Taking an impression is an important step in complete denture construction as it provides an accurate negative registration of the denture bearing and border seal areas of the edentulous mouth. The impression must cover as much of the denture bearing surface as possible to provide retention, support, and stability of the denture. It must also record fine tissue details and form the denture borders. Selecting the proper impression material based on the patient's mouth condition is important. A complete denture impression should provide retention, support, stability, tissue preservation, and esthetics.
2. 1. Diagnosis and Examination. 5.Jaw relation.
2. Taking Impression: 6.Mounting.
Primary impression.
7.Setting of teeth.
Secondary impression.
3. Master cast . 8.Waxing up.
4. Record block: 9.Try in.
Record base. 10.Denture insertion.
Occlusal rim.
3.
4. 1)Arch form
• It may be square,ovoid or tapered.
• Each shape of this has a role in retention and stability
of denture.
• Square arch form ►more retention,stability& also
support due to increase surface area coverage.
• Oval & tapered arch form ►less retention, stability
so the dentist should think about other means to
increase retention.
5. 2)Vault form
• It may be V-shape or U-shape or flat shape
vault.
• U-shape vault ► good retention & stability.
• V-shape vault ►good stability but less
retentive and this can improved by making
good peripheral seal.
• Flat shape vault ►good retention but less
stable and this can improved by making good
adaptation.
6. 3)Residual ridge contour
• It may be rounded,knife edge,flat resorped, flappy
fibrous ridge.
• Every type needs special impression material &
technique.
• Rounded firm ridge► taking impression with alginate.
• Knife edge ridge► taking impression with rubber base
material.
• Flat shape ridge ►taking impression with compound.
• Flappy fibrous ridge ►need special impression
technique as selective pressure technique.
7. 4)maxillary tuberosity
• It aids in support&retention of the upper
denture as complete coverage give wide
area under denture which help in support
and also give good seal which help in
retention.
• It is very important to know the size&form
to know how to deal with.
8. 5)Retro molar area
• It is called the postdam of lower denture so it should
cover to help in retention of lower denture.
6)Maxillary&Mandibular undercuts
• It needs a special impression material as alginate or
rubber base.
9. 7)Tori
• It may found in the palate (torus palatinus) or in the
mandible (torus mandibularies)
• The tori if present at the patient mouth it may cause
interference with denture making as it may cause
rocking of the denture and may also lead to
ulceration to the tissue and pain to the patient.
• So if it is small ► make relief.
if it is large ► surgical removal.
• Torus palatinus if present in midline of the palate and
not relieved it lead to rocking of the denture and
may also lead to midline fracture of upper denture.
10. 8) Tongue size & position
• It may be one of the interference factors in
making denture and may affect the stability
of the lower denture.
• In edentulous patient for long time tongue
take large space and adapt it self to move
freely so the dentist should tell the patient to
be patient as the tongue will move the lower
denture.
11. 9)Saliva
The amount and consistency of saliva play an
important role in making a denture as it help in:
• Selection of suitable impression material.
• Detection of the amount of base plate retention
that help in recording of accurate vertical and
horizontal relation.
• Great value in complete denture retention.
12. 10)Mucosa
• If it is flabby the dentist should follow a special
impression technique as selective pressure
technique.
11)Depth of the sulcus
• Shallow sulcus ► needs special impression
technique with adequate peripheral seal to increase
retention & stability.
13. is one of the important steps in denture
construction as all steps depend on its
exactness, it is a negative registeration of the
entire denture bearing and border seal area
present in the edentulous mouth .
14. Primary impression:
• made in stock tray for making ►a study cast on
which a special tray is constructed.
15. Secondary impression:
• made in special tray for making ►a master cast on
which the denture is constructed.
16. • Impression must cover all maximum allowable
possible denture bearing surface to assure wide
distribution of stress and less pressure per unit area .
• Impression must form the denture borders.
• Impression must record the fine details of the
surface of soft tissue to be covered by the denture.
• Impression materials should be selected according
the patient's mouth.
17. Complete denture impression should provide :
Retention"
• It is the resistance to vertical force away from the soft
tissue.
• It depends on ► peripheral seal.
►post dam in upper arch.
And ►close adaptation to undistorted
mucosa
18. "Support"
• It is the resistance to vertical force towards
the basal seat.
• Maximum coverage provide distribution of
load over wide area ►the force per unit area
is reduced ►help in preservation of the
supporting structures.
20. Denture stability depends on:
• The size and form of the basal ridge.(loss of vertical
high of the ridge and increase flappy movable tissue
decrease stability.)
• The quality of the final impression impression.
• The form of the polished surface.
• The proper location and the arrangement of the
artificial teeth.
• Denture stability is very important to► preservation
denture supporting structures.
21. "Tissue preservation"
• Preservation of the remaining residual ridges is
the main objectives.
• Keep in mind that : pressure in the impression
technique results to pressure in the denture and
results to soft tissue damage and bone resorption.
"Esthetics"
Denture should :
► Restore facial contour.
► provide lip suuport.
22.
23. • The custom tray (commonly made by acrylic resins)
should be fabricated 24 hours before the impression
procedure.
• Should be well adapted on the primary cast.
• Free of voids and nodules on the surface facing the
tissues.
24. • Free of voids or nodules.
• The surface of cast should be hard and dense.
• The side walls of a cast should be vertical.
• The base of cast should not be less than 10mm.
• The base of the cast is parallel to the edentulous
ridge.
25. • The contour of the anterior border of the base
of maxillary cast is pointed at the midline and
curved from canine to canine in the
mandibular cast.
• The peripheral roll should be not deeper than
3-4 mm and the edges of the cat extending
out from this 3-4 mm wide.
• The land area of 2-3 mm should be
maintained around the entire cast.
26.
27. • Well adapted to the final cast.
• Stable both on the cast and in the mouth.
• Rigid.
• Free of voids or projections on the surface that
contacts the oral mucosa.
• Easily removed fron the cast.
• Smooth and rounded.
• The border length and thickness is approxamitely the
same as the final denture base.
• Fabricated from materials that are dimensionally
stable.
28. • It should be well attatched to the underlying base.
• It must be placed directly over the ridge.
• It should follow the form of the arch.
• It should have a smooth surface.
• It must be constructed from a material that easy to
manage.
• Its width must permit occlusion of the upper and
lower occlusion rims.
29.
30. means the static &functional relation of the mandible to
maxilla.
Orientation relation
is the references in the cranium ,when the mandible in the
most posterior position it can be rotated in sagittal plane
around transverse axis plassing through the condyles,this
axis can be located by :
Kinematic facebow.
Arbitrary facebow.
31. Vertical relation
• The vertical space between upper and lower jaw or
the amount of jaw separation allowable for
denture
• There are 3 types :
VD at Rest
VD of occlusion
VD of other position
32. The effect of excessive occlusal VD
• Discomfort
the patient has acqired over a period of many years
cortical pattern which control automatically
&unconsciously certain mandibular movement
• Trauma
the premature striking of the teeth causes constant
truma on the tissue
• Clicking of teeth
premature contact of teeth during speech or eating
will produce clicking
• Appearance
over-oppeninng may result in an elongation of the
face
33. The effect of inadeqate occlusal VD
• Cheek biting
• TMJ troubles
• Inadeqate eating & chewing
• Ms fatigue
• Angular chelitis
34. Horizotal relation
• The significance of the centric is the irregular
loss of teeth has often shunted the mandible
into aslight protrusive or lateral position .
• The muscles ,the ligaments, the bones, the teeth
&all structures grow into what may be named { A
muscle center}.
35. How to record centric relation ?
• THere are 2 concepts :
• Minimal pressure technique ,so;tissue not displaced
while recording the opposing teeth touch at their 1st
contact ,so will not stimulate pt. to clench.
• With heavy pressure technique ,so tissue displaced
while recording So produce the same displacement
when heavy pressure where applied on the denture .
• The choice bet.2 methods depends on the concept of
occlusion selected .
• Recording horizontal jaw relation ;
• Inter occlusal or cheeck bite method .
• Graphical or Gothic arch tracing.
36.
37. • A laboratory procedure of attaching the maxillary
and the mandibular cast to an articulator or similar
instrument.
• A mechanical instrument that represents the
tempromandibular joint and jaws which maxillary and
mandibular casts may be attatched to stimulate some or
all mandibular movement.
38. • The articulator must accurately maintain the correct
horizontal and vertical relationship of the patient.
• The casts must be easily removed and attatched to
the articulator without losing their correct
relationship.
• Should have an incisal guide pin with a positive stop
to preserve the patient vertical dimension.
• Should be able to open and close in a hing like
fashion.
• The articulator should accept a facebow transfer.
• The condylar guidance should allow right,left lateral
protrusive movement.
• The incisal guidance should be adjustable.
39. To achieve balanced occlusion we must
arrange teeth in anatomical articulation...
Balanced occlusion
• At any occlusal relationship maximum number of
teeth are in contact and therefore the masticatory
pressure is distributed over the suppoting tissues.
Stability
• Maximum number of teeth contact no tilting of the
denture occur
40. Reduced truma
• as the masticatory pressure will be distributed as
evently as possible and thus reduce damage to the
supporting tissues.
Efficiency
• Griding and cutting of food stuff are possible
because lateral and protrusive movement can be made
to maintain balanced articulation also chewing time
and masticatory cycle will be reduced pressure on the
supporting tissues and bone resorption will be
reduced.
41. Functional movement
• Patients will become accustomed to dentures which
anatomically set up as it allow a continuation of
normal masticatory movement.
Time saving
• As balanced articulation have been obtained by the
technician in the laboratory only minor spot grinding to
be done in the clinic and thus save time.
42. For anterior teeth
• We must take in consideration esthetic&phonetics.
44. (Law of balanced articulation)
• Condylar guidance.
• Incisal guidance.
• Cusp height.
• Compensating curves.
• Orientation of the occlusal plane.
45. • Waxing-up: is the process of waxing and carving of the
wax to the shape and contour of a trial denture into the
desired form.
46. The form of the polished surfaces and the proper
location of the artificial teeth play a major role in:
• Stability of the dentures
• Influences its retentive quality.
• Influences the aesthetic of the denture.
• Support the cheeks, lips and tongue
47. Upper denture
• The wax periphery must be
– extended to the maximum depth.
– Fully rounded
– Highly polished.
• The labial waxing may be thickened in order to restore lost
facial contour.
• The buccal surface should face downwards and outwards.
• Festooning and cusped eminence should be provided.
• Gingival crests should be trimmed exactly to the finished
line. No deep grooves should be done.
• Stippling of the facial surface.
• The palatal surface will face inwards and downwards.
• The palate should have an even thickness of 2.5 mm.
48. Lower denture
• The labial surface concave.
• The peripheries
– Fully rounded
– Highly polished.
• In the premolar region the buccal surface flat and thin.
• In the molar region
– The wax thickened and widened
– Face outwards and upwards.
• The lingual surface must face inwards and upwards
(concave). The concavity does not extend under the teeth
(in the middle of the flange) so that the tongue does not
raise the denture.
• The wax should be extended to cover the maximum area
possible in the retromolar region.
The lingual flange should not be bulky
49. • Preliminary insertion of a complete denture wax-up
trial denture to determine the
fit, esthetics, maxillomandibular relations
• It is the last opportunity to evaluate many of the
pervious steps already accomplished
• It is also offers an excellent opportunity for patient's
acceptance of the finished prosthesis
50. • Check maxillomandibulor relationship
– Centric occlusion
– Centric relation
– Acceptance of the vertical dimension of the occlusion
• Determine if the position of the teeth and the contours
of the denture bases are compatible with the
surrounding oral enviroment
• To verify tooth selection and arrangement for proper
esthetics and phonetics
• To make additional interocclsual maxillomandibulor
records if needed for future adjustment of the
articulator
51. The appointment of denture insertion is the moment
awaited by the patient.
• physical needs required for performing adequate
function without causing truma to the supporting
structures.
• physiological needs by allowing the proper support
needed by the muscles to provide proper esthetic.
• psychologic needs by providing proper function and
esthetic.
52. • To check retention,stability,accurancy of jaw
relation.
• To instruct the patient how to use his denture.
• To advice the patient on the proper care of his
dentures and supporting tissues.
• To advice the patient on the limitations to be
expected of his denture.
53.
54. • Dental patients with complete dentures need to take
care of their oral health, just as if they still had their
natural teeth.
• The most important thing these dentures are trying
to achieve is restoring the patient’s lifestyle.
• Dentures ideally remain unchanged; yet, your mouth
is constantly changing. If you fail to wear your
dentures for a while, for your own reasons, you will
find it doesn’t fit any more. As we grow old, the oral
cavity tends to shrink and the gum line to withdraw.
55. • Many patients with dentures consider that they
no longer need to visit their dentist, since they
have no more natural teeth to take care of. Even if
you no longer have your natural teeth, your visits
to the dentist must not become history. You need
to maintain a healthy oral cavity and keep your
dentures in good shape. Even at a more advanced
age, patients can experience misalignments of
their dental arches. It is highly important that you
prevent and treat denture irritations and
infections. It is better to ask your doctor how
often you need to come back for a dental check-
up.
56. • Dentures are meant to improve the quality of life in
patient who lost their natural teeth, not to cause
further inconvenience.
• When not in your mouth, your dentures should be
kept in a glass of water or other special liquid. Do not
place them in hot water and do not let them dry! You
need to clean them on a daily basis, using a
toothbrush. Never use rough detergents to clean your
dentures.
• Don’t try to fix your broken dentures at home. As
strange as it may seem, many patients try to glue
their broken dentures with chemical adhesives they
buy from the supermarket and try to adjust them
using a nail file or similar to avoid accidents, don’t do
this at home! Ask your dentist about any necessary
repair.