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 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.