A 51-year-old female patient reported to the department of Prosthodontics, with a chief complaint of looseness of both upper and lower dentures and desired the replacement of the same. Her history revealed that, she had been edentulous for 15 years and had been wearing dentures for 14 years.\nThe intra-oral examination revealed a narrow and constricted U-shaped flat palatal vault and severely resorbed maxillary and mandibular ridges []. The treatment plan decided for the patient was the fabrication of a hollow maxillary complete denture combined with neutral zone concept to enhance the retention and stability of dentures. Because of severely resorbed ridges and increased inter-ridge distance, fabrication of hollow maxillary complete denture with utilization of neutral zone concept was planned for better stability and retention.\nMaxillary and mandibular impression was made followed by border molding with green-stick (DPI Pinnacle tracing sticks, The Bombay Burmah Trading Corporation Ltd.,) and final impression with zinc oxide eugenol impression paste (DPI Impression paste, The Bombay Burmah Trading Corporation Ltd.,). Compound occlusal rims were fabricated by using modeling compound (DPI Pinnacle Impression Compound, The Bombay Burmah Trading Corporation Ltd.) mixed with greenstick (DPI Pinnacle Tracing sticks, The Bombay Burmah Trading Corporation Ltd.) in ratio of 3:7 i.e. 3 parts impression compound +7 parts greenstick compound) as per McCord's technique for making a neutral zone record by having the patient perform various Orofacial movements. Then index of this record was then made with plaster of Paris and rims were duplicated in wax. The maxilla-mandibular relationship was recorded using wax occlusal rims and transferred to the articulator and the artificial teeth were arranged. Try in procedure was done and then, all the wax excluding the wax surrounding the teeth was removed and replaced with light body elastomeric impression material (Aquasil Ultra LV Dentsply Caulk, Milford, USA). Trial denture bases were reinserted into the patient's mouth and she was instructed to perform various Orofacial movements so as to record the polished surface of the denture in harmony with the Orofacial musculature. After the try in procedure, wax up was done and dentures were made ready for processing. The mandibular denture was processed using the conventional procedures.\nThe Special Steps Taken for the Fabrication of Hollow Maxillary Complete Denture were as Follows:\nThe maxillary trial denture was flasked [] and dewaxed in the conventional manner []. Half of the heat cure PMMA (Trevalon, Dentsply India Pvt. Ltd., Gurgaon, India) in dough stage was positioned accurately over the dewaxed mould and then salt crystals were placed over it []. Above that, the remaining heat cure resin was packed and cured at 74 degree C for 7-8 hours []. Cured denture was retrieved [] and 2 holes were made in the thickest palatal area []. All the residual salt crystals were removed by flushing water with the high pressure syringe through the holes. After making sure that all the salt crystals have been removed, the escape holes were closed with autopolymerizing resin (Trevalon, Dentsply India Pvt. Ltd., Gurgaon, India) []. The hollow cavity seal was verified by immersing the denture in water, if no air bubbles are evident, an adequate seal is confirmed. The dentures were inserted in the patient's mouth [] and instructions regarding care, hygiene and maintainance were given. On 3-month follow up, the patient reported that she was quite comfortable with the dentures and she had encountered no problems.
A 65-year-old male came to the department for replacement of missing teeth and complained of sunken cheek appearance on either side. On examination, the patient has a completely edentulous maxillary and mandibular arch with a sunken buccal cheek []. The treatment plan decided was complete denture prosthesis with buccal cheek plumper on either side of the maxillary denture to improve esthetics.\nThe primary impression was taken with impression compound, and the primary cast was made with dental plaster. Self-cure acrylic resin special tray was fabricated, and border molding was completed using green stick compound, and the final impression was taken with zinc oxide eugenol impression paste. Record base was fabricated with self-cure acrylic resin, and occlusion rims were constructed. During the jaw relation procedure, it was found that the occlusal rim does not provide enough support for the cheek muscles. To improve the esthetics, the extra waxes were added on both sides of the occlusal rims near the first molar region until it provided enough support to the cheek muscles []. It was verified that the extra waxes did not cause dislodgment of record bases. Semi-anatomic teeth were selected according to the patient age, sex, and personality. The trial denture base was tried in the patient; the esthetics, phonetics, and jaw relation were verified. Facial esthetics was checked whether the wax buccal pad provided necessary esthetics without dislodging the wax trial denture base during functional movements of the cheek muscles. To reduce the weight of the prosthesis, the wax in the buccal pad was scooped out creating an open bulb with the border's thickness of 1.5 mm around the periphery []. The routine flasking, dewaxing, packing, and curing procedures were done. After deflasking, the complete denture was retrieved, trimmed, and polished. Since the open bulb could lead to food accumulation, the shellac base plate was used to form the lid for the buccal pouch []. After the extension and stability of maxillary complete denture with buccal pouch was checked in the patient mouth, lid with the shellac base plate material was replaced with heat cure acrylic, which was sealed with the hollow cheek plumper using self-cure acrylic resin [].\nThe maxillary complete denture with closed hollow bulb cheek plumper, and the mandibular complete denture was inserted []. The esthetics, the phonetics, and the stability of the prosthesis were checked. The patient was reviewed at 24 h, and the complete denture was found to be satisfactory both in esthetics and function.