By: Buhay, Joyce Cruz, Vianca DMD4A

Contents of the Report

Types of denture fractures Causes of denture fractures Problems with repairing fractures Contraindications Repair material Procedure Repairing fractured teeth

Types of Denture Fracture

Midline fractures Fracture or chipping of a portion of the denture Complex fractures (more than two pieces) Cracks in the denture Fracture or dislodgement of one or more teeth

Causes of Fracture

Accidental dropping during removal or cleaning Inability to handle dentures due to poor neuromuscular control Faulty denture design resulting in areas of inadequate thickness Prominent median palatine raphe with inadequate thickness

Faulty occlusion Excessive amounts of masticatory force applied by some patients Poor laboratory techniques

Problems with repairing fractures

May not fit well after repairs Occlusal changes can occur

Contraindications
The broken pieces cannot be assembled accurately When the dentures need to be replaced anyway due to poor fit or occlusal wear or any other reason

Repair Material
Self- curing or autopolyerizing resin (not as strong as heat cured) Visible light activated resin (VLC Triad)

y Easy to use, can be carved, cures quickly

and does not cause any warpage or distortion.

Procedure
Assembling the segments Pouring the cast Preparing the fracture site Repairing and curing

Assembling the segments

The fracture site is cleaned well of any debris The pieces are assembled accurately and stabilized with an old bur and sticky wax. Quick setting cyanoacrylate glue (super glue) may also be used to hold the pieces together Wax should not be placed over the fracture site The accuracy of the assembly is carefully verified by visual inspection

Pouring the cast

Undercuts in the denture are carefully blocked out Plaster is poured into the denture to make a cast

Preparing the fracture site

The denture is separated from the cast and 2 to 3 mm acrylic is removed from the fracture site A wide bevel is created on either side of the fracture line After applying separating medium, the denture is replaced back on the cast

Repairing and Curing

Autopolymerizing acrylic powder and liquid is applied alternatively in increments till the fracture site is filled to excess Curing is completed by placing it in a pressure pot containing water at 100 degrees F under pressure of around 30 psi for about 30 minutes. Curing under pressure helps to increase the density and strength of the acrylic

The denture should not be removed from the cast while curing After curing the denture is removed, trimmed and polished

Metal Strengtheners

Indicated for patients who exert great amount of force during mastication often leading to fracture. May be made of metals like steel, gold, aluminum etc. Chromium cobalt commonly used due to lightweight, less expensive compared to gold Other includes the use of high impact strength resins or fibre reinforced dentuers.

A strengthener is placeed entirely within the structure of the acrylic resin base (except in the region of the stops)

Repairing Fractured Teeth

Fractured tooth must be carefully removed using burs Removal must be as far as possible the labial ridge-lap area New tooth is selected Small amount of acrylic is placed inside the tooth bed and the tooth carefully position into, there should be no spills on the labial side

a plaster index may also be used to position teeth The tooth is waxed into position, after which the plaster index is made. The tooth is removed and the wax eliminated with hot water. The index is coated with separating media and the tooth is position with the help of the indes

Autopolymerizing acrylic is applied to the site using the: Brush technique

y the powder is picked up using a brush

moistened with monomer

sprinkle on technique
y The powder and monomer is sprinkled

alternatively

After setting it is cured in a pressure chamber and followed by trimming and finishing Porcelain teeth are removed by trimming from the lingual side Repair using light cured resin (Triad VLC) is preferable whenever available as it is easy to carve.

Happy New Year!