Simplified
procedure
denture teeth
for making
Carl A. Hansen,
DDS,* Keith
Clear, DDS,b and Phil
College of Dentistry, University of Florida, Gainesville, Fla.
gold occlusal
Wright,
surfaces
on
DDSC
The procedure
described is used to reproduce,
in gold, the occlusal morphology
of
complete and removable
partial denture teeth or those of an implant-supported
prosthesis.
The gold occlusal surfaces are made after all adjustments
are completed and the occlusion is harmonious.
An acrylic resin strut reinforces
the wax
patterns, and a reline jig is used to accurately
stamp out the occlusal anatomy in
wax. Careful adherence
to the step-by-step
procedure
is required
to achieve an
excellent result. (J PROSTHET
DENT1994;71:413-6.)
S
everal methods have been advanced in the dental
literature to construct gold occlusalsurfaceson the teeth
of a removable prosthesis.1-7
In comparisonto resin teeth,
the advantagesof gold occlusal surfacesinclude the following: (1) greater resistance to wear and subsequent
changesin the horizontal and vertical occlusal relationship2V8;(2) better chewing efficiency becauseof preservation of cuspalmorphology1,2;(3) excellent compatibility in
function against opposing surfacesof gold, acrylic resins,
porcelain, or natural teeths; and (4) increasedresistanceto
fracture of the prosthetic teeth and increasedstrength of
the baseof the prosthesis.2*4The disadvantageof gold occlusal surfaceson denture teeth is the expenserelated to
the time and materials required to make and adjust them.4
Some patients may also object to the display of gold,
although others may considerthis feature an assetin disguising the existence of denturese3*
4
Gold occlusal surfacesshould accurately duplicate, in
gold, the resultant occlusalanatomy establishedfrom occlusal and denture baseadjustmentsmade over a seriesof
appointments.6In addition to occlusaladjustmentsby the
dentist, the resinteeth will wear slightly during this period
and tend to generatea more harmoniousocclusalrelationship.2The procedureshouldnecessitatelittle or no occlusal
adjustment after the gold occlusalsurfacesare placed on
the prosthesisso as to reduce the cost of the procedure.
This article presentsa detailed procedure for making cast
gold occlusalsurfacesthat meet the preceding goals.
PROCEDURE
“Assistant Professor, Department of Prosthodontics.
bPrivate practice, Denver, Colo.
cPrivate practice, Anchorage, Alaska.
Copyright @ 1994 by The Editorial Council of THE JOURNAL
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1994
3.
4.
5.
6.
7.
8.
1. When the prosthesisis a removable partial denture,
make an irreversible hydrocolloid impressionwith the
prosthesisin the patient’s mouth. The prosthesismust
PROSTHETIC DENTISTRY.
0022-3913/94/$1.00
+ .lO.
2.
1011152793
OF
9.
10.
be picked up with the impressionor placed in the impressionbefore the cast is poured.
Block out undercuts in the denture baseswith wax and
pour the impressionin dental stone.
Mount the stone cast with the removable partial denture or, in the caseof a complete denture, mount the
complete denture in a reline jig (National Keystone
Co., Cherry Hill, N.J.) (Fig. 1).
Block out all undercuts on the cast with Play Doh material (Playskool Inc., Pawtucket, R.I.). Bring the
blocked-out area slightly superior to the necks of the
teeth (Fig. 2).
Lubricate the stone teeth and adjacent surfaceswith
a stone separator such as Super-Sep (Sybron/Kerr
Dental Manufacturing Co., Romulus, Mich.), and
make a counterdie or index with vacuum-mixed improved dental stone. Paint the occlusalsurfacesof the
denture teeth with stone to prevent trapping of air
(Fig. 3).
Allow the stonecounterdie to completely set, and then
separatethe memberthat contains the prosthesis(die)
from the counterdie (Fig. 4).
Prepare the resin denture teeth by reducing the
occlusal surfaces by approximately 1.5 mm (depth
grooves are helpful). After reducing the occlusalsurfaces,place a groove down the center of all of the teeth
to a depth of 2.5 mm. Carry the groove through the
marginalridgesof the most anterior and most posterior
tooth. Ascertain that no undercuts are created.
Lubricate the counterdie and denture generouslywith
Duralay inlay pattern resin lubricant (RelianceDental
Manufacturing Co., Worth, Ill.).
Place two drops of the pattern resinliquid in a dappen
dish, add resin powder, and mix until a doughlike consistency is reached.Roll the dough out into a thin cylindrical form between wet fingers and place in the
central groove (Fig. 5).
Completely closethe die and counterdie together in the
reline jig. After 20 to 30 seconds,openthe jig. Trim the
excess resin away from the margins
of the prepared
413
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HANSEN,
CLEAR,
AND
WRIGHT
Fig. 1. Prosthesis to receive gold occlusal surfaces is mounted in top half of reline jig.
Fig. 2. Undercuts and lingual portion of cast are blocked out with Play-Doh material.
Fig. 3. A, Stone separator applied to exposed surface of teeth. B, Vacuum-mixed
improved dental stone is brushed onto all exposed surfaces of denture and stone teeth. C,
Top half of reline jig is tightened down into stone patty on bottom half of jig.
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Resultant counterdie showsocclusalanatomy of teeth.
Narrow roll of pattern resin dough placed in central groove.
Excessresin removed with carving instrument before resin sets.
Completed patterns made of wax over and attached to pattern resin strut.
8. Sprues attached to resin struts ready for investing.
9. Completed castings luted to resin denture teeth with composite resin bonding
material.
Fig.
Fig.
Fig.
Fig.
Fig.
Fig.
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teeth, and carefully lift the pattern resin material off
the teeth (Fig. 6). Reapply the lubricant to the counterdie and teeth, and replace the pattern in the groove.
The pattern must extend to the most mesial and/or
distal point of the groove so it may be easily accessed.
Later it will serve as a rigid strut to aid in lifting the
wax pattern from the denture teeth.5 At this point the
resin pattern must not be polymerized.
Close the halves of the reline jig tightly together and
wait 2 to 3 minutes. Open the jig and remove the polymerized pattern. When the pattern resin extends to
or beyond the margin of the teeth, reduce it with a bur
made to grind acrylic resin after the pattern resin is
removed from the teeth.
Use green soap, warm water, and a brush to remove all
of the lubricant from the teeth and stone counterdie.
Completely dry both cleaned pieces and apply Slaycris
Slikdie lubricant (S. W. Washington, Portland, Ore.).
Cut a 5 ml wide strip of Almore bite registration wax
(Almore International, Portland, Ore.) the length of
the central groove of the quadrant. Heat the warm wax
in a water bath at 135” F for 45 seconds. Adapt the
warm wax into the counterdie with firm finger pressure.
Lift the wax from the counterdie. Reapply the die lubricant to the stone counterdie. Resoften the wax
slightly in warm water, and again firmly press the wax
into the counterdie.
Place the resin pattern in the central groove of the
teeth, and slowly close the two halves of the jig. The jig
can be placed in the water bath while closing to soften
the wax and permit better flow.
Let the die and counterdie cool, then open the jig, and
separate the parts. Trim the excess wax back to the
margins. Make any necessary corrections or additions
to the wax pattern (Fig. 7). If desired, the wax/resin
pattern(s) may be articulated against an opposing anatomic cast to verify the occlusion at this time. In this
event, the cast with the prosthesis should have indexes
on the base and should be mounted on an articulator
with an accurate registration before it is mounted on
the reline jig (step 3). When the resin and wax pattern
must be compressed in the jig again, the pattern should
be removed, the die and counterdie recleaned with
green soap and warm water as before, and new lubricant applied. This procedure is necessary to prevent
the wax from sticking to the teeth or the stone counterdie as heavy pressure is applied. The wax pattern
HANSEN,
CLEAR,
AND
WRIGHT
with the resin strut is easily removed from the denture
teeth by engaging the end of the resin pattern with a
wax carver and carefully lifting.
16. Sprue the patterns (Fig. 8), invest, cast in type III or
IV gold, and finish them in the customary manner.
Each unit in the castings should weigh approximately
0.5 pennyweight.
17. Use a small inverted cone bur to place undercuts at the
base of the strut. Also place undercuts in the channel
in the resin teeth. Thoroughly scrub the resin teeth
with green soap and warm water, and further clean
them with acrylic resin monomer applied with a cotton
pellet.
18. Lute the castings to the denture teeth with composite
resin cement (Fig. 9). Acrylic solder (Parkell, Farmingdale, N. Y.) is an excellent adhesive for this purpose.
Strain out most of the red fibers from the resin powder
before using.
SUMMARY
This article describes a procedure for duplicating precisely the occlusal surfaces of functionally acceptable
acrylic resin denture teeth in gold. An acrylic resin reinforcing strut prevents distortion of the wax pattern, and a
reline jig is used to stamp the anatomy in wax.
REFERENCES
1. Schultz AW. Comfort and chewing efficiency in dentures. J PROSTHET
DENT 1951;1:38-48.
2. Wallace DH. The use of gold occlueal surfaces in complete and partial
dentures. J PROSTHET DENT 1964;14:326-33.
3. Koehne CL, Morrow RM. Construction
of denture teeth with gold occlud
surfaces. J PROWHET
DENT 1970;23:449-55.
4. Morrow
RM, Rudd KD, Rhoads JE. Dental laboratory
procedures.
Complete dentures. Vol I. 2nd ed. St. Louis: CV Moshy, 19%X87-222.
5. Morrow RM, Rudd KD, Rhoads JE. Dental laboratory procedures. Removable partial dentures. Vol III. 2nd ed. St. Louis: CV Mosby,
1986:493-6.
6. Woodward JD, Gattozzi JG. Simplified gold occlueal technique for removable restoration.
J PROSTHET DENT 1972;27:447-50.
7. Elkins WE. Gold occlueal surfaces and organic occlusion in denture
construction.
J PROSTHET DENT 1973;30:94-8.
8. Whitbeck P, Ivanhoe JR. Occlusal relationships.
Dent Clin North Am
1985;29:149-61.
Reprint
requests
DR. CARL A.
UNIVERYITY
COLLECE OF
DEPARTMENT
Box 100435
GAINESVILLE,
to:
HANSEN
OF FLORIDA
DENTEWRY
OF PROSTHOD~NTICS
FL 32610-0435
VOLUME
71
NUMBER
4