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 Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 5  |  Issue : 2  |  Page : 102-104

An innovative and simple type of unconventional interim labial partial denture


Department of Prosthodontics, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India

Date of Web Publication25-Oct-2016

Correspondence Address:
Aruna J Bhandari
Department of Prosthodontics, Rural Dental College, Pravara Institute of Medical Sciences, Loni - 413 736, Ahmednagar, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-4696.192976

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  Abstract 

In routine dental practice, we come across many patients who present with different contour and forms of residual ridges. These may range from severely resorbed to well-formed bulky ridges. There are certain cases in which the premaxilla is labially inclined, and therefore, there is formation of moderate to severe labial undercut. As a result, fabricating esthetic dentures is a task. In such cases, there are two treatment options, namely, surgical and nonsurgical. Surgical treatments include labial alveoloplasty, which is invasive and we have to wait until healing occurs. Hence, a nonsurgical, noninvasive treatment option for construction of complete denture is desired. The labial flanges need to be modified to decrease the fullness on wearing dentures. Thus, labial denture prosthesis is a good and viable treatment modality.

Keywords: Gum fit denture, labial denture, palate free denture, unconventional dentures, wing denture


How to cite this article:
Bhandari AJ, Saraf V, Khokhani R, Vikhe D. An innovative and simple type of unconventional interim labial partial denture. J Dent Allied Sci 2016;5:102-4

How to cite this URL:
Bhandari AJ, Saraf V, Khokhani R, Vikhe D. An innovative and simple type of unconventional interim labial partial denture. J Dent Allied Sci [serial online] 2016 [cited 2021 Jun 18];5:102-4. Available from: https://www.jdas.in/text.asp?2016/5/2/102/192976


  Introduction Top


Prosthodontic rehabilitation is one of the challenging tasks for a dentist. In spite of every care regarding oral and dental hygiene, still there may be loss of few or all the teeth either due to extraction or exfoliation. Restoration of the lost teeth and its associated parts is important for esthetic, phonetics, mastication, comfort, and health of the underlined tissues. Routine prosthesis in the form of conventional complete dentures or partial dentures either removable or fixed is given in ideal or near ideal conditions. However, fabrication of a denture can be a challenging when the intraoral conditions are less than ideal. Removable dentures have three surfaces viz. polished surface, impression surface or tissue surface and occlusal surface. In some partially dentate cases where the upper anterior teeth are missing and lower anterior teeth are almost touching the upper palate, there is severe deep bite [Figure 1] and also severe labial undercut is present [Figure 2]. Then, in such situation, there is absolutely no space for routine partial dentures having palatal plate. If routine cast partial dentures are fabricated, lower teeth will hit the upper palatal plate and there will be posterior disocclusion. Prosthesis may be of esthetic value but patient may not be able to use the routine partial denture during mastication because remaining natural posterior teeth will not occlude if palatal plate is given in the anterior region. Treatment methods to improve the patient's denture foundation and ridge relation are usually either nonsurgical or surgical or combination of both methods.[1]
Figure 1: Diagnostic casts showing severe deep bite

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Figure 2: Diagnostic casts showing severe labial undercut

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When there is severe labial undercut, such condition can be corrected surgically before the construction of denture to enable the patient to satisfy esthetics and also function successfully. Overall goal of reconstructive preprosthetic surgery is to provide an environment for prosthesis which will restore function, be stable, aid retention, preserve the associated structure and satisfy esthetics.[2]

However, surgical aid is not always possible. Preprosthetic surgery is only of value if a better prosthesis can be constructed as a consequence.[3] Moreover, patient has to be made aware that the surgical procedure will be helpful for future denture wearing.[4] Still patients are not comfortable and are reluctant about the idea of surgery. Furthermore, surgery may be contraindicated due to medical problems. These patients can be restored by labial flange type of unconventional dentures.

An innovative, simple clinical procedure for fabrication of labial denture is described:


  Steps for Fabrication of Labial Denture Top


  1. Record the maxillary and mandibular partially dentate impressions in elastomeric impression material or alginate irreversible hydrocolloid impression material
  2. Pour the impressions to obtain the upper and lower casts
  3. Diagnostic mounting or hand articulation is done by occluding the upper and lower casts
  4. Recording of centric occlusion
  5. Mounting it on the articulator
  6. Selection of the anterior teeth
  7. Arrangement of the anterior teeth. In general, there is extra space, and hence arrangement of anterior teeth can be done by keeping spacing or extra teeth can be arranged as per esthetic demand [Figure 3]
  8. Modification of the modeling base plate wax should be done as labial flange in the labial undercut area only. Labial flange should extend from maxillary left premolar to right premolar area on both sides depending on the edentulous situation only. No palatal plate is given as lower teeth are touching to the upper ridge [Figure 4]
  9. Try in of the labial denture
  10. Waxing and carving of the trial dentures
  11. Packing and finishing of the denture are done as for conventional dentures. Denture material used can be either pink color or clear acrylic resin. Denture can be fabricated in heat cure acrylic resin or autopolymerizing cure acrylic resin
  12. Denture insertion
  13. Postinsertion instruction and follow-up regarding insertion, removal and hygiene of the denture.
Figure 3: Arrangement of the anterior teeth

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Figure 4: Interim labial denture without palatal plate

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  Discussion Top


In clinical conditions where premaxilla is labially inclined and accompanying severe labial undercut with deep bite and lower anterior teeth touching to the palate, one cannot make routine cast partial denture having palatal plate for support. Restoration of a partially edentulous arches in such condition is a challenging task for a clinician where a clinician has to give due consideration in fulfilling the necessary requirements of the patient. Such conditions can be rehabilitated by giving unconventional dentures such as labial denture, palate-free denture, wing denture, flange denture, or gum fit denture.

This labial denture will definitely improve esthetics and assist in function. Denture may not contribute greatly to the mastication; however, the masticatory efficiency of the remaining natural teeth is not altered. Since the labial plate is seated in the labial undercut and lies below the upper lip, there is good retention and stability. Furthermore, patient will be comfortable as surgical procedure is not done and labial flange for the denture is given. Denture has only labial flange so called as labial denture or flange dentures. Denture is resting only on the gums and hence can be called as gum fit dentures. Denture is not having palatal plate so called as palate-free dentures. If the labial frenum is very deep, the modification of gum fit denture can be done as wing denture in which the labial flange is relieved in the labial frenum region and it appears as two wings from either side on both sides of the frenum so called as wing denture.[5]

Most of the partially edentulous arches exhibits tipped, rotated, and extruded teeth with less space between the edentulous areas, and remaining natural teeth, which requires extensive knowledgeable planning and fore thought so vital to a successful outcome as it is in the practice of removable partial denture. This article is for the standardization of the procedures for the fabrication of interim labial partial denture.


  Conclusion Top


Although preprosthetic surgery helps in recontouring the ridges to fabricate a prosthesis for esthetics, function, comfort, and health, but still if there are certain limitations, then nonsurgical prosthesis in the form of unconventional dentures can be constructed for patient's esthetics, function, and satisfaction.

Financial support and sponsorship

Nil.

Conflict of interest

There are no conflicts of interest.\

 
  References Top

1.
Zarb G, Bolender C. Pre-prosthetic surgery: Improving the patients denture bearing areas and ridge relation. In: Prosthodontic Treatment for Edentulous Patients. 12th ed. New Delhi: Mosby Elsevier Publication; 2004. p. 100.  Back to cited text no. 1
    
2.
Terry BC, Zarb GA. Report on the 4th international congress on preprosthetic surgery, Palm Springs, USA, 18-20 April, 1991. Int J Oral Maxillofac Surg 1991;20:314-6.  Back to cited text no. 2
    
3.
Lawson WA. Objectives of pre-prosthetic surgery. Br J Oral Surg 1972;10:175-88.  Back to cited text no. 3
    
4.
Hillerup S. Preprosthetic surgery in the elderly. J Prosthet Dent 1994;72:551-8.  Back to cited text no. 4
    
5.
Srivastav V, Singh L, Chopra D, Parashar A, Rathore P. Gum fit denture an alternative to alveoloplasty. J Dent Sci Oral Rehabil 2011;(4):51-2.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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Abstract
Introduction
Steps for Fabric...
Discussion
Conclusion
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