A 42-year-old male patient reported to Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India requesting replacement of his missing teeth. On intraoral examination, the patient had completely edentulous maxillary and mandibular arches. He had lost his teeth over a period of 3 years because of periodontal problems and was edentulous for the past 2 years. The patient was conscious about his sunken cheeks and desired a prosthesis that would make his face look fuller and healthier. He was leading a socially isolated life due to the psychological stress of his appearance. Treatment plan was formulated, keeping the patient’s demand in mind. It was decided to give the patient maxillary and mandibular complete dentures with intraoral closed faced magnet retained cheek plumpers for the maxillary denture. Primary impressions of maxillary and mandibular arches were made using impression material (Y Dents, MDM Corporation, Delhi). Custom trays were made using autopolymerizing acrylic resin. Border molding was done using low fusing impression compound (DPI Pinnacle, The Bombay Burmah Trading Corporation Limited, Mumbai, India) and wash impression was made with medium body addition silicone impression material (Aquasil, Dentsply/ caulk). Jaw relations were recorded. For the try-in appointment waxed denture was first tried for occlusion and esthetics. At the same appointment, cheek plumpers were made in wax and were attached to the upper waxed-up denture. Then it was evaluated to give the patient a fuller appearance. A dramatic change in the appearance with and without wax-up cheek plumper was observed and it was immediately accepted by the patient. The waxed plumper was separated from the waxed-up denture. After that flasking and dewaxing procedures were completed separately for the final pros-thesis and cheek plumpers. The mold space was packed with heat-polymerizing acrylic material (DPI, Mumbai, India) and curing procedures were performed according to the manufacturer’s instructions. After deflasking, the cured final prosthesis and plumpers were retrieved. Trimming, finishing, and polishing procedures were performed. Then a pair of commercially available magnets (cobalt-samarium, Ambika Corporation, New Delhi, India), 5 mm in diameter and 2 mm in thickness was employed to retain the cheek plumper with final prosthesis (). Provision for placement of magnets in the flange of the final prosthesis and in the cheek plumper was made and positioned with the help of autopolymerizing resin (, & ). Complete polymerization was ensured by placing in a pressure pot and finishing and polishing was then carried out. The attachment of plumper to the prosthesis was first checked outside the patient’s mouth ( & ). The prosthesis along with the plumper was then checked in the patient’s mouth for comfort, function and esthetics ().\nThe patient was educated about the positioning of the plumper to the prosthesis. The patient’s demands were fulfilled ( & ). He was called for regular check up to evaluate any soreness or looseness of dentures.
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.