View
1.136
Download
0
Category
Tags:
Preview:
Citation preview
Complete Dentures
Appointment 2
Final Impressions
Introduction•Trays•Border molding•Making Impression•Post-Dam
Baseplates
Trim master cast
Draw outline 2 mmshort of periphery.
Block out undercutswith wax or putty.
Border of Mandibular Custom Tray
Make wax spacers
2 mm cutback1 thickness wax
Roll out tray material.
Adapt tray material and
form a handle.
Making a Custom Tray
1.Trim off excess acrylic.
2. Trytray oncast.
3.Observe the tray handle.
Finished TraysFingerRests
Finger rests are placed on traysfor severely atrophic mandibles.
Finished Trays
9-10mm
6-7mm 11-12mm
Finished Mandibular Trays
Triad Trays
Adapt tray material to casts and trim any excess material.
Triad Tray Finished
Finished Tray
Tray is cut backto the 2mm wax
spacer.
Wax is leftin place until
border moldingis completed.
Note the sizeand shape ofthe handles.
Tray ExtensionsBefore the finalimpressions are madeALWAYS check thetrays for proper fitand extension.
Fitting the tray
Fitting the tray
Fitting the tray
Fitting the trayPoints to relieve in the mouth.
Modeling Plastic•Gray or green•Water bath•128-135oF•Ice
Armamentarium
Border Molding
Making an impressionof the vestibule duringfunction.
•Selective pressure
Fitting the tray
TemperAlways remember to temper the compound
in a water bath before placing it in the mouth to avoid serious burns.
Border Molding•Temper in waterbath 3-5 sec. thenplace in the mouthafter 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 andbecome more confident thentry the following technique.
Start by border molding
the labial and buccalflanges on the mandibular.
Do one side of the lingualflange before moving to
the other side.
Move to the other sideand 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 torchto soften selected areasand replace in mouth.
Remove the wax spacerprior to making impression.
Border Molding Maxillary
Do Anterior First.
Muscle Trimthe maxillary
custom tray in the mouth.
First do one side...
...then the other.
Finish with the postpalatal seal.
Border-Molded Maxillary Tray
Properly Border-moldedMaxillary Trays
Polyether Technique
Polyether impressionmaterial can also beused for border-molding the final tray.
Polyether Technique•Advantages
•Disadvantages
•Reduces overextension.•Quick
•Cost•Taste
Polyether•It is critical that thetrays are madecorrectly.
•2mm shy of fornixof vestibules.•2mm thick.
Polyether
Paint on adhesive.Mix impression material.
PolyetherA
B
C
A.Load tray with polyether impression material.B. Place tray in mouth.C. Borders of tray are defined by impression.
Polyether
Follow the same procedure for themaxillary impression. The most obvious difference between the twotrays is that the maxillary border molding does not cover the tray.
Polysulfide
Impression
Polysulfide•Remove Wax•Trim MP•Tray Adhesive
FinalImpression
•Ready to make finalimpression.
•Trays are retentive.•Borders are finished.
Impression•Final impressions are:
•Of uniform thickness.•(1mm)•Free of voids.•Contoured over ridge.
Impression•Possess excellantsurface detail.•Not be too thick atthe borders (25mm)or overextended.
Procedure
After the border molding is completed the spacer wax isremoved and the tray is painted with adhesive.
Wax spacer is removed.
Adhesive is painted on.
ARMAMENTARIUM FOR FINAL IMPRESSION
Procedure
The patient isseated in theupright position.
•Mouthwash•Reduce the saliva.
Procedure
The patient isasked to suckon a piece ofice to reducethe function of the palatine glands.
Procedure
Approximately 3-3.5 inches oflight 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 heldin place for 6-8 minutes.
•Tissue detail•Voids•Even thickness
Hold tray in place.
Zinc Oxide-Eugenol Paste Final Impressions
Other Types of Impressions
Polyvinylsiloxane Impression
COMPLETED FINAL MANDIBULAR IMPRESSION
HIGHLY DETAILED REPRODUCTION OF TISSUE SURFACE
Land Area
POST DAM
Advantages•Aids In retention of theupper 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 betweenthe moveable and immovable tissues of the soft palate.
FoveaePalatina
Two small pits, one on eachside of the mid-line, near thejunction of the hard and softpalate.
Landmarks
Hamular NotchFovea
Soft Palate
House classified the soft palateaccording to how it drapes.
House Classifications
CLI
CLII
CLIII
Soft Palate, Class I
Vibrating line
5-10 mm
Soft Palate: Class II
•Area for placement ofthe post-dam isreduced to 3-5mm.•Most common typefound in patients.
Soft Palate: Class II
Vibrating Line
Class II
3-5mm
Soft Palate: Class III
•Represents the mostlimited area.
•It usually ranges from1-3 mm.
Soft Palate: Class III
•It is easiest to locate.•Care should be takennot to overextend thedenture.
Soft Palate: Class III
1-3 mm
Vibrating line
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
Placement Zone
CD
Class III
Bead End of Denture
Locating the Post-Dam
•Dry the area with 4X4gauze.•Palpate the tuberosity,midpalatal raphae, andhamular nitch.
Procedure
•Mark the hamularnotch with sterile inkstick.•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 sothat the post palatal seal is clearly marked.
Box and Pour
Boxing wax should extend 10 mmabove impression.
Box and Pour
Finishing land area of maxillary master cast.
Making a BaseplateSprinkle Method
•Work In sections •sift powder
•wet with monomer
Making a Baseplate
Keep wet with monomerto avoid “sugar” look.
Making a BaseplateFinger Adapted Dough Method
Forming resin well in dough stage.
Making a BaseplateFinger 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
Recommended