MULTI -CUP DENTURES ARE SO GOOD AND SO COOL

MULTI -CUP DENTURES ARE SO GOOD AND SO COOL

1. RESTORATION OF SEVERELY RESORBED RIDGES USING MULTI-CUP DENTURES A JOURNAL CLUB PRESENTATION GUIDED BY: Dr.M.BHARATHI PROFESSOR AND HEAD OF THE DEPARTMENT DEPARTMENT OF PROSTHODONTICS AND CROWN AND BRIDGE PRESENTED BY: Dr.G.S.V RAJA SAMEERA (I MDS) 1

2. CONTENTS: INTODUCTION. CASE REPORT 1. CASE REPORT 2. CONCLUSION. REFERENCES. 2

3. INTRODUCTION Dr Arthur C Jermyn, originally from Rochester, New York, resurrected the idea of suction cup-retained dentures with research that began in 1952. By 1963, after experimenting with many polymer materials and suction cup designs, he finalized his technique. He settled on a high molecular weight dimethylpolysilane because of its physical properties, ease of handling and survivability. This material, coupled with Dr Jermyn’s unique suction cup design, has been used for decades to produce dentures with significantly enhanced retention and stability. 3

4. CASE REPORT 1 A 35-year-old female patient was reported to the department, for replacement of her unsatisfied complete dentures with history of extraction of her teeth due to periodontal problems 6 years back. Her intraoral examination revealed severely resorbed maxilla and mandible. Also, because of her fear and low economic condition she was unwilling to undergo surgical intervention to facilitate prosthesis retention. So considering these facts, maxillary and mandibular multicup dentures were planned. Severely resorbed maxilla and mandible 4

5. PROCEDURE Impressions of maxillary and mandibular edentulous arches were made using irreversible hydrocolloid impression material. Border molding, final impression and jaw relations procedures were carried out and the denture try-in done. The maxillary and mandibular trial dentures were waxed up, flasked and dewaxed. The heat cure acrylic resin was packed and after curing process, the flasks were deflasked ; the dentures were remounted, finished and polished. Precise holes were prepared in the duplicated master cast using cup-shaped stainless steel bur and straight hand piece. The holes were 2 mm in diameter, approximately 1 mm deep, and had walls with a 12.5° taper. They were spaced 1 to 1.5 mm apart, and prepared perpendicular to the palatal and ridge surfaces. They were not prepared over frenum attachments or within 2 mm of the denture borders. 5

6. Precise holes prepared on master cast Stainless steel bur 6

7. The permanent soft liners were then added to processed complete dentures by creating space for the material in the base prior to making reline impressions. The liner space was prepared 2 mm short of all denture borders with 90° butt joint margins and 1 to 2 mm deep. Multicup maxillary and mandibular complete dentures were inserted. Follow-up was done at 1 day, 1 week, 2 weeks and 1 month intervals. The basal tissues of the patient showed expected shallow imprints of the suction cups but no signs of inflammation. Denture cleanser, which is not strong and do not cause breakdown of delicate suction cups, was recommended. The patient was more satisfied, comfortable and happy with the new dentures. 7

8. Holes prepared with 12.5° taper Happy and satisfied patent 8

9. DISCUSSION The multicup denture liner was used to enhance retention, stability and comfort for complete denture wearers, particularly for those with significant resorption of their alveolar ridges. A large number of small suction cups formed from a soft permanent soft liner serve to grip the oral tissues without causing any pathosis. The tissues tend to assume the negative form of these cups, but they return to normal when the dentures are removed. The tissues appear normally moist, pink, and healthy. The multicup denture liner offered a viable alternative to enhance denture retention when patient desired and was unwilling for other treatment modalities. 9

10. CASE REPORT 2 A 46-yearold female patient with a history of multiple failed attempts at implant treatment in her maxilla,reported to the department of Prosthodontics. 14 implants had been removed, with the remaining ones not fully integrated and in unfavourable positions for restoration. The patient was left with a severely resorbed maxilla. The lower arch, however, was reasonably well aligned and dentate. An attempt at a conventional upper complete denture was not successful due to poor retention and stability. Further surgery, including supplementary grafting and implant placement, was considered but ultimately rejected due to the high risk of failure. Therefore, it was decided to attempt the use of a multiple suction cup denture to improve retention and stability 10

11. Drilling of trephine holes into master cast Sealed down primary base Acrylic teeth in opposing half of flask following wax elimination Master cast following the boiling out procedure 11

12. Application of wax spacer Acrylic resin dough packed over the teeth Adhesive being applied Molloplast B being placed over the trephine holes on the master cast 12

13. Close-up of intaglio surface showing tiny suction cups Finished denture Patient wearing finished denture 13

14. DISCUSSION This case describes the management of a patient who presented with multiple failed implants. In the presented case, the patient had experienced failure of all the implants placed into her maxilla. The use of a suction cup to aid retention is a well-known physical principle. The flexible suction cup is applied to a surface, forcing the air inside the suction cup to be expelled. When the user stops applying a force to the suction cup the elastic properties of the material cause it to return to its original shape. This increases the volume, lowering the pressure inside the suction cup, compared to atmospheric pressure. It is this pressure differential which creates the retention. 14

15. CONCLUSION There have been times when the most logical solutions to the most difficult clinical problems have come from the distant past rather than the cutting edge of dental technology. Multi-cup dentures are a type of removable denture that uses multiple cups or compartments to hold the denture in place. It's essential to consult with a dentist or prosthodontist to determine if multi-cup dentures are the best option for your specific needs. 15

16. REFERENCES Chandrakala V, Nandeeshwar DB. Restoration of the Severely Resorbed Maxilla and Mandible using the Multicup Denture. 10.5005/jp-journals-10015-1111. R. Vasant and G. S. Bassi. Use of the multi-cup denture for a severely resorbed maxilla: a clinical report. BRITISH DENTAL JOURNAL VOLUME 212 NO. 9 MAY 12 2012. Robert L. Engelmeier , DMD, MS, Maria L. Gonzalez, DDS, MS, & Maribel Harb , DDS, MS. Restoration of the Severely Compromised Maxilla Using the Multi-Cup Denture. June 29, 2006. doi : 10.1111/j.1532-849X.2007.00241.x. 16

17. THANK YOU 17