Addition of a Tooth onto a Denture
Frequently, it is necessary to carry out a denture tooth addition. Before and after the repair of a fractured tooth, the entire tooth may need a replacement. Simpler cases may just require that an existing tooth be replaced in the denture. The same sequence is used for these cases.
Different Types of Addition Whether anterior or posterior, you will need to determine with the replacement tooth if the tooth is either missing or fractured. Patient records may help, or it may be necessary to have the patient “drop by” for a shade match of the tooth. Most general practices will probably not have a stock of “spare teeth” at the office lab. You can make an emergency repair with composite “bonded” to the fractured denture tooth.
What if the Whole Tooth is Missing? If the tooth is missing entirely, more creativity will be required. The denture subsequently has to be “picked up” at the laboratory up to 48 hours of service. Converting a “provisional” partial denture to a complete denture when the remaining teeth are being extracted is another possibility for repair. It is necessary to take a good alginate impression just before sending the patient to surgery for the extractions. The next steps are: selecting an appropriate shade of self-curing acrylic, bulking mixing it, and pouring it in the impression of the teeth to be extracted as seen here. After the teeth have been run in acrylic, a cast is poured into the impression and the appliance.
Positioning and Curing Teeth The resulting cast with “acrylic teeth” is seen to be correctly positioned. The acrylic flanges are painted on the model with self-cure acrylic. After the self-cure acrylic hardens, the appliance is removed from the cast and the flanges and tissue side are contoured and polished. The same sequence is used for an upper provisional appliance being converted to a temporary complete denture. Alginate impression just before surgery must be taken and modification during surgery is required. The same procedure is used for the upper provisional appliance after the acrylic teeth have been “poured” into the impression.
Addition of Denture Flanges Flanges are added to the temporary appliance with self-cure acrylic and polished. There is a variety of techniques available. For example, when an alginate “index” was poured into the denture and the position of the tooth was “shaped” with a scalpel blade. Another technique is when self-cure acrylic is used to create a pink acrylic
layer in which we set the denture tooth. The temporary denture is then lined with a temporary soft liner for the patient.