Department of Biologic and Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, 1011 N University Ave, Ann Arbor, MI 48109, USAUnited States
Department of Endodontics, Prosthodontics, and Operative Dentistry, University of Maryland, School of Dentistry, 650 W Baltimore St, Baltimore, MD 21201, USAUnited States
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Prior to the fabrication of implant-supported fixed complete dentures, the existing or transitional removable complete dentures can be used to establish the optimal jaw relation. This article introduces a simple technique to accurately transfer the established jaw relation from removable complete denture to final fixed prosthesis.
Keywords: Jaw relation transfer; Conventional complete denture; Implant-supported complete denture
Implant-supported or retained complete dentures are increasingly accepted as an al- 1-4 ternative to conventional dentures for the oral rehabilitation of edentulous patients.1-4 In most
clinical situations, there exists a transitional period when patients need to wear conventional
complete dentures while waiting for the osseointegration of dental implants. These transitional
complete dentures can greatly facilitate the establishment of optimized jaw relation. However,
it remains a challenge for clinicians to accurately and efficiently transfer the established jaw
relation obtained with these conventional complete dentures to implant-supported prostheses.
Several reports have described the use of duplicate dentures to transfer vertical dimension of 5-8 occlusion at the centric relation position to fabricate the final implant-supported prostheses.5-8
In all these reports, an additional duplication step is required, during which inaccuracy might
be introduced. A technique was recently reported to transfer jaw relation with an existing den-
ture.9 In this technique, the intaglio surface of the denture must be relieved to accommodate the
autopolymerization of acrylic resin or a rigid vinyl polysiloxane impression material around the
healing abutments. However, the success of this approach relies heavily on the accurate seating
of the denture on the cast as in patient’s mouth, which is soft and resilient. Thus, precise seating
The technique described below can aid clinicians to accurately and conveniently trans-
fer the established jaw relation information from the conventional complete denture to the im-
implants to achieve desirable stability.
1. Remove the existing complete denture after confirming its
correct vertical dimension and centric occlusion.
2. Insert a bite registration aid (Straumann, Andover, MA, USA)
on the most posterior implant unilaterally (Figure 1).
3. Prepare an occlusal opening in the denture in the area corre-
sponding to the location of bite registration aid (Figure 2)
4. Seat the existing complete denture and make sure that the bite
registration aid is below the occlusal surface.
5. Lubricate the prepared denture and opposing teeth with petro-
leum jelly (Pearson Lab Supplies, Sylmar, CA, USA).
6. Add a small amount of autopolymerizing pattern resin (GC
America, Alsip, IL, USA) to the top of bite registration aid and
ask patient to occlude in the established occlusal position (Fig-
ure 3).
8. Insert a second bite registration aid on an anterior implant and
repeat steps 3 to 7.
9. Insert a third bite registration aid on a contra-lateral poste-
rior implant and repeat steps 3 to 7 to establish a tripod support
(minimal number of support).
10. (Optional) Insert additional bite registration aids on other
implants and repeat steps 3 to 7.
11. Connect the individual bite registration aids with pattern
resin to acquire a jaw relation record (Figure 5).
12. Take a face bow transfer and mount the casts by using the
jaw relation record (Figure 6).
13. Repair the denture with autopolymerizing acrylic.
The described technique can facilitate the accurate
transfer of jaw relations from existing conventional complete
denture to implant-supported complete denture. It is simple,
economical and can significantly reduce the number of vis-
its needed to fabricate implant retained prosthesis. In order to
minimize the shrinkage of pattern resin, it is advisable that one
bite registration be performed at a time. However, it is also ac-
ceptable for clinicians to prepare multiple occlusal openings in
the dentures and insert several bite registration aids at the same
time. Other materials can also be used to obtain jaw relation re-
cords (e.g. elastomeric bite registration material, etc.). Although
a Straumann bite registration aid is used in the aforementioned
case, any commercially available implant system can use this
technique with modifications. Screw-retained temporary abut-
ments instead of a Straumann bite registration aid can be used
if such is the case. Temporary abutments need to be modified
to be below the occlusal surface in order to provide room for
the occlusal registration material. After having obtained occlusal
registration (step 6), a small screw access hole in the center of
the pattern resin needs to be drilled for the registration device
to be removed. To achieve sufficient stability, a slightly larger
occlusal opening (and thus a larger recording pattern resin) is
required to accommodate a patent screw access hole.
The authors would like to thank Dr. Biyun Wu for critically read-
ing the manuscript and final editing.
The authors have no conflicts of interest to declare.