I N C O M P L E T E D E N T U R E

REMOUNTING

Introduction

Laboratory remounting

Clinical remounting

Remounting

It is the procedure by which the processed dentures are returned to their previous mounting on the articulator

to correct occlusal errors resulting from the various steps during denture construction.

There are 2 types of remounting :

Laboratory remounting

• Performed after deflasking before the dentures are handed to the patient

Clinical remounting

• Done on new recordings from the patient and new mounting

Importance of remounting

If remounting is skipped, dentures will:

Deform underlying tissues

Destruct supporting bone

Discomfort the patient

The occlusal errors can be concealed and cannot be easily located and corrected at a later stage

1.Laboratory remounting

It is the procedure by which the processed dentures are returned back to their previous mounting on the articulator to correct the occlusal errors resulting from laboratory procedures during processing.

N.B

Advantages of laboratory remount :

1. Errors in the processed denture are easily spotted on the articulator rather than in patient’s mouth.

2. Correcting occlusal errors before denture insertion provides the patient with comfort and psychological

confidence.

3. Selective grinding is performed to remove only premature occlusal contacts, thus restoring occlusal vertical dimension and centric occlusion

2-Clinical remounting

Clinical remounting is a procedure where by occlusal adjustment is carried-out on the articulator after remounting the dentures with new records obtained from the patient.

These records are :

1.Facebow record.

2.Remount record index to mount the maxillary denture on the articulator

3.Centric relation record to mount the mandibular denture

Steps of clinical remounting

1.Preparation of remount record index. 2. Preparation of remount cast(new cast). 3. Orientation of maxillary cast on the articulator (facebow or remount record index). 4.Centric interocclusal record. 5.Mounting the mandibular cast . 6. Selective grinding.

1.Preparation of remount record index.

It is occlusal registration of the maxillary denture which is recorded on a remount jig attached to the lower member of the articulator to preserve the original facebow mounting record.

Its done before flasking of the denture or after laboratory remount

2. Preparation of remount casts

Master cast is destroyed during removal of the processed denture during de-flasking, so new remounting casts are fabricated after finishing and polishing of the denture

3. Orientation of maxillary cast to the articulator

Made either by :

- Facebow record ( after finished denture)

- Remount record (before flasking)

3. Orientation of maxillary cast to the articulator

4. Centric interocclusal record

Mandibular denture is oriented to the maxillary denture by a centric interocclusal record taken from the patient.(ALU wax)

5.Mounting the mandibular cast

6. Selective grinding

It is the modification of the occlusal and incisal surface of the teeth by grinding at selected positions by spots made by articulating paper.

N.B:

Selective grinding should be done also intraorally after being done on articulator

6. Selective grinding

Methods of detecting occlusal errors:

1.articulating paper

2.Wax occluding template

6. Selective grinding

Correction of occlusal errors:

Correction centric position

Correction in eccentric position

1. working side

2. non working side

3. Correction in protrusive position

6. Selective grinding

General rule: Functional cusps should not be altered (palatal cusps of maxillary denture and buccal cusps of mandibular denture) If the functional cusps are indicated for modification, the

opposing fossae should be modified or the opposing cusp incline is ground.

Functional cusp height should never altered: 1. To maintain the vertical dimension 2. To maintain the functional efficiency

Errors in centric position

1- Opposing teeth can be too long and hold other teeth out of contact

Correction:

Deepening of the fossae

6. Selective grinding

Errors in centric position

2- Upper and lower teeth can be too nearly end to end. Correction: 1.Cusp inclines are ground. 2.Central fossae become broader by grinding : …Buccal inclines of the lower lingual cusp …Palatal inclines of the upper buccal cusp 3 The cusps are not reduced

6. Selective grinding

Errors in centric position

3- Upper teeth can be too far buccal in relation to lower teeth

6. Selective grinding

Errors in working side:

Errors in working side:

Errors in working side:

Errors in working side

Errors in balancing side

Errors in balancing side

Error in protrusive

Extra-oral selective grinding is more preferable than intraoralselective grinding for the following reasons:

1.Presence of compressible tissue under the denture, that may move with the denture especially in flabby ridge and very resorbed ridges, while in extra-oral selective grinding the dentures are on hard bases (casts). 2. The bad psychological impact on the patient as he will see his teeth ground in front of him in intra-oral selective grinding. 3. Eliminates continuous removal and replacement of denture 4. Lateral excursion (right and left) and protrusive movements are difficult . 5. More accurate markings (NO SALIVA)

Advantages of Remounting

1. Occlusal correction is done on the articulator rather than inside the patient mouth thus reducing patient participation and gives better psychological reaction. 2. The articulator provide stable rather than resilient soft tissue foundation. 3. More accurate articulating paper markings are exposed due to the absence of the saliva. 4. It is easier to see, spot and correct errors on the articulator rather than in the patient mouth.