An innovative metal base denture design for a 55-year-old menopausal woman
A 55-year-old edentulous denture wearer female reported with the chief complaints of burning sensation in the oral cavity especially in anterior portion of mouth, frequent redness of mucosa, inability to sense temperature changes of food, and recurrent allergic and microbial infections with present acrylic dentures. Medical history revealed that the patient was undergoing treatment under a gynecologist for menopausal symptoms. Dental history revealed patient was edentulous since 2 years and had been experiencing above problems since 1 year.\nSo it was decided to fabricate a complete denture with a customized metal palate design that along with the ongoing treatment from gynecologist would relieve the patient from symptoms because contact sensitivity to denture base materials or to allergens and microbial antigens on the acrylic denture plate plays a greater role in burning sensation in edentulous persons.[]\nThe customized metal palate, apart from fulfilling the patient's needs, was designed in an innovative way with metal loops in specific directions and positions that would enhance interlocking with acrylic portion and also not to interfere with the teeth arrangement of artificial teeth.\nThe primary impression was made with irreversible hydrocolloid. Custom tray was fabricated and secondary impression was made with zinc oxide eugenol. The final cast derived from this impression was duplicated and refractory cast was formed. The refractory cast is used for the fabrication of the customized metal palate.\nA sheet of green spacer wax was adapted on the palatal portion of the cast covering the crest of the ridge and extending 2-3 mm beyond it. Loops of 2-3 mm length made of wax were attached to the peripheral border of the previously adapted palatal spacer wax. It was taken care that all these loops were 2-3 mm short of the sulcus as shown by straight arrow []. These loops would enhance the interlocking of acrylic. This was important because no loop should interfere with the acrylic border of the denture extending into the sulcus.\nTiny loops were placed slightly palatal to the crest as shown by the curved arrow []. The height of these loops was such that it would not interfere with the arrangement of artificial teeth but was sufficient enough for inflow of acrylic resin. A butt joint was created palatal to the crest at the junction of acrylic and metal that enhances the strength of the metal acrylic junction creates a smooth joining of acrylic with metal avoiding any step formation, thus making it comfortable for the patient.\nFor making the butt joint, a 2-mm cylindrical blue wax beading was adapted palatal to the crest of the ridge as shown by straight arrow []. A bard parker knife was run 45° to the border of the bead. Once the design of the palate in wax was done, wax sprues were attached and casting was done. The metal palate after finishing was placed now on the master cast [] and maxillary rim was made for jaw relations []. The jaw relations were recorded and teeth arrangement was done. After curing, the maxillary metal denture was finished and polished []. The patient's pre-treatment [] and post-treatment [] photographs showed marked improvement in esthetics. After 3-month follow-up, patient reported drastic improvement in symptoms previously mentioned.