Guide+to+Complete+Dentures

1) Preliminary Impressions ** __– clinic appointment- can use diagnostic casts__ **

2) Outline of custom trays should be 1-2 mm short of vestibular depth on final impressions – **__do this before clinical appointment__**
 * Posterior border cross fovea palatinae
 * Block out wax (Aluwax)
 * Labial anteriors
 * Lateral tuberosities
 * Rugae
 * mid palatal suture line
 * Mandibular undercuts
 * Labial anteriors
 * Retromylohyoid undercut
 * Immediate dentures – block out teeth with pink wax and make custom trays over teeth

2) Make tissue stops – **__clinic appointment__**
 * Trim tissue stops after out of mouth
 * Border mold à trim 1-2 mm to prevent air entrapment
 * Impression ready
 * Apply Adhesive layer
 * Impression
 * VPS (5 min) – Vinyl polysiloxane
 * RBI (8-10 mins) – Polysulfide
 * 50/50 mounting stone and pumice- make putty (VASELINE) à green stone
 * OR use Alginate and no Vaseline is needed
 * Trim land areas to 3-4 mm width beyond the periphery of the impression
 * Trim base to 10 mm thickness at its thinnest area

3) Make wax rims –**__Do this prior to appointment__**
 * Maxillary Wax Rim: 18-19 mm from depth of labial frenum notch to rim; 14-15 mm from flange to rim at 1st molar
 * MN Wax Rim: posteriorly 2/3rds the height of retromolar pad; 14-15 mm from labial frenum notch to rim
 * Immediate dentures- just make wax rims the height of existing teeth or use as base-guideline.
 * Make wax rims in between existing teeth

3) Try in wax rims –**__Clinic appointment__**
 * Try-in wax rims in patient’s mouth
 * Adjust contours of wax rims
 * Determine occlusal plane
 * Determine vertical dimension of occlusion
 * Make a facebow transfer
 * Make bite registration in centric relation
 * Pick out patients teeth size, shape, and shade
 * __ Send to lab – 5 day turn around __

4) Esthetics with teeth in wax- **__Clinic appointment__**
 * Check occlusion/ fit
 * Adjust teeth in wax if needed
 * Check esthetics with patient
 * Get patient to sign esthetics consent (pros consent)
 * __ Send to lab- 6 day turn around __

5) Final delivery –**__clinic appointment__**
 * Adjust occlusion
 * Chair side (make sure u mount on articulator before this appointment or you will have to adjust all intraorally)
 * Immediate (adjust post extractions intraorally- the more you adjust here- the

Courtesy of Luke Carubia

//For a more in depth step by step guide with pictures download this PDF from Nikita//