Customize the denture bases by heating in hot water 175F for 3 minutes and then adapting them on a model and trimming any overextensions

1. Stabilize the maxillary modular denture:
   1. The preferred technique involves placing a functional impression material (Adaptol by Jelenco or Dinabase by Sultan) within the confines of the tissue surface of the denture while following the manufacturer's instructions. Continue refining the material until proper border extension and tissue detail is achieved.
   2. An alternative technique involves placing modeling compound stops in the right and left anterior, and the right and left posterior ridge segments of the modular denture. Insert the maxillary modular denture to the desired esthetic position and check for:
      1. Parallelism of the occlusal plane to (a) the alatragus line and (b) the interpupillary line.
      2. Midline
      3. Lipline
      4. Lip support
   3. Border mold with modeling compound or material of choice. Trim and blend excess border molding material into base of modular denture.
   4. Apply proper impression material adhesive and make a final impression with material of choice. Seat the modular denture to the modeling compound reference stops.
   5. Remove maxillary modular denture and inspect for anatomical replication.
   6. Trim and blend excess impression material into base of modular denture.
   7. Mark vibrating line on palatal mucosa and record posterior palatal seal form with indelible pencil. Trim impression material to posterior border.
   8. Reseat maxillary modular denture.
2. Stabilize the mandibular modular denture:
   1. The preferred technique involves placing a functional impression material (Adaptol by Jelenco or Dinabase by Sultan) within the confines of the tissue surface of the denture while following the manufacturer's instructions. Continue refining the material until proper border extension and tissue detail is achieved. The use of a functional impression material will help in the development of an occlusal with posterior, bilateral contacts of equal intensity.
   2. An alternative techique involves placing modeling compound stops as in Step 1.a. above and have patient close in centric relation to previously established occlusal vertical dimension; center the midlines.
   3. Make an occlusal index of centric occlusion to serve as a guide during impression making. Border mold with modeling compound or material of choice.
   4. Apply proper impression material adhesive and make a final impression with material of choice. Seat the modular denture to the modeling compound reference stops.
   5. Remove mandibular modular denture and inspect for anatomical replication.
   6. Trim and blend excess impression material into base of modular denture.
   7. Reseat mandibular modular denture.
3. Pre-processing check - with both modular dentures seated, evaluate:
   1. esthetics
   2. phonetics
   3. retention
   4. stability
   5. centric and eccentric occlusion
   6. rest vertical dimension
   7. occlusal vertical dimension
   8. inter occlusal distance

   You and your patient must be completely satisfied with all of these factors; if any are unsatisfactory, you must remake your impressions in order to reposition the modular dentures. Fit, form and function of the processed dentures depend on correct assessment at this temporary stabilized stage.

4. Dental laboratory

   Send the impressions to the dental laboratory with an occlusal registration. The case will be post damned, jumped, finished, polished, and remounted to make the needed occlusal corrections.

5. Insertion and adjustments:
   1. Use pressure indicator past and appropriate burs, stones, rubber wheels, etc. to achieve desired contact between the dentures and the stress bearing mucosal areas.
   2. Adjust centric and eccentric occlusal contacts.
   3. If required, adjust occlusion and articulator, utilizing necessary check bites.

Since esthetics and the occlusal plane may be most readily determined with this denture, it is advisable to place and stabilize this prosthesis first. Remember, the vertical positioning of this denture will impact upon the available interarch space and your ability to establish an acceptable vertical dimension of occlusion. Leave sufficient spacing to allow for the correct placement of the mandibular denture while maintaning an appropriate amount of interocclusal space.

1. After modifying the peripheral borders of the Maxillary MiraDent Denture, if necessary, and adapting the moldable aspects of the MiraDent Denture intraorally or on a study cast, apply the visible light curable reline resin (Astron VLC, Triad, etc.) to the tissue surface of the denture . Follow the manufacturer's instructions. Caution: be certain that the posterior border is seated completely.

2. Using a Fox plane, verify the occlusal plane in relation to the interpupillary and ala-tragus planes. It is important to be accurate in your assessment of these relationships.

3. Border mold the peripheral extensions of the reline material. Remove and inspect making sure that there are no areas of over extension which were inadequately trimmed at the preliminary stage.

4. Any voids or incomplete areas may be added to and corrected. Excess material along the periphery should be knife trimmed and removed.

5. Re-insert the maxillary denture and re-inspect until tissue detail and extensions are appropriate. Constantly evaluate both the occlusal plane and esthetics.

6. Insert the trimmed mandibular denture and verify the vertical dimension of occlusion as well as centric relation-occlusion. As long as you are within acceptable limits, you may proceed. If the vertical dimension of occlusion is open, you must re-evaluate the temporary positioning of the maxillary denture and/or the patient's vertical dimension of occlusion.

   Do not proceed until you are sure that a desirable occlusal vertical dimension can be achieved.

With an indelible transfer stick, mark the posterior limit on the patient's maxillary tissues (this is the vibrating line - the junction of the maxillary movable and immovable tissues). Reinsert the maxillary denture and transfer the mark to the denture.

Trim any excess material posterior to this marking making certain that the hamular notch areas of the maxillary denture are left intact.

The removal of any and all occlusal interferences and/or prematurities will require the making of an interocclusal centric relation registration and the mounting of the complete dentures. Remount casts may need to be fabricated by blocking out all tissue surface undercuts. A plaster cast is then fabricated.

After mounting the finished dentures on their remount casts using the interocclusal record, remove all occlusal interferences using the BULL rule. Adjust prematurities on the inner inclines of the upper buccal cusps and the inner inclines of the lower lingual cusps.