PRIMARY IMPRESSION AND PRIMARY CAST

Dr. Barbara Kispélyi

Associate Professor
Semmelweis University, Faculty of Dentistry
Department of Prosthodontics
SEMMELWEIS UNIVERSITY
FACULTY OF DENTISTRY
DEPARTMENT OF PROSTHODONTICS
CURRICULUM:
Prosthetic treatment of the edentulos patient
- Chairside steps
- Labside steps

From web
Completely edentoulous elderly
patient

Prof. Fejérdy és mtsai: A felnőtt lakosság fogelevesztési dinamiikája Magyarországon

Fogorvosi Szemle 1998
From: Basker et al.: Prosthetic treatment of the edentulous patient
THE COMPLETE EDENTULOUSNESS CAUSES:

1. Biological changes - mastiction

2. Social changes
3. Changes in appearance
4. Phonation
5. Psychic

From web
• GERONTOLOGY
• GEROSTOMATOLOGY
• GEROPROSTHETIC

From web
MEDICAL AND DENTAL HISTORY
• Main complaint
• Medical history
• Dental History
• Clinical examination
- extraoral
- intraoral (stomato-oncologic
examination!)

Dr. Károlyházy

Diagnosis Treatment plan Prognosis

SPECIALITIES:
• In medical history
• In dental history
• Psychological changes
• Social changes

From web
IMPRESSION (IN GENERAL):
An imprint of the teeth an adjacent surfaces, structures

PRIMARY IMPRESSION:
negative likeness of the denture bearing tissues

From web
- overextended
- static
- taken by a stock-tray
STOCK TRAY
Requirements:
- rigid
- size and shape
- border extension
- retain its shape
PARTS OF THE TRAY

floor
flanges

handle

From A. Abusallamah
 TYPES I.: STOCK TRAY

Material:
-Metallic (aluminum, stainless steel)

-Non metallic:
- Plastic tray (can be sterilized)
- Plastic tray (disposable)

From web
 TYPES II.: STOCK TRAY

• Perforated
• Non-perforated

From web
 TYPES III.: STOCK TRAY

• size
• form
• edentulous

From web
TRAY SELECTION
TRAY SELECTION I.:

From web
TRAY SELECTION II.:
• 3-5 mm of clearance with
soft tissues
• Differencies in impression
materials

From: Basker et al.: Prosthetic treatment of the edentulous patient and from web
TRAY SELECTION III.:

• Maxillary trays should extend slightly beyond vibrating line

• Mandibular trays should cover the retromolar pads

From web
TRAY MODIFICATION:

• Trays can be modified with wax or compound to extend the tray if

desired

From web
IMPRESSION MATERIALS FOR PRIMARY
IMPRESSION
IMPRESSION MATERIALS FOR PRIMARY
IMPRESSION:
• Alginate – irreversible hydrocolloid
• Impression compound
• Elastomer impression materials
• Impression plaster

From web
ALGINATE
• Inexpensive
• Easy to manipulate and secure
• Requires no special equipment
• Good viscosity – high viscosity type is the best
• Dimension stability between circumstances
Usually found in a box or In a bag basically presented as
powder & we mix it with water with
a measure cup
 WORKING TIME AND SETTING TIME
• Working time:
Regular set: 2-3 minutes
Fast-set: 1.25-2 minutes
• Setting time:
Regular set: 2-5 minutes
Fast set (by adding materials by the factory): 1-2 minutes

From web
INFLUENCE THE WORKING AND SETTING
TIME:
• water temperature
• Powder : Liquid

From web
 TROUBLESHOOTING ALGINATE IMPRESSION
• Premature set (hot water)
• Slow set (cold water)
• Voids (air bubbles with the mixing)
• Distortion (not accurate as may be we remove the impression while it still liquid)
• Excess alginate at back of tray(may be more alginate is placed)

From web
PREPARATION OF THE MOUTH:
1. Before dentures are made
Conditions involving the oral mucosa:
- denture stomatitis
- inflammatory papillary hyperplasia of the palate
- angular cheilitis
Conditions involving the bone:
- Sharp and irregular bone
- Undercat ridges
- Tori
- Pathology within the bone

2. Immediately before the impression

From: Basker et al.: Prosthetic treatment of the edentulous patient and web
PATIENT PREPARATION BEFORE THE
IMPRESSION:

• Correct position of the dental chair and patient

• Dry the mucosa
• Don’t let patient close

Prof. Fábián és mtsai: A fogpótlástan alapjai

TAKING THE IMPRESSION
MEASURING POWDER

• Fluff (shake) the powder,

measure, tap and flatten
the scoop with powder
• Use three scoops for
syringe impressions

From web
PRIMARY IMPRESSION:
• Find the correct position of the dental chair and patient
• Support the tray during setting - do not leave the patient
• Movement causes distortion

Prof. Fábián és mtsai: A fogpótlástan alapjai

 IMPORTANT CONSIDERATIONS TO
ENSURE ACCURATE IMPRESSION
• 2-4 mm bulk material in tray
• Snap action removal from mouth
• Allow extra 1-2 minutes after setting to improve tear strength
• Stored in a moist environment to avoid loss of water evaporation
and deformation
• Disinfect in less than 10 minutes to avoid dimensional instability
• Alginate syringe technique

From web
ALGINATE SYRINGE TECHNIQUE:
• Retromylohyoid area
• Hamular notches
• Retrozygomal area

From web
PRIMARY IMPRESSIONS – FINAL STEPS:
 Evaluate impression - Criteria for acceptable alginate impression:
- All anatomical landmarks and relevant soft tissue recorded
- No large voids
- Free of debris
- No distortion

 Rinse thoroughly with water and spray with disinfectant to coat all surfaces,
 Hold in water

From web
THE RESULT:

From web
LABORATORY STEPS
CAST:
The cast is a positive likeness of the denture bearing tissues

PRIMARY CAST:
Made according to a primary impression. Special tray is constructed onto it (after
outlining the borders of the special tray at the dental office)

Dr. Károlyházy
POURING A CAST

• Weighing powder, measure water

• Vacuum mix (less time, stronger cast)

From web
POURING A CAST
• Casts should be a minimum of 12 mm in thinnest part
• Separate the alginate impression from the stone cast after
45 minutes

From web
TRIMMING CASTS

• Trim the base on the

model trimmer parallel to
the residual ridges
• Leave the vestibular
reflection intact for
making a special/custom
tray
THANK YOU FOR YOUR ATTENTION!
 SPECIAL TRAY

Dr. Barbara Kispélyi

Associate Professor
Semmelweis University, Faculty of Dentistry
Department of Prosthodontics
Primary impression Primary cast Special tray

From web
 OUTLINE

Primary impression Primary cast

Dr. Kivovics

From: Basker et al.: Prosthetic treatment of the edentulous patient and from web
 ANATOMICAL LANDMARKS OF THE
EDENTULOUS MAXILLA AND MANDIBLE
 From web

Mucous membrane
 ANATOMICAL LANDMARKS AND
THEIR CLINICAL SIGNIFICANCE IN
EDENTULOUS MAXILLARY ARCH
MAXILLA – LABIAL FRENULUM, BUCCAL
FRENULUM

From web
LABIAL AND BUCCAL VESTIBULE

From web
 DISTO-BUCCAL AREA
CORONO-MAXILLARY SPACE
HAMULAR NOTCH

From: Basker et al.: Prosthetic treatment of the edentulous patient

VIBRATING LINE

From: Basker et al.: Prosthetic treatment of the edentulous patient

HARD PALATE

From: Basker et al.: Prosthetic treatment of the edentulous patient

RESIDUAL ALVEOLAR RIDGE

From: Basker et al.: Prosthetic treatment of the edentulous patient

RUGAE AND INCISIVE PAPILLA

From: Basker et al.: Prosthetic treatment of the edentulous patient

MAXILLARY TUBEROSITIES

From web
 ANATOMICAL LANDMARKS AND
THEIR CLINICAL SIGNIFICANCE IN
EDENTULOUS MANDIBULAR ARCH

From web
MANDIBLE – LABIAL FRENULUM, BUCCAL
FRENULUM, LINGUAL FRENULUM

From: Basker et al.: Prosthetic treatment of the edentulous patient

LABIAL AND BUCCAL VESTIBULE

From web
RETROMOLAR PAD

From: Basker et al.: Prosthetic treatment of the edentulous patient

EXTERNAL OBLIQUE RIDGE

From web
BUCCAL EXTENSION

From web
LINGUAL POUCH

From web
 SPECIAL TRAY

- Clinical applications
- Parts
- Types
- Laboratory steps
 Clinical application:
SPECIAL TRAY:
 Completely edentulous patient
 Subtotal edentulous patient
 Removable partial denture
 Special anatomical situations
 Implantology
 Reconstruction prosthesis
PURPOSE OF SPECIAL TRAY:

Minimize:
 Impression material distortion
Uniform thickness
Rigid tray
 Tisssue distortion
Less viscous material
Accurately adapted tray

From: Basker et al.: Prosthetic treatment of the edentulous patient

 Parts:
AUXILIARY HANDLES:

Intraoral Extraoral

From web
 Types:
TYPES OF SPECIAL TRAYS:
1. Close fitting
Used with very low viscosity impression materials, since it provide a thin
layer after setting:
- Zn-eugenol paste
- very low viscosity elastomers

2. Spaced
Used with high viscous impression material (3mm)
- alginate
- medium or high viscosity elastomers

From web
CLOSE FITTING TRAY:

From web
SPACED TRAY:

From web
 SPECIAL/CUSTOM TRAY
Materials:
Resins:
- Visible light curing resins
- Self curing resins
- Heat curing resins
Thermoplastic materials
- sellak

From web
RESINS:

 Rigid, retain its shape

 Not thermoplastic
 Types
- self-curing (clear)
- heat-curing (clear)
- visible light curing
Sellak:
 Breakable (undercuts, wire-reinforcement)
 Thermoplastic (green stick, oroplastic
impression materials)
 Cheap
 Special tray:

Sellak Light Self Heat

curing curing curing

Precision
SELLAK SPECIAL TRAY:
SELLAK SPECIAL TRAY:
SELLAK SPECIAL TRAY:
SELLAK SPECIAL TRAY:
SELLAK SPECIAL TRAY:
FÉNYREKÖTŐ AKRILÁT EGYÉNI KANÁL
KÉSZÍTÉSÉNEK LÉPÉSEI:
 Special tray:

Sellak Light Self Heat

curing curing curing

Precision
VISIBLE LIGHT CURING RESIN SPECIAL TRAY:
VISIBLE LIGHT CURING RESIN SPECIAL TRAY:
VISIBLE LIGHT CURING RESIN SPECIAL TRAY:
VISIBLE LIGHT CURING RESIN SPECIAL TRAY:
 Special tray:

Sellak Light Self Heat

curing curing curing

Precision
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:

Molding process:
3-6 Bar
40°C
20-30 minute
SELF-CURING RESIN (CLEAR) SPECIAL TRAY:
 Special tray:

Sellak Light Self Heat

curing curing curing

Precision
HEAT-CURING RESIN (CLEAR) SPECIAL TRAY:
HEAT-CURING RESIN (CLEAR) SPECIAL TRAY:
HEAT-CURING RESIN (CLEAR) SPELIAL TRAY:

100-105°C
60-90 minutes
HEAT-CURING RESIN (CLEAR) SPECIAL TRAY:
 CONCLUSION:

The best:
Heat-curing resin (clear) special tray
OLD DENTURE - USE AS A SPECIAL TRAY!

RELINE

REBASE

From: Basker et al.: Prosthetic treatment of the edentulous patient

THANK YOU FOR YOUR ATTENTION!