Address for correspondence

Dr. N. KalavathyDepartment of ProsthodonticsDAPM RV Dental CollegeBangaloreEmail: drkalavathy@gmail.com

almost 10 years and the problem (fractured denture) with the

current denture was since a week.

On intra-oral examination revealed an U-shaped palatal vault

and severely resorbed mandibular ridge. The treatment plan

decided for the patient was the fabrication of a hollow

complete mandibular denture.

1. Maxillary and mandibular impression was made

followed by border moulding and final impression with

zinc oxide eugenol impression paste.

Figure 1: Intra oral view of the mandibular arch

Procedure for fabrication

Introduction

Case Report

For more than 150 years, it was believed that the weight of the

lower denture contributes to both retention and stability.

However, studies have shown that retention and stability can

be achieved by improving the fit of the denture bases rather

than addition of extra weight to the dentures and also the

weight of the lower denture may not affect its retention and

stability.

“No step in denture construction should be stopped short of

perfection yet many dentures are worn which have,

imperfections built into them provided they have peripheral

seal sufficient to hold them in place”.

Various studies have shown that both retention and stability

can be achieved even with reduced weight of the denture in

severely resorbed ridges by improving the quality of

impression , thereby achieving a good peripheral seal.

1,2,3,4

A 75-year-old female patient reported to the department of

Prosthodontics, with a chief complaint of fractured lower

denture and desired the replacement of the same.

Her history revealed that, she was an old denture wearer for

Hollow mandibular complete denture - A case report

Case Report

N Kalavathy, M Mitha Shetty, Premnath, Karuna Pawashe, RKV Patel

Department of Prosthodontics, DAPM RV Dental College, BangaloreDepartment of Prosthodontics, Rajiv Gandhi Dental College, Bangalore

SRM University Journal of Dental Sciences Volume 1, Issue 3, October - Decembret 2010

Abstract

The severely atrophied jaw can have various treatment

options. The treatment option involved in this article is

hollowing the denture so as to reduce the weight of the

denture, thereby enhancing stability and retention, reducing

the further resorption of the jaws. This article describes an

alternative method for the fabrication of hollow mandibular

complete denture. It incorporates fabrication of clear,

vacuum form shim ensure that there is adequate room for

resin and teeth.

everely resorbed ridge, shim, hollow

mandibular complete denture

Keywords: S

243

progresses, causing reduced supporting tissue with larger

restorative space between maxillary and mandibular residual

ridges.

In general, a heavy denture whether maxillary or mandibular

is likely to cause poor denture bearing ability. Even though it

is suggested that gravity and the adiitional weight to the

mandibular complete denture may aid in prosthetic retention,

it is not an universally accepted one.

Extensive volume of the denture base material in prosthesis

provided to patients with large maxillofacial defects or severe

residual ridge resorption is always a challenge to

prosthodontists. To increase the retention and stability of

heavy prosthesis, many methods have been tried like utilising

the undercuts , modifying the impression technique, use of

magnets , use of implants , etc.

Apart from this, when we look into the history of bulkier

prosthesis reduction in prosthesis weight also have been tried

by making the denture hollow. Such weight reduction

approaches have been achieved using a solid 3-dimensional

spacer including dental stone, cellophane wrapped asbestos,

silicone putty or modelling clay during the laboratory

procedures which are removed later to provide a hollow

denture base.

There are studies in which it is proved that, by reducing the

weight of the mandibular denture ,either by making a hollow

mandibular denture or by altering the plane of occlusion to

some extent, preservation of the existing residual alveolar

ridge is possible. An added advantage with a hollow

mandibular denture is a comparable increase in retention and

stability that can be achieved, which is problem with the

conventional (heavy) mandibular denture.

Holt , processed a shim of acrylic resin over the residual ridge

and used a spacer .Almost a similar technique with necessary

modifications was followed for the clinical procedure which

is likely to have reduced the weight of the denture by 25% .

The care of severely resorbed ridges is mainly taken care by

broad area coverage within functional limits, decreased

number of teeth, decreased bucco lingual width of the teeth,

improved tooth form, avoidance of inclined planes, provision

for adequate tongue room , adequate interocclusal distance

apart from a hollow denture base.

The advantages of hollow dentures are reduction in the

excessive weight of the acrylic resin, resulting in the lighter

1

3,6-18

3

2. The maxilla-mandibular relationship was recorded

using occlusal rims on permanent denture base and

transferred to the articulator and the artificial teeth were

arranged.

3. Try in procedure was done.

The special steps taken for the fabrication were as follows:

4. The trial denture was duplicated with irreversible

hydrocolloid and poured in dental stone

5. A clear template of the duplicated stone cast was made

using a 0.3” thermoplastic sheet

6. Two split dental flasks with interchangeable counters

were used for processing

7. Trial denture was flasked and dewaxed in the

conventional manner using base 1 and counter 1

8. A wax shim (2 sheet thickness) was adapted over the

ridge lap surfaces of denture teeth (counter 1) and

flasking was done by placing the base 2 over counter1

9. Both the halves were separated without boil out. One

sheet thickness was removed from base 2

10. With the wax shim (one sheet thickness) placed on the

base of the second flask, counter2 was poured

11. Dewaxing and processing of set 2 (base and counter 2)

was done to obtain a heat cured acrylic shim (1mm

thick)

12. Heat cure acrylic shim was positioned accurately over

the permanent denture base using the clear template

fabricated previously on the trial denture inorder to

ensure that there is adequate space between the resin

and the teeth

13. The denture base and acrylic shim were then sealed at

the borders using self cure acrylic resin to make a

hollow denture base

14. The hollow denture base was then immersed in water to

ensure a proper seal

15. The original counter1 was reseated on the base1 and

verified for complete closure of the flask

16. Heat cure acrylic resin was packed and processed in the

conventional manner, finally finished and polished

17. The hollow cavity seal was verified by immersing the

denture in water, if no air bubbles are evident, an

adequate seal is confirmed.

Extreme resorption of the ridge whether maxilla or mandible

will lead to a reduced denture bearing area which in turn will

affect retention, stability and support for the complete

denture. Problems that are likely to be faced may be due to

narrower and more constricted residual ridge as the resorption

Discussion

Hollow mandibular complete denture - A case report N Kalavathy et al

244 Streamdent, 1(3), 2010

Base 2 Counter 1(Removal of 1 sheet thickness wax) (With dewaxed teeth)

Base 2

Base 2 and counter 2 Acrylic shim(Dewaxing of 1 sheet thickness (processed acrylic shim)was followed by processing)

Base 1(occlusal view) Base 1(side view)(Clear acrylic template tried over the acrylic shim)

Base 1(acrylic shim sealed with permanent denture base using self

cure acrylic resin)

prosthesis, decreases the load on the residual alveolar ridge

making the patient comfortable.

Impression of the trial denture Duplicated stone cas

Duplicated stone cast with Clear acrylic templatethermoplastic sheet

Base 1 and counter 1 Base 2 and counter 2

Base 1 with trial denture Base 1 and counter 1(Dewaxing done with

permanent denture base andteeth in place)

Counter 1 Counter 1(Adaptation of 2 sheet thickness wax on dewaxed teeth)

245Streamdent, 1(3), 2010

Hollow mandibular complete denture - A case report N Kalavathy et al

Base 1 and counter 1 (showing the hollow denture in place

with dewaxed teeth)

Final processed hollow denture

Rehabilitation of severely resorbed ridges is a challenge to the

prosthodontist. Even though, the choice of rehabilitation can

be overdentures, implant retained over-dentures, ridge

augmentation, etc, many a times the patients who comes with

such a problem are geriatric patients with many systemic

illness. Hence, the best way is to rehabilitate them with

conventional complete dentures. Apart , from modifying the

impression technique to get maximum denture bearing area,

modifying the type of denture also may be better accepted by

patients. Hence, loose denture weight for healthy and

comfortable living.

1. Michael o'Sullivan, Nancy Hansen, Robert J. Cronin,

David R. Cagna. The hollow maxillary complete

denture: a modified technique. J. Prosthe.Dent. june

2004; 9:591-594.

2. Horst Buckner. Construction of a denture with hollow

Conclusion

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