Impressions1
Transcript of Impressions1
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Complete Dentures
Appointment 2
Final Impressions
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Introduction•Trays•Border molding•Making Impression•Post-Dam
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Baseplates
Trim master cast
Draw outline 2 mmshort of periphery.
Block out undercutswith wax or putty.
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Border of Mandibular Custom Tray
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Make wax spacers
2 mm cutback1 thickness wax
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Roll out tray material.
Adapt tray material and
form a handle.
Making a Custom Tray
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1.Trim off excess acrylic.
2. Trytray oncast.
3.Observe the tray handle.
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Finished TraysFingerRests
Finger rests are placed on traysfor severely atrophic mandibles.
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Finished Trays
9-10mm
6-7mm 11-12mm
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Finished Mandibular Trays
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Triad Trays
Adapt tray material to casts and trim any excess material.
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Triad Tray Finished
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Finished Tray
Tray is cut backto the 2mm wax
spacer.
Wax is leftin place until
border moldingis completed.
Note the sizeand shape ofthe handles.
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Tray ExtensionsBefore the finalimpressions are madeALWAYS check thetrays for proper fitand extension.
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Fitting the tray
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Fitting the tray
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Fitting the tray
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Fitting the trayPoints to relieve in the mouth.
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Modeling Plastic•Gray or green•Water bath•128-135oF•Ice
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Armamentarium
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Border Molding
Making an impressionof the vestibule duringfunction.
•Selective pressure
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Fitting the tray
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TemperAlways remember to temper the compound
in a water bath before placing it in the mouth to avoid serious burns.
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Border Molding•Temper in waterbath 3-5 sec. thenplace in the mouthafter removal.
•Trim
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Muscle Trimming
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stable. no tray displacement.no tissue impingement.
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Border mold the mandibular tray first.
•Less chance of gagging patient.•Patient is more cooperative.•Familiarizes patient with procedure.•Allays apprehension.
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•Start by doing small areas.•Do the critical areas first.
• Lingual Frenum• Labial Frenum• Buccal Frenum
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Functional Border Molding
Sublingual Roll
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Border Molding
Function Check
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Functional Border Molding
Buccal Frenum
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Heat with alcohol torch.
Temper, then muscle trim again.
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As you gain more skill andbecome more confident thentry the following technique.
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Start by border molding
the labial and buccalflanges on the mandibular.
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Do one side of the lingualflange before moving to
the other side.
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Move to the other sideand finish that side of
the lingual flange.
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Finish the lingual frenum area of the mandibular denture by having the pt. thrust out his tongue.
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Heat with alcohol torchto soften selected areasand replace in mouth.
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Remove the wax spacerprior to making impression.
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Border Molding Maxillary
Do Anterior First.
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Muscle Trimthe maxillary
custom tray in the mouth.
First do one side...
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...then the other.
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Finish with the postpalatal seal.
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Border-Molded Maxillary Tray
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Properly Border-moldedMaxillary Trays
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Polyether Technique
Polyether impressionmaterial can also beused for border-molding the final tray.
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Polyether Technique•Advantages
•Disadvantages
•Reduces overextension.•Quick
•Cost•Taste
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Polyether•It is critical that thetrays are madecorrectly.
•2mm shy of fornixof vestibules.•2mm thick.
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Polyether
Paint on adhesive.Mix impression material.
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PolyetherA
B
C
A.Load tray with polyether impression material.B. Place tray in mouth.C. Borders of tray are defined by impression.
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Polyether
Follow the same procedure for themaxillary impression. The most obvious difference between the twotrays is that the maxillary border molding does not cover the tray.
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Polysulfide
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Impression
Polysulfide•Remove Wax•Trim MP•Tray Adhesive
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FinalImpression
•Ready to make finalimpression.
•Trays are retentive.•Borders are finished.
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Impression•Final impressions are:
•Of uniform thickness.•(1mm)•Free of voids.•Contoured over ridge.
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Impression•Possess excellantsurface detail.•Not be too thick atthe borders (25mm)or overextended.
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Procedure
After the border molding is completed the spacer wax isremoved and the tray is painted with adhesive.
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Wax spacer is removed.
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Adhesive is painted on.
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ARMAMENTARIUM FOR FINAL IMPRESSION
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Procedure
The patient isseated in theupright position.
•Mouthwash•Reduce the saliva.
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Procedure
The patient isasked to suckon a piece ofice to reducethe function of the palatine glands.
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Procedure
Approximately 3-3.5 inches oflight body Permalastic is used to make the impression.
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Procedure
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Procedure
Loading the impression tray.
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Procedure
FUNCTIONAL MOVEMENTS
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Mandibular Impression
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“Show-through” of border molding
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The filled tray.
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Muscle trim.
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Procedure
The impression is heldin place for 6-8 minutes.
•Tissue detail•Voids•Even thickness
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Hold tray in place.
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Zinc Oxide-Eugenol Paste Final Impressions
Other Types of Impressions
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Polyvinylsiloxane Impression
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COMPLETED FINAL MANDIBULAR IMPRESSION
HIGHLY DETAILED REPRODUCTION OF TISSUE SURFACE
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Land Area
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POST DAM
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Advantages•Aids In retention of theupper denture.•Helps control Gagging.•Compensates for processing shrinkage.
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Landmarks•Hamular Notch•Vibrating Line•Midpalatal Suture•Glandular Zone•Fovea Palatina
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Vibrating Line Imaginary line across the posterior part of the palate, marking the division betweenthe moveable and immovable tissues of the soft palate.
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FoveaePalatina
Two small pits, one on eachside of the mid-line, near thejunction of the hard and softpalate.
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Landmarks
Hamular NotchFovea
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Soft Palate
House classified the soft palateaccording to how it drapes.
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House Classifications
CLI
CLII
CLIII
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Soft Palate, Class I
Vibrating line
5-10 mm
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Soft Palate: Class II
•Area for placement ofthe post-dam isreduced to 3-5mm.•Most common typefound in patients.
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Soft Palate: Class II
Vibrating Line
Class II
3-5mm
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Soft Palate: Class III
•Represents the mostlimited area.
•It usually ranges from1-3 mm.
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Soft Palate: Class III
•It is easiest to locate.•Care should be takennot to overextend thedenture.
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Soft Palate: Class III
1-3 mm
Vibrating line
Class III
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Vibrating Line
Located within these areas according to the type of soft palate. The area must be palpated to determine how far the line can be placed.
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Vibrating line
Placement Zone
CD
Class III
Bead End of Denture
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Locating the Post-Dam
•Dry the area with 4X4gauze.•Palpate the tuberosity,midpalatal raphae, andhamular nitch.
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Procedure
•Mark the hamularnotch with sterile inkstick.•Locate by having the patient say ‘Ah’ in short bursts.
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Procedure
Palpate and mark the area of the hamular notch.
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Post Dam
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Procedure
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Post-Dam
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Procedure
Connect to vibrating line.
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Procedure
Reinsert Impression.
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Post-Dam
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Post-Dam
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Post-Dam
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Post-Dam
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Box and Pour•Rim, box, pour, separate, and trim the final cast.•You will need to retrace the marks on the cast sothat the post palatal seal is clearly marked.
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Box and Pour
Boxing wax should extend 10 mmabove impression.
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Box and Pour
Finishing land area of maxillary master cast.
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Making a BaseplateSprinkle Method
•Work In sections •sift powder
•wet with monomer
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Making a Baseplate
Keep wet with monomerto avoid “sugar” look.
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Making a BaseplateFinger Adapted Dough Method
Forming resin well in dough stage.
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Making a BaseplateFinger Adapted Dough Method
Place dough over cast and adapt it well.
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Making a Baseplate
Cure in warm pressure pot@ 20 psi/20 minutes.
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Making a Baseplate
Remove from cast and trim off flash.
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Immediate Mandibular CD Boxed Impression and Final Cast