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Complete Dentures
   Appointment 2
       Final
     Impressions
Introduction
•Trays
•Border molding
•Making Impression
•Post-Dam
Baseplates




                   Draw outline 2 mm
                   short of periphery.


Trim master cast                   Block out undercuts
                                   with wax or putty.
Border of Mandibular Custom Tray
Make wax spacers



    2 mm cutback
   1 thickness wax
Making a Custom Tray




Roll out tray    Adapt tray
  material.      material and
                form a handle.
2. Try
                  tray on
                   cast.



                            3.Observe
 1.Trim off                  the tray
excess acrylic.               handle.
Finished Trays
            Finger
            Rests




Finger rests are placed on trays
for severely atrophic mandibles.
Finished Trays
    6-7mm   11-12mm
9-10mm
Finished Mandibular Trays
Triad Trays




Adapt tray material to casts
and trim any excess material.
Triad Tray Finished
Finished Tray     Wax is left
                      in place until
                     border molding
                      is completed.




Tray is cut back      Note the size
to the 2mm wax        and shape of
    spacer.           the handles.
Tray Extensions
 Before the final
 impressions are made
 ALWAYS check the
 trays for proper fit
 and extension.
Fitting the tray
Fitting the tray
Fitting the tray
Fitting the tray
Points to relieve in the mouth.
Modeling Plastic
   •Gray or green
   •Water bath
   •128-135 F
            o

   •Ice
Armamentarium
Border Molding
Making an impression
of the vestibule during
function.
  •Selective pressure
Fitting the tray
Temper
Always remember to temper the compound
 in a water bath before placing it in the
       mouth to avoid serious burns.
Border Molding
•Temper in water
bath 3-5 sec. then
place in the mouth
after removal.
 •Trim
Muscle Trimming
stable. no tray displacement.
   no tissue impingement.
Border mold the
     mandibular tray first.

•Less chance of gagging patient.
•Patient is more cooperative.
•Familiarizes patient with procedure.
•Allays apprehension.
•Start by doing small areas.
•Do the critical areas first.
    •Lingual Frenum
    • Labial Frenum
    • Buccal Frenum
Functional Border Molding




       Sublingual Roll
Border Molding




 Function Check
Functional Border Molding




        Buccal Frenum
Heat with alcohol torch.




Temper, then muscle trim again.
As you gain more skill and
become more confident then
try the following technique.
Start by border molding
   the labial and buccal
flanges on the mandibular.
Do one side of the lingual
 flange before moving to
     the other side.
Move to the other side
and finish that side of
  the lingual flange.
Finish the lingual frenum area of
the mandibular denture by having
the pt. thrust out his tongue.
Heat with alcohol torch
to soften selected areas
  and replace in mouth.
Remove the wax spacer
prior to making impression.
Border Molding Maxillary




    Do Anterior First.
Muscle Trim
 the maxillary
custom tray in
  the mouth.
 First do one
    side...
...then the other.
Finish with the postpalatal seal.
Border-Molded Maxillary Tray
Properly Border-molded
    Maxillary Trays
Polyether Technique
 Polyether impression
material can also be
used for border-
molding the final tray.
Polyether Technique
 •Advantages
   •Reduces overextension.
   •Quick
 •Disadvantages
   •Cost
   •Taste
Polyether
•It is critical that the
trays are made
correctly.
 •2mm shy of fornix
 of vestibules.
 •2mm thick.
Polyether




Paint on adhesive.   Mix impression
                       material.
Polyether
A




                              B

           A.Load tray with polyether
           impression material.
           B. Place tray in mouth.
           C. Borders of tray are
    C      defined by impression.
Polyether



Follow the same procedure for the
maxillary impression. The most
obvious difference between the two
trays is that the maxillary border
molding does not cover the tray.
Polysulfide
Impression
 Polysulfide
 •Remove Wax
 •Trim MP
 •Tray Adhesive
Final
 Impression
•Ready to make final
impression.
 •Trays are retentive.
 •Borders are finished.
Impression
•Final impressions are:
•Of uniform thickness.
•(1mm)
•Free of voids.
•Contoured over ridge.
Impression
•Possess excellant
surface detail.
•Not be too thick at
the borders (25mm)
or overextended.
Procedure
 After the border molding is
completed the spacer wax is
removed and the tray is
painted with adhesive.
Wax spacer is removed.
Adhesive is painted on.
ARMAMENTARIUM FOR FINAL IMPRESSION
Procedure
The patient is
seated in the
upright position.
 •Mouthwash
  •Reduce the saliva.
Procedure
The patient is
asked to suck
on a piece of
ice to reduce
the function of
the palatine
glands.
Procedure
  Approximately 3-3.5 inches of
light body Permalastic is used
to make the impression.
Procedure
Procedure




Loading the impression tray.
Procedure




FUNCTIONAL MOVEMENTS
Mandibular Impression
“Show-through” of
  border molding
The filled tray.
Muscle trim.
Procedure
The impression is held
in place for 6-8 minutes.
    •Tissue detail
    •Voids
    •Even thickness
Hold tray in place.
Other Types of Impressions




 Zinc Oxide-Eugenol Paste
      Final Impressions
Polyvinylsiloxane Impression
COMPLETED FINAL MANDIBULAR IMPRESSION




   HIGHLY DETAILED REPRODUCTION OF TISSUE SURFACE
Land Area
POST DAM
Advantages
•Aids In retention of the
upper denture.
•Helps control Gagging.
•Compensates for
processing shrinkage.
Landmarks
•Hamular Notch
•Vibrating Line
•Midpalatal Suture
•Glandular Zone
•Fovea Palatina
Vibrating Line
   Imaginary line across the
posterior part of the palate,
marking the division between
the moveable and immovable
tissues of the soft palate.
Foveae
       Palatina
  Two small pits, one on each
side of the mid-line, near the
junction of the hard and soft
palate.
Landmarks




Fovea
           Hamular Notch
Soft Palate
House classified the soft palate
  according to how it drapes.
House Classifications

                     CLI




              CLII

      CLIII
Soft Palate, Class I


      5-10 mm

Vibrating line
Soft Palate: Class II
•Area for placement of
the post-dam is
reduced to 3-5mm.
•Most common type
found in patients.
Soft Palate: Class II
    Vibrating Line



  3-5mm




              Class II
Soft Palate: Class III
 •Represents the most
 limited area.
     •It usually ranges from
            1-3 mm.
Soft Palate: Class III
•It is easiest to locate.
 •Care should be taken
 not to overextend the
 denture.
Soft Palate: Class III
         Vibrating line



1-3 mm

     Class III
Vibrating Line

Located within these areas
according to the type of soft
palate. The area must be
palpated to determine how
far the line can be placed.
Vibrating line


                            Class III

Placement Zone
   CD


     Bead
                 End of Denture
Locating the Post-Dam

  •Dry the area with 4X4
  gauze.
  •Palpate the tuberosity,
  midpalatal raphae, and
  hamular nitch.
Procedure
•Mark the hamular
notch with sterile ink
stick.
•Locate by having the
patient say ‘Ah’
in short bursts.
Procedure




Palpate and mark the area
   of the hamular notch.
Post Dam
Procedure
Post-Dam
Procedure




Connect to vibrating line.
Procedure




Reinsert Impression.
Post-Dam
Post-Dam
Post-Dam
Post-Dam
Box and Pour
•Rim, box, pour, separate,
and trim the final cast.
•You will need to retrace
the marks on the cast so
that the post palatal seal
is clearly marked.
Box and Pour




Boxing wax should extend 10 mm
       above impression.
Box and Pour




Finishing land area of maxillary
           master cast.
Making a Baseplate
     Sprinkle Method




    •Work In sections
       •sift powder
     •wet with monomer
Making a Baseplate




 Keep wet with monomer
  to avoid “sugar” look.
Making a Baseplate
Finger Adapted Dough Method




      Forming resin well
       in dough stage.
Making a Baseplate
Finger Adapted Dough Method




   Place dough over cast and
          adapt it well.
Making a Baseplate




  Cure in warm pressure pot
    @ 20 psi/20 minutes.
Making a Baseplate




Remove from cast and
   trim off flash.
Immediate Mandibular CD
Boxed Impression and Final Cast

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Impressions1