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Sp.imp.procedures./ dentistry dental implants/ 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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  • 1. SPECIAL IMPRESSIONSPECIAL IMPRESSION PROCEDURES FOR COMPRISEDPROCEDURES FOR COMPRISED CLINICAL CONDITIONSCLINICAL CONDITIONS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. AIMSAIMS To customize the denture bases to the supporting tissues To develop the functional border of the denture To enhance retention & stability To obtain optimal esthetics To maintain health of the oral tissues www.indiandentalacademy.com
  • 3. PRINCIPLESPRINCIPLES Denture base should cover maximum possible supporting area. Impression surface should achieve closest possible contact with underlying tissues. Border form of the prosthesis should establish a peripheral seal ; support lips and cheeks functionally and esthetically. www.indiandentalacademy.com
  • 4. SPECIAL IMPRESSION PROCEDURESSPECIAL IMPRESSION PROCEDURES 1. Controlled - Minimally displacive impression techniques, E.g. displaceable (flabby) upper ridge. 2. Controlled – Pressure impression techniques, E.g. Fibrous / Knife edge / Unemployed lower ridge 3. Functional impressions, E.g. Indeterminate peripheral extensions 4. Denture space impressions, (External impressions), E.g. When the denture is subjected to excessive displacing forces from surrounding musculature www.indiandentalacademy.com
  • 5. Controlled - Minimally displacive impression techniques Patients wearing upper complete denture opposed by lower natural teeth. Chronic complete denture wearers Maxillary anterior ridge replaced by fibrous tissue; reduced support for dentures. Patient complains of loose dentures Impression techniques to avoid undue tissue displacement. www.indiandentalacademy.com
  • 6. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) Method AMethod A Special tray with a window cut in the region of the displaceable tissue. www.indiandentalacademy.com
  • 7. Wash impression with ZOE paste. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) Border molding with low fusing compound. www.indiandentalacademy.com
  • 8. Tray re-inserted, impression plaster syringed over displaceable tissue. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) www.indiandentalacademy.com
  • 9. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) Completed impression. www.indiandentalacademy.com
  • 10. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) • Method BMethod B – Special tray with a window cut in the region of the displaceable tissue. – Border molding with low fusing compound. www.indiandentalacademy.com
  • 11. Impression made with medium – bodied / monophase elastomer. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) www.indiandentalacademy.com
  • 12. Light - bodied elastomer syringed over window area. Dental plaster syringed over set, light - bodied elastomer. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) www.indiandentalacademy.com
  • 13. Completed Impression Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) www.indiandentalacademy.com
  • 14. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) Method CMethod C Special tray fabricated with no window. Border molding with low fusing compound. www.indiandentalacademy.com
  • 15. Impression made using ZOE paste / monophase elastomer. When set, impression material corresponding to displaceable tissue removed and tray perforated. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) www.indiandentalacademy.com
  • 16. Impression plaster / light bodied elastomer syringed over displaceable tissue. Tray reseated and impression completed. Controlled - Minimally displaciveControlled - Minimally displacive impression techniques (Contd…)impression techniques (Contd…) www.indiandentalacademy.com
  • 17. Controlled – Pressure impressionControlled – Pressure impression techniquestechniques IndicatedIndicated Unemployed lower alveolar ridge unable to provide acceptable support against vertical loads and positive stability against lateral forces. www.indiandentalacademy.com
  • 18. Controlled – PressureControlled – Pressure impression techniquesimpression techniques (Contd…)(Contd…) MethodMethod Primary impression made with alginate or putty elastomer. Impression relieved over ridge crest area and wash impression obtained with low viscosity material. www.indiandentalacademy.com
  • 19. Customized special tray with 2mm spacer constructed. Spacer removed ; tray perforated in crestal region . Controlled – PressureControlled – Pressure impression techniquesimpression techniques (Contd…)(Contd…) www.indiandentalacademy.com
  • 20. Low fusing compound used to obtain impression of primary cast with special tray. Controlled – PressureControlled – Pressure impression techniquesimpression techniques (Contd…)(Contd…) www.indiandentalacademy.com
  • 21. Impression reduced in the region of buccal & lingual sulci ; border molding refined in patient’s mouth. Painful areas relieved. Tray re-insertion should not result in pain. Impression completed with light – bodied elastomer. Controlled – PressureControlled – Pressure impression techniquesimpression techniques (Contd…)(Contd…) www.indiandentalacademy.com
  • 22. Functional impressionsFunctional impressions IndicationsIndications Reduced retentive forces ( Atrophic ridges ) High displacing forces ( Uncontrolled muscle activity) Peripheral form molded by peri–denture musculature. Existing denture utilized for the procedure. www.indiandentalacademy.com
  • 23. MethodMethod Tissue conditioning materials usually employed for the procedures. Functional impressionsFunctional impressions (Contd…)(Contd…) www.indiandentalacademy.com
  • 24. Impression surface & periphery of existing denture reduced by 1.5-2mm to create space. Fitting surface of denture cleaned & dried. Material mixed & spread over fitting surface. Functional impressionsFunctional impressions (Contd…)(Contd…) www.indiandentalacademy.com
  • 25. Denture seated in patients mouth; patient instructed to close in centric occlusion. Patient encourage to perform functional movements such as talking, swallowing, smiling, to obtain a functionally generated impression. Functional impressionsFunctional impressions (Contd…)(Contd…) www.indiandentalacademy.com
  • 26. Denture removed after 5 – 6 minutes ;Denture removed after 5 – 6 minutes ; inspected and surplus material trimmed.inspected and surplus material trimmed. Functional impressionsFunctional impressions (Contd…)(Contd…) www.indiandentalacademy.com
  • 27. Patient returns after few / 24 hours;Patient returns after few / 24 hours; impression inspected & cast poured.impression inspected & cast poured. Functional impressionsFunctional impressions (Contd…)(Contd…) www.indiandentalacademy.com
  • 28. Denture space determinationDenture space determination (External Impressions)(External Impressions) AimsAims To determine the space within which the denture can be sited without being subjected to excessive displacing forces from the surrounding musculature. www.indiandentalacademy.com
  • 29. Denture spaceDenture space The portion of the oral cavity that is or may be occupied by the maxillary and / or mandibular denture (s). www.indiandentalacademy.com
  • 30. Neutral ZoneNeutral Zone That area in the mouth, where, duringThat area in the mouth, where, during functions thefunctions the forcesforces of the tongueof the tongue pressingpressing outwardoutward areare neutralizedneutralized by theby the forcesforces of the cheeks and lips pressingof the cheeks and lips pressing inwardinward.. Hence a possible zone of equilibrium www.indiandentalacademy.com
  • 31. IndicationsIndications Past denture looseness due to powerful lower lip activity. Non-replacement of missing teeth leading to tongue / cheeks / lips partially occupying the usual denture space. Enlarged tongue, E.g. Down’s Syndrome. Abnormal anatomy, E.g. Hemimandiblectomy. Inability to wear a lower denture Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 32. Denture space determinationDenture space determination (Contd…)(Contd…) How to record neutral zone?How to record neutral zone? Generally done for lower Done at any stage of CD fabrication Materials used-Waxes,ZnOE,rubber base putty, self-cure acrylic, impression compound,tissue conditioners. www.indiandentalacademy.com
  • 33. On accurate master casts, stabilized denture bases are constructed. Wire loops embedded over ridge crest for retention. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 34. Low fusing compound rims attached to bases. Patient trained to perform a range of functional movements such as smiling, swallowing, speaking, etc. Compound rims softened and denture bases inserted ; functional movements carried out. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 35. Denture space determinationDenture space determination (Contd…)(Contd…) Recommended movementsRecommended movements Smile Swallow ‘ooh’ ‘ah’ www.indiandentalacademy.com
  • 36. Denture space determinationDenture space determination(Contd…)(Contd…) www.indiandentalacademy.com
  • 37. Wash impression obtained with light – bodied elastomer brushed on compound rims. Functional movements repeated. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 38. Plaster matrices constructed around records. Matrices guide in arranging & waxing teeth & polished surfaces in optimum denture space. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 39. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 40. After wax trial is completed, external impressions are obtained using ZOE paste / light – bodied elastomer. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 41. PrecautionsPrecautions Stable record bases not interfering with muscle activity. Patient to be trained in molding procedure prior to insertion of loaded tray. Excessive volume of molded material to be avoided – causes distortion of potential denture space. External impression may be totally unlike the shape of a “normal” denture, hence laboratory staff must be instructed about reproduction of the recorded contours. Denture space determinationDenture space determination (Contd…)(Contd…) www.indiandentalacademy.com
  • 42. Denture space determinationDenture space determination Modifications of basic techniqueModifications of basic technique Determination of the optimal space for a segment of a denture. ( E.g. The lower anterior region) Determination of the fit of the completed denture to the potential space. www.indiandentalacademy.com
  • 43. Determination of the optimalDetermination of the optimal space for a segment of a denturespace for a segment of a denture Teeth & majority of the base trimmed from appropriate segment. Patient trained in molding routine. Insert loaded tray in mouth, mold while setting and inspect after set. Re-insert in mouth and check for stability. Matrices help to contour teeth & base appropriately.www.indiandentalacademy.com
  • 44. Determination of the fit of theDetermination of the fit of the completed denture to the potential spacecompleted denture to the potential space To detect interference to normal muscle activity by an existing denture. Coat low viscosity elastomer on borders & polished surfaces of denture. Denture inserted & molding routine performed. Exposed denture base indicative of interference & corrected accordingly. www.indiandentalacademy.com
  • 45. In a Nut Shell…In a Nut Shell… CLINICAL FINDINGCLINICAL FINDING PRIMARYPRIMARY IMPRESSIONSIMPRESSIONS SECONDARYSECONDARY IMPRESSIONSIMPRESSIONS TECHNIQUETECHNIQUE Upper ridge displaceable Alginate Two - step technique Controlled minimally displacive technique Resorbed, fibrous, lower ridge – pain on palpation Alginate / putty elastomer ZOE / light – bodied elastomer wash on low fusing compound impression Controlled pressure impression technique Atrophic ridges with indeterminate peripheral extensions - Functional molding with tissue conditioners Existing denture modified & material molded by functional movements Resorbed ridges with hyper active musculature Impression compound / alginate / putty 1.ZOE / monophase for master impression. 2.Low fusing compound / tissue conditioner / light bodied elastomer / resin for external impression. Denture Space determination done by external impressions for contour of polished surfaces www.indiandentalacademy.com
  • 46. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com