TIPS
household vegetable oil lubricant. A common source of this pad material is 3/16 inch polyurethane foam sponge found as packing material for carded denture teeth sets (Dentsply International, York, Pa.). The pad provides thermal insulation and tactile sensation without adhering to the heated resin. 5. Correct interproximal and occlusal anatomy by redefining them with waxing instruments after selectively reheating the splint material with an alcohol torch. 6. Remove the matrix and trim it as desired.
uses for provisional e prosthodontics Robert
W. Loney,
DDS,
crown
FROM
OUR
READERS
Although speed may not be an issue in making a matrix, this method is faster because it takes less time to heat and trim a smaller piece of splint material, and several matrices can be made from a single sheet of thermoplastic resin. Reprint requests to: LT. COL. KENNETH E. BLOODWORTH USA DENTAC FORT ORD. CALIFORNIA 93941
remover
forceps
in
MSa
University of Saskatchewan, College of Dentistry, Saskatoon, Saskatchewan Forceps designed for removing interim crowns and fixed partial dentures can also be used to expedite the polishing and cementing of restorations, the removal of temporarily cemented permanent restorations, and the adjustment and setting of denture teeth. Forceps used for removing provisional restorations (Temp gripper, Holmes
aAssociate Professor and Director, Division of Removable Prosthodontics. 1Q/4/35594
Dental Co., Hatboro, Pa.) expedite many prosthodontic procedures (Fig. 1). They may be used in the following situations. REMOVING
PROVISIONAL
RESTORAT~
Slight buccolingual rocking is used in conjunction with a pulling motion to loosen a provisional fixed partial denture or crown (Fig. 2). When provisional restorations are exceptionally retentive, a spoon excavator may be used in a wedging fashion between the provisional crown margin and the tooth to facilitate removal. FINISHING OR HOLDING RESTORATIONS DURING
PROVIS CEMEN
The use of forceps can minimize the chances of dropping single-unit interim restorations during polishing procedures (Fig. 3). When single-unit provisional restorations are being cemented or when large provisional fixed partial dentures are lubricated with petroleum jelly before cementation, it may be difficult for the dentist to gain an adequate grasp on
ig. 1. Temp gripper, Holmes Dental Co. 734
Fig. 2. Rocking and pulling motion used to remove interim restoration. MAY
1992
VOLUME
67
NUMEElt
5
TIPS
FROM
OUR
READERS
Fig. 3. Temporary wheel.
crown polished
Fig.
with pumice and rag
Fig.
5. Bur used to adjust denture tooth.
6. Rapid reduction
of denture tooth on lathe.
Fig. 4. Temporarily cemented permanent crown removed with forceps and Richwill crown remover.
the provisional restoration. Forceps can be used to facilitate transferral from the assistant to the dentist and final positioning intraorally. If interim restorations are accidentally dropped in the oral cavity, these forceps provide an ideal means of quickly recovering the restoration. REMOVING PROVISIONALLY FINAL RESTORATIONS
CEMENTED
When final full coverage restorations must be cemented temporarily, they can be removed without damage by using Richwill crown removers (Almore International Corp., Portland, Ore.) (Fig. 4). When opposing teeth have large amalgams or full-coverage restorations, the manufacturer warns that they can be loosened if the Richwill crown removers are used in the conventional manner. In these instances, the crown remover should be warmed as recommended, grasped with the forceps, and placed over the restoration to be removed. Heavy cervical pressure is exerted toward the restoration via the forceps. The restoration is removed in the rapid manner suggested by the manufacturer. THE
JOURNAL
OF PROSTHETIC
DENTISTRY
Fig. ‘7. Denture tooth moved bodily and tilted during final wax try-in.
ADJUSTING
DENTURE
TEET
Denture teeth often require reduction on the tissue surface to be properly positioned on the wax trial baseplate. This task is often made difficult by the small size of the 735
TIPS
denture teeth and the latex gloves worn by the dentist. The use of forceps minimizes the chances of dropping the denture teeth during adjustment by providing a secure grip on the tooth. Gloved hands are away from the immediate vicinity of the adjustment site, thus minimizing the potential of accidental “grabbing” of the gloves by the rotary instruments. Teeth are grasped by the mesial and distal surfaces to prevent damage to the esthetic surfaces of the teeth. Firm pressure is applied to prevent loss of the tooth during grinding procedures. Denture teeth can be finely adjusted with a dental bur in a handpiece or rapidly reduced with a lathe and arbor band without fear of losing the tooth (Figs. 5 and 6). When a lathe is used, a finger may be placed underneath the tooth to stabilize it during reduction (Fig. 3). MOVING WAX-UPS
DENTURE
TEETH
IN DENTURE
Wax spatulas can be used to move denture teeth during the initial denture setup stages. However, the use of spatulas usually results in simple tilting motions, sometimes difficult to control. The use of forceps with serrated jaws allows for bodily movements and more controlled tilting
Treatment Victor
J. Miller,
dentures:
Acrylic
partial
FROM
OUR
READEXS
movements of the denture teeth (Fig. 7). Teeth can easily be extruded or intruded without affecting their axial inelination. Wax around the tooth to be moved is softened with an alcohol torch, the jaws of the forceps are placed on the buccal and lingual surfaces of the denture teeth, and the desired combination of tilting and bodily movements are exerted on the tooth. If the wax is sufficiently softened, minimal force is required to adjust the position and angulation of the tooth. When large changes in position are required, the tooth may be removed and additional wax added or removed. An added benefit of this technique of moving teeth in the final phases of a wax try-in is that the finished wax-up is minimally disturbed by use of the forceps. Reprint requests to: DR. ROBERT W. LONEY COLLEGE OF DENTISTRY, UNIVERSITY OF SASKATCHEWAN SASKATOON, SASKATCHEWAN, SIN OWO CANADA
denture
and stabilizatia
BSe, BChDa
University of Saskatchewan, College of Dentistry, Saskatoon, Saskatchewan It is popularly believed that masticatory muscle hyperactivity may be associated with signs and symptoms of craniomandibular dis0rders.l Loss of molar support has been reported to lead to an increase in the asymmetry of electromyographic activity of the masseter muscles, and lateral positioning of the mandible appears to affect electromyographic asymmetry of the anterior temporal muscle.2 Stabilization splints are regarded as effective in treating some craniomandibular disorders and reduced asymmetric electromyographic activity of the masticatory muscles.3 Patients who have signs and symptoms of craniomandibular disorders and who are missing posterior teeth, with or without occlusal instability (Fig. l), can be treated by modifying removable partial acrylic resin dentures. These prostheses can then function as a stabilization splint (Fig. 2). 1. Irreversible hydrocolloid impressions are made of maxillary and mandibular arches and casts are made. 2. Acrylic resin removable partial dentures are fabricated aAssistantProfessor,Department of Restorative and Prosthetic Dentistry. 16/4/36683 136
1, Intraoral view shows loss of posterior teeth and decrease in vertical dimension of occlusion.
Fig.
in the traditional way. Zero-degree teeth are used posteriorly (usually maxillary), and these are set in as flat a plane as possible. 3. An anterior ramp is built, which together with the O-degree teeth should allow for an increase in vertical dimension of occlusion and multidirectional freedom of contact movement. MAY
1992
VOLUME
67
NUMBER
5
household vegetable oil lubricant. A common source of this pad material is 3/16 inch polyurethane foam sponge found as packing material for carded denture teeth sets (Dentsply International, York, Pa.). The pad provides thermal insulation and tactile sensation without adhering to the heated resin. 5. Correct interproximal and occlusal anatomy by redefining them with waxing instruments after selectively reheating the splint material with an alcohol torch. 6. Remove the matrix and trim it as desired.
uses for provisional e prosthodontics Robert
W. Loney,
DDS,
crown
FROM
OUR
READERS
Although speed may not be an issue in making a matrix, this method is faster because it takes less time to heat and trim a smaller piece of splint material, and several matrices can be made from a single sheet of thermoplastic resin. Reprint requests to: LT. COL. KENNETH E. BLOODWORTH USA DENTAC FORT ORD. CALIFORNIA 93941
remover
forceps
in
MSa
University of Saskatchewan, College of Dentistry, Saskatoon, Saskatchewan Forceps designed for removing interim crowns and fixed partial dentures can also be used to expedite the polishing and cementing of restorations, the removal of temporarily cemented permanent restorations, and the adjustment and setting of denture teeth. Forceps used for removing provisional restorations (Temp gripper, Holmes
aAssociate Professor and Director, Division of Removable Prosthodontics. 1Q/4/35594
Dental Co., Hatboro, Pa.) expedite many prosthodontic procedures (Fig. 1). They may be used in the following situations. REMOVING
PROVISIONAL
RESTORAT~
Slight buccolingual rocking is used in conjunction with a pulling motion to loosen a provisional fixed partial denture or crown (Fig. 2). When provisional restorations are exceptionally retentive, a spoon excavator may be used in a wedging fashion between the provisional crown margin and the tooth to facilitate removal. FINISHING OR HOLDING RESTORATIONS DURING
PROVIS CEMEN
The use of forceps can minimize the chances of dropping single-unit interim restorations during polishing procedures (Fig. 3). When single-unit provisional restorations are being cemented or when large provisional fixed partial dentures are lubricated with petroleum jelly before cementation, it may be difficult for the dentist to gain an adequate grasp on
ig. 1. Temp gripper, Holmes Dental Co. 734
Fig. 2. Rocking and pulling motion used to remove interim restoration. MAY
1992
VOLUME
67
NUMEElt
5
TIPS
FROM
OUR
READERS
Fig. 3. Temporary wheel.
crown polished
Fig.
with pumice and rag
Fig.
5. Bur used to adjust denture tooth.
6. Rapid reduction
of denture tooth on lathe.
Fig. 4. Temporarily cemented permanent crown removed with forceps and Richwill crown remover.
the provisional restoration. Forceps can be used to facilitate transferral from the assistant to the dentist and final positioning intraorally. If interim restorations are accidentally dropped in the oral cavity, these forceps provide an ideal means of quickly recovering the restoration. REMOVING PROVISIONALLY FINAL RESTORATIONS
CEMENTED
When final full coverage restorations must be cemented temporarily, they can be removed without damage by using Richwill crown removers (Almore International Corp., Portland, Ore.) (Fig. 4). When opposing teeth have large amalgams or full-coverage restorations, the manufacturer warns that they can be loosened if the Richwill crown removers are used in the conventional manner. In these instances, the crown remover should be warmed as recommended, grasped with the forceps, and placed over the restoration to be removed. Heavy cervical pressure is exerted toward the restoration via the forceps. The restoration is removed in the rapid manner suggested by the manufacturer. THE
JOURNAL
OF PROSTHETIC
DENTISTRY
Fig. ‘7. Denture tooth moved bodily and tilted during final wax try-in.
ADJUSTING
DENTURE
TEET
Denture teeth often require reduction on the tissue surface to be properly positioned on the wax trial baseplate. This task is often made difficult by the small size of the 735
TIPS
denture teeth and the latex gloves worn by the dentist. The use of forceps minimizes the chances of dropping the denture teeth during adjustment by providing a secure grip on the tooth. Gloved hands are away from the immediate vicinity of the adjustment site, thus minimizing the potential of accidental “grabbing” of the gloves by the rotary instruments. Teeth are grasped by the mesial and distal surfaces to prevent damage to the esthetic surfaces of the teeth. Firm pressure is applied to prevent loss of the tooth during grinding procedures. Denture teeth can be finely adjusted with a dental bur in a handpiece or rapidly reduced with a lathe and arbor band without fear of losing the tooth (Figs. 5 and 6). When a lathe is used, a finger may be placed underneath the tooth to stabilize it during reduction (Fig. 3). MOVING WAX-UPS
DENTURE
TEETH
IN DENTURE
Wax spatulas can be used to move denture teeth during the initial denture setup stages. However, the use of spatulas usually results in simple tilting motions, sometimes difficult to control. The use of forceps with serrated jaws allows for bodily movements and more controlled tilting
Treatment Victor
J. Miller,
dentures:
Acrylic
partial
FROM
OUR
READEXS
movements of the denture teeth (Fig. 7). Teeth can easily be extruded or intruded without affecting their axial inelination. Wax around the tooth to be moved is softened with an alcohol torch, the jaws of the forceps are placed on the buccal and lingual surfaces of the denture teeth, and the desired combination of tilting and bodily movements are exerted on the tooth. If the wax is sufficiently softened, minimal force is required to adjust the position and angulation of the tooth. When large changes in position are required, the tooth may be removed and additional wax added or removed. An added benefit of this technique of moving teeth in the final phases of a wax try-in is that the finished wax-up is minimally disturbed by use of the forceps. Reprint requests to: DR. ROBERT W. LONEY COLLEGE OF DENTISTRY, UNIVERSITY OF SASKATCHEWAN SASKATOON, SASKATCHEWAN, SIN OWO CANADA
denture
and stabilizatia
BSe, BChDa
University of Saskatchewan, College of Dentistry, Saskatoon, Saskatchewan It is popularly believed that masticatory muscle hyperactivity may be associated with signs and symptoms of craniomandibular dis0rders.l Loss of molar support has been reported to lead to an increase in the asymmetry of electromyographic activity of the masseter muscles, and lateral positioning of the mandible appears to affect electromyographic asymmetry of the anterior temporal muscle.2 Stabilization splints are regarded as effective in treating some craniomandibular disorders and reduced asymmetric electromyographic activity of the masticatory muscles.3 Patients who have signs and symptoms of craniomandibular disorders and who are missing posterior teeth, with or without occlusal instability (Fig. l), can be treated by modifying removable partial acrylic resin dentures. These prostheses can then function as a stabilization splint (Fig. 2). 1. Irreversible hydrocolloid impressions are made of maxillary and mandibular arches and casts are made. 2. Acrylic resin removable partial dentures are fabricated aAssistantProfessor,Department of Restorative and Prosthetic Dentistry. 16/4/36683 136
1, Intraoral view shows loss of posterior teeth and decrease in vertical dimension of occlusion.
Fig.
in the traditional way. Zero-degree teeth are used posteriorly (usually maxillary), and these are set in as flat a plane as possible. 3. An anterior ramp is built, which together with the O-degree teeth should allow for an increase in vertical dimension of occlusion and multidirectional freedom of contact movement. MAY
1992
VOLUME
67
NUMBER
5
