[emoji23]


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He's getting ready for Super Tuesday

 

[JMN]

Are you a politician? That sounds like a politician...[emoji23]


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I sure hope not.


My wife says no. I'm too honest.

 

[JMN]

He's getting ready for Super Tuesday

The only super thing about my Tuesday is my new pricelist goes active.

 

[JKraver]

Never deliver early. e that mistake once then they started asking for them early on the script. Never again. I don't need to be the hero. I just need to be paid.


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That's fine request it early and take the rush fees.

 

[JKraver]

I am also in house so being a hero here is a good thing.