Special impression techniques/ dentistry dental implants


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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.

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Special impression techniques/ dentistry dental implants

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. Severely resorbed mandibular ridge • Lack of ideal amount of supporting structures decreases support and encroachment of the surrounding mobile tissues onto the denture border reduces both stability and retention. The main aim is to gain maximum area of coverage. • Flange technique by Lott & Levin(1966) involves making impressions of the soft structures of the mouth adjacent to the buccal, lingual and palatal surfaces and incorporating the resulting extension or flange into the denture. • Tryde(1965) used the dynamic impression method. – Dynamic impression methods.JPD 1965;VOL-16 • Krammeck used modelling compound to record the extensions. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. Hypermobile or hyperplastic ridges • These ridges should be recorded without distortion. Zafrulla Khan technique( 1981). Hobkirk technique – rubber base material Filler technique- two tray technique. www.indiandentalacademy.com
  6. 6. WINDOW TECHNIQUE • Jaggers, Shay and Zafrulla Khan : Impressions of unsupported movable tissues; JADA october 1981, 103; 590-592 www.indiandentalacademy.com
  7. 7. • In conditions where patients have worn maxillary complete denture opposed only by mandibular anterior teeth. www.indiandentalacademy.com
  8. 8. COMBINATION SYNDROME • KELLY (1972) introduced the term “Combination Syndrome” www.indiandentalacademy.com
  9. 9. • The remaining soft tissues in the anterior maxillary region are easily distorted by routine impression procedures, resulting in an unstable denture base. • Surgical reduction of the pliable tissues often results in the loss of the anterior mucobuccal fold area. this may cause retention problems www.indiandentalacademy.com
  10. 10. • To avoid these problems, a technique that minimises distortion when impressions of edentulous arches with unsupported, moveable tissues are made is used. www.indiandentalacademy.com
  11. 11. PROCEDURE • A primary impression is made and a cast is poured. • An indelible pencil is used to outline the unsupported movable tissue. • A single custom tray is made, and an opening is cut in the tray as indicated by the transfer of indelible pencil line. www.indiandentalacademy.com
  12. 12. • Modelling plastic is adapted bilaterally on the posterior aspect of the tray to act as handles. • The tray is adjusted in the mouth, and a routine border molding is formed. www.indiandentalacademy.com
  13. 13. • The tray is painted with an adhesive and a regular body impression is made. • The excess material is trimmed to the outline of the aperture www.indiandentalacademy.com
  14. 14. • The completed base impression is returned to the mouth. • This impression does not touch the unsupported tissues. www.indiandentalacademy.com
  15. 15. • Then a highly mucostatic impression material, impression plaster is brushed on the unsupported movable tissue. • The initial layer precludes entrapment of air and enables visualisation of the unsupported tissue. www.indiandentalacademy.com
  16. 16. • A separating media is applied to the impression plaster and the master cast is made www.indiandentalacademy.com
  17. 17. AN IMPRESSION PROCEDURE FOR THE SEVERELY ATROPHIED MANDIBLE : JPD 1995 ; 73(6); 574-577 DeFranco and Sallustio JPD; june 1995; 73(6); 574-577 www.indiandentalacademy.com
  18. 18. • The objective is to maximize the supportive aspect of the available denture foundation by two approaches - Functional - Anatomic www.indiandentalacademy.com
  19. 19. • Peripheral borders are developed functionally with the mouth closed • The final phase of impression is made with the mouth open to satisfy the anatomic approach www.indiandentalacademy.com
  20. 20. PROCEDURE • A maxillary final impression is made and cast is poured • Construct a record base for the maxillary cast and develop a flat wax occlusal rim. www.indiandentalacademy.com
  21. 21. • Make a preliminary impression of the mandible and make a lower tray to be used initially as a record base with a flat wax occlusion rim. • Make a jaw registration at a selected vertical dimension of occlusion. www.indiandentalacademy.com
  22. 22. • Develop the border extensions with tissue conditioning material. • Develop the lingual borders with the mouth open and have the patient make essential tongue movements. • Also instruct the patient to border mold the material physiologically by producing “ooo” and “eee” sounds while biting on the occlusal rim. www.indiandentalacademy.com
  23. 23. • Repeat the step as often as necessary to develop proper extension. • Relieve the tray wherever it shows through the conditioning material before each subsequent addition. • Remove overextensions with a hot knife blade. www.indiandentalacademy.com
  24. 24. • Leave each application of conditioning material in the mouth approx. 10 minutes to allow it to stabilize. • After the desired extensions are formed with the conditioning material, make the final second impression with a polysulfide rubber impression material with the mouth open and use standard border molding procedures. www.indiandentalacademy.com
  25. 25. • Pour the cast immediately to avoid distortion of the material. www.indiandentalacademy.com
  26. 26. • This procedure will provide the patient with a denture that has function with maximum support and stability. • The greatest disadvantage of this procedure is the amount of the time necessary to develop the final impression. The average appointment time needed is 45-60 mins. www.indiandentalacademy.com
  27. 27. • Appelbaum and Rivetti : WAX BASE DEVELOPMENT FOR COMPLETE DENTURE IMPRESSIONS; JPD; may 1985; 53(5); 663-666 www.indiandentalacademy.com
  28. 28. Developing the base with mouth temperature wax • A preliminary functional impression tray with wax occlusion rims is made with an opposing occlusion rim or denture. • The tray trimmed to relieve functioning muscle impingements. • A closed mouth impression with mouth temperature wax is made to establish maximum coverage within tissue tolerance. www.indiandentalacademy.com
  29. 29. • The IOWA wax is prepared in a container in a hot water bath and is applied to the tray with a soft brush. (firm contact produces glossy surface) • After full ridge tissue contact is made, wax is applied to the borders and is adapted to the functioning musculature to develop the border and flanges of impression tray. www.indiandentalacademy.com
  30. 30. • Essential actions : - Protrusion and retrusion of the lips for the facial musculature (“proo-wiss”) - Moving the mandible laterally and protrusively to record coronoid process of mandible - Placing the tongue alternatively into the cheeks and by wiping the lips by the tongue to develop lingual and retromylohyoid flange of mandibular tray www.indiandentalacademy.com
  31. 31. • The impression is allowed to remain in the mouth and allowed to remain for 8 to 12 minutes to permit as close adaptation of the wax to all surfaces as possible. • During this period, the patient periodically performs the approppriate muscle functions. And then ice-cold water is poured into the mouth to chill the wax, and the impression is carefully removed. www.indiandentalacademy.com
  32. 32. • Impression is boxed by plaster and pumice and cast is poured. • Separating media is applied on the cast and after the separating media has dried, an autopolymerising soft resilient liner is applied to the undercuts. • Spacer is applied and a resin tray is fabricated www.indiandentalacademy.com
  33. 33. • When the tray resin has set, the bottom side of the cast is reduced on a cast trimmer just short of contact with the tray material. • The cast with tray is placed in hot water to soften the wax shim and the cast is fractured with a hammer to permit recovery of the tray without damage www.indiandentalacademy.com
  34. 34. • Wax spacer is removed, and excess resin is removed from the tray. • The final impression material, metallic oxide paste is mixed according to manufacturer’s directions and loaded into the tray. • Impression material is wiped along all the flanges of the impression tray in contact with functioning musculature. www.indiandentalacademy.com
  35. 35. • The patient is instructed to perform the previously described muscular movements while the impression material is developing its body. • The tray is removed from the mouth after the material has set and the impression is inspected. www.indiandentalacademy.com
  36. 36. • This technique permits the harnessing and stabilizing effects of an active musculature to operate on the ultimate denture base. • The musculature imparts properties of retention and stability to the base that will tend to provide the greatest longevity for the residual alveolar ridge. www.indiandentalacademy.com
  37. 37. www.indiandentalacademy.com