Remount cast fabrication for occlusal equilibration against artificial denture teeth.

aClinical Associate Professor, Department of Biologic and Materials Sciences, Division of Prosthodontics. bClinical Assistant Professor, Department of Biologic and Materials Sciences, Division of Prosthodontics. (J Prosthet Dent 2009;101:350-351) Establishment of a balanced and harmonious occlusion is a prerequisite for the successful rehabilitation of edentulous patients.1,2 Clinical remounting of the prosthesis simplifies the occlusal equilibration procedure by enhancing the visual detection of occlusal discrepancies, ensuring the accuracy of occlusal adjustments, and minimizing the errors occurring from the viscoelastic nature of the mucosa.1,2 The occlusal relation is evaluated visually by closing the artificial denture teeth against the opposing stone cast, and occlusal contact marks are identified with repeated impact and gliding contacts by means of articulating papers or ribbons placed between the denture teeth and the stone teeth.3,4 Gypsum material is readily accessible, convenient to use, and rigid; however, the stone teeth are not as tough as the artificial denture teeth and are brittle and susceptible to wear and breakage with repeated occlusal contact.3,4 Several methods have been introduced to address the problems of wear, chipping, or fracturing of the stone teeth against the opposing denture teeth. The remount casts are fabricated of low-fusing metal alloy,5 vinyl polysiloxane (VPS) impression material,6 or a combination of VPS, acrylic resin, and dental plaster.7 A cast made of low-fusing metal alloy addresses the problems associated with the weakness of the gypsum materials. It is durable and wear resistant; however, the procedure requires special materials and devices.5 In addition, incorporation of bismuth in the alloy (48-55%) to reduce shrinkage may present health hazards with the inhalation of the fumes developed when burnt out. The method using VPS material facilitates the remounting procedure because it is quick and easy to use and permits the rigid portion of the denture to pass into the undercut area.6,7 The block-out procedure may not be an important consideration because of the resiliency of the silicone material. In addition, the material is resistant to wear or chipping during occlusal adjustment. However, the accuracy of the occlusal contact marks indentified against the silicone tooth is suspect because of the viscoelastic nature of the silicone material. The resiliency of the silicone material may be managed by processing acrylic resin in the incisal or occlusal one third of the silicone tooth.7 This method may provide a stiffer surface against the artificial denture tooth; however, it requires a number of materials and procedures in which dowel pins are inserted into the acrylic resin to connect with the silicone material and dental plaster. The purpose of this article was to describe a simple and accurate procedure of fabricating a remount cast, in which a thin layer of tooth-colored acrylic resin is processed over the gypsum material to present a stiff, wear resistant, and tough surface that can endure the repeated impact and gliding occlusal contacts against the artificial denture teeth. The impression is lined with a thin layer of acrylic resin and poured in dental plaster. Polymerization of the acrylic resin is accelerated with heat from the exothermic reaction of the dental plaster. The acrylic resin shell is secured to the dental plaster by engaging undercuts presented by the tooth and tissue contours. The impression should be stored in a humid environment, and the potential dimensional change of the acrylic resin with polymerization is negligible with the use of a minimal volume of resin. The occlusal contact marks are readily identified on the denture teeth and the tooth-colored acrylic resin surface for an accurate assessment and selective adjustment of occlusion. This procedure can also be extended to fabricate a remount cast for a removable partial denture.