You are on page 1of 9

Over view of all laboratory procedure during RPD production

Notes: -The dr. was talking a lot in Arabic so I tried my best to translate what he said. -The dr. was repeating a lot so I just wrote the things that he didn't say before. -I think that all of us now know almost everything about the lab procedure so inshalla you will study this lec. Very quickly. -For more understanding you can listen to the record, I didn't put pictures in the script because the slide full of it so check the slide with script.

The laboratory procedures for metal frame work PD are very similar to the procedure of acrylic PD with one major significant difference which is the metal frame work! The steps for metal frame work fabrication: 1) Like every dental indirect procedure we need dental impression, we start up with initial impression, we make it with Alginate with stock try. 2) From initial impression we pour our initial cast which is made of: *edentulous plaster. *dentate stone. 3) We make our custom try, in complete denture we place one layer of wax spacer, But in RPD we place one layer over the edentulous area in the palate and two layer over the teeth because we want it thicker we want a greater thickness of the impression material so it doesn't tear so it's more flexible when it comes out of the

undercut around the teeth, so we have 2 layer of spacer around the teeth. 4) We make our Final impression with the custom tray and we use any kind of elastomeric material (addition silicon, condensate silicon, polyether, and sometime polysulfide) you can also use Alginate which we usually use! Because it's economical and it's easy to work with but silicon more accurate. 5) We pour our secondary cast with type three or four stone then we do surveying to know the shape of the teeth and the favorable &unfavorable undercut, is the way we decide how to insert and remove the denture so there is good retention and stability of the denture. With the surveyor we draw our initial design ,when we draw the design we decide where the rest, the GP are going to be, where the missing teeth are, and we design what the frame work will going to look like depending on the surveying .but this is our initial design! we still haven't apply it in the patient's mouth ,So we took the custom tray and we make our final impression .After we finish our final impression we get our secondary cast .

What is the difference between the final cast and the primary cast? In the patient mouth we don't have any rest seat or any Gide plate we just have natural teeth with filling sometime, so I take an impression & I pour a cast then I do surveying to decide where I'm going to put the rests and the Gide plane, these are the modification that I need to do .then I take the custom tray and the blue print ( ) and go to the clinic, I look in the patient mouth is it modified in anyway ? not yet ! So I prepare the rest seat and the GP and so on and I try the best I can to stick with my original design! Because what we do in the clinic is not necessarily identical to what we intent to do! We try our best to do parallel surfaces to prepare rests look nice rounded triangular in shape.

we do all these preparation and then we do our final impression using custom tray then we send it to the lab and we pour our modified or Final cast (working cast) and on this cast will be rest and the GP that I prepare it , not the one that I intent it ! but the one that I actually prepare whether they are good or bad .sometime I want to remove undercut sometime I want it to place a very deep rest and I end up with a shallow one ! if I find that the modification are good I can continue if they are bad sometime I have to go back and re-prepare. So again the on final cast we have all the preparation that we intent it to do. 6) Now we have the working cast, In the lab we have a problem this cast is made of gypsum, don't care which type is it 1,2,3... Gypsum above a certain temperature will break down! We said the gypsum is good when we want to make complete acrylic denture, acrylic needs just to melt the wax in the boiling water temperature and this temp. will not destroy the cast. The basic procedures in the Dentistry is the Lost wax technique all the indirect procedure follow it , I shape something out of wax , I invest it ,make a mold out of it , I melt the wax and then I replace the wax with acrylic or metal ! If I want to replace it with acrylic all I need to do is to melt the wax and put the acrylic inside, I need temp. maximum 95-100C , the stone could stand this temp. The problem is that Co-Cr alloy has melting temp. Which exceed 1000C! ,titanium melting temp 2800C and some noble alloys goes up and down .so if you put a stone cast in such high temp. It will turn into powder. And because of this we make a copy of our stone cast with a harder and more heat resistance material. 7) We double-cat our cast with one of the duplicating material which is either:

Duplicating material

Agar Agar

Addition silicon

a)Agar-Agar : We use Agar Agar in the lab while gypsum we use it in the clinic, agar agar is thermoplastic material if we heat it will become a liquid, jell, solid. It can be jell like or liquid according to the temperature while the gypsum we mix the powder and the water we have a chemical mix once it set we can't re-use it again, but agar agar can be re-used! b) Addition silicon: We can re-pour the material (the mold) but not re-use it. And it's more expensive than agar agar! So we make a copy, we had our final cast with the preparation made out of stone, now we have another cast which we double-cat it with the duplicating material then we make our refractory cast" heat resistance cast" that is made of investment material and the type of investment which we use it's called phosphate bounded investment or we can use sulfate bounded investment but it's weaker! 8) Now we have two cast look exactly the same one is made out of stone and the other made of phosphate bounded investment, this cast additional to that it's a made of heat resistance material also there is another advantage of it, in the master cast where ever we want to block out we block out with wax where ever we want a clasp we put a step, you placed arbitrary block out ,parallel ,shaped block out and relief . we put the wax in the cast , all the wax that was in the secondary cast will

also be copied and will turns into investment , thats mean the stone + wax block out turns into investment! 9) Now we have an investment cast, we don't go back to the patient! We continue the procedure in the investment cast. As we did last week in the lab we started to make the metal frame work and everything you shaped it out of wax will turns into metal , So you shape ,you place the major connector ,the minor connector the lattice ,the mesh work ,the clasps and everything you need to and they came in different color but in the end all of them will turn into metal ! We complete the mold by pouring more investment in the top of it, we sprue, now I have investment mold like the flask of the complete denture but it's made of investment not from stone. 10) I get rid of the wax in the Co-Cr by putting the investment in an oven and I raise the temp. Almost to 1000C, the wax not only will become liquid but it will burn out! I end up with a very hot empty mold, then we melt the Co-Cr alloy and we pour it inside the mold .it not that simple we have to raise the Co-Cr temp. in a special casting machine , So we place it and we pour the metal inside the mold, it will go into all the spaces that we create it for the wax ,we will get a metal piece which we will finish and polish just like we did in the complete denture. We have a metal frame work what happened to the refractory cast? The refractory cast was destroyed after we poured the metal because of the high temperature. And now our reference if we want to change anything we go back to our secondary stone cast! . on the secondary cast I use my metal frame work almost like base plate I use it to do jaw relation record, I use it to set the teeth , to make the waxing and the festooning in the area where will be going teeth and now I process the metal frame work like I do to the acrylic denture . 11) I will do for all the teeth and wax flasking, baking, curing and I will add teeth to the metal frame work.

(The dr. starts looking to the slides and reading from them and just repeating every thing again! So I just wrote what he didn't say before "slide number 5") p.s. to make the refractory cast stronger we apply a layer of hot bee's wax above it , this wax make a very thin layer on the surface of the cast so it become anti- scratch ( ) and become very strong on the surface! Now we are going to do design on this metal frame work we said that we either use wax we shape it with our hand or we use prefabricated wax which we should put it in the right orientation. We have different sizes and shapes of this wax, we place the wax on the surfaces, you can see here stippled wax it has same surface like the rough texture of the roof of the mouth some patient like it to be smooth others like it to be rough like natural palate, We adapted the wax on the cast. p.s. the external finish line is the junction between the metal frame work and the acrylic and it's away from the tissue, and we have the internal finish line which is toward the tissue. Because we place shaped block out where the clasp was now we have step in the refractory cast, this step will tell me exactly where to put the clasp . it's important to put the clasp in the right place because only the tip of the clasp should be in the undercut and everything else should be above the survey line above the undercut .So remember in the Co-Cr everything should be on the survey line or above it except the tip of the retentive arm of the clasp! And then we have to smoothen everything together, sometime we have to use wrought wire we add it to the metal frame work, if you remember from the lec. Of direct retainer we know that the cast alloy is ridge but the wrought wire is very flexible, so if I want a flexible clasp and not a ridge one I can place a wrought wire clasp with the metal frame work in the same prostheses! Here you can see the mandibular major connector which is a half bear shape lingual bar major connector comes in different diameter but usually it 4mm tall and 2mm wide. And as you know we should place it 4mm away from the free gingival margin.

Here you can see the mesh work, the lattice work. Now once I finish my wax frame work I can't do what I do with complete denture , I can't pour the investment from above and close it! Because the wax will be stock inside and I can't separate it again like the complete denture so what I do is I make a channel for the wax to go out and for the metal to go in! and I called this channel" sprue", they have nothing to do with the final frame work the only function of them is to make a way for the wax to go out and for the metal to go in . The cast is made out of investment and the second layer the top of the mold is also made out of the investment I put this cast inside this box and I pour investment over it, the investment will go everywhere around the mold, in the top except in sprue and the wax shaped which I shaped and now I end up with mold look like this (see slide #16). Now there is a wax inside it and as I said I get rid of it by using a very high temperature oven so place it in the oven for 2-5 hours depending on the size and number of the mold which we place. wax will burn out and the thing that will stay is this cylinder which is empty from inside ( ),So the oven heats up the mold (the investment)and then I take it out and I put it in the casting machine, this machine is to pour the metal with ( ) .. So it will melt the alloy, I put the small pieces of metal in the machine and then either I use a very hot flame or a very strong coil in the induction heating machine within 0.5-1 minute the solid metal will become liquid! Then I press a button or I release the spring so the metal will flow from the container into the mold. There are several methods of how we can pour the metal inside the mold but the most common two methods are: 1) The centrifuged casting: The mold will be on an arm and when we press the button the metal will be poured inside the mold and there is a spring, this spring will make the mold rotate (centrifuged) in a very high speed and because of the weight

of the metal will make the metal get in the details of the mold because it's too hot! 2) Suction: Very strong suction or vacuum will cause the metal to be sucked into the mold. (The dr. starts showing videos about the centrifuged and he is explaining again what they do). p.s. all this work should be done very fast within half to one minute or the metal will cool down and we can't pour it! Now after we pour the metal inside the mold and it cools down the metal will fill up the mold, it will fill up the area of the metal frame work which you waxed up and it will also fill up to the top, it will fill the sprues and the sprue former and remember this is not part of the prosthesis! So what I do is that I tap on it and I remove the investment after it cools down I end up with something like this ,can you see the Wight investment stuck to the metal ,this is dental frame work which as we know is made of Co-Cr and the Cr is here for the passivity, it protect the cobalt from oxidation, so here in the picture the black color is the cr oxide I have to clean it and finish and polish it using a nuzzle( ) sandblasting machine, there is a fine sand which is aluminum oxide particles 50-250 micron in diameter, it's very strong sand and it will remove the investment which is attached to the frame work . Then we use very strong metal discs to do the final finishing, and we cut away the sprues, we do final polishing using "electro polishing machine" (which contain an acid and electrical current which will go throw the frame work and this current will cause part of the Co-Cr to be removed and leave it very shiny) this machine will remove one molecular layer from the metal from the surface and that will give the final polishing and shine! Finally we will do fitting, the metal frame work should fit in the master cast and I use disclosing material (see slide #19). Then I have to make

sure that it fit in the patient's mouth then I can do jaw relation record, wax try in and set the teeth, then I process the teeth on the denture after I do mounting and I will end up with a denture with the teeth on it. I have two lost wax process: 1) For the metal frame work: which I made my refractory cast for 2) To make the acrylic and the teeth which I used it with the master cast.

(The dr. is showing a video) Nowadays we can make all this work with computers! But it's very expensive. The end Done by: Hadeel sumrain.

): ..

You might also like