Published online: 2019-04-05

THIEME
42 Case Report

Prosthodontic Management of Single Complete

Denture with Reinforced Metal Denture Base:
A Case Report
Chhavi Sharma1 Manjit Kumar1 Ajay Bansal1 Sanjan Verma1 Shak Mehta1

1 Department of Prosthodontics, Bhojia Dental College, Baddi, Address for correspondence Chhavi Sharma, MDS, Department
Solan, Himachal Pradesh, India of Prosthodontics, Bhojia Dental College, Baddi, Solan 173205,
Himachal Pradesh, India (e-mail: cshrma1026@gmail.com).
Dent J Adv Stud 2019;7:42–45

Abstract For improvement in longevity of complete denture prosthesis in place of c­ onventional

poly methyl methacrylate denture base material, metal denture base is used to
­rehabilitate complete edentulous maxillary arch as it helps in preventing ­resorption
of residual ridges and improves fracture resistance, better dimensional stability, more
Keywords accuracy, less weight, and better retention of prosthesis. For better prognosis there
►►complete denture are many factors, but major factors such as retention, stability, and support are more
►►metal denture base important. Metal denture base leads to improvement in physical properties of the
►►polymer resin prosthesis.

Introduction and metal should be carefully located and formed to ensure

proper palatal contour and to reduce weight and maximum
According to French, artificial dentures function like strength.7
­mechanical machines in an anatomic environment. In c­ ases
in which there is a clash between esthetic and functional
requirements, a choice is to be made by favoring one at the Case Report
expense of the other or make some amount of c­ ompromises A 45-year-old male patient reported to the Department of
in most situations.1 Polymers are the dominant m ­ aterial Prosthodontics, Bhojia Dental College and Hospital, Baddi,
for the fabrication of denture bases. Materials such as with a chief complaint of upper completely missing teeth.
­polymethyl ­methacrylate may be molded and polymerized The patient also complained about fracture of upper denture.
by use of a variety of techniques. These polymeric bases pres- In the past dental history, he got treated with 14 units fixed
ent ­acceptable physical, biologic, and esthetic characteristics dental prosthesis in the lower arch and denture for the upper
at moderate expense. However, there are instances in which arch. Detailed case history was recorded, and no significant
these bases fail because of poor denture base adaptation. medical concerns were observed (►Fig. 1).
Failure may also be caused by excessive masticatory forces
when we fabricate single complete denture against the natu-
Intraoral Examination
ral and fixed dentition. In those situations, metal alloys have
been used to strengthen the bases and prevent fracture.2 Intraoral examination revealed completely edentulous max-
To increase rigidity and fracture resistance, metals and illary ridge and opposing 14 units fixed dental prosthesis.
metal alloys are cast into thin sheets and incorporated in According to Len Tolstunov classification, the patient was
denture bases.3 Interference with phonation also get decrease ­classified under class I modification 2 condition in which the
due to thinner metallic denture base.4 These bases are more upper arch was completely edentulous with stable fixed full
accurate and dimensionally stable.5 Being highly thermal dentition in the mandibular arch. Mucosa was normal, and
conductive property of metal denture base is responsible for opposing prosthesis required minor alterations. Saliva was
enhancing tissue health with their contact.6 of medium consistency, and the patient was cooperative and
Procedure of fabrication of metal denture base is not philosophical. The patient had class II (medium) arch size
cost-effective and not complicated. The junction of resin with square arch form according to house classification. The

received DOI https://doi.org/ ©2019 Bhojia Dental College and

September 26, 2018 10.1055/s-0039-1685126 Hospital affiliated to Himachal
accepted after revision ISSN 2321-1482. Pradesh University
February 11, 2019
published online
April 5, 2019
 Prosthodontic Management of Single Complete Denture Sharma et al. 43

Fig. 1 Preoperative extra- and intraoral views of patient. Fig. 2 Impressions and casts.

patient’s ridge was high with flat crest and parallel sides. His
hard palate was U-shaped with class I soft palate that was
horizontal and demonstrated little muscular movement.
In this case, more tissue coverage was possible for posterior
palatal seal.

Treatment Procedure
Preliminary impression of the edentulous maxilla was made
with impression compound (Rolex, Delhi, India) and was
poured with plaster of paris (Dentex, Jammu, India) for the
fabrication of a custom special tray. The peripheral tracing
procedures were completed with green stick impression
compound (DPI Pinnacle, Mumbai, India), and the secondary
impression was made with zinc oxide eugenol impression
material (DPI Impression Paste, Mumbai, India). Master cast
was poured with dental stone (Kala Bhai, Mumbai, India)
type III (►Fig. 2).
Duplication of master cast was done by using reversible
hydrocolloid AGAR impression material (Wirodouble,
Bremen, G ­ ermany) and poured with refractory material Fig. 3 Wax patterns and metal denture base.
(Kala Bhai Ultrarock, Mumbai, India). Wax pattern (Yeti,
Engen, Germany) was made on refractory cast invested with
phosphate-bonded investment material (Dellodent, Japan), teeth. Though a perfect balanced occlusion is impossible to
and casting was done. Metal denture base was fabricated achieve in such cases with involvement of fixed dental pros-
(►Fig. 3). thesis in opposing arch, a maximum effort was made to get
Trial denture base and occlusion rim were fabricated. an occlusion that was as close to balanced occlusion. Trial of
At this stage, jaw relation records were used to mount and the denture was done (►Fig. 4).
verify the positions of maxillary and mandibular casts. Denture fabrication was done with conventional m ­ ethod
After mounting, tooth arrangement was done according to using heat cure resin poly methyl methacrylate (DPI Heat
­anatomic, functional, and esthetic guidelines by establish- Cure, Mumbai, India) by keeping metal framework at the
ing bilateral balanced occlusion. Adjustments in the a
­ rtificial respective maxillary cast. A butt joint was created palatal to
teeth were incorporated in preference to making natural the crest at the junction of acrylic and metal to enhance the

Dental Journal of Advance Studies Vol. 07 No. 1/2019

44 Prosthodontic Management of Single Complete Denture Sharma et al.

Fig. 4 Jaw relation and trial denture base.

strength of metal acrylic junction. This helps in creating a According to (GPT 9), Metal Base is defined as the metallic
smooth joining of acrylic with metal avoiding any step for- portion of a denture base forming a part or the entire basal
mation, thus making it comfortable for the patient. M
­ axillary surface of the denture; it serves as a base for the attachment
denture was inserted into the patient’s mouth after the of the resin portion of the denture base and the teeth.
occlusal adjustment, and proper care and maintenance of the Major indication of complete denture reinforced metal
prosthesis instructions were given to the patient (►Fig. 5). base where patients with natural dentition or fixed dental
prosthesis in opposing arch as presence of unmodified
opposing dentition prevents occlusal balance during function,
Discussion
thereby compromising stability and retention and eventually
The part of a complete or removable partial denture leading to frequent mechanical failures of the prosthesis.
that rests upon the basal seat and to which the teeth are Any factor that exacerbates the deformation of the base or
attached is known as denture base. alters its stress distribution may predispose the polymethyl

Fig. 5 Acrylised metal denture base and denture insertion.

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 Prosthodontic Management of Single Complete Denture Sharma et al. 45

methacrylate denture to fracture. In patients with high or Conclusion

low position of palatal surface, when the actual center of the
denture was at a significant distance from the “ideal” center Treatment efficacy and effectiveness will depend on the
of the denture, no tori palatini as well as exostosis or bony knowledge of properties of different prosthodontic materials
prominences were present, and in unilateral residual ridge by the dentist. Metal denture bases are strong to resist
resorbed patients, inadequate interarch space was present. destructive failure, help in providing comfort to the patient,
Other indications of metal denture base are tooth-supported and solve the problem of recurrent fractures. In addition,
partial dentures and where inadequate interarch space is metal denture bases are good thermal conductor and light
present. weight; thus, patients perceive natural feeling. Also, their
There are various ideal requirements of a denture base thin base increases denture stability.
material that it should be biocompatible. Material should Conflict of Interest
have good abrasion resistance as well as high thermal con- None declared.
ductivity. Density and solubility and sorption to oral fluids
should be less.
Cast metal denture bases have various advantages over References
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There are a few disadvantages regarding metal denture
base: it is difficult to reline and rebase, it compromises
esthetic qualities, and it is contraindicated in patients allergic
to base metal alloys.

Dental Journal of Advance Studies Vol. 07 No. 1/2019