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SPECIAL IMPRESSION
PROCEDURES FOR COMPRISED
CLINICAL CONDITIONS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
AIMS
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 maintainwww.indiandentalacademy.com
health of the oral tissues
PRINCIPLES
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
SPECIAL IMPRESSION PROCEDURES
1.

Controlled
techniques,

-

Minimally

displacive

impression

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
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
Controlled - Minimally displacive
impression techniques (Contd…)

Method A
Special tray with a window cut in the
region of the displaceable tissue.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)
Border molding with
low fusing compound.

Wash impression
with ZOE paste.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

Tray re-inserted, impression
syringed over displaceable tissue.

www.indiandentalacademy.com

plaster
Controlled - Minimally displacive
impression techniques (Contd…)

Completed impression.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

• Method B
– Special tray with a window cut in the region of
the displaceable tissue.
– Border molding with low fusing compound.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

Impression made with medium –
bodied / monophase elastomer.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)
Light - bodied elastomer syringed over
window area.
Dental plaster syringed over set, light - bodied
elastomer.

www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

Completed Impression
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

Method C
Special tray fabricated with no window.
Border molding with low fusing compound.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

Impression made using ZOE paste / monophase
elastomer.
When set, impression material corresponding to
displaceable tissue removed and tray perforated.
www.indiandentalacademy.com
Controlled - Minimally displacive
impression techniques (Contd…)

Impression plaster / light bodied elastomer
syringed over displaceable tissue.
Tray reseated and impression completed.
www.indiandentalacademy.com
Controlled – Pressure impression
techniques

Indicated
Unemployed lower alveolar ridge unable to
provide acceptable support against vertical
loads and positive stability against lateral
forces.
www.indiandentalacademy.com
Controlled – Pressure
impression techniques (Contd…)

Method
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
Controlled – Pressure
impression techniques (Contd…)

Customized special tray with 2mm spacer
constructed.
Spacer removed ; tray perforated in crestal
region .
www.indiandentalacademy.com
Controlled – Pressure
impression techniques (Contd…)

Low fusing compound used to obtain
impression of primary cast with special
tray.
www.indiandentalacademy.com
Controlled – Pressure
impression techniques (Contd…)
Impression reduced in the
region of buccal & lingual
sulci ; border molding
refined in patient’s mouth.
Painful areas relieved.
Tray re-insertion
not result in pain.

should

Impression completed with
light – bodied elastomer.
www.indiandentalacademy.com
Functional impressions
Indications
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
Functional impressions (Contd…)

Method
Tissue
conditioning
materials
employed for the procedures.
www.indiandentalacademy.com

usually
Functional impressions (Contd…)

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.
www.indiandentalacademy.com
Functional impressions (Contd…)
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.
www.indiandentalacademy.com
Functional impressions (Contd…)

Denture removed after 5 – 6 minutes ;
inspected and surplus material trimmed.
www.indiandentalacademy.com
Functional impressions (Contd…)

Patient returns after few / 24 hours;
impression inspected & cast poured.
www.indiandentalacademy.com
Denture space determination
(External Impressions)
Aims
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
Denture space

The portion of the oral cavity that is or may be
occupied by the maxillary and / or mandibular
denture (s).
www.indiandentalacademy.com
Neutral Zone
That area in the mouth, where, during
functions the forces of the tongue
pressing outward are neutralized by the
forces of the cheeks and lips pressing
inward.
Hence a possible zone of equilibrium
www.indiandentalacademy.com
Denture space determination
(Contd…)
Indications
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
www.indiandentalacademy.com
Denture space determination
(Contd…)
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
Denture space determination
(Contd…)

On accurate master casts, stabilized
denture bases are constructed.
Wire loops embedded over ridge crest for
retention.
www.indiandentalacademy.com
Denture space determination
(Contd…)
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. www.indiandentalacademy.com
Denture space determination
(Contd…)
Recommended movements
Smile
Swallow
‘ooh’
‘ah’

www.indiandentalacademy.com
Denture space determination(Contd…)

www.indiandentalacademy.com
Denture space determination
(Contd…)

Wash impression obtained with light – bodied
elastomer brushed on compound rims.
Functional movements repeated.
www.indiandentalacademy.com
Denture space determination
(Contd…)

Plaster matrices constructed around records.
Matrices guide in arranging & waxing teeth &
polished surfaces in optimum denture space.
www.indiandentalacademy.com
Denture space determination
(Contd…)

www.indiandentalacademy.com
Denture space determination
(Contd…)

After wax trial is completed, external impressions
are obtained using ZOE paste / light – bodied
elastomer.

www.indiandentalacademy.com
Denture space determination
(Contd…)
Precautions
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.
www.indiandentalacademy.com
Denture space determination
Modifications 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
Determination of the optimal
space 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
Determination of the fit of the
completed 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
In a Nut Shell…
CLINICAL FINDING

PRIMARY
IMPRESSIONS

SECONDARY
IMPRESSIONS

TECHNIQUE

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.

www.indiandentalacademy.com

Denture Space
determination done
by external
impressions for
contour of polished
surfaces
www.indiandentalacademy.com

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Sp.imp.procedures. /certified fixed orthodontic courses by Indian dental academy

  • 1. SPECIAL IMPRESSION PROCEDURES FOR COMPRISED CLINICAL CONDITIONS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. AIMS 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 maintainwww.indiandentalacademy.com health of the oral tissues
  • 3. PRINCIPLES 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 PROCEDURES 1. Controlled techniques, - Minimally displacive impression 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 displacive impression techniques (Contd…) Method A Special tray with a window cut in the region of the displaceable tissue. www.indiandentalacademy.com
  • 7. Controlled - Minimally displacive impression techniques (Contd…) Border molding with low fusing compound. Wash impression with ZOE paste. www.indiandentalacademy.com
  • 8. Controlled - Minimally displacive impression techniques (Contd…) Tray re-inserted, impression syringed over displaceable tissue. www.indiandentalacademy.com plaster
  • 9. Controlled - Minimally displacive impression techniques (Contd…) Completed impression. www.indiandentalacademy.com
  • 10. Controlled - Minimally displacive impression techniques (Contd…) • Method B – Special tray with a window cut in the region of the displaceable tissue. – Border molding with low fusing compound. www.indiandentalacademy.com
  • 11. Controlled - Minimally displacive impression techniques (Contd…) Impression made with medium – bodied / monophase elastomer. www.indiandentalacademy.com
  • 12. Controlled - Minimally displacive impression techniques (Contd…) Light - bodied elastomer syringed over window area. Dental plaster syringed over set, light - bodied elastomer. www.indiandentalacademy.com
  • 13. Controlled - Minimally displacive impression techniques (Contd…) Completed Impression www.indiandentalacademy.com
  • 14. Controlled - Minimally displacive impression techniques (Contd…) Method C Special tray fabricated with no window. Border molding with low fusing compound. www.indiandentalacademy.com
  • 15. Controlled - Minimally displacive impression techniques (Contd…) Impression made using ZOE paste / monophase elastomer. When set, impression material corresponding to displaceable tissue removed and tray perforated. www.indiandentalacademy.com
  • 16. Controlled - Minimally displacive impression techniques (Contd…) Impression plaster / light bodied elastomer syringed over displaceable tissue. Tray reseated and impression completed. www.indiandentalacademy.com
  • 17. Controlled – Pressure impression techniques Indicated Unemployed lower alveolar ridge unable to provide acceptable support against vertical loads and positive stability against lateral forces. www.indiandentalacademy.com
  • 18. Controlled – Pressure impression techniques (Contd…) Method 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. Controlled – Pressure impression techniques (Contd…) Customized special tray with 2mm spacer constructed. Spacer removed ; tray perforated in crestal region . www.indiandentalacademy.com
  • 20. Controlled – Pressure impression techniques (Contd…) Low fusing compound used to obtain impression of primary cast with special tray. www.indiandentalacademy.com
  • 21. Controlled – Pressure impression techniques (Contd…) Impression reduced in the region of buccal & lingual sulci ; border molding refined in patient’s mouth. Painful areas relieved. Tray re-insertion not result in pain. should Impression completed with light – bodied elastomer. www.indiandentalacademy.com
  • 22. Functional impressions Indications 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. Functional impressions (Contd…) Method Tissue conditioning materials employed for the procedures. www.indiandentalacademy.com usually
  • 24. Functional impressions (Contd…) 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. www.indiandentalacademy.com
  • 25. Functional impressions (Contd…) 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. www.indiandentalacademy.com
  • 26. Functional impressions (Contd…) Denture removed after 5 – 6 minutes ; inspected and surplus material trimmed. www.indiandentalacademy.com
  • 27. Functional impressions (Contd…) Patient returns after few / 24 hours; impression inspected & cast poured. www.indiandentalacademy.com
  • 28. Denture space determination (External Impressions) Aims 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 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 Zone That area in the mouth, where, during functions the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. Hence a possible zone of equilibrium www.indiandentalacademy.com
  • 31. Denture space determination (Contd…) Indications 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 www.indiandentalacademy.com
  • 32. Denture space determination (Contd…) 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. Denture space determination (Contd…) On accurate master casts, stabilized denture bases are constructed. Wire loops embedded over ridge crest for retention. www.indiandentalacademy.com
  • 34. Denture space determination (Contd…) 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. www.indiandentalacademy.com
  • 35. Denture space determination (Contd…) Recommended movements Smile Swallow ‘ooh’ ‘ah’ www.indiandentalacademy.com
  • 37. Denture space determination (Contd…) Wash impression obtained with light – bodied elastomer brushed on compound rims. Functional movements repeated. www.indiandentalacademy.com
  • 38. Denture space determination (Contd…) Plaster matrices constructed around records. Matrices guide in arranging & waxing teeth & polished surfaces in optimum denture space. www.indiandentalacademy.com
  • 40. Denture space determination (Contd…) After wax trial is completed, external impressions are obtained using ZOE paste / light – bodied elastomer. www.indiandentalacademy.com
  • 41. Denture space determination (Contd…) Precautions 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. www.indiandentalacademy.com
  • 42. Denture space determination Modifications 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 optimal space 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 the completed 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… CLINICAL FINDING PRIMARY IMPRESSIONS SECONDARY IMPRESSIONS TECHNIQUE 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. www.indiandentalacademy.com Denture Space determination done by external impressions for contour of polished surfaces