psrtea terior erisdie

refitting

anteriody residual of

but ridges

the

tissue

occlusal may

cclusal forces are fmces transmitted

cause

surface

bone of the

ix-n-

resorption. prostheses

ed to i-mprove comfmt and maintain the tissue surface of this a complete denture, it ~u~~ti~n5 as a c tial demure, refore, a reline procedure that readapts the mucosa-s rted portion of the prosthesis bilaterally shdd be used. This article describes a method of refitting a removabie oss~o~nteg~ated prosthesis co~ta~~~~gan anterior bamzlip atta~b~e~t.

ith the aid of ~~ess~~e-~~di~at~~~ ray or paste, mate and relieve all pressure areas ax trouble spot.5 from the tissue surface of the mandibular prosthesis. With a ~Qtto~-ti~~ea applicator, apply a light eoati ~etro~at~~ to the bar-clip region of the denture. ethacrylate t~ss~~-~~~d~t~on~~g resin osworth co., Skokie, lml.)to the nlucosaof the denture to act as both a tissue cmditboner as well a8 a functional impression. emove

Functional inqxession completed. Clip be protected by wet tisme.

REFITTING

BAR-CLIP

REMOVABLE

PROSTHESIS

5. Prosthesis separated from master cast after processing. Anterior protective cast remains in place.

Fig.

Fig.

3, Protected clip is covered by cast stone.

Fig.

Fig.

4. Prosthesis with cast is mounted on duplicator.

with a scalpel any impression material that has flowed into the bar-clip attachment and dismiss the patient for 24 hours. Relieve any surfaces of the original acrylic resin base that are exposed through the tissue conditioner; remove all of the remaining tissue conditioner; and add new conditioner as in step 2. Severely distorted mucosa may necessitate repetition of this step several times at 24-hour intervals until an acceptable final impression is made. A satisfactory impression will have an even layer of tissue conditioner over the entire tissue surface of the prosthesis with none of the original hard acrylic resin base visible through the impression (Fig. 2). Protect the bar-clip area by packing wet tissue paper into it and flowing utility wax into any undercuts around the clip attachment (Fig. 2). 5. Pour stone in the remaining cavity of the protected bar-

THE

6. Anterior protective cast is removed,

JOURNAL

OF PROSTHETIC

DENTISTRY

7. Tissue surface of relined prosthesis prior to delivery. Clip is unaltered and undamaged.

Fig.

clip attachment. The stone should have a smooth, convex surface and be lightly lubricated when dry to prevent adherence to the master cast. The denture should be kept moist in a humidor or covered during this step (Fig. 3).

675

pour

'?I V&en

the

cast

the

j5

irn~r~si0~

properly

i

stone. This east will in~ubr~ca~d anterior cast

set, remiwe

the boxier

mate-

The need for relining an implant-supported prosthesis is the same if not greater than that for a conventional mandibular complete denture. However, the reline procedure for the implant supported prosthesis differs in. that the fit and integrity of the attachments must be maintained and protected during processing. A method for functionally rear-clip removable prosthesis attached to OSseointegrat~d implants has been presented. This ~ne~~o~ allows the operator to place either a resilient or a conventional acq&c resin reline while preserving the fit and integrity of the bar-clip attachment.

I. Branemark PI, Zarb GA, Albrektsson T. Tissue-integrated prostheses. Chicago: Quintessence FubIishing Co Inc, 1987;283-292. 2. Desjardins IV?. Tissue-integrated prostheses for edentulous patients with nnrmai and abnormal jaw relationships. J PROSTHET DENT

1988;59:180-7, Reprint reyuesrs to. DR. Au B~LOURI BAVL~~CCLLEGEOFDENTISTRY 3302 GASTQN AVE. DALLAS, TX 75246