Daily Archives: May 26, 2007

Reprocil is my new best friend

After doing block carving and vacuform plastic matrix acrylic for a while it has been nice using this material we have been introduced to called reprosil. It comes in many forms, the pictures here is the putty stuff, there is also light, medium and heavy bodied stuff that allows for greater detail, etc. We should be using it soon. This post is short, but I want to illustrate the difference it makes.

The material comes in two buckets. You mix equal parts from both buckets and get a Play-doh type of material. You squish it onto the teeth and let it set. After a few minutes it has turned into a stiff rubbery type of material. Here are some pictures:

reprocil

reprocil

When it sets you prepare the teeth like shown in previous articles and then you use this reprocil as a mold for the original tooth anatomy. Lets see if I can clarify this for you:

  1. Reprosil impression
  2. Prepare teeth
  3. Place acrylic into the reprosil mold and squish it onto prepared teeth
  4. The teeth that come out look like the old teeth and fit onto the prepared teeth.
  5. Time saved: 30 minutes

I have been told that not many dentists use this, and in fact you will rarely use it in the clinic on patients. There are even easier methods than this. Still, it is good to get your hands on everything possible. Here is the difference between the two teeth. Notice the teeth in the typodont are the ones I carved that you thought looked so sweet. i admit they are not my best performance, but this WAS my first one ever. Compare it to the reprosil model.
Reprocil vs vacuform
It is good that we are taught how to carve out of acrylic because sometimes you will be faced with a patient that comes into your office with a broken tooth and you will not have original tooth structure to go by. You will have to carve one and make sure it is of high quality to be used as a temporary. Many students at Temple in the clinics still block carve their temporary crowns.

Finishing the Three Unit Bridge

Now that I have made the plastic form I can start to make the three unit bridge. Vaseline the teeth you have prepared so the acrylic doesn’t stick to them. You don’t use vaseline in a patient, their saliva lubricates everything enough so the acrylic doesn’t stick. Mix the liquid monomer with the polymer sand and pour it into the plastic matrix. Try not to get any air bubbles while pouring. If you do then you can always fill them in later, but it takes extra time.

acrylic three unit bridge

This photo shows what the acrylic looks like after it has been placed on the teeth and the plastic matrix has been removed. Right now it is pretty rubbery. Here are some more shots:

Acrylic three unit bridge

Here is the temporary removed from the mouth. From here it is placed in water or off to the side until it is fully dried.

temporary acrylic bridge

As you can tell there is not very much detail, however it is better than a basic block carving of acrylic. There is still much work to do. The next picture shows the underside of the temporary. Acrylic shrinks a lot so this probably won’t fit on the teeth anymore. A re-line has to be done. A re-line is the process of carving out the middle of these teeth, pouring more acrylic into the hole and then re-seating the bridge back onto the crown preparations. Here is the underside of the crown. The two teeth that fit over the existing prepared teeth are called abutments, the middle tooth which will be ‘floating’ is called the pontic. Ideally the pontic will be in contact with the gingiva to stimulate the tissue on chewing and to keep the bone from resorbing.
Bottom of Acrylic Temporary

After some more carving of the teeth, they start to take form. There are various diamond burs, carbide burs and discs used to get the final results. Here are some shots of the work in progress.

Placement after refinement

final product

This project took me about 10-15 hours. In a couple of weeks we have a practical where we have to do this in three hours. I have noticed in dental school the learning curve is very low at first and it can be frustrating while trying to nail the skills. But once you reach a certain point that curve shoots up exponentially. Before you get any ideas of becoming cocky, let me assure you that when you do reach this exponential growth of skill, you will most certainly be taught a new procedure that leaves you back at the low point in the curve. Let’s hope I can get to the high point of the curve before the practical. Here is my final product:

underneath

bridge

bridge