Cu-sil dentures – a novel approach to conserve few remaining teeth: Case reports …

Jain JK et al Journal of International Oral Health 2015; 7(8):138-140

Received: 18th February 2014  Accepted: 23th May 2015  Conflicts of Interest: None Case Report
Source of Support: Nil

Cu-sil dentures – a novel approach to conserve few remaining teeth: Case reports
Jayesh Kumar Jain1, C R Allama Prabhu2, Mohammed Al Zahrane3, Mohammed Sayed Al Esawy4,
Sunil Lingaraj Ajagannanavar5, Kapil Singh Pal6

Contributors: and retention, compromised masticatory function, undermine

1
Senior Lecturer, Department of Prosthodontics, College of esthetic appearance.2,3
Dental Sciences, Davangere, Karnataka, India; 2Senior Lecturer,
Department of Public Health Dentistry, College of Dental Sciences, Va Crum and Rooney have proved in their studies that there is
Davangere, Karnataka, India; 3Assistant Professor, Department of relatively far less alveolar bone resorption when some teeth are
Dental and Oral Health, Prince Sultan Military College of Health, present as compared to edentulous patients.1 Other advantage of
Kingdom of Saudi Arabia; 4Researcher, Department of Information
preserving natural teeth is maintenance of proprioceptive ability
Technology, College of Engineering, King Saud University,
of periodontium and gives psychological benefit to the patient.4
Riyadh 11433, Kingdom of Saudi Arabia; 5Senior Lecturer,
Department of Public Health Dentistry, College of Dental Sciences,
Davangere, Karnataka, India; 6Senior Lecturer, Department of
Treatment options for such arches with very few remaining
Prosthodontics, RKDF Dental College and Research Centre, teeth include overdentures, immediate denture, and transitional
Bhopal, Madhya Pradesh, India. dentures. Transitional dentures prove to be a good treatment
Correspondence: for patients who are not willing for any extraction or endodontic
Dr. Jain JK. Om Nivas, 183/5-6, Vasanta Road, Davangere - 577 001, procedures. Cu-sil denture is one such transitional denture,
Karnataka, India. Phone: +91-9482834466/8970511944. Email: which is opted for treatment in dental practice but can prove
[email protected] an easy and affordable treatment option.
How to cite the article:
Jain JK, Prabhu CRA, Al Zahrane M, Al Esawy MS, Ajagannanavar SL, Cu-sil denture is basically a complete denture with holes
Pal KS. Cu-sil dentures – a novel approach to conserve few remaining allowing the remaining natural teeth to emerge through the
teeth: Case reports. J Int Oral Health 2015;7(8):138-140. denture. The holes are surrounded by the gasket of silicone
Abstract:
rubber which clasps the neck of natural teeth, thus allowing a
The present prime concern in dentistry is on preservation of
natural suction to form under the denture.4 It is the simplest,
remaining natural teeth. Presence of few teeth in oral cavity help
in preserving alveolar ridge integrity, maintain the proprioception, gentlest removable partial denture, but the fabrication
and gives psychological benefit to the patient. Transitional denture requires special armamentarium and material, which makes
provides us with alternative treatment plan for the patients willing its technique sensitive, time-consuming and expensive. This
to replace their missing teeth while retaining their very few case report describes an alternative technique to fabricate Cu-
remaining teeth. A relatively newer type of transitional denture sil denture in normal dental set-up using commonly available
is Cu-sil denture. A Cu-sil denture is a denture with holes, lined long-term soft liners.
by a gasket of silicone rubber, the holes thus providing space for
remaining natural teeth to emerge into the oral cavity through the Case Reports
denture. Cu-sil denture is the simplest removable partial denture, Case 1
but its fabrication requires special armamentarium and material. A 62-year-old male patient was self-referred to the Department
This case report represents a simple chairside technique to fabricate of Prosthodontics, College of Dental Sciences, Davangere with
Cu-sil dentures in usual dental set-up.
a chief complaint of poor esthetic, speech difficulty, and wanted
Key Words: Cu-sil denture, partially edentulous arch, soft liners, replacement of missing teeth (Figure 1a). Dental history
transitional denture revealed that the missing teeth were extracted due to caries.

Introduction Patient presented with mandibular Kennedy’s Class III mod 2

Dentistry has long recognized the difference that the presence partially edentulous arch with missing 36, 46, 45, 31, 41. In the
of teeth makes to preserve the alveolar ridge in its place. Thus, maxillary arch, only four teeth were remaining; that were 13,
the prime target of present-day dentistry is on preservation 17, 18, and 23. Only 35 and 47 had Grade I mobility. Oral
of teeth and periodontium. Several studies have shown that hygiene was fair. Patient was not willing for any extraction or
removal of all natural teeth and wearing of complete dentures endodontic treatment. A definitive treatment plan could not be
for a long time generally results in alveolar bone loss. 1 worked out for this patient. Thus, a removable partial denture
Extraction of entire dentitions followed by complete denture for the mandibular arch and a Cu-sil denture for the maxillary
replacements leads to psychological trauma, reduced stability, arch was planned.

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Cu-sil dentures – a novel approach to conserve few remaining teeth: Case reports …
Jain JK et al Journal of International Oral Health 2015; 7(8):138-140

Procedure mouth (Figure 2b).Occlusion was checked and post-insertion

Maxillary and mandibular arch impressions were made using instructions were given as same as for any removable prosthesis.
dual impression technique and poured with dental stone
(Figure 1a). Temporary denture bases were fabricated using The patient was comfortable at the time of insertion and follow-
auto-polymerizing acrylic resins. Then, occlusal rims were up after two weeks. Due to the probability of fungal growth on
prepared and bite registration was done. The setup was the soft liner material, regular care has to be provided regarding
mounted on an articulator. Teeth arrangement and try-in maintenance of good oral and denture hygiene. Patient has
procedures were executed in routine manner. The wax up of the been told to replace the silicone liner with fresh one every
maxillary denture was done similar to a complete denture except 8-12 months.
for the holes corresponding to the remaining natural teeth.
The dentures were cured with heat-cure acrylic resin. After Case 2
the denture was finished and polished, the space in maxillary A 42-year-old male patient came with the chief complaint of
partial denture around the remaining teeth was widened to difficulty in mastication and poor appearance due to several
give clearance of 4-5 mm around the teeth (Figure 2a).4 Silicon missing teeth. The patient has been partially edentulous since
adhesive was applied to denture and mixing of silicone soft 2 years. Intraoral examination revealed Kennedy’s Class I
liner base and catalyst was done and placed into oral cavity to mod 1 condition with missing 17, 16, 27, 26, 11, 21. Only 37
occupy space between denture and natural teeth. Denture was present in the mandibular arch (Figure 3a). It was decided to
inserted in patient’s mouth and held in position. After setting fabricate a partial denture for the maxillary arch and transitional
of the material, denture was removed. The excess liner material denture for the mandibular arch as the patient was not willing
was trimmed and denture was finally inserted in patient’s for extraction.

a a

b b

Figure 1: (a) Pre-operative view of case 1. (b) Maxillary and Figure 3: (a) Pre-operative view of case 2. (b) Maxillary and
mandibular master casts of case 1. mandibular master casts of case 2.

a a

b b
Figure 2 :(a) Completed Cu-sil denture with holes of case 1. Figure 4: (a) Completed Cu-sil denture of case 2.
(b) Final denture in the patient’s mouth of case 1. (b) Completed Cu-sil denture in the patient’s mouth of case 2.

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Cu-sil dentures – a novel approach to conserve few remaining teeth: Case reports …
Jain JK et al Journal of International Oral Health 2015; 7(8):138-140

The Cu-sil like denture can serve as conventional full denture

if the patient later loses all the natural teeth.5 Cu-sil dentures
serve as a solution for lone standing or very few remaining teeth
present in the dental arch.

Cu-sil dentures are contraindicated for patients with numerous,

evenly distributed natural teeth across the dental arch, this will
result in a weak appliance. They should be avoided in patients
with bruxism, severe undercut areas and patient with high smile
line.5 The gingiva of remaining teeth is covered totally, which
may lead to plaque accumulation, which can be avoided by
regular check-ups and proper hygiene maintenance.

Conclusion
Figure 5: Postoperative view of case 2. Cu-sil denture is not very common. Still, a Cu-sil denture is an
acceptable option and serves as a viable treatment alternative
Impressions of both arches were made using dual impression in few situations. It is an excellent option for the patients who
technique and the same procedure as Case 1 has been followed want to replace their missing teeth while retaining their very
(Figures 3b, 4a, 4b, and 5). few remaining teeth.

Discussion References
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by fabrication of over dentures or immediate dentures or in overdentures – A 5 year study. J Prosthet Dent
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need of endodontic procedures, requirement of more patient Patients, 12th ed. St. Louis, MO: Mosby; 2013. p. 6-23,
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their teeth extracted as it has a detrimental effect on their 3. Zarb GA, Bolender CL, Hickey JC, Carlsson GE. Boucher’s
psychology. Thus, Cu-sil dentures serve as an amicable Prosthodontic Treatment Foredentulous Patients, 10th ed.
treatment option for such patients. St. Louis, MO: Mosby; 1997. p. 71-99.
4. Khandelwal M, Punia V. Saving one is better than
Cu-sil like dentures are aimed at preserving the remaining none: Technique for cu-sil like denture – A case report.
natural teeth and have a positive effect on retention and stability 2011;03(01):41-5.
of dentures. It gives the patient psychological satisfaction of 5. Gagandeep K, Sangeetha G, Deepika S. Cusil denture:
retaining the natural teeth. No special impression techniques or A novel conservative approach- A case report. Unique J
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