Are you in the process of building your dental practice from the ground up? If so, the compact pressure molding unit, MiniSTAR S thermoforming machine, should be at the top of your "must-have" list.

The MiniSTAR S Thermoforming Machine, offered by Great Lakes Orthodontics, is a game-changer in dental equipment. This remarkable machine boasts the unique ability to apply positive pressure onto the working model while simultaneously creating a vacuum underneath the cast.

This dynamic combination ensures that thermoplastic materials achieve the perfect thickness and adhere seamlessly to supporting structures. This makes a world of difference compared to thermoforming machines relying solely on vacuum technology. When you aim to work with a fully intact stone model, the MiniSTAR S is indispensable.

This article explores five additional "out-of-the-box" applications where the MiniSTAR S has been proven to benefit our patients significantly.

MiniSTAR S Thermoforming Machine Application: Creating a Record Base Over Dental Implants

Imagine a scenario where a patient returns from the surgeon's office with four integrated dental implants in the maxilla. These implants are positioned parallel to each other, making them ideal candidates for an overdenture using abutments directly connected to the fixtures, such as locators or Novaloc. However, upon clinical evaluation, it becomes apparent that the dental implants are positioned palatally to the planned position of the upper teeth.

The objective is to develop a record base that streamlines the communication process, helping the patient grasp the challenges posed by the implant positions and their implications for the treatment outcome.

To address this, we applied a 1.5mm layer of Copyplast over the implant abutments on a stone model. After trimming the Copyplast, we replaced it on the model. Subsequently, we pressed a 1.5mm layer of Clear Splint Biocryl over the Copyplast layer, completing the record base.

Clear Splint Biocryl offers a unique advantage — it allows us to visualize the dental implants and landmarks on the working model. This visualization aids in precisely positioning the teeth in wax before conducting an intra-oral evaluation.

With the MiniSTAR S and these innovative applications, you can elevate your dental practice to new heights, providing exceptional patient care and communication. Stay tuned for more insights on how this remarkable machine can transform your practice.

Thermoplastic record base over dental implant abutments.
Figure 1: Thermoplastic record base over dental implant abutments.

Whether the record base is made for an edentulous maxilla with or without dental implants, the patient can evaluate a prototype of the definitive prosthesis. The discussion becomes more productive by focusing on the details applicable to their situation.

Radiographic Guide for Posterior Maxilla Surgery

In another scenario, the surgeon's office contacts us on a Friday with an urgent request to prepare a radiographic guide for a surgery scheduled for the upcoming Monday.

Given the tight time, we explore several viable options for promptly crafting this essential tool. The primary objective of the surgical procedure is to construct two 3-unit dental implant-supported fixed bridges for the upper left and upper right posterior segments.

Additionally, the surgeon intends to perform a maxillary sinus augmentation through a lateral window approach. In this context, teeth 6-11 play a crucial role in supporting the stability and retention of the surgical guide. Extending the guide over the palate may also prove beneficial in minimizing any potential medial-to-lateral movement, depending on the specific surgical flap design.

Radiographic guide for dental implants in posterior maxilla
Figure 2: Radiographic guide for dental implants in posterior maxilla.

The process involved creating a two-layer radiographic guide. We pressed 1.5 mm Copyplast over the remaining anterior teeth, carefully trimming it. Then, we added posterior teeth (one premolar and two molars) and applied 1.5 mm Clear Splint Biocryl over the intended surface area for the surgical guide. But here is the key: We strategically incorporated holes through the acrylic posterior teeth, allowing us to fill them with radio-opaque material. This clever technique aids in precise positioning using a CBCT. After evaluating, we can effortlessly remove the radio-opaque material, leaving a tailored guide essential for the initial osteotomy step.

Interim Removable Partial – A Digital Design Approach

As teeth gradually succumb to the relentless forces of caries, dentists often find themselves at a crucial juncture: the point at which anterior teeth require attention and restoration.

In these moments of decision-making, dentistry's art and science converge. One solution, particularly in cases involving congenitally missing upper right canines, is the careful orchestration of full coverage restorations and the creation of an interim removable partial — a strategy designed to bridge the transition seamlessly.

Embracing the power of digital design software opens a world of possibilities. It allows us to artfully mimic the proportions of the teeth, ensuring that the interim partial harmoniously blends with the anterior teeth that have faithfully served the patient for years. It is about addressing the immediate dental needs and preserving the esthetics and functions that have become integral to the patient's identity.

First, denture teeth are milled from a resilient acrylic puck known as Polymethyl Methacrylate (PMMA), providing both strength and a lifelike appearance. Then, a model is prepared to accommodate a 1.5 mm Copyplast layer. This layer extends over the palate and onto the palatal surfaces of the supporting teeth, finally reaching the distal surface of the terminal tooth in the arch.

The magic happens as the acrylic denture teeth connect seamlessly to the Copyplast layer. This connection is achieved with auto-polymerizing (self-cure) acrylic, which ensures a strong and durable bond. This intricate process takes place within a specialized pressure pot, where each element of the interim partial comes together, combining artistry and functionality.

The creation of an interim removable partial is a testament to the evolving landscape of dentistry, where technology meets artistry to serve our patients' best interests. It is about restoring teeth and preserving smiles, confidence, and quality of life. With digital design software and precision craftsmanship, we continue to push the boundaries of what is possible, ensuring that our patients embark on their dental journey with the utmost comfort and aesthetic grace.

Interim removable prosthesis with milled teeth and Copyplast.
Figure 3: Interim removable prosthesis with milled teeth and Copyplast.

When faced with an unplanned interim removable partial, picture this scenario: a patient presents with a central incisor bearing a clean fracture at the soft-tissue level. The patient arrives with the crown and the optimism that a straightforward re-cementation will suffice.

Much like the previous case, our approach involved applying a 1.5 mm layer of Copyplast, gently pressed over the palate, extending to the palatal surfaces of the adjacent teeth, providing support. To ensure a seamless restoration, we modified and secured the full-coverage crown to the Copyplast using auto-polymerizing (self-cure) acrylic in a pressure pot, ensuring lasting and dependable results.

Interim removable prosthesis working with existing restoration.
Figure 4: Interim removable prosthesis working with existing restoration.

Interim Obturator Prosthesis

Transformed by the transformative impact of MiniSTAR, this patient's life and well-being were significantly improved. Their medical history is marked by radiation treatment, tooth loss, and the emergence of a communication issue with the maxillary sinus. As one can imagine, this presented significant challenges, affecting their ability to speak, eat, and even drink water comfortably.

In response, we crafted an interim obturator prosthesis. We employed 1.5 mm Copyplast material, molded over the remaining teeth and the palatal surface, extending seamlessly into the sinus area. The use of laboratory putty allowed us to create essential space. At the same time, an acrylic covering was meticulously fashioned to ensure that the obturator portion of the prosthesis remained lightweight — this design consideration aimed to minimize any discomfort or inconvenience for the patient.

To further enhance functionality and esthetics, denture teeth were integrated into the acrylic covering, seamlessly blending with the Copyplast material. This approach created a synergistic effect, like an Essex retainer, providing optimal retention and resistance. The smooth surface of the Copyplast, extending into the sinus area, contributed significantly to the patient's comfort and adaptability to this uniquely designed prosthesis.

Interim obturator with Copyplast, acrylic, and denture teeth.
Figure 5: Interim obturator with Copyplast, acrylic, and denture teeth.

There are many ways to use a MiniSTAR S Thermoforming machine. Spear Online has videos demonstrating how to make anterior bite plane appliances, a soft appliance, a prep guide, and optimizing a putty matrix. Watch Using the MiniSTAR and Using Pressure and Vacuum Units to Create Thermoplastics.

Douglas G. Benting, D.D.S., M.S., F.A.C.P. is a member of Spear Resident Faculty.



Comments

Commenter's Profile Image Gary R.
January 29th, 2024
Thanks for yet another informative and useful article Doug! You rock!!