Filling the Voids
All right, so I was saying that you have to secure it right away.
So what I do is I just kind of use this little salt and pepper technique. I dip in the in the monomer and then I pick up a little bit of powder and then I just apply it around the cylinder.
Just filling in around the cylinders just to secure them in place, and after I do that, I'm going to go ahead and do a bulk fill. But if I did the bulk fill without securing each cylinder in place, the acrylic's not really going to wrap around the cylinder as well as I'd like it to, which could lead to the temporary breaking.
If you have a little acrylic like injectable acrylic in a gun you can apply it with that too. So either way works.
What you can also do at this point is just attach some analogs so that way you don't risk damaging the platform or getting acrylic inside the access hole. But I like to live dangerously so I'm just not going to do that.
Okay, so now that we've already filled the area around the cylinder so there's acrylic grabbing all of those little grooves of the cylinders on each implant, right, so there's no grooves exposed anymore. I'm going to go ahead and bulk fill all of this.
So what that means is I'm going to mix the acrylic and just use my little monject and inject all of it. Or again like I said you can use the little acrylic mixing gun that you can get from like zest anchors or a bunch of places probably make it too.
I'm going to show you right now how to bulk fill the inside of the conversion prosthesis. There's an art to not filling too much because if you fill too much, you'll never be able to go ahead and seat that prosthesis back on the implants.
So if you want to be super sure that you're going to be able to have a really well-fitting prosthesis, you can go ahead and take a closed tray impression like you see here in this picture. You can take a closed tray impression, pour that, and then do your work on top of that model.
Here I'm showing you how to do it without a model, but if you want to be 100% sure, take an impression, pour a quick model, and then work on that.
Time to bust out the heavy-duty mixing bowl.
I just bulk-filled all these areas and then now for the little areas to fill in, I'm going to use that little salt and pepper technique again.
All right, at this point, what you can do after you already did the bulk fill, you can put it in some hot water. Let's put that in some hot water and put that into a pressure pot. This will help the acrylic set a little bit less with fewer pores.
Just a little salt and pepper technique again. And again, if you want to be super safe about it, put some analogs on these guys so that way you don't damage, that way you don't accidentally get acrylic inside.
You have to be really careful when you're filling this stuff in because when you fill too much in here, it might not seat properly anymore. So actually try to be really careful when you're adding to the intaglio.
So kind of remember how far your implants stick out and fill accordingly.
All right, so now the inside is all filled up, or the intaglio is all filled up. Now I'm going to turn it upside down and I'm going to see if there's any voids on this side that need to be filled in.
So like over here, if you get acrylic on the teeth, you want to make sure to wipe it off pretty quickly so that way it doesn't get stuck and it's hard to polish later.
This one on this side is a little bit tough, so what I would do is pop that little screw out, put a little q-tip applicator, you know, one of those cotton tip applicator sticks in there, and then just add acrylic around it. So let's just go ahead and do that.
The thing with this though is if you add acrylic like this, the acrylic is going to get stuck to the wood, so I'm just going to go ahead and dip it in some Vaseline first.
All right, I'm going to put it right there, and now I'm going to go ahead and add acrylic around it.
And then once this sets up, then I'm going to just kind of twist this a little bit so that way it doesn't stay bonded and then I'll take it out.
So everything's pretty much filled in. Like I said, be really careful when filling in the intaglio. This is probably, at least for me, it's probably the most common source of complication that if you overfill this, you won't ever be able to get it to seat again.
I like to minimally fill it, so never fill past your platforms. But you're you are pretty safe to fill where there's huge voids in there.
As you can see, there's a lot of there's still flanges, there's like weird extensions, the shape is all weird too.
So this next step, I'm going to go ahead and trim off the distal extensions, and I'm going to polish up the denture and make it look pretty.
But right now, let me go ahead and move this. Take this guy out. Actually, the acrylic still setting up, so I'm not going to remove it quite yet.
All right, now it's kind of hardened up, so I'm going to rotate this and then pop it out and see, I still got my little screw channel there.
All right, so now this is ready for finishing and polishing.
All right, here's a summary of the steps for securing and filling a conversion prosthesis:
- Start by using a salt and pepper technique to apply monomer and powder around the cylinder.
- If you have injectable acrylic, you can use that to apply the material.
- Consider attaching analogs to protect the platform and prevent acrylic from getting inside the access hole.
- Fill in around the cylinders to secure them in place.
- Do a bulk fill, ensuring that the acrylic wraps around the cylinders to prevent temporary breaking.
- If desired, take a closed tray impression and work on a model for a better fit.
- Fill in any remaining voids using the salt and pepper technique.
- Put the prosthesis in hot water and then into a pressure pot to help the acrylic set with fewer pores.
- Check for voids on the other side and fill them in as needed.
- Be careful not to overfill the intaglio, as it may prevent proper seating.
- If necessary, add acrylic around screw channels using a q-tip applicator dipped in Vaseline.
- Trim off any excess and polish the denture for a finished look.
- Allow the acrylic to fully set before removing the prosthesis from the model.
Following these steps will help ensure a secure and well-fitting conversion prosthesis.