目次
PART 1 Introduction to the Biofunctional Prosthetic System(BPS)
Chapter 1 What is the Biofunctional Prosthetic System (BPS)?
1 .Now is the time for a simple, easy-to-learn denture fabrication technique
2 .A systematic denture fabrication system will save the future of prosthodontics
3 .Globally recognized denture fabrication system (BPS)
4 .Function of BPS and increasing esthetic demands
5 .Emergence of BPS
6 .What is BPS?
7 .A technique for achieving suction of the mandibular complete denture, and BPS
8 .Goals of BPS
Chapter 2 Basic Fabrication Steps of a BPS Denture (Step 1 to Step 4)
Step 1: Examination to preliminary impression and primary bite registration
#1: Examination
#2: Preliminary impressions of the maxillary and mandibular residual ridges
by double-impression technique using Accu-Dent System
#3: Primary bite registration using the Centric Tray
#4: Preliminary casts and custom tray outlines
#5: Mounting the casts using the Horizontal Guide
#6: Custom tray fabrication with the Gnathometer M
Step 2: Final impressions of the maxillary and mandibular ridges to denture tooth setup
#7: Final functional impressions of the maxillary and mandibular alveolar ridges
with Virtual silicon materials
#8: Determination of occlusal vertical dimension and horizontal mandibular position with Gnathometer M.
#9: Facebow transfer using the Universal Transferbow System (UTS)
#10: Denture tooth selection
#11: Casts poured from the final functional impressions and mounting of the casts
#12: Model analysis
#13: Denture tooth setup using a two-dimensional or three-dimensional template and shaping of the polished surface
Step 3: Wax denture try-in to finishing
#14: Try-in of wax dentures
#15: Processing and finishing the dentures (using the Ivocap System)
#16: Remounting and occlusal adjustment
#17: Final polishing
Step 4: Fitting and delivering the completed dentures
#18: Fitting and delivering the completed dentures
PART 2 Advanced (1) Clinical Application of Suction Mechanism for the Mandibular Complete Denture
Chapter 3: Integration of Mandibular Denture Suction and BPS
1 .The reader is the witness
2 .Recommendation for a suction-effective denture: Suction leads to success in mandibular complete denture treatment
3 .Differences between conventional and suction-effective dentures
4 .Impression technique that everyone can achieve
5 .Learn the basics of BPS and raise your skill level with the suction mechanism
6 .Why is suction easier to obtain for the maxillary denture and more difficult for the mandibular denture?
Chapter 4 Understanding the Suction Mechanism
1 .What is the suction mechanism of the maxillary complete denture?
1-1. Sealing mechanism in the maxilla
1 )Interior/exterior double closure (labiobuccal area)
2 )Close contact closure (posterior palatal seal)
2 .What is the suction mechanism of the mandibular complete denture?
2-1. Absolute requirements for mandibular complete denture suction
2-2. Sealing mechanism of the mandibular complete denture
1 )Interior/exterior double closre (labiobuccal area)
2 )Seal in the lingual area
A.Seal in the sublingual fold region
(1) When the region is rich in spongy tissue
(2) When spongy tissue is lacking
(3) Oral environment of the sublingual fold region in the mouth and on the cast
B.Compensatory seal in the retromylohyoid muscle fossa region
3 )Sealing mechanism in the retromolar pad region
(1) Close contact closure with the mucosal surface in the retromolar pad region and the interior surface of the denture base
(2)Posterior border seal with the tongue and buccal mucosa above the polished surface in the retromolar pad region
PART 3 Advanced (2) Perfect Manual for Fabrication of Suction-Effective Dentures Using BPS
Chapter 5 Step 1: Examination to Preliminary Impressions and Bite Registration
1 .Importance of the pretreatment patient questionnaire (Oral Health Impact Profile-14)
2 .Diagnosis of mandibular denture suction
2-1. Examination and diagnosis of pre-treatment mandibular jaw position
1 )Predictive occlusal analysis based on hyoid bone position
2- 2. Simple intraoral examination of mandibular denture suction
1 )Intraoral examination
2 )Intraoral conditions required for mandibular denture suction
(1) How to examine the residual ridge with a good amount of ridge mucosa
(2) How to examine the sublingual fold region rich in spongy tissue
(3) Analysis of retromylohyoid muscle fossa space for denture base extension past the mylohyoid ridge
(4) Examination of the retromolar pads
2-3. Diagnosis of suction based on the intraoral findings
3 .Collaboration between the dentist and dental technician
4 .Biologic information to be provided to the dental technician
4-1. Patient complaints and psychologic state (OHIP-14 questionnaire)
4-2. Radiographs (panoramic and TMJ)
4-3. Intraoral photographs (of residual ridges)
4-4. Facial photographs taken in younger days
5 .Technicians’attendance at wax try-ins
6 .Preliminary impression of the maxillary ridge using the Accu-Dent System
6-1. Accu-Dent System is the impression-taking system of choice for maxillary preliminary impression.
1 )The benefit of double impression providing a simple and clean preliminary impression
2 )Impression-taking procedure
(1) Selection of tray size
(2) Mixing the impression material and loading the tray
(3) Impression-taking procedure
(4) Completion of the maxillary preliminary impression
7 .Preliminary impression of the mandibular ridge using the FCB Tray: The first step to mandibular denture suction
7-1. Closed-mouth impression in mandibular rest position using the FCB Tray
1 )FCB Tray material (disposable type)
2 )Impression materials for the FCB Tray
3 )Impression steps using the FCB Tray
(1) Tray selection
(2) Tray try-in
(3) Tray positioning
(4) Mixing the impression material and loading the tray
4 )How to transform the mandibular Accu-Tray into the FBC Tray
8 .Marking the outline for the maxillary custom tray on the cast
8-1. The outline in the posterior border area
1 )Nose-blowing method
2 )“Ah” line method
3 )Procedure for drawing the maxillary custom tray outline
9 .The outline for the mandibular custom tray to achieve suction
9-1. The outline for the mandibular custom tray on the preliminary impression taken with the FCB Tray
9-2. Differences between the preliminary impressions taken with the FCB Tray and conventional tray
1 )Myostatic outline (custom tray outlines based on static muscle attachments)
10.Centric Tray
10-1. What is the Centric Tray?
10-2. How to determine the occlusal vertical dimension using the Centric Tray
10-3. How to handle the Centric Tray when using silicone putty
11.Mounting the preliminary casts
11-1. How to use the Horizontal Guide
12.How to fabricate a custom impression tray conducive to mandibular denture suction mechanism
12-1. How to fabricate two types of custom impression trays
12-2. Six ideas for custom tray fabrication to achieve mandibular denture suction
1 )Six ideas for custom tray fabrication to achieve mandibular denture suction
2 )Procedure for fabrication of Gnathometer M-mounted custom trays
3 )Procedure for fabrication of wax rim-mounted custom trays using the average value of edentulous ridges (when Gnathometer M is not used)
13.Try-in of Gnathometer M-equipped custom trays
13-1. Checking the occlusal plane of the Gnathometer M
13-2. Checking errors in intermaxillary relationship
Chapter 6 Step 2: Maxillary and Mandibular Final Impressions to Setup of Denture Teeth
1 .Maxillary final functional impression
1-1. Maxillary final impression
1-2. Preparation for mandibular final impression
2 .The suction-effective mandibular final impression ? With a focus on the closed-mouth functional impression ?
2-1. Key points to consider for the suction-effective mandibular final impression of the mandibular ridge
1 )Importance of impression materials
2 )Importance of five basic movements for good to moderately resorbed ridges
2-2. Mandibular final impression procedure
3 .Correction of the occlusal vertical dimension after the final impressions, and Gothic arch tracing
3-1. Reasons for determining the occlusal vertical dimension first
1 )How to correct the OVD after the final impressions
3-2. Gothic arch tracing
3-3. Gothic arch tracing with the Gnathometer M
4 .Denture tooth selection
4-1. Selection of anterior teeth
4-2. Selection of posterior teeth
5 .Boxing
5-1. Boxing the final impressions (5 mm below the borders) and making the casts
6 .Mounting the final casts
7 .Model analysis
8 .Occlusal scheme of BPS
9 .Setting denture teeth (lingualized occlusion)
9-1. Setting mandibular posterior teeth (set-up sequence: 34, 44→35, 45→36, 46→37, 47)
9-2. Setting maxillary posterior teeth (set-up sequence: 16, 26→14, 24→15, 25→17, 27)
9-3. Occlusal check after set-up
Supplement: Complete denture occlusion for advanced level
S-1. Recommendation for lingualized occlusion with a small anterior overjet
1 )Ideal occlusion for the natural dentition for dentate individuals
2 )Traditional concept of ideal occlusion for complete dentures
3 )Increase of anterior overjet with balanced occlusion
4 )Reasons for loss of anterior overjet after start of denture wear
5 )A smaller anterior overjet is preferred for chewing
Chapter 7 Step 3: Wax Denture Try-in to Finishing
1 .The basic contours of the polished surfaces derived from function
1-1. The peripheral zone that is crucial to border seal
1-2. The polished surfaces that affect swallowing, phonetics, and tongue posture
1 )Shape of the buccal polished surfaces in the posterior area where the oral phase of swallowing is completed
2 )Proper form of the maxillary palatal polished surface for speech and swallowing functions
3 )Shape of the mandibular lingual polished surface to guide the tongue into natural posture
1-3. Lip support areas
1 )Labial surface of the maxillary anterior area
2 )Labial surface of the mandibular anterior area
1-4. Buccal polished surfaces that vary depending on the level of cheek activity(to prevent food traps)
1 )Shaping the polished surface for the modiolus
2 )Waxing the polished surface to accommodate the movement of the buccal frena and buccal mucosa in the mandibular posterior area
3 )Shaping the mandibular buccal polished surface by estimating the patient’s function
1-5. Reproducing the polished surfaces using plaster cores
2 .Wax denture try-in
3 .Denture processing (using SR Ivocap System)
4 .Remounting for occlusal adjustments
Chapter 8 Step 4: Fitting and Delivering the Finished Dentures
1 .Fitting the finished dentures
1-1. Pressure Indicator Paste test
PART 4 Managing Difficult Cases with BPS
Chapter 9 Managing Patients with Difficult-to-Treat Totally Edentulous Mandibles Using BPS
1 .Use of double-check bite to increase the precision of denture fabrication
1-1. Chairside time-saving
1-2. Determination of individual condylar inclinations with a double-check bite technique using the Christensen phenomenon
2 .Reasons for difficulty of achieving mandibular denture suction in patients with severe alveolar ridge atrophy
2-1. Oral environment where suction is difficult to obtain
3 .Clinical management of patients with severely resorbed mandibular ridges
3-1. Functional impression technique for difficult cases (two movements)
1 )Two movements that aid in achieving a good border seal in difficult cases
3-2. Methods of fabricating the final dentures using therapeutic dentures
1 )A totally edentulous patient with occlusal instability in whom mandibular denture suction was achieved through occlusal adjustments and relining
2 )A patient successfully treated using a flat-table therapeutic denture
3-3. Treatment of difficult edentulous mandibles using two-implant supported overdentures
1 )Current status of implant overdentures (IOD)
2 )Advantages of IOD
3 )Indications for a mandibular two-IOD
4 )Japan Denture Association consensus on IOD
(1) IOD fabrication based on the suction technique for the mandibular complete
(2) Safe implant surgery
(3) Professional cleaning to prevent pri-implantitis
5 )IODs and risk of peri-implantitis
6 )Attachments for mandibular two-IODs
3-4. Clinical cases of IOD treatment using extra-hard SR Phonares teeth resistant to occlusal forces transmitted by IODs
1 )SR Phonares teeth with esthetics and strength
Chapter 10 Managing Patients with Difficult-to-Treat Maxillary Ridges Using BPS
1 .What causes flabby ridges in the anterior maxilla?
1-1. The biggest cause is anterior chewing!
1-2. Causes of the anterior chewing that leads to flabby ridges
1 )Dominance of periodontal sensation around remaining mandibular anterior teeth(in maxillary single denture cases)
2 )The body’s attempt to unload the TMJ(in maxillary single denture, and maxillary and mandibular complete denture cases)
1-3. Factors that promote flabby ridges
1 )Genetic factors
2 )Anatomical factors that make the alveolar ridge susceptible to resorption
3 )Problems related to denture fabrication: Setup of denture teeth
4 )Acquired factors
1-4. Kelly combination syndrome
2 .Treatment of edentulous maxillae with single dentures
2-1. Keys to success of maxillary single denture treatment
2-2. When molars are present on both sides
2-3. When molars are present only on one side
2-4. When all molars are missing, particularly when only the first premolars and anterior teeth are remaining
1 )Implant placement in the mandibular molar area to obtain rigid occlusal support
2 )Fabricate a rigid telescopic denture with inner crowns placed on remaining anterior teeth
3 )An implant-supported telescopic mandibular denture is made as a combination of 1) and 2)
3 .Treating totally edentulous cases with maxillary flabby ridges
First stage: Denture fabrication
Second stage: Treatment of flabby ridge
Third stage: Maintenance
PART 5 Esthetic Enhancement with BPS
Chapter 11 Esthetic Enhancement with BPS Boosts Patients’ Self-Esteem.
1 .Increasing demand for esthetic complete dentures
1-1. Offering dentures that meet the patient’s esthetic demands
1-2. Esthetic evaluation
2 .Denture esthetics with SR Phonares
2-1. Application of SR Phonares to BPS partial dentures
3 .Denture esthetics with SR Phonares and gingival characterization
3-1. Gingival characterization using Candulor products
3-2. Esthetics expressing the patient’s individuality
