Hollow Denture & Artificial Saliva:Prosthodontic Management of Xerostomia & Resorbed Ridges - A Case Report

Introduction

Resorbed Ridges as well as Xerostomia are common clinical cases found.

The weight of a denture is often a dislodging factor . Hence, a light weight denture with salivary substitutes is required for better retention in such situations.

What is Xerostomia & Resorbed Ridge

Xerostomia is defined as dryness of the mouth due to the lack of normal secretion of saliva.

Resorbed Ridge is defined as the the diminished quality and quantity of bone that remains after the removal of the teeth.

O/E Decreased Salivary Flow Resorbed Mandibular

Ridge High Palatal Vault

Maxillary Ridge Increased inter-arch space Systemic Findings-

Nothing Relevant Reported

Steps in Fabrication of Hollow Denture with Salivary reservoir

Preliminary Impression

Final Impression Jaw Relation Wax Try In & Speech

Evaluation Insertion

Up to tryin routine Lab steps Palatal Index Formation Processing of maxillary denture Adaptation of sheet on palatal

index , flasking and processing in clear heat- polymerized resin

Palatal Window Creation Adaptation of soft liner on the

palatal window and processing Attachment of floor of the

reservoir to the palatal surface using auto polymerising resin

Drilling of hole in the reservoir

Clinical Steps Laboratory Steps

Maxillary & Mandibular Final Impression

Wax Try-In

Palatal Wax Up After Speech Evaluation

Measuring Depth Of reservoir

using endodontic file

Flasking and Fabrication Of Palatal Stone Index

Fabrication Of Roof of the Reservoir

Wax Spacer Adapted To Create Palatal window

Roof Of reservoir with Palatal Window

Roof Of Reservoir with resilient soft liner

Finished & polished denture with lid of reservoir attached using

auto-polymerizing resin.

FABRICATION OF HOLLOW DENTURE

LOWER TRIAL DENTURE FLASKEDINTERCHANGEAABLE FLASK

After Dewaxing

Wax up – adding one layer thickness of the wax over the cast & mold

POST FLASKING AND DEWAXING OF TEETH CONTAINING MOLD

POST FLASKING AND DEWAXING OF FLASK CONTAINING MASTER CAST USING INTERCHANGEABLE FLASKS

Processed – lower denture part containing teeth and denture base

mandibular hollow denture attaching two parts using auto -polymerising acrylic resin

Hollow Denture Floating in water

Injecting Artificial Saliva In the Reservoir

Artificial Saliva Coming out of the hole when applying pressure

Patient Instructions & Recall Visits

Demonstrate to the patient how to inject saliva substitute through the hole in both Maxillary and mandibular reservoir

by using a 5 Ml disposable syringe and needle. Provide a treatment record card and ask the patient to note

every time the reservoir is filled, the quantity of substitute, and the time till the reservoir is empty.

Patient is instructed to clean the denture using 2% sodium hypochlorite

Make a 24 hr. first recall appointment Make a 1-week recall appointment. After 1 week, evaluate the record and

calculate the average duration of flow. The duration of flow provided by artificial

saliva reservoirs should range from 2 to 5 hours.

Increase or reduce the size of the hole to adjust the flow rate.

Discussion Control Mechanism Speech Evaluation

DISADVANTAGES &LIMITATIONS Time Limit Patient Selection Regular Maintainance

CONCLUSION Functional Reservoir Ease and simplicity Cost effectivness

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