SlideShare une entreprise Scribd logo
1  sur  29
DIFFERENT THEORIES OF IMPRESSION MAKING AND
RATIONALE FOR THE DIFFERENT TECHNIQUES IN
COMPLETE DENTURE TREATMENT
Introduction
Theory means observation based on principles and concept is the
application of these theories. Impression forms a important virtue for the
success of compete denture treatment and hence the concepts of impression
should be properly understood. From time immemorable there have been
different theories that had been advocated. Green Brothers were the first to
introduce the principle of muco compression during impression technique. The
shortcomings of this principle gave rise to the mucostatic technique by Hary L.
Page with high regard for tissue health. But again due to the disadvantage of
this technique, there was an impetus for the introduction of the selective
pressure technique which combined the concepts of both the previous
techniques. There are various techniques adopted by different practitioners and
there may be as many techniques as the number of dentists regarding
impression which in general means negative likeness but in prosthodontics it is
the negative registration of the denture bearing denture stabilizing, denture
bracing and peripheral limiting structures obtained in one of the plastic /
semiplastic materials which is registered at the moment of crystallization of the
impression material.
At the moment of crystallization means that the tissues are registered at
a particular moment. Since the denture bearing tissues are always in a state of
flux with new cells being generated and cells being shed of at different moment
of time, the tissues at the time of impression making will differ from that at the
time of denture insertion.

1
It is not feasible to group all the techniques into rigid compartments but
a broad classification is possible. They may be classified as scientific /
empheric depending on whether they are based on knowledge of anatomy.
b. They may be classified as open / closed mouth impressions depending on
the condition of the mouth at the time of impression making.
c. They may be classified as either pressure, nonpressure / minimal pressure,
and selective pressure depending on the amount of pressure applied at the
time of making impressions.
Prior to 1600 complete denture replacement were not made due to lack
of understanding of retention.
 In 1711, Mathian Gottfried Purman recorded the use of wax.
 In 1728 Pieree Fauchard made dentures measuring the mouth with
compases and cutting bone into an approximate shape for the space to be
filled.
 In 1736, Phillip Pfaff of Germany made impressions in wax sections of half
of the mouth at a time.
1845-1899
 In 1886 Richardson mentioned about making plaster impressions of tissues
at rest and achieving adhesion by contact.

2
• Concepts of atmospheric pressure, maximum extension of the denture
bearing area, equal distribution of pressure and close adaptation of the
denture bearing tissues were stressed.
• Many changes in impression making became evident during this era. A
single impression formely deemed sufficient, advanced to a method using
priliminary impression of guttapercha, beeswax or modelling compound
followed by secondary wash impression made of plastic within preliminary
impression.
1900 – 1929
 A concentrated effort was directed towards accuracy.
Most impression were of compressive type and by the closed mouth
technique. To prevent buildup of excessive pressures vents were made.
Closed mouth technique
 In this technique the supporting tissues recorded in a functional
relationship.
 The movement of all related tissues were in normal functional movements
such as swallowing, talking, sucking and occlusal contacts.
 A pressure similar to that of mastication was developed through the
occlusal rins.
This according to Stanley P Freeman-amount of tissue compression is
like that in function.

3
 Selective pressure technique.
 The disadvantage of closed mouth technique is the tendency of
overextention or underextention.
 Release of pressure of occlusion may permit a rebound of denture.
 It is contraindicated in the presence of considerable amount of movable
tissue.
The open mouth technique is preferred because the operator can see
whether the border molding is done properly.
The functional manipulation cannot be used routinely not all patients
can truly move the impression materials as needed, some may use extreme
movements and others use.
 Two techniques were developed for the management of flabby ridge.
1st technique – it was of muco compressive type compound impression which
displaced the flabby tissue paratally.
2nd technique – it was advocated by Greene Brothers, which captured the tissue
in its passive form.
 Concepts of posterior palatal seal were developed by Liberthal and Greene.
 For the first time there were references to movement of tissues and the
mandible during impression making.

4
 Border molding was done against the direction of muscle fibres as
advocated by Wilson.
 There were others like Nichais, Neil Fish, Swenson et al who advocated
manipulation in border molding in the direction of its fibres.
 It was during this era that the concept of esthetics in impression making was
introduced.
MUCOCOMPRESSIVE TECHNIQUE
 The muco compressive technique was initiated by Greene Brothers. They
introduced a modeling

plastic, a method for manipulating it and a

technique that is said to have been the first to utilize all the denture bearing
area for denture retention.
 They were the first to teach the closed mouth all modeling plastic technique
called the Greene Brothers all compound impression.
 The main objective of this technique was to attain better retention of the
dentures.
The typical technique by Greene brothers was as follows.
• A preliminary impression was made in impression compound and a custom
tray was constructed using baseplate with its periphery 1/8 th inch shorter
than the denture outline.
• With this tray another impression with compound was taken.

5
• Well fitting rinse with uniform occlusal surface were made and the height
of the bite adjusted against a similar bite rim on the mandibular ridge.
• Areas to be relieved like median raphe was softened on the impression and
was again inserted in the mouth and was held under biting pressure for one /
two minutes.
• The peripheral margins of the impression was then softened and border
molding was done by asking the patient to give various cheek and lip
movement as in whistling and smiling.
• The posterior palatal seal was obtained by swallowing movements by the
patient under biting pressure.
• The claims made by the advocates of this technique was that since border
molding was done in their functional positions, the final dentures would
retain well and cannot be dislodged during functional movements of the
jaw.
Variations in this technique
• Some used the preliminary impression itself as the tray and impression to be
improved by border molding.
• Some preferred to make custom trays in a more stable and stronger material
than compound for better results.

6
• Relief in hard areas was obtained in number of ways. Some custom trays
were made with escape holes in areas overlying the hard tissues and close
adaptation provided in those areas covering the soft tissues.
• Some use low fusing compound by softening and adapting it to the soft
tissues.
• Some advocate unnatural movement of the mouth along with massaging of
the cheeks and lips from outside during border molding.
• Post dam is obtained in number of ways.
• The addition of soft wax like carding wax or low fusing compound for this
purpose is common.
• Scraping of cast is also used.
The amount of pressure applied to the tissues in the muco compressive
technique was not only great but was applied to the centre of the palate and the
peripheral tissues which were not well suited to receive the maximum biting
load this interferes with normal blood supply of the tissues resulting in their
breakdown.
As soon as this change took place both the peripheral seal and excellent
retention were lost. Hence the retention achieved by these means was transient
and harmful to the health of tissues.
Dentures made by this technique would fit well during mastication i.e.
only a short period each day, but would not be closely adapted to the tissue
when the patient was at rest. This is because of the rebounding of tissues.

7
These disadvantages indicated a need for spacer in the custom tray
fabrication.
1930-1948
• Concept of mucostatics was introduced by Harry L. Page in 1938.
• Addison in 1944 also mentioned the same principle of making impressions
of displaceable tissue in its passive state and considered interfacial surface
tension as one of the main factors of retention.
• With new materials like zincoxide eugenol, waxes, elastomers, individual
tray construction was emphasized.
Minimal pressure technique based on mucostatic principle
• In a Brochure published by Hary L. Page in 1946 he stated that all soft
tissues were cheifly fluid and 80% or more of the tissues are composed of
water. According to pascal’s law which states that any pressure applied to a
confined fluid is transmitted undiminished and equally in all directions.
Page contended that since the soft tissues are confined under a denture, any
pressure applied will be transmitted in all directions.
• The advocates of this principle considered interfacial surface tension as the
only important retentive mechanism in complete dentures. Therefore they
did not resist vertical displacement, which was the only movement capable
of interrupting surface tension. However, Dykins recommended a short
lingual flange to resist lateral displacement.

8
• According to the principle of mucostatics the impression material had to
record without distortion, every detail of the mucosa so that a completed
denture would fit all minute elevations and depressions. So much emphasis
was placed on recording details that separating substances could not be used
at any point in the procedure.
• Mucostatics further demanded a metal base. Gold, one of the most accurate
metals was bypassed in favour of chrome alloy which are not considered to
be quite so accurate as gold.
A typical impression method representing this technique was as follows.
• A compound impression was made in a suitable tray and a cast was made.
• On this base plate wax was adapted which acted as a spacer according to
denture outline.
• Custom tray was fabricated over this spacer.
• A soft ribbon of carding wax was applied at the posterior margin of the
maxillary tray and it was placed in the mouth under light pressure and
patient was asked to do swallowing movements inorder to obtain a posterior
palatal seal.
• A small amount of impression plaster mixed into a smooth consistently was
placed in the tray, introduced in the mouth and was slowly raised to position
and held with as little pressure as possible.
• No border molding was advocated but the soft plaster was expected to mold
itself to the relaxed vestibular tissues.

9
• The impression was held till the impression hardened and was then
removed.
Variations in the technique
• Some techniques use compound instead of wax for obtaining post dam.
• Some techniques advocate post dam over the final impression.
• Zinc oxide eugenol and alginate had also been used for similar results.

• Page’s application of Pascal’s law to the field of denture impressions is only
partly correct because the tissues involved are not wholly incompressible
and fluids may escape through the borders of the denture.
• Page’s claim that retention is a function of surface tension alone is also
objectionable because this tensile force itself is dependent upon adhesion
and cohesion.
• The elimination of use of separating media results in distortion of the cast.
• The use of chrome cobalt as denture bases results in failure of accurate
detail reproduction.
• The mucostatic principle ignores the value of dissipating masticatory forces
over as largest possible basal seat area. Further the mucostatic denture
minimized the retentive role of the musculature as described by Fish in
1948.

10
The merit of this technique was its high regard for health and
preservation of tissue.
1948 – 1964
• There was an increased emphasis on biologic factors of complete denture
impression making.
• Selective pressure concept by Boucher became popular.
• Craddock, Landa et al advocated use of escape vents.
• More attention was given to esthetics in the impression techniques used
greater emphasis was on flanges, border molding, posterior palatal seal and
denture extension.
• In 1948, the mucoseal technique – a variation of the mucostatic technique
was introduced.
• Vacustatics concept was developed by Milo V. Kubalib and C. Buffington
to eliminate the functional limitations of impressions.
Selective pressure technique based on selective pressure theory
• Advocated by Boucher in 1950 it combines the principles of both pressure
and minimal pressure techniques.
• The philosophy of the selective pressure technique is that certain areas of
the maxilla and mandible are by nature better adapted for withstanding
extra loads from the forces of mastication. These tissues are recorded under

11
slight placement of pressure while other tissues are recorded at rest or
relieved with minimal pressure in a position that will offer maximum
coverage with the least possible interference with the health of surrounding
tissues.
• Here an equillibrium between the resilient and the non resilient tissues is
created.
Primary stress bearing areas of maxilla are crest of alveolar ridge and
the horizontal plate of palatine bone and in the mandible it is the buccal shelf
area.
Secondary stress bearing areas of the maxillary foundation are rughae
area and the slopes of the ridge in the mandibular foundation.
Areas requiring minimum pressure are incisive papilla, midpalatine
suture, tori in the maxilla and crest of mandibular residual ridge.
In the maxilla, the tissue underlying the region of posterior palatal seal
has glandular and soft tissue between the mucous membrane lining and the
periosteum covering the bone. This tissue can be more readily displaced for the
maintenance of peripheral seal of the maxillary denture.
An earlier technique representing this group consisted of the following
steps:


A well fitting tray with a uniform clearance of about 5mm was selected
and a compound impression was obtained with little border molding done
on the peripheries.

12


This compound impression was separated from the metal tray and its
peripheral borders were trimmed 1 – 2 mm short.



The base portion of the impression was then scrapped evenly to a depth
of about 2mm except in the posterior seal area where no scraping was done.



A sufficient amount of creamy mix of plaster was spread over this
impression and was placed in the mouth with little pressure.
The cheeks and lips were lightly patted from outside while the plaster

was still soft. This procedure gave sufficient value like seal without
exaggerated pressure on soft tissues.
Variations in the technique


Most of the techniques prefer taking a preliminary impression and using
a custom tray rather than use the initial compound impression for further
improvement.



The preliminary impressions are usually taken in compound but
materials like alginate, elastomeric impression materials are also used.



Certain methods advocate the use of three small compound stops in the
base area of special tray before doing border molding. This prevents the
periphery of the tray from impinging on the tissues and it standardizes the
relation of the tray to limiting tissues for every insertion of tray.



The amount of material, consistency of material, use of space or escape
vents and the manual pressure with which the impression is made are all

13
possible variable which have been used to advantage by different
techniques.
The mucoseal technique was stated by Pryor in 1948 which was
introduced as a variation to the mucostatic technique.
• The anterior lingual border is molded by the floor of the mouth with the
tongue in repose.
• The tray is extended horizontally backward, over the sublingual glands
towards the tongue to effect a border seal.
• Thus this technique utilizes the benefit of minimal pressure and also
provides maximum extension of denture borders and maximum coverage of
denture bearing area.
Sub-atmospheric pressure technique based on the concept of mucostatics


Milo V. Kubalik and Bert C. Buffington developed this
technique the objective of which was to reduce the stress on any given
tissue by increasing load bearing area. the form of the tissue is recorded
vertically and laterally, when a controlled partial vacuum is established in
impression tray specially built for the patient. It is maintained in the mouth
without direct mechanical support of any kind. The difference between the
subatmospheric pressure within the tray and the atmospheric pressure
outside the tray is all that is needed to centre the tray over the ridges in a
static position. A vacuum is developed between the soft tissues and the tray.
A recording material in a fluid state flows from the border region into the

14
evacuated space and develops the basal tissues. Border seal is determined
by the readings remaining constant.
Materials used
1. Alginate, modeling plastic or a reversible hydrocolloid for preliminary
impression.
2. Clear acrylic resin for making the final impression.
3. An adequate sealing agent for use around special fittings in the tray.
4. Thermoplastic border recording impression material.
5. A fluid (low viscosity) impression material that seats firmly enough to
avoid distortion.
6. A periphery wax to be used as a flexible material between impression
and the boxing wax.
Molding Exercises
For the maxillary impression the patient is told
1. To suck on the tube (this pulls the cheeks in a starts border molding).
2. To say “00000” and EEEE alternately (This refines the border molding
of the buccal and labial flanges and provides space for the frenum.
3. To blow against closed nostril (This flexes the soft palate and molds the
posterior palatal seal area. Wipes of any excess adapted extending
beyond the border of the tray.

15
4. To move the mandible from side to side (This molds the flanges lateral
to the tuberosities.
5. To swallow warm water (This allows for swallowing movements in the
shape of the posterior palatal seal.
6. To open and close the mouth (This records the shape and action of the
paramusculature used in extreme opening and closing movements.
For mandibular impression the patient is instructed
1. To suck on the tube (This flexes the labial, buccal and lingual vestibular
structures and mold the flanges in these regions).
2. To force the tip of the tongue against the palate (This forcibly molds the
flange in the sublingual space with the paralingual musculature.
3. To say “0000” and “EEEE” alternatively (This further molds the buccal
and labial flanges)
4. To lick the upper and lower lip (This molds the flanges in the lingual
space in the region of Wharton’s ducts and genioglossus muscle.
5. To place the tongue in the right cheek and left cheek (This further molds
the flange in the sublingual fold space).
6. To swallow warm water (This molds the posterolingual flange in
relation to the palatoglossus and mylohyoid musculature).
7. To tense and flex the lower jaw as if clenching one’s teeth (This molds
the buccal flange from the external oblique ridge to the retromolar pad.

16
1965 – 1982


New techniques had been developed to manage compromised
conditions.

For poor mandibular ridges – Sublingual flange technique by Tyrde and
Robert Flange technique by Lott and Levin.
For hyperplastic alveolar ridges by Zafarulla Khan, William H. Filler.
Impression techniques for severely resorbed foundation
Flange technique by Lott and Levin introduced in 1966 involves making
impressions of soft tissues of mouth adjacent to the buccal, lingual, labial,
palatal surface and incorporating the resulting extensions or flange in the
denture. Flange wax was rolled from the retromolar pad area to the sublingual
region, large enough to restore the diameter of estimated resorption and patient
is asked to forcefully perform functions of swallowing etc to give border
extensions which covers maximum surface area (genial tubercles and
sublingual gland).
Tyrde in 1965 used the dynamic impression method on the same
principle to obtain sublingual flange.
Roberto Von Krameck et al in 1982 used modeling compound to record
the extensions. This sublingual flange extension increases the tissue surface
without interfering the functions of mastication, deglutition and phonation. The
active incorporation of tongue activity also stabilizes the denture.
Impression technique for patients with unsupported movable tissue
(Hyperplastic or flabby tissue):

17
William H. Filler described a technique using two trays.
a.

Preliminary maxillary and mandibular impressions were made in
stock trays with alginate impression method and casts were poured.

b.

The maxillary and mandibular casts were placed on the surveyor
and all the tissue undercuts were blocked out with utility wax.

c.

A single thickness of baseplate wax was formed over the casts to
form a spacer. The spacer is terminated short of the posterior palatal seal
area so that the tray material would contact the tissue in this area.

d.

A tinfoil sustitute was applied to the casts and the first of the two
trays was made in autopolymerizing acrylic resin. Most of the basal surface
of the tray was removed except for the lattice work of acrylic resin which
strengthens the trays.

e.

The maxillary and mandibular trays are then keyed to orientate
the second tray in atleast three places. These keyed positions correspond
with an extension of the second tray and will insure proper seating of the
second tray over the first tray.

f.

The entire first tray was covered with a single thickness of
baseplate wax, ensuring that the keyed positions here kept free of wax. Both
the first resin tray and the casts were painted with tin foil substitute.

g.

The second trays were made in the same manner as the first and
extend past the relieved area of maxillary and mandibular trays and fit into
keyed positions.

18
h.

With round bur, numerous holes were made in the second tray.

i.

The deepest portion of the vault of maxillary tray was removed to
create a stop when the final impression was made. The initial tray was
sealed with minimum pressure and autopolymerizing resin on a tongue
depressor was gently placed in the opening in the vault. When the resin had
set a stop was created on the firm and stable palatal tissue.

Clinical impression procedure
The borders of the maxillary tray are formed by adding



low fusing compound and border molding it. A finger placed over the resin
stop will ensure a stable tray. The basal plate was removed and the flanges
reduced 1-2mm with the exception of the part over the tuberosites and
posterior palatal seal area of the maxillary tray.
The mandibular tray was stabilized by the addition of



modeling plastic on the buccal flanges in the region of first and second
molars and in the anterior part of the tray in the incisor area. The
mandibular tray was border molded and baseplate wax was removed from
the mandibular tray every where except at the three points used for
stabilization.
Both the trays were painted with permlastic adhesive.



Light body permlastic was used in initial tray as a corrective wash
impression material. After it set the tray was removed from the mouth and
all excess material was trimmed from the borders and from the area where
the second tray would come into contact with the first tray to key
themselves.

19


The second impression was made with plastogum used
in corrective wash impression and plastogum was painted over the entire
vault and all available tissue surface not included in the first impression.
The second tray was filled with plastogum and gently vibrated into place
until keyed parts of the tray were in contact. The two trays were held lightly
together until the impression material set and then the impression was
removed as a unit and the two trays were sealed together with sticky wax.
Zafarulla Khan described a technique where a window was cut in the

custom tray where the unsupported area was present. The unsupported area was
recorded with impression plaster and the remaining area was recorded with
perrmlastic impression material.
Other techniques used in case of flabby tissues
a. Hobrick described a technique where only a single custom tray was used.
Border molding was done in the usual manner and impression was made
with heavy bodied addition silicone. The area of movable tissue was cut out
and relief holes were made and wash impression was made with light
bodied impression material.
b. Joh D. Watter recorded the healthy denture bearing tissue with ZnoE and
the displaced tissue with impression plaster.
c. Split method by Allan Mack is useful if tissues are exceptionally flabby. A
loosely fitting tray made with heavy relief over the flabby areas was taken.
Plaster was mixed and applied over the flabby area to a thickness of about
3mm and was allowed to set tray was filled with 2nd mix of plaster and the

20
impression was made with the initial coating of flabby areas thus acting as a
splint while the impression was made and being removed.
Other techniques used for poor foundation
a. Modified Fournet Tuller

technique by Allan Mack also utilizes the

principle of achieving maximum peripheral seal together with minimal
pressure on the crest of the ridge to obtain retention and stability.
b. Winkler described a technique which used tissue conditions and over
extended primary impression of alginate was made. Occlusal wax rims were
constructed and the borders were adjusted so that the lingual flange and
sublingual crescent area were in harmony with the resting and active phases
of the floor of the mouth by as open and closed mouth technique 3
applications of conditioning material were used – each application for
approximately 8-10 minutes. The third and final wash was made with light
bodied material. The technique resulted in an impression that had tissue
placing effect with relatively thick buccal lingual and sublingual crescent
area.
Miller used mouth temperature waxes instead of tissue conditioners.
Klein proposed the development of impression without a tray, as a stock tray
may cause some distortion of the tissue and may result in a over extended
impression. He used a moldable material (putty silicone) reinforced by an
internal metallic core which was placed over the residual ridge and the borders
molded by speech exercises. A low viscosity material was placed on the
impression surface of this tray and functional impression was made.

21
Impression technique for restricted access to the mouth
Walter described a technique with the use of sectional stock trays.
Impressions of each side of the jaw was made on at a time and two holes were
joined and cast was poured.
The recording of denture borders may be done by either hand
manipulation and functional movement.
Hand manipulation
The contour of the denture borders may be obtained by the dentist with
the use of manipulation of lips and cheeks within functional limits. Patients
tongue movements record the lingual borders.
Functional movements
The denture borders are also formed by having the patient make
functional or physiological movement such as swallowing sucking, grinning,
licking etc.
Tench’s neuromuscular concept values the functions of sucking and
swallowing while making the impression to bring the denture base into
harmony with the physiological behaviour of the muscles. Forming an
impression by neuromuscular concept develops a completely passive contact of
all impression borders to the basal seat tissues, passively fills all marginal
spaces and develops basal seat area coverage that is compatible with function.
Barone states that normal or natural movements will provide better
borders than by manipulation.

22
The only truly functional or physiological method of making
impressions is the so called dynamic impression. In this technique the basal
seat and borders are obtained with the use of impression materials that continue
to flow over an extended period of time such as tissue conditioning materials or
wax. This material is placed in the patients transitional denture and the patients
normal activities mold the borders over a period of time.
Functional reline rebase technique is based on the same principle.

Discussion
In the mucostatic principle
Clinical procedure in selective pressure technique:
1. Preliminary examination and conditioning of the patient.
2. Seating the patient:
i. Patient should be in a upright position and relaxed.
ii. The jaw should be at the level of the operator’s elbow for maxillary
and at the level of operator’s shoulder for mandibular impression.
3. The hands should be washed in the view field of the patient even though
they may have been previously washed.
4. The tray should be selected from the stock trays which should be kept ready
sterilized while inserting the tray in the patient’s mouth using a rotatory
movement. There should be an equal clearance of 6-8 mms. Between the
tray and the tissues all round.
5. Operator’s position:

23
i. Right back side of the patient for upper impression.
ii. Right side front of the patient for lower impression.
The selected tray should cover the entire denture bearing area. Check the
tuberosity area in the maxillary and lingual pouch in the mandibular
foundation.
6. Compound is softened in chotwater.
i. A large bowl should be used.
The compound is kneaded thoroughly to soften it uniformly. In case
maxillary impression the compound is molded to a rounded form, placed in the
centre of the tray and thoroughly spread over the surface of the tray.
In case of mandibular impression the compound is formed into a rope
form and spread over the surface of the tray.
In case of maxillary impression, the tray is centered slightly anterior to
the final position assumed by the tray when it is correctly seated. It is then
moved upward and backward direction. The compound is manipulated by
index finger into the deep buccal sulcus area. In case of mandibular impression
the tray is centered exactly over the ridge and seated straight down. With the
index finger the compound should be manipulated into the deep lingual pouch.
 Simulation of the tissue should then be done.
 The compound is allowed to harden and withdrawn from the mouth.

24
 The impression is chilled in cold water and examined thoroughly. It is
examined for completeness border tissue functions, distortion and gross
physical defects.
Materials used:
a. Low fusing impression compound sticks – Advocated by Boucher.
b. Autopolymerizing acrylic resins
Advocated by Jones – not used due to the heat of polymerization and
monomer irritant.
c. Tissue conditioning materials (modified resins)
Chare has described the use of one such tissue conditioning material.
They are effective when used correctly. They set slowly and continue to flow
under pressure at a rate inversely proportional to time becoming stiffer but
never losing resiliency.
d. Metallic pastes and elastomeric materials.
Ideally body elastomeric impression material is used. Smith Dale E has
advocated one technique where the border molding is done in one step with
polyether impression material.
e. Impression waxes
Use of impression wax adapted for border molding was reported by
Knapl. But these waxes distort easily.
f. Perio pack : Kerk and Idolt has described one step border molding with the
use of periopack.

25
The diagnostic cast is made of dental plaster. The form of the custom
tray helps us to make impression based on specified theory. The areas to be
retrieved on the casts and undercut areas are marked and blocked with wax.
Care must be taken while providing relief, as excessive relief causes flabby
tissue formation. The custom tray must be 2mm less than the denture outline
except in the posterior palatal seal and retromolar pad area. The peripheries of
the tray should not be sharp / rough.
The custom trays are checked in the mouth. The tray should cover the
entire denture bearing area. If the tray is underextended, compound should be
added wherever necessary. If the tray is overextended the tray should be
trimmed where required. The tray is also checked for retention and stability.
Border molding is done quadrant by quadrant (By hand manipulation)
within the functional limits of tolerance.
Border molding:
The shaping of the border areas of an impression tray by functional or
manual manipulation of the tissue adjacent to the borders to duplicate the
contour and size of the vestibule.
Glossary of prosthodontic lesions 7th edition.
 The anterior limit of posterior palatine seal area is marked using T –
burnisher. The line of minimal function is marked by asking the patient to
tell Ah.
 The low fusing impression compound is softened and placed in this area the
tray is seated in the mouth to obtain posterior palatine seal.

26
 The tray is then checked for completed border molding. It should have same
appearance as the finished denture. The tray is reinserted and border seal
and retention and stability are checked.
The different material used for final impression are
a. Impression plaster (Rarely used).
b. Zinc oxide eugenol paste – 2mm.
c. Irreversible and reversible hydrocolloids – 6mm
d. Elastomeric impression materials – 4mm, 2mm.
e. Mouth temperature waxes –
f. Soft acrylic resins (functional impression) – 1-2mm
The relief wax spacer is removed. If zinc oxide eugenol paste is used, it
should be mixed fairly stiff and a ribbon of even thickness of paste should be
applied to the tray. The tray is quickly inserted and sealed in the correct
position and border molding is carried out by gently simulating tissue function
in those areas.

Conclusion
Although there are many techniques with varied logic, the success of the
prosthodontics treatment depends on the clinical diagnostic alumen,
understanding of the theories of impression making and its application by the
operator.

27
References
1.

Boucher : Prosthodontic treatment for edentulous
patients.

2.

Boucher C.O. : A critical analysis of mid century
impression technique for full dentures. J. Prosthet. Dent., 1 : 472-491.

3.

Ellinger Charles W. “Synopsis of complete denture.

4.

Edgar N. Starke : Historical review of complete
denture impression materials. JADA, 91 : 1037-1041.

5.

Filler W. H. : Modified impression technique for
hyperplastic alveolar ridges. J. Prosthet. Dent., 25 : 609-612, 1971.

6.

Glossary of Prosthodontics. J. Prosthet. Dent.,
Edition 7th, 81 : 48-110, 1999.

7.

Heartwell Charles M. : Syllabus of complete
dentures.

8.

Luin Bernard : Impressions for complete dentures.

9.

Lott F. and Luin B. : Flange technique : An
anatomic and physiologic approach to increase retention, function, comfort
and appearance of dentures”. J. Prosthet. Dent., 13 : 394-413, 1966.

28
10.

Milo V. Kubalek and Bert C. Bufington :
Impressions by the use of substathmospheric pressure. J. Prosthet. Dent., 16
: 213-223, 1966.

11.

Page H.H. : Mucostatics, A principle not a
technique by Harry L. Page, Chicago, 1946.

12.

Portar C.G. : Mucostatics – A panaua or propagan.
J. Prosthet. Dent., 3 : 464-466.

13.

Sharry J.J. :Complete denture prosthodontics.

14.

Tyrde G.K. : Dynamic impression method. J.
Prosthet. Dent., 15 : 1023-1034, 1965.

15.

Udani T.M. : Critical analysis of complete denture
impression procedures (unpublished article).

16.

Victor O. Lucia : Mucostatics, text book of
treatment of edentulous patients. 17-21.

29

Contenu connexe

Tendances

occlusion/jaw relation/ centric registeration 4th year tripoli
occlusion/jaw relation/ centric registeration 4th year tripoliocclusion/jaw relation/ centric registeration 4th year tripoli
occlusion/jaw relation/ centric registeration 4th year tripoliMuaiyed Mahmoud Buzayan
 
Impression procedures for compromised ridges/cosmetic dentistry courses
Impression procedures for compromised ridges/cosmetic dentistry coursesImpression procedures for compromised ridges/cosmetic dentistry courses
Impression procedures for compromised ridges/cosmetic dentistry coursesIndian dental academy
 
II. impression making for complete denture
II.  impression making for complete denture II.  impression making for complete denture
II. impression making for complete denture Amal Kaddah
 
04- Occlusion in prosthodontics- Concepts of occlusion.ppt
04- Occlusion in prosthodontics- Concepts of occlusion.ppt04- Occlusion in prosthodontics- Concepts of occlusion.ppt
04- Occlusion in prosthodontics- Concepts of occlusion.pptAmal Kaddah
 
Jaw Relation Record
Jaw Relation Record Jaw Relation Record
Jaw Relation Record Amal Kaddah
 
Clinical Steps for Complete Denture Construction 4- Steps of recording jaw r...
Clinical Steps for Complete Denture Construction  4- Steps of recording jaw r...Clinical Steps for Complete Denture Construction  4- Steps of recording jaw r...
Clinical Steps for Complete Denture Construction 4- Steps of recording jaw r...Amal Kaddah
 
impression techniques in Removable Partial Denture
impression techniques in Removable Partial Denture impression techniques in Removable Partial Denture
impression techniques in Removable Partial Denture Dr.Richa Sahai
 
MANAGEMENT OF SEVERELY RESORBED RIDGES
MANAGEMENT OF SEVERELY RESORBED RIDGES MANAGEMENT OF SEVERELY RESORBED RIDGES
MANAGEMENT OF SEVERELY RESORBED RIDGES Kate Maundu
 
implant supported complete denture/ cosmetic dentistry training
implant supported complete denture/ cosmetic dentistry trainingimplant supported complete denture/ cosmetic dentistry training
implant supported complete denture/ cosmetic dentistry trainingIndian dental academy
 
Balanced occlusion and its importance/ cosmetic dentistry training
Balanced occlusion and its importance/ cosmetic dentistry trainingBalanced occlusion and its importance/ cosmetic dentistry training
Balanced occlusion and its importance/ cosmetic dentistry trainingIndian dental academy
 
Pontics Design in fixed prosthodontics
Pontics Design in fixed prosthodonticsPontics Design in fixed prosthodontics
Pontics Design in fixed prosthodonticsIndian dental academy
 
The posterior palatal seal
The posterior palatal sealThe posterior palatal seal
The posterior palatal sealakanksha arya
 
Arrangement of teeth in class 2 relation
Arrangement of teeth in class 2 relationArrangement of teeth in class 2 relation
Arrangement of teeth in class 2 relationRohan Vadsola
 
SOFT TISSUE MANAGEMENT IN FPD
SOFT TISSUE MANAGEMENT IN FPDSOFT TISSUE MANAGEMENT IN FPD
SOFT TISSUE MANAGEMENT IN FPDkrishnagopan
 
OCCLUSION IN COMPLETE DENTURES
OCCLUSION IN COMPLETE DENTURESOCCLUSION IN COMPLETE DENTURES
OCCLUSION IN COMPLETE DENTURESpranav verma
 

Tendances (20)

occlusion/jaw relation/ centric registeration 4th year tripoli
occlusion/jaw relation/ centric registeration 4th year tripoliocclusion/jaw relation/ centric registeration 4th year tripoli
occlusion/jaw relation/ centric registeration 4th year tripoli
 
Impression procedures for compromised ridges/cosmetic dentistry courses
Impression procedures for compromised ridges/cosmetic dentistry coursesImpression procedures for compromised ridges/cosmetic dentistry courses
Impression procedures for compromised ridges/cosmetic dentistry courses
 
II. impression making for complete denture
II.  impression making for complete denture II.  impression making for complete denture
II. impression making for complete denture
 
04- Occlusion in prosthodontics- Concepts of occlusion.ppt
04- Occlusion in prosthodontics- Concepts of occlusion.ppt04- Occlusion in prosthodontics- Concepts of occlusion.ppt
04- Occlusion in prosthodontics- Concepts of occlusion.ppt
 
20.occlusal schemes monoplane-neutrocentric concept
20.occlusal schemes monoplane-neutrocentric concept20.occlusal schemes monoplane-neutrocentric concept
20.occlusal schemes monoplane-neutrocentric concept
 
Obturator
Obturator Obturator
Obturator
 
Jaw Relation Record
Jaw Relation Record Jaw Relation Record
Jaw Relation Record
 
Clinical Steps for Complete Denture Construction 4- Steps of recording jaw r...
Clinical Steps for Complete Denture Construction  4- Steps of recording jaw r...Clinical Steps for Complete Denture Construction  4- Steps of recording jaw r...
Clinical Steps for Complete Denture Construction 4- Steps of recording jaw r...
 
impression techniques in Removable Partial Denture
impression techniques in Removable Partial Denture impression techniques in Removable Partial Denture
impression techniques in Removable Partial Denture
 
8.boxing impressions and making casts
8.boxing impressions and making casts8.boxing impressions and making casts
8.boxing impressions and making casts
 
MANAGEMENT OF SEVERELY RESORBED RIDGES
MANAGEMENT OF SEVERELY RESORBED RIDGES MANAGEMENT OF SEVERELY RESORBED RIDGES
MANAGEMENT OF SEVERELY RESORBED RIDGES
 
implant supported complete denture/ cosmetic dentistry training
implant supported complete denture/ cosmetic dentistry trainingimplant supported complete denture/ cosmetic dentistry training
implant supported complete denture/ cosmetic dentistry training
 
Balanced occlusion and its importance/ cosmetic dentistry training
Balanced occlusion and its importance/ cosmetic dentistry trainingBalanced occlusion and its importance/ cosmetic dentistry training
Balanced occlusion and its importance/ cosmetic dentistry training
 
15.concepts of complete denture occlusion
15.concepts of complete denture occlusion15.concepts of complete denture occlusion
15.concepts of complete denture occlusion
 
Pontics Design in fixed prosthodontics
Pontics Design in fixed prosthodonticsPontics Design in fixed prosthodontics
Pontics Design in fixed prosthodontics
 
The posterior palatal seal
The posterior palatal sealThe posterior palatal seal
The posterior palatal seal
 
Arrangement of teeth in class 2 relation
Arrangement of teeth in class 2 relationArrangement of teeth in class 2 relation
Arrangement of teeth in class 2 relation
 
SOFT TISSUE MANAGEMENT IN FPD
SOFT TISSUE MANAGEMENT IN FPDSOFT TISSUE MANAGEMENT IN FPD
SOFT TISSUE MANAGEMENT IN FPD
 
Retention of complete dentures
Retention of complete denturesRetention of complete dentures
Retention of complete dentures
 
OCCLUSION IN COMPLETE DENTURES
OCCLUSION IN COMPLETE DENTURESOCCLUSION IN COMPLETE DENTURES
OCCLUSION IN COMPLETE DENTURES
 

En vedette

impression techniques of complete denture
impression techniques of complete dentureimpression techniques of complete denture
impression techniques of complete dentureakanksha arya
 
Theories, Principles & Objectives of impression Making Of Completely Edentul...
Theories, Principles & Objectives of impression Making  Of Completely Edentul...Theories, Principles & Objectives of impression Making  Of Completely Edentul...
Theories, Principles & Objectives of impression Making Of Completely Edentul...Self employed
 
Concept and tecnique of impression making in complete dentures
Concept and tecnique of impression making in complete denturesConcept and tecnique of impression making in complete dentures
Concept and tecnique of impression making in complete denturesVinay Kadavakolanu
 
Impressions in complete dentures
Impressions in complete denturesImpressions in complete dentures
Impressions in complete denturesShebin Abraham
 
Techniques of impression making in complete dentures/ orthodontics courses on...
Techniques of impression making in complete dentures/ orthodontics courses on...Techniques of impression making in complete dentures/ orthodontics courses on...
Techniques of impression making in complete dentures/ orthodontics courses on...Indian dental academy
 
SELECTION AND ARRANGEMENT OF ARTIFICIAL TEETH
SELECTION AND ARRANGEMENT OF ARTIFICIAL TEETHSELECTION AND ARRANGEMENT OF ARTIFICIAL TEETH
SELECTION AND ARRANGEMENT OF ARTIFICIAL TEETHShankar Hemam
 
maxillary anatomical landmarks
maxillary anatomical landmarksmaxillary anatomical landmarks
maxillary anatomical landmarksAkansha Narela
 
Principles of tooth preparation
Principles of tooth preparationPrinciples of tooth preparation
Principles of tooth preparationrakeshrakz
 
Introduction to complete_denture
Introduction to complete_dentureIntroduction to complete_denture
Introduction to complete_denturegalrabeah
 
Balanced occlusion aditi ghai
Balanced occlusion aditi ghaiBalanced occlusion aditi ghai
Balanced occlusion aditi ghaiAditi Ghai
 
Principles of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial DenturesPrinciples of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial DenturesVinay Kadavakolanu
 
effect of aging on edentulous state
effect of aging on edentulous stateeffect of aging on edentulous state
effect of aging on edentulous stateshabeel pn
 
Basic principles in impression making 2
Basic principles in impression making  2Basic principles in impression making  2
Basic principles in impression making 2Prosth Ozone
 
Elements and principles of design
Elements and principles of designElements and principles of design
Elements and principles of designcindi shepard
 
Basic principles in impression making
Basic principles in impression makingBasic principles in impression making
Basic principles in impression makingProsth Ozone
 
Basic principles in impression making 5
Basic principles in impression making 5 Basic principles in impression making 5
Basic principles in impression making 5 Prosth Ozone
 
Basic principles in impression making 4
Basic principles in impression making  4Basic principles in impression making  4
Basic principles in impression making 4Prosth Ozone
 
Different theories of impression making in complete denture treatment/cosmeti...
Different theories of impression making in complete denture treatment/cosmeti...Different theories of impression making in complete denture treatment/cosmeti...
Different theories of impression making in complete denture treatment/cosmeti...Indian dental academy
 
Impression procedures for complete denture cases / oral surgery courses  
Impression procedures for complete denture cases / oral surgery courses  Impression procedures for complete denture cases / oral surgery courses  
Impression procedures for complete denture cases / oral surgery courses  Indian dental academy
 
Phonetics in complete dentures./ dentistry course in india
Phonetics in complete dentures./ dentistry course in indiaPhonetics in complete dentures./ dentistry course in india
Phonetics in complete dentures./ dentistry course in indiaIndian dental academy
 

En vedette (20)

impression techniques of complete denture
impression techniques of complete dentureimpression techniques of complete denture
impression techniques of complete denture
 
Theories, Principles & Objectives of impression Making Of Completely Edentul...
Theories, Principles & Objectives of impression Making  Of Completely Edentul...Theories, Principles & Objectives of impression Making  Of Completely Edentul...
Theories, Principles & Objectives of impression Making Of Completely Edentul...
 
Concept and tecnique of impression making in complete dentures
Concept and tecnique of impression making in complete denturesConcept and tecnique of impression making in complete dentures
Concept and tecnique of impression making in complete dentures
 
Impressions in complete dentures
Impressions in complete denturesImpressions in complete dentures
Impressions in complete dentures
 
Techniques of impression making in complete dentures/ orthodontics courses on...
Techniques of impression making in complete dentures/ orthodontics courses on...Techniques of impression making in complete dentures/ orthodontics courses on...
Techniques of impression making in complete dentures/ orthodontics courses on...
 
SELECTION AND ARRANGEMENT OF ARTIFICIAL TEETH
SELECTION AND ARRANGEMENT OF ARTIFICIAL TEETHSELECTION AND ARRANGEMENT OF ARTIFICIAL TEETH
SELECTION AND ARRANGEMENT OF ARTIFICIAL TEETH
 
maxillary anatomical landmarks
maxillary anatomical landmarksmaxillary anatomical landmarks
maxillary anatomical landmarks
 
Principles of tooth preparation
Principles of tooth preparationPrinciples of tooth preparation
Principles of tooth preparation
 
Introduction to complete_denture
Introduction to complete_dentureIntroduction to complete_denture
Introduction to complete_denture
 
Balanced occlusion aditi ghai
Balanced occlusion aditi ghaiBalanced occlusion aditi ghai
Balanced occlusion aditi ghai
 
Principles of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial DenturesPrinciples of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial Dentures
 
effect of aging on edentulous state
effect of aging on edentulous stateeffect of aging on edentulous state
effect of aging on edentulous state
 
Basic principles in impression making 2
Basic principles in impression making  2Basic principles in impression making  2
Basic principles in impression making 2
 
Elements and principles of design
Elements and principles of designElements and principles of design
Elements and principles of design
 
Basic principles in impression making
Basic principles in impression makingBasic principles in impression making
Basic principles in impression making
 
Basic principles in impression making 5
Basic principles in impression making 5 Basic principles in impression making 5
Basic principles in impression making 5
 
Basic principles in impression making 4
Basic principles in impression making  4Basic principles in impression making  4
Basic principles in impression making 4
 
Different theories of impression making in complete denture treatment/cosmeti...
Different theories of impression making in complete denture treatment/cosmeti...Different theories of impression making in complete denture treatment/cosmeti...
Different theories of impression making in complete denture treatment/cosmeti...
 
Impression procedures for complete denture cases / oral surgery courses  
Impression procedures for complete denture cases / oral surgery courses  Impression procedures for complete denture cases / oral surgery courses  
Impression procedures for complete denture cases / oral surgery courses  
 
Phonetics in complete dentures./ dentistry course in india
Phonetics in complete dentures./ dentistry course in indiaPhonetics in complete dentures./ dentistry course in india
Phonetics in complete dentures./ dentistry course in india
 

Similaire à Different theories of impression making in complete denture/certified fixed orthodontic courses by Indian dental academy

theories of impression making in complete denture
theories of impression making in complete denturetheories of impression making in complete denture
theories of impression making in complete denturedipalmawani91
 
Impression anoop/prosthodontic courses
Impression anoop/prosthodontic coursesImpression anoop/prosthodontic courses
Impression anoop/prosthodontic coursesIndian dental academy
 
Principles_and_objectives_of_impressions_in__CD_pavan.pptx
Principles_and_objectives_of_impressions_in__CD_pavan.pptxPrinciples_and_objectives_of_impressions_in__CD_pavan.pptx
Principles_and_objectives_of_impressions_in__CD_pavan.pptxPavanPreetham4
 
Impressions in complete denture
Impressions in complete denture Impressions in complete denture
Impressions in complete denture Dr.Richa Sahai
 
Alternative Procedure to Improve the Stability of Mandibular Complete Denture...
Alternative Procedure to Improve the Stability of Mandibular Complete Denture...Alternative Procedure to Improve the Stability of Mandibular Complete Denture...
Alternative Procedure to Improve the Stability of Mandibular Complete Denture...Miriam E. Catalina Rojas Tapia
 
COMPLETE DENTURE IMPRESSIONS NEW_112735.pptx
COMPLETE DENTURE IMPRESSIONS NEW_112735.pptxCOMPLETE DENTURE IMPRESSIONS NEW_112735.pptx
COMPLETE DENTURE IMPRESSIONS NEW_112735.pptxDrIbadatJamil
 
Management of cleft lip and palate
Management of cleft lip and palate Management of cleft lip and palate
Management of cleft lip and palate VijaiShivappa
 
Cocktail impression technique
Cocktail impression techniqueCocktail impression technique
Cocktail impression techniqueCPGIDSH
 
Periodontal instruments, surgery
Periodontal instruments, surgeryPeriodontal instruments, surgery
Periodontal instruments, surgerySalar Zeinali
 
management of vertical maxillary excess /certified fixed orthodontic courses ...
management of vertical maxillary excess /certified fixed orthodontic courses ...management of vertical maxillary excess /certified fixed orthodontic courses ...
management of vertical maxillary excess /certified fixed orthodontic courses ...Indian dental academy
 
Relining and Rebasing
Relining and RebasingRelining and Rebasing
Relining and RebasingAnuja Gunjal
 
Impression procedures for compromised ridges / implant dentistry course/ imp...
Impression procedures for compromised ridges  / implant dentistry course/ imp...Impression procedures for compromised ridges  / implant dentistry course/ imp...
Impression procedures for compromised ridges / implant dentistry course/ imp...Indian dental academy
 
Principles and techniques of impresion
Principles and techniques of impresion Principles and techniques of impresion
Principles and techniques of impresion shari kurup
 

Similaire à Different theories of impression making in complete denture/certified fixed orthodontic courses by Indian dental academy (20)

theories of impression making in complete denture
theories of impression making in complete denturetheories of impression making in complete denture
theories of impression making in complete denture
 
Impression anoop/prosthodontic courses
Impression anoop/prosthodontic coursesImpression anoop/prosthodontic courses
Impression anoop/prosthodontic courses
 
Prostho@
Prostho@Prostho@
Prostho@
 
Principles_and_objectives_of_impressions_in__CD_pavan.pptx
Principles_and_objectives_of_impressions_in__CD_pavan.pptxPrinciples_and_objectives_of_impressions_in__CD_pavan.pptx
Principles_and_objectives_of_impressions_in__CD_pavan.pptx
 
Periodontal plastic surgery
Periodontal plastic surgeryPeriodontal plastic surgery
Periodontal plastic surgery
 
Impressions in complete denture
Impressions in complete denture Impressions in complete denture
Impressions in complete denture
 
Alternative Procedure to Improve the Stability of Mandibular Complete Denture...
Alternative Procedure to Improve the Stability of Mandibular Complete Denture...Alternative Procedure to Improve the Stability of Mandibular Complete Denture...
Alternative Procedure to Improve the Stability of Mandibular Complete Denture...
 
COMPLETE DENTURE IMPRESSIONS NEW_112735.pptx
COMPLETE DENTURE IMPRESSIONS NEW_112735.pptxCOMPLETE DENTURE IMPRESSIONS NEW_112735.pptx
COMPLETE DENTURE IMPRESSIONS NEW_112735.pptx
 
Pps / dental implant courses
Pps / dental implant coursesPps / dental implant courses
Pps / dental implant courses
 
Management of cleft lip and palate
Management of cleft lip and palate Management of cleft lip and palate
Management of cleft lip and palate
 
Theories of impression making
Theories of impression makingTheories of impression making
Theories of impression making
 
Ankita222
Ankita222Ankita222
Ankita222
 
Cocktail impression technique
Cocktail impression techniqueCocktail impression technique
Cocktail impression technique
 
Periodontal instruments, surgery
Periodontal instruments, surgeryPeriodontal instruments, surgery
Periodontal instruments, surgery
 
management of vertical maxillary excess /certified fixed orthodontic courses ...
management of vertical maxillary excess /certified fixed orthodontic courses ...management of vertical maxillary excess /certified fixed orthodontic courses ...
management of vertical maxillary excess /certified fixed orthodontic courses ...
 
Relining and Rebasing
Relining and RebasingRelining and Rebasing
Relining and Rebasing
 
estlander.flap.ppt
estlander.flap.pptestlander.flap.ppt
estlander.flap.ppt
 
Impression procedures for compromised ridges / implant dentistry course/ imp...
Impression procedures for compromised ridges  / implant dentistry course/ imp...Impression procedures for compromised ridges  / implant dentistry course/ imp...
Impression procedures for compromised ridges / implant dentistry course/ imp...
 
Pps jc
Pps  jcPps  jc
Pps jc
 
Principles and techniques of impresion
Principles and techniques of impresion Principles and techniques of impresion
Principles and techniques of impresion
 

Plus de Indian dental academy

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian dental academy
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Indian dental academy
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeIndian dental academy
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesIndian dental academy
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Indian dental academy
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  Indian dental academy
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Indian dental academy
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesIndian dental academy
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Indian dental academy
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesIndian dental academy
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Indian dental academy
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesIndian dental academy
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Indian dental academy
 

Plus de Indian dental academy (20)

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdom
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics pratice
 
online fixed orthodontics course
online fixed orthodontics courseonline fixed orthodontics course
online fixed orthodontics course
 
online orthodontics course
online orthodontics courseonline orthodontics course
online orthodontics course
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant courses
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental courses
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic courses
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic courses
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic courses
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry courses
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  
 

Dernier

CLASSIFICATION OF ANTI - CANCER DRUGS.pptx
CLASSIFICATION OF ANTI - CANCER DRUGS.pptxCLASSIFICATION OF ANTI - CANCER DRUGS.pptx
CLASSIFICATION OF ANTI - CANCER DRUGS.pptxAnupam32727
 
4.11.24 Mass Incarceration and the New Jim Crow.pptx
4.11.24 Mass Incarceration and the New Jim Crow.pptx4.11.24 Mass Incarceration and the New Jim Crow.pptx
4.11.24 Mass Incarceration and the New Jim Crow.pptxmary850239
 
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxGrade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxkarenfajardo43
 
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...DhatriParmar
 
ARTERIAL BLOOD GAS ANALYSIS........pptx
ARTERIAL BLOOD  GAS ANALYSIS........pptxARTERIAL BLOOD  GAS ANALYSIS........pptx
ARTERIAL BLOOD GAS ANALYSIS........pptxAneriPatwari
 
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptxDecoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptxDhatriParmar
 
Q4-PPT-Music9_Lesson-1-Romantic-Opera.pptx
Q4-PPT-Music9_Lesson-1-Romantic-Opera.pptxQ4-PPT-Music9_Lesson-1-Romantic-Opera.pptx
Q4-PPT-Music9_Lesson-1-Romantic-Opera.pptxlancelewisportillo
 
4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptx4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptxmary850239
 
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITWQ-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITWQuiz Club NITW
 
How to Fix XML SyntaxError in Odoo the 17
How to Fix XML SyntaxError in Odoo the 17How to Fix XML SyntaxError in Odoo the 17
How to Fix XML SyntaxError in Odoo the 17Celine George
 
4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptx4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptxmary850239
 
MS4 level being good citizen -imperative- (1) (1).pdf
MS4 level   being good citizen -imperative- (1) (1).pdfMS4 level   being good citizen -imperative- (1) (1).pdf
MS4 level being good citizen -imperative- (1) (1).pdfMr Bounab Samir
 
Mythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITWMythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITWQuiz Club NITW
 
4.9.24 School Desegregation in Boston.pptx
4.9.24 School Desegregation in Boston.pptx4.9.24 School Desegregation in Boston.pptx
4.9.24 School Desegregation in Boston.pptxmary850239
 
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...DhatriParmar
 
Scientific Writing :Research Discourse
Scientific  Writing :Research  DiscourseScientific  Writing :Research  Discourse
Scientific Writing :Research DiscourseAnita GoswamiGiri
 
Using Grammatical Signals Suitable to Patterns of Idea Development
Using Grammatical Signals Suitable to Patterns of Idea DevelopmentUsing Grammatical Signals Suitable to Patterns of Idea Development
Using Grammatical Signals Suitable to Patterns of Idea Developmentchesterberbo7
 

Dernier (20)

CLASSIFICATION OF ANTI - CANCER DRUGS.pptx
CLASSIFICATION OF ANTI - CANCER DRUGS.pptxCLASSIFICATION OF ANTI - CANCER DRUGS.pptx
CLASSIFICATION OF ANTI - CANCER DRUGS.pptx
 
4.11.24 Mass Incarceration and the New Jim Crow.pptx
4.11.24 Mass Incarceration and the New Jim Crow.pptx4.11.24 Mass Incarceration and the New Jim Crow.pptx
4.11.24 Mass Incarceration and the New Jim Crow.pptx
 
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxGrade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
 
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
 
ARTERIAL BLOOD GAS ANALYSIS........pptx
ARTERIAL BLOOD  GAS ANALYSIS........pptxARTERIAL BLOOD  GAS ANALYSIS........pptx
ARTERIAL BLOOD GAS ANALYSIS........pptx
 
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptxDecoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
 
Q4-PPT-Music9_Lesson-1-Romantic-Opera.pptx
Q4-PPT-Music9_Lesson-1-Romantic-Opera.pptxQ4-PPT-Music9_Lesson-1-Romantic-Opera.pptx
Q4-PPT-Music9_Lesson-1-Romantic-Opera.pptx
 
4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptx4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptx
 
prashanth updated resume 2024 for Teaching Profession
prashanth updated resume 2024 for Teaching Professionprashanth updated resume 2024 for Teaching Profession
prashanth updated resume 2024 for Teaching Profession
 
Paradigm shift in nursing research by RS MEHTA
Paradigm shift in nursing research by RS MEHTAParadigm shift in nursing research by RS MEHTA
Paradigm shift in nursing research by RS MEHTA
 
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITWQ-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
 
How to Fix XML SyntaxError in Odoo the 17
How to Fix XML SyntaxError in Odoo the 17How to Fix XML SyntaxError in Odoo the 17
How to Fix XML SyntaxError in Odoo the 17
 
4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptx4.16.24 Poverty and Precarity--Desmond.pptx
4.16.24 Poverty and Precarity--Desmond.pptx
 
MS4 level being good citizen -imperative- (1) (1).pdf
MS4 level   being good citizen -imperative- (1) (1).pdfMS4 level   being good citizen -imperative- (1) (1).pdf
MS4 level being good citizen -imperative- (1) (1).pdf
 
Mythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITWMythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITW
 
4.9.24 School Desegregation in Boston.pptx
4.9.24 School Desegregation in Boston.pptx4.9.24 School Desegregation in Boston.pptx
4.9.24 School Desegregation in Boston.pptx
 
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
 
Scientific Writing :Research Discourse
Scientific  Writing :Research  DiscourseScientific  Writing :Research  Discourse
Scientific Writing :Research Discourse
 
Faculty Profile prashantha K EEE dept Sri Sairam college of Engineering
Faculty Profile prashantha K EEE dept Sri Sairam college of EngineeringFaculty Profile prashantha K EEE dept Sri Sairam college of Engineering
Faculty Profile prashantha K EEE dept Sri Sairam college of Engineering
 
Using Grammatical Signals Suitable to Patterns of Idea Development
Using Grammatical Signals Suitable to Patterns of Idea DevelopmentUsing Grammatical Signals Suitable to Patterns of Idea Development
Using Grammatical Signals Suitable to Patterns of Idea Development
 

Different theories of impression making in complete denture/certified fixed orthodontic courses by Indian dental academy

  • 1. DIFFERENT THEORIES OF IMPRESSION MAKING AND RATIONALE FOR THE DIFFERENT TECHNIQUES IN COMPLETE DENTURE TREATMENT Introduction Theory means observation based on principles and concept is the application of these theories. Impression forms a important virtue for the success of compete denture treatment and hence the concepts of impression should be properly understood. From time immemorable there have been different theories that had been advocated. Green Brothers were the first to introduce the principle of muco compression during impression technique. The shortcomings of this principle gave rise to the mucostatic technique by Hary L. Page with high regard for tissue health. But again due to the disadvantage of this technique, there was an impetus for the introduction of the selective pressure technique which combined the concepts of both the previous techniques. There are various techniques adopted by different practitioners and there may be as many techniques as the number of dentists regarding impression which in general means negative likeness but in prosthodontics it is the negative registration of the denture bearing denture stabilizing, denture bracing and peripheral limiting structures obtained in one of the plastic / semiplastic materials which is registered at the moment of crystallization of the impression material. At the moment of crystallization means that the tissues are registered at a particular moment. Since the denture bearing tissues are always in a state of flux with new cells being generated and cells being shed of at different moment of time, the tissues at the time of impression making will differ from that at the time of denture insertion. 1
  • 2. It is not feasible to group all the techniques into rigid compartments but a broad classification is possible. They may be classified as scientific / empheric depending on whether they are based on knowledge of anatomy. b. They may be classified as open / closed mouth impressions depending on the condition of the mouth at the time of impression making. c. They may be classified as either pressure, nonpressure / minimal pressure, and selective pressure depending on the amount of pressure applied at the time of making impressions. Prior to 1600 complete denture replacement were not made due to lack of understanding of retention.  In 1711, Mathian Gottfried Purman recorded the use of wax.  In 1728 Pieree Fauchard made dentures measuring the mouth with compases and cutting bone into an approximate shape for the space to be filled.  In 1736, Phillip Pfaff of Germany made impressions in wax sections of half of the mouth at a time. 1845-1899  In 1886 Richardson mentioned about making plaster impressions of tissues at rest and achieving adhesion by contact. 2
  • 3. • Concepts of atmospheric pressure, maximum extension of the denture bearing area, equal distribution of pressure and close adaptation of the denture bearing tissues were stressed. • Many changes in impression making became evident during this era. A single impression formely deemed sufficient, advanced to a method using priliminary impression of guttapercha, beeswax or modelling compound followed by secondary wash impression made of plastic within preliminary impression. 1900 – 1929  A concentrated effort was directed towards accuracy. Most impression were of compressive type and by the closed mouth technique. To prevent buildup of excessive pressures vents were made. Closed mouth technique  In this technique the supporting tissues recorded in a functional relationship.  The movement of all related tissues were in normal functional movements such as swallowing, talking, sucking and occlusal contacts.  A pressure similar to that of mastication was developed through the occlusal rins. This according to Stanley P Freeman-amount of tissue compression is like that in function. 3
  • 4.  Selective pressure technique.  The disadvantage of closed mouth technique is the tendency of overextention or underextention.  Release of pressure of occlusion may permit a rebound of denture.  It is contraindicated in the presence of considerable amount of movable tissue. The open mouth technique is preferred because the operator can see whether the border molding is done properly. The functional manipulation cannot be used routinely not all patients can truly move the impression materials as needed, some may use extreme movements and others use.  Two techniques were developed for the management of flabby ridge. 1st technique – it was of muco compressive type compound impression which displaced the flabby tissue paratally. 2nd technique – it was advocated by Greene Brothers, which captured the tissue in its passive form.  Concepts of posterior palatal seal were developed by Liberthal and Greene.  For the first time there were references to movement of tissues and the mandible during impression making. 4
  • 5.  Border molding was done against the direction of muscle fibres as advocated by Wilson.  There were others like Nichais, Neil Fish, Swenson et al who advocated manipulation in border molding in the direction of its fibres.  It was during this era that the concept of esthetics in impression making was introduced. MUCOCOMPRESSIVE TECHNIQUE  The muco compressive technique was initiated by Greene Brothers. They introduced a modeling plastic, a method for manipulating it and a technique that is said to have been the first to utilize all the denture bearing area for denture retention.  They were the first to teach the closed mouth all modeling plastic technique called the Greene Brothers all compound impression.  The main objective of this technique was to attain better retention of the dentures. The typical technique by Greene brothers was as follows. • A preliminary impression was made in impression compound and a custom tray was constructed using baseplate with its periphery 1/8 th inch shorter than the denture outline. • With this tray another impression with compound was taken. 5
  • 6. • Well fitting rinse with uniform occlusal surface were made and the height of the bite adjusted against a similar bite rim on the mandibular ridge. • Areas to be relieved like median raphe was softened on the impression and was again inserted in the mouth and was held under biting pressure for one / two minutes. • The peripheral margins of the impression was then softened and border molding was done by asking the patient to give various cheek and lip movement as in whistling and smiling. • The posterior palatal seal was obtained by swallowing movements by the patient under biting pressure. • The claims made by the advocates of this technique was that since border molding was done in their functional positions, the final dentures would retain well and cannot be dislodged during functional movements of the jaw. Variations in this technique • Some used the preliminary impression itself as the tray and impression to be improved by border molding. • Some preferred to make custom trays in a more stable and stronger material than compound for better results. 6
  • 7. • Relief in hard areas was obtained in number of ways. Some custom trays were made with escape holes in areas overlying the hard tissues and close adaptation provided in those areas covering the soft tissues. • Some use low fusing compound by softening and adapting it to the soft tissues. • Some advocate unnatural movement of the mouth along with massaging of the cheeks and lips from outside during border molding. • Post dam is obtained in number of ways. • The addition of soft wax like carding wax or low fusing compound for this purpose is common. • Scraping of cast is also used. The amount of pressure applied to the tissues in the muco compressive technique was not only great but was applied to the centre of the palate and the peripheral tissues which were not well suited to receive the maximum biting load this interferes with normal blood supply of the tissues resulting in their breakdown. As soon as this change took place both the peripheral seal and excellent retention were lost. Hence the retention achieved by these means was transient and harmful to the health of tissues. Dentures made by this technique would fit well during mastication i.e. only a short period each day, but would not be closely adapted to the tissue when the patient was at rest. This is because of the rebounding of tissues. 7
  • 8. These disadvantages indicated a need for spacer in the custom tray fabrication. 1930-1948 • Concept of mucostatics was introduced by Harry L. Page in 1938. • Addison in 1944 also mentioned the same principle of making impressions of displaceable tissue in its passive state and considered interfacial surface tension as one of the main factors of retention. • With new materials like zincoxide eugenol, waxes, elastomers, individual tray construction was emphasized. Minimal pressure technique based on mucostatic principle • In a Brochure published by Hary L. Page in 1946 he stated that all soft tissues were cheifly fluid and 80% or more of the tissues are composed of water. According to pascal’s law which states that any pressure applied to a confined fluid is transmitted undiminished and equally in all directions. Page contended that since the soft tissues are confined under a denture, any pressure applied will be transmitted in all directions. • The advocates of this principle considered interfacial surface tension as the only important retentive mechanism in complete dentures. Therefore they did not resist vertical displacement, which was the only movement capable of interrupting surface tension. However, Dykins recommended a short lingual flange to resist lateral displacement. 8
  • 9. • According to the principle of mucostatics the impression material had to record without distortion, every detail of the mucosa so that a completed denture would fit all minute elevations and depressions. So much emphasis was placed on recording details that separating substances could not be used at any point in the procedure. • Mucostatics further demanded a metal base. Gold, one of the most accurate metals was bypassed in favour of chrome alloy which are not considered to be quite so accurate as gold. A typical impression method representing this technique was as follows. • A compound impression was made in a suitable tray and a cast was made. • On this base plate wax was adapted which acted as a spacer according to denture outline. • Custom tray was fabricated over this spacer. • A soft ribbon of carding wax was applied at the posterior margin of the maxillary tray and it was placed in the mouth under light pressure and patient was asked to do swallowing movements inorder to obtain a posterior palatal seal. • A small amount of impression plaster mixed into a smooth consistently was placed in the tray, introduced in the mouth and was slowly raised to position and held with as little pressure as possible. • No border molding was advocated but the soft plaster was expected to mold itself to the relaxed vestibular tissues. 9
  • 10. • The impression was held till the impression hardened and was then removed. Variations in the technique • Some techniques use compound instead of wax for obtaining post dam. • Some techniques advocate post dam over the final impression. • Zinc oxide eugenol and alginate had also been used for similar results. • Page’s application of Pascal’s law to the field of denture impressions is only partly correct because the tissues involved are not wholly incompressible and fluids may escape through the borders of the denture. • Page’s claim that retention is a function of surface tension alone is also objectionable because this tensile force itself is dependent upon adhesion and cohesion. • The elimination of use of separating media results in distortion of the cast. • The use of chrome cobalt as denture bases results in failure of accurate detail reproduction. • The mucostatic principle ignores the value of dissipating masticatory forces over as largest possible basal seat area. Further the mucostatic denture minimized the retentive role of the musculature as described by Fish in 1948. 10
  • 11. The merit of this technique was its high regard for health and preservation of tissue. 1948 – 1964 • There was an increased emphasis on biologic factors of complete denture impression making. • Selective pressure concept by Boucher became popular. • Craddock, Landa et al advocated use of escape vents. • More attention was given to esthetics in the impression techniques used greater emphasis was on flanges, border molding, posterior palatal seal and denture extension. • In 1948, the mucoseal technique – a variation of the mucostatic technique was introduced. • Vacustatics concept was developed by Milo V. Kubalib and C. Buffington to eliminate the functional limitations of impressions. Selective pressure technique based on selective pressure theory • Advocated by Boucher in 1950 it combines the principles of both pressure and minimal pressure techniques. • The philosophy of the selective pressure technique is that certain areas of the maxilla and mandible are by nature better adapted for withstanding extra loads from the forces of mastication. These tissues are recorded under 11
  • 12. slight placement of pressure while other tissues are recorded at rest or relieved with minimal pressure in a position that will offer maximum coverage with the least possible interference with the health of surrounding tissues. • Here an equillibrium between the resilient and the non resilient tissues is created. Primary stress bearing areas of maxilla are crest of alveolar ridge and the horizontal plate of palatine bone and in the mandible it is the buccal shelf area. Secondary stress bearing areas of the maxillary foundation are rughae area and the slopes of the ridge in the mandibular foundation. Areas requiring minimum pressure are incisive papilla, midpalatine suture, tori in the maxilla and crest of mandibular residual ridge. In the maxilla, the tissue underlying the region of posterior palatal seal has glandular and soft tissue between the mucous membrane lining and the periosteum covering the bone. This tissue can be more readily displaced for the maintenance of peripheral seal of the maxillary denture. An earlier technique representing this group consisted of the following steps:  A well fitting tray with a uniform clearance of about 5mm was selected and a compound impression was obtained with little border molding done on the peripheries. 12
  • 13.  This compound impression was separated from the metal tray and its peripheral borders were trimmed 1 – 2 mm short.  The base portion of the impression was then scrapped evenly to a depth of about 2mm except in the posterior seal area where no scraping was done.  A sufficient amount of creamy mix of plaster was spread over this impression and was placed in the mouth with little pressure. The cheeks and lips were lightly patted from outside while the plaster was still soft. This procedure gave sufficient value like seal without exaggerated pressure on soft tissues. Variations in the technique  Most of the techniques prefer taking a preliminary impression and using a custom tray rather than use the initial compound impression for further improvement.  The preliminary impressions are usually taken in compound but materials like alginate, elastomeric impression materials are also used.  Certain methods advocate the use of three small compound stops in the base area of special tray before doing border molding. This prevents the periphery of the tray from impinging on the tissues and it standardizes the relation of the tray to limiting tissues for every insertion of tray.  The amount of material, consistency of material, use of space or escape vents and the manual pressure with which the impression is made are all 13
  • 14. possible variable which have been used to advantage by different techniques. The mucoseal technique was stated by Pryor in 1948 which was introduced as a variation to the mucostatic technique. • The anterior lingual border is molded by the floor of the mouth with the tongue in repose. • The tray is extended horizontally backward, over the sublingual glands towards the tongue to effect a border seal. • Thus this technique utilizes the benefit of minimal pressure and also provides maximum extension of denture borders and maximum coverage of denture bearing area. Sub-atmospheric pressure technique based on the concept of mucostatics  Milo V. Kubalik and Bert C. Buffington developed this technique the objective of which was to reduce the stress on any given tissue by increasing load bearing area. the form of the tissue is recorded vertically and laterally, when a controlled partial vacuum is established in impression tray specially built for the patient. It is maintained in the mouth without direct mechanical support of any kind. The difference between the subatmospheric pressure within the tray and the atmospheric pressure outside the tray is all that is needed to centre the tray over the ridges in a static position. A vacuum is developed between the soft tissues and the tray. A recording material in a fluid state flows from the border region into the 14
  • 15. evacuated space and develops the basal tissues. Border seal is determined by the readings remaining constant. Materials used 1. Alginate, modeling plastic or a reversible hydrocolloid for preliminary impression. 2. Clear acrylic resin for making the final impression. 3. An adequate sealing agent for use around special fittings in the tray. 4. Thermoplastic border recording impression material. 5. A fluid (low viscosity) impression material that seats firmly enough to avoid distortion. 6. A periphery wax to be used as a flexible material between impression and the boxing wax. Molding Exercises For the maxillary impression the patient is told 1. To suck on the tube (this pulls the cheeks in a starts border molding). 2. To say “00000” and EEEE alternately (This refines the border molding of the buccal and labial flanges and provides space for the frenum. 3. To blow against closed nostril (This flexes the soft palate and molds the posterior palatal seal area. Wipes of any excess adapted extending beyond the border of the tray. 15
  • 16. 4. To move the mandible from side to side (This molds the flanges lateral to the tuberosities. 5. To swallow warm water (This allows for swallowing movements in the shape of the posterior palatal seal. 6. To open and close the mouth (This records the shape and action of the paramusculature used in extreme opening and closing movements. For mandibular impression the patient is instructed 1. To suck on the tube (This flexes the labial, buccal and lingual vestibular structures and mold the flanges in these regions). 2. To force the tip of the tongue against the palate (This forcibly molds the flange in the sublingual space with the paralingual musculature. 3. To say “0000” and “EEEE” alternatively (This further molds the buccal and labial flanges) 4. To lick the upper and lower lip (This molds the flanges in the lingual space in the region of Wharton’s ducts and genioglossus muscle. 5. To place the tongue in the right cheek and left cheek (This further molds the flange in the sublingual fold space). 6. To swallow warm water (This molds the posterolingual flange in relation to the palatoglossus and mylohyoid musculature). 7. To tense and flex the lower jaw as if clenching one’s teeth (This molds the buccal flange from the external oblique ridge to the retromolar pad. 16
  • 17. 1965 – 1982  New techniques had been developed to manage compromised conditions. For poor mandibular ridges – Sublingual flange technique by Tyrde and Robert Flange technique by Lott and Levin. For hyperplastic alveolar ridges by Zafarulla Khan, William H. Filler. Impression techniques for severely resorbed foundation Flange technique by Lott and Levin introduced in 1966 involves making impressions of soft tissues of mouth adjacent to the buccal, lingual, labial, palatal surface and incorporating the resulting extensions or flange in the denture. Flange wax was rolled from the retromolar pad area to the sublingual region, large enough to restore the diameter of estimated resorption and patient is asked to forcefully perform functions of swallowing etc to give border extensions which covers maximum surface area (genial tubercles and sublingual gland). Tyrde in 1965 used the dynamic impression method on the same principle to obtain sublingual flange. Roberto Von Krameck et al in 1982 used modeling compound to record the extensions. This sublingual flange extension increases the tissue surface without interfering the functions of mastication, deglutition and phonation. The active incorporation of tongue activity also stabilizes the denture. Impression technique for patients with unsupported movable tissue (Hyperplastic or flabby tissue): 17
  • 18. William H. Filler described a technique using two trays. a. Preliminary maxillary and mandibular impressions were made in stock trays with alginate impression method and casts were poured. b. The maxillary and mandibular casts were placed on the surveyor and all the tissue undercuts were blocked out with utility wax. c. A single thickness of baseplate wax was formed over the casts to form a spacer. The spacer is terminated short of the posterior palatal seal area so that the tray material would contact the tissue in this area. d. A tinfoil sustitute was applied to the casts and the first of the two trays was made in autopolymerizing acrylic resin. Most of the basal surface of the tray was removed except for the lattice work of acrylic resin which strengthens the trays. e. The maxillary and mandibular trays are then keyed to orientate the second tray in atleast three places. These keyed positions correspond with an extension of the second tray and will insure proper seating of the second tray over the first tray. f. The entire first tray was covered with a single thickness of baseplate wax, ensuring that the keyed positions here kept free of wax. Both the first resin tray and the casts were painted with tin foil substitute. g. The second trays were made in the same manner as the first and extend past the relieved area of maxillary and mandibular trays and fit into keyed positions. 18
  • 19. h. With round bur, numerous holes were made in the second tray. i. The deepest portion of the vault of maxillary tray was removed to create a stop when the final impression was made. The initial tray was sealed with minimum pressure and autopolymerizing resin on a tongue depressor was gently placed in the opening in the vault. When the resin had set a stop was created on the firm and stable palatal tissue. Clinical impression procedure The borders of the maxillary tray are formed by adding  low fusing compound and border molding it. A finger placed over the resin stop will ensure a stable tray. The basal plate was removed and the flanges reduced 1-2mm with the exception of the part over the tuberosites and posterior palatal seal area of the maxillary tray. The mandibular tray was stabilized by the addition of  modeling plastic on the buccal flanges in the region of first and second molars and in the anterior part of the tray in the incisor area. The mandibular tray was border molded and baseplate wax was removed from the mandibular tray every where except at the three points used for stabilization. Both the trays were painted with permlastic adhesive.  Light body permlastic was used in initial tray as a corrective wash impression material. After it set the tray was removed from the mouth and all excess material was trimmed from the borders and from the area where the second tray would come into contact with the first tray to key themselves. 19
  • 20.  The second impression was made with plastogum used in corrective wash impression and plastogum was painted over the entire vault and all available tissue surface not included in the first impression. The second tray was filled with plastogum and gently vibrated into place until keyed parts of the tray were in contact. The two trays were held lightly together until the impression material set and then the impression was removed as a unit and the two trays were sealed together with sticky wax. Zafarulla Khan described a technique where a window was cut in the custom tray where the unsupported area was present. The unsupported area was recorded with impression plaster and the remaining area was recorded with perrmlastic impression material. Other techniques used in case of flabby tissues a. Hobrick described a technique where only a single custom tray was used. Border molding was done in the usual manner and impression was made with heavy bodied addition silicone. The area of movable tissue was cut out and relief holes were made and wash impression was made with light bodied impression material. b. Joh D. Watter recorded the healthy denture bearing tissue with ZnoE and the displaced tissue with impression plaster. c. Split method by Allan Mack is useful if tissues are exceptionally flabby. A loosely fitting tray made with heavy relief over the flabby areas was taken. Plaster was mixed and applied over the flabby area to a thickness of about 3mm and was allowed to set tray was filled with 2nd mix of plaster and the 20
  • 21. impression was made with the initial coating of flabby areas thus acting as a splint while the impression was made and being removed. Other techniques used for poor foundation a. Modified Fournet Tuller technique by Allan Mack also utilizes the principle of achieving maximum peripheral seal together with minimal pressure on the crest of the ridge to obtain retention and stability. b. Winkler described a technique which used tissue conditions and over extended primary impression of alginate was made. Occlusal wax rims were constructed and the borders were adjusted so that the lingual flange and sublingual crescent area were in harmony with the resting and active phases of the floor of the mouth by as open and closed mouth technique 3 applications of conditioning material were used – each application for approximately 8-10 minutes. The third and final wash was made with light bodied material. The technique resulted in an impression that had tissue placing effect with relatively thick buccal lingual and sublingual crescent area. Miller used mouth temperature waxes instead of tissue conditioners. Klein proposed the development of impression without a tray, as a stock tray may cause some distortion of the tissue and may result in a over extended impression. He used a moldable material (putty silicone) reinforced by an internal metallic core which was placed over the residual ridge and the borders molded by speech exercises. A low viscosity material was placed on the impression surface of this tray and functional impression was made. 21
  • 22. Impression technique for restricted access to the mouth Walter described a technique with the use of sectional stock trays. Impressions of each side of the jaw was made on at a time and two holes were joined and cast was poured. The recording of denture borders may be done by either hand manipulation and functional movement. Hand manipulation The contour of the denture borders may be obtained by the dentist with the use of manipulation of lips and cheeks within functional limits. Patients tongue movements record the lingual borders. Functional movements The denture borders are also formed by having the patient make functional or physiological movement such as swallowing sucking, grinning, licking etc. Tench’s neuromuscular concept values the functions of sucking and swallowing while making the impression to bring the denture base into harmony with the physiological behaviour of the muscles. Forming an impression by neuromuscular concept develops a completely passive contact of all impression borders to the basal seat tissues, passively fills all marginal spaces and develops basal seat area coverage that is compatible with function. Barone states that normal or natural movements will provide better borders than by manipulation. 22
  • 23. The only truly functional or physiological method of making impressions is the so called dynamic impression. In this technique the basal seat and borders are obtained with the use of impression materials that continue to flow over an extended period of time such as tissue conditioning materials or wax. This material is placed in the patients transitional denture and the patients normal activities mold the borders over a period of time. Functional reline rebase technique is based on the same principle. Discussion In the mucostatic principle Clinical procedure in selective pressure technique: 1. Preliminary examination and conditioning of the patient. 2. Seating the patient: i. Patient should be in a upright position and relaxed. ii. The jaw should be at the level of the operator’s elbow for maxillary and at the level of operator’s shoulder for mandibular impression. 3. The hands should be washed in the view field of the patient even though they may have been previously washed. 4. The tray should be selected from the stock trays which should be kept ready sterilized while inserting the tray in the patient’s mouth using a rotatory movement. There should be an equal clearance of 6-8 mms. Between the tray and the tissues all round. 5. Operator’s position: 23
  • 24. i. Right back side of the patient for upper impression. ii. Right side front of the patient for lower impression. The selected tray should cover the entire denture bearing area. Check the tuberosity area in the maxillary and lingual pouch in the mandibular foundation. 6. Compound is softened in chotwater. i. A large bowl should be used. The compound is kneaded thoroughly to soften it uniformly. In case maxillary impression the compound is molded to a rounded form, placed in the centre of the tray and thoroughly spread over the surface of the tray. In case of mandibular impression the compound is formed into a rope form and spread over the surface of the tray. In case of maxillary impression, the tray is centered slightly anterior to the final position assumed by the tray when it is correctly seated. It is then moved upward and backward direction. The compound is manipulated by index finger into the deep buccal sulcus area. In case of mandibular impression the tray is centered exactly over the ridge and seated straight down. With the index finger the compound should be manipulated into the deep lingual pouch.  Simulation of the tissue should then be done.  The compound is allowed to harden and withdrawn from the mouth. 24
  • 25.  The impression is chilled in cold water and examined thoroughly. It is examined for completeness border tissue functions, distortion and gross physical defects. Materials used: a. Low fusing impression compound sticks – Advocated by Boucher. b. Autopolymerizing acrylic resins Advocated by Jones – not used due to the heat of polymerization and monomer irritant. c. Tissue conditioning materials (modified resins) Chare has described the use of one such tissue conditioning material. They are effective when used correctly. They set slowly and continue to flow under pressure at a rate inversely proportional to time becoming stiffer but never losing resiliency. d. Metallic pastes and elastomeric materials. Ideally body elastomeric impression material is used. Smith Dale E has advocated one technique where the border molding is done in one step with polyether impression material. e. Impression waxes Use of impression wax adapted for border molding was reported by Knapl. But these waxes distort easily. f. Perio pack : Kerk and Idolt has described one step border molding with the use of periopack. 25
  • 26. The diagnostic cast is made of dental plaster. The form of the custom tray helps us to make impression based on specified theory. The areas to be retrieved on the casts and undercut areas are marked and blocked with wax. Care must be taken while providing relief, as excessive relief causes flabby tissue formation. The custom tray must be 2mm less than the denture outline except in the posterior palatal seal and retromolar pad area. The peripheries of the tray should not be sharp / rough. The custom trays are checked in the mouth. The tray should cover the entire denture bearing area. If the tray is underextended, compound should be added wherever necessary. If the tray is overextended the tray should be trimmed where required. The tray is also checked for retention and stability. Border molding is done quadrant by quadrant (By hand manipulation) within the functional limits of tolerance. Border molding: The shaping of the border areas of an impression tray by functional or manual manipulation of the tissue adjacent to the borders to duplicate the contour and size of the vestibule. Glossary of prosthodontic lesions 7th edition.  The anterior limit of posterior palatine seal area is marked using T – burnisher. The line of minimal function is marked by asking the patient to tell Ah.  The low fusing impression compound is softened and placed in this area the tray is seated in the mouth to obtain posterior palatine seal. 26
  • 27.  The tray is then checked for completed border molding. It should have same appearance as the finished denture. The tray is reinserted and border seal and retention and stability are checked. The different material used for final impression are a. Impression plaster (Rarely used). b. Zinc oxide eugenol paste – 2mm. c. Irreversible and reversible hydrocolloids – 6mm d. Elastomeric impression materials – 4mm, 2mm. e. Mouth temperature waxes – f. Soft acrylic resins (functional impression) – 1-2mm The relief wax spacer is removed. If zinc oxide eugenol paste is used, it should be mixed fairly stiff and a ribbon of even thickness of paste should be applied to the tray. The tray is quickly inserted and sealed in the correct position and border molding is carried out by gently simulating tissue function in those areas. Conclusion Although there are many techniques with varied logic, the success of the prosthodontics treatment depends on the clinical diagnostic alumen, understanding of the theories of impression making and its application by the operator. 27
  • 28. References 1. Boucher : Prosthodontic treatment for edentulous patients. 2. Boucher C.O. : A critical analysis of mid century impression technique for full dentures. J. Prosthet. Dent., 1 : 472-491. 3. Ellinger Charles W. “Synopsis of complete denture. 4. Edgar N. Starke : Historical review of complete denture impression materials. JADA, 91 : 1037-1041. 5. Filler W. H. : Modified impression technique for hyperplastic alveolar ridges. J. Prosthet. Dent., 25 : 609-612, 1971. 6. Glossary of Prosthodontics. J. Prosthet. Dent., Edition 7th, 81 : 48-110, 1999. 7. Heartwell Charles M. : Syllabus of complete dentures. 8. Luin Bernard : Impressions for complete dentures. 9. Lott F. and Luin B. : Flange technique : An anatomic and physiologic approach to increase retention, function, comfort and appearance of dentures”. J. Prosthet. Dent., 13 : 394-413, 1966. 28
  • 29. 10. Milo V. Kubalek and Bert C. Bufington : Impressions by the use of substathmospheric pressure. J. Prosthet. Dent., 16 : 213-223, 1966. 11. Page H.H. : Mucostatics, A principle not a technique by Harry L. Page, Chicago, 1946. 12. Portar C.G. : Mucostatics – A panaua or propagan. J. Prosthet. Dent., 3 : 464-466. 13. Sharry J.J. :Complete denture prosthodontics. 14. Tyrde G.K. : Dynamic impression method. J. Prosthet. Dent., 15 : 1023-1034, 1965. 15. Udani T.M. : Critical analysis of complete denture impression procedures (unpublished article). 16. Victor O. Lucia : Mucostatics, text book of treatment of edentulous patients. 17-21. 29