SPECIAL IMPRESSION PROCEDURE FOR TOOTH-TISSUE

SUPPORTED REMOVABLE PARTIAL DENTURES

This situation requiring special impression procedure includes not only
distal extension partial edentulous situations like Class I and II but also
includes long span anterior edentulous ridge (including atleast 6 anterior
teeth). Where the ridge must supply some support for the partial denture (ong
span Class I!).
" tooth supported remo#able partial denture can be constructed on a
master cast made from a single$ pressure free impression that records the teeth
and the residual ridge in their anatomic form$ because here$ the denture bas
doesn%t contribute to the support of the partial denture much significantly as
most of the stress is transmitted through abutment teeth.
" dual impression technique is used to equali&e as much as possible the
support deri#ed from the edentulous ridge and that recei#ed from abutment
teeth. Tooth is captured in its anatomic form 'hile impression of soft tissue$
must be made in such manner as to record the tissues in a functioning form.
IMPRESSION TECHNIQUES
(asically t'o dual impression techniques
)hysiologic * functional +electi#e pressure
Impression technique Impression technique
,. -cean . /indel%s techniques
0. 1unctional 2elining Technique
3. 1luid 'ax technique
"ltered cast impression technique
4r
Corrected cast impression technique
,
In both the fluid 'ax functional impression technique and selecti#e
pressure technique$ an impression of the displaced edentulous ridge is made
using an impression tray attached to the frame'ork$ and the master cast is
altered to accommodate the ne' ridge impression. 1or this reason technique is
often referred to as the altered cast impression technique.
McLEANS PHYSIOLOGIC IMPRESION
1or this dual impression a custom impressin tray 'as constructed o#er a
preliminary cast of the arch$ a functional impression of distal extension ridge
'as made 'ith patient applying steady biting and then a second impression
'ith hydrocolloid material 'as made 'ith the first impression held in its
functional position 'ith finger pressure.
5ra'back6 1inger pressure could not produce the same functional
displacement of the tissue that biting force produced. The apparent ad#antage
of technique 'as lost 'ith this 'eakness.
HINDELS MODIFICATION
,. /indel de#eloped trays for second impression 7'ith irre#ersible
hydrocolloid8 those 'ere pro#ided 'ith holes so that finger pressure could
be applied through the tray.
0. "nother main change 'as the impression of edentulous ridge 'as not
made under pressure but 'as an anatomic impression of the ridge at rest
made 'ith a free9flo'ing &inc oxide eugenol paste.
0
+o here$ teeth and ridge 'ere reproduced in anatomic form only$ but
t'o 'ere related to each other in a functional form.
FUNCTIONAL RELINING METHOD
In this method$ functional impression for support of a distal extension
denture base is obtained after the partial denture has been completed.
)artial denture is constructed on a cast made from a single impression$
usually of irre#ersible hydrocolloid. This is an anatomic impression and no
attempt is made to alter it.
To allo' room for impression material bet'een the denture base and
the ridge$ space must be pro#ided. :niform space can be obtained by adapting
a soft metal spacer o#er the ridge on the cast before processing the denture
base. "fter processing the metal is remo#ed lea#ing an e#en space. 4r
1lo' lo' fusing modeling plastic o#er the tissue surface of the denture
base$ tempering the modeling plastic in a 'aterbath and seating it in patients
mouth. /eating$ tempering and resection must be done se#eral times.
5etermine border extensions correctly.
To pro#ide space for the impression material$ the entire surface of
modeling plastic may be scraped to a depth of approximately ,mm or remo#e
entire thickness of modeling plastic o#er the crest of the ridge.
-ake final impression 'ith ;4<
4r
If undercuts are present$ one can use elastomers.
3
It has the ad#antage that the amount of soft tissue displacement can be
controlled by the amount of relief gi#en to the modeling plastic before final
impression is made. =reater the relief$ less 'ill be the tissue displacement.
FLUID-WAX FUNCTIONAL IMPRESSION: can b !a"
,. To correct the distal extension edentulous ridge portion of the original
master cast or
0. To make a reline impression for an existing partial denture.
Term6 1luid 'ax is used to denote 'axes that are firm at room
temperature and ha#e the ability to flo' at mouth temperature for e.g. I4W"
Wax . >orrecta Wax ?o. @.A.
>ey for functional impression 'ith these 'axes lies in the consistency
of fluid 'ax used6 basically impression 'ax flo's sluggistly and a thin layer
of 'ax 'ill flo' less readily than a thicker layer. 2elief of , or 0 mm is gi#en.
Wax is fluid at B,C to B@C C pf 'ater bath temperature. "nother
ad#antage is that the maximum extension of peripheral borders of denture base
can be recorded 'ith >orrecta Wax ?o. ,$ ('hich is more #iscous
comparati#ely) 'ithout interfering 'ith function. (orders must be short of all
mo#able tissues$ but not more than 0mm$ as material does not ha#e sufficient
strength to support itself beyond that distance.
Tray must remain in mouth for minimum Bmins after each addition of
'ax. 1inally impression should be left in the mouth for ,0 minutes. ?e' cast
should be poured as soon as possible because 'ax is fragile and subDect to
distortion.
@
SELECTIVE PRESSURE IMPRESSION OR SELECTIVE
PLACEMENT IMPRESSION
What is differentEF )re#iously discussed techniques$ produced a
generali&ed displacement of the mucosa to a greater or lesser degree.
+electi#e pressure impression attempts to direct more force to those
patients of the ridge able to absorb stress 'ithout ad#erse response. To do this$
the tissue surface of the tray is selecti#ely relie#ed.
In some patient if #ery easily displaceable tissue is present$ holes may
be made through impression tray. -ore #iscous the impression material
greater 'ill be the tendency for displacement. ;inc oxide eugenol paste can be
used as it is an accurate impression material of intermediate #iscosity$
especially 'hen undercuts are not a problem. 4ther'ise rubber base
impression materials are useful.
The artificial point for operator is to determine #isually that all rests and
indirect retainers are completely seated 'hile impression making. "#oid
applying any do'n'ard pressure on the impression tray.
To prepare altered cast$ line is dra'n ,mm posterior to distal abutment
tooth at right angles to long axis of ridge. +econd line is dra'n at right angles
to first$ beginning medial to lingual sulcus. 2emo#e outlined area 'ith
handsa'. -ake longitudinal retention groo#es on cut surface of cast to pro#ide
mechanical retention for ne' portion of cast to be poured. (eading and boxing
is done and minimal set$ boxing is remo#ed and cast is trimmed and corrected$
cast is used to complete partial denture.
B