Clinical Case Report On The Effect Of Shellac Plate Reserved Space And Silicone Rubber Pad For The Restoration Of Complete Denture With Mandibular Alveolar Ridge Resorption

Objective: To observe the clinical effect of shellac plate reserved space silicone rubber pad to improve the restoration of complete denture with mandibular alveolar ridge resorption,to provide a reference for clinical use of soft rebasing material for improving the restoration effect.Methods: To select 24 patients that complete denture or mandibular complete denture need restoration in prosthodontic department of Dalian medical university affiliated dental hospital from November 2014 to December 2016.There were 11 males and 13 females,aged from 53 to 89 years old,the average age is 73 years old.Inclusion criteria:(1)Mandibular alveolar ridge resorption is low or like knife edge;(2)The alveolar ridge of the mandible have undercut or bony;(3)Oral mucosa is thin,no flexibility,easy to cause tenderness;(4)because of age,general condition and other reasons are not suitable for surgery;(5)No systemic diseases and insanity.After the informed consent of patients and signed a letter consent,with effective and ineffective two indicators to judge the clinical effect.Making edentulous impression by the method of conventional red paste individual tray,and perfusion plaster model.And then making conventional maxillary metal palatal plate and wax base,making production of metal plate and the maxillary palatal wax base,mandibular metal grid,it leaving alveolar ridge mucosa 2 ~ 3mm,and make 4 elliptic and cylindrical metal register pin on both sides posterior and cuspid area(or anterior teeth)in order to control the rebasing material thickness and accurate reposition.Make temporary base with double base plate,the edge of denture base end at 1~1.5mm upon the mucosal fold,the metal grid with heating is pressed into the temporary base and make it in place,cover the surface with red wax sheet.Making wax rim,?jaw relation record?tooth arrangement?wax pattern try-in?glue filling and polishing by using conventional methods,but retain the shellac plate.After complete denture wear and occlusal adjustment evenly,removing the shellac plate,and using a set of silicone rubber coupling agent coated on the base tissue surface,and filling the tissue surface with the silicone rubber,then put the denture into the patient's mouth,adjusting the position of the upper and lower dentition at central occlusion relation,asking patient to bite,meanwhile doing muscle trimming.After the silicone rubber freezing,trimming the surplus silicone rubber with knife,and then polishing the edge of silicone rubber by professional tools of polishing silicone rubber.The patients were followed up for 3 to 25 months,and the prosthesis condition and clinical effect were evaluated.Results: After 24 patients used the method of shellac plate reserved space and silicone rubber pad,followed up for 3 to 25 months,22 cases had good effect,effective rate was 91.7%.The denture was not easy to drop when eating and talking,good mastication force,no pain or other discomfort,good retention and stability,the mucosa had no swelling or ulcer,there was not denudation phenomenon between the silicone rubber edge and the base plate.2 cases had poor effect,one patient had foreign body sensation?poor retention?masticatory function was general,the denture retention became better after relining.The other patient felt pain and discomfort,the masticatory function of this patient was poor at one side of posterior teeth,and this side mucosa which corresponding to metal locating pin had turned white?slight ulcer,the occlusal contours of artificial teeth was too shallow,these symptoms relief after local buffer and trimming occlusal contours.24 cases of patients had used the complete denture for 3 to 25 months,no cases of rebasing material and base plate were separated.Conclusion:1.The use of silicone rubber pad for shellac plate reserved space is easy to achieve thickness uniformity of soft rebasing material,reduce the pain,increase the degree of comfort,obviously improve the restoration effect of complete denture with mandibular alveolar ridge resorption.2.The method of shellac plate reserved space can increase the adhesion between the rebasing material and the base plate,prolong the service life.