A self-grinding occlusal plane template to help modify an uneven occlusal plane before providing definitive restorations
2020; Elsevier BV; Volume: 125; Issue: 3 Linguagem: Inglês
10.1016/j.prosdent.2020.03.002
ISSN1097-6841
AutoresPravinkumar G. Patil, Smita Nimbalkar,
Tópico(s)Facial Nerve Paralysis Treatment and Research
ResumoUneven alignment of the natural teeth is a common clinical occurrence, which may be caused by eruption, wear, or drifting of teeth.1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar A normal occlusal plane, such as with a curve of Monson,2The glossary of prosthodontic terms. Ninth edition.J Prosthet Dent. 2017; 117: e1-105PubMed Google Scholar,3Monson G.S. Occlusion as applied to crown and bridgework.J Nat Dent Assoc. 1920; 7: 399-413Abstract Full Text PDF Google Scholar is a primary objective of restorative procedures and facilitates natural mandibular movements and mastication.1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar Devices and techniques have been described to evaluate and correct the occlusal plane, including the Broderick occlusal plane analyzer,4Bedia S.V. Dange S.P. Khalikar A.N. Determination of the occlusal plane using a custom-made occlusal plane analyzer: a clinical report.J Prosthet Dent. 2007; 98: 348-352Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar the Yurkstas metal occlusal template,5Yurkstas A.A. Single dentures.in: Sharry J.J. Complete denture prosthodontics. 2nd ed. McGraw-Hill, New York1968: 300Google Scholar and the custom made occlusal plane template (OPT).1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar,6Muley B.Y. Patil P.G. Khalikar A.N. Puri S.B. Simple technique to fabricate custom made occlusal plane template.J Indian Prosthodont Soc. 2014; 14: S334-S336Crossref PubMed Scopus (2) Google Scholar The OPT can be used to detect an uneven occlusal plane on the diagnostic cast or directly in the mouth. The present technique demonstrates a modification of the OPT by attaching abrasive paper to the convex surface of the OPT to facilitate trimming of the uneven surfaces on a diagnostic cast to identify potential occlusal areas for modification in the mouth. The procedure is demonstrated on a mandibular diagnostic cast of a patient for whom a maxillary single removable complete denture was planned.1.Fabricate a custom made OPT as described by Muley et al6Muley B.Y. Patil P.G. Khalikar A.N. Puri S.B. Simple technique to fabricate custom made occlusal plane template.J Indian Prosthodont Soc. 2014; 14: S334-S336Crossref PubMed Scopus (2) Google Scholar and Foong and Patil1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar (Fig. 1A). Obtain a volleyball (Mikasa MVA310; Mikasa Sports) with a diameter of approximately 20.7 cm (8.1 inches). Note that the size closely corresponds to the Monson sphere (with a diameter of 8 inches).2The glossary of prosthodontic terms. Ninth edition.J Prosthet Dent. 2017; 117: e1-105PubMed Google Scholar,3Monson G.S. Occlusion as applied to crown and bridgework.J Nat Dent Assoc. 1920; 7: 399-413Abstract Full Text PDF Google Scholar Adapt modeling wax (Modelling Wax; Vertex Dental) (or boxing wax) (in a similar manner to that of boxing of an impression) on the surface of the volleyball to create a circular box of approximately 10 cm in diameter. Pour Type III dental stone (Dental Stone; Pro Dental) into the wax box adapted on the surface of the volleyball. After setting, separate the cast and smooth the surface to prepare a concave cast-form. Adapt a 1.5-mm-thick, hard, thermoplastic sheet (Duran; Scheu Dental Technology) onto the cast-form in a vacuum forming machine (Ministar; Scheu) (Fig. 1A).1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar,6Muley B.Y. Patil P.G. Khalikar A.N. Puri S.B. Simple technique to fabricate custom made occlusal plane template.J Indian Prosthodont Soc. 2014; 14: S334-S336Crossref PubMed Scopus (2) Google Scholar Keep the original circular shape of the OPT and do not further shape it according to the U-shape arch. Alternately procure a stock metal occlusal plane template (Yurkstas) if available.2.Procure an abrasive paper (Silicone carbide waterproof abrasive paper electro-coated; Eagle sandpaper) and cut it in a circular manner according to the size of the circular OPT (10 cm diameter).3.Cut along the radius of the circular shaped abrasive paper and stick it on the convex surface of the OPT with a quick-setting cyanoacrylate adhesive (Super Glue; TEX-YEAR Industries Inc) to make a self-grinding OPT (Fig. 1B, 1C). Note that the single cut made along the radius helps to accommodate the convexity of the OPT. For the maxillary cast to modify, the abrasive paper can be glued to the concave surface of the OPT.4.Identify a minimum of 4 points: distobuccal cusp tips of the mandibular right and left first molars and the cusp tips of the mandibular canines on the diagnostic cast.1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar,3Monson G.S. Occlusion as applied to crown and bridgework.J Nat Dent Assoc. 1920; 7: 399-413Abstract Full Text PDF Google Scholar Note that, in situations where any of these 4 cusp tips are not in even occlusal plane, they need to be modified before grinding. If the identified cusp tips are damaged or do not occlude, the cusp tips can be built-up with dental stone, and, if the tip is supra-erupted, it can be trimmed to ensure the identified 4 points are in an even occlusal plane to provide a plane of reference.5.Apply a thin layer of a quick-setting cyanoacrylate adhesive (Super Glue; Tex Year Industries Inc) on these identified cusp tips to protect them from accidental wear during grinding, as these points are considered to form a plane of reference and as a part of a Monson curve.6.Paint the occlusal and axial surfaces of all teeth on the cast with student watercolors (Camlin) (Fig. 2A). Select a color that contrasts with the cast.Figure 2A, Diagnostic cast painted blue. B, Self-grinding OPT on painted diagnostic cast. C, Grinding areas easily identifiable. OPT, occlusal plane template.View Large Image Figure ViewerDownload Hi-res image Download (PPT)7.Use the self-grinding OPT to grind the occlusal surfaces (Fig. 2B). Continue grinding until the template touches all 4 identified cusp-tips. Note that, the trimmed surface areas will be easily identifiable on the occlusal surfaces of the cast (Fig. 2C).8.Use this modified cast to identify the corresponding areas in mouth for tooth modification to achieve an even occlusal plane. Proceed to adjust the teeth in the mouth in a conventional manner by considering the amount of tooth reduction (within enamel or superficial dentin).1Foong K.W. Patil P.G. Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: a case report.Saudi Dent J. 2019; 31: 148-154Crossref PubMed Scopus (2) Google Scholar,4Bedia S.V. Dange S.P. Khalikar A.N. Determination of the occlusal plane using a custom-made occlusal plane analyzer: a clinical report.J Prosthet Dent. 2007; 98: 348-352Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar9.Alternately, adapt a vacuum-formed clear template on the modified cast and cut the template at the level of the trimmed tooth surfaces with a scalpel blade as described by Tan.7Tan H.K. A preparation guide for modifying the mandibular teeth before making a maxillary single complete denture.J Prosthet Dent. 1997; 77: 321-322Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Mark the margins of the cuts on the template and place it in the mouth. Note that the portions of natural teeth protrude through the template, which can be easily identified for grinding.7Tan H.K. A preparation guide for modifying the mandibular teeth before making a maxillary single complete denture.J Prosthet Dent. 1997; 77: 321-322Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar
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