Impressions in Complete Dentures

An imprint / negative likeness of the teeth &/or edentulous areas where the teeth have been removed, made in a plastic material which becomes relatively hard or set while in contact with the tissues. A complete denture impression is a negative registration of the entire denture bearing, stabilizing & border seal areas present in the edentulous mouth.s

Classification
Depending on theories of impression making Mucostatic / passive impression (Richardson & Henry L. Page) Mucocompression / functional impression (Carole Jones & Greene brothers) Selective Pressure impression (Boucher)

Classification
Depending on the technique Open mouth / Closed mouth technique

Hand manipulation for functional movements (Dynamic impression) Depending on type of tray Stock tray / Custom tray impression

Classification
Depending on purpose of the impression Diagnostic / Primary / Secondary

Depending on the material used Agar, Alginate, Impression Compound, Plaster, Wax, Silicone, Thiokol rubber impression.

Principles of impression making

Oral tissues must be healthy Impression should include basal seat within limits Borders must be in harmony with anatomical & physiological limitations of oral structures Selective pressure tech. shd be used Sufficient space should be provided within impression tray for imp. material Guiding mechanism (tissue stops & handle) shd be provided for correct positioning of tray Imp. Shd be removed from mouth without damaging the mucosa Materials used shd be dimensionally stable External shape of impression shd be similar to ext. form of complete denture

Objectives of impression making

P preservation of remaining natural structures R retention E esthetics S stability S support

Preservation of remaining natural structures

Impression shd record details in appropriate form to prevent injury to the tissues Relief to non-stress bearing areas, thus preventing damage Avoid overextensions

Retention
That quality inherent in the prosthesis which resists the force of gravity, adhesiveness of foods, and the forces associated with the opening of the jaws It is the ability of denture to withstand displacement against the path of insertion Factors affecting retention Anatomical ----size & quality of denture bearing area Physiological viscosity of saliva (thick/thin) Physical -------- adhesion, cohesion, surface tension, capillarity & atmospheric pressure Mechanical ---- undercuts, retentive springs, magnets, adhesives, suction chambers/discs Muscular ------ Neutral zone

Stability
The quality of a denture to be firm, steady, or constant, to resist displacement by functional stresses & not to be subject to change of position when forces are applied It is the ability of the denture to withstand horizontal forces. Factors affecting stability Vertical height of ridge -- resorbed ridge poor stability Quality of soft tissue ---- firm / flabby tissues Quality of impression---- accurate, smooth, stable Occlusal plane ------------ should be parallel to ridge Arrangement of teeth --- balanced occlusion Contour of the polished surfaces

Support

The resistance to vertical forces of mastication, occlusal forces & other forces applied in a direction towards the denture bearing area. Achieved by covering as much area as possible This helps to distribute forces - snowshoe

Esthetics

Thickness of flanges Impression should reproduce width & height of sulcus

Recording the Preliminary Impression

TRAY A receptacle into which a suitable material is placed to make an impression A device which is used to carry, confine & control an impression material while making an impression Stock tray metal / plastic, 2-3mm clearance, shd cover tuberosity & hamular notch Special tray A custom made device prepared for a particular patient which is used to carry, confine & control an impression material while making an impression Material used shd be well adapted, stable, 2mm thick, contrast in colour & 2mm short in sulcus Fabrication of tray shellac, self cure resin, thermoplastic resins, vacuum formed Vinyl or Polystyrene Storing the trays

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