CLEAR CLONE CONCEPT DENTURE - part 3
Enter the Clear Clone Denture Technique (part 3) Clinical Technique
You have the C3 dentures back from Drake.
Time to get impressions and jaw relation records.
Be sure to have the following:
- Heavy body fast set PVS (I use Kettenbach Panasil)
- Light body REGULAR SET (I use Kettenbach Panasil)
- PVS adhesive (use same brand as impression material)
- Acrylic Burs
- Disposable brush
- Perio Probe
It’s a good idea to try the C3s in the mouth. Make sure they do not impinge on any tissues. Its easy to look through the clear acrylic and see if there are any heavy pressure points. Additionally, make sure the occlusion is reasonably stable between the C3 and whatever it opposes. You don’t need perfect occlusion with 22 stops. Just a handful of contacts that are stable and the C3 is not rocking about. Adjust occlusion if needed.
Note the pressure points on the mandibular along the premolar border areas. It’s a good idea to relieve these with your acrylic bur.
Check border extensions. If you desire to extend borders, now is the time. Use heavy body fast set in 2 or 3 increments to capture new borders. BE SURE TO APPLY ADHESIVE TO THE BORDERS and onto the intaglio. (see the blue adhesive in the photo)
This border molding was done in two steps. The posterior palatal seal and tuberosities and partway toward the peripheral frenula on each side are first. Be sure to have the patient go through all the oral calisthenics that we discussed a few Blog entries back. Open wide, try to blow air through your nose while I pinch your nostrils, and the ever popular “suck on my finger”. Typically, I also place a small dollop onto the rugae area to further refine a stop to avoid overseating the tray.
Remove the C3 after border molding and inspect. You can add additional material if you fail to capture adequate borders. You can also cut back with the acrylic bur if you have impingements/bleedthroughs.
PLEASE REMEMBER, this is a CLOSED BITE impression.
Even when doing border molding, place the opposing C3 and have the patient close into full occlusion during the impression procedures. It is really easy to lose jaw to jaw relationship during impressions. This is particularly true if too much material is placed during wash procedure.
Once borders are satisfactory, Its time to do a wash impression. From this point, you can use the same technique we discussed previously when doing a denture reline. You will use a thin wash of regular set PVS over the entire intaglio surface, have the opposing appliance already in place and gently but deliberately place the wash laden C3 into the mouth. Have the patient gently close into maximum intercuspation (it should be the same as you confirmed with just the C3 in place). Once in place, gently border mold and do all the border molding tricks you have up your sleeve. (pinch nose and have patient blow, purse lips, “suck on my finger” etc)
Now repeat these procedures on the opposing arch.
When finished, take a final bite registration and facebow. This will give the lab all necessary information. Be sure to write a thorough prescription and provide specific details of any changes desired that are different than the C3.
If midline is off, its easy to score the new midline on the C3 and darken it with a Sharpie Marker. Be sure to take a photograph.
I find the C3 a very handy tool for a variety of edentulous patient based treatment. If you learn this technique, it can create a very efficient workflow for your cases, be them traditional dentures or full mouth implant restorations.