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7. Final Impressions John Beumer III,  DDS, MS, Robert Duell, DDS and Eleni Roumanas Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA  School of Dentistry This program of instruction is protected by copyright ©.  No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.
Final Impressions
Impression Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Impression Techniques
We attempt to record the tissues at rest.  The only  exception is the posterior palatal seal area Maxillary tuberosity Posterior palatine glands Posterior Palatal Seal
[object Object],Selective Pressure Technique
Final Impressions Appointment: ,[object Object],[object Object],[object Object],[object Object]
[object Object],Final Impressions Appointment:
Armamentarium: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Custom Impression Trays ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Final Impressions-Custom Trays
[object Object],[object Object],[object Object],[object Object],[object Object],Final Maxillary Impressions
Final Maxillary Impressions ,[object Object],[object Object],[object Object]
The tray must extend 2-3mm beyond the vibrating line Final Maxillary Impressions ,[object Object],[object Object],[object Object],Hamular notch Vibrating  line
[object Object],[object Object],[object Object],[object Object],[object Object],Custom Tray
Maxillary tray sequence of border molding: The posterior palatal seal area is added last and the tray is tested for peripheral seal.
Border Molding Heat the modeling  compound over a flame
[object Object],Border Molding
[object Object],[object Object],Border Molding
[object Object],Border Molding
[object Object],[object Object],Border Molding
[object Object],[object Object],Trimming the compound:
[object Object],[object Object],Trimming the compound:
[object Object],[object Object],A Border Molding- Overextension:
Area “A” has been refined.  Note that the denture extension in this area is thinner and flatter.  What structure limits the thickness and length of the denture border in this region? A Border Molding Coronoid Process
Note the difference Before After
Border molding the labial flange-Area “C” ,[object Object],[object Object],[object Object],[object Object]
Don’t pull down on the lip .  This maneuver will foreshorten the denture flange. Border Molding
[object Object],Developing the Posterior Palatal Seal- Area “D”
[object Object],Developing the Posterior Palatal Seal- Area “D”
Trim compound in  posterior palatal seal area ,[object Object]
Pull on the tray handle to test retention.  If retention is lacking  check the following: 1)  Check buccal pouch, hamular notch  and  posterior palatal  seal area 2)  Check the length and thickness  of the denture extensions   Testing Peripheral Seal
Compare the extensions of the border molded tray  with those of the old denture.
If the retention is adequate you are ready to cut  back the compound. Border Molding-Cut Back
[object Object],[object Object],[object Object],Border Molding-Cut Back
What is the purpose of the vent hole? ,[object Object],[object Object],[object Object],Caution:  Do not drill the palatal relief hole(s) in the maxillary tray until are borders have been molded and the peripheral seal demonstrated.
[object Object],Apply Tray Adhesive
Selection of Impression Materials ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Key factors for a successful impression:
[object Object],[object Object],Key factors for a successful impression (cont’d)
[object Object],[object Object],Key factors for a successful impression (cont’d)
[object Object],[object Object],Key factors for a successful impression (cont’d)
[object Object],* Be sure to drape the patient before making the final impression.  Polysulfide  material cannot be removed and permanently stains clothing. Key factors for a successful impression (cont’d)
[object Object],We don’t need an impression of the uvula. Key factors for a successful impression (cont’d)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Key factors for a successful impression (cont’d)
[object Object],Key factors for a successful impression (cont’d)
Remove the impression.  Examine it carefully.  What factors make for a good impression?  ,[object Object],[object Object],[object Object],[object Object],Completed Maxillary Impression
[object Object],[object Object],Trim and Disinfect the Impression
[object Object],Completed Maxillary Impression
[object Object],[object Object],[object Object],Final Impressions:Boxing & Pouring
Window Tray Impression Technique ,[object Object],Mobile tissues are most often seen anteriorly and may be particularly prominent in patients with combination syndrome.  It is inadvisable to remove these mobile tissues because the underlying bony ridge is usually knife edged.  These tissues act as a cushion and rarely impinge upon the interocclusal space.
[object Object],[object Object],[object Object],[object Object],Window Tray Impression Technique(cont’d)
[object Object],Window Tray Impression Technique(cont’d)
[object Object],[object Object],[object Object],Window Tray Impression Technique(cont’d)
[object Object],[object Object],Window Tray Impression Technique(cont’d)
Master Mandibular Impression ,[object Object],[object Object],[object Object],[object Object],[object Object]
Completed Mandibular Impression Tray ,[object Object],Finger rests
Fabrication of custom trays from the existing denture ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fabrication of custom trays from the existing dentures ,[object Object]
Fabrication of custom trays from existing dentures ,[object Object],[object Object],[object Object]
[object Object],[object Object],Mandibular Custom Tray
[object Object],[object Object],Mandibular Custom Tray
[object Object],Our  objective  is to maximize the extensions of the new denture.
Mandibular  Sequence of Border Molding
[object Object],Mandibular  Sequence of Border Molding
[object Object],Border Molding
[object Object],[object Object],[object Object],[object Object],Border molding the buccal flange-Area “A”
[object Object],[object Object],[object Object],Trimming the labial flange-Area “A”
Section “A” on one side is complete.  This defines the proper tray extension for this area. Completed Buccal Flange
Add compound to area “B” (buccinator insertion, masseter groove region and area defining the posterior border associated with the retromolar pad). Temper, carefully rotate the tray into the mouth, and ask the patient to close while holding the tray in position, resisting the closure with your forefingers on the finger rests. Border molding the posterior flange-Area “B”
Area “A” and area “B” have been completed and trimmed.  Avoid displacing the tissues associated with the retromolar pad. Border Molding –Completed Areas “A &C”
[object Object],Border molding the labial flange-Area “C”
[object Object],Border molding the lingual flange-Area “D”
[object Object],[object Object],Border molding the lingual flange-Area “D”
[object Object],[object Object],Border molding the lingual flange-Area “E”
Border molding is completed.  Inspect carefully to ensure that the extensions are well defined.  The borders should be smooth and rounded . Note the varying  thickness of the lingual flange.  The thinnest border extends into the retromylohyoid space. Border Molding Completed
[object Object],[object Object],[object Object],[object Object],Border Molding- Cut Back
[object Object],Apply Tray Adhesive
[object Object],Do not overload  the tray. Mandibular Impression
[object Object],Do not let go of the tray . Hold the tray in position until the material has polymerized. Mandibular Impression
[object Object],Mandibular Impression
[object Object],Mandibular Impression
What factors make for a good impression?   ,[object Object],[object Object],[object Object],[object Object]
Alternate Technique- Virtual PVS ,[object Object],[object Object],[object Object],[object Object]
Alternate Technique-Virtual PVS ,[object Object],[object Object]
[object Object],[object Object],Alternate Technique- Virtual PVS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Alternate Technique- Virtual PVS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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7. final impressions

  • 1. 7. Final Impressions John Beumer III, DDS, MS, Robert Duell, DDS and Eleni Roumanas Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA School of Dentistry This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.
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  • 5. We attempt to record the tissues at rest. The only exception is the posterior palatal seal area Maxillary tuberosity Posterior palatine glands Posterior Palatal Seal
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  • 16. Maxillary tray sequence of border molding: The posterior palatal seal area is added last and the tray is tested for peripheral seal.
  • 17. Border Molding Heat the modeling compound over a flame
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  • 25. Area “A” has been refined. Note that the denture extension in this area is thinner and flatter. What structure limits the thickness and length of the denture border in this region? A Border Molding Coronoid Process
  • 26. Note the difference Before After
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  • 28. Don’t pull down on the lip . This maneuver will foreshorten the denture flange. Border Molding
  • 29.
  • 30.
  • 31.
  • 32. Pull on the tray handle to test retention. If retention is lacking check the following: 1) Check buccal pouch, hamular notch and posterior palatal seal area 2) Check the length and thickness of the denture extensions Testing Peripheral Seal
  • 33. Compare the extensions of the border molded tray with those of the old denture.
  • 34. If the retention is adequate you are ready to cut back the compound. Border Molding-Cut Back
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  • 64. Mandibular Sequence of Border Molding
  • 65.
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  • 69. Section “A” on one side is complete. This defines the proper tray extension for this area. Completed Buccal Flange
  • 70. Add compound to area “B” (buccinator insertion, masseter groove region and area defining the posterior border associated with the retromolar pad). Temper, carefully rotate the tray into the mouth, and ask the patient to close while holding the tray in position, resisting the closure with your forefingers on the finger rests. Border molding the posterior flange-Area “B”
  • 71. Area “A” and area “B” have been completed and trimmed. Avoid displacing the tissues associated with the retromolar pad. Border Molding –Completed Areas “A &C”
  • 72.
  • 73.
  • 74.
  • 75.
  • 76. Border molding is completed. Inspect carefully to ensure that the extensions are well defined. The borders should be smooth and rounded . Note the varying thickness of the lingual flange. The thinnest border extends into the retromylohyoid space. Border Molding Completed
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