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The selective-pressure impression technique combines aspects of both techniques, as pressure is applied
to certain tissues while other areas are captured with
minimal pressure. This impression philosophy is
credited to Boucher5 and is based on a histologic understanding of the supporting tissues. Areas that are anatomically favorable to withstanding pressure, such as
the buccal surface of the maxillary alveolar process, lateral palate, or buccal shelf in the mandible, are loaded.
These areas are supported by dense cortical bone. The
rugae, midline raphe, mandibular alveolar ridge, and
areas of movable tissue are relieved because they do
not provide the same favorable anatomic quality for
withstanding functional load.
Each of the above philosophies considers how much
pressure will result in the most retentive, stable, and well
functioning denture; however, as long as the denture
base is processed with heat-polymerized PMMA, distortion can occur, resulting in a discrepancy between the
denture and palate. Denture bases fabricated from
heat-polymerized PMMA exhibit dimensional change
owing to volumetric shrinkage of as much as 6%.7 The
shrinkage of the resin results in a space between the palate and definitive cast as well as heavy pressure on the
lateral flange area (Fig. 1). This results in a denture
THE JOURNAL OF PROSTHETIC DENTISTRY 299
Fig. 2. A, Typical maxillary denture processed with heat-polymerized PMMA with poor palatal contact as demonstrated with
disclosing paste. B, Maximum palatal adaptation of denture base using modified selective-pressure technique as demonstrated
with disclosing paste.
2.
3.
base that does not contact the palate completely and thus
has less than ideal support, stability, and retention
(Fig. 2, A).
Various techniques have been described to minimize
or compensate for polymerization shrinkage of PMMA
through modification of the processing technique.
Some advocate modifying the definitive cast with holes
to anchor the acrylic resin during polymerization.8,9
Others have described a technique using high-expansion
dental stone to compensate for PMMA shrinkage.10 The
objective of this article is to describe a selective-pressure
impression technique that is intended to improve adaptation of the maxillary denture base by compensating for
polymerization shrinkage of the acrylic resin.
TECHNIQUE
1. Make a preliminary impression with irreversible
hydrocolloid and pour it in dental stone. Mark the
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4.
5.
6.
DISCUSSION
This technique provides many of the same advantages
as the posterior palatal seal; however, it affords a much
larger contact area with the supporting tissues than does
the posterior palatal seal. By displacing the tissues of
the palate and effectively creating a deeper vault on the
definitive cast, the technique compensates for the
shrinkage of the PMMA. The result is a denture that
has improved contact with the palatal tissues. There
are no significant disadvantages to this technique. If
the denture base is evaluated with PIP and is found
to have excessive pressure, these areas can be easily
adjusted.
As an alternative to this impression technique, the
definitive cast could be adjusted by arbitrarily scraping
stone in the palatal vault. This would create an artificially deepened vault to compensate for polymerization
shrinkage comparable to carving a posterior palatal seal.
However, the impression technique described above is
a more controlled method for creating a similar result.
SEPTEMBER 2004
SUMMARY
The selective-pressure impression technique described provides the clinician with a method for improving the palatal adaptation of maxillary complete
dentures fabricated with heat-polymerized PMMA.
REFERENCES
1. Latta GH, Bowles WF 3rd, Conkin JE. Three-dimensional stability of new
denture base resin systems. J Prosthet Dent 1990;63:654-61.
2. Lechner SK, Lautenschlager EP. Processing changes in maxillary complete
dentures. J Prosthet Dent 1984;52:20-4.
3. Graf H. Bruxism. Dent Clin North Am 1969;13:659-65.
4. el-Khodary NM, Shaaban NA, Abdel-Hakim AM. Effect of complete denture impression technique on the oral mucosa. J Prosthet Dent 1985;53:
543-9.
5. Boucher C. Complete denture impressions based on the anatomy of the
mouth. J Am Dent Assoc 1944;31:17-24.
6. Addison I. Mucostatic impression. J Am Dent Assoc 1944;31:941-50.
7. Craig R. Restorative dental materials. 11th ed. St. Louis: Mosby; 2002.
p. 647.
8. Laughlin GA, Eick JD, Glaros AG, Young L, Moore DJ. A comparison of
palatal adaptation in acrylic resin denture bases using conventional and
anchored polymerization techniques. J Prosthodont 2001;10:204-11.
9. Polyzois GL. Improving the adaptation of denture bases by anchorage to
the casts: a comparative study. Quintessence Int 1990;21:185-90.
10. Sykora O, Sutow EJ. Posterior palatal seal adaptation: influence of high expansion stone. J Oral Rehabil 1996;23:342-5.
11. Zarb GA, Bolender CL, Carlsson G, Boucher CO. Bouchers prosthodontic
treatment for edentulous patients. 11th ed. St. Louis: Elsevier; 1997. p.
332-46.
Reprint requests to:
DR JACQUELINE P. DUNCAN
DEPARTMENT OF PROSTHODONTICS
UNIVERSITY OF CONNECTICUT HEALTH CENTER
FARMINGTON, CT 06030-1615
FAX: 860-679-1370
E-MAIL: jduncan@nso2.uchc.edu
0022-3913/$30.00
Copyright 2004 by The Editorial Council of The Journal of Prosthetic
Dentistry
doi:10.1016/j.prosdent.2004.06.001
301