Clinical Case Report Of Restoring Maxillary Complete Denture By Using Red Wax Making The Functional Post Dam Area

Objective:The clinical effect observation of improving maxillary complete denture retention through making the functional post dam area by using red wax,to discuss the method of improving maxillary complete denture retention with palatal muscles functional movement,and to provide reference for improving the clinical success rate of restoration.Methods : Choosing 20 patients(male11,female9,age52 ~ 85)in prosthodontic department of Dalian medical university affiliated dental hospital from 2014.11 to 2016.11,including 14 cases of complete denture,6 cases of maxillary single complete denture,all patients were conformed to the standard of cases.According to the form of the soft palate,cases were divided into three types: vertical type 5 cases,intermediate type 8 cases,horizontal type 7cases.The basic flow:(1)regular oral treatment before check and restoration,for patients with restoration again,we will analyze the reason of failure and avoid the same problem;(2)making individual tray by using red paste impression;(3)making final impression;(4)making the functional post dam area: making the similar shape “M” as regular form of the post dam area,and formation a slope which thinning from back to front by wax knife trimming,then fixed the “M” wax on the post dam area with fused wax.Heating the wax sheet on the impression slowly and evenly with alcohol lamp or hair dryer,after most wax surface getting soft,placed it in the mouth and ask patients pronouncing "yi" or "ah",keep for10~15 seconds(red wax from soft to hard).Putting small amount of thin alginate impression material evenly on the "M" shape wax surface,and place it in the mouth again,at last finishing the functional post dam area impression after solidification;(5)perfusion plaster model;(6)finishing jaw relation record?teeth arrangement?try-in?occlusal adjustment and polishing.The clinical effect evaluate was base on the patient satisfaction questionnaire with satisfaction?general?poor.Satisfaction:when patient speak loudly or gargle,the denture don't drop,has no pronunciation disorder?foreign body sensation?nausea?pain and discomfort,mucous membrane of the post dam area has no swelling or ulcer.General: General pronunciation is normal,but some pronunciation was influenced.After wear a slightly longer time,the patient have swallowing discomfort,mucous membrane of the post dam area have mild redness,but no ulcer;Poor: When patient eating,talking,gargling,the denture is easy to drop,there is a clear pronunciation disorder? speech slurred? foreign body sensation?nausea? pain and discomfort,mucous membrane of the post dam area have obvious redness and ulcer.Evaluating the clinical effect after 3~6 months.Result: Making the functional post dam area by using red wax for 20 patients.19 patients were satisfied with the restoration effect,the denture don't drop when patient speaking loudly?gargling?largely opening his mouse or chewing,1 patient with vertical soft palate can use denture chewing or largely opening his mouse,but the denture drop occasionally when he speaking loudly or gargling.the satisfaction is 95%;one patient feel his voice is not clear enough,the satisfaction of pronunciation recovery is 95% with retention and stabilization;1 patient's pronunciation is not clear,the satisfaction of voice is 95%;3 patients feel foreign body sensation,the satisfaction of comfort is 85%,the comprehensive satisfaction is 91.25%.One of 7 patients with horizontal type soft palate have red and swollen and pain at local mucosa,obviously foreign body sensation?pronunciation is influenced mildly,the satisfaction is 85.7%.;one of 5 patients with vertical soft palate have ulcer and dysphagia,obviously foreign body sensation,1 patient's denture has no good retention,and feel mild foreign body sensation,the satisfaction is 60%;the denture retention of 8 patients with intermediate type soft palate is good,the mucosa of post dam area were no red,ulcer and other discomfort,the success rate is 100%,the comprehensive effective rate was 85%.In patient satisfaction survey case,the observation indexes have the overlap phenomenon,3 patients required dealing with,one patient with horizontal soft palate and one patient with vertical type need polishing the post dam area one time to remove the discomfort,the denture retention of the other patient with vertical type palate restore normal after using the same method reworking the denture.By clinical observation and visit for 3 ~ 6 months,20 patients were satisfied with restoration effect.Conclusion:1.The method of making the functional post dam area by using red wax can effectively improve the retention force of maxillary denture when the palatal muscles in functional exercise.2.The form of post dam area with different soft palate is different in width and depth.Vertical type soft palate is more difficult to control in accuracy than other types when making the functional post dam area.