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.
age 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 li"eness but in prosthodontics it is
the negative registration of the denture bearing denture stabili#ing! denture
bracing and peripheral limiting structures obtained in one of the plastic $
semiplastic materials which is registered at the moment of crystalli#ation of the
impression material.
%t the moment of crystalli#ation means that the tissues are registered at
a particular moment. &ince the denture bearing tissues are always in a state of
flu' with new cells being generated and cells being shed of at different moment
of time! the tissues at the time of impression ma"ing will differ from that at the
time of denture insertion.
(
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 "nowledge of anatomy.
b. They may be classified as open $ closed mouth impressions depending on
the condition of the mouth at the time of impression ma"ing.
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 ma"ing impressions.
rior to ()** complete denture replacement were not made due to lac"
of understanding of retention.
In (+((! ,athian Gottfried urman recorded the use of wa'.
In (+-. ieree Fauchard made dentures measuring the mouth with
compases and cutting bone into an appro'imate shape for the space to be
filled.
In (+/)! hillip faff of Germany made impressions in wa' sections of half
of the mouth at a time.
184!18""
In (..) 0ichardson mentioned about ma"ing plaster impressions of tissues
at rest and achieving adhesion by contact.
-
1oncepts of atmospheric pressure! ma'imum e'tension of the denture
bearing area! equal distribution of pressure and close adaptation of the
denture bearing tissues were stressed.
,any changes in impression ma"ing became evident during this era. %
single impression formely deemed sufficient! advanced to a method using
priliminary impression of guttapercha! beeswa' or modelling compound
followed by secondary wash impression made of plastic within preliminary
impression.
1"## $ 1"%"
% concentrated effort was directed towards accuracy.
,ost impression were of compressive type and by the closed mouth
technique. To prevent buildup of e'cessive pressures vents were made.
C&o'(d )out* t(c*ni+u(
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! tal"ing! suc"ing and occlusal contacts.
% pressure similar to that of mastication was developed through the
occlusal rins.
This according to &tanley Freeman2amount of tissue compression is
li"e that in function.
/
&elective pressure technique.
The disadvantage of closed mouth technique is the tendency of
overe'tention or undere'tention.
0elease 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 e'treme
movements and others use.
Two techniques were developed for the management of flabby ridge.
1
st
technique 3 it was of muco compressive type compound impression which
displaced the flabby tissue paratally.
2
nd
technique 3 it was advocated by Greene Brothers! which captured the tissue
in its passive form.
1oncepts 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 ma"ing.
4
Border molding was done against the direction of muscle fibres as
advocated by 5ilson.
There were others li"e 6ichais! 6eil Fish! &wenson 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 ma"ing was
introduced.
MUCOCOMPRESSI,E 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 utili#e 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 ob7ective of this technique was to attain better retention of the
dentures.
The typical technique by Greene brothers was as follows.
% preliminary impression was made in impression compound and a custom
tray was constructed using baseplate with its periphery ($.
th
inch shorter
than the denture outline.
5ith this tray another impression with compound was ta"en.
8
5ell fitting rinse with uniform occlusal surface were made and the height
of the bite ad7usted against a similar bite rim on the mandibular ridge.
%reas to be relieved li"e 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 as"ing the patient to give various chee" 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
7aw.
,-ri-tion' in t*i' t(c*ni+u(
&ome used the preliminary impression itself as the tray and impression to be
improved by border molding.
&ome preferred to ma"e custom trays in a more stable and stronger material
than compound for better results.
)
0elief in hard areas was obtained in number of ways. &ome custom trays
were made with escape holes in areas overlying the hard tissues and close
adaptation provided in those areas covering the soft tissues.
&ome use low fusing compound by softening and adapting it to the soft
tissues.
&ome advocate unnatural movement of the mouth along with massaging of
the chee"s and lips from outside during border molding.
ost dam is obtained in number of ways.
The addition of soft wa' li"e carding wa' or low fusing compound for this
purpose is common.
&craping 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 ma'imum biting
load this interferes with normal blood supply of the tissues resulting in their
brea"down.
%s soon as this change too" place both the peripheral seal and e'cellent
retention were lost. Hence the retention achieved by these means was transient
and harmful to the health of tissues.
9entures 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.
+
These disadvantages indicated a need for spacer in the custom tray
fabrication.
1".#!1"48
1oncept of mucostatics was introduced by Harry L. age in (:/..
%ddison in (:44 also mentioned the same principle of ma"ing impressions
of displaceable tissue in its passive state and considered interfacial surface
tension as one of the main factors of retention.
5ith new materials li"e #inco'ide eugenol! wa'es! elastomers! individual
tray construction was emphasi#ed.
Mini)-& /r(''ur( t(c*ni+u( 0-'(d on )uco't-tic /rinci/&(
In a Brochure published by Hary L. age in (:4) he stated that all soft
tissues were cheifly fluid and .*; or more of the tissues are composed of
water. %ccording to pascal<s law which states that any pressure applied to a
confined fluid is transmitted undiminished and equally in all directions.
age 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! 9y"ins recommended a short
lingual flange to resist lateral displacement.
.
%ccording 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. &o much emphasis
was placed on recording details that separating substances could not be used
at any point in the procedure.
,ucostatics 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 t1/ic-& i)/r(''ion )(t*od r(/r('(ntin2 t*i' t(c*ni+u( 3-' -' 4o&&o3'5
% compound impression was made in a suitable tray and a cast was made.
=n this base plate wa' was adapted which acted as a spacer according to
denture outline.
1ustom tray was fabricated over this spacer.
% soft ribbon of carding wa' was applied at the posterior margin of the
ma'illary tray and it was placed in the mouth under light pressure and
patient was as"ed to do swallowing movements inorder to obtain a posterior
palatal seal.
% small amount of impression plaster mi'ed 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.
6o border molding was advocated but the soft plaster was e'pected to mold
itself to the rela'ed vestibular tissues.
:
The impression was held till the impression hardened and was then
removed.
,-ri-tion' in t*( t(c*ni+u(
&ome techniques use compound instead of wa' for obtaining post dam.
&ome techniques advocate post dam over the final impression.
>inc o'ide eugenol and alginate had also been used for similar results.
age<s application of ascal<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.
age<s claim that retention is a function of surface tension alone is also
ob7ectionable 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
minimi#ed the retentive role of the musculature as described by Fish in
(:4..
(*
The merit of this technique was its high regard for health and
preservation of tissue.
1"48 $ 1"64
There was an increased emphasis on biologic factors of complete denture
impression ma"ing.
&elective pressure concept by Boucher became popular.
1raddoc"! Landa et al advocated use of escape vents.
,ore attention was given to esthetics in the impression techniques used
greater emphasis was on flanges! border molding! posterior palatal seal and
denture e'tension.
In (:4.! the mucoseal technique 3 a variation of the mucostatic technique
was introduced.
?acustatics concept was developed by ,ilo ?. @ubalib and 1. Buffington
to eliminate the functional limitations of impressions.
S(&(cti7( /r(''ur( t(c*ni+u( 0-'(d on '(&(cti7( /r(''ur( t*(or1
%dvocated by Boucher in (:8* it combines the principles of both pressure
and minimal pressure techniques.
The philosophy of the selective pressure technique is that certain areas of
the ma'illa and mandible are by nature better adapted for withstanding
e'tra loads from the forces of mastication. These tissues are recorded under
((
slight placement of pressure while other tissues are recorded at rest or
relieved with minimal pressure in a position that will offer ma'imum
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.
rimary stress bearing areas of ma'illa are crest of alveolar ridge and
the hori#ontal plate of palatine bone and in the mandible it is the buccal shelf
area.
&econdary stress bearing areas of the ma'illary foundation are rughae
area and the slopes of the ridge in the mandibular foundation.
%reas requiring minimum pressure are incisive papilla! midpalatine
suture! tori in the ma'illa and crest of mandibular residual ridge.
In the ma'illa! 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 ma'illary denture.
An (-r&i(r t(c*ni+u( r(/r('(ntin2 t*i' 2rou/ con'i't(d o4 t*( 4o&&o3in2
't(/'8
% well fitting tray with a uniform clearance of about 8mm was selected
and a compound impression was obtained with little border molding done
on the peripheries.
(-
This compound impression was separated from the metal tray and its
peripheral borders were trimmed ( 3 - mm short.
The base portion of the impression was then scrapped evenly to a depth
of about -mm e'cept in the posterior seal area where no scraping was done.
% sufficient amount of creamy mi' of plaster was spread over this
impression and was placed in the mouth with little pressure.
The chee"s and lips were lightly patted from outside while the plaster
was still soft. This procedure gave sufficient value li"e seal without
e'aggerated pressure on soft tissues.
,-ri-tion' in t*( t(c*ni+u(
,ost of the techniques prefer ta"ing a preliminary impression and using
a custom tray rather than use the initial compound impression for further
improvement.
The preliminary impressions are usually ta"en in compound but
materials li"e alginate! elastomeric impression materials are also used.
1ertain 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 standardi#es 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
(/
possible variable which have been used to advantage by different
techniques.
The mucoseal technique was stated by ryor in (:4. 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 e'tended hori#ontally bac"ward! over the sublingual glands
towards the tongue to effect a border seal.
Thus this technique utili#es the benefit of minimal pressure and also
provides ma'imum e'tension of denture borders and ma'imum coverage of
denture bearing area.
Su0!-t)o'/*(ric /r(''ur( t(c*ni+u( 0-'(d on t*( conc(/t o4 )uco't-tic'
,ilo ?. @ubali" and Bert 1. Buffington developed this
technique the ob7ective 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 "ind. 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. % vacuum is developed between the soft tissues and the tray.
% recording material in a fluid state flows from the border region into the
(4
evacuated space and develops the basal tissues. Border seal is determined
by the readings remaining constant.
M-t(ri-&' u'(d
(. %lginate! modeling plastic or a reversible hydrocolloid for preliminary
impression.
-. 1lear acrylic resin for ma"ing the final impression.
/. %n adequate sealing agent for use around special fittings in the tray.
4. Thermoplastic border recording impression material.
8. % fluid Alow viscosityB impression material that seats firmly enough to
avoid distortion.
). % periphery wa' to be used as a fle'ible material between impression
and the bo'ing wa'.
Mo&din2 E9(rci'('
For the maxillary impression the patient is told
(. To suc" on the tube Athis pulls the chee"s in a starts border moldingB.
-. To say C*****D and EEEE alternately AThis refines the border molding
of the buccal and labial flanges and provides space for the frenum.
/. To blow against closed nostril AThis fle'es the soft palate and molds the
posterior palatal seal area. 5ipes of any e'cess adapted e'tending
beyond the border of the tray.
(8
4. To move the mandible from side to side AThis molds the flanges lateral
to the tuberosities.
8. To swallow warm water AThis allows for swallowing movements in the
shape of the posterior palatal seal.
). To open and close the mouth AThis records the shape and action of the
paramusculature used in e'treme opening and closing movements.
For )-ndi0u&-r i)/r(''ion t*( /-ti(nt i' in'truct(d
(. To suc" on the tube AThis fle'es the labial! buccal and lingual vestibular
structures and mold the flanges in these regionsB.
-. To force the tip of the tongue against the palate AThis forcibly molds the
flange in the sublingual space with the paralingual musculature.
/. To say C****D and CEEEED alternatively AThis further molds the buccal
and labial flangesB
4. To lic" the upper and lower lip AThis molds the flanges in the lingual
space in the region of 5harton<s ducts and genioglossus muscle.
8. To place the tongue in the right chee" and left chee" AThis further molds
the flange in the sublingual fold spaceB.
). To swallow warm water AThis molds the posterolingual flange in
relation to the palatoglossus and mylohyoid musculatureB.
+. To tense and fle' the lower 7aw as if clenching one<s teeth AThis molds
the buccal flange from the e'ternal oblique ridge to the retromolar pad.
()
1"6 $ 1"8%
6ew techniques had been developed to manage compromised
conditions.
For poor mandibular ridges 3 &ublingual flange technique by Tyrde and
0obert Flange technique by Lott and Levin.
For hyperplastic alveolar ridges by >afarulla @han! 5illiam H. Filler.
I)/r(''ion t(c*ni+u(' 4or '(7(r(&1 r('or0(d 4ound-tion
Flange technique by Lott and Levin introduced in (:)) involves ma"ing
impressions of soft tissues of mouth ad7acent to the buccal! lingual! labial!
palatal surface and incorporating the resulting e'tensions or flange in the
denture. Flange wa' was rolled from the retromolar pad area to the sublingual
region! large enough to restore the diameter of estimated resorption and patient
is as"ed to forcefully perform functions of swallowing etc to give border
e'tensions which covers ma'imum surface area Agenial tubercles and
sublingual glandB.
Tyrde in (:)8 used the dynamic impression method on the same
principle to obtain sublingual flange.
0oberto ?on @ramec" et al in (:.- used modeling compound to record
the e'tensions. This sublingual flange e'tension increases the tissue surface
without interfering the functions of mastication! deglutition and phonation. The
active incorporation of tongue activity also stabili#es the denture.
I)/r(''ion t(c*ni+u( 4or /-ti(nt' 3it* un'u//ort(d )o7-0&( ti''u(
:H1/(r/&-'tic or 4&-001 ti''u(;8
(+
5illiam H. Filler described a technique using two trays.
a. reliminary ma'illary and mandibular impressions were made in
stoc" trays with alginate impression method and casts were poured.
b. The ma'illary and mandibular casts were placed on the surveyor
and all the tissue undercuts were bloc"ed out with utility wa'.
c. % single thic"ness of baseplate wa' 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. % tinfoil sustitute was applied to the casts and the first of the two
trays was made in autopolymeri#ing acrylic resin. ,ost of the basal surface
of the tray was removed e'cept for the lattice wor" of acrylic resin which
strengthens the trays.
e. The ma'illary and mandibular trays are then "eyed to orientate
the second tray in atleast three places. These "eyed positions correspond
with an e'tension 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 thic"ness of
baseplate wa'! ensuring that the "eyed positions here "ept free of wa'. 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
e'tend past the relieved area of ma'illary and mandibular trays and fit into
"eyed positions.
(.
h. 5ith round bur! numerous holes were made in the second tray.
i. The deepest portion of the vault of ma'illary tray was removed to
create a stop when the final impression was made. The initial tray was
sealed with minimum pressure and autopolymeri#ing resin on a tongue
depressor was gently placed in the opening in the vault. 5hen the resin had
set a stop was created on the firm and stable palatal tissue.
C&inic-& i)/r(''ion /roc(dur(
The borders of the ma'illary tray are formed by adding
low fusing compound and border molding it. % finger placed over the resin
stop will ensure a stable tray. The basal plate was removed and the flanges
reduced (2-mm with the e'ception of the part over the tuberosites and
posterior palatal seal area of the ma'illary tray.
The mandibular tray was stabili#ed 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 wa' was removed from
the mandibular tray every where e'cept at the three points used for
stabili#ation.
Both the trays were painted with permlastic adhesive.
Light body permlastic was used in initial tray as a corrective wash
impression material. %fter it set the tray was removed from the mouth and
all e'cess material was trimmed from the borders and from the area where
the second tray would come into contact with the first tray to "ey
themselves.
(:
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 "eyed 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 stic"y wa'.
>afarulla @han 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.
Ot*(r t(c*ni+u(' u'(d in c-'( o4 4&-001 ti''u('
a. Hobric" 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. Foh 9. 5atter recorded the healthy denture bearing tissue with >noE and
the displaced tissue with impression plaster.
c. &plit method by %llan ,ac" is useful if tissues are e'ceptionally flabby. %
loosely fitting tray made with heavy relief over the flabby areas was ta"en.
laster was mi'ed and applied over the flabby area to a thic"ness of about
/mm and was allowed to set tray was filled with -
nd
mi' of plaster and the
-*
impression was made with the initial coating of flabby areas thus acting as a
splint while the impression was made and being removed.
Ot*(r t(c*ni+u(' u'(d 4or /oor 4ound-tion
a. ,odified Fournet Tuller technique by %llan ,ac" also utili#es the
principle of achieving ma'imum peripheral seal together with minimal
pressure on the crest of the ridge to obtain retention and stability.
b. 5in"ler described a technique which used tissue conditions and over
e'tended primary impression of alginate was made. =cclusal wa' rims were
constructed and the borders were ad7usted 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 /
applications of conditioning material were used 3 each application for
appro'imately .2(* 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 thic" buccal lingual and sublingual crescent
area.
,iller used mouth temperature wa'es instead of tissue conditioners.
@lein proposed the development of impression without a tray! as a stoc" tray
may cause some distortion of the tissue and may result in a over e'tended
impression. He used a moldable material Aputty siliconeB reinforced by an
internal metallic core which was placed over the residual ridge and the borders
molded by speech e'ercises. % low viscosity material was placed on the
impression surface of this tray and functional impression was made.
-(
I)/r(''ion t(c*ni+u( 4or r('trict(d -cc('' to t*( )out*
5alter described a technique with the use of sectional stoc" trays.
Impressions of each side of the 7aw was made on at a time and two holes were
7oined and cast was poured.
The recording of denture borders may be done by either hand
manipulation and functional movement.
H-nd )-ni/u&-tion
The contour of the denture borders may be obtained by the dentist with
the use of manipulation of lips and chee"s within functional limits. atients
tongue movements record the lingual borders.
Function-& )o7()(nt'
The denture borders are also formed by having the patient ma"e
functional or physiological movement such as swallowing suc"ing! grinning!
lic"ing etc.
Tench<s neuromuscular concept values the functions of suc"ing and
swallowing while ma"ing 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.
--
The only truly functional or physiological method of ma"ing
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 e'tended period of time such as tissue conditioning materials or
wa'. 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.
Di'cu''ion
In the mucostatic principle
1linical procedure in selective pressure techniqueG
(. reliminary e'amination and conditioning of the patient.
2. Seating the patient:
i. atient should be in a upright position and rela'ed.
ii. The 7aw should be at the level of the operator<s elbow for ma'illary
and at the level of operator<s shoulder for mandibular impression.
/. 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 stoc" trays which should be "ept ready
sterili#ed while inserting the tray in the patient<s mouth using a rotatory
movement. There should be an equal clearance of )2. mms. Between the
tray and the tissues all round.
5. Operators position:
-/
i. 0ight bac" side of the patient for upper impression.
ii. 0ight side front of the patient for lower impression.
The selected tray should cover the entire denture bearing area. 1hec" the
tuberosity area in the ma'illary and lingual pouch in the mandibular
foundation.
6. Compound is sotened in chot!ater.
i. % large bowl should be used.
The compound is "neaded thoroughly to soften it uniformly. In case
ma'illary 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 ma'illary 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 bac"ward direction. The compound is manipulated by
inde' finger into the deep buccal sulcus area. In case of mandibular impression
the tray is centered e'actly over the ridge and seated straight down. 5ith the
inde' finger the compound should be manipulated into the deep lingual pouch.
&imulation of the tissue should then be done.
The compound is allowed to harden and withdrawn from the mouth.
-4
The impression is chilled in cold water and e'amined thoroughly. It is
e'amined for completeness border tissue functions! distortion and gross
physical defects.
M-t(ri-&' u'(d8
a. Low fusing impression compound sticks 3 %dvocated by Boucher.
b. Autopolymeriing acrylic resins
%dvocated by Fones 3 not used due to the heat of polymeri#ation and
monomer irritant.
c. Tissue conditioning materials !modified resins"
1hare 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. #etallic pastes and elastomeric materials.
Ideally body elastomeric impression material is used. &mith 9ale E has
advocated one technique where the border molding is done in one step with
polyether impression material.
e. Impression wa$es
Hse of impression wa' adapted for border molding was reported by
@napl. But these wa'es distort easily.
f. %erio pack & @er" and Idolt has described one step border molding with the
use of periopac".
-8
The diagnostic cast is made of dental plaster. The form of the custom
tray helps us to ma"e impression based on specified theory. The areas to be
retrieved on the casts and undercut areas are mar"ed and bloc"ed with wa'.
1are must be ta"en while providing relief! as e'cessive relief causes flabby
tissue formation. The custom tray must be -mm less than the denture outline
e'cept in the posterior palatal seal and retromolar pad area. The peripheries of
the tray should not be sharp $ rough.
The custom trays are chec"ed in the mouth. The tray should cover the
entire denture bearing area. If the tray is undere'tended! compound should be
added wherever necessary. If the tray is overe'tended the tray should be
trimmed where required. The tray is also chec"ed for retention and stability.
Border molding is done quadrant by quadrant ABy hand manipulationB
within the functional limits of tolerance.
<ord(r )o&din28
The shaping of the border areas of an impression tray by functional or
manual manipulation of the tissue ad7acent to the borders to duplicate the
contour and si#e of the vestibule.
Glossary of prosthodontic lesions +
th
edition.
The anterior limit of posterior palatine seal area is mar"ed using T 3
burnisher. The line of minimal function is mar"ed by as"ing the patient to
tell %h.
The low fusing impression compound is softened and placed in this area the
tray is seated in the mouth to obtain posterior palatine seal.
-)
The tray is then chec"ed 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 chec"ed.
"he dierent material used or inal impression are
a. Impression plaster A0arely usedB.
b. >inc o'ide eugenol paste 3 -mm.
c. Irreversible and reversible hydrocolloids 3 )mm
d. Elastomeric impression materials 3 4mm! -mm.
e. ,outh temperature wa'es 3
f. &oft acrylic resins Afunctional impressionB 3 (2-mm
The relief wa' spacer is removed. If #inc o'ide eugenol paste is used! it
should be mi'ed fairly stiff and a ribbon of even thic"ness of paste should be
applied to the tray. The tray is quic"ly inserted and sealed in the correct
position and border molding is carried out by gently simulating tissue function
in those areas.
Conc&u'ion
%lthough 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 ma"ing and its application by the
operator.
-+
R(4(r(nc('
(. Boucher G rosthodontic treatment for edentulous
patients.
-. Boucher 1.=. G % critical analysis of mid century
impression technique for full dentures. F. rosthet. 9ent.! ( G 4+-24:(.
/. Ellinger 1harles 5. C&ynopsis of complete denture.
4. Edgar 6. &tar"e G Historical review of complete
denture impression materials. F%9%! :( G (*/+2(*4(.
8. Filler 5. H. G ,odified impression technique for
hyperplastic alveolar ridges. F. rosthet. 9ent.! -8 G )*:2)(-! (:+(.
). Glossary of rosthodontics. F. rosthet. 9ent.!
Edition +
th
! .( G 4.2((*! (:::.
+. Heartwell 1harles ,. G &yllabus of complete
dentures.
.. Luin Bernard G Impressions for complete dentures.
:. Lott F. and Luin B. G Flange technique G %n
anatomic and physiologic approach to increase retention! function! comfort
and appearance of denturesD. F. rosthet. 9ent.! (/ G /:424(/! (:)).
-.
(*. ,ilo ?. @ubale" and Bert 1. Bufington G
Impressions by the use of substathmospheric pressure. F. rosthet. 9ent.! ()
G -(/2--/! (:)).
((. age H.H. G ,ucostatics! % principle not a
technique by Harry L. age! 1hicago! (:4).
(-. ortar 1.G. G ,ucostatics 3 % panaua or propagan.
F. rosthet. 9ent.! / G 4)424)).
(/. &harry F.F. G1omplete denture prosthodontics.
(4. Tyrde G.@. G 9ynamic impression method. F.
rosthet. 9ent.! (8 G (*-/2(*/4! (:)8.
(8. Hdani T.,. G 1ritical analysis of complete denture
impression procedures Aunpublished articleB.
(). ?ictor =. Lucia G ,ucostatics! te't boo" of
treatment of edentulous patients. (+2-(.
-: