Complete Denture Techniques for the 21st Century

Washington State Dental Association's2010 Pacific Northwest Dental Conference

Presents

Complete Denture Techniques for the 21st Century Improving George Washington’s Wooden Teeth

M. Nader Sharifi, DDS, MS

Friday, June 18, 2010

12:30 p.m. - 3:30 p.m.

Official DisclaimerNeither the content of a program nor the use of specific products in courses should be

construed as indicating endorsement or approval by thePacific Northwest Dental Conference orWashington State Dental Association

Improving George Washington’s Wooden Teeth:Complete Denture Techniques for the 21st Century

M. Nader Sharifi, D.D.S., M.S.Pacific Northwest Dental ConferenceWashington State Dental Association

Seattle, WA Friday June 18, 2010

2009 M. Nader Sharifi, D.D.S., M.S. Page 1

About Your Speaker:

M. Nader Sharifi, D.D.S., M.S. holds a certificate in prosthodontics and amasters degree in biomaterials from Northwestern University. He receivedhis dental education at the University of Illinois. He has presentednumerous topics on implant dentistry since his graduation. Hispresentations on restorative dentistry and patient care have earned himrecognition from esteemed study groups, societies and associationsnationwide. Dr. Sharifi is a former assistant professor at NorthwesternUniversity and former on-call consultant for Nobel Biocare.

Dr. Sharifi currently maintains a full-time private practice of adult generaldentistry in Chicago’s downtown loop. As a five day a week wet gloveddentist, he is interested in ensuring time saving and cost effective care. In1996 he was named to the American Dental Associations Speakers Bureauand in 2007 Chicago Dental Society honored him with the GordonChristenson Distinguished Lecturer Award.

If you would like, you can reach Dr. Sharifi easiest via the internet. Pleasefeel free to direct any questions or comments at any time to his Emailaddress at MNSDDSMS @ AOL.com.


Removable Prosthodontic ClassificationM. Nader Sharifi, D.D.S., M.S.

I. Completely Edentulous: McGarry, et al.: J Prosthodontics 1999; 8:27-39.A. Class I

1. Mandibular bone measures 21 mm or more at thesmallest measurement on a panorex radiograph.

2. Angle Class I jaw classification.3. Well shaped arch form (U shaped)4. High, well rounded ridges. Changes are Underlined

B. Class II1. Mandibular bone measures 16 - 20 mm at the smallest

measurement on a panorex radiograph.2. Angle Class I jaw classification.3. Well shaped arch form (U shaped)4. High or low, well rounded ridges.5. Muscles that have limited influence on stability.6. Mild systemic or psychological modifiers.

C. Class III1. Mandibular bone measures 11 - 15 mm at the smallest

measurement on a panorex radiograph.2. Angle Class I, II or III jaw classification.3. Challenged arch form (V or Square shaped).4. Low, well rounded ridges or basal bone.5. Muscles that compromise stability.6. Moderate systemic or psychological modifiers.7. TMD, xerostomia, or hyperglossitis.

D. Class IV1. Mandibular bone measures less than 10 mm at the

smallest measurement on a panorex radiograph.2. Angle Class I, II or III jaw classification.3. Challenged arch form (O shaped).4. Ridges resorbed to basal bone.5. Muscles that compromise stability.6. Moderate systemic or psychological modifiers.7. Hyperactive gag reflex.8. Maxillary-mandibular incoordination (Parkinson’s)9. Refractory patient (unrealistic expectations).


M. Nader Sharifi, DDS, MS • 30 North Michigan • Suite 1303 • Chicago, IL 60602 • 312-236-1576

Patient Name Social Security Number Date

Prosthetic Findings

Maxillary Arch: U Shaped V Shaped O Shaped Square Shaped

Ridges: High Low Post-extraction Knife-edged Basal bone

Hard Palate: Deep Shallow Medium Soft Palate Class

Tuberosities (R) (L) Torus Attached Mucosa %

Frenum: Anterior (R) (L) Teeth

Mandibular Arch: U Shaped V Shaped O Shaped Square Shaped

Ridges: High Low Post-extraction Knife-edged Basal bone

Lateral Throat Form Class Torus Attached Mucosa %

Buccal Shelf: Large Medium Small

Frenum: Anterior (R) (L) Teeth

Tongue: Position Movement

Saliva Consistency Amount

Jaw Classification: Class I Class II Class III

Existing Prosthesis:Pt.’s Opinion:

Retention: Good Adequate PoorStability: Good Adequate PoorSupport: Good Adequate PoorEsthetics: Good Adequate PoorPhonetics: Good Adequate PoorOcclusion: Good Adequate Poor

Facial Shape: Square Square-tapering Ovoid Triangular Round

Profile: Flat Rounded Inverted

Coloring: Hair Eyes Complexion


Course Outline:I. What we will need to know at the end of the day:

A. The Big Three: Retention, Support and Stability – Stability is KeyB. Next Two: Esthetics and PhoneticsC. Main One: Occlusion – Excellent Occlusion overcomes poor borders.

II. Occlusal Design – This is the difference maker.A. Neurocentric Flat Plane Occlusion

1. Flat Plane Teeth Throughout Mouth.2. Indications – Very poor bone, poor muscle control3. Controlled in Set-up on the Articulator.

a) Mandibular incisors, cuspids, premolars and molars are allon same plane.

b) Maxillary posterior teeth are set to have appropriate contactand overjet.

c) Anterior open bite, can have overjet, NO overbite.B. Balanced Occlusion

1. Bilateral Working and Balancing Side Contacts2. Cusp Form Teeth Throughout Mouth3. Indications – Esthetics and Chewing Efficiency4. Controlled in Set-up on the Articulator.

a) Maxillary incisors, cuspids, premolars and first molar mesialcusps all on same plane.

b) Cusps then rise to shallow Curve of Spee.c) All mandibular teeth interdigitate tightly.d) Anterior open bite, can have overjet and overbite.

C. Lingualized Occlusion1. Bilateral Working and Balancing Side Contacts2. Cusp Form Teeth in Maxilla, Flatter Plane in Mandible3. Indications – Esthetics with poor bone remaining or One arch is

natural, the other removable partial or complete.4. Controlled in Set-up on the Articulator.

a) Maxillary incisors, cuspids, premolars and first molar mesialcusps all on same plane.

b) Cusps then rise to shallow Curve of Spee.c) Mandibular posterior teeth have central groove contact to

palatal cusps of the maxilla.d) No posterior contact of maxillary buccal cusps.e) Anterior open bite. If lowers are 0° – no overbite.

5. Lingualized Options – Ivoclar OrthoLingual; Myerson LingualIntegration; Vita Physiodens; Dentsply 33°/22°; 22°/10° or 10°/0°

III. Delivery of Occlusion:


A. Centric Occlusion – Again, this is the difference maker.1. Use Occlusal Indicator Wax to eliminate prematurities.

a) Tap, tap, tap, and squeeze with 80% pressure.b) Adjust Central Groove of Lower Archc) Prosthesis - equal retention with and without wax

2. If set up is lingualized occlusion, eliminate buccal contacts.B. Eccentric Occlusion – Use horseshoe blue/blue articulating paper to

eliminate interferences, then red/black to remove eccentric disclusions.1. Lingualized – blue/blue first, red/black second

a) Blue/Blue slide side-to-side: Adjust buccal interferences onpremolars on the lower and molars on the upper denture

b) Without Paper: Watch and ask patient where “hitches” occurc) Red to Upper, slide side-to-side; Black to Upper, tap-tap-tap

in centric, then adjust the upper denture to eliminate hitches.d) Red to lower, slide side-to-side; Black to Lower, tap-tap-tap

in centric, then adjust the lower denture to eliminate hitches.e) In lingualized occlusion, eliminate all buccal contacts.

2. Balanced Occlusion – Complete one side working at a time. Canalso adjust contralateral balancing. Then check other side and backagain. Twice as many adjustments as with Lingualized occlusion.

3. Red to upper – right working only, Black to upper – centric only –adjust upper. Red to upper – left working only – adjust upper. Redto lower – right working only – adjust lower. Red to lower – leftworking only – adjust lower. Repeat PRN.

IV. Centric Relation – the use of an intra-oral tracing device significantly decreasesthe need for occlusal adjustments – and remounts – at delivery.A. First of all, we really don’t need to make our CR record at VDO.B. The maxillary and mandibular wax rims have been finalized to the incisal

edge positions. This differs from VDO by the amount of overbite utilized.CR record is taken once the upper and lower wax rims have beenfinalized to the closest speaking space. This is not VDO. It is closer toVDO than the freeway space. Once CR is made and the baseplatesmounted, the incisal pin is CLOSED to allow overbite – that is VDO.

C. CR Methods:1. Patient closure on own – Fully edentulous pts. are fairly repeatable2. Tongue to top, back roof of mouth – Retracts jaw.3. Bilateral Manipulation – Fingers under mandible, thumbs on lower

wax rim, rotate closed.4. Intra-oral gothic arch tracing devices – Coble Balancer. Y & M

Recorder. Massad Balancer – These require a single set ofbaseplates and do not require a “pre-mounting” for success.


a) Email me for better instructions than you can get from anymanufacturer.

b) Polyvinyl Siloxanes – Can make two bites, one for confirmation.(1) Cut Notches in Both Arches

c) Protrusive – Edge to edge for condylar inclination5. Facebow – Necessary. This is a full mouth rehab.

a) Use dentate fork with bite registration materialsV. Getting Wax Records to the CR Step – Wax Rims and Record Collection

A. Wax Rim Fabrication – Use auxiliaries or the lab.1. Alma Gauge – Excellent Starting Point

a) Measure old denture and add estimates to lengthb) Male horizontal 7-9 mm; Female horizontal 8-11 mmc) Use “Papilla-meter” for Vertical

B. Maxillary Wax Rim – Use first.1. Anterior Contour – Profile esthetics, use your fingers for cuspids.2. Anterior Vertical Height – Use fricatives as the starting point. If the

patient has an “airy” sound to fricatives, we need to add wax. Ifthere is a “poppy” sound, then we need to remove wax. As soon asthe fricative sounds are clear, we can now check for esthetics. Wecan get clear fricatives through about 3-5 mm of vertical heightvariation, therefore use incisal edge show as the final estheticdeterminate for anterior vertical height. Know that women showmore incisal edge at rest than men and we all show less as we age.

C. Maxillary Horizontal1. Intrapupillary Line – Side to side plane.2. Fox Plane (Dentsply) – We use the Fox Plane to get the incisal

edge position to be level from the right to the left. If you use thepatient’s eyes as the guide, have the patient stand and support theFox Plane with their thumbs. Evaluate the eyes and the Fox Planeto ensure parallelism. Make changes as needed.

3. Ala-Tragus Line – Anterior to posterior plane. Once the intra-pupillary line has been leveled, use the Ala of the nose and theTragus of the ear to level the plane from the front to the back. Sincethe tragus can be up to 15 mm long, this line can vary significantly.Evaluate the plane from the facial view to confirm that the lowerlip creates a pleasurable smile line with the upper arch wax rim.

4. Buccal Corridor – Once the occlusal plane has been completed, addor remove wax from the buccal corridor for esthetics of a wide archcompared to a narrow arch. This is strictly esthetic.

D. Mandibular Wax Rim


1. Anterior Contour – Very difficult because the mandibular archresorbes facially. This tends to be a thin area on the denture, checkthe profile to see if there is a concavity below the lower lip.

2. Anterior Vertical Height – Sibilant sounds are the final determiningfactor, but I start with the first premolar area being approximatelythe level of the lower lip at rest (not during speech). Again,remember that the lower arch resorbes facially so the lower anteriorteeth are rarely placed very facial to the crest of the ridge.

3. Earl Pound – “Let “S” be your guide.” Using sibilant sounds, addwax to the lower anterior vertical height until it appears as thoughthe incisors are touching, but are not. Consider placing dentureteeth in the wax rims for difficult patients. I keep the posterior asan open bite to allow the use of the Coble Balancer for CR records.

E. Changing Vertical Dimension – When a patient appears to need theirvertical opened, they may have contact during sibilant sounds at a verticalthat we think would look good esthetically. Have the patient read out loudfor ten minutes (leave the room so that you don’t hear improvement).When you return ask the patient to say their name, address phone numberand check if they have contact any longer. If they’ve improved, they willaccommodate to the new vertical without the need for a “training”denture. If they still have sibilant sound contact, then plan for a trainingdenture to open the vertical dimension slowly.1. Estimate total vertical change needed (example: 3 mm)2. Divide by 3 (example: 1 mm)3. Fabricate wax rim at vertical height where not tooth contact exists,

then add first third (example: 1 mm). Make the training denture atthis vertical height with posterior bite blocks. Deliver this (1mmopened) denture – the patient will have contact with this vertical.

4. Three weeks later the patient will return without having occlusalcontact while speaking. Now we can add another one-thirdmeasurement to the posterior bite blocks. I do this with the CobleBalancer. Mount the balancer, open or close the maxillary pin untilthe posterior cusps are 1 mm separated from the bite block(example was 1 mm – each case will be one-third of total openingdesired). Mix acrylic and add to roughened bite block. Close onCoble Balancer and generate gothic arch tracing until acrylic is set.Grind excess acrylic to a flat surface and confirm centric contactswith Occlusal Indicator Wax, eccentric with articulating paper.

5. Three weeks later repeat this process.6. Three weeks later the patient should be done, but may welcome

more opening or require a small amount of closing. Complete the


closing with Occlusal Indicator Wax, complete the opening in thesame manner. This new vertical is the height for the lower denture.An upper denture does not need to be remade, but can be done soas a convenience denture.

F. Records – Facebow, Centric Relation, “Vertical”, Protrusive.G. Post Dam – Compensates for processing shrinkage.

1. Functional – Pressure with impression material.2. Visual – Reflect light to extension of baseplate, if a shadow exists

when patient says “aah” then the baseplate is overextended on thevibrating line, trim till no shadow. Done at the records appointment

VI. Tooth SelectionA. Mold Guides – Dentsply Facial shield breaks down the mold guides to

useable resources by determining tooth shape and size.1. Tooth Shape Matches Facial Shape.2. Tooth Size Proportional to Facial Size.

B. Mold Guide – Ivoclar Intra-Nasal Measurement does same for Blue LineC. Tooth Form – Rounded versus square incisal edges.D. Materials – All materials are hardened.

1. Hardened Composite – May be soft inside.2. Hardened Acrylic – Excellent wear characteristics.3. Porcelain – Only F/F – Hardest material in the mouth

a) What’s the opposing arch? Porcelain only opposes porecelainE. Esthetic Requirements – Porcelain no longer necessary, but is still betterF. Poor Combinations – Porcelain anteriors, acrylic posteriors.

VII. Completely Edentulous Patient Impression TechniquesA. Initial Impressions

1. Irreversible Hydrocolloid (Alginate)a) Canned Alginate – As good as anything else.b) Syringable Alginate – System 1 meant for initial imp. only

B. Final Impressions1. Rubber Base with Green Stick Compound

a) Break 2/3 stick of compound and drop in water bathb) Mold tempered stick to each area of the trayc) Retemper in the water bath and seat in the mouthd) Border Molding Upper – Can keep adding

(1) Upper Right – pull cheek down and back(2) Upper Left – pull cheek down and back(3) Upper Anterior – smile really big, blow a kiss(4) Posterior – open wide, move side to side

e) Border Molding Lower – Can keep adding(1) Lower Right – pull cheek up and back


(2) Lower Left – pull cheek up and back(3) Lower Anterior – smile, blow a kiss(4) Lingual Left & Right – oppose pressure

f) Impression Making – Trim border molding; add adhesive(1) Wash with light body impression material(2) Repeat all border molding steps two times

2. Polyvinyl Siloxanes with Fast-Set Bite Registration Border Molda) Border Molding Sections – Bite Registration Material

(1) Whole Right Side – Inject into the vestibule(2) Whole Left Side – Inject into the vestibule(3) Posterior – Inject onto the impression tray

b) Impression Making – Trim border molding; add adhesive(1) Wash with light body material

3. Polyvinyl Siloxanes with Stock Tray Technique – Dentsply DVDa) Use Massad Trays from Dentsply

(1) Heat and Trim as Needed to “Customize” to Archb) Create Tissue Stops with Heavy Body Material

(1) Support Tray Position Artificiallyc) Border Molding ENTIRE ARCH: Heavy Body Material

(1) Inject onto the impression tray(2) Have Patient Hold Cheek Retractors(3) Trim Border Mold material and Tray as Needed(4) This step often needs to be repeated

d) Impression Making: Light or Medium Bodied MaterialsC. Hydrocast Reline Technique

1. System 1 irreversible hydrocolloid impression – fabricatebaseplates and wax rims; records, mount, set teeth and wax trial

2. Process denture and have lab complete a selective grind, thenfabricate a Hydrocast Jig, break-out and hollow grind intaglio

3. At delivery appointment, fill denture with Microseal and seat inlubricated Hydrocast Jig for at least 10 minutes; trim material 2 mmfrom flanges (I do this the morning of the delivery appointment)

4. Adjust centric occlusion intra-orally with occlusal indicator wax.Also soak lubricated Hydrocast jigs in “wet” water.

5. Line dentures with Hydrocast functional impression material dipinto “wet” water and seat in Hydrocast jigs. Soak for ten minutes in“wet” water – lightly trim excess

6. Seat in patient’s mouth and read – out loud – for 10 minutes; grosstrim buccal excess; patient wears for 24 hours (eating and sleeping)

7. Next day, drop off and pour cast and send to lab for a reline.a) Impression material does not set up – it must be poured.


8. If adjustments are necessary, mark with wax pencil, adjust acrylicwith a bur (adjustments would only be necessary if acrylic stuckout of the Hydrocast). Mix fresh Hydrocast and repeat steps 6 & 7a) If patient wears dentures for second 24 hour period then next

morning is just to drop off dentures – no chair time necessary(1) Pour dentures over lunch hour & ship to lab for reline

9. Re-deliver dentures – Remove undercuts, recheck occlusionD. Cast Fabrication

1. Boxing and Pouringa) Mix Pumice/Mounting Stone at a 60/40 ratiob) Most Ideal: 40% corn starch, 30% pumice & mounting stonec) Insert Impression, Allow to Set; Trim on model trimmerd) Apply Boxing Wax, Rubber Band and Pour Stone

2. Ideal Cast Landmarks – ensure land area for finishing denturesVIII. Cost Analysis of Quality Complete Dentures

A. Expect about 5 hours with HydrocastB. Expect 4.5 hours with Rubber Base or PVS Impressions

1. Compare to your office 3-Unit Fixed Bridgea) Time for 3-Unit, Cost for 3-Unit is likely less in your office

2. Why charge more to replace one tooth than to replace all the teeth?3. Your office demographics support your 3-unit bridge fee…

a) Create a full/full complete denture fee similar, if not more.IX. F/F Case Completion - Start to Finish Step-By-Step On next Page


X. F/F Case Completion - Start to FinishA. Initial Exam & Models

1. Prosthetic Findings Sheet (page 3 of handout)a) Identify Anatomic Limitations (things we won’t likely change)b) Evaluate Existing Prosthesis: Retention, Stability, Support and

Esthetics, Phonetics, Occlusion(1) Are Patient Complaints/Existing Conditions Correlating?

2. Use American College of Prosthodontists Classification System (page 2)3. System 1 Irreversible Hydrocolloid

B. Final Impression if Rubber Base or PVS (skip this step with Hydrocast)1. Border Mold Custom Tray with Compound or PVS2. Trim Border Mold then Wash with Rubber Base or PVS

C. Records – Wax Rims, Tooth Selection, Facebow, Centric1. Earl Pound – Fricatives and Sibilants for Closest Speaking Space2. Intra-Oral Tracing Device for CR (2) and Protrusive3. Tooth Selection

D. Wax Trial – Confirm Esthetics and Bite1. Ensure Anterior Open Bite – Allows for Anterior Characterization2. Confirm Shim Stock Holds intra-orally same as Articulator3. Evaluate for Smooth Side-to-Side Eccentric Movements4. Patient Evaluates for Size, Shape, Shade and Position

a) Last Chance to Make Changes without a ChargeE. Microseal and Hydrocast – Use the Hydrocast Jig

1. Microseal on Jig before Patients2. Check Occlusion – Centric with Wax, Eccentric with Paper3. Hydrocast – Jigs for 10’ then Read for 10’, Trim Gross Excess

F. 24 Hour –Adjustment and Cast Fabrication (repeat or extend)1. This could also be scheduled at 48 hours

G. Re-delivery – Occlusal Indicator Wax, Horseshoe for Balance1. Centric should be very close, but ensure it is excellent2. Refine the eccentric contacts

H. One Week Post Delivery Adjustment1. Expect occlusal adjustments for sore spots more than acrylic2. Use Pressure Indicating Paste from Mizzy when checking acrylic

a) Vertical dab, apply PIP to entire intaglio surface, seat andhave patient chew up and down on cotton rolls while youmove them around the arch – adjust for pressure areas.

b) Crestal Marks – Check centric prematurities with waxc) Non-crestal Ridge Marks – Check eccentrics with paper

3. Oral Hygiene Instruction4. Recall – annual oral cancer screening exams & occlusal adjustment


Reference List

Textbooks:1. Branemark PI, Zarb GA, Albrektsson T: Tissue Integrated Prostheses. Quintessence

Publishing Co., Inc. Chicago, IL 1985.2. Feine JC, Carlsson GE: Implant Overdentures: The Standard of Care for Edentulous Patients.

Quintessence Publishing Co., Inc. Chicago, IL 2003.3. Hayakawa I: Principles and Practices of Complete Dentures – Creating the Mental

Image of a Denture. Quintessence Publishing Co., Chicago, IL 2004.4. Hickey JC, Zarb GA, Bolender CL: Boucher’s Prosthodontic Treatment for Edentulous

Patients. 9th Edition. C.V. Mosby, St. Louis, MO 1985.5. Levin B: Complete Denture Impressions. Quintessence Publishing Co., Chicago, IL 1984.6. Sharifi MN: Essential Dental Handbook: Chapter on Removable Prosthodontics. Edited

by Edwab RJ, Penn Well Publishing Co., Tulsa, OK 2002. Call 800-752-9764(10%Coupon: DOAE05)

Journal Articles:1. Atwood D: Clinical, cephalometric and densitometric study of reduction of residual ridges. J Prosthet

Dent 1971; 26:280.2. Becker CM, Swoope CC, Guckes AD: Lingualized occlusion for removable prosthodontics. J Prosthet

Dent 1977; 38:601.3. Berg E, Johnsen TB, Ingebretsen R: Psychological variables and patient acceptance of complete

dentures. Acto Odontol Scand 1986; 44:77.4. Brewer AA, Reibel RB, Nassif MN: Comparison of zero degree teeth and anatomic teeth on complete

dentures. J Prosthet Dent 1967; 17:28.5. Brudvik JS, Howell PG: Evaluation of eccentric occlusal contacts in complete dentures. Int J Prosthet

1990; 3:146-157.6. Clough H, Knodle J, Pudwill S, Myron L, Taylor D: A comparison of lingualized occlusion and

monoplane occlusion in complete dentures. J Prosthet Dent 1983; 50:176.7. Colon A, Kotwal K, Mangelsdorff A: Analysis of the posterior palatal seal and the palatal form as

related to the retention of complete dentures. J Prosthet Dent 1983; 47:23.8. Curtis T, Langer Y, Curtis D, Carpenter R: Occlusal considerations for partially or completely

edentulous skeletal class II patients. Part I: Background information. J Prosthet Dent 1988; 60:202.9. Friedman N, Landesman H, Wexler M: The influences of fear anxiety and Depression on the patient’s

responses to complete dentures. Part II. J Prosthet Dent 1988; 59:45.10. Frush JP, Fisher RD: Introduction to dentogenic restorations. J Pros Den 1955; 5:586-95.11. Frush JP, Fisher RD: How dentogenic restorations interpret the sex factor. J Prosthet Dent 1956;

6:160-172.12. Frush JP, Fisher RD: How dentogenic restorations interpret the personality factor. J Prosthet Dent

1956; 6:441-449.13. Frush JP, Fisher RD: The age factor in dentogenics. J Prosthet Dent 1957; 7:5-13.14. Frush JP, Fisher RD: The dynesthetic interpretation of the dentogenic concept. J Prosthet Dent 1958;

8:558-581.15. Frush JP, Fisher RD: Dentogenics: Its practical application. JPD 1959; 9:914-921.16. Haines R, Barrett S: The structure of the mouth in the mandibular molar region. J Prosthet Dent 1959;

9:962.17. Jacoboson T, Krol A: A contemporary review of the factors involved in complete denture retention,

stability and support: Part I: Retention. J Prosthet Dent 1983; 49:5.


18. Jacoboson T, Krol A: A contemporary review of the factors involved in complete denture retention,stability and support: Part II: Stability. J Prosthet Dent 1983; 49:165.

19. Jacoboson T, Krol A: A contemporary review of the factors involved in complete denture retention,stability and support: Part III: Support. J Prosthet Dent 1983; 49:306.

20. Kelly E: Changes caused by a mandibular removable partial denture opposing a maxillary completedenture. J Prosthet Dent 1972; 27:140.

21. Kotwal K: Beyond classification of behavior types. J Prosthet Dent 1984; 52:874.22. Lang B, Razzoog M: A practical approach to restoring occlusion for edentulous patients. Part I -

Guiding principles of tooth selection. J Prosthet Dent 1983; 50:455.23. Lang B, Razzoog M: A practical approach to restoring occlusion for edentulous patients. Part II -

Arranging the functional and rational mold combination. JPD 1983; 50:599.24. Lang BR, Razzoog ME: Lingualized integration: tooth molds and an occlusal scheme for edentulous

patients. Implant Dentistry 1991; 1:204-211.25. Levin B: A re-evaluation of Hanau’s laws of articulation and the Hanau quint. J Prosthet Dent 1978;

39:254.26. Mazurat RD: Longevity of partial, complete, and fixed prostheses: a literature review. J Can Dent

Assoc 1992; 58:500-504.27. Millsap C: The posterior palatal seal area for complete dentures. DCNA 1964; 11:663.28. Niedermeier WH, Kramer R: Salivary secretion and denture retention. JPD 1992; 67:211-216.29. Pound E: Accurate protrusive registration for patients edentulous in one or both jaws. J Prosthet Dent

1983; 50:584.30. Pound E: Applying harmony in selecting and arranging teeth. DCNA 1962; 3:242.31. Pound E: Controlling anomalies of vertical dimension and speech. JPD 1976; 36:124.32. Pound E: Let “S” be your guide. J Prosthet Dent 1977; 38:482.33. Pound E: The mandibular movements of speech and their seven related values. J Prosthet Dent 1966;

5:835.34. Saunders T, Gillis R Jr., Desjardins R: The maxillary complete denture opposing the mandibular

bilateral distal extension partial denture: Treatment considerations. J Prosthet Dent 1979; 41:124.35. Schulte JK, Anderson GC, Sakaguchi RL, DeLong R: Wear resistance of isosit and

polymethymethacrylate occlusal splint material. Dental Materials 1987; 3:82.36. Shannan J: A bilaterally balanced occlusal scheme for patients with arch width and curvature

discrepancies. J Prosthet Dent 1980; 44:101.37. Sharifi MN: Functional Impression for the Complete Denture. Quintessence Dental Technology

Yearbook 2002.38. Slagter AP, Olthoff LW, Bosman F, Steen WH: Masticatory ability, denture quality, and oral

conditions in edentulous subjects. J Prosthet Dent 1992; 68:299-307.39. Tallgren A: The continuing reduction of the residual alveolar ridges in complete denture wearers: A

mixed longitudinal study covering 25 years. J Prosthet Dent 1972; 27:120.40. von Fraunhofer JA, Fazavi R, Khan Z: Wear characteristics of high-strength denture teeth. J Prosthet

Dent 1988; 59:173-175.


Product List

1. Alma Gauge - For fabricating maxillary wax rims. Purchase through: LantzDental Prosthetics, Maumee, OH 800-788-5385.

2. Compound for border molding impression trays - Green Stick Compound. Kerr,Romulus, MI; 800-537-7123.

3. Denture Teeth - Antaris/Postaris. Ivoclar, 800-533-6825.4. Denture Teeth - Physiodens. Vita; 800-828-3839.5. Denture Teeth - Trublend and Portrait. Dentsply; 800-877-0020.6. Denture Teeth - Enigma. Leach and Dillon Products; 800-535-2633.7. Denture Teeth - Myerson Lingualized Integration Teeth. Austenol; Chicago,

IL; 800-621-0381.8. Denture Tooth Selection Face Shield - Trubyte Tooth Indicator. Dentsply;9. Fox Plane - For Leveling Occlusal Plane. Dentsply; 800-877-0020.10. Functional Impression Material - Hydrocast. Kay See Dental, Kansas City, MO;

800-842-8844.11. Functional Impression Material - holds VDO for functional impressions –

Microseal. AMCO International; 800-523-074012. Intra-oral device for CR and occlusal evaluation - Coble Balancer. Order from

Lantz Dental Prosthetics, Maumee, OH 800-788-5385.13. Intra-oral device for CR and occlusal evaluation - Massad Balancer. Order from

Stern/Empire Dental Lab, Houston, TX 713-688-1301.14. Central Bearing Device - Y & M Dental, Overland Park, KS 913-851-8079.15. Intra-oral post dam tissue marking sticks - Dr. Thompson’s Sanitary

Applicators. Great Plains Dental, Kingman, KS; 316-532-3888.16. Impression Material - System 1 & 2 Alginate. Ivoclar; 800-344-5457.17. Impression Material – Aquasil. PVS with Massad Technique. Dentsply; 800-

877-0020 Request DVD.18. Occlusal Indicator Wax - For Occlusal Adjustments and Delivery of Dentures.

Kerr, Romulus, MI; 800-537-7123.19. Papillameter – Estimates Vertical Length of Maxillary Wax Rim. Blue Dolphin

Products, Morgan Hill, CA 800-448-8855.20. Pressure Indicating Paste - For Post Delivery Adjustments of Denture Sore

Spots. Order from your dental supplier.21. Reline Material - New Truliner. Bosworth Dental, Skokie, IL 708-679-340022. Rubber base impression material (light and medium) - Permlastic. Kerr,

Romulus, MI; 800-537-7123.23. Wax Records Spatula - Rim Former. Blue Dolphin Products, Morgan Hill, CA

800-448-8855.

Complete Denture Techniques for the 21st Century

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